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
The way I look at this type of question is by thinking what kind of bug is causing each disease. For example, TB is a bacterial disease; on the other hand, chicken pox is viral. The second fact to look at is what kindof precautions both diseases require...in this case chicken pox is airborne and contact while TB is airborne. Both diseases require a private room for the agent that causes both diseasesis different. feliz3
fungemia= a bloodstream infection caused by a fungal organism
Any vascular access device can serve as the source for a bloodstream infection
contamination can occur from the patient's own flora traveling in the interior of the catheter or by contamination of internal tubing during manipulation
Conditions that suggest the presence of a vascular devise infection:
a) client has a catheter which appears septic, but has no obvious reason to suggest a predisposition to sepsis
b) the site of the vascular line of insertion appears red, swollen or draining (especially purulent drainage)
c) the client has a central vascular line at the onset of sepsis
d) the bloodstream infection is caused by Candida species (fungi) or by common skin organisms such as staphylocci, Bacillus or Corynebacterium
e) there is no infection at another body site to indicate probable source of sepsis
f) the client remains septic after appropriate therapy without removal of the vascular access device
I believe you are sitting for the NCLEX this Wednesday, so I did a little research and found the notes posted by hugmebaby72 on September 2008. It has information about infection control, what client requires a private room for which disease...the answers to questions that seem to plague us with confusion to most of us as far as infection control is concerned. I hope this information helps you. I give the credit and gratitude to hugmebaby72 who originally posted these notes. Thanks, feliz3
PS I pray for you, Sirisiri, determinedgal1 and others who will take the NCLEX this month to have perfect information recall, strong critical thinking skills and confidence within yourselves over your own skills and knowledge. Amen
Here are some very important facts. I got it from Random Facts thread. Very helpful for our review. Check the thread for other contents review. Good luck guys!!!
For contact precautions
diseases/conditions include: C. diff, E. coli, scabies
Room needs to be private unless room has another patient infected with the same organism
Room needs to be private unless room has another patient infected with the same organism. Maintain spacial distance of 3 feet when near patient.
Also remember standard precautions apply to ALL PATIENTS regardless of diagnosis when in contact with any bodily fluid, blood, secretions/excretions, nonintact skin, and mucous membranes
1.
Varicella (chickenpox) requires use of airborne precautions and contact precautions as well.
2. If a patient is on contact precautions, have family members and other visitors wear a gown and gloves as outlined by your facility (hospital
1. When wearing gown and/or gloves, make sure to take them off and properly dispose of them, before leaving the patien'ts room.
#2. Pt's with herpes zooster (shingles) that is active should have the same precautions as a patient with chicken pox---airborne and contact
#3. Pt's on droplet precaution can have their room door left open.
#4. Instruct visitors for pt's with droplet precautions to try to keep a distance of three feet between them and the pt.
#5. Pt's with croup should be on contact precautions
Barrrier Protection: single room maintained under negative pressure
door kept closed except when someone is entering
exiting the room
Negative airflow pressure used in room, (min of 6 - 12 air exchanges per hour depending on the facility
Ultraviolet germicide irradiation or high-efficiency
particulate air filter used in the room
Mask or personal respiratory protection device used
Mask placed on the client when client needs to
leave the room; client only leaves only if necessary!
RSV is contact precautions. So wear gloves and a gown. It is a respiratory infection that is transmited through contact with the secretions.
When you put your protective gear on start from top to bottom : mask-> gown-> and gloves. When you take them off start from bottom to top: gloves->gown->mask. (I tried to research this part just to make sure it is what I remember it to be, but found nothing so Im not 100% certain)
Wash hands between patients and whenever visibly soiled.
This is what I found on CDC web site (Guideline for Isolation
Precautions:Preventing Transmission of Infectious Agents in Healthcare Settings 2007 pdf doc) pp 129-130. There are even pictures showing the procedures
DONNING PPE (Personal Protective Equipment)
GOWN
Fully cover torso from neck to knees, arms to end of wrist, and wrap around the back
Fasten in back at neck and waist
MASK OR RESPIRATOR
Secure ties or elastic band at middle of head and neck
Fit flexible band to nose bridge
Fit snug to face and below chin
Fit-check respirator
GOGGLES/FACE SHIELD
Put on face and adjust to fit
GLOVES
Use non-sterile for isolation
Select according to hand size
Extend to cover wrist of isolation gown
SAFE WORK PRACTICES
Keep hands away from face
Work from clean to dirty
Limit surfaces touched
Change when torn or heavily contaminated
Perform hand hygiene
REMOVING PPE
Remove PPE at doorway before leaving patient room or in anteroom
GLOVES
Outside of gloves are contaminated!
Grasp outside of glove with opposite gloved hand; peel off
Hold removed glove in gloved hand
Slide fingers of ungloved hand under remaining glove at wrist
GOGGLES/FACE SHIELD
Outside of goggles or face shield are contaminated!
To remove, handle by “clean” head band or ear pieces
Place in designated receptacle for reprocessing or in waste container
GOWN
Gown front and sleeves are contaminated!
Unfasten neck, then waist ties
Remove gown using a peeling motion; pull gown from each shoulder toward the same hand
Gown will turn inside out
Hold removed gown away from body, roll into a bundle and discard into waste or linen receptacle
MASK OR RESPIRATOR
Front of mask/respirator is contaminated – DO NOT TOUCH!
Grasp ONLY bottom then top ties/elastics and remove
Discard in waste container
HAND HYGIENE
Perform hand hygiene immediately after removing all PPE!
Chicken pox(13-17 days)--prodromal, child have malaise, fever, anorexia.
Rash is pruritic, and starts out as a macule then papule then a vesicle.
Spread by direct contact, droplet and contaminated object.
ISOLATE till all vesicles are crusted; it can be spread from 2 days before the rash begins.
Avoid use of aspirin due to Reye's syndrome, use tylenol.
Airborn--door can be closed..measles (RUBEOLA), M. tuberculosis, disseminated zoster(shingles), varicella(chicken pox)--again can cohort and place in same room with the same infective organism.
Droplet--door may be open---Streptococcus pharyngitis, meningitis, pnemonia...private room or pt with same infection--involves contact with mucous membranes of nose or mouth...happens during talking, coughing, suctioning. MAINTAIN 3FEET between infected patients and visitors.
Tuberculosis, pt is on isolation for 2-4 weeks (until there are 3 negative sputum cultures.)
Syphilis--painless chancre that fades within 6 weeks...on palms and soles there is a copper colored rash...spread by contact with mucous membranes and also congenitally...tx with penicillin G IM
AIRBORNE
Anthrax
Chickenpox/ Shingles
Influenza
Measles
Rubeola
Smallpox
TB
PPE: N95/Mask; room is (-) pressure; pt must wear mask when transported
DROPLET
Bacterial Meningitis
Mumps
Pertussus
Pneumonia
Rubella
PPE: Mask; pt must wear mask when transported
CONTACT
Chickenpox
Croup
Cdif
Ecoli
RSV
Scabies
VRE
PPE: Gown, gloves
Transmission-based Precautions: ADC
A - Airborne
D - Droplet
C - Contact
AIRBORNE PRECAUTION (credit goes to the one who posted this on April thread, sorry can't remember your name)
My - Measles
Chicken - Chickenpox
Hez - Herpes Zoster (Disseminated)
TB - TB
Private room
Negative pressure with 6-12 air exchanges per hour
UV
Mask
N95 Mask for TB
DROPLET PRECAUTION
think of SPIDERMAN!
S - Sepsis
S - Scarlet fever
S - Streptococcal pharyngitis
P - Parvovirus B19
P - Pertussis
P - Pneumonia
I - Influenza
D - Diptheria (Pharyngeal)
E - Epiglottitis
R - Rubella
M - Mumps
M - Meningitis
M - Mycoplasma or meningeal pneumonia
An - Adenovirus
Private room
Mask
CONTACT PRECAUTION
MRS.WEE
M - Multidrug resistant organism
R - Respiratory infection - RSV
S - Skin infections
W - Wound infections
E - Enteric infections - clostridium defficile
E - Eye infections
Skin Infections:
V - Varicella zoster
C - Cutaneous diptheria
H - Herpes simplex
I - Impetigo
P - Pediculosis
S - Scabies, Staphylococcus
Private room
Gloves
Gown
Mumps is respiratory precautions.
Rubella is keep away from pregnant women.
Scarlet Fever is respiratory precautions till 24 hr after therapy is started.
German Measles ( Rubella ) requires standard precautions and droplet precautions
thankou feliz3....that is means if I have a patient traeting deal with wake up from beth and I dont let him do it is enough for declared false imprisonment.....ok...thats was my dought
thankou feliz3....that is means if I have a patient traeting deal with wake up from beth and I dont let him do it is enough for declared false imprisonment.....ok...thats was my dought
again thankyou
I need a bit of clarification...I do not understand the meaning of the case scenario you're presenting. feliz3
I am done with my studying. Thanks for posting the wonderful information. I will take my exam tomorrow, we might get a bad storm, in our state. The pearson center might even close, Just pray I do my exam tomorrow. Thanks and bless your heart.
feliz , this site also helped me, i belive someone posted long time on this thread...
cdc guidelines for isolation precautions in hospitals
minnesota dept. of health
yale new haven hospital infection control manual
use airborne precautions for patients known or suspected to have serious illnesses transmitted by airborne droplet nuclei. these include:
measles (rubeola)
varicella (chicken pox) – requires contact prec. as well
herpes zoster (shingles), disseminated – requires contact prec. as well
tb
severe acute repiratory syndrome (sars)
airborne precautions include personal respiratory protection and special ventilation and air handling. airborne transmission occurs through either: airborne droplet nuclei (small particles, 5 micrograms or smaller, of evaporated droplets containing microorganisms that remain suspended in the air for long periods of time) or dust particles that contain an infectious agent.
microorganisms carried by the airborne route can be widely dispersed by air currents and may become inhaled by a susceptible host in the same room or over a long distance form the source patient – depending on environmental factors such as temperature and ventilation.
airborne precautions include standard precautions plus personal respiratory protection (n95 respirator) or powered air-purifying respirator (papr) and airborne infection isolation room (aiir). these rooms must, at a minimum, provide negative pressure with a minimum of 6 air exchanges per hour, and exhaust directly to the outside or through hepa filtration.
droplet precautions: droplets can be transmitted during coughing, sneezing, talking, and during certain procedures such as suctioning or bronchoscopy. droplets generally travel no further than 3 feet from patient. droplet precautions include standard precautions plus surgical mask worn when working within 3 feet of the patient.
in addition to standard precautions, use droplet precautions for patients known or suspected to have serious illnesses transmitted by large particle droplets. these include:
invasive haemophilus influenza (h.influenza), type b disease, including meningitis, pneumonia, epiglottitis, and sepsis
invasive neisseria meningitides disease, including meningitis, pneumonia, and sepsis
other serious bacterial respiratory infections spread by droplet transmission, including:
diptheria (pharyngeal)
mycoplasma pneumonia
pertussis
pneumonic plague
strep (group a) pharyngitis, pneumonia, or scarlet fever in infants and young children
serious viral infections spread by droplet transmission, including:
adenovirus
influenza
mumps
parvovirus b19
rubella (german measles)
contact precautions
in addition to standard precautions, use contact precautions for patients known or suspected to have serious illnesses easily transmitted by direct patient contact or by contact with items in the patient's environment. examples of such illnesses include:
gastrointestinal, respiratory, skin, or wound infections or colonization with multidrug-resistant bacteria judged by the infection control program, based on current state, regional, or national recommendations, to be of special clinical and epidemiologic significance
enteric infections with a low infectious dose or prolonged environmental survival, including:
clostridium difficile
for diapered or incontinent patients: enterohemorrhagic escherichia coli o157:h7, shigella, hepatitis a, or rotavirus
[*]respiratory syncytial virus, parainfluenza virus, or enteroviral infections in infants and young children
[*]skin infections that are highly contagious or that may occur on dry skin, including:
diphtheria (cutaneous)
herpes simplex virus (neonatal or mucocutaneous)
impetigo
major (noncontained) abscesses, cellulitis, or decubiti
pediculosis
scabies
staphylococcal furunculosis in infants and young children
zoster (disseminated or in the immunocompromised host)†
[*]viral/hemorrhagic conjunctivitis
[*]viral hemorrhagic infections (ebola, lassa, or marburg)
measles (rubeola)requiresstandard precautions and [color=#002163]airborne precautions. *no mask required if immune to measles. *note: all healthcare workers should have received 2 doses of the measles vaccine if born after 1957. if born prior to 1957, one is considered immune. limit transport of patient; if transporting is necessary, place n-95 mask on patient. private-negative pressure room required. duration of precautions: duration of illness
note: patient should be evaluated for evidence of concurrent (active) pulmonary tuberculosis. if evidence exists for active pulmonary tuberculosis [color=#002163]airborne precautions are required.
pulmonary tuberculosis, confirmed or suspected (including laryngeal disease) requires standard precautions and [color=#002163]airborne precautions. wear n-95/ hepa respirator prior to entering patient's room. limit transport of patient; if transporting is necessary, place n-95 mask on patient. private-negative pressure room required. duration of precautions: duration of illness
chickenpox (primary varicella zoster infection) requires standard precautions, [color=#002163]airborne precautions and contact precautions. negative pressure room required. *no mask required if immune to varicella. limit transport of patient; if transporting is necessary, place a n-95 mask on patient; all staff who have contact with patient during transport must be immune. contact precautions: don and remove gown and gloves upon entering and exiting pt’s room. dedicate non-critical pt care equipment. duration of precautions: maintain precautions until all lesions are crusted. the average incubation period for varicella is 10 to 16 days, with a range of 10 to 21 days. place exposed susceptible patients on airborne precautions beginning on the 10th day after exposure and continuing until 21 days after last exposure (up to 28 days if vzig has been given).
anthrax – cutaneous and anthrax-inhalational requires standard precautions. anthrax may be a disease indicating possible bioterrorism.
gastroenteritis, including cholera, e.coli, rotavirus, giardia, etc: requires standard precautions*but requires the use of contact precautions for diapered or incontinent patients including children under 6 years of age.
decubitis ulcer - majorrequires standard precautions and contact precautions. a major decubitus ulcer is one that is not contained by a dressing. duration of precautions: until wound heals over and stops draining. minorrequires standard precautions only.
diptheria – cutaneous and diptheria -- pharyngeal: standard and contact. duration of precautions: until off all antibiotics and until two cultures obtained 24 hours apart are negative.
arthropod-borne viral encephalitisrequires standard precautions. examples: west nile encephalitis, eastern equine encephalitis, western equine encephalitis, st. louis encephalitis, california (lacrosse) encephalitis
invasive hemophilus influenzae disease: ie: h. influenza meningitis, h. influenza epiglottitis: standard and droplet precautions. duration of precautions: until 24 hours of effective antimicrobial therapy has been given.
epstein-barr virus, including mononucleosis: standard precautions
fifth’s disease: standard and droplet, *but in an immunocompetent (normal) patient with acute disease, it is not communicable after onset of rash; thus, droplet precautions are not then necessary. duration of precautions for others: for an immunocompromised patient with chronic disease--duration of hospitalization. aplastic crisis or red cell aplasia (e.g. sick cell patients) --maintain droplet precautions for 7 days
leprosy (hansen’s disease): standard precautions.
hepatitis a, b, c, d, e: standard precautions, except for diapered/incontinent patients and type a.
impetigo: standard and contact. duration of precautions: until 24 hours after initiation of effective therapy.
kawasaki syndrome: standard precautions
legionnaire’s disease: standard precautions
meningococcal meningitis (due to neisseria meningitides): standard and droplet precautions.
pneumococcal meningitis: standard precautions
mumps: standard and droplet. duration of precautions: for 9 days after onset of swelling.
norwalk viral gastroenteritis: standard precautions *but requires the use of contact precautions for diapered or incontinent patients including children under 6 years of age. duration of precautions is duration of illness.
respiratory syncytial virus (rsv): standard and contact precautions. can be roomed with other rsv pts as long as there are no other significant organisms present (ie mrsa, vre, etc)
smallpox: standard, airborne, and contact precautions. smallpox is a public health emergency and may be a disease indicating possible bioterrorism. linen: all laundry should be placed in biohazard bags and autoclaved before laundering. patient transport requires approval of hospital epidemiologist or designee. duration of isolation: to be determined by hospital epidemiology.
typhoid fever, including salmonellosis—all salmonella species: standard *but requires the use of contact precautions for diapered or incontinent patients including children under 6 years of age for duration of illness.
whooping cough is pertussis; requires standard and droplet precautions. maintain precautions until 5 days after patient is placed on effective therapy.
I am done with my studying. Thanks for posting the wonderful information. I will take my exam tomorrow, we might get a bad storm, in our state. The pearson center might even close, Just pray I do my exam tomorrow. Thanks and bless your heart.
Certainly Sirisiri,
I have been praying for you and another person who told me she is siting on 12/18/08. I know you and her are ready. Thank you for the excellent information you just posted, Sirisiri. Remember that if the weather conditions do not allow you to sit for the NCLEX tomorrow, more power to you for you have an extra day to relax. Sit to take your test with joy and satisfaction for you are ready for it. Best, feliz3
important lab values taken from saunders 4th edition
author: linda anne silvestri
creatine kinase=creatine phosphokinase
it is a serum enzyme found in brain, cardiac and muscles that reflects tissue
catabolism (breakdown) resulting from cell trauma. ck levels begin to raise 6 hours after muscle damage and peaks at 18hrs and returns to normal in 2-3days. there are three ck isoenzymes(forms that a given enzyme could take).
note: exercising vigorously 24 hours before testing for ck levels or getting an im injection may falsely elevate ck levels. why? that's a critical thinking question
troponins=cardiac markers, increased amounts are released into the bloodstream.they are regulatory proteins found in skeletal and myocardial muscle when an mi causes damage to the myocardium.
lab values:
name normal value
1) ck 26-174 units/l
a) ck-mm=skeletal muscle 95%-100% of total number above
b) ck-bb= brain band 0%
c) ck-mb=myocardial band 0% - 5% of total
2) tropinin 1 > 0.6 ng/ml - 1.5 ng/ml
level elevates 3 hrs after an mi injury and remains elevated
for 7-10 days. normal value is usually lower than 0.6 ng/ml
3) troponin t > 0.1 ng/ml - 0.2 ng/ml
a higher level of this enzyme values is consistent with an mi
myoglobin= a protein found in cardiac and skeletal muscle. oxygen-binding protein which will be released to the bloodstream whenever there is a skeletal muscle injury. normal value is less than 90 mcg/l. the level will raise in two hours after an mi with a rapid decline in the level after 7 hours. it has limited use as a tool for diagnosing mi. what other reasons are there besides its time limitations? :redbeathe
23) white blood cells 4, 500 - 11,000 cells/cubic mm
wbc differential:
neutrophils 56% or 1,800-7800 cells/cubic mm
bands(immature neutrophils) 3% 0r 0-700 cells/cubic mm
eosinophils 2.7 % or 0-450 cells/cubic mm
basophils 0.3% or 0-200 cells/cubic mm
lymphocytes 34% or 1,000-4800 cells/cubic mm
monocytes 4% or 0-800 cells/cubic mm
note: a "shift to the left" means that an increased number of immature neutrophils are present in the blood, meaning bands which an indication of an aggressive infection going on or recovery from bone marrow depression. best, :zzzzz feliz3
rirsri
63 Posts
Kim, you are right, thats what i was thinking but i wasnt sure.