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....

[rirsri]

Does anyone know when do we clamp tube feeding? am thinking its between feeding to prevent loss of liquid but am not real sure.

[saber_rider]

here's a tip:

"CAUUUTION is CANCER"

C-hange in bowel habits

A-sore that oes not heal

U -nexplained sudden weight loss

U -nusal bleeding or discharge

U -enxplained Anemia

T-hickening or lump in the breast or elsewhere

I-ndigestion or difficulty swallowing

O-bvious change in wart or mole

N-Nagging cough or hoorificeness of voice

Hope this help...

have a nice day...:)

[acissej]

does anyone know when do we clamp tube feeding? am thinking its between feeding to prevent loss of liquid but am not real sure.

cap or clamp off the ng tube when not in use to prevent backflow of stomach contents or accumulation of air in the stomach

-->reduces bloating/cramps

for i know the thoughts that i think toward you, says the lord, thoughts of peace and not of evil, to give you a future and a hope.

jeremiah 29:11

[babyuk1]

hello guys,

some random facts

Rule of 9's for calculating TBSA for burns

A. Head= 9%

B. Arms = 18%( 9% each)

C. Back= 18%

D. Legs= 36%( 18% each)

E. Genitalia= 1%

Cultural and Religious Considerations in Health Care

Arab American cultural attributes -females avoid eye contact with males, touch is accepted if done by same sex health care providers, most decisions are made by males,

Muslim( Sumni) refuse organ donations most Arabs do not eat pork they avoid icy drinks when sick or hot/cold drinks together, colostrum is considered harmful to the newborn

Asian American cultural attributes;

They avoid direct eye contact, feet are considered dirty

The feet should be touched last during assessment, males make most of the decisions; they usually refuse organ donations; they generally do not prefer cold drinks, believe in the hot- cold Theory of the illness.

Native American cultural attributes-They sustain eye contact; blood and organ donations is generally refused; they might refuse circumcision; may prefer care from the tribal shaman rather than using western medicine

Mexican American cultural attributes - They might avoid direct eye contact with authorities; they might refuse organ donations; most are very emotional during bereavement; believe in the hot - cold theory of illness.

Religious Beliefs

Jehovah's witnesses -no blood products should be used

Hindu- no beef for items containing gelatin

Jewish -special dietary restrictions, use of kosher foods

Therapeutic diets

Renal Diet -- --high calorie, high carbohydrates, low potassium, low sodium, and fluid restriction intake= output plus 500 ml

GOUT DIET- low purine; omit poultry ("cold chicken") medication for acute episodes

Colchicine; maintenance medication: Zyloprim.

Heart healthy diet -- --low fat(less than 30% of calories should be from fat)

Meconium is the first fecal material passed by the neonate

Normal urine output for the neonate is fifteen to 60 ML; ( 1/2 an ounce 2oz.) per day

Children under age six who have the history of pica are at risk for lead poisoning

The four types of play of onlooker play, solitaire play, parallel play, and associative play

The ability to identify an object by touch is called stereognosis

Regressions means a return to an earlier stage of development

Thats it for now guys...

I would also like to congratulate our new RN's and Goodluck to all December 2008 test takers and for us who still needs to pass their NCLEX prayers are with you my friends :redbeathe:redbeathe:redbeathe

[tsprague]

there is another one call frye's 3300 nursing bullets nclex-rn 6th edition..check it out

these are great!! Can you tell me where I can find some of these for the LPN NCLEX

Thanks

Tammy

[kim211]

hi everyone,

this is my 1st time posting, hope this help! or if it doesnt just ignore it..thank you!

BURNS (STOP,DROP,ROLL) DO NOT RUN BECAUSE IT WILL (+)INCREASE OXYGEN CAUSING MORE BURN

• PARTIAL(SUPERFICIAL) PINK TO RED
  
• DEEP PARTIAL-RED TO WHITE,BLISTER,EDEMA
  
• FULL THICKNESS-CHARRED(BLK OR BROWN)WAXY,WHITE,[/u] DUE TO MUSCLE TISSUE,BONE AND NERVE THAT CONDUCTING PAIN IS BEING DESTROY! PT LOST OF SENSATION :zzzzz

TX:

LACTATED RINGER

SILVER NITRATE-skin will turn black (normal)

VIT. B, C, IRON

TPN: ^HIGH CALORIE/^CARBOHYDRATE/^PROTEIN (think skinny person tryin to gain weight)

PRESSURE GARMENTS-prevent scarring

[kim211]

these are great!! Can you tell me where I can find some of these for the LPN NCLEX

Thanks

Tammy

I bought the book along with others through borders

[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

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 hopeless 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

pseudo suicide 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. adventitious (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.

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

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

[rirsri]

I have a quick question, can pt with chickenpox share a room with a patient with TB. A'm thinking No, can someone tell me. Thanks

[kim211]

seizure

• typical absence:(3-12 yrs)blank out stare, amnesia, temp. loss of consciousness (10-30 secs)(50-100 times/day)
  
• myoclonic:light jerking, awake
  
• tonic/clonic :^(+)increase msl tone,loss consciousness
  
• brief impairment:complex partial seizure

remember by(to/mingle/to/bond) or (my/boob/to/touch) sorry alittle naughty there excuse me

[kim211]

I have a quick question, can pt with chickenpox share a room with a patient with TB. A'm thinking No, can someone tell me. Thanks

I don't think it is safe for pt. with chicken pox because he/she might be get infected with TB. Even though they are both airborne precaution but they have different infecting agents. However, that is just my opinion! anyone else has other advice?

[kim211]

digoxin

**herbals that (+) increase ^digoxin (lanoxin) level

ginseng/ hawthorn / licorine (-)k+ / mahuang

**take apical pulse for 1 min. adult(60)/ infant

**(0.5-1)iv/ po divide dose over 24hr

**low k+= (+)risk toxicity(hr go down) so good to eat potassium food

**s/e: halos around dark objects