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
You said you are taking the NCLEX within a week...I wish you for you to be totally in control during the test. When you read a question, may feel you that even if you do not know the answer you can pretty much figure it out the right choice. I wish for you and the others who are taking it a calm and relaxed experience.
Hello, Im new here but I want to share a link that has a complete list of Precautions - Standard,Airborne,Droplet and Contact...including the proper procedures...hope this helps...thanks!
This is in response to your question about the formula for calculation drug dosages and flow rates. I will do problem #1.
The question is asking you to calculate flow rate because the answer must be expressed in terms of ml/hr, and that is a flow rate.
Rule 1: For calculating flow rate when the dosage is known you would convert into like units. For example you have a dosage of dopamine expressed in micrograms per kilograms per minute. However, you have the weight of the patient expressed in pounds and the premixed bag has the dopamine dosage expressed in milligrams. Do the conversion.
There are 2.2 pounds in one kilogram. The weight of your patient is 80 kg. As for the dopamine there are 1,000 micrograms in one milligram. The weight of dopamine is 800,000mcg. The formula you are using to solve this problem is the following:
D(desired amount in dose[mcg or mg]/time[mininutes or hours]) X Q
H(what you have available in the bag)
Q= quantity in the bag Formula= D x Q
H
5mcg/kg min/800,000 mcg x 80kg / hr x 60 min x 500 ml=
12,000,000 ml/800,000 hr
units cancel out and you end up with a flow rate of 15ml/hr
This is in response to your question about the formula for calculation drug dosages and flow rates. I will do problem #1.
The question is asking you to calculate flow rate because the answer must be expressed in terms of ml/hr, and that is a flow rate.
Rule 1: For calculating flow rate when the dosage is known you would convert into like units. For example you have a dosage of dopamine expressed in micrograms per kilograms per minute. However, you have the weight of the patient expressed in pounds and the premixed bag has the dopamine dosage expressed in milligrams. Do the conversion.
There are 2.2 pounds in one kilogram. The weight of your patient is 80 kg. As for the dopamine there are 1,000 micrograms in one milligram. The weight of dopamine is 800,000mcg. The formula you are using to solve this problem is the following:
D(desired amount in dose[mcg or mg]/time[mininutes or hours]) X Q
H(what you have available in the bag)
Q= quantity in the bag Formula= D x Q
H
5mcg/kg min/800,000 mcg x 80kg / hr x 60 min x 500 ml=
12,000,000 ml/800,000 hr
units cancel out and you end up with a flow rate of 15ml/hr
Best, feliz3
The formula is D/H x Q...it is difficult to do division sign by using the underling character for the letters do not align. feliz3
I added RSV to the droplet precautions, now making the SPIDERMAN look like this:
DROPLET (CONTACT +)
think of SPIDERMAN! (having a runny nose)
(4 Ss, 5 Ps & 3 Ms) (The spider DROPS from the ceiling)
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 - Respiratory Syncytial Virus (RSV)
R - Rubella
M - Mumps
M - Meningitis, bacterial
M - Mycoplasma or meningeal pneumonia
An - Adenovirus
And, according to the CDC website regarding varicella, it should have airborne precautions, at least until the vesicles have crusts, so now that makes VCHIP change to CHIPS:
* Skin Infections:
CHIPS
C - Cutaneous diptheria
H - Herpes simplex
I - Impetigo (ok to care by pregnant nurse, need to wear gloves and gowns)
P - Pediculosis
S - Scabies, Staphylococcus
And here's the Standard & Airborne. Please correct me if you see anything not up to par!
nurse should expect to give à aiperiden (akineton)
(antiparkinson agent)
-used to counteract extra pyramidal side effects.
alcohol withdrawls - steadily increasing vitals with a client withdrawing from alcohol is a sign that d.t.'s (delirium tremens) are approaching, can be avoided with additional sedation.
bronchoscopy - client recovering from bronchoscopy should be positioned in semi-fowler's position.
-check vitals q15 min. until stable.
-assess for respiration difficulties like stridor
-dyspnea results from laryngeal edema
-laryngospasm
ketoconazole (nizoral) - 200mg daily - drug of choice to treat candidiasis.
hyponatremia s/s
- h/a apprehension and
-lethargy
-muscle twitching
-convulsions
-diarrhea finger printing of skin.
haldol s/sx
-include galactorrhea lactation
(excessive or spontaneous flow of milk)
-gynecomastia - (excessive growth of male mammary glands
note: must explain to the client that it's s/e of haldol.
antiembolism stockings - should be worn the entire hospital stay only removed for baths and replaced after skin is dry.
ms pt.
-39 weeks gestating with -bp 127/72 -pulse 72 -cervix 4 cm -fht 124.
-nurse should anticipate reduction in amount of pain medication to a ms pt.
note: there is an overall decrease in pain perception due to multiple sclerosis.
lumbar puncture
- to confirm meningitis in a child most important action by the nurse:
-is to restrain the child.
note:this prevents trauma during the procedure.
priority - client admitted for a cva
whose prescription for warfarin coumadin expired 2 days ago takes priority over -immuno-suppressed patients.
note: possible recurence of a stroke.
salem sump ng tube - hob elevated 60 to 90 degrees.
(gravity is used to help with placing this tube.)
sle - should be in remission for at least 5 months prior to trying to conceive.
kussmaul respiration - a sign of hyperglycemia
diaphoresis and trembling - a sign of hypoglycemia
informed consent - from either divorced parent is sufficient.
resp rate of 8 - is too low. if morphine was adminstered.
-this sign should necessitate a nurse to administer narcan immediately - respiratory depression
child poisoned with -lighter fluid: -should induce vomiting.
however vomiting iscontraindicated: with ingestion of hydrocarbons due to danger of aspiration.
manic patient - during meal time if patient is in seclusion - they should be kept in seclusion and the meal served while remaining in seclusion for safety.
aseptic techniques (sterile) - with 50% burn over body due to high risk for infection.
diabetes - when morning self-monitoring of blood glucose (smbg) reading shows 214 and 230 and the patient is on regular and nph insulin.
-best action by the nurse: is to adjust nph by increasing it 3 units.
never want to eliminate evening snacks completely, only adjust and encourage exercise is good.
compazine (prochlorperazine) (anxiolytic) - should be considered incompatible in a syringe with all other medications.
nutritional status - best indicator is albumin levels 4.09/dl. note: weigh gain could be ascites.
sickle cell crisis - adequate hydration is a priority with sickle cell crisis.
billroth 1 - note: after gastrectomy and vagotomy planning discharge have client avoid large meals high in simple sugars. to avoid dumping syndrome.
glipizide (glucotrol) (antidiabetics)- is effective for diabetics who produce minimal amounts of insulin.
hemophilia a - best medication for a child with hemophilia a
=codeine phosphate (paveral)(therapeutic)
note: assess blood pressure, pulse, rr- assess level of sedation
terbutaline (brethine) (bronchodilator) - should be withheld with heart rate 144.
note: s/e of this med is tachy, nervousness, tremors, h/a, possible pulmonary edema.
hep a - 18 month old with hep a:
-contact precaution
-child is placed in a private room.
haldol decanoate (haloperidol)(antipycotic)
-should be given in deep large muscle mass with 2" needle 21 gauge - single dose.
note: patient should lie in recumbent position for 1 hour after administration of this drug.
pvc's - lidocaine (antiarrhythmic agent) is the drug of choice for pvc's or for consecutive pvc's.
note: it is unexpected for a 3 month old to grasp a toy just out of reach - unexpected until 6 months of age.
gout pain - encourage weight bearing while ambulating.
note: that rom may aggravate pain
hiv - newborn of an hiv+ mother admitted to the nursery should include (standard precaution) in poc.
s&s of post infusion phlebitis
- reddened area
-red streaks at the site
addison's disease - most important for nurse to instruct:
-steroid replacement
hx of oliguria:
-htn
-periph. edema (with bun 25)
-nurse should restrict protein in patient's diet.
cranial nerve # 7 - facial nerve:
-provides motor activity to facial muscle.
ex: crooked smile nurse should assess #7.
priority - during discharge with a client with hiv taking azt (azidothymidine zidovudine) (nucleoside reverse transcriptase inhibitor) at home nurse writes a schedule of when the medicine should be taken planning and written is more effective for adherence to time frame.
poc for client - on bed rest to promote evening rest and sleep the most important is to = encourage daytime activities.
colon surgery - an appropriate action to take with a client returning from colon surgery:
-is to ask the client to lift his head off the pillow
-this assesses if there is remaining effects of neuromuscular blocking agents
note: may block ability to breathe deeply.
penrose drain - when changing dressing on incision remove one layer at a time (to avoid dislodging drain)
developmental stage of a 40 y/o - starts to measure life accomplishments with goals.
note: sterile = aseptic
clean = antiseptic
rheumatoid arthritis - most important is:
-assist client with heat application
-rom exercise
note: this reduces swelling, increases circulation, diminishes stiffness while preserving joint mobility.
myxedema - there is a slowing of all body functions.
note: decreased temperature would be revealed.
esophageal speech - client swallows air and then eructates it while forming words with his mouth.
increased icp - 4 month old with increased icp
-high pitched cry.
findings - find a 2 year old with:
-fx femur
-several lacerations
-bruises of unexpected origin
report finding to cps.
reduced oxygen level- symptoms that indicate reduction of o2 levels -ex: bp 150/90, pulse 90
-pulling of ng tubing
-picking at bed covers
ewald tube - is large, orogastric tube
-designed for rapid lavage:
note: insertion often causes gagging and vomiting, suction equipment must be available.
oxytocin (pitocin) (misc ob/gyn agents) - important for safe administration of oxytocin = palpate the uterus frequently.
The formula is D/H x Q...it is difficult to do division sign by using the underling character for the letters do not align. feliz3
Here there is the solution to your second problem:
Rule: For calculating dosages when the flow rate (ml/hr) is known, you need to convert to like units, calculate ml/min, and calculate the dose (mg/min) using the Formula Method I showed you before. If the drug is ordered by weight, then, you need to calculate so it is expressed as dose/kg/min.
70kg patient
flow rate= 42ml/hr convert to minutes
42ml/hr divided by 1hr/60min
= 0.7ml/min
convert 50mg/250ml into mcg/ml
Remember this fact: 1,000 mcg=1mg
You have 50,000 mcg of dobutamine in 250ml of solution
Now you have: 50,000 mcg dobutamine/250 ml multiplied by 0.7ml/min
50,000mcg/250ml X 0.7ml/min= 35,000mcg/250 (the milliliters cancel out) and you are left with mcg/kg/min
Now you have to divide 35,000 mcg by 250 multiplied by 70kg (weight of your patient)
35,000mcg/17500kg/min= 2 mcg/kg/min that represents the dose requested from you to find out.
The formulas you copied down are not necessary for solving these problems for the problems do not give you a drip factor, which is usually given, neither the problem is talking about single or double dosages. Those formulas are confusing to you for these problems are way simpler than that. I hope this helps, Sir. feliz3
Electrolyte Imbalances Effects on Cardiac Monitor Readings (EKG)
hypocalcemia(
-- prolonged QT segment
ST segment= represents part of ventricular repolarization
QT segment= represents ventricular refractory time or the total time required for ventricular depolarization and repolarization. QT segment duration= 0.32-.4 secs.
hypercalcemia(>10.0mg/dl)--shortened ST segment
-- widened T-wave
T-wave= represents ventricular repolarization and ventricular diastole
- should be taken with meals to decrease gi upset.
post op - abdominal surgery low fowlers position 15 degrees takes pressure off of suture line.
pressure ulcers s&s - blanching or hyperemia that doesn't disappear is a warning sign for pressure ulcers
late decelerations - stop infusion of pitocin(oxytocin)(misc ob/gyn agents)
abdominal surgery - with complaints of left leg dull aches nursing intervention:
- elevate extremities to promote venous return and
-decrease venous pressure toà relieve pain and edema.
systematic desensitization:
note:phobias are a learned response and the goal is to eradicate the phobic response by replacing with relaxation responses by using muscle relaxation techniques with it. (guided imagery)
detached retina - classic signs are:
-bright flashes of light
-client stating that protions of visual field is dark
impetigo - with a child the nurses 1st priority:
-is to notify the child's parents first.
infant with samonella:
-priority is contact precausion 1st to prevent transmission.
-then other implementations can be performed.
note: - magnesium sulfate (iv) (mineral and electrolyte replacement/supplements) can cause:
-slowing of the respiratory rate in an infant and hyporeflexia.
-the normal resp. rate for an infant is 30 - 60 per min.
-nightmares are frequently experienced at this age
decreased rbc - s/sx:
-fatigue
-pallor
-exertional dyspnea
rheumatic fever - is the most common cause of mitral valve problems. ex: mitral stenosis.
paracentesis - most important nurse intervention in preparing a client for this procedure to to have them void just before the procedure.
swan ganz - indirectly measures pressure in the ventricles. note: cvp reading measure the pressure in the r ventricles. the swan ganz catheter measures the pulmonary artery wedge pressure which is an indirect reading of the pressure in the l ventricle.
trigeminal neuralgia - (tic douloureux) - the nursing care should be directed toward preventing stimuli to the area and decreasing pain - ex: eat soft warm foods.
dic - disseminated intravascular coagulation (dic) - there is oozing blood from the venipuncture site and abdominal incision.
note: dic is an acquired clotting disorder from overstimulation, prolonged oozing from sites of minor trauma first symptom.
lecithin sphingomyelin (l/s) ratio = 3:1. - with a 33 week gestation - nurse anticipates c-section delivery due to lungs adequately mature there is no need to postpone delivery and c-section is preferred with preterm infants.
diabetes type 1 - client states " i have a quivering feeling in my stomach" is given priority due to the fact that this is a sign of hypoglycemia.
hypoglycemia signs also include:
-tachycardia
-cold clammy
-skin,
-weakness
-pallor
nurse: check bs
-offer milk.
abdominal abscess - drain inserted:
- assessment that is best made by nurse to report is the character of the drainage
- ex: purulent or otherwise major priority over amount and consistency.
appendectomy - following surgery nurse notices large amount of serosanguineous drainage on dressing.
most important for the nurse to obtain is:
-"was tissue drain placed during surgery"
-this is frequently done during surgery to prevent accumulation in wound,
dressing should be reinforced.
third trimester of pregnancy - nurse most concerned with:
-epigastric pain
-indicates impeding convulsion
-takes precedence over sob because this is expected.
pyloric stenosis - 4 week old - the statement expected from the mother is "my son is fussy and hungry all the time. baby becomes lethargic, dehydrated, and malnourished.
tagamet - (cimetidine) (anti ulcer agent) - an indication that further teaching is necessary if client's statement is
" my stool may change color while i'm on this medication".
note: no change in stool color with cimetidine. assess patient for epigastric or abdominal pain and frank or occult blood in the stool, emesis, or gastric aspirate but no stool color change.
mononucleosis - s&s include
-sore throat, flu-like symptoms for the previous 2 weeks and physical exam reveals enlarged lymph nodes.
-advise family not to share drinking glass or silverware with anybody.
note: mono is spread by direct contact avoid contact with cups and silverware for about 3 months.
bulimic - most therapeutic to analyze a bulimic client's eating habits and the circumstances that precipitate the client's eating problems -
note: assigning a thought feelings action (tfa) journal relating to client's eating behaviors will be most helpful to the nurse and therapeutic to the client.
bacterial meningitis - mother is afraid of perminant brain damage of her child. most therapeutic communication is : " it is unlikely possibility, but if your child doesn't develop normally, your pediatrician will help you with any problems".
note: bacterial meningitis if treated early, good prognosis: may be complications and long term effects (seizure disorders, hydrocephalus, impaired intelligence, visual and hearing defects).
herniorrhaphy - most important one hour before is confirm that the consent form has been signed.
note: surgical consent should be rechecked before going to surgery.
note: assessment for allergies should be done earlier then 1 hour before surgery.
addison's disease - increased salt should be increased during periods of stress.
note: with decrease ü in aldosterone, there is an û increased excretion of sodium: sodium intake should be increased.
note:the nurse should be concerned with auscultating an s3 ventricular gallop on a 78 year old woman.
note: ventricular gallop is an early sign of heart failure (hf).
note: teaching is effective with a pca pump when client says" if i start itching i need to call you"
note: itching is a common side effect of narcotics used in pca pain management.
thorazine (chlorpromazine) (antipsychotic)-client should report if they have difficulty urinating.
note: dry mouth, weight gain and constipation can be resolved at home. difficulty with urination can become a severe health problem unless treated.
digoxin (lanoxin) (antiarrhythimics)
-theraputic level is 0.5 -2.0.
if blood level comes back 2.0.
**medication should be held and physician notified.
pleur evac -fluid in the water seal chamber does not fluctuate, indicates re-expansion of lung. and x-ray will confirm this.
glasgow coma scale -5 indicates coma[color=olive], client requires frequent assessment.
note: after mi the most common complication following is dysrhythmia, with ventricular types being the most serious.
cholecystectomy -expected drainage is 500-1000 ml/day,
however complaints of sever abdominal pain after surgery could indicate peritonitis or wound infection
colonoscopopy-
note:all activities that the client participated in before the colostomy may be resumed after appropriate healing of the stoma or incisions.
3 year old -when assisting a parent on foods it is best to allow finger foods for this age group.
note: child is going through autonomy versus shame and doubt stage
-finger foods allow child the necessary independence for this stage.
note: distended abdomen with splenomegaly
- possibility of internal bleeding, life-threatening situation
acute asthma attack - most concerned if patient's respiration rate increases from 86 to 100 beats per minute.
note: pulse increase is due to decrease in oxygenation of tissues.
note: pallor is unreliable indicator of deterioration of status.
demerol 100 mg po q4h (meperidine)(opioid analgesics) - without much relief. valid suggestion for the nurse to make to the physician regarding pain medication - administer medication q4 around the clock.
note: around the clock (atc) administration of analgesics is more effective in maintaining blood levels to alleviate the pain associated with cancer.
elderly with dementia - when planning care it is best to speak slowly in a face to face position.
note: providing flexibility leads to confusion schedules need to be routine.
note: propranolol (inderal) (antianginals, antiarrhythmics) decreases the effectiveness of atorvastatin. (lipitor) (lipid-lowering agents)
note: patient on lipitor and the following statement made by client should be told to the physician " i take inderal.
droplet precausion - a child with pertussis.
note: bronchitis is the inflammation of large airway, standard precautions., tonsillitis standard precaution.
total hip replacement - most important for the nurse to apply thigh high ted hose to promote venous return.
note: use of antiembolic hose and or sequential compression devices decreases venous stasis and reduces risk of thrombus formation.
hip fracture with buck's traction - most important action by the nurse is to turn the client every 2 hours to the unaffected side. immobility is the leading cause of problems with buck's traction, important to turn client to unaffected side.
reflux - with infant should be maintained in an upright position: hob should be raised at a 30 degree angle.
after an appendectomy. - patient complains of pain. after administering analgesics the following action should be to elevate the hob 30 to 45 degrees.
note: this would reduce stress on suture line and provide for comfort.
lumbar puncture (lp) - best to prepare a 5 year old is to - do a mock run-through of the procedure.
note: excellent method to use with a child because it incorporates actually "feeling:" many aspects of the procedure as they are explained.
parathyroidectomy -should be concerned with a client eating quantities of food from which of the following food groups - milk products
note: low calcium diet is recommended preoperatively.
-diet should be high in phosphorus and low in calcium.
thermal injury - most concerned with:
-increased respiratory rate
-decrease bp.
note: may indicate burn wound sepsis, a life threatening complications of thermal injury.
elderly client - drinks plenty of fluids however has a diet that consists of starch. he lives alone with a limited income
- most important to increase protein intake.
note: protein is needed to slow down the degeneration process of aging.
test positive for tuberculosis:
-client placed on isoniazid (inh) 4 weeks ago.
-nurse is most concered if client has fatigue and dark urine.
note: this is an initial indications of hepatic dysfunction.
dx with schizophrenia - becomes increasingly withdrawn to point of mutism. most important action is to - sit with client for brief period of time.
note: nurse should maintain contact with client but not make demands to communicate or participate in activities.
wet to dry - dressing for a client of an infected abdominal incision. the nurse should intervene if client's spouse wets the old dressing with sterile saline before removing it.
note: it is contraindicated - dressing should be removed dry so wound debris and necrotic tissue are removed with old dressing.
spina bifida - of an 2 day old infant in for surgery repair. mother is concerned that infant would be confined to a wheelchair. best statement by nurse - " the corrective surgery will not change your child's physical disability"
note: spinal nerves that are destroyed by the myelomeningocele cannot be corrected: nothing can return function to portions of the body that are innervated by the spinal nerves below the site of the myelomeningocele.
electrical burns -
note: electrical burn injuries are typically more injurious to underlying tissue, such as nerve and vascular tissue, which require complex and timely treatment.
child of 5 years old - with closed head injury
- best action is to assess orientation to person, place and time every hour. *early signs of increased icp are alterations in orientation.
cystic fibrosis - statement that indicates parental understanding about the cause of their newborn's diagnosis of cf - " both of us carry a recessive trait for cystic fibrosis.
note: cystic fibrosis is inherited by an autosomal recessive trait.
right sprained ankle - learning to walk with a cane. nurse should be positioned by standing on the client's left side and slightly behind the client.
note: stand slightly behind client on strong side.
note:if resistance is met with trying to flush diluted heparin into a subclavian triple lumen catheter. action nurse should take is to secure the lumen with a luer - lock cap and notify the physician.
note: streptokinase (streptase,or kabbikinase) (thrombolytics) may be used to dissolve clot. if unsuccessful, lumen is labeled as clotted off.
administration of medication to a 4 month old - most appropriate is to place the medication in an empty nipple and allow the infant to suck.
note: never add to child's formula feeding.
note: nurse should verify the order with a physician about im injection of demerol for pain to a client receiving thrombolytic therapy.
note: bleeding can occur with im injections.
note:douching makes pap smear inaccurate. have client avoid douching for 24 hours.
medication contraindicated - for a patient with hemophilia a = oxycodone terephthalate (percodan)(equals oxycodone and aspirin) (opioid analgesics) - contraindicated for persons with bleeding disorder, contains aspirin.
patient with sickle cell crisis with an infiltrated iv - is a priority due to iv fluids are critical to reduce clotting and pain.
thanks everyone @ this thread for great info and ur time . i took nclex this morning it shut down @ 75.i think i did pretty good or the exam was too easy. i don't know hope i pass
jobimol
64 Posts
:)Some random facts,
Some says marry money but my brother says bad business marry money.
1st 2nd 3rd 4th 5th 6th 7th 8th 9th 10th 11th 1 2th
To remember cranial nerve-which one is sensory or motor or both.
s-sensory,
m-motor,
b- both(sensory or motor:typing