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 want to make a few comments about two medications on your list, the first one is magnesium sulfate which is also an antidysrhythmic that suppress dysrhythmias by inhibiting abnormal pathways in the electrical conduction system of the heart. This drug also is used as anticonvulsant for seizure prevention in pregnant women with eclampsia. This antidote to this drug is calcium gluconate. A person given an infusion of magnesium sulfate needs to have a heart monitor in place, frequent assessment of respirations, blood pressure and neurological functions. This drug cannot be given with food because food affects its absorption. It is imperative to monitor respirations when using this drug because one of the sides effects of it is reduced respiratory rate. This drug is contraindicated if the patient has a heart block, myocardial damage or renal failure. If the patient has preeclamsia this drug is continued for the first 12 hours postpartum. High doses of this drug can cause loss of deep tendon reflexes, heart block, respiratory paralysis and cardiac arrest. You must have calcium gluconate readily available in case the patient manifests drug toxicity symptoms.
Mannitol(Osmitrol) is another drug used with extreme caution for clients with increased intracraneal pressure. First, this drug comes in in chrystal form which needs to be dissolved in warm water and the nurse must use a special filter in the syringe before administering this drug. Must monitor renal function for diuresis is expected...meaning the patient is going to urinate a lot for this drug draws fluid from the brain cells. A patient with increased intracraneal pressure must have the head of the bed eleveted 30 degrees, by the way. feliz3
hi , i 'd like to say thank you for all the people from this great site ! today i just found that i passed rn exam ! i did it ! i am so excited and in shock when i get the news !
hi , i 'd like to say thank you for all the people from this great site ! today i just found that i passed rn exam ! i did it ! i am so excited and in shock when i get the news !
i am an rn now !
and good luck to people who will take the exam !
god bless !
dearest mikhy,
my heartfelt congratulations to you!!! i wish you a looooooong and successful career as a registered nurse. sincerely, feliz3
I want to make a few comments about two medications on your list, the first one is magnesium sulfate which is also an antidysrhythmic that suppress dysrhythmias by inhibiting abnormal pathways in the electrical conduction system of the heart. This drug also is used as anticonvulsant for seizure prevention in pregnant women with eclampsia. This antidote to this drug is calcium gluconate. A person given an infusion of magnesium sulfate needs to have a heart monitor in place, frequent assessment of respirations, blood pressure and neurological functions. This drug cannot be given with food because food affects its absorption. It is imperative to monitor respirations when using this drug because one of the sides effects of it is reduced respiratory rate. This drug is contraindicated if the patient has a heart block, myocardial damage or renal failure. If the patient has preeclamsia this drug is continued for the first 12 hours postpartum. High doses of this drug can cause loss of deep tendon reflexes, heart block, respiratory paralysis and cardiac arrest. You must have calcium gluconate readily available in case the patient manifests drug toxicity symptoms.
Mannitol(Osmitrol) is another drug used with extreme caution for clients with increased intracraneal pressure. First, this drug comes in in chrystal form which needs to be dissolved in warm water and the nurse must use a special filter in the syringe before administering this drug. Must monitor renal function for diuresis is expected...meaning the patient is going to urinate a lot for this drug draws fluid from the brain cells. A patient with increased intracraneal pressure must have the head of the bed eleveted 30 degrees, by the way. feliz3
Another thing I want to add concerning Mannitol is that this drug has to have a port of its own, meaning, it cannot go through the same port with other drugs for there is a risk to form crystals when in contact with other drugs through the port wall. This fact is true about Dilantin (anticonvulsant) and Potassium. Potassium cannot be given IVPush or intramuscular injectionever because Potasium is caustic, and it will burn and possibly colapse the patient's vein. It is imperative to assess the needle site where potassium is infused for signs of infiltration, phlebitis and cellulites. Potassium when given IV must be diluted, the patient must have a renal assessment and have a heart monitor in place. feliz3
when a child is having a temper tantrum, should you ignore the behavior? (according to Kaplan) I thought in nclex world, you shouldn't "ignore". please explain. thanks.
Giving in to a child’s temper tantrum is detrimental to the child’s emotional health. It teaches the child that if they have a tantrum, they will be given what they want. Giving in to a temper tantrum leads to habitual tantrums that can extend far past three years of age.
When a child has their first tantrum, caregivers can try to soothe and calm the child. If the child is unresponsive to the attempts made to soothe their frustrations, caregivers should ignore the tantrum.
When a child realizes that he or she will not be indulged or rewarded for their tantrums, temper tantrums generally subside.
here's for you roze...(just reposting again, credit goes to whoever posted it before. thank you).
concepts of fluid and electrolyte balance
fluid transport
body fluid compartments
* intracellular fluid (icf): fluid within cells; two thirds of body fluid is icf
* extracellular fluid (ecf): fluid outside of cells; made up of two components, interstitial fluid (fluid surrounding cells) and fluid within vascular space (blood vessels)
* fluid constantly moves among intracellular, interstitial, and vascular spaces to maintain maintain body fluid balance
* icf is most stable and is fairly resistant to major fluid shifts
* vascular fluid is least stable; it is quickly lost or gained in response to fluid intake or losses
* interstitial fluid is reserve fluid, replacing fluid either in blood vessels or cells, depending on need
osmosis
* osmosis is a major force in body fluid movement and intravenous (iv) fluid therapy; cell membranes and capillary membranes are semipermeable; water moves into and out of cells and capillaries by osmosis
osmolality and osmotic pressure
* osmolality is concentration of solute (particles) measured per kilogram of -water, while osmolarity is concentration of solute (particles) measured per liter of solution (solvent does not have to be water)
* hypotonic: having a lower osmolality than normal plasma; water is pulled out of blood vessels into cells, resulting in decreased vascular volume and increased cell water
* hypertonic: having a higher osmolality than normal plasma; water is pulled from cells into blood vessels, resulting in increased vascular volume and decreased cell water.
excess fluid volume (fluid overload)
1. a state in which rate of fluid intake or retention exceeds rate of fluid loss in body; goal is to restore fluid balance
2. types of fluid volume excess (fve)
* isotonic fluid excess is caused by renal failure, heart failure, excess fluid intake, high corticosteroid levels, or high aldosterone levels
* hypotonic fluid excess (water intoxication) is caused by repeated plain water intake enemas or repeated plain water ng tube or bladder irrigations, overuse or excessive speed of hypotonic iv fluid infusions, excessive plain water intake (such as in extreme dieting), syndrome of inappropriate adh secretion (siadh), or psychogenic polydipsia
* hypertonic: caused by excessive salt intake
hyponatremia
* hyponatremia is a serum sodium (na+) level below 135 meq/l (normal range 135-145 meq/l)
* obtain daily weights; a weight loss of more than 0.5 pounds in 24 hours is considered to be caused by fluid loss
* monitor for resolution of manifestations of hyponatremia, including cns changes such as confusion, lethargy, and seizures
* protect client from injury and maintain a safe environment if client experiences neurological changes due to hyponatremia
hypernatremia
* hypernatremia is a serum na+ level greater than 145 meq/l (normal range 135-145 meq/l)
* excess always exists in a hyperosmolar (osmotic pressure greater than normal plasma pressure) state
nursing assessment
* common signs are related to water shift from cells (cellular dehydration) vascular space and sodium's role in nerve impulse transmission and muscle contraction
* neuromuscular: twitching, tremor and hyperreflexia, agitation and cns irritability, hallucinations, seizures, coma
* gi: watery diarrhea, nausea, thirst
* risk factors: age (very young or old), otc or prescribed medications, high-sodium diet or excessive use of salt as flavoring
hypokalemia
* hypokalemia is a serum potassium (k+) level below 3.5 meq/l (normal range 3.5-5.1 meq/l)
* always use an infusion pump, paying attention to rate, intake, and output
* never administer k+ by iv push or intramuscular routes because these methods can lead to fatal dysrhythmias
* know signs and symptoms of hyperkalemia and report these to health care provider
hyperkalemia
* hyperkalemia is a serum k+ level greater than 5.1 meq/l (normal range --3.5-5 1meq/l)
* actual hyperkalemia (k+ level in the ecf is elevated)
nursing assessment
* cardiovascular: irregular, slow heart rate, decreased bp, ecg changes (narrow, peaked t waves, widened qrs complexes, prolonged pr intervals, flattened p waves, frequent ectopy, ventricular fibrillation, and ventricular standstill)
* respiratory: unaffected until levels are very high, leading to muscle weakness and paralysis and causing respiratory failure
* neuromuscular: muscle twitching (early) and cramps, irritability, anxiety; a late sign is ascending flaccid paralysis involving arms and legs
* gi: hyperactive bowel sounds, diarrhea, nausea
therapeutic management
* decrease k+ intake: implement prescribed k+ restrictions; do not administer k+ supplements; refer client to dietitian to evaluate hidden dietary intake of k+
* promote k+ excretion: increase urinary output and monitor adequate renal function
* continued monitoring of client: serum k+ levels; report abnormals; assess cardiac status, and signs and symptoms of hyperkalemia and metabolic acidosis
* whenever possible, determine and treat underlying cause to restore balance
* dialysis may be performed for intractable conditions to prevent development of potentially lethal problems or if client's clinical condition warrants immediate intervention
* monitor for response to therapeutic treatment
* sodium polystyrene sulfonate (kayexalate), to reduce k+ levels, can be given either orally or as an enema with an osmotic agent (sorbitol) to decrease possible constipation
* intravenous medications
* calcium gluconate
* regular insulin and dextrose (usually 50%) solution (shifts k+ from ecf to icf)
* sodium bicarbonate
* k+-wasting diuretics (loop diuretics and thiazide and thiazide-like diuretics)
client teaching
* recognize predisposing factors
* avoid foods that are high in k+
* examine food labels and medication packages to determine k+ content
* cardiovascular: decreased bp; ecg changes include prolonged qt interval and lengthened st segment; cardiac arrest can occur
* respiratory: laryngospasm can occur, leading to respiratory compromise and airway failure; respiratory arrest can occur
* renal: low serum calcium levels are associated with renal failure; other electrolyte disturbances are seen in conjunction with clinical manifestations of renal failure
* neuromuscular: paresthesias and tingling in hands and feet; muscle spasms of extremities and face; positive chvostek's (twitching of cheek) and trousseaus's sign (spasm of arm when bp cuff inflated); hyperactive reflexes and increased irritability and apprehension; mental status changes ranging from depression. memory impairment, delusion, and hallucinations, to convulsions
* gi: possible hyperactive bowel sounds and diarrhea, intestinal cramps
* musculoskeletal: possible bone fractures due to demineralization; in children chronic hypocalcemia may retard growth and cause rickets; can lead to osteomalacia and osteoporosis in adults
* other systems: development of cataracts; dry, brittle nails and dry hair; complaints of bone pain; increased bleeding or bruising, bone thinning, and fractures
therapeutic management
* treatment focuses on restoring normal levels, preventing complications, and treating underlying problems
* replacement therapies
* calcium gluconate (more common) or calcium chloride (less common; irritating to vein) by slow iv push in an emergency; may give slow iv infusion of calcium gluconate until tetany has been controlled or until calcium reaches 8 to 9 mg/dl
* daily oral doses of elemental ca++, usually 1.0 to 3.0 grams/day
* calcitriol, vitamin d supplements, or phosphorus-binding antacids based on need
* thiazide diuretics may be used to decrease urinary excretion of calcium
hypercalcemia
* hypercalcemia: an abnormally elevated serum ca++ level(>10.5 mg/dl); symptoms may not appear until serum ca++ level is higher than 12 mg/dl
* predisposing clinical conditions
* other risk factors
* clients with cancer or known metastasis
* clients with hyperparathyroidism
* clients who are immobile due to clinical conditions or sedentary lifestyle
* excessive dietary intake of ca++ -rich foods
* excessive intake of antacids for gastric distress
nursing assessment
* cardiovascular: hypertension, decreased st segments and shortened qt interval on ecg, cardiac dysrhythmias such as heart block, and cardiac arrest
* neuromuscular: headache and confusion, subtle changes in personality to acute psychosis, fatigue, decreased deep tendon reflexes (dtrs); impaired memory and bizarre behavior, lethargy, or coma (seizures are rare)
therapeutic management
* decrease ca intake
* limit milk and dairy products
* eliminate use of calcium carbonate antacids until ca++ levels return to no
* promote calcium excretion
* use loop diuretics, such as furosemide (lasix) or ethacrynic acid (edecrin ) to promote increased urine output so that more ca++ will be excreted
* maintain hydration of 3,000 to 4,000 ml (3-4 l) of fluid/day; oral fluids should be high in acid-ash, such cranberry or prune juice
* give 0.9% sodium chloride (nacl) infusion of 300 to 500 ml/hr up to 6 liter as ordered until volume status restored, then 0.45 % nacl may be used; watch for fluid overload as a complication of therapy, especially with preexisting cardiac or respiratory disease
* corticosteroids to decrease gi absorption of ca++ : prednisone 20 to 50 me po bid is usual dose or 40 to 100 mg daily in four divided doses; may take 5 to 10 days for ca++ levels to fall
* chronic management of hypercalcemia is effective only with parathroidectomy for primary hyperparathyroidism
* continued monitoring of client: strict i & 0, daily weight, serum ca++ and phosphorus levels, possible ecg monitoring
* treatment of hypercalcemic crisis
* isotonic saline (0.9% nacl) at 300 to 500 ml/hr initially and up to 6 liters until intravascular volume restored or calcium level is 8 to 9 mg/dl
* biphosphonates, such as pamidronate (aredia) iv to inhibit bone resorption returns ca++ to normal within 24 to 48 hours with effects lasting for weeks in most clients
* plicamycin (mithracin) iv to inhibit bone resorption specifically if hypercalcemia induced by metastasis
* salmon calcitonin may temporarily lower ca++ level by 1 to 3 mg/dl in clients with severe hypercalcemia
* phosphorus iv to decrease ca++ because of inverse relationship in emergency situations only
* dialysis: during oliguric/anuric stage, severe renal dysfunction can lead to life-threatening fluid and electrolyte imbalances
* prevent injuries and maintain safe environment
* monitor for pathologic fractures in clients with long-term hypercalcemia
* assist client with mobility to prevent injury and maintain safety
hypermagnesemia
* hypermagnesemiaserum mg++ level greater than 2.1 meq/l (normal range 1.4-2.1 meq/l)
nursing assessment
* neuromuscular symptoms (most common): decreased dtrs and depressed neuromuscular activity; symptoms are similar to those seen in hyperkalemia
* cardiovascular: hypotension, bradycardia, bradyarrhythmias, flushing and se tion of warmth, possible cardiac arrest
* ecg may show prolonged pr interval, widened qrs complex, and elevated t wave
* cns: somnolence, weakness and lethargy, respiratory depression, and coma
* therapeutic management
* decrease mg++ intake; withhold mg++-containing drugs (antacids) and enemies
* promote mg++ excretion using diuretics (in stable renal function)
* provide rehydration to promote increased urinary output and mg++ excretion
* emergency treatment includes iv calcium gluconate to antagonize effect of mg" and counteract cardiac and respiratory symptoms
* dialysis: in clients with renal failure, dialysis may be necessary for mg - removal; if hemodialysis is not feasible, peritoneal dialysis is an option
* monitor i & o
* identify risk factors such as antacid use, laxative use, diabetic instability. and renal failure
* promote client safety
hypochloremia
* hypochloremia: a serum chloride (cl-) level that falls below 95 meq/l (normal range 95-108 meq/l)
hyperchloremia
* hyperchloremia: a serum cl- level greater than 108 meq/l (normal range 95--108 meq/l)
hypophosphatemia
* hypophosphatemia: serum phosphorus level of less than 2.5 mg/dl (normal range 2.5-4.5 mg/dl)
hyperphosphatemia
* hyperphosphatemia:serum phosphorus level of greater than 4.5 mg/dl(normal range 2.5-4.5 mg/dl)
nursing assessment
* most signs relate to the development of hypocalcemia or soft tissue calcification
* ecg changes and conduction disturbance, tachycardia
* calcium phosphate deposits in nonosseous sites such as the kidney and heart
* numbness and tingling around the mouth and in the fingertips, muscle spasm. and tetany from the increased phosphorus and corresponding decreased ca++
* anorexia, nausea, vomiting
therapeutic management
* restrict or eliminate phosphorus in diet, phosphorus-containing medications x enemas
* administer phosphate binding agents
* perform renal dialysis in clients with renal failure
* treat concurrent hypocalcemia
* monitor renal function carefully, particularly urine output, bun, creatinine
* monitor i & 0; keep clients well hydrated- pay particular attention to types of fluids being ingested (avoid carbonated beverages, which are high in phosphates)
* monitor for signs and symptoms of tetany, such as positive trousseau's and chvostek's signs
cardiovascular disorders
serum drug levels:
* digoxin:therapeutic range is 0.5 to 2.0 ng/ml; early signs of toxicity include nausea, vomiting, anorexia; abdominal pain, bradycardia, other dysrhythmias, and visual disturbances (yellow to green halos) may occur
* quinidine: therapeutic range is 2 to 6 mcg/ml; signs of toxicity include tinnitus, hearing loss, visual disturbances, nausea, dizziness, widened qrs, ventricular dysrhythmias
electrolytes:normal levels of sodium (135-145 meg/l), potassium (3.5-5.1 meg/l), calcium (8.6-10.2 mg/dl), and magnesium (1.8-2.6 mg/dl) are essential for proper cardiac function; cardiac disorders and medications can alter electrolyte balance;
* potassium (k+): hypokalemia such as with diuretic therapy increases risk of dig*italis toxicity, ventricular dysrhythmias; hyperkalemia from renal disease or ex*cess potassium supplements can lead to ventricular dysrhythmias and asystole;
* sodium (na+): hyponatremia with long-term diuretic therapy; hypernatremia could occur with excess saline iv infusion
* calcium: cardiac effects of hypocalcemia include ventricular dysrhythmias, prolonged qt interval and cardiac arrest; hypercalcemia shortens qt inter*val and causes av block, digitalis hypersensitivity, and cardiac arrest
* magnesium: cardiac effects of decreased magnesium include ventricular tachycardia and fibrillation, while increased magnesium causes bradycardia, hypotension, prolonged pr and qrs intervals
serum lipid profile: a measurement used to determine risk of developing atherosclerosis
* includes total serum cholesterol(
* high-density lipoproteins (hdl): transport cholesterol to liver for excretion ("good" cholesterol); normal is 30 to 70 mg/dl
* low-density lipoproteins (ldl): transport cholesterol to peripheral tissues ("bad" cholesterol) and increases risk of heart disease; normal is under 130 mg/dl
thank you guys! this sites rocks!!!!!:heartbeat
hugmebaby_72
161 Posts
Reposting previous Random Facts from allnurses.com: (Credit goes to whoever posted these facts.Thank You!!!)
Pharmacology Notes:
Librium - antianxiety used to tx symptoms of acute alcohol withdrawal.
Cogentin - used to tx parkinsonian side effects of Thorazine (antipsychotic med)
Methadone Hydrochloride - opiod analgesic; tx for narcotic withdrawal
Procardia - antianginal med (CCB) decreases myocardial O2 demand.
Digoxin - strengthens myocardial contractio0n & slows conduction thru AV node
Coumadin - inhiits prothrombin synthesis
Amicar - antifibrinolytic; prevents recurrence of subarachnoid hemorrhage.
Lithium - tx manic phase of bipolar
Nimodipine - CCB; decreases spasm in cerebral blood vessels
Diltiazem - CCB; inhibits Ca+ influx in vascular smooth muscle; reduces myocardial O2 demand & decreases force of ventricular contraction
Clotrimazole - antifungal; treats rashes.
Terbutaline (Brethine) and Magnesium Sulfate- treatment for preterm labor
Dilantin can cause gingival hyperplasia, advise good oral hygiene and freq. dental visits, IVPush for Dilantin should be - 25-50 mg/min (or 2-3 mins)
Pharmacology - any of the –mycin - check for tinnitus or hearing loss
Don’t give beta blockers to anyone with respiratory problems i.e asthma, copd.
Vasopressin is also known as antidiuretic hormone
NEVER NEVER NEVER administer KCl via IV push.
Beta Blockers and ACE Inhibitors are less effective in African Americans than Caucasians.
Vinca Alkaloids (Vincristine) lead to neurotoxicity and can present with numbness and tingling in the legs or paralytic ileus.
No narcotics to any head injury – won’t be able to accurately assess LOC, so pick the narcotic if you have an order to question.
Mannitol for ICP
Narcan is given for to reverse respiratory depression...a rate of 8 or less is too low and requires nursing action.
Celebrex is contraindicted in pts with a history of cirrhosis.
Foscarnet (Foscavir) can be toxic to kidneys so creatinine is monitored.
Calcium isn't an antidote for hypermagnesemia. Renal filtration is how excess Mg is removed-- that or of course dialysis.
Instead, calcium helps to stabilize the electrical gradients of muscle and nerve cells, which helps to prevent dysryhthmias.