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
pls i need help with rooming pts in the nclex they do not give you the same organism to room with i do know that a pt with chickenpox is roomed with a chickenpox pt but when i read a questiom it did not give me the option of chicken pox in the choices of answers
post aortic femoral bypass graft - after ambulation, it is important to determine the continued integrity of the graft, which is done by checking the pedal pulse of affected leg
severe forms of chronic venous disorders - lower extremity edema is the usual initial complaint; pitting edema may be seen at first, but as the edema becomes more chronic, the skin and subcutaneous tissues are replaced by fibrous tissues, resulting in thick, hardened contracted skin.
chronic venous insufficiency -leathery, brawny appearance from erythrocyte extravasation to the extremity, persistent edema, stasis dermatitis, and pruritus.
venous stasis ulcers - characteristically form near the ankle on the medial aspect with wound margins that are irregularly shaped with tissue that is a ruddy color.
gangrenous wounds and diminished peripheral pulses are associated with arterial occlusive disease.
first few hours after femoral bypass graft surgery - greatest risk for graft occlusion; a dramatic increase in the level of pain; loss of a palpable pulse or pulses distal to the operative site; extremity pallor or cyanosis; decreasing ankle-brachial index measurements; numbness, tingling, or a cold extremity temperature may indicate occlusion of the bypass graft and should be reported immediately; pulses have usually returned to normal strength in the operating room after revascularization
ankle-brachial index (abi) –normal resting is 1 or 1.1. ; means that the blood pressure at the ankle is the same as or greater than the pressure at the arm and indicates that there is no significant narrowing or blockage of blood flow.
shock progresses – narrowing pulse pressure
inderal - primary action is to slow the cardiac rate, therefore decrease in cardiac output; effective in the treatment of hypertension or dysrhythmias that result in tachycardia
low therapeutic dose dopamine - support renal perfusion when administered in low doses in the initial stages of shock by dilatation of renal arteries
“statin” drugs - for hyperlipidemia are hepatotoxic;liver enzyme levels should be determined as a baseline before administration of the drug is started and periodically throughout therapy.
mannitol – increased tubular excretion of water; is an osmotic diuretic
dopamine iv - increases blood pressure to increase the adequacy of cardiac output; will increase renal perfusion and increase the urinary output.
dopamine (intropin) - at low doses increases renal perfusion; at intermediate doses, it increases myocardial contractility, which increases cardiac output and oxygen delivery; at high doses, it causes vasoconstriction and ventricular dysrhythmias.
dobutamine (dobutrex) - usually given in conjunction with dopamine because it has a vasodilation effect, improves cardiac output, and is less likely to cause dysrhythmias.
hypovolemic pt should receive adeq fluid replacemt first - before the initiation of a potent vasopressor, such as levophed; otherwise the intense vasoconstriction effect will lead to a further reduction in tissue perfusion
cor pulmonale -jugular vein distention with the client in a sitting position, or with a 45-degree head elevation, is indicative of an increase in the central venous pressure.
first-degree heart block - can only be evaluated with an ecg or monitor tracing because the distinguishing factor is a prolonged p-r interval
pvcs - irritable foci occurring in the ventricles, which are indicators of cardiac irritability; frequently precede the development of ventricular tachycardia
central venous pressure increase - would indicate right-sided heart failure
map & cr - increased in heart failure
post central line insertion - check for bil breath sounds to determine whether a pneumothorax has occurred as a complication of the insertion procedure
pedal edema - weigh client to det fluid retention
femoral arteriogram -local anesthetic given to lessen discomfort
sinus or atrial tachycardia - heart rate at or above 100 beats/min, the presence of p waves for each qrs complex, a pr interval below 0.20, the t wave should be present after each qrs complex, and the rhythm should be regular
cyanotic heart defect - cyanosis, irritability, clubbing of the digits, shortness of breath, crouching or squatting, heart murmur, respiratory tract infections that recur excessively, and stunted growth
diltiazem (cardizem) - calcium channel blocker; reducing heart rate, which will decrease chest pain as well as decrease and blood pressure in the treatment of hypertension
normally, functional closure of the ductus arteriosus occurs by about 15 hours of life in healthy infants born at term. iv indomethacin (indocin) was the conventional therapy to promote closure of pda in preemies, but indomethacin affects blood flow to organs such as the kidneys and so may lead to complications such as renal failure
ibuprofen -(the active ingredient in advil, motrin, medipren, and nuprin) has been found to work as well as indomethacin in treating pda in preterm infants with respiratory distress syndrome and is less likely to impair kidney function
appendicitis - position of comfort is on the side with the legs flexed against the abdomen; the head of the bed should remain slightly elevated to decrease the upward spread of infection in case the appendix ruptures
continent kock's ileostomy - catheter is placed in the stoma during surgery and is irrigated every 2 to 4 hours postoperatively; catheter may be left in place for about 4-6 days; client is taught how to catheterize his stoma every 2 to 4 hours to remove any drainage or urine
Creutzfeldt-Jakob disease (CJD) is a very rare and incurable degenerative neurological dse. that is mostly fatal.
Among the types of transmissible spongiform encephalopathy found in humans it is the most common.
S/S
- rapidly progressive dementia that leads to memory loss
- personality changes and hallucinations
- speech impairment
- jerky movements (myoclonus)
- balance and coordination dysfunction (ataxia)
- changes in gait
- rigid posture
- seizures
Note: The duration of the dse varies sporadic CJD can be fatal within months or even weeks .
Some pt's sypmtoms can continue for years.
It usually affects people aged 45–75, most commonly appearing in people between the ages of 60–65. The exception to this is the more recently-recognised 'variant' CJD (vCJD), which occurs in younger people.
INFECTION CONTROL
CONTACT PRECAUTION:
MRSA
Croup
Hepatitis A
Imetigo
C. Diff.
DROPLET PRECAUTION:
Adenovirus
Influenza
Parvovirus B19
Streptococcus
pharyngitis
Diptheria
STANDARD PRECAUTION:
Lyme dse.
Herpes zozter (localized)
Meningococcal pneumonia
Non contained cellulitis
Haemophilus Influenza pneumonia
AIRBORNE PRECAUTION:
Varicella
Tuberculosis
Measles
This is it for now guys:nuke: have a lovely weekend:redpinkhe
ACE-Is: cat. D especially in the 2nd and 3rd trimester... only use if there is an emergency situation...for instance if the mother's life is great danger. Ace-I is considered cat. C during the 1st trimester.
ARBs: cat. D throughout the pregnancy
here is the link to more medications that are contraindicated in pregnancy.
gastric ca -achlorhydria, an absence of free hydrochloric acid in the stomach
peritonitis -abdominal pain & distention caused by fluid leaking into the peritoneal cavity, fever, nausea, vomiting, and altered bowel habits (inability to pass gas and feces)
pyloric stenosis - infant should be weighed daily and placed on his or her right side to prevent aspiration after feeding
tef - elevate infant's head 30 degrees decreases gastric reflux into the trachea.
post cleft palate repair -on the side with head slightly elevated to prevent pooling of secretions in the oropharynx; positioning on the back can lead to aspiration of pooling secretions; repair is begun at 6 to 18 months, after some development of the affected area has occurred.
cleft lip repair - done at 3 mos
if w/ s/s of appendicitis -should avoid ambulation so that peristalsis is prevented or activities that increase pain, such as walking; and activity would increase risk of rupture
ngt post colon resection or colostomy - to prevent abdominal distention in the client who has had bowel surgery until after peristalsis has returned, bowel sounds are evident, and the colostomy begins to function
pud - "gnawing, burning, or boring" pain
right shoulder pain - describes diaphragmatic irritation, most often caused by free air in the abdominal cavity, which is a common postoperative complication
perforation- usually preceded by sudden sharp abdominal pain
indigestion - heartburn and substernal discomfort
bowel obstruction - bowel sounds proximal to the obstruction are frequently hyperactive; bowel sounds distal to the obstruction will be hypoactive
bowel sounds are considered absent if they are not detected after listening to all four quadrants for a total of 5 minutes.
placement of a central line - very easy to cause a pneumothorax; immediate evaluation of the breath sounds is important. a chest x-ray film should also be obtained after the procedure is completed; the placement of the line should be verified before beginning administration of the hyperalimentation solution
daily irrigations are not indicated for an ileostomy and would cause a loss of digestive enzymes, fluid, and electrolytes.
misoprostol (cytotec) - protects the lining of the stomach by stimulating the secretion of mucous and increasing the bicarbonate production; a gastric antisecretory agent
metoclopramide - is a gi stimulant and should not be given in situations where an intestinal obstruction is suspected
severe hepatic disease - diet aimed in reducing ammonia levels through consumption of low-protein foods and simple carbohydrates
referred shoulder pain - common response after a laparoscopic cholecystectomy. the laparoscopic procedure uses carbon dioxide to expand the peritoneal cavity for better visibility, while the gallbladder is removed through a tiny incision; activity and walking will help to absorb the carbon dioxide
Is anyone else taking the online Hurst review? I cant get the webpage to come up. I was on it earlier today now it wont even go to the site. I was just wondering if anyone else was having problems? Thank you.
Dearest Isobelle5287 finished her last post with Referred Pain and I'm willing to pick up where she ended the subject, so there is the definition of referred pain and I have attached a picture of locations of referred pain and what organ we need to assess when a client is complaining of pain on one of those areas shown. feliz3
Referred Pain = Pain perceived as coming from an area different from that in which the pathology is occurring. An example of this would be the perception of left arm or jaw pain in a person having a myocardial infarction.
This is the attachment...I put some notes on picture for guiding me feliz3
Please, click on the picture to see bigger. Thanks, feliz 3
PS this would not have been possible without the kind assistance of super moderator
Silverdragon102. I want to thank her publicly.
I do not know why is so hard just to put a simple attachment on this page. Please, bear with me I just sent a message to silverdragon102, supermoderator about having difficulties attaching the picture. feliz3
levodopa – (parkinsons) first side effect to be noticed may be gastrointestinal problems like anorexia, n&v. ; taking medication with meals may alleviate these symptoms.
most csf leaks resolve spontaneously; child should be maintained on bed rest until drainage ends.
early symptom of parkinson’s disease -slowness of movements in all normal activities of daily living
parkinson’s – mood fluctuations
irritability and vomiting are common signs of increased intracranial pressure in the infant; the symptoms are often delayed in the infant because of the open fontanels
done to pts w/ increased icp -hyperventilation causes respiratory alkalosis, which results in cerebral vasoconstriction; this decreases the circulating cerebral blood volume and thus decreases intracranial pressure
ms early signs - include difficulty with fine motor movement, especially of the head and neck; often, visual disturbance/ diplopia is the most ominous sign
tonic-clonic or generalized seizure - loss of consciousness and involvement of all the major motor muscles
cerebral palsy – in infant, feeding difficulties because of poor sucking ability and persistent tongue thrust
cerebral palsy - often occurs as a result of hypoxia during labor and delivery; it is more likely with a premature, small child (1500 gm) or with a difficult labor and delivery
(c5) level of injury -intercostal muscles and diaphragm can be affected; high risk for development of respiratory compromise
pupillary checks - pupils are checked for the reaction to light and accommodation, which is controlled by cranial nerve iii (oculomotor)
post lumbar puncture - increase oral intake to facilitate the body’s replacement of the cerebrospinal fluid that withdrawn
ms -prevention of constipation and urinary tract problems is important in the health promotion; keeping cool, not warm, is associated with improvement of neurological function
bed to a wheelchair transfer - should move his upper body to the wheelchair first and then move his legs from the bed to the wheelchair
myelogram- sensation of flushing is a typical response to radiopaque dye when it is injected intravenously
simple partial seizure - unilateral paresthesia, numbness and tingling, and spastic movement of the extremities (old term is jacksonian seizure); no loss of consciousness or incontinence of bowel or bladder
myasthenic crisis - respiratory muscles are affected and aspiration is a concern; compromises respirations and may result in infections, aspiration and respiratory insufficiency
myelomeningocele usual complication –hydrocephalus; rapid increase in head size (increase in frontal occipital circumference), irritability, suture line separation, and bulging fontanels; eyes appear to look downward only, with the cornea prominent over the iris (sunset sign)
osteoarthritis - gradual onset and affects weight-bearing joints with pain that is more pronounced after exercise
herniated lumbar disk pre-op - movement and sensation should be evaluated before surgery to have as a base for evaluation during the postoperative recovery period
balanced suspension traction with a thomas splint -check the groin area where the thigh is supported
extrapyramidial side effects (eps) are in conjunction with antipsychotics may cause sudden onset of (eps) these are side effects:
acute dystonia: painful & frightening spasms of tongue, throat, face, jaw , eyes, neck, or back muscles.
symptoms: presents as eye closing, severe upward deviation of the eyeballs, neck muscle contraction that pulls the neck to one side, severe dorsal arching of the neck and back, & difficulty swallowing.
tx: anticholinergic drugs (in oral or im forms) are rapidly effective.
akathisia: clients verbalize an inner restlessness described as irritability or tension.
outward signs: motor restlessness, pacing, foot tapping, rocking, & inability to remain still.
symptoms: are due to cholinergic predominance resulting from dopamine blockade because dopamine and acetylcholine usually exist in balance in the brain.
tardive dyskinesia (td): an abnormal condition characterized by involuntary, repetitious movements of the muscles of the face, limbs, and trunk. facial movements may include tongue thrusting and writhing, lip pursing or smacking, facial grimaces, and chewing movements. rapid, jerking, and slow writhing movements may, at the onset, occur any where in the body; these movements are usually first noticed by family members.
symptoms: of td may decrease or disappear for a while, but typically td is permanent. newer antipsychotics tend to carry a lower risk of causing td.
toxic affect:
neuroleptic malignant syndrome: is life threatening condition.
symptoms: muscle rigidity, extreme eps, severely elevated temperature, hypertension, and tachycardia. it can result in respiratory failure and cardiac collapse. occurs in 1-2 days after initial dose given
selective serotonin reuptake inhibitors & monoamine oxidase inhibitors list a few:
ssris ( i.e. paxil, celexa, prozac, zoloft, luvox, lexapro) &
serotonin syndrome: consists of autonomic instability, with sweating, agitation, confusion, hyperreflexia, hallucinations, fever, tremor, rigidity, delirium, seizures, coma, and even death. ssris in conjunction with maois causes this.
feliz3
feliz3
feliz3
382 Posts
The Body's reaction to Acid-Base Imbalances
Best, feliz3
Condition
pH
PaCo2
HCO3
How the body compensates?
Metabolic acidosis
low
normal
low
With compensation
low
low
low
Hyperventilation to blow off excess CO2 and conserve HCO3
Metabolic alkalosis
high
normal
high
With compensation
high
high
high
Hypoventilation to increase CO2
Kidneys keep H+ and excrete HCO3
Respiratory acidosis
low
high
normal
With compensation
low
high
high
Kidneys conserve HCO3
And eliminate H+ to increase pH
Respiratory alkalosis
high
low
normal
With compensation
high
low
low
Kidneys eliminate H+ to decrease pH