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 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.
Questions about peak expiratory flow are in connection with mechanical ventilation, but before discussing that subject, I want to post facts about lung sounds and where to locate them when using the stethoscope.
Types of breaths sounds and their location:
1) Bronchial---------------------- trachea and larynx
tracheal, tubular (other names for the same sounds)
2) Broncovesicular--------------- over the major bronchi
3) Vesicular --------------------over the peripheral lung fields where air
enters the bronchi
If you read a question describing broncovesicular sounds, now you know which area of the lungs the question is talking about.
Tracheal breath sounds
high-pitched, loud, harsh, hollow sounding, equal on inspiration and expiration.
Bronchial breath sounds
High-pitched, blowing, muffled, expiratory sound slightly longer than inspiratory.
Broncovesicular breath sounds
louder and harsher than vesicular sounds, muffled vesicular sound combined with with loud guttural sound, equal on inspiration and expiration.
Vesicular breath sounds
soft and low-pitched, rustling or breezy, three times longer on inspiration than expiration.
Mechanical ventilation:
Tidal volume=the volume of air the patient receives with each breath, that will be determined by the doctor and the ventilator would be set according to his orders.
Fraction of inspired oxygen(FiO2)= O2 concentration delivered to the patient which is determined by the patient's condition and arterial blood gases (ABGs).
Rate=number of ventilator breath delivered per minute.
Sighs= volumes of airthat are 1.5 to 2 times the set tidal volume. The sighs are delivered 6-10 times per hour. Sighs may be used to prevent atelectasis (collapsed, airless lung).
Peak Airway Inspiratory Airway Pressure= the pressure needed for the ventilator to deliver a set tidal volume at a given compliance (the elasticity, extensibility and distensibility of the lungs and the thoracic structures)
Causes of Ventilator Alarm:
Note: Assess your patientfirst and the ventilator second.
High-Pressure alarm
1) increased secretions
2) wheezing or broncospasm causes decreased airway size,
remember, the ventilator is preset according to certain
compliance (see above definition)
3) Displacement of endotracheal tube
4) Endotracheal tube obstruction due to water or a kink
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
Assault= Putting a client in fear of a harmful or offensive contact. The victim fears and believes that harm will result as a direct consequence from the threat perceived coming from the care giver.
Battery= An intentional touching of a client's body without his/her consent.
Invasion of privacy= Includes violating confidentiality, intruding on private client or family matters and sharing client information with unauthorized persons.
False Imprisonment= A client is not allowed toleave a health care facility; however, there is no legal justification for detaining the client. False imprisonment is committed when restraining devises are used without an appropriate clinical justification.
Defamation= False communication or a careless disregard for the truth that causes damage to someone's reputation. This could be done in writing(libel) or verbally(slander).
Fraud= Results from a deliberate deception intended to produce unlawful gains.
Negligence=Failure to provide care that a reasonable person ordinarily would use in similar circumstances.
Malpractice= Failure to met the standards of acceptable care, which results in harm to another person.
Restrains:
Definition= Devises designed for protecting the client used for limiting the physical activity of a client or to immobilize him/her or an extremity.
Kinds of restrains:
Physical--restricts client's movements through the application of a physical devise
Chemical--drugs given to a patient for inhibiting a specific behavior or movement, for example a sick patient in a mechanical ventilator who fights the machine is given vecuroniun bromide, a paralytic agent which relaxes skeletal muscles so the patient cannot fight the mechanical ventilator. Obviously that chemical restrain is needed for that patient to breathe. There are specific rules governing the use of any kind of restrains on a patient:
1) A restrain must have a doctor's order.
2) There cannot be a standing order for a restrain.
3) Physician's order must state
a) the type of restrain
b) identify the behavior for which the restrain is used
c) identify the limit or time frame for use
4) Physician"s orders for restrains must be renewed within a specific time
frame which is usually 24 hours.
5) Restrains are not to be ordered PRN(as needed)
6) The reason for the use of the restrain has to be told to the patient and his/her family and their permission must be asked.
7) Restrains should not interfere with any treatment given to the patient or affect the patient's health.
8) to secure the restrain a half-bow knot should be used for it is easy to undo and it is safe.
9) The patient must have enough slack to allow movement of the body. Do not secure the restrains to the bed's side rails, use for that the bed's frame or a chair.
10) Assess the skin integrity, neuromuscular and circulatory status every 30 minutes and remove the restrainevery 2hours to permit muscle exercise and promote circulation. Continually assess and document the need for restrain.
Note: Not following those rules while restraining a patient is definedby law as false imprisonment. feliz3
st john's wort - used for self-treatment of depression.
diabetes - higher rate of occurrence in african americans
asian americans - higher incidence of stomach and liver cancers.
rape victim - obtaining informed consent for examination is a priority before any action is taken, including obtaining laboratory specimens and notifying the police. this is part of process which initiates the chain of custody of the specimens and their collection.
hostage response is when victims assume responsibility for the violence inflicted on them. victims tend to blame themselves for the abuse and develop a sense of unworthiness.
valacyclovir (valtrex) - a form of acyclovir; indicated in the oral treatment of herpes zoster and recurrent genital herpes in immunocompetent adults.
down syndrome - have a high incidence of congenital heart disease, especially atrial defects.
when assisting in the medical treatment of alcohol withdrawal, the nurse should encourage intake of fluids providing they are not too somnolent. alcohol depletes the body of fluid,
bulimia nervosa - russell's sign, which is the presence of bruises or calluses on the thumb or hand, caused by trauma from self-induced vomiting.
cocaine - can cause seizures, which is one of the most serious side effects of cocaine use.
cocaine withdrawal - physical activity will help to dissipate anxiety and decrease the cravings
delirium tremens - alcohol withdrawal syndrome, which occurs most often after 24 hours; visual and tactile hallucinations, confusion, tachycardia, and possibly seizures
dementia - symptoms of confusion are worse at night. this may be referred to as "sundowning syndrome" in clients with alzheimer's disease.
chlorpromazine (thorazine) - one of the common side effects of antipsychotic medications is drowsiness; it usually diminishes after the client has taken the medication for a few days.
:typing
"a journey of a thousand miles begins with a single step."
postural hypotension occurs with phenothiazides (chlorpromazine, fluphenazine)
li toxicity - diarrhea, confusion, ataxia, slurred speech, hypotension, seizures, oliguria, coma, and death; increased thirst and urination; polydipsia, polyuria, and fine tremors are some of the very early signs of lithium toxicity
generalized anxiety - can be managed with either benzodiazepines (librium) or an antidepressant.
donepezil (aricept) - cholinesterase inhibitor drug indicated for treatment of alzheimer's type dementia
clozapine (clozaril) - antipsychotic that can cause a potentially fatal blood dyscrasia characterized by agranulocytosis (decreased wbcs, specifically neutrophils)
older adult with alcohol withdrawal - short-acting benzodiazepines, such as ativan, are preferred in older clients or when liver damage is suspected, because it is not metabolized by the liver.
methotrexate- causes gi tract irritations from toxicity; avoid sunlight and maintain effective birth control while on the medication.
sulfamylon (burn cream) - carbonic anhydrase inhibitor, and when systemically absorbed, can precipitate metabolic acidosis; used to treat bacterial growth under the eschar; causes a burning or stinging sensation on application, and pain management should be planned; old ointment should not be removed.
glaucoma has a strong hereditary tendency; those with a family history of glaucoma should have intraocular pressure monitored yearly after the age of 30 instead of waiting until after the age of 40 as would low-risk individuals.
myringotomy - to promote drainage by making a surgical incision into the tympanic membrane, which also relieves the pressure, prevents eardrum perforation, and reduces pain.
meniere's disease - assess the frequency and severity of attacks to plan best for the client's safety.
infants are obligate-nose breathers - nose drops given before feeding promotes clearance of the nasal passages; limit use of it once a day
conductive hearing loss - may result from acute otitis media, perforation of the eardrum, and obstruction of the ear canal, as by cerumen
stapedectomy - experience dizziness, vertigo, and nystagmus from changes in endolymph fluid; observe fall precautions
hydrochlorothiazide - is a diuretic that may be used to decrease the lymph fluid buildup in the ear (i.e. meniere's disease)
13 days to go... :typing ... ... :zzzzz
"a journey of a thousand miles begins with a single step."
high priority patient who has a cast that complains of a funny feeling: affected extremity indicates neurovascular compromise, and requires immediate assessment.
note: client in early stages of labor with a diagnosis of complete placenta previa must be prepared for an immediate cesarean section. implementation, cannot deliver lady partslly.
note:patient with epiglottitis who is having an early complications of hypoxemia: will present with heart rate of 148 beats per minute. the hr correlates with hypoxemia and is an early finding, along with restlessness.
after stabilizing a client with severe multiple trauma injuries from a motor vehicle accident, which of the following actions by the nurse is best? – ans.
1. limit visiting hours to promote optimal rest
2. arrange for a psychologist to visit with the family.
3. arrange for the family to meet with a social worker to discuss financial aid.
4. arrange for clergy to visit with the client and family as requested.
should remove nitro-patchbefore mri is performed.
if a family member verbalizes that a family member will closely watch the apnea monitor at all times. nurse should be concerned because this indicates a feeling that monitor may not let them know if their infant stops breathing.
patient admitted to the hospital with dry mucous membranes and decreased skin turgor. vital are bp – 120/70, temp, 101 degrees f, pulse 88, resp 14. lab tests indicate the serum sodium is 150 meq/l and the hct is 48%. the nurse expects the physician to order which of the following iv fluids? – ans.
1. -d5 ns,
2. -0.9 na cl
3. -lactated ringer
4. -0.45% na cl,
note: isotonic solution pushing fluid back to the cells. specific to dehydration.
“i should wash my hands before redressing my wound”
– indicated understanding of asepsis, hallmark is hand washing.
a mother with a 4 year old comes in to confirm her second pregnancy. the most important action for a nurse to do is - identify the client’s general health needs. (physical needs)
the priority for a nurse in caring for a client diagnosed with perforated bowelsecondary to a bowel obstruction is to prepare the client for emergency surgery.
note: this can lead toperitonitis if not addressed.
a mother brings her 17 month old son to the well baby clinic for a routine checkup. she confides to the nurse that she is concerned because her son sucks his thumb, especially at night when he is put to bed.
which of the suggestions by the nurse is best?
– don’t intervene at this time. this behavior usually subsides after 24 months of age.
note: normal behavior, peaks at 18 – 20 months, most prevalent when child is hungry or tired.
when administering calcium edta (edetate calcium disodium) (antidotes) and dimercaprol (bal inoil)(antidotes) for elevated blood lead levels the action that has the highest priority is to rotate the injectionsites. this with prevent tissue damage and promote tissue absorption of the medicine.
note: dimercaprol (bal inoil)(antidotes) treatment of acute poioning with:
-mercury
-gold
-orificenic
used adjunct with edetate calcium disodium in treatment of server lead poisoning accompaneied by encephalopathy or blood level > 100mcg/dl
priority question for ob _ immediate intervention is always given to a multipara woman at four weeks gestation reporting unilateral , dull abdominal pain. this indicates an etopic pregnancy and needs to be evaluated.
a patient with a thermal injury to the right arm – the observation that is most important to report to the doctor is – gastric ph less than 6.0 –
note:decrease in gastric ph could indicate hypersecretion of hydrogen ions,predisposing factor to stress ulcer formation.
note: situational crisis: priority is to determine how client coped with crisis in the past and build on client’s coping strategies.
note: -if oil is placed on a wound it is most important to wash the burn with soap and water –
note:cooking fat applied to an open wound increases the possibility of infection: burns should be rinsed immediately with tap water to reduce the heat in the burn.
client with dx of hyperparathyroidism – the most important symptom to report to the next shift is – hematuria
note: hematuria is a sign of renal calculi:55% of hyperparathyroid clients have renal stones.
note: dx with multiple sclerosis – most important for the nurse to include in instructions – is to avoid overexposure to heat and cold –
note: this may cause damage related to the changes in sensation
several days after a client had a myocardial infarction, the physician places the client on a 2-gm sodium diet.
which of the following selections indicates to the nurse an understanding of the diet? – ans.
1. scrambled egg, orange slices, and milk,
2. instant oatmeal, toast and orange juice,
3. poached egg, bacon and milk,
4. biscuit, fruit cup and sausage.
note: instant oatmeal has sodium added
note: all items are low in sodium with correct answer due to milk is allowed on a salt restricted diet.
instruction about the medication is effective when a pt. on naproxen sodium (anaprox) (nonopioid analgesics, nonsteroidal anti-inflammatory agents, antipyretics) states “ i should call my doctor if my stools turn very dark” –
note: nsaids can cause gastrointestinal bleeding
note:during a dressing change the old dressing should notbe saturated with sterile saline before it is removed. the dressing should be removed dry so that wound debris and necrotic tissue are removed with old dressing.
note: most important for nurse to assess for before administering calcium gluconate 10% 500 mg iv stat – is patency of the vein. if injected into the extravascular tissues, calcium gluconate can cause a severe chemical burn.
note: a child admitted with failure to thrive has just had a positive sweat test. – nurse anticipates what change in the child’s poc? – ans.administration of replacement enzymes.
note: positive for sweat test indicate cyctic fibrosis.
note:best recommendation during discharge for a patient who suffered a mild mi and smokes one pack of cigarettes per day– ans.
participate in a program such as nicotine avoidance.
a pt. has a sengstaken-blakemore tube in place. the nurse enters the room and finds the pt. in respiratory distress. which of the following actions should the nurse take first? – ans.
cut the balloon ports and remove the tube.
note: scissors always secured at the bedside: remove tube if observe signs of respiratory distress or airway obstructioncaused by upward displacement of esophageal balloon.
it is most important for the nurse to include which of the following instruction with prenatal vitamins. – ans.
take prenatal vitamins with orange juice at bedtime.
note:taking the vitamins with something acidic increases the absorption of iron. taking them with food at bedtime decreases the possibility of nausea, as the client will be asleep.
to promote safety in the environment of a client with a marked depression of t cells, – ans.
remove any standing water left in containers or equipment.
note: water should not be allowed to stand in containers, such as respiratory or suction equipment because this could act as a culture medium.
note: proper med administration carafate (sucralfate) (anti ulcer agent): should be taken 1 hour ac (before meals) and the maalox (aluminum hydroxide with magnesium hydroxide) (antacids)1 hour pc (after meals).
a client develops severe, crushing chest pain radiating to the left shoulder and arm – best prn med the nurse should administer should be – ans.
morphine sulfate iv (opioid analgesic)
note:this med reduces pain, anxiety and cardiac workload: reduces the preload and afterload pressures.
the nurse cares for a client diagnosed with dementia in a long term care facility. which of the following actions by the nurse is best? –– ans.
direct conversation toward assisting the client to reminisce and talk about important past events in life.
note:geriatric client should be encouraged to talk about his life and important things in the past because he has recent memory loss.
which of the following is the first nursing action that should be implemented for a client after a lady partsl delivery? – ans.
check the patient’s lochial flow.
note:complication of hemorrhage assessed by observing lochial flow.
note:when recording client’s chief complaint – it should be recorded using the client’s own words. – ans.
“my stomach hurts after dinner every night”
a client comes to the nurse’s station for the prescribed antipsychotic medication. the nurse notes that the client has torticollis , an arched back, and rapid movement of the eyes. which of the following actions should the nurse take first? – ans.
administer the prn trihexyphenidyl (artane) (antiparkinson agents)im immediately
(torticollis definition: spasmodic contraction of neck muscles causing head to tilt to one side and chin pointing to other side mcgraw hill nurse’s dictionary 2007)
note:administer cogentin(benztropine)(antiparkinson agents). or artane(trihexyphenidyl)(antiparkinson agents). – assessment, no validation required.
note: a preschool client’s mother reports that the child has freq. abouts of gastroenteritis. most important quest. to ask
“does the child attend a day care center?” –
note: environments with increased numbers of children (day care) more likely to promote infections due to close living conditions and increased likelihood of disease transmission.
note:desired response to fluid replacement with a patent dx with hypovolemia. – ans.
cvp reading of 8 cm of water pressure.
note:normal range of cvp is 3-12 cm water pressure so 8 indicates desired results.
client with elevated vital signs, hallucinations and aggressivebehavior that are possibly on hallucinogenic drugs – following action is to decrease environmental stimulation.
note: symptoms will subside with time and decreased stimulation.
note: early stages of hepatic encephalopathy is – having difficulty describing what he does at work.
note: impaired thought processes is early symptoms.
proper weight gain pregnancy is:
-2-5 lbs in the first trimester,
-0.66- 1.1 weely in 2nd and 3rd trimester.
-so 14 lbs in the fifth month is normal. 5 + 8 = 13.
a young adult comes to the aids clinic for treatment of large, painful, purplish-brown open areas on his right arm and back. the nurse should instruct the client to take which of the following actions? – ans.
clean the area carefully with soap and warm water every day, and cover them with a sterile dressing.
note:open kaposi’s sarcoma lesions should be cleaned and dressed daily to prevent secondary infection.
the nurse assesses an infant who had a repair of a cleft lip and palate. the respiratory assessment reveals that the infant has upper airway congestion and slightly labored respirations. which of the following nursing actions is most appropriate? – ans.
position the infant on one side.
note:will facilitate drainage of mucus from upper airway and will promote adjustment to breathing through the nose.
note:pitocin(oxytocin) (misc o/b gyn agents) should always be a secondary infusion controlled by an iv pump.
a client is admitted with a diagnosis of renal calculi and is experiencing severe pain. meperidine (demerol)(narcotic analgesics) 75 mg im is given prior to the change of shift. which of the following symptoms is most important for the nurse to report to the next shift? – ans.
change in the location and character of pain.
note: location of the pain depends on location of renal stone: character of pain changes depending on location or movement of stone.
note: -nursing interventions should involve distracting and redirecting behaviors for a bipolar disorder patient in the manic phase.
note: gown gloves and mask are appropriate for rubella (german measles) = droplet precaution.
note: flagylshouldn’t be taken with alcohol. it will cause antabuse (disulfiram)(alcohol antagonist drug)like reactions. should also be taken with food to decrease gastric upset.
note:4 year old with sickle cell anemia, baby aspirin (salicylates) (antipyretics, nonopioid analgesics) shouldn’t be given for complains of pain.
note: aspirin(salicylates) (antipyretics, nonopioid analgesics) can cause a hemorrhage during a sickle cell crisis.
which of the following findings indicates to the nurse that a client’s salem sump tube (nasogastric) was functioning effectively? – ans.
the presence of a hissing sound from the blue lumen tube.
note: hissing sound is indicative that air is freely exiting the airway; purpose is to provide continuous steady suction without pulling gastric mucosa.
the nurse cares for a pt. with deep partial thickness and full thickness burns. the client receives morphine sulfate 15 mg iv(opioid analgesic). the nurse notes a decrease in bowel sounds and slight abdominal distention which of the following. actions, if taken by the nurse, is best? – ans.
explore alternative pain management techniques.
note: morphine (opioid analgesic)
is drug of choice forburn pain management, when side effect becomes apparent, exploration of alternative pain management techniques such as visualization becomes important.
note:how to obtain a throat culture from a client diagnosed with pharyngitis. – ans.
quickly rub a cotton swab over both tonsillar areas and the posterior pharynx.
note: height and weight changes in a year
height: at age 6 – 12 children grow about 2 inches (5 cm) a year
weight: gain 4.5 – 6.5lb (3 – 3 kg) a year
height: at age 7 about 44 – 51 inches (111.8 – 129.7cm)
a mother brings her 7 year old daughter to the outpatient clinic for a routine check up. the girl weighs 50.25 lb (22.85 kg) and is 48 inches (121.7 cm) tall. the nurse notes that the child has gained 2.5 lb and grown 3 inches in the past year. which of the following. responses by the nurse is best?- ans.
" your daughter's height and weight are within normal limits."
note: first 24 hours of tpn - nurse should evaluate blood glucose level.
note: total parenteral nutrition (tpn), or hyperalimentation, has a high glucose content important to monitor glucose levels.
the nurse receives a phone call from a nursing assistant who states that her 5 year old child has developed chickenpox. it would be most important for the nurse to ask which of the following.- ans.
"have you had the chicken pox?"
note: need to ascertain if staff has had the disease, if not, varicella zoster immune globulin (vzig) can be given,
-exclude from patient care from the:
10th day after first exposure through the 21st day after last exposure.
unless given than:(28th day if vzig given)
the nurse knows that which of the following.plans would be a priority for an infant with a positive pku blood test? - ans.
place the infant on lofenalac formula.
note: guthrie blood test evaluates neonate for phenylketonuria (pku).
note:lofenalac formula is low in phenylalanine but contains minerals and vitamins to provide a balanced nutritional formula.
phenylketonuria definition: phenylpyruvic acid in the urine. *a recessive hereditary disease caused by the body's failure to oxidize an amino acid (phenylalanine) to tyrosine, because of a defective enzyme.
24 hr after abdominal surgery, which of the following. plans is a nursing priority to prevent complication of flatulence? - ans.
assist the client to walk in the hall every two hours.
note: twalking in the hall, this action will increase peristalsis, decreasing the development of flatus.
a client admitted with metastatic cancer has received chemotherapy for three months.
lab values include:
rbc 3.8 millin/mm3,
wbc 3,000/mm3,
hgb 9.3 g/dl,
platelets 50.000/mm5 .
the nurse expects the patient to exhibit which of the following symptoms? - ans.
bp 120/70, pulse 100, respirations 16. -
note: increase pulse and respiration are caused by decreased oxygenation of tissues. - the patient will be pale due to anemia,
normal rbc male - 4.3 - 5.9 million/mm3,
female 3.5 - 5.5 mill./mm3
normal wbc 4,000 - 11,000/mm3,
normal hgb male 13,5 - 17.5 g/dl, female 12 - 16 gt/dl
a physician writes an order for an hiv positive infant to receive inactivated polio (ipv) immunization. which of the following. nursing actions is most appropriate?- ans.
administer the immunization.
note: inactivated polio (ipv) appropriate,
contraindications include:
- anaphylactic reaction to neomycin,
- streptomycin, or
- polymyxin- b.
a client is placed on cephalexin monohydrate (keflex) (cephalosporins, first generation) prophylactically after surgery. which of the following foods should the nurse encourage?- ans.
yogurt and acidophilus milk.
note:these foods will help maintain normal intestinal flora, which may be altered by the keflex.
note: a client with aids who had a chest tube removed yesterday and is complaining of crackling under his skin - indicates subcutaneous emphysema, which is indication of pneumothorax,
observe client for respiratory distress, contact physician.
note:if nurse enters the room to find a tracheotomy tube dislodged. the nurse should immediately replace the tracheotomy tube.
note:a client with sunken eyeballs and fruity breath
indicates diabetic ketoacidosis,
treatment: with normal saline and regular insulin.
note: hep-a: is not infectiouswithin a week or so after the onset of jaundice, child can return to school. activity at that time depends on the child's energy level.
which finding indicates to the nurse that a client experiencing alcohol withdrawal is in need of more sedation to control the severity of withdrawal symptoms? - ans.
elevated pulse rate
note:pulse rate is a good indicator of client's progress through withdrawal, increasingly elevated pulse signals:
- impending alcohol withdrawal
- delirium requiring more sedation.
a client developed diabetes insipidus following. a craniotomy. the nurse provides discharge instructions for the client and spouse. which of the following statements, if made by the client indicates to the nurse that further teaching is needed? - ans.
-"i should weigh myself every day
-drink less fluid if i gain more than 5 lb over a week".
note: - desmopressin (ddavp, stimate)(hormone) treatment of diabetes insipidus nasally or sq required for remainder of life.
during the physical assessment, the nurse determines the need to perform the bulge test. which of the following statements, if made by the nurse is best- ans.
"please lie down and extend your legs"
note: bulge test: confirms presence of fluid in the knee,
client's leg should be extended and supported on the bed.
note:cromolyn sodium (intal, nasalcrom) (misc antiallergy agents) is used to prevent the release of histamine and other allergy-triggering substances.
- correct statement would be
" i will take the medicine before i begin any vigorous exercise".
note:favorable results from administration of medicationlevothyroxine (synthroid) (harmoe) is increased urine output.
note: medication increases metabolic processes of body,
including glomerular filtration, edema will decrease as water is excreted.
note:- appropriate action in palpating the uterine contractions would be to:
- place one hand on the abdomen over the fundus, and
- with the fingertips presses gently.
a nurse was sued for malpractice but is proved innocent. which fact from the case was decisive in determining the outcome? - ans.
you guys absolutely helped me a lot.. I THANK YOU FOR ALL THE GOOD INFO HERE AND SUPPORT....
I took my first try and failed at 265 questions.. like everyone else here, i felt devastated and discourage... DONT BE... MOVE ONE and study harder .. i took it the second time and passed at 75 questions.... im officially an RN...
how i did it?
-i answered all medsurg questions at NCLEX 3500
-did KAPLAN CD questions
-a little bit of SAUNDAERS..
...... and also 99% is prayer and faith to above!!! GOODLUCK TO ALL OF YOU AND CONGRATS TO PEOPLE WHO PASSED
you guys absolutely helped me a lot.. I THANK YOU FOR ALL THE GOOD INFO HERE AND SUPPORT....
I took my first try and failed at 265 questions.. like everyone else here, i felt devastated and discourage... DONT BE... MOVE ONE and study harder .. i took it the second time and passed at 75 questions.... im officially an RN...
how i did it?
-i answered all medsurg questions at NCLEX 3500
-did KAPLAN CD questions
-a little bit of SAUNDAERS..
...... and also 99% is prayer and faith to above!!! GOODLUCK TO ALL OF YOU AND CONGRATS TO PEOPLE WHO PASSED
XII:Hypoglossal--tongue thrust, watch for right/left deviation(abnormal sign). Inspect tongue for atrophy.
XI:Accessory--(sternomastoid & trapezius muscles) shrug, ask client to move head against the resistance of your hand
X:Vagus--use tongue blade to inspect uvula, ask to phonate "ahhh"
IX:Glossopharyngeal--test for the presence of gag reflex, slightly tickle the back of the throat
VIII:Accustic Vestibulocochlear--Weber test, use the tunning fork
VII:Facial--smile, frown, watch for an uneven smile(abnormal sign) raise eyebrows, puff cheecks
VI:Abducens--lateral movement of the eyes
V:Trigeminal--muscles of mastication, open jaw, clench teeth. Watch for anhidrosis (no sweat or moisture on the face)
IV:Trochlear--extraoccular movement of the eyes
III:Occulomor--Pupilary size while you shine a light into the eye, watch for ptosis(droopie eyelids) miotic pupils(uneven pupil size)--signs of neurological abnormalities
note: cranial nerves III, IV, VII--eye movement, up/down, to the left and right
II: Vision--Snellen Chart, test for visual acuity & funduscopic
I:Smell--ask the patient to close eyes and ask to identify common household odors
Deep Tendon reflexes--limbs should be relaxed and in symmetric position when you use a reflex hammer on one foot compare your results with the other foot or if you are doing the elbow do the same:compare results.
-risk to fetus may have been identified in animal studies; not confirmed in humans
example: tylenol
[color=dimgray]category c
[color=#696969]-animal studies have shown risk to fetus; controlled studies have not been performed in women; potential benefit may warrant use of the drug
[color=#696969]example: rifampin
category d
-positive evidence of human fetal risk (teratogenic)
-safe for the mother, not the fetus
example: tetracycline, coumadin
category x
-studies in animals or humans have shown fetal abnormalities and/or death
-risks in pregnant women outweigh potential for benefits
example: accutane (simply touching of accutane can cause absorption)
feliz3
feliz3
feliz3
382 Posts
Questions about peak expiratory flow are in connection with mechanical ventilation, but before discussing that subject, I want to post facts about lung sounds and where to locate them when using the stethoscope.
Types of breaths sounds and their location:
1) Bronchial---------------------- trachea and larynx
tracheal, tubular (other names for the same sounds)
2) Broncovesicular--------------- over the major bronchi
3) Vesicular --------------------over the peripheral lung fields where air
enters the bronchi
If you read a question describing broncovesicular sounds, now you know which area of the lungs the question is talking about.
Tracheal breath sounds
high-pitched, loud, harsh, hollow sounding, equal on inspiration and expiration.
Bronchial breath sounds
High-pitched, blowing, muffled, expiratory sound slightly longer than inspiratory.
Broncovesicular breath sounds
louder and harsher than vesicular sounds, muffled vesicular sound combined with with loud guttural sound, equal on inspiration and expiration.
Vesicular breath sounds
soft and low-pitched, rustling or breezy, three times longer on inspiration than expiration.
Mechanical ventilation:
Tidal volume=the volume of air the patient receives with each breath, that will be determined by the doctor and the ventilator would be set according to his orders.
Fraction of inspired oxygen(FiO2)= O2 concentration delivered to the patient which is determined by the patient's condition and arterial blood gases (ABGs).
Rate=number of ventilator breath delivered per minute.
Sighs= volumes of airthat are 1.5 to 2 times the set tidal volume. The sighs are delivered 6-10 times per hour. Sighs may be used to prevent atelectasis (collapsed, airless lung).
Peak Airway Inspiratory Airway Pressure= the pressure needed for the ventilator to deliver a set tidal volume at a given compliance (the elasticity, extensibility and distensibility of the lungs and the thoracic structures)
Causes of Ventilator Alarm:
Note: Assess your patient first and the ventilator second.
High-Pressure alarm
1) increased secretions
2) wheezing or broncospasm causes decreased airway size,
remember, the ventilator is preset according to certain
compliance (see above definition)
3) Displacement of endotracheal tube
4) Endotracheal tube obstruction due to water or a kink
in the tubbing.
5) patient is anxious or fights the ventilator
Low-Pressure alarm
1) Patient spontaneously breathing--that's nice :redpinkhe
2) disconnection or leak in the ventilator or in the patient's
airway cuff occurs :uhoh21:
I hope this information helps. feliz3 :typing