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
Hello to everyone thanks for all the great info. I dont understand maslow. Kaplan Decision Tree says that physical needs take priority over psychosocial needs. What r physical needs and whart r psychosocial needs.
Hello to everyone thanks for all the great info. I dont understand maslow. Kaplan Decision Tree says that physical needs take priority over psychosocial needs. What r physical needs and whart r psychosocial needs.
psychosocial are emotions, love and belonging, self esteem, etc...
physiological needs are air, food, rest....
more information on Maslow's examples and contraindictation thread
kawasaki syndrome: = "acute systemic vasculitis" unknown cause
tx: iv immuneglobulin & salicylates therapy = standard precautions
65 year-old & older - most reliable sign of infection:
=tachycardia, tachypena, confusion,
(fever may be absent-is absent in 25-30% of clients)
"infection in elderly" (more than 20% of elderly may present w/out any leukocytosis)
ngt tube feeding: hob up 30; warm feeding to rm temperature
(rn measures ph aspirate); infuse no less than 30 mins.
clamp proximal end of feeding tube at end of feeding: - prevents air from entering stomach.
*chronic alcoholic: c/o tremors, confusion & heart is feeling as if its racing
-chronic alcohol use is most common cause.
-*of hypomagnesemia (
-cardiac arrest
└> manifestations:ó neuromuscular irritability, tremors, tetany, and seizures.
*ivf in active labor= lactated ringers solution: (has electrolytes) even if requesting an epidural for pain!
begin physical assessment while patient is lying in bed: then, ask patient to sit on side of bed, transfer to chair, then observe gait.
** myelomeningocele: (neonate born w/ this) place in position: on abdomen w/face turned to side -prevents pressure onto the sac-like protrussion on his back- pressure would result in iicp or may rupture sac- or meningitis, due to infection
-leading to meningitis infection; cover lesion w/most sterile drsg.
chf if pink-tinged sputum:intervene-may be blood/fluid accumulation in lungs.
fhr 150-160 at apex of contraction:
fhr is 125:àreturns to baseline at completion of contraction
-rn should: continue to monitor fhr: (the above indicates early deceleration- b/c of head compression- this is reassuring fetal heart tone pattern.
-instructive drives & their accompanying anxiety are repressed & converted into a physical symptom.
sulfaslazine (azulfidine):
sulfonamides used to treat inflammatory bowel disease ibd (e.g. ulcerative colitis)
└> increases fluids to prevent crystallization in the kidney tubules
└> may turn urine orange-red, temporarily
└> decreases bowel inflammation -take w/food
└>diarrhea is common s/sx ulcerative colitis- continue taking sulfaslazine (azulfidine)
sulfaslazine (azulfidine): for ibd ulcerative colitis
*if iv set delivers 60 drops per minute: drops per minute equals ml per hour
child receiving 40 drips ivf per minute. iv set has drip factor of 60 drops per ml
at this rate, how many hours will it take nurse to infuse 400ml?
40 drops/min = 40 ml/hr
400 ml = 10 (10 hrs)
40 ml/hr
see first?
19 y/o scheduled for tonsillectomy - not priority
25 y/o scheduled for inguinal hernia repair- stable
32 y/o scheduled for mastoidectomy
-chronic ear infection often cause vertigo priority client due to safety
39 y/o scheduled for removal of nasal polyp -stable client
black colosh - may cause hypotension when used: in comb w/ antihypertensive drugs (tenormin) (atenolol) (metorolol)
dyspareunia (painful intercourse): explore/assess personal menstrual history.
**priority side effect surgery on a 2 month old infant:
="encourage the parents to stroke the infant"
-tactile stimulation is imperative for infants emotional development &
-stimulate post surgery sedation!
digoxin toxicity s/sx: confusion & reports of seeing yellow halos around lights -
digoxin toxicity is of great concern in à presence of diarrhea (hypokalemia) or attention of elytes.
*lithium toxicity early signs:
-slurred speech,
-muscle weakness
-n/v diarrhea
-thirst,
-polyuria
ëexpected w/lithium=mild thirst
ëadvanced signs of lithium toxicity = cause hand tremors, in coordination ,
gi upset, mental confusion
ësevere toxicity=ataxia (definition=which is the unsteady and clumsy motion of the limbs or torso due to the failure of the coordination of muscle movements.)
developmental milestones:
13-15 months= walks without help at 13-15.
18 months = builds a tower of 3 to 4 blocks at 18 months
24 months= uses 2 to 3 word sentences at 24 months
30 months= jumps with both feet at 30 months
chronic cns disorders assoc with alcoholism
korsakoff's psychosis: assess for "confabulation" or memory disturbance in order to fill in gaps, patient invents elaborate happenings
wernieke's syndrome: form of dementia related to thaimine deficiency
*10 year-old child sports safety teachings most likely:
(not water safety; water safety more for toddler & preschool)
(recreational water safety for adolescents)
ascities management:
first administer: albumin- to pull back fluids into blood vessesl so diuretics can remove excess first.
second administer: spiroaldactone
2 year-old: provide with finger food,
(2 yr working on autonomy- finger foods provide this independence!)
instruction moving patient: supine position to standing position at left side of bed with walker: (s/p spinal fussion)
focus on using arms, the left elbow as a pivot w/the left hand grasping mattress edge & the right hand pushing on the mattress above the elbow, then slide legs over side of the mattress
- this maintains spinal alignment & prevents injury; easy to accomplish
- (entire spine must be kept straight through out transfeer)
- do not bend knees w/spinal fusion; à swinging legs contraindicated too!
-
prenatal home visit to a pregnant client - most important for nurse to
follow-up /intervene is:
a cat is sleeping on the windowsill*
(cat= toxoplasmosisrisk to pregnant client & unborn infant)
(this "cat" is even more priorty than throw rugs on the dam floor)
ltb diagnosis laryngotracheobronchitis: inspiratory stridor and restlessness
fear of heights = projection and displacement
8 weeks gestation and test positive for vdrl = must instruct client the importance of penicillin for the prescribed time
note:the renal threshold for glucose is elevated in elderly
ultrasound detects: gestational age
amniocentesis: determines spinal cord problems and blood problems
head lice: must instruct to repeat shampoo in 7 to 10 days
for patient with mental retardation: - must assess level and determine client's comprehension.
early signs and symptoms of preclampsia:
facial swelling and proteinuria
most likely to observe in iv drug users: cellulitis
with a cva nurse can only prevent: corneal abrasion with a cva
nursecan not prevent: inability to talk, loss of gag reflex or open affected eye.
play
4 year old : associative play
infant: solitary play
toddler: parallel play = toddler
addisonian crisis:restlessness and rapid weak pulse
fundus location : umbilicus for palpation in 4th stage of labor
post - op patient of cataract surgery: you would caution the patient from sudden movements and bending over due to causes pressure on suture lines.
alcohol problems: tremors increased temp. nocturnal leg cramps complaints of joint pain
dwarfism: delicate features (appear younger then chronological age)
rocephin (cephalosporin): most important for nurse to monitor, the surface of tongue (hairy tongue)
note: black hairy hairy tongue (lingua villosa) is a common condition caused by defective desquamation results from a variety of precipitating factors. some of these factors include poor oral hygiene, tooth loss (because a soft diet does not allow for normal desquamation from rough food scraping the tongue), chronic or extensive use of antibiotics, and radiation treatments to the head and neck. patients with hairy tongue are more often than not coffee or tea drinkers and often use tobacco.
clomid (clomiphene) medication (fertility drug): - induces ovulation by changing hormonal effects on ovary.
naprosyn (naproxen)- nsaid (anti-inflammatory): nurse should assess: for fluid retention and dizziness
cortisol converts: protein and fat into glucose and also an anti-inflammatory agent
note:cortisol is a steroid hormone released from the adrenal cortex in response to a hormone called acth (produced by the pituitary gland). it is usually referred to as the "stress hormone" as it is involved in response to stress 6. it increases blood pressure and blood sugar, and reduces immune responses.
breast feeding mother should increase her calorie intake:
by 500 calories per day.
note: the fluid in water seal chamber doesn't fluctuate with respiration = this indicates no more air leaking into pleural space.
3 month old scheduled for barium swallow: = should be npo 3 hours prior to the procedure.
note: when preparing for cholesterol screening only sip water for 12 hours are permitted for 12 hours before plasma cholesterol screening to achieve accurate results
toddler with lead poisoning: the fluid to be encouraged when given a choice of water, fruit punch, orange juice and milk.
**milk due to vit - d which optimized deposition of lead in long bones.
second stage after denial is anger:
1st stage= denial
2nd stage= anger
3rd stage = bargaining,
4th stage = depression
5th stage = acceptance
intravenous pyelogram (ivp): able to examine the urinary tract by x-ray. evaluates the kidney function.
nephrotic syndrome:
= client teaching for diet is
= adequate protein and low sodium.
colostomy: needs to be irrigated at the same time everyday.
prior to sending client for cardiac cauterization:
= most important to report if client has an allergy to shellfish
note: iodine is uesed. - this will avoid anaphylactic shock during procedure.
sci spinal cord injury- assessment findings are - sever pounding headache, profuse nasal congestion and piloerection(goose flesh)
note: piloerection:erection of the hair of the skin.
when caring for a child with rsv respiratory syncytial virus - gown and gloves need to be on.
s/sx:resemble the common cold. however, rsv infection can also result in pneumonia, especially in the very young, the very old or those with weakened immune systems. symptoms generally begin four to six days after exposure. symptoms generally develop slowly over a period of several days. the contagious period is usually less than 10 days after symptoms begin, but occasionally is longer.
note:respiratory syncytial virus is a respiratory illness caused by a virus. it is spread through contact with droplets from the nose and throat of infected people when they cough and sneeze. rsv can also spread through dried respiratory secretions on bedclothes and similar items.
amniocentesis - detects blood disorders such as hemolytic disease
hemolytic reactions - hypotension, low back pain, and fever
graves disease - nurse expects weight loss 10 in 3 weeks, also restless, heat intolerance, reflexes hyperactive.
reminiscing group - provides an environment for social interaction and companionship
radium implant - most important to chart, date, and time of removal with total time of implant treatment
miller abbott tube - reason to remove fluid and gas from small intestines - provides for intestinal decomporssion, intestinal tube is often used for treatment of paralytic ileus.
pku test - (phenyiketonuria) - specimen should be collected as close to discharge as possible but not after 7 days.
a common reaction of a husband of a rape victim - emotionally distressed and needing assistance
fas - (fetal alcohol syndrome) of a newborn - replace vitamins, depleted -
note: adequate intake of vit-b complex is necessary for normal cns function
addison's disease - darker skin that is more pigmented
best to start toilet training at 20 months
turp - continuous irrigation is used to enable urine to keep flowing
tpn- discontinued abruptly - results in hypoglycemia -
s/sx: are diaphoresis, confusion, and tachycardia.
rml - right middle lobe of lung to auscultate -
right anterior chest between 4th and 6th intercostals.
note: can not auscultate the rml from the posterior.
myasthenia gravis - client has increased muscle fatigue so nurse needs to assess muscle groups towards the end of the day.
meniere's syndrome - nurse stands directly in front of patient so - client doesn't have to move or turn head to see nurse. decreasing movement of head decreases vertigo attacks.
mri- takes approx. 90 minutes with no discomfort and no dye is used for this procedure
ivp - (pyelography) - nurse should contact physician if client state that they are on metformin (glucophage) -
note: this should be discontinued 48 hours prior to procedure due to contrast media can cause life threatening lactic acidosis.
patient refusing cancer meds - require an rn due to assessment skills needed for this patient - should not be deligated.
narcan - short half life and may need to be repeated in 2 to 3 minutes.
Cushing's Syndrome= overproduction of cortisol hormone produced in the adrenal cortex which is part of the adrenal glands which sit on top of the kidneys.
Signs:
1) high blood sugar---makes the patient prone to infections
3) watch for Potassium which tends to decrease---heart arrhythmias
4) fat face due to fluid retention
5)truncal obesity
6)buffalo hump (fat accumulation on the back of the neck)
7) exosthalmus ( eyes look "bug out") due to increase level of cortisol
8) extremities appear thin, presence of muscle wasting, leg sores that do not heal
Note this patient is not a good candidate for steroids in general people with high blood sugar as in diabetic are definitely not good candidates for steroids...but patient need a good antiinflammatory such as a steroids are known to be. Therefore, if this patient has to on steroids(cortisone0 please watch for side effects of steroids which are:
a) increase blood sugar---remember this patient has high blood sugar
to begin with as a result of an increased level of cortisol
b) increased risk for infection
c) increased edema
This patient is going to need emotional support for this disease changes the persons appearance negatively.
Addison Disease= Decreased production of cortisol.
Signs:
1) craving salt---low sodium level, so the patient craves salty foods
2) hyponatremia---watch for low blood pressure
3) hypoglycemia---complains of weakness, tired all the time, low energy
this lack of energy is the most insidious in times of stress
4) anorexia, nausea, vomiting, diarrhea
5) as sodium is low, so is water---remember water follows sodium, so the patient is seriously dehydrated
6) weight loss---remember, anorexia, the reason for the weight loss
7) skin turned bronzed---due to increased levels melanocite stimulating hormone(MSH)
TX: coticorsteroids---avoid Addisonian Crisis which would be precipitated by a mayor stressor such as adrenal insufficiency
Signs of Addsinian Crisis:
1) profound weakness---cannot get out of bed-no energy for that
2) severe abdominal, back and leg pain
3) high fever---hypothermia
4) peripheral vascular collapse
5) renal failure
I had fun studying for this, hormone activity is interesting. feliz3
i got alot of questions on peak expiratory flow rate on my last test that i didn't understand and ive been looking it up and have found little information about it, does anybody have any info that is easy to understand, i can't really find normal values, cuz they differ for age and stuff idk im just worried about it showing it up again.
Patients must have a muscle strengthening medication Prostigmin or Mestilon on time.
Sx:
1) dropping eyelids---difficulty moving her face muscles, this patient cannot even open his/her eyes
2) patient does not have sensory deficit, no loss of reflexes or muscle atrophy---the patient can feel but has a hard time moving the musclesneeded to move around even to take in a breath of air
Note: Time is of the essence with this kind of patient. Myasthenia Gravis is a progressive disease caused by failure in the transmission of nerve impulses by a neurotransmitter called acetylcholine. If there is no acetylcholine there is no muscle movement remember we use the muscle of the diaphragm for respiration: no acetylcholine we die for we cannot breathe! This disease is very serious, and on top of that it is tricky. We need to learn to recognize the difference between a cholinergic crisis (too much acetylcholine circulating) versus myasthenic crisis ( no acetylcholine at all--I told you what that means for the poor patient) Tensilon is a drug with a short half life that will strenghten muscle weakness if the patient is having an myasthenic crisis. If the patient is having a cholinergic crisis Tensilon would do nothing, but it is a good diagnostic tool for figuring out fastwhat's wrong with the patient.
Management of Myastenia Gravis:
1) Do not allow the patient to exercise or get an infection of any kind.
2) Must administer medications on time otherwise the patient will end up hooked to a ventilator
3) Must avoid sedatives, tranquilizers, muscle relaxants ( no, kidding...) which cause respiratory depression
4) During a myasthenic crisis do not give to the patient anything to eat or drink ---high risk for aspiration---
5) after the crisis assess, assess, assess--ability to swallow and if the patient has improved give a soft diet easy to swallow. :uhoh21: feliz3
1.a 176 lbs patient with minimal urine output has been prescribed with dopamine at
5 mcg/kg/min. the premixed bag of dopamine contains 800 mg in 500 ml dextrose
5% in water. how many ml of the solution containing dopamine should the nurse administer each hour?
( round off the nearest whole number)
2.a 70 kg male client is receiving dobutamine drip at a rate of 42 ml/hour. if the preparation of the solution contains 50 mg dobutamine in 250 ml of dextrose 5% in water, what is the present dose of the drug received by the client?
I went through a flash card site last night on You Tube & wrote down the infectious processes on that site & combined them with those from the UCSF Medical Center, so this is my updated version. I can't guarantee it 100%, but it looks pretty accurate to me...
S - Scarlet fever
S - Sepsis
S - Streptococcal pharyngitis
S - Streptococcus, group A
P - Parainfluenza
P - Parvovirus B19
P - Pertussis (whooping cough)
P - Pneumonia (Haemophilus influenzae)
P - Pneumonic plague
I - Influenza
D - Diptheria (pharyngeal)
E - Epiglottitis due to H. influenzae
R - Rubella
M - Mumps
M - Meningitis, bacterial
M - Mycoplasma or meningeal pneumonia
An - Adenovirus
New version of Contact, still remember MRS. WEE and VCHIPS
Thanks to all of you fellow posters! Being the organization person that I am, I copy the helpful info from this site & try organizing them on my word processor. Makes a very handy study tool, but also takes TIME, which I budget for myself each day. I also am using the NCLEX 3500 site on top of Saunders and find that the quesitons are refreshingly different, so a good combo. Best of all, I like the fact that the 3500 site is FREE! Wish I had found it earlier, but maybe it would have been TOO much studying! I guess there IS a limit? Good luck to all the November test takers! Mine is Nov. 18, ONE WEEK FROM TODAY!!!
feliz3
anrrn2004
16 Posts
Hello to everyone thanks for all the great info. I dont understand maslow. Kaplan Decision Tree says that physical needs take priority over psychosocial needs. What r physical needs and whart r psychosocial needs.