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
pt with increased icp => lumbar puncture is contraindicated b/c risk of brain herniation
if pt states "i have a constant throbbing headache! this is the worst headache i ever had" => may be having icb (intracranial bleeding); assess pt for increased icp, and of course notify md
cardinal sign of increased icp => change in loc (level of consciousness)
but normal saline would be ordered before you start the blood because before you infuse the blood product you would run normal saline through the line first. for a hemolytic reaction you wouldnt flush the tubing because the bad blood is still in there..it would be flushed right into the pt (we dont want that)...you would take down the blood tubing and infuse normal saline through primary tubing. the other actions are correct like sending the blood to the lab and the urinary cath because of renal involvement possibly. as for the doctors order if it is an emergency situation you dont have time to wait on an order for saline like in cases of shock, anaphylaxis, etc. thats when the nurses judgement would come in. i hope i dont get one like that on the boards it can get confusing. in my opinion they need to make just one nclex book so all the info would be the same.
some NS before blood is correct. (2 bags -PC &NS), but the Focus of the Qs was on actions if Hemolitic reaction occurs. you did stop PC, changed tubing and sent it to bank, got UA, but then ...some sources ...whether to Infuse NS or make IV lock...mosby say IV lock.
basically (in real life) perhaps nothing bad will happer if one nurse give NS in this particular case, to fight shock.
But in ideal world nurse should do nurse measures to treat shock and start with positioning , safety, ABCD, keep patent IV. while one does this, Dr may arrive (I hope so;))
just one thing about this treatment= this is an "old school" treatment of dic that does not work in every case. the way to resolve dic is to stop the problem that is causing it.
example- i had a patient in the or last year who was 8 mo pregnant and fell and broke her arm on her childs toy. the arm was fixed at hospital a, and she went on her way until 8 days later when she came to hospital b and collapsed in the er. she was rushed to us in surgery at hospital b where she had a c-section to save the baby and we found a huge liver laceration (like 8 cm long). platelets....16,000 yeah that number is correct 16,000. so doc infused every blood product that we could get our hands on and we packed sponges over the liver to keep it from bleeding more, left the sponges in and sent her to icu to get some supportive measures until she was stable enough to come back down to the or. we all had tried to think of everything possible to get her to stop bleeding and i even asked about heparin but the doc said that is an old treatment and it is not appropriate for every patient and that you had to fix the injury for the body to come out of dic.
good point, but that's not how it shows up on the test. what's done in real life doesn't matter when we're taking nclex.
for the purposes of this forum we have to go with the information as it will appear on nclex.
i wish i had found this forum weeks ago. i take my test today!!!!
some NS before blood is correct. (2 bags -PC &NS), but the Focus of the Qs was on actions if Hemolitic reaction occurs. you did stop PC, changed tubing and sent it to bank, got UA, but then ...some sources ...whether to Infuse NS or make IV lock...mosby say IV lock.
basically (in real life) perhaps nothing bad will happer if one nurse give NS in this particular case, to fight shock.
But in ideal world nurse should do nurse measures to treat shock and start with positioning , safety, ABCD, keep patent IV. while one does this, Dr may arrive (I hope so;))
Remember....The NCLEX tower of nursing, stick to it. Don't ever apply the real world of nursing with NCLEX. :zzzzz
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Jack_ICU
288 Posts
few quick facts...
later...