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
hi all! i'm happy to find this thread. i'm a slow reader and so it will take time for me to read all the 262 pages and counting... keep throwing the "facts", guys! so far, i love the tip about psychotropic drugs and CNS stimulant/depressant. somehow, i get lost with psychotropic drugs and its side effects because there's so many of them.
feliz3 - it's on page 258/259. i think, it's more like a general tip/strategy in regard to psychotropic drugs/meds. you particularly mentioned to pay attention to it. thanks to you!
1) Air Embolism= a bolus of air that enters the vein through an inadequately primed IV line, from a loose connection, during tubing change or during removal of the IV
a) tachycardia
b) dyspnea
c) hypotension
d) cyanosis
e) decreased level of consciousness (LOL)
f) loud churning sound heard over the pericardium that results from air in the right ventricle may be audible
even without the stethoscope
Air Embolism Prevention
prime IV tubing with fluid before use, and monitor for any air bubbles in the tubing
secure all connections
replace the IV fluid before the bag is empty
if the client has a catheter for tube feeding, clamp it when not in use
instruct the client on Valsalva maneuver for tubing and cap replacements
for tubing and cap changes place the client in Trendelenberg position with the head turned in the opposite direction of the insertion site---insertion site is in the right side
What to do if air embolism is suspected
1) clamp the tubing
2) turn the client to left side with the head of the bed lowered (Trendelenberg) to trap the air in the right atrium
3) notify the physician
4) give oxygen as needed
5) take the client's vital signs
6) documment the occurrence and actions taken
2) Catheter Embolism=An obstruction that results from breakage of the catheter tip during the IV line insertion or removal
a) decreased blood pressure
b) pain along the vein where the IV has been placed
c) weak, rapid pulse
d) cyanosis of the nail beds
e) loss of consciousness (LOC)
What to do if catheter embolism is suspected
1) Remove the catheter carefully
2) Inspect the catheter when removed
3) If the catheter tip has broken off, place a tourniquete as proximally as possible to the IV site on the affected limb
4) Notify the physician immediately
5) Obtain an x-ray to see the location of the broken off tip
6) Prepare the client for surgery to remove the catheter piece(s) if necessary
3) Use an infusion pump and frequently check the drip or pump rate setting particularly in clients at risk of hypervolemia such as cardiac heart rate and kidney failure clients
4) Add a time strip to the IV bag or bottle
5) Monitor for signs of circulatory overload
What to do if fluid overload is suspected?
1) decrease the flow rate to a minimum, at a keep vein open rate
2) elevate the head of the bed
3) keep the client warm
4) assess lung sounds
5) assess for edema
6) notify the physician
7) document assessment and actions taken
4) Electrolyte Overload= Caused by too rapid or excessive infusion or by the use of an inappropriate IV solution.
--Signs depend on the specific electrolyte overload imbalance--
Memorize all the electrolytes and their signs and symptoms observed
whenever there is hyper/hypo amount of a specific electrolyte in the blood
Prevention/Interventions of Electrolyte Overload
a) assess lab values reports
b) verify it is the correct solution to be given what you are looking at
c) calculate and monitor the flow rate
d) use an infusion pump and frequently check the flow rate or pump setting
e) add a time strip (label) to the bag or bottle
f) place a medication sticker on the bag or bottle if a medication such as KCL, has been addedto the IV
solution
g) monitor for signs of specific electrolyte imbalances and notify the doctor if that is happining
5) Hematoma=the collection of blood in the tissues after an unsuccessful venipuncture or after the venipuncture site is discontinued and blood continues to ooze into the tissue
a) ecchymosis, immediate swelling and leakage of blood at the site of the IV
b) hard and painful lumps at the IV site.
Prevention/Interventions for Hematoma
a) when starting an IV, avoid piercing the posterior wall of the vein
b) do not apply a tourniquet to the extremity immediately after an unsuccessful venipucture
c) when discontinuing an IV, apply pressure to the site for at least one minute an elevate the extremity, apply
pressure for clients who are taking anticoagulants, or with bleeding disorders
d) If hematoma develops, elevate the extremityand apply pressure and ice as prescribed
e) monitor for signs of hematoma
6) Infection= * (read Note)
a) local infection: redness, swelling, and drainage at the IV site--monitor this for you do not want a local infection to become systemic
b) systemic(sepsis): chills, fever, malaise, headache, nausea, vomiting, backache and tachycardia--Watch for this forit is life threatening :uhoh21:
* Note: An IV puncture provides a route for entry for microorganisms into the body. Therefore, sterile technique is critical for anything which travels by the IV route enters the bloodstreamimmediately. The longer the IV therapy continues the greater the risks for infection. Therefore, infection assessment and prevention is a top priority.
Preventing Infections at an IV Site
Wash hands thoroughly before inserting an IV line and before working with an IV line
Use sterile technique when inserting an IV line and when changing the dressing over the IV site
When inserting an IV line, clean the skin with an antimicrobial solution, using inner to outercircular motion (or per agency policy) per NCLEX it is inner to outer circular motion
Change the venipuncture site every 48-72 hours (per NCLEX)
Change the IV dressing every 72 hours or whenever the dressing is wet or contaminated or as specified by your employer
Change the IV tubing every 24-72 hours (per NCLEX)
Label the tubing, dressing and solution bags clearly indicating the date and time when last changed
Do not let an IV tubing touch the floor becauseof the potential for bacterial contamination and possibly sepsis
Before adding medications to IV solutionsgiven to a client, swab the access ports with 70% alcohol, another equally effective solution
Do not let an IV bag or bottle of solution hang formore than 24 hours because of the potential for bacterial contamination and possibly sepsis
Never place a restrain over a venipuncture site--safety issue--
When administering an IV solution which requires a filter, such as lipids, albumin or blood components, change the filter every 24-72 hours (per NCLEX) to prevent bacterial growth in the filter
assess for predisposition to infections
monitor white blood cells counts
check fluid containers for cracks, leaks, cloudiness and/or other evidence of contamination
use antimicrobial ointment at the IV site
differentiate a local infection from a systemic infection--how would you do that?
if infection occurs discontinue IV immediately, place the venipucture devicein a sterile container for possible culture, call the physician
DOCUMENT EVERYTHING you have done to prevent an infection at the IV site
prepare to obtain blood cultures as prescribed if there is an infection in the IV site
restart an IV in the opposite arm to differentiate sepsis=systemic infection from a local infection at the IV site
At-Risk Clients for Infection
the immunocompromised clients already debilitated with diseases such as the flu, cancer or AIDS
clients receiveing such as chemotherapy who have an altered or lowered WBC
older clients because aging alters the effectiveness of the immune system which places the edlerly at risk for infection
the very young for not having a fully developed immune system
7) Infiltration=a form of tissue damage; it is also called extravasation, seepage of the of IV fluid out of the vein and into the surrounding interstitial spaces; disloging of the vein access device or perforation of the vein wall or when venous backpressure occurs bacause of a clot or a venospasm
a) edema
b) pain
c) coolness at the IV site, it may/may not have blood return
Prevention/Interventions for Infiltration
a) avoid venipunture over an area of flexion
b) anchor the cannula and a loop of tubbing securely with tape
c) use an armboard or splint as needed is the client is restless or active
d) assess the IV site for signs of inflitration and coolness compairing it with the opposite extremity
e) monitor IV for a decrease or cessation of flow
f) evaluate the IV site for infiltration by occluding the vein proximal to the IV site. If the IV fluid continues
to flow, the IN cannula is probably outside the veir or infiltrated. If the IV flow stops after the occlusion
of the vein, the IV device is in the vein, still.
g) lower the IV fluid container below the IV site, and and monitor for the appearance of bllos in the IV tubing,
if blood appears in the tubing, the IV is most likely in the vein
What to do if infiltration occurs
1) Remove the IV device, immediately
2) Do not rub the inflitrated area for it can cause a hematoma
3) Elevate the extremity
4) Apply compresses (warm or cool depending on the IV solution that was infusing per doctor's order) over
the affected area
5) Document the assessment of the infiltration, its effects and the actions taken
8) phlebitis=inflammation of the vein
a) heat
b) redness and tenderness at the IV site
c) skin at the IV site is not swollen or hard
d) intravenous infusion sluggish
What to do if phlebitis occurs
1) If phlebitis occurs remove the IV device immediately and restart it in the opposite extremity
2) Notify the doctor if phlebitis is suspected and apply warm moist compresses, as prescribed
3) Document the assessment for phlebitis, its effects and actions taken
9) Thrombophlebitis=development of a clot due to the inflammation of the vein
a) hard cord like vein where the IV is placed
b) heat, redness tenderness at the IV site
c) intravenous infusion sluggish
What to do if thrombophlebitis occurs
1) Never irrigate the catheter--why so?
2) remove the IV
3) notify the physician
4) document the assessment for thrombophlebitis, its effects and actions taken
Prevention/Interventions for Phlebitis and Thrombophlebitis
a) use an IV cannula smaller than the vein
b) avoid using lower extremities (legs/feet) as an access area for starting an IV line--why so?
c) avoid venipuncture over an area of flexion
d) anchor the cannula and loop the tubing securely with tape
e) use an armboard or splint if needed if the client is restless or active
f) change venipuncture site every 48-72 hours (per NCLEX)
10) Tissue Damage=kinds of tissue most commonly damaged includes the skin, veins, and subcutaneous tissue;
it is uncomfortable for the client and cause permanent negative effects such as thickly scarred skin
a) skin color changes
b) sloughing of the skin
c) discomfort at the IV site
Prevention/Interventions for Tissue Damage
a) use a careful and gentle approach when applying the tourniquet
b) avoid tapping the skin over the vein when starting the IV line since the skin in this condition is sensitive
to pain
c) monitor for ecchymosis when penetrating the skin with the cannula
d) assess for allergies to tape and/or dressing adhesive
e) monitor the skin for signs of tissue damage
f) notify the doctor if tissue damage is suspected
g) document the assessment for tissue damage and its effects
Following the death of a female client who is Muslim, the nurse should plan on providing the family with: postmortem care of the body by a female nurse.-- The Muslim culture believes that the same sex should provide care after death.
For a child with arthritis associated with rheumatic fever, the joints are usually so tender that even the weight of bed linens can cause pain. Use of a bed cradle is recommended to help remove the weight of the linens on painful joints.
Sickle cell disease is an inherited disease that is present at birth. However, 60% to 80% of a newborn's hemoglobin is fetal hemoglobin, which has a structure different from that of hemoglobin S or hemoglobin A. Sickle cell symptoms usually occur about 4 months after birth, when hemoglobin S begins to replace the fetal hemoglobin.
The anemia seen in children with leukemia is caused by the bone marrows over production of immature white blood cells at the expense of producing red blood cells and platelets.
The most commonly used site for bone marrow aspiration in children is the posterior iliac crest, the back of the hipbone. This area is close to the body's surface but removed from vital organs. The area is large, so specimens can easily be obtained. For infants, the proximal tibia and the posterior iliac crest are used. The middle of the chest or sternum is the usual site for bone marrow aspiration in an adult.
Cardiac status must be monitored carefully in the initial phase of KD(KAWASAKI DISEASE) because the child is at high risk for congestive heart failure. Therefore, the nurse needs to assess the child frequently for signs of congestive heart failure (CHF), which would include respiratory distress and decreased urine output.
The first sign of opiod withdrawal—Diaphoresis. It can occur between 6-12 hours. Abdominal cramping, fever and nausea may occur later between 48-72 hours.
Swimming is an ideal activity for a child with hemophilia because it is a noncontact sport. Many noncontact sports and physical activities that do not place excessive strain on joints are also appropriate.
Ibuprofen prolongs bleeding time and is contraindicated in clients with leukemia. Non-narcotic drugs other than ibuprofen or aspirin, such as acetaminophen (Tylenol), may be prescribed to control pain. Narcotic analgesics, such as acetaminophen with codeine or propoxyphene hydrochloride, may be required when pain is severe.
As the hemophilic infant begins to acquire motor skills, the risk of bleeding increases because of falls and bumps. Such injuries can be minimized by padding vulnerable joints.
Bleeding into the joints in the child with hemophilia leads to pain and tenderness, resulting in restricted movement. Therefore, an early sign of hemarthrosis would be the child's reluctance to move a body part.
In children, cardiac catheterization usually involves a right-sided approach because septal defects permit entry into the left side of the heart. The catheter is usually inserted into the femoral vein through a percutaneous puncture.
I've just told Sirisiri in a private message that today I changed the date to take the NCLEX from February 18th to March 31st because there is a strong possibility that I may have to have surgery on my right eye. This month I am consulting another ophthalmologist for second opinion on that issue...in the meantime, I continue developing stronger skills in critical thinking and prioritization for that is what the NCLEX is all about. Best, feliz3 :heartbeat
Osmosis=the movement of a pure solvent, such as water, through a semipermiable membrane from an area of lesser concentration of particles to an area of greater concentration of particles in an attempt to equalizeconcentrations in both sides of the membrane.
These are the hypotonic solutions
1) 0.45% saline (1/2 NS)
2) 0.225% saline (1/4 NS)
3) 0.33% saline ( 1/3 NS)
A hypotonic solution has less concentration of particles in solution than the concentration of particles in the body fluids. Therefore, body fluids have a higher concentrationof particles relative to any of these three hypotonic solutions.
If you have to give an IV of a hypotonic solution (per doctor's order) administer it SLOWLY to prevent cellular edema
Question a doctor's order to give an IV of a hypotonic solution to an edematous client with CHF or renal failure
These are the hypertonic solutions
1) 3% saline (3% NS)
2) 5% saline ( 5% NS)
3) 10% dextrose in water ( D10 W)
4) 10% dextrose in water in 0.9% saline ( D5 W/NS)
5) 5% dextrose in 0.45% saline (D5 W/1/2 NS)
6) dextrose in Lactated Ringer's solution
Hypertonic solutions are used to treat hypovolemia, as in massive blood or fluid loss, when plasma expanders such as Dextran or albumin are not available
Hypertonic solutions have a higher concentration of particles relative to body fluids
These are the isotonic solutions
1) 0.9% saline (NS)
2) 5% dextrose in water ( D5 W)
3) 5% dextrose in 0.225% saline (D5 W/1/4 NS)
4) Lactated Ringer's (also known as) Hartmann's solution
Components of Lactated Ringer's solution:
a) lactate ion = C3H5O3- in combination with sodium
b) NaCl, KCl, CaCL2, NaC3H5O3 (sodium lactate)
Lactated Ringer's solution is contraindicated in clients with kidney failure, CHF and hypoproteinemia---why?
isotonic solution have the same osmolality (concentration) of body fluids
isotonic solutions do not enter the cells because no osmotic force exists to shift body fluids
isotonic solutions are used to increase the extracellular (outside the cell) fluid volume
the normal adult osmolality (concentration of plasma fluid)= 270-300mOsm/Kg of water
To assess the median nerve status, the client should be instructed to grasp the nurse's hand. The nurse should note the strength of the client's first and second fingers. A weak grip may indicate compromise of the median nerve. Asking the client to move the thumb toward the palm and back to neutral position is assessing the radial nerve status. Asking the client to spread all fingers wide and resisting pressure is assessing the ulnar nerve status. Monitoring for flexion of the beceps by raising the forearm is assessing for cutaneous nerve status.
An asymmetry of facial features is specific to cranial nerve VII, the facial nerve. A difficulty in swallowing is associated with CN IX (glossopharyngeal). Loss of smell is common with injury to CN I (olfactory). Ptosis occurs with damage to the CN III (oculomotor). Cranial nerve X is the vagus nerve and is responsible for the gag reflex.
PT and PTT tests should be evaluated to determine the effectiveness for receiving fresh plasma.
Alcoholic (Laennec's) cirrhosis is associated with alcohol abuse. Post necrotic cirrhosis is the results of a toxic substance. Chronic biliary obstruction may cause biliary cirrhosis. Cardiac cirrhosis may result from a long-standing right-sided heart failure.
Following a craniotomy, the best position to have the client in is to keep the head of the bed elevated 30 degrees to prevent increased intracranial pressure.
The normal respiratory rate for a newborn infant is 30 to 60 breaths per minute. Tetany is the major sign of hypoparathyroidism.
With intrinsic renal failure, there is a fixed specific gravity and the urine tests positive for proteinuria. In postrenal failure, there is a fixed specific gravity and little or no proteinuria. In prerenal failure, the specific gravity is high, and there is very little or no proteinuria.
The four physical defects of the heart in Tetralogy of Fallot include overriding aorta, right ventricular hypertrophy, ventricular septal defect, and pulmonary valve stenosis.
The stomach capacity of a newborn infant is approximately 10 to 20 ml. It is 30 to 90 ml for a 1 week old infant, and 75 to 100 ml for a 2 to 3 week infant.
I've just told Sirisiri in a private message that today I changed the date to take the NCLEX from February 18th to March 31st because there is a strong possibility that I may have to have surgery on my right eye. This month I am consulting another ophthalmologist for second opinion on that issue...in the meantime, I continue developing stronger skills in critical thinking and prioritization for that is what the NCLEX is all about. Best, feliz3 :heartbeat
God bless you on your surgery and exam Feliz3.
Yes, just continue practicing but remember not to put too much strain on that eye. :)
The longer the IV therapy continues the greater the risks for infection. Therefore, infection assessment and prevention is a top priority.
Best, feliz3 :heartbeat
feliz3
382 Posts
Which page number is that? Thanks, feliz3