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
i thank you so much for your posting such wonderful things it really was helpful.
i took nclex week ago; i did not know what happened until i found my license in the mail last night. finally i passed.
it was 170+ qs i worked out all multiple choices but one sata no calculations many from priority, infection control, not much pharma. but some drugs on the add.
just be good on your understanding they after all you are tested on your skills.
Thanks so much Ment2be!! I always had trouble with this normal development activities but you give a very good tip: easier for me to remember, Thanks again
* Anemia that results when iron supply is inadequate for optimal RBC formation because of excessive iron loss from bleeding, decreased dietary intake, or malabsorption
Nursing assessment
* Fatigue and weakness
* Shortness of breath
* Pallor (ear lobes, palms, and conjunctiva)
* Brittle spoonlike nails
* Cheilosis (cracks in the corners of the mouth)
* Smooth, sore tongue
* Dizziness
* Pica (craving to eat unusual substances such as clay or starch)
* Blood sample shows microcytic and hypochromic anemia (small RBC diameter with decreased pigmentation) and an increase in red cell size distribution width (RDW)
* Decreased MCV, MCH, and MCHC; analyzed only when hemoglobin is low
* Low serum iron level and elevated serum iron-binding capacity or low serum ferritin levels
Therapeutic management
* Examine stools for occult blood; endoscopic examination and other diagnostic procedures may be performed to detect possible sources of bleeding
* Increase intake of iron-rich foods, such as organ meats, meat, beans, green leafy vegetables, molasses, and raisins
* Administer iron supplements
* Administer parenteral iron dextran (InFed) by deep IM route via Z-track method
* Determine stool color, consistency, frequency, and amount; may appear greenish black and tarry; caution client that iron supplements usually cause constipation and client should take preventive measures (fluids, fiber)
Client teaching
* Take iron on an empty stomach; absorption of iron is decreased with food; ab*sorption may be enhanced when taken with an acidic beverage (such as one with vitamin C), but avoid grapefruit Mice
* Foods high in iron include organ meats (beef or calf liver, chicken liver), other meats, beans (black, pinto, and garbanzo), leafy green vegetables, raisins, and molasses
MEGALOBLASTIC ANEMIA
* Vitamin B12, deficiency anemia
* A type of anemia characterized by macrocytic RBCs
Nursing assessment
* Pallor or slight jaundice with a complaint of weakness
* Smooth, sore, beefy red tongue (glossitis), and cheilosis (cracking of lips)
* Diarrhea
* Paresthesias (numbness or tingling in extremities)
* Impaired proprioception (difficulty identifying one's position in space. which may progress to difficulty with balance)
* Clients with this anemia tend to be fair-haired or prematurely gray Macrocytic (megaloblastic) anemia (RBC diameter >8) with increase in MCV and MCHC
* Gastric secretion analysis reveals achlorhydria: absence of free hydrochloric acid in a pH maintained at 3.5
* Twenty-four-hour urine for Schilling test (a vitamin B12 absorption test th indicates if client lacks intrinsic factor by measuring excretion of orally ad-ministered radionuclide-labeled B12) confirms diagnosis of pernicious anemia
Therapeutic management
* Medication therapy: parenteral vitamin B12,100 to 1000 mcg subcutaneously daily for 7 days, then once a week for 1 month, then monthly for lifetime is usually prescribed; a nasal form is now available also
Client teaching
* Dietary sources of vitamin B12 include dairy products, animal proteins
Folic acid—deficiency anemia
Nursing assessment
* Pallor, progressive weakness, fatigue
* Shortness of breath
* Cardiac palpitations
* GI symptoms are similar to B12 deficiency but usually more severe (glossitis, cheilosis, and diarrhea)
* Neurological symptoms seen in B12 deficiency are not seen in folic acid deficiency and therefore assist in differentiating these two types of anemia
* RBC analysis shows macrocytic (megaloblastic) anemia (RBC diameter, high MCV with low hemoglobin, low serum folate level
Therapeutic management
* Includes dietary counseling and administration of folic acid
Client teaching
* Dietary sources of folic acid such as green leafy vegetables, fish, citrus yeast, dried beans, grains, nuts, and liver
APLASTIC ANEMIA
Nursing assessment
* Pallor and fatigue
* Palpitations and exertional dyspnea
* Infections of the skin and mucous membranes
* Bleeding from gums, nose, lady parts, or rectum
* Purpura (bruising)
* Retinal hemorrhage
* Blood counts reveal pancytopenia (decreased RBC, WBC, and platelets)
* Decreased reticulocyte count
* Bone marrow examination reveals decrease in activity of bone marrow or no cell activity
Therapeutic management
* Institute reverse isolation to protect client from infection
* Monitor for evidence of bleeding
* Avoid invasive procedures including rectal temperatures
Client teaching
* Methods to prevent infection such as avoiding crowds, maintaining good hygiene, hand washing, and elimination of uncooked foods from the diet
* Methods to prevent hemorrhage such as using a soft toothbrush, avoiding contact sports, and use of an electric razor
* Avoid drugs that increase bleeding tendency, such as aspirin
Sickle Cell Disease
Nursing assessment
* Pallor and jaundice
* Fatigue and possible irritability
* Large joints and surrounding tissue may become swollen during crisis
* Priapism (abnormal, painful, continuous erection of member) may occur if penile veins are obstructed
* Severe pain
* Anemia with sickle cells noted on a peripheral smear
* Hemoglobin electrophoresis to detect presence and percentage of hemoglobin is used for a definitive diagnosis
* Elevated serum bilrubin levels
* Elevated reticulocyte count
Therapeutic management
* Care of client in sickle cell crisis
o Recognize that client may have severe pain and medicate accordingly, usually with opioid analgesics
o Administer 02 to increase oxygenation to cells
o Promote hydration to decrease blood viscosity; provide oral intake of at 6 to 8 quarts daily or IV fluids of 3 liters daily
o Monitor for complications such as vaso-occlusive disease (thrombosis), hy*poxia, CVA, renal dysfunction, priapism leading to impotence, acute chest syndrome (fever, chest pain, cough, pulmonary infiltrates, and dyspnea), an substance abuse
o Manage infection if appropriate
Medication therapy
* Narcotic (opioid) analgesics during the acute phase of sickle cell crisis, often at large doses
Client teaching
* Ways to prevent sickle cell crisis
* Maintain an oral intake of at least 4 to 6 quarts a day; avoid conditions that might predispose to dehydration
* Avoid high altitudes
* Prevent and promptly treat infections
* Use stress-reduction strategies
* Avoid exposure to cold
* Avoid overexertion
Anemia
* Children with persistent anemia might experience frequent bouts of otitis media and upper respiratory infections.
Pernicious Anemia
* For the exam, you should know the names for the various B vitamins and realize that they can be used interchangeably in test items;
* B1 (Thiamine)
* B2 (riboflavin)
* B3 (niancin)
* B6 (pyridoxine)
* B9 (folic acid)
* B12 (cyanocobalamin)
Sikle Cell Anemia
* When multiple transfusions are given, reduce iron overload and hemosiderosis with subcutaneous chelating injections of deferoxamine (Desferal)
* Morphine is the drug of choice for acute pain in sickle cell anemia. Meperidine is contraindicated due to the possibility of central nervous system stimulation in these clients that could lead to seizure activity.
* An easy to remember general nursing care for clients with sickle cell anemia is to remember the following
* H - heat
* H – hydration
* O – oxygen
* P – pain relief
Polycythemia Vera
This disorder is characterized by thicker than normal blood. There is an increase in the client’s hemoglobin to levels of 18 g/dL, RBC of 6 million/mm or hematocrit at 55% or greater and increased platelets)
* With polycythemia, the client is at risk for cerebrovascular accident (CVA), myocardial infarction, (MI) and bleeding due to dysfunctional platelets.
Hemophilia
* Intracranial bleeding is the major cause of death in clients with hemophilia
* Cryoprecipitates are no longer used for treatment of hemophilia because HIV and hepatitis cannot be removed.
Transfusion Therapy
* Severe reactions occur during the first 50mL of blood transfused. Stay with the patient for the initial 15-30 min of infusion
congratulations hase2000!!!! best wishes in your nursing career! 
PolarBear44
18 Posts
Reiter syndrome - causes a triad of symptoms: arthritis, conjunctivitis, and urethritis.