OK I know this sounds stupid but I have a friend that gets really freaked out before big tests like finals, HESI, NCLEX, and usually we get together and a few days before I start throwing out random facts at her. On 2 different tests she said the only way she got several questions was from the random facts that I threw at her that she never would have thought of!
SOOOOO..... I thought that if yall wanted to do this we could get a thread going and try to throw out 5 random facts or "things to remember". NCLEX is coming and the more I try to review content the more I realize that I have forgotten so......here are my 5 random facts for ya:
OH and BTW these came from rationales in Kaplan or Saunders no made up stuff:
1️⃣ A kid with Hepatitis A can return to school 1 week within the onset of jaundice.
2️⃣ After a patient has dialysis they may have a slight fever...this is normal due to the fact that the dialysis solution is warmed by the machine.
3️⃣ Hyperkalemia presents on an EKG as tall peaked T-waves
4️⃣ The antidote for Mag Sulfate toxicity is ---Calcium Gluconate
5️⃣ Impetigo is a CONTAGEOUS skin disorder and the person needs to wash ALL linens and dishes seperate from the family. They also need to wash their hands frequently and avoid contact.
Oh, ohh, one more...
? Vasopressin is also known as antidiuretic hormone
:typing i found lots of nclex information from skatebetty, so all of this is her work and all credit goes to her. i just happened to be skimming the nclex forum pages going back to 2006 and found these tips from her. so i am posting them here for us to study from. all of the credit goes to her, it is all her work. thanks skatebetty!!!
agnosia - i don't know what it is (when an object is placed in hand)
apraxia - my practiced skills are lost (can't carry out a purposeful activity)
procainamide - for dysrhythmias unresponsive to lidocaine
ridaura - gold, for arthritis (think shiny, aura)
tessalon - anti-tussive (sounds like tuss)
cognex - for alzheimer's (sounds like cognition)
calcium carbonate has the most calcium of oral types
neupogen - sounds like "generates neutrophils"
epogen - sounds like "erythropoetein generator"
flomax - improves urinary flow with bph (urine flows)
dimetane - an antihistimine (dimetapp)
which anti-coagulant is safe in pregnancy? heparin is! it does not cross the placenta, so when it is ordered, give it, and when you do it is sub-q.
what is a t-tube? i'd never heard of one. it drains bile from the bile duct after gallbladder sx, and there could be a lot of drainage, up to 400 cc's/day. it should be bloody initially, and then green. count it as output.
why does skin temperature drop when someone is experiencing acute pain? because they are sweating (diaphoretic).
what's a ureteral catheter? it may be placed to drain urine from the ureter along with a foley. the foley gets d/c'd first, the ureteral one can be clamped so your patient can pee normally, and then you unclamp it to see how much residual there is! once there is no residual it is also d/c'd. who knew?
what if you find your turp patient in a wet bed? the catheter is either too small, or the patient is having bladder spasms, causing leakage.
what's given for alcohol withdrawl? librium. narcotic withdrawl? methadone. narcotic withdrawl with respiratory depression? there you go...narcan.
who get's c-diff? hospitalized patients, that's who. almost half of your patients who get diarrhea in the hospital have c-diff, and got it from somebody who works there.
you've run out of tube feeding. which solution is most like tpn while you're waiting for the pharmacy? d10w.
what is the solution of choice for volume replacement in the er? lactated ringers.
how does acute renal failure differ in s/s from chronic? with acute there is an oliguric phase when the kidney is really sick, followed by a diuretic phase when the kidney is starting to get better and urine starts to flow again. with chronic, the kidney slowly deteriorates, and output decreases.
with portal hypertension or cirrhosis think “bleeder” because of esophageal varices, and also reduced or no clotting factors being produced by the sick liver. while we’re talking about the liver, remember it is highly vascular, which means when it is injured by trauma, or even a needle biopsy it will bleed right out. position a patient on the right side after a liver biopsy to help splint the injury.
for everybody wanting to ‘maslow’ nutrition ahead of safety with a depressed client, just toss your pyramid right out the window, and choose safety first. suicide precautions.
while we’re talking about priorities don’t think you must always choose an assessment over an intervention if both are options. use your instincts and your logic! if the options are listed to “suction copious secretions" or "monitor o2sat" you better get the secretions out, especially if the stem says you’ve assessed the patient already and what is the next nursing action.
don’t push all those dangerous objects out of the way first when your kid is on the floor seizing. turn him on his side. airway first, then remove hazardous objects.
prolonged hypoxia in kids, like with tetralogy of fallot, does bad stuff. for starters the body tries to compensate for low o2 by pushing out more immature rbc’s, which hypercoagulates the blood increasing the kids risk of seizures and cva’s. the kid is also at risk for cardiac arrest and respiratory failure. remember, nothing’s getting oxygen.
don’t you ‘schedule frequent rest periods’ for that kid newly diagnosed with cf. he needs exercise, which is a good adjunct to the chest physiotherapy in keeping his lungs clear. now if your cf kid is exercising with a sickle cell kid, make sure that one doesn’t get over-heated. dehydration triggers sc crisis. keep his fluids up. no demerol with sickle cell either.
steroids complicate things while they're reducing inflammation. they increase the risk for osteoporosis, increase glucose, and delay wound healing. they also cause weight gain (have ya’ll seen tonya harding lately? she says it’s the prednisone) and increase the risk of infection. watch sore throats and fevers for pts. on steroids.
ever touched a colostomy bag? me either. just know to remove flatus by opening the bottom of the bag, and to empty it when it is approximately 1/3 to ½ full.
these are 3 days of her tips...she has tips for another 4-5 days, so i will copy and paste them in the next few posts. happy studying! i test this month! yikes!!!!
i found lots of nclex information from skatebetty, so all of this is her work and all credit goes to her. i just happened to be skimming the nclex forum pages going back to 2006 and found these tips from her. so i am posting them here for us to study from. all of the credit goes to her, it is all her work. thanks skatebetty!!!
pediatric tips:
what is an intraosseous infusion? in pediatric life-threatening emergencies, when iv access cannot be obtained, an osseous (bone) needle is hand-drilled into a bone (usually the tibia), where crystalloids, colloids, blood products and drugs can be administered into the marrow. it is a temporary, life-saving measure, and i have seen it once! (gruesome.) when venous access is achieved it can be d/c’d. one medication that cannot be administered by intraosseous infusion is isoproterenol, a beta agonist. (i don’t know more about that drug; it was just pointed out on a practice exam.)
during sickle cell crisis there are two interventions to prioritize: fluids and pain relief.
with glomerulonephritis you should consider blood pressure to be your most important assessment parameter. dietary restrictions you can expect include fluids, protein, sodium, and potassium.
remember yesterday when i mentioned how congenital cardiac defects result in hypoxia which the body attempts to compensate for (influx of immature rbc’s)? labs supporting this would show increased hematocrit, hemoglobin, and rbc count.
did you know there is an association between low-set ears and renal anomalies? now you know what to look for if down’s isn’t there to choose. (just to expand on it a little, the kidneys and ears develop around the same time in utero. hence, they're shaped similarly. which is why when doing an assessment of a neonate, if the nurse notices low set or asymmetrical ears, there is good reason to investigate renal functioning. knowing that the kidneys and ears are similar shapes helped me remember this).
school-age kids (5 and up) are old enough, and should have an explanation of what will happen a week before surgery such as tonsillectomy.
if you gave a toddler a choice about taking medicine and he says no, you should leave the room and come back in five minutes, because to a toddler it is another episode. next time, don’t ask.
the first sign of pyloric stenosis in a baby is mild vomiting that progresses to projectile vomiting. later you may be able to palpate a mass, the baby will seem hungry often, and may spit up after feedings.
we know kawasaki disease causes a heart problem, but what specifically? coronary artery aneurysms d/t the inflammation of blood vessels.
a child with a ventriculoperitoneal shunt will have a small upper-abdominal incision. this is where the shunt is guided into the abdominal cavity, and tunneled under the skin up to the ventricles. you should watch for abdominal distention, since fluid from the ventricles will be re-directed to the peritoneum. you should also watch for signs of increasing intracranial pressure, such as irritability, bulging fontanels, and high-pitched cry in an infant. in a toddler watch lack of appetite and headache. careful on a bed position question! bed-position after shunt placement is flat, so fluid doesn’t reduce too rapidly. if you see s/s of increasing icp, then raise the hob to 15-30 degrees.
what could cause bronchopulmonary dysplasia? dysplasia means abnormality or alteration. mechanical ventilation can cause it. premature newborns with immature lungs are ventilated and over time it damages the lungs. other causes could be infection, pneumonia, or other conditions that cause inflammation or scarring.
it is essential to maintain nasal patency with children
watch out for questions suggesting a child drinks more than 3-4 cups of milk each day. (milks good, right?) too much milk reduces intake of other essential nutrients, especially iron. watch for anemia with milk-aholics. and don’t let that mother put anything but water in that kid’s bottle during naps/over-night. juice or milk will rott that kids teeth right out of his head.
what traction is used in a school-age kid with a femur or tibial fracture with extensive skin damage? ninety, ninety. huh? i never heard of it either. the name refers to the angles of the joints. a pin is placed in the distal part of the broken bone, and the lower extremity is in a boot cast. the rest is the normal pulleys and ropes you’re used to visualizing with balanced suspension. while we’re talking about traction, a kid’s hinder should clear the bed when in bryant’s traction (also used for femurs and congenial hip for young kids).
if you can remove the white patches from the mouth of a baby it is just formula. if you can’t, its candidiasis.
just know the mmr and varicella immunizations come later (15 months).
undescended testis or cryptorchidism is a known risk factor for testicular cancer later in life. start teaching boys testicular self exam around 12, because most cases occur during adolescence.
not pediatrics but have to throw it in – a guy loses his house in a fire. priority is using community resources to find shelter, before assisting with feelings about the tremendous loss. (maslow).
no aspirin with kids b/c it is associated with reye’s syndrome, and also no nsaids such as ibuprofen. give tylenol.
csf in meningitis will have high protein, and low glucose.
it is always the correct answer to report suspected cases of child abuse.
no nasotracheal suctioning with head injury or skull fracture.
feed upright to avoid otitis media.
position prone w hob elevated with gerd. in almost every other case, though, you better lay that kid on his back (back to sleep - sids).
pull pinna down and back for kids
kids with rsv; no contact lenses or pregnant nurses in rooms where ribavirin is being administered by hoot, tent, etc.
positioning with pneumonia – lay on the affected side to splint and reduce pain. but if you are trying to reduce congestion the sick lung goes up. (ever had a stuffy nose, and you lay with the stuff side up and it clears?)
a positive ppd confirms infection, not just exposure. a sputum test will confirm active disease.
coughing w/o other s/s is suggestive of asthma. speaking of asthma, watch out if your wheezer stops wheezing. it could mean he is worsening.
you better pick ‘do vitals’ before administering that dig. (apical pulse for one full minute).
tet spells treated with morphine.
group-a strep precedes rheumatic fever. chorea is part of this sickness (grimacing, sudden body movements, etc.) and it embarrasses kids. they have joint pain. watch for elevated antistreptolysin o to be elevated. penicillin!
don’t pick cough over tachycardia for signs of chf in an infant.
random tips:
no milk (as well as fresh fruit or veggies) on neutropenic precautions.
tylenol poisoning – liver failure possible for about 4 days. close observation required during this time-frame, as well as tx with mucomyst.
radioactive iodine – the key word here is flush. flush substance out of body w/3-4 liters/day for 2 days, and flush the toilet twice after using for 2 days. limit contact w/patient to 30 minutes/day. no pregnant visitors/nurses, and no kids.
the main hypersensitivity reaction seen with antiplatelet drugs is bronchospasm (anaphylaxis).
common sites for metastasis include the liver, brain, lung, bone, and lymph.
orthostasis is verified by a drop in pressure with increasing heart rate.
bence jones protein in the urine confirms multiple myeloma.
don’t fall for ‘reestablishing a normal bowel pattern’ as a priority with small bowel obstruction. because the patient can’t take in oral fluids ‘maintaining fluid balance’ comes first.
pernicious anemia s/s include pallor, tachycardia, and sore red tongue.
with flecainide (tambocor), an antiarrythmic, limit fluids and sodium intake, because sodium increases water retention which could lead to heart failure.
basophils release histamine during an allergic response.
adenosine is the treatment of choice for paroxysmal atrial tachycardia.
iatragenic means it was caused by treatment, procedure, or medication.
other than initially to test tolerance, g-tube and j-tube feedings are usually given as continuous feedings.
four side-rails up can be considered a form of restraint. even in ltc facility when a client is a fall risk, keep lower rails down, and one side of bed against the wall, lowest position, wheels locked.
your cancer patient is getting radiation. what should you be most concerned about? skin irritation? no. infection kills cancer patients most because of the leukopenia caused by radiation.
a breast cancer patient treated with tamoxifen should report changes in visual acuity, because the adverse effect could be irreversible.
pneumovax 23 gets administered post splenectomy to prevent pneumococcal sepsis.
let’s say every answer in front of you is an abnormal value. if potassium is there you can bet it is a problem they want you to identify, because values outside of normal can be life threatening. normal potassium is 3.5-5.0. even a bun of 50 doesn’t override a potassium of 3.0 in a renal patient in priority.
you better be making sure that patient on dig and lasix is getting enough potassium, because low potassium potentiates dig and can cause dysrrhythmias.
you will ask every new admission if he has an advance directive, and if not you will explain it, and he will have the option to sign or not.
an example of when you would implement before going through a bunch of assessments is when someone is experiencing anaphylaxis. get the ordered epinephrine in them stat, especially if they stem clearly states the s/s (difficulty breathing, increasing anxiety, etc.)
in a disaster you should triage the person who is most likely to not survive last.
:typing i found lots of nclex information from skatebetty, so all of this is her work and all credit goes to her. i just happened to be skimming the nclex forum pages going back to 2006 and found these tips from her. so i am posting them here for us to study from. all of the credit goes to her, it is all her work. thanks skatebetty!!!
agnosia - i don't know what it is (when an object is placed in hand)
apraxia - my practiced skills are lost (can't carry out a purposeful activity)
procainamide - for dysrhythmias unresponsive to lidocaine
ridaura - gold, for arthritis (think shiny, aura)
tessalon - anti-tussive (sounds like tuss)
cognex - for alzheimer's (sounds like cognition)
calcium carbonate has the most calcium of oral types
neupogen - sounds like "generates neutrophils"
epogen - sounds like "erythropoetein generator"
flomax - improves urinary flow with bph (urine flows)
dimetane - an antihistimine (dimetapp)
which anti-coagulant is safe in pregnancy? heparin is! it does not cross the placenta, so when it is ordered, give it, and when you do it is sub-q.
what is a t-tube? i'd never heard of one. it drains bile from the bile duct after gallbladder sx, and there could be a lot of drainage, up to 400 cc's/day. it should be bloody initially, and then green. count it as output.
why does skin temperature drop when someone is experiencing acute pain? because they are sweating (diaphoretic).
what's a ureteral catheter? it may be placed to drain urine from the ureter along with a foley. the foley gets d/c'd first, the ureteral one can be clamped so your patient can pee normally, and then you unclamp it to see how much residual there is! once there is no residual it is also d/c'd. who knew?
what if you find your turp patient in a wet bed? the catheter is either too small, or the patient is having bladder spasms, causing leakage.
what's given for alcohol withdrawl? librium. narcotic withdrawl? methadone. narcotic withdrawl with respiratory depression? there you go...narcan.
who get's c-diff? hospitalized patients, that's who. almost half of your patients who get diarrhea in the hospital have c-diff, and got it from somebody who works there.
you've run out of tube feeding. which solution is most like tpn while you're waiting for the pharmacy? d10w.
what is the solution of choice for volume replacement in the er? lactated ringers.
how does acute renal failure differ in s/s from chronic? with acute there is an oliguric phase when the kidney is really sick, followed by a diuretic phase when the kidney is starting to get better and urine starts to flow again. with chronic, the kidney slowly deteriorates, and output decreases.
with portal hypertension or cirrhosis think "bleeder" because of esophageal varices, and also reduced or no clotting factors being produced by the sick liver. while we're talking about the liver, remember it is highly vascular, which means when it is injured by trauma, or even a needle biopsy it will bleed right out. position a patient on the right side after a liver biopsy to help splint the injury.
for everybody wanting to 'maslow' nutrition ahead of safety with a depressed client, just toss your pyramid right out the window, and choose safety first. suicide precautions.
while we're talking about priorities don't think you must always choose an assessment over an intervention if both are options. use your instincts and your logic! if the options are listed to "suction copious secretions" or "monitor o2sat" you better get the secretions out, especially if the stem says you've assessed the patient already and what is the next nursing action.
don't push all those dangerous objects out of the way first when your kid is on the floor seizing. turn him on his side. airway first, then remove hazardous objects.
prolonged hypoxia in kids, like with tetralogy of fallot, does bad stuff. for starters the body tries to compensate for low o2 by pushing out more immature rbc's, which hypercoagulates the blood increasing the kids risk of seizures and cva's. the kid is also at risk for cardiac arrest and respiratory failure. remember, nothing's getting oxygen.
don't you 'schedule frequent rest periods' for that kid newly diagnosed with cf. he needs exercise, which is a good adjunct to the chest physiotherapy in keeping his lungs clear. now if your cf kid is exercising with a sickle cell kid, make sure that one doesn't get over-heated. dehydration triggers sc crisis. keep his fluids up. no demerol with sickle cell either.
steroids complicate things while they're reducing inflammation. they increase the risk for osteoporosis, increase glucose, and delay wound healing. they also cause weight gain (have ya'll seen tonya harding lately? she says it's the prednisone) and increase the risk of infection. watch sore throats and fevers for pts. on steroids.
ever touched a colostomy bag? me either. just know to remove flatus by opening the bottom of the bag, and to empty it when it is approximately 1/3 to ½ full.
these are 3 days of her tips...she has tips for another 4-5 days, so i will copy and paste them in the next few posts. happy studying! i test this month! yikes!!!!
thanks for the info...when are you taking your exam...i'm taking my exam this month too....:up:goodluck!!!
How are you? I take mine Oct 14th!!!!! I am so seriously thinking of pushing it back to the end of the month....but am not sure yet, this will be my 4th attempt, so I am doubting myself although I know I shouldn't be!!! When do you test? All the best of luck to you as well!
I am fixing to post some more of skatebetty's tips....so look out for them!!
again everyone please keep in mind all of this work and credit goes to skatebetty!
the vital sign you should check first with high potassium is pulse (due to dysrhythmias).
give neostigmine to clients with myesthenia gravis about 45 min. before eating, so it will help with chewing and swallowing.
anectine is used for short-term neuromuscular blocking agent for procedures like intubation and ect. norcuron is for intermediate or long-term.
the parathyroid gland relies on the presence of vitamin d to work.
glucagon increases the effects of oral anticoagulants.
bleeding is part of the 'circulation' assessment of the abcd's in an emergent situation. therefore, if airway and breathing are accounted for, a compound fracture requires assessment before glasgow coma scale and a neuro check (d=disability, or neuro check)
the immediate intervention after a sucking stab wound is to dress the wound and tape it on three sides which allows air to escape. do not use an occlusive dressing, which could convert the wound from open pneumo to closed one, and a tension pneumothorax is worse situation. after that get your chest tube tray, labs, iv.
an occlusive dressing is used if a chest tube is accidentally pulled out of the patient.
when o2 deprived, as with a pe, the body compensates by causing hyperventilation (resp alkalosis). should the patient breathe into a paper bag? no. if the pao2 is well below 80 they need oxygen. look at all your abg values. as soon as you see the words pe you should think oxygen first.
a typical adverse reaction to oral hypoglycemics is rash, photosensitivity.
serum acetone and serum ketones rise in dka. as you treat the acidosis and dehydration expect the potassium to drop rapidly, so be ready, with potassium replacement.
fluids are the most important intervention with hhns as well as dka, so get fluids going first. with hhns there is no ketosis, and no acidosis. potassium is low in hhns (d/t diuresis).
atropineblocks acetylcholine (remember it reduces secretions).
decorticate positioning in response to pain = cortex involvement. decerebrate in response to pain = cerebellar, brain stem involvement
dantrium, for spasticity, may take a week or more to be effective.
decreased acetylcholine is related to senile dementia.
hyperactive deep tendon reflexes, vision changes, fatigue and spasticity are all symptoms of ms
after removal of the pituitary gland you must watch for hypocortisolism and temporary diabetes insipidus.
position on right side with legs flexed after appendectomy.
hirschsprung's diagnosed with rectal biopsy looking for absence of ganglionic cells. cardinal sign in infants is failure to pass meconium, and later the classic ribbon-like and foul smelling stools.
intussusception common in kids with cf. obstruction may cause fecal emesis, currant jelly-like stools (blood and mucus). a barium enema may be used to hydrostatically reduce the telescoping. resolution is obvious, with onset of bowel movements.
with omphalocele and gastroschisis (herniation of abdominal contents) dress with loose saline dressing covered with plastic wrap, and keep eye on temp. kid can lose heat quickly.
after a hydrocele repair provide ice bags and scrotal support.
no phenylalanine with a kid positive for pku (no meat, no dairy, no aspartame).
second voided urine most accurate when testing for ketones and glucose.
never give potassium if the patient is oliguric or anuric.
nephrotic syndrome is characterized by massive proteinuria (looks dark and frothy) caused by glomerular damage. corticosteroids are the mainstay. generalized edema common.
a positive western blot in a child
for hiv kids avoid opv and varicella vaccinations (live), but give pneumococcal and influenza. mmr is avoided only if the kid is severely immunocompromised. parents should wear gloves for care, not kiss kids on the mouth, and not share eating utensils.
hypotension and vasoconstricting meds may alter the accuracy of o2 sats.
an antacid should be given to a mechanically ventilated patient w/ an ng tube if the ph of the aspirate is
ambient air (room air) contains 21% oxygen.
the first sign of ards is increased respirations. later comes dyspnea, retractions, air hunger, cyanosis.
normal pcwp (pulm capillary wedge pressure) is 8-13. readings of 18-20 are considered high.
first sign of pe is sudden chest pain, followed by dyspnea and tachypnea.
high potassium is expected with carbon dioxide narcosis (hydrogen floods the cell forcing potassium out). carbon dioxide narcosis causes increased intracranial pressure.
pulmonary sarcoidosis leads to right sided heart failure.
an ng tube can be irrigated with cola, and should be taught to family when a client is going home with an ng tube.
happy studying! i test soon.....yikes!!! question is....am i ready to test or not to test?
:wink2: hello, this is the last set of skatebetty's tips! all credit goes to her!! thanks!
digitalis increases ventricular irritability, and could convert a rhythm to v-fib following cardioversion.
if your normally lucid patient starts seeing bugs you better check his respiratory status first. the first sign of hypoxia is restlessness, followed by agitation, and things go downhill from there all the way to delirium, hallucinations, and coma. so check the o2 stat, and get abg's if possible.
the biggest concern with cold stress and the newborn is respiratory distress.
look carefully when you have no idea. in a word like rhabdomyosarcoma you can easily ascertain it has something to do with muscle (myo) cancer (sarcoma). the same thing goes for drug names. for example, if it ends in -ide it's probably a diuretic, as in furosemide, and amyloride.
lasix can cause a patient to lose his appetite (anorexia) due to reduced potassium.
if your laboring mom's water breaks and she is any minus station you better know there is a risk of prolapsed cord.
in a five-year old breathe once for every 5 compressions doing cpr.
after g-tube placement the stomach contents are drained by gravity for 24 hours before it can be used for feedings.
cephalhematoma (caput succinidanium) resolves on its own in a few days. this is the type of edema that crosses the suture lines.
during the acute stage of hep-a gown and gloves are required. in the convalescent stage it is no longer contagious.
low magnesium and high creatinine signal renal failure.
pain is usually the highest priority with ra
if a tb patient is unable/unwilling to comply with tx they may need supervision (direct observation). tb is a public health risk.
level of consciousness is the most important assessment parameter with status epilepticus.
crackles suggest pneumonia, which is likely to be accompanied by hypoxia, which would manifest itself as mental confusion, etc.
can't cough=ineffective airway clearance
absence of menstruation leads to osteoporosis in the anorexic.
toddlers need to express autonomy (independence)
a patient with a low hemoglobin and/or hematocrit should be evaluated for signs of bleeding, such as dark stools.
a laxative is given the night before an ivp in order to better visualize the organs.
a patient with liver cirrhosis and edema may ambulate, then sit with legs elevated to try to mobilize the edema.
managing stress in a patient with adrenal insufficiency (addison's) is paramount, because if the adrenal glands are stressed further it could result in addisonian crisis. while we're on addison's, remember blood pressure is the most important assessment parameter, as it causes severe hypotension.
after pain relief, cough and deep breathe is important in pancreatitis, because of fluid pushing up in the diaphragm.
safety over nutrition with a severely depressed client.
prolonged hypoxemia is a likely cause of cardiac arrest in a child.
fluid volume overload caused by ivc fluids infusing too quickly (or whatever reason) and chf can cause an s3
coarctation of the aorta causes increased blood flow and bounding pulses in the arms
a newly diagnosed hypertension patient should have bp assessed in both arms
depression often manifests itself in somatic ways, such as psychomotor retardation, gi complaints, and pain.
respiratory problems are the chief concern with cf
speaking of tb... ppd is positive if area of induration is:
>5 mm in an immunocompromised patient
>10 mm in a normal patient
>15 mm in a patient who lives in an area where tb is very rare.
another tip:
hba1c - test to assess how well blood sugars have been controlled over the past 90-120 days. 4-6 corresponds to a blood sugar of 70-110; 7 is ideal for a diabetic and corresponds to a blood sugar of 130.
bsa is considered the most accurate method for medication dosing with kids. (i though it was weight, but apparently not)
place a wheelchair parallel to the bed on the side of weakness
if one nurse discovers another nurse has made a mistake it is always appropriate to speak to her before going to management. if the situation persists, then take it higher.
sepsis and anaphylaxis (along with the obvious hemorrhaging) reduce circulating volume by way of increased capillary permeability, which leads to reduced preload (volume in the left ventricle at the end of diastole). this is a toughie...think about it.
amniotic fluid is alkaline, and turns nitrazine paper blue. urine and normal lady partsl discharge are acidic, and turn it pink.
gonorrhea is a reportable disease
remember the phrase "step up" when picturing a person going up stairs with crutches. the good leg goes up first, followed by the crutches and the bad leg. the opposite happens going down. the crutches go first, followed by the good leg.
while treating dka, bringing the glucose down too far and too fast can result in increased intracranial pressure d/t water being pulled into the csf.
polyuria is common with the hypercalcemia caused by hyperparathyroidism.
remember the action of vasopressin because it sounds like "press in", or vasoconstrict.
water intoxication will be evidenced by drowsiness and altered mental status in a patient with tur syndrome, or as an adverse reaction to desmopressin (for diabetes insipidus).
burning sensation in the mouth, and brassy taste are adverse reactions to lugol solution (for hyperthyroid). report it to the doc.
give synthroid on an empty stomach
extra insulin may be needed for a patient taking prednisone (remember, steroids cause increased glucose).
nonfat milk reduces reflux by increasing lower esophageal sphincter pressure
patients with gerd should lay on their left side with the hob elevated 30 degrees.
unusual positional tip - low-fowlers recommended during meals to prevent dumping syndrome. limit fluids while eating.
in emphysema the stimulus to breathe is low po2, not increased pco2 like the rest of us, so don't slam them with oxygen. encourage pursed-lip breathing which promotes co2 elimination, encourage up to 3000ml/day fluids, high-fowlers and leaning forward.
theophylline causes gi upset, give with food
tb drugs are liver toxic. (does your patient have hepb?) an adverse reaction is peripheral neuropathy.
thats the end of her tips everyone! happy studying! i wish everyone taking it soon the very best of luck!
MsDiva812
48 Posts
Thanks for this:bow: