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
8) short, deep breaths (Kussmal's breathing pattern)
9) fruity breath odor
10) confusion
This is seen in people with diabetes mellitus type and rarely seen in patients with diabetes II---older people with diabetes II may be the exception. When blood glucose is greater or equal to 240 mg/dl test urine for ketones every 4-6 hours. An infection and a fever will increase blood sugar levels in diabetics.
left sacrum posterior= assess fhr: above ubilicus on mother's left side
liver biopsy àexhale hold breath
t tube 12 hours post cholesectomy of:300 ml drainage good/ok document
delay in development in a 9 month old is: child uses a palmar grasp to hold objects (p234 prentice hall) this should have disappeared at 1-3 months
radium implantà cervical cancer nurse should: keep the used linen in room till implants are removed
if patient states i can't feel my toes: assess by checking skin temperature of foot. **not ask him to wiggle toes!!
adrenocortical insuffciency nurse would expect: decreased sodium, glucose, increased potassium
fhr initally 150, after apex of contraction: the fhr drops to 12; when contracion is completed the fhr is 130 this is: late deceleration
dpt @ 4 wks than again at ?
infant cutting teeth: has 26 teeth
women 35 weeks getation (i find unexpected):
rbc: 4.9
hgb: 15
hct: 45%
conversion (defense mechanism): client converts his anziety over school performance on exams into a physical symptom that interfers w/ability to perform e.g. "i was unable to take my final b/c i was unable to write.
obbssive compulsive ritual: means patient is attempting to achieve: avoid severe levels of anxiety (not exressing anxiety- but strategy to avoid it)
calan verapamil a ca chanel blocker (ccb) that depress myocardial contractions, dialates: used along with otherantihypertensves can cause htn,
hrt failure assess: for peripheral edema
early fetal deceleration: a slowing early in the conraction, usually a normal finding on heart tracings
myelogram test involves a lumbar puncture: w/ injection of contrast media alllowing x-ray visual of vertebral canal.
total hip replacement: okay for side lying as long as abduction is maintained
cuffed tracheostomy tube in place: purpose of cuff is to ô risk of aspiration intro trachea by the cuff sealing the tracheostomy from the trachea
ect
can dissrupt short term memory
can cause ha
can cause transiet confusional state
report "backache" to md s/p ect b/c it's not usual after ect!
infant reflexes
moro's reflex
dissappears after 3 to 4 months
suddan jarring extention & abduction of extremities &
fanning of fingers w/index finger & thumb in c-shape
tonic neck reflex
disappears 3 to 4 months
when head is turned to side arm & leg extends on that side &
oppisite arm/leg flexes
grasp reflex
touching palms of hands on soles of feet cause flexion of hands/toes
palms grasp
disspear after 3 mos
planter grasp
lessened by 8 mos.
babiniski reflex
disappears after 12 months
toes will fan out
incision line is red: complication (swelling under sutures is expected)
feeding tube feedings:
rinse bag change form every 4 hours is approprate b/c there is an ó growth of organisms after 4 hours
health promotion & maintance safety
droplet precautions
meningococcal meningitis = droplets
wear: gown
gloves
mask
goggles
**(not for: lyme disease (ticks) pnumonia carnii)
tb= droplet
meningococcal vaccine
high risk group: college students b/c dorms / closed quarters can be viral or bacterial worse b/c of excudate
total hip patient: place in a room with a patient w/blanced suspension traction (clean with clean)
sickle cell crisis: clean so place in a room with patient with multiple sclerosis (ms)= (clean also)
lyme dx: connectient lyme, connectient
abt: usually bid
pottery cup: lead poisoning potential
*toxic hepatitis : from a medication (commonly tylenol)...considered safe/clean patient
cesium implant : for ca of abdomen- ok to disgard
urine /geces
in hospital bathroom
(does not need biohazard container)
unidentified contaminent exposed :
frist- determine the ceontamination that occurred in the field
(doesn't matter which type of contaminate it was)
trunk toys= dangerous
amniocentesis at 16 weeks gestation: nurse should have patient void/empty bladder prior to amniocentesis.
keep studying :heartbeatthis will soon pay off goal
chicken & small pox = recommend for first responds
place infected clients in same room as other infected clients : (and place clean patient w/clean patient)
irritable bowel syndrome= alternating diarrhea and constipation (noninflamatory)
inflammatory bowel disease= ulceation colitis!
chiron's disease = chronic diarrhea stools 10-12 times/day & vomiting with severe abdominal distention cramping after eating.
"pain" is indicative of inflammation & infection: at operative site (aka)
"psychosocial basic care comfort c5 page 207
crutch-walking- non wt. bearing w/left leg (affected):
advance both crutches & than the right leg (3 point crutch walking)
cane walking
right side weakness
client advances with left leg first.
when going up stairs up with the good; down with the bad.
pathological fracture
risk factors:
corticosteroids
bone ca
osteoporosis
if djd:- carry handbag on shoulder
-open door know clockwise
-no! -never turn knobs counter clockwise
hydrocephalus: ó iicp (infant)
-elevating head will not help
-to correct:
provide small frequent feedings
blockage: will not drain
head trauma: elevate head
eructates: burping
plucking at bed covers and talks to the wall: = hypoxia - possible fat embolism from femur fracture
capillary refill
meningitis sx: bring to md
ha
napping
sensitive to light
rash on back
propylthiouracil (ptu) for: thyroid storm/ htn
propranolol (inderal) - htn (beta-blocker)
urinary output
30- 50 ml / hr is good!!
150 ml/hr is bad!! (=3 times normal) - on tpn
acute glomerulonephritis most concerned with:
fixed urine specific gravity= bad (ô value)
means impending renal failure
ileal conduit: best to use: connecting tubing attached to a gravity container
1c=240
8 oz= 240
2 c= 480
capd continuous ambulatory peritoneal dialysis: schedule meals during out flow (effluent) times
cimetidine (tagamet): w/chronic renal failure
-assess memory important
-change loc= toxicity
(h2 blocker/antisecratory)
-for duodenal ulcer prevention
moribund: dying death immanent
**never give antidepressant: to a manic (bipolar) client
*assess for suicide in manic clients:
do not give antidepressants
validate & reorient (always): with psych clients
geodon: reality orientation
geodon: atypical antipsychotic
tx:
-schizophrenia
-acute bipolar
-mania
monitor:
-orthostatic hypotension
-blood glucose if diabetic
korsakoff's: eat thiamine (organ meats)
heroin: s/sx
-agitation
-sweating
-abdominal cramps (opiate withdrawal)
splinter hemorrhages of nail beds:
-o2 status
assess:
heart sounds:
-mitral regurgitation
-endocarditis
suction trach first: than oral second
restlessness:
-hypoxia
-airway assessment
mona:
m=morphine
o=oxygen
n=nitro
a=asa
beta blockers
* cpr: trauma (consider cpr as trauma)
-so, tissue plaminogen activator (tpa)
-is contraindicated
if cpr has been performed-b/c cpr is traumatic
digoxin:
slows heart rate
increases contractility
long half life
digoxin o.k. to have a few hours late: breakfast/to lunch ok
inactivity: more a priority
cortisone & digoxin:
together à can cause digoxin toxicity: b/c leads to hypokalemia
infant development
infant sits alone to play à 7-9 months
infant grasp reflex is strong à 1-3 months
à grasp reflex disappears after 3 months
infant brings objects to the mouth à 4-6 months
infant eats with fingersà 10-12 months
tetralogy of fallot (tof): enlarge the hole of nipple of formula bottle-to ó calorie needs with tetralogy of fallot needs with teralogy of fallot (tof)à (enlarging hole allows obtaining nourishment easily-feed q 3 hours and soon after awakening so infant doesn't cry.
*fhr of 100 (bradycardia): appropriate ó ivf (iv fluid) to wide open adenosine (adenocard) antidysrhythmic agent
legionnaire's disease: cause is legionella pneumophila; found in water this is stagnant & warm in hot water tanks -spread by aerosolization in air to client (showers, whirlpools, ac cooling towers)
peripheral arterial disease pad or peripheral vascular disease pvd- should not sit with feet dangling; instead, sit with feet flat on the floor=> to prevent hyperflexsion of knee and compression of pelvic, thighs and popliteal area vessels with supporting weight of lower extremities.
plasmapheresis: for patient with guillain-barre: most important to have: -have a warm blanket- manage hypothermia during plasmapheresis-(similar to hemodialysis) to remove antibodies causing symptoms of guillain-barre
cleft lip care: feed infant with a rubber tipped syringe and bubble frequently rubber tip can be placed @ side of mouth hold infant in a upright position => cleft lipped swallow excess air-thus require frequent "bubbling."
clean surgical (cleft lip) site: with saline or hydrogen peroxide after feeding position infant on back or on side to prevent trauma to suture line.
(clift lip) never allow use of straws to drink fluid, no cookies, no toast, and no hard foods, never allow sucking of fingers- allows suture to heal.
** blood noted at venipuncture site and around an iv catheter is potential: dic (disseminated intravascular coagulation = life threatening
**septic shock/sepsis = most common cause of dic
toddlers: engage in parallel play (two children side by side) (18- 3 yr-old)
page 28
carbidopa /levodopa (sinemet): effective if: "my hubby is better able to ambulate"
└> reduces nuchal rigidity and bradykinesia and facilitates ambulation/ mobility (tremors do not disappear with sinemet use)
out look for meningitis is much better now than it was back then (is factual) responds to mom's concerns alleviates distress
digoxin levels: toxic if over 2 mg/ml; normal therapeutic = 0.5 to less than 2 mg/ml
digoxin iv:rn must stay with patient; infuse over 5 mins. minimum; we diluted sol. immediately observe iv site- extravasations can lead to tissue and sloughing.
full bladder necessary for transabdominal pelvic ultrasounds: "drink four glasses h20 1 hr before and do not urinate." à only take 30 mins
defense mechanisms:
dissociation = unconscious separation of painful feeling from a difficult situation idea or object ("look at all the rescue trucks, it's like watching a movie")
propranolol (inderal) contraindicated: in client's with history of heart failure and pulmonary edema.
menstruation & toxic shock syndrome teachings:
avoid all kinds of lady partsl products that contain deodorants- may irritate vulva -lady partsl lining
female begins to vomit or diarrhea during my period: contact md- vomit/diarrhea= s/sx toxic shock syndrome
use tampons during day and sanitary pad at night- tampon should be changed every 4 hours.
pcp phencyclidine piperidine (drug over dose): s/sx: patient. stares blankly, unsteady gait, stiff muscles eyes move rapidly = intoxication (aka angel dust) side to side and up and down.
plan for: aggressive behaviors- assault, belligerent, or suicidal, htn, fever tachy = possible resp. arrest
buck's extension traction: never remove weights when repositioning a client (with out an m.d. order) wow!
pr interval: normal ([color=#339966]0.12-0.20 seconds)
serum amylase: normal ([25-151 units/dl
serum ammonia: normal [color=#993300]35 to 65 mcg/dl
calcium: adult ([8.6-10 mg/dl) child (8 to 10.5 mg/dl) term
partial thromboplastin time (aptt): normal ([]20-36 seconds]) therapeutic 1.5-2.5
prothrombin:
normal ([male: 9.6-11.8 seconds]) and female: 9.5-11.3 seconds
platelet count: normal (]150,000-400,000 cells/ul
albumin level: normal ([color=#33cccc][3.4 to 5 g/dl
serum osmolality:
normal ([color=#339966][]285 to 295 mosm/kg)àhigh value indicates dehydration
safe suction range: normal ([infant] ]50-95 mm hg child] -]95-115 mm hg[[color=maroon]adult][color=#993300][]100-120 mm hg])
serum lithium: normal ([]1 to 1.5 meq/l]) acute mania -serif']0.6 to 1.4 meq/l) maintenance treatment
phenytoin (dilantin): normal serum ([color=#333399][]10 to 20 mcg/mldigoxin: therapeutic blood level (]0.8 to 2.0 ng/ml
magnesium sulfate: therapeutic range ([]4 to 8 mg/dl
pregnancy temperature: normal (36.2-37.6 celcius] or [color=#ff9900]]98-99.6 farenheit
wbc’s in pregnancy: normal (11,000 to 15,000 cells/mm3, up to 18,000 cells/mm3). immediate postpartum period, (maybe as high as 25,000 to 30,000 cells/mm3)
stomach capacity:
ønewborn infant (10 to 20 ml)
ø1-week-old (30 to 60 ml)
ø2-3-week-old infant (75 to 100 ml)
ø1-month-old infant (90 to 150 ml)
left atrial pressure: normal ([]1 to 10 mm hg])
fibrinogen levels: normal (]male: 180 to 340 mg/dl]) and ([]female: 190 to 420 mg/dl) with disseminated intravascular coagulation the fibrinogen level drops because fibrinogen is used up in the clotting process.
insulin
(regular, humulin r)
type: fast acting
onset: ½ -1 hr
peak: 2-4 hr
duration: 6-8 hr
insulin
(nph, humulin n)
type: intermediate acting
onset: [color=#ff9900]2hr
peak: [color=#ff9900]6-12hr
duration [color=#ff9900]18-26hr
insulin
(ultralente, humulin u)
type: slow acting
onset: 4hr
peak:8-20hr
duration: 24-36hr
(humulin 70/30)
type: combination
onset:½ hr
peak: 2-12hr
duration: 24hr
central venous pressure: --11 mm hg = too much fluid
potassium: 3.5-5.0 meq/lsodium: 135-145 meq/l
calcium: [4.5-5.2 meq/l or 8.6-10 mg/dl
magnesium: []1.5-2.5 meq/l
chloride: []96-107 meq/lpr measurements: normal ]0.12 to 0.20 second
qrs measurements: normal ([color=#3366ff][]0.04 to 0.10 second
ammonia: 35 to 65 ug/dl
amylase:25 to 151 iv/l
lipase: 10 to 140 u/l
cholesterol: 140 to 199 mg/dl
ldl:
hdl: 30 to 70 mg/dl
triglycerides:
bilriubin
direct: 0 to 0.3 mg/dl
indirect: 0.1 to 1.0 mg/dl
total:
protein: 6.0 to 8.0 g/dl
uric acid: male 4.5 to 8 mg/dl and female 2.5 to 6.3 mg/dl
glycosylated hemoglobin hba1c: good control 7.5% or less
serum creatinine: 0.6 to 1.3 mg/dl
bun: 9-25 mg/dl
normal ck is 26-174 u/l
troponin i value: normal ([color=#666699]
troponin t: >0.1 to 0.2 ng/ml = mi
erythrocyte studies: 0-30 mm/hour
serum iron: male 65-175 ug/dl and female 50-170 ug/dl
rbc: female 4 to 5.5 million/ul and male 4.5 to 6.2 million/ul
[color=#333333][color=#333333]major side effects chemo therapy and nursing interventions
[color=#333333]
nausea and vomiting
administer antiemetics (e.g. plasil) routinely every 4-6 hours after as well as before chemotherapy is started
withhold food and fluids 4-6 hours before chemotherapy
a light, dry snack may be allowed
improve patient's appetite and minimize food aversion by:
providing 5-6 small meals per day
provide bland, non-greasy foodsàcrackers, toast
serving foods at room temperature or slightly cooleràless odor
diarrhea
administer antidiarrheals as ordered
maintain perineal careàto prevent infection and minimize discomfort; medicated creams may be prescribed
give clear liquids as toleratedàapple juice, ginger ale, jello, broth
instruct patient to avoid milk products, spicy foods, and hard to digest foods temporarilyàto rest the bowel
monitor potassium, sodium, and chloride levels
measure i&o regularly
- stomatitis
provide and instruct patient on good oral hygieneàinspect mouth regularly, use non-alcoholic mouthwash (e.g.)diluted hydrogen peroxide),removal of ill-fitting dentures, use of soft-brsitled toothbrush
provide health teachings on the importance of:
keeping mucous membranes moistàlet patients suck on popsicle
avoidance of hot and spicy foodsàpasta and tacos
avoidanceof acidic and/or carbonated food and drinks,cola, orange juice, grapefruit juice
keeping food at room temperature or slightly cool
[*]apply water-soluble lubricant such as ky jelly to dry, cracked lips
[*]offer viscous lidocaine before meals to minimize discomfort
more to come later:
keep studying it will be over soon:yeah::yeah: .... goal
[color=#333333][children who have a depressed immune system related to hiv or chemotherapy should not be given routine immunizations]
[color=#333333][color=#333333]premature rupture of the membranes (prom) is a leading cause of newborn sepsis. after 12-24 hours of leaking fluid, measures are taken to reduce the risk to mother and the fetus/newborn]
[color=#333333][color=#333333]kidneys maintain fluid volume through adjustments in urine volume
[color=#333333]any activity that involves straining should be avoided in clients with glaucoma. such activities would increase intraocular pressure
[color=#333333]:nuke:a prickling sensation is an indication of compartment syndrome and requires immediate action by the nurse.
[color=#333333][color=#333333]the most important aspects of home care for a child with acute spasmodic croup are humidified air and increased oral fluids. moisture soothes inflamed membranes. adequate systemic hydration aids is mucociliary clearance and keeps secretions thin, white, watery, and easily removed with minimal coughing
[color=#333333][color=#333333][color=#333333]this priority intervention prevents pressure caused by pooling of blood, thus minimizing the pain. without this measure, a firm elastic bandage, opioid narcotics, or guided imagery will have little effect. opioid narcotics are given for severe pain.
[color=#333333][color=#333333][color=#333333][color=#333333]cold stress causes increased risk for respiratory distress. the baby delivered in such circumstances needs careful monitoring. in this situation, the newborn must be warmed immediately to increase its temperature to at least 97 degrees fahrenheit (36 degrees celsius[color=#333333][color=#333333]after delivery.
[color=#333333][color=#333333][color=#333333][color=#333333][color=#333333] the high glucose levels which crossed the placenta to the fetus are suddenly stopped.
[color=#333333][color=#333333][color=#333333][color=#333333][color=#333333]the newborn continues to secrete insulin in anticipation of glucose. when oral feedings begin, the newborn will adjust insulin production within a day or two
:typing
feliz3
382 Posts
Ketoacidosis early symptoms:
1)thirst or dry mouth
2)frequent urination
3) increased glucose levels
4) increased level of ketones in urine
ketoacidosis late symptoms:
5) constantly feeling tired
6) dry, flushed skin
7) nausea & vomiting
8) short, deep breaths (Kussmal's breathing pattern)
9) fruity breath odor
10) confusion
This is seen in people with diabetes mellitus type and rarely seen in patients with diabetes II---older people with diabetes II may be the exception. When blood glucose is greater or equal to 240 mg/dl test urine for ketones every 4-6 hours. An infection and a fever will increase blood sugar levels in diabetics.
Hyperosmolar Hyperglycemic Nonketotic Syndrome (HHNS) symptoms:
1) blood sugar level greater or equal to 600 mg/dl
2) dry, parched mouth
3) extreme thirst (may gradually disappear)
4) warm, dry skin that does not sweat
5) high fever (greater or equal to 101 F degrees)
6) sleepiness or confusion
7) loss of vision
8) hallucinations
9) weakness on one side of the body
10) dark urine
Prone to happen to patients with diabetes II (non insulin dependent) Usually brought by an illness or an infection. :typing feliz3