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
I have sent you a private msg. I hope all goes well with you. You are soo smart and am sure You will pass the nlcex. And continue to practice prioritization questions. YOu get that you pass the nlcex!! To all of you who are still waiting to take good luck and I will continue to pray for you guys.
Someone asked the following questions, but I do not remember who posted the questions and the post is no longer here...odd...The person wanted to know the reason why I chose the answers... anyway here are the questions and answers:
1) Blood gases were drawn at 7:00am on all four clients. None of the clients were on any type of Oxygen therapy and had not received any type of breathing treatment prior to the blood gases being drawn. Which blood gas results should be of greatest concern to the nurse?
a) 24 yr pneumonia client with pH=7.33, pCO2=49, pO2=90 and HCO3=26
b) 35 yr asthma client with a pH=7.37, pCO2=46, pO2=95, and HCO3=29
c) 45 yr with a chest tube and with a pH=7.40, pCO2=40, pO2=90 and HCO3=24
d) 65 yr with COPD and pH=7.35, pCO2=48, PO2=82 and HCO3=28
Before answering this type of questions I write down the normal values and compare them with the lab values given
Normal values:
pH= 7.35-7.45
pCO2= 35-45 mmHg
PO2=80-100 mmHg
HCO3=22-27 mEq/L
O2 saturation= 90-100%
By comparing values you can eliminate question C first because those values are normal
eliminate question d because it is compensated alkalosis
eliminate question b because it is compensated alkalosis
The answer is a that patient is in respiratory acidosis. I am open to corrections if I am wrong.
2) Which task would be the least appropriate to delegate a nursing assistant
a) feed a 10 month old a bottle who has crackles bilaterally, harsh, productive cough and in room air
b) help a 10 year old with cystic fibrosis, diminished breath sounds in the Right Lower Lobe (RLL) up to the bathroom
c) obtain vital signs of a 9 yr who was admitted yesterday for acute asthma exacerbation
d) obtain the respiratory rate of a 6 week old infant who was admitted two hours ago with a respiratory rate of 64
I am not sure but to me the most predictable outcome of all these clients is the nine year old with cystic fibrosis which is item B for all the other clients are outside of the scope of what a nursing assistant can do due to unpredictability of outcomes for all other clients. The rest of the choices involved assessment, critical observation and judgment tasks which are for the registered nurse, only. If you disagree, please do let me know, the reason so I learned something, too. Thanks, feliz3
How to analyze any blood gas question on the NCLEX
Memorize these normal values:
pH = 7.35-7.45
PCO2 = 35-45 mmHg (acidic) ---respiratory function indicator
HCO3 = 22-26 mEq/L (basic or alkaline) ----bicarbonate ion (HCO3-) is the metabolic function indicator
pO2 = 80-100 mmHg
02 saturation = 90-100%
Oxigen/hemoglobin curve: no shift is the normal
In acidosis in acidosis the pH is decreased compared to the normal value
In alkalosis the pH is elevated compared to the normal value
First Step:
LOOK at the pH
a) is it elevated?----alkalosis
b) is it decreased?---acidosis
Second Step--determine whether it is a respiratory or metabolic imbalance
LOOK at pCO2elevated or decreased compared to the normal value?
a) if pCO2 is elevated but pH is decreased (opposite relationship between pCO2 and pH compared to their respective normal values)----respiratory imbalance
pCO2 and pH do not have opposite relationship? --- move to the third step
Third Step--determining a metabolic imbalance
LOOK at the bicarbonate ion HCO3- (metabolic function indicator)
do HCO3 and pH are both elevated? --- metabolic imbalance
Note: Compensation has taken place if the pH is in the normal range of 7.35-7.45. If the pHis not within the normal range you need to look at pCO2 (respiratory function indicator) and HCO3 (metabolic function indicator)
Step Four --- determining the state of compensation
Respiratory Imbalance ---look at HCO3 to the determine the state of compensation
a) if pH is low, pCO2 is elevated but HCO3 remains normal ---uncompensated respiratory acidosis
b) if pH is on the normal range and pco2 is normal but HCO3 is abnormal --- compensated respiratory imbalance
Metabolic Imbalance
a) Look at the pCO2 value to determine the state compensation
a) if pH and HCO3 reflect a corresponding relationship both either low or elevated but pCO2 is normal the metabolic imbalance is uncompensated.
b) pH and HCO3 are normal but PCO2 is abnormal the metabolic imbalance is compensated
analize the following: Client brought to ER for has been vomiting for three days. Nurse noticed the client was hypoventilating with a respiratory rate of 6 breaths/minute. Blood gasses value were the following. What do you think is happening with this client?
Guyz can anyone help me i'm confuse with this: After receiving extensive abdominal surgery, He has 1000 ml of LRS infusing via a central line. The Dr. orders the i.v fluid to be infused at 125 ml/hour plus the total output of the previous hour. The drip factor of the tubing is 15 gtt/minute and the output for the previous hour was 75ml via foley cat., 50 ml via ngt, and 10 ml via jackson prat tube. for how many drops per minute should the nurse set the i.v flow rate to deliver the correct amount of fluid? Answer in a whole number.
answer ____gtt/min.
Can someone answer it and i will compare on my answer, seems confusing, please include the solution. thanks.
The Dr. orders the i.v fluid to be infused at 125 ml/hour plus the total output of the previous hour. The drip factor of the tubing is 15 gtt/minute and the output for the previous hour was 75ml via foley cat., 50 ml via ngt, and 10 ml via jackson prat tube. for how many drops per minute should the nurse set the i.v flow rate to deliver the correct amount of fluid? Answer in a whole number.
answer ____gtt/min.
Can someone answer it and i will compare on my answer, seems confusing, please include the solution. thanks.
The correct formula is Volume in ML/time in minutes X drop factor
Someone asked the following questions, but I do not remember who posted the questions and the post is no longer here...odd...The person wanted to know the reason why I chose the answers... anyway here are the questions and answers:
1) Blood gases were drawn at 7:00am on all four clients. None of the clients were on any type of Oxygen therapy and had not received any type of breathing treatment prior to the blood gases being drawn. Which blood gas results should be of greatest concern to the nurse?
a) 24 yr pneumonia client with pH=7.33, pCO2=49, pO2=90 and HCO3=26
b) 35 yr asthma client with a pH=7.37, pCO2=46, pO2=95, and HCO3=29
c) 45 yr with a chest tube and with a pH=7.40, pCO2=40, pO2=90 and HCO3=24
d) 65 yr with COPD and pH=7.35, pCO2=48, PO2=82 and HCO3=28
Before answering this type of questions I write down the normal values and compare them with the lab values given
Normal values:
pH= 7.35-7.45
pCO2= 35-45 mmHg
PO2=80-100 mmHg
HCO3=22-27 mEq/L
O2 saturation= 90-100%
By comparing values you can eliminate question C first because those values are normal
eliminate question d because it is compensated alkalosis
eliminate question b because it is compensated alkalosis
The answer is a that patient is in respiratory acidosis. I am open to corrections if I am wrong.
2) Which task would be the least appropriate to delegate a nursing assistant
a) feed a 10 month old a bottle who has crackles bilaterally, harsh, productive cough and in room air
b) help a 10 year old with cystic fibrosis, diminished breath sounds in the Right Lower Lobe (RLL) up to the bathroom
c) obtain vital signs of a 9 yr who was admitted yesterday for acute asthma exacerbation
d) obtain the respiratory rate of a 6 week old infant who was admitted two hours ago with a respiratory rate of 64
I am not sure but to me the most predictable outcome of all these clients is the nine year old with cystic fibrosis which is item B for all the other clients are outside of the scope of what a nursing assistant can do due to unpredictability of outcomes for all other clients. The rest of the choices involved assessment, critical observation and judgment tasks which are for the registered nurse, only. If you disagree, please do let me know, the reason so I learned something, too. Thanks, feliz3
hello feliz3
the answer is d. although the assistant can technically count
respirations per minute, the infant's initial respiratory rate of 64 indicates a need for further
respiratory assessment that only the RN can perform
speaking about acidosis and alkalosis...could anybody answer my question if pt. with hyperemesis gravidarum suffers with acidosis from ketosis ( using fat as an alternative to glucose - vomiting ) or alkalosis from loss of hydrogen from prolonged vomiting. There are assessments findings: metabolic acidosis, fruity breath. In diagnostic evaluation is: ABG analysis reveals alkalosis, urine ketone levels are elevated. I don't know to find the connection... Thanks
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)
feliz3
382 Posts
Absolutely, I will have you on my prayers, and all the others who, like me, continue getting ready to sit. Best, feliz3