Anyone Up For Random FACT THROWING??

[CrazyScrubNurse]

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

OK your turn....

[feliz3]

hello:

can you please give the name of a good website to find most popular med. ads in usa

thanks

Good Evening Dayo,

I need clarification on your request, perhaps is a language barrier, but I do not really know what is you are requesting from me. Best, feliz3

[feliz3]

child having a tet spell prioriitized nursing interventions - 1. administer 100% oxygen this promote vasodilation 2. knee to chest position to facilitate increase systemic vascular resistence 3. administer morphine sulfate to relax.

Dear Hollyberrys720,

I have with your post the same problem I had with Dayo's. What do you mean by "child having a tet spell"---what's that? Would you, please, clarify your posts number 1-3? Thanks, feliz3

[curlilockz]

Dumpings Syndrome: related to gastric surgeries; reduce carb intake, do not drink liquids with meals, lie down after eating; S/S vertigo, syncope, sweating, pallor, tachycardia 5-30 min after eating

Ammonia levels rise in cirrhosis because the liver cannot break this down. Leads to hepatic encephalopathy. Ammonia is the end product of protein - low protein diet. Give lactulose to decrease ammonia levels and bowel pH.

Pancreatitis: severe pain in epigastric region radiating to the back. Give Demerol becaue morphine causes spasms in the sphincter of Oddi. Avoid lying flat because this streches the peritoneum, causing more pain.

[feliz3]

• Hirschsprung's disease (congenital megacolon) is the congenital absence of parasympathetic ganglia in the distal portion of the colon and rectum which results in lack of peristalsis.

• Ortolani's sign (an audible click or palpable jerk that occurs with thigh abduction) confirms congenital hip dislocation in a neonate.

Abduction=to move away from the midline

Adduction=to move toward the midline

parasympathetic ganglia = Masses of nerve tissue existing outside the central nervous system (CNS).

CNS = Brain + Spinal cord.

The autonomic nervous system regulates key functions including the activity of the cardiac (heart) muscle, smooth muscles (e.g., of the gut), and glands. The autonomic nervous system has two divisions:

1. The sympathetic nervous system that accelerates the heart rate, constricts blood vessels, and raises blood pressure.

2. The parasympathetic nervous system slows the heart rate, increases intestinal and gland activity, and relaxes sphincter muscles. The part of the nervous system of vertebrates that controls involuntary actions of the smooth muscles and heart and glands. Also known as the involuntary nervous system, this part of the system executes actions unconsciously in the organism.

Note: this information was taken from the website biology online.

http://www.biology-online.org/dictionary/Autonomic_nervous_system

The bullet information has been taken from Frye's 3300 Nursing Bullets

• Scoliosis is a lateral S-shaped curvature of the spine

• A client who is receiving total parenteral nutrition, the nurse should monitor glucose and electrolyte levels. Usually, the patient will be on a sliding insulin scale.

• In women, pelvic inflammatory disease is a common complication of gonorrhea.

Those are my five facts for today. Thanks, feliz3 :typing

[vadee]

If you are having problems with understanding the difference between compensated and uncompensated ABG stuff (it's an interactive exercise site)...here is a link that I have found to be very helpful! But I would recommend drawing the tic tac toe to help you with this (download and look at VICKYRN's posting). Instead of using arrows, I just wrote down the numbers inside the boxes (the arrows were confusing me). Noticed that with it is FULLY COMPENSATED, the pH is within NORMAL LIMITS (7.35-7.45) vs PARTIALLY.

[ohnoanothertest]

I wanted to start off by saying thank you to everyone who has posted to this board. I have read over half of them so far and they are wonderful! I also would like to make my contributions and this is what I have for now. Thanks again everyone! Hope to see more!

Another way to remember ABG's:

pH 7.35=acid 7.45=alk

pco2 35=alk 45=acid (respiratory component, lungs)

hco3 22=acid 26=alk (metabolic component, kidneys)

Now remember this*** acid, alk, alk, acid, acid, alk

When doing an ABG equation write each value down and match them into your chart from above

e.g. values, then acid or alk, then match

pH =7.32 acid-matches

pco2 =46 acid-matches= respiratory acidosis

Hco3 =25 alk-doesn't match (however, is it compensating= is the pH in normal range)

(when there are three of the same values, all alk or acid determine if it is respiratory or metabolic by the value the furthest from normal ranges)

pH is in normal range so the kidneys are compensating for the lungs decomposition-= compensated respiratory acidosis

[Taimanov]

viral culture is placed on ice.

woods light examination- skin is viewed under ultraviolet light through a woods glass

darken room before examination

poison ivy , poison oak and poison sumac- dermatitis that develops through contact with urushiol

erysipelas-superficial inflammation; strep A.

koebner phenomenon-development of psoriatic lesions at site of injury

paronychia-infection of tissue around nail plate. common at middle aged women and DM pts

[Taimanov]

regitine- administers IV, faster than olol type drugs in decreasing BP.

iliac artery angioplasty- measure abdominal girth(bleeding)

key features of fat embolism- hypoxemia, decrease PO2

acetazolamide treats metabolic alkalosis

zyprexia- first line schizo treatment targeting both + and - symptoms

petechiae- sign of septicemia

lead greater than 20 - do chelation; IF less than 20 remove the patient to the source

strabismus- check in preschool children

hydrocephalus- post op( supine/neutral) . After 24 hours position unoperated site

[Taimanov]

VLCD ( very low calorie diet ) - should only be than in the hospital ( close monitoring )

streptokinase- s/e allergic reaction.

urokinase- s/e hypertension

TPA- s/e chestpain

parlodel should not be given to pts taking oral contraceptives.

pitressin- drink a glas of water each dose.

mucomyst-can cause outpouring of secretions; suction setup needed

amphoterecin b- causes hypo K

[Taimanov]

MUGA scan- used with dye to check M.I.

tongue furrows- check if FVD

hot liquids can induce vommiting

flagyll- best given IV side drip- ( metallic taste )

estrogen decreases libido

cryptosporidium causes watery diarrhea

[folashade 37]

u had nothing else to do that day I suppose lol

[lucky08]

psychiatric emergencies

acute alcohol intoxication

assessment:

• drowsiness, slurred speech, tremor, impaired thinking ,nystagmus, nausea, vomiting, hypoglycemia, increased respiration, grandiosity, loss of inhibitions, depression

• nursing diagnosis:

• injury , risk for

nursing :

• quiet environment ,allow to “sleep it off”

• monitor vital signs

• protect airway from aspiration

• assess for injuries

psychiatric emergencies

hallucinogenic drug intoxication

assessment :

• eye:

• red-marijuana;

• dilated-lsd, mescaline, belladonna;

• constricted-heroin and derivatives

•

psychiatric emergencies

care plan:

1, talk down :

* keep talking ,keep eyes open

* focus on here and now, inanimate objects

* use simple, concrete , repetitive statement,

* repetitively orient to time, place

* confidentiality; don’t moralize, challenge beliefs

2. medication

* valium

* lithium

3. hospitalization: (if more than 12-18hrs)

psychiatric emergencies

homicidal or assaultive reaction

cause:

* antisocial behavior, paranoid psychosis, previous violence, substance abuse, depression.

intervention:

* physically restrain if client has a weapon

* separate from intended victims

* approach: calm and unhurried

* prevent suicidal behavior

psychiatric emergencies

suicidal

• suicidal ideation

• 1.concepts and principles related to suicide

• 2.assessment of suicide

• composite picture: male,older than 45 yrs,unemployed,divorced,living alone, depressed, history of substance abuse and suicide within family

psychiatric emergencies----suicidal

• 10 factors to predict potential suicide and assess risk:

*age,sex,and race: teenage, older age, more women make attempts, more men complete ; occurs in all races and socioeconomic groups.

*recent stress related to loss.

• clues to suicide:

* verbal clues: direct “i am going to shoot myself ”; indirect: “this is the last time you’ll ever see me”

* behavior clues: direct: pills, razor; indirect: sudden lifting of depression, buying a casket, giving away cherished belonging, writing a will.

psychiatric emergencies----suicidal

• suicide plan: the more details, the higher risk

• previous suicidal behavior

• medical and psychiatric status

• communication:the risk reduced if the patient has talked about

psychiatric emergencies----suicidal

• style of life: such as substance abuse

• alcohol: alcohol reinforce helpless and hopless feeling

• resources: the fewer resources, the higher risk

psychiatric emergencies----suicidal

nursing care plan

• short-term goals

* medical : gastric lavage, respiratory and vascular support, wound care

• suicide precautions

*one to one supervision at all time

*check whereabout every 15 min

*explain to client what you will be doing, and why accompany the client for tests, procedures

*look through client’s belongs, remove any potentially harmful objects : pills, matches, belts, razors, glass, tweezers

*allow visit, but maintain one-to-one supervision

*check that visitors don’t leave potentially harmful objects

*meal tray : contains no glass or metal silverware

don’t discontinue without order

psychiatric emergencies----suicidal

• general approaches

• observe closely at all times

• be available ; empathy

• avoid : extremes in your own mood

• focus : directly on client’s self-destructive idea

• make a contract: no suicide within 24 hrs; or call someone

• point out client’s self-responsibility for suicidal act

• support the part of the client that wants to live

• remove sources of stress : make all decision when client is severe depression

• prove hope: problem can be solved with help

• provide with opportunity to be useful

psychiatric emergencies

pseudosuicide attempts:

• cry for help

• desire to manipulate others

• need attention

• self-punishment

• wish to punish others

• what will you do when you facing ~ ?

crisis intervention

• definition of crisis

• sudden event in one’s life disturbs homeostasis , during which usual coping mechanisms cannot resolve the problem

a. maturational (internal, relate to developmental

stages and associated role changes)

b. situational (external, associate with a life event )

c. adventitous (relate to a disaster)

crisis intervention

• characteristic of crisis intervention:

a. acute, sudden onset

b. responsive to brief therapy with focus on immediate problem

c. focus shifted from the psyche in the individual to the individual in the environment; deemphasis on intrapsychic aspects

d. crisis is time limited (usually up to 6wk)

crisis intervention

nursing care plan:

• goal:

• return to precrisis level

• focus here and how

care plan:

• encourage expressing

• explore past coping skill and reinforce adaptive ones

• set limit

• use all resource

domestic violence

characteristics

• 1.victims: feel helpless, powerless; blame themselves, ambivalent about leaving the relationship

• 2. abusers: often blame the victims, use power to threaten and subject victims to their assault

• 3.cycle of stages

a. buildup of tension

b. battering

c. calm

risk factors

• learned responses

• pregnant women and whose with one or more preschool children

• women who fear punishments form abuser

care plan

a. provide safe environment; refer to community resources for shelter.

b. treat physical injuries

c. document injuries

d. supportive, nonjudgmental approach

e. encourage individual and family therapy for victim and abuser.

rape-trauma syndrome

assessment :

• physical trauma

• emotional trauma: tears, hyperventilation, anxiety, self-blame, anger, fears, phobia, sleeping and eating problem.

rape-trauma syndrome

nursing care:

• acknowledge feeling,

• handle legal matters and police contact

• medical attention

• notify family and friends

• remain available and supportive

• contraception discussing

• explore guilt and shame feeling

• maintain confidentiality and neutrality

• health teaching :

*avoid isolated areas and being helpful to strangers

*how to resist attack : scream , run

*teach what to do if pregnancy or std is outcome

battered child

clues in history:

• delay in seeking medical care

• discrepancies

• multiple er visits

• vague and contradictory story

clue in physical examination:

• child : withdrawn, apathetic, does not cry

• child : doesn’t turn to parents for comfort; unusual desire to please parent; fear parents

• child: poorly nourished

• multiple bruises, old bruises in addition to fresh one

• burns: cigarette burs, rope marks

• clues in parent : exaggerate care and concern

battered child

nursing :

• report suspected child abuse

• conduct assessment interview in private with child and parent separated

• be supportive and nonjudgmental

evaluation:

• parents have agreed to seek help

sexual abuse children

assessment: (characteristic)

• relationship: filling paternal role (uncle, grandfather, cousin) with unquestioned access to the child

• methods of pressuring victim into sexual activity: offering material good, misrepresenting moral standards (“it is ok”)

• methods of pressuring victim to secrecy : fearing of punishment ,no being believed, rejection, being blamed for the activity, abandonment

disclosure:

• direct visual or verbal confrontation and observation by others

• verbalization of act by victim

• visible clues : excess money and candy,, new clothes, pictures

• sings and symptoms: bed-wetting; excessive bathing ,tears, avoiding school, somatic distress

• overly solicitous parental attitude toward child

sexual abuse children

• child feeling:

• guilty.

• responsible for being a victim.

• powerlessness

nursing :

• safe environment

• encourage child to verbalize feeling

• observe for symptoms: phobic reaction when hearing or seeing offender; sleep pattern changes, nightmares

• look for silent reaction

health teaching :

* teach child that his (her) body is private

* teach family

elder abuse

concepts:

• elders who are currently being abused often abused their abusers

• victim: diminished self-esteem, feeling responsibility for the abuse, isolated

• abuser: physical or psychosocial stressors

• legal : most states have mandatory laws to report elder abuse

nursing :

• early case finding , early treatment

• report case to law enforcement agencies

• provide elder with phone number

• shelter

• self help group

sleep disturbance

types of sleep :

• rapid eye movement sleep

• non-rem sleep

• sleep cycle (90 min)

• adolescents spend 30% rem of total sleep time; adults : 15% ;

nursing care:

• obtain sleep history

• duplicate normal bedtime rituals

• environment : quiet , dim lights,

• encourage daytime exercise

• allow uninterrupted sleep cycle: 90 min

• back rub, warm milk, relaxation

• taper off hypnotics

• avoid caffeine and hyperstimulation at bedtime

• ?? what about taking a nap during daytime?

eating disorders

anorexia nervosa

• anorexia nervosa is an illness of starvation related to a severe disturbance of body image and a morbid fear of obesity; it is an eating disorder, usually seen in adolescences.

assessment:

• body-image disturbance

• ambivalence: hoards food; avoids food

• low sex drive

• pregnancy fears

• self-punitive behavior leading to starvation

• physical signs:

*weight loss

*amenorrhea and secondary sex organ atrophy

*hyperactivity: compulsiveness, excessive gum chewing

*constipation

*hypotension, bradycardia, hypothermia

*skin: dry, poor turgor

bulimia

• bulimia nervosa is another type of eating disorder (binge-purge syndrome) also encountered primarily in late adolescence or early adulthood. it is characterized by at least two binge-eating episodes of large quantities of high calories food over a couple of hours followed by disparaging self-criticism and depression, self-induced vomiting, abuse of laxatives, and abuse of diuretics are commonly associated．

eating disorders

analysis

• a. altered nutrition, less than body requirements, and fluid volume deficit

• b. risk for actual fluid deficit

• c. risk for self-inflicted injury

• d. altered eating

• e. body –image disturbance/chronic low self esteem

• f. compulsive behavior

nursing care plan

• help reestablish connections between body sensations (hunger) and responses (eating).

*weigh regularly , at same time, with same amount of clothing , with back to scale

*water drinking is avoided before weighing

*one-to-one supervision during and after mealtime to prevent attempts to vomit food

*monitor exercise program, set limits in physical activity

• monitor physiological signs and symptoms

• health teaching

• explain normal sexual growth and development to improve knowledge and confront sexual fear

• behavior modification to reestablish awareness of hunger

• teach parents skills in communication

evaluation:

• attains and maintains minimal normal weight for age and height

• regular meal

• awareness hunger, talking about being hungry

• increase self-esteem

:typing.......