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....

[fmAtoZ&backagain]

Nitroglycerin

• a cholinergic blocking agent may delay the sublingual absorption of nitroglycerin because of dry mouth .
• verapamil reduces afterload and with concurrent use of nitroglycerine can cause (increase) hypotension.
• nitroglycerine causes vasodilation=increase iop
• do not give when bp is
• in empty stomach - avoid alcohol.
• discard unused nitroglycerine tablets 3-6 months after bottle opened (spray nitroglycerin can last longer) & obtain new prescription. tingling or burning sensation under your tongue or flushing or warmth in your face and neck-not everyone feels these effects, some do not give that efect
• avoid exposed of pills to heat, moisture, or air for long periods of time
• se: throbbing ha (acetaminophen/ibuprofen can be used), flushing skin, dizziness, fainting,
• viagra=no nitroglycerin
• long-term nitrates, you may need to take them at uneven intervals throughout the day to prevent nitrate tolerance (lose ability to vasodilate. does not occur with fast-sublingual nitro)
• nitrates can also relieve chest pain due to prinzmetal's angina and syndrome x.

[fmAtoZ&backagain]

Celexa (citalopram):

- ssri (antidepressant, eating disorders, alcoholism, panic disorder, social phobia).

- feel the benefit of his action in 3-5 wks

- weight gain

- decrease libido and/or anorgasmia.

- suicide risk in youth (at the beginning or when dose is increased)

- overdose: vomit, sedation, arrhythmia, sweats, coma.

- may give a withdrawal (discontinuation syndrome? do not stop suddenly o give 20 mg prozac.

- cross-reaction with lexapro. interact with st john’s wort & tryptophan à serotonin syndrome (v-sindic: maois).

- increase bleeding w nsaids, coumadin

[fmAtoZ&backagain]

grapefruit – don’t take with (interact with p450 – cyp3a4)

- benzo’s (zolam,zepam)

- ritonavir (proteasa inhivitor)

- sertraline

- buspirone (buspar) – increases levels

- ccb – verapamil (celan) – increase dose

- carbamazepine (tegretol ) – increase dose

- statins - simvastatin – increased risk of rhabdomyolyis

- ace-I - losartan

- antiarrhytmics: amidarne, dronedarone, quinidine, disopyramide – increase qt interval

- cyclosporine – increase dose

- omaprazole

- methadone – increase dose

[kibriab]

I am trying to get a person taking nclex-rn just for sharing information one another ,if any body willing please post me and I will reply as soon as I can.

[Murze]

Hi guys, I just wanna thank this forum for being a great help on my review, I took my exam last Aug 3 and did the pearsonvue trick and got the good pop up:yeah:, I still coudn't believe that I've pass cause I'm sleepy when I took the test, I couldn't remember what hep c is, LOL,. I coudn't sleep the day before I took my exam, I think it was 4am when I slept, good thing I scheduled my exam at 1pm, I saw my name on the ca brn site and later on they sent my license. Just think positive guys, everyday face yourself in the mirror and tell to yourself I can do it, always stay focused and always pray to god.

[Carebear77]

This thread is awesome. I read every post and I took my nclex-RN the other day and because of this thread I was able to answer some questions I wouldn't have had the answer to and I passed my exam :) Thanks so much for posting this thread and those who gave great stuff to remember. :)

[fmAtoZ&backagain]

shared by: schalke20

rn

- invasive procedure = i am rn educated

- initial/comprehensive/baseline (assessments)

- assess (frequent/ongoing =unstable patients)

- managing and leading client care environment

ex. clients who are in severe and refusing meds (needs more assessment)

- review

- nsg process/ nsg judgement use (apie= assessment,planning, implementation,evaluation)

- encourage

- develop

- use of iv meds (ex. plasma, blood products-- these and iv are done by rn only)

- consult/counsel/suggest & update

- admission .. new & post op

- teach

- educate

- discharge & admission preparation

lpn/lvn-

-certain invasive task =i-sound star cross ++

- im adm

- sq adm.

- oral meds adm

- urinary catheterization

- nitroglycerin

- dreassing of wound (changing & irrigating) very commonly seen q.

- suctioning

- tube feeding

- auscultate/listen

- routine/standard

- check(s)

- reinforce/remind

- observe

- set up (basic equipment)

- specimen collection & data colletion

+

-blood glucose readings

-monitor

-review/teach-- usually standard practices (hand washing/hygiene) or med administration (ie. eye drops) -- rn mostly teaches/educated and lpns reinforce

+

cast & toe amputation are stable clients and need on going assessment and pain mgt./la charity book(don’t know too..just dont deprive with it.. just follow the book

data collection such as listening to lung sounds & checking for peripheral edema_part of lpn scope of practice: /lacharity book

** don't assign lvn/lpn to do a task an nurse assistant can complete**

nursing assistant/uap- unlicense assistive personnel

- non invasive procedure/basic care =sparrtacus groam +++

-skin care (ex. bed rest with a skin tear and hematoma from a fall 2 days ago, apply and care for a client’s rectal pouch )

-positioning-- special positioning-- requires initial education by rn -- assistant will assist not teach

-ambulation/ assisting with adl (ambulation of fractured hip only rn& pt) ( patienst with chestube ambulating the hall-lpn/lvn)

-recording & monitoring of v/s (bp,pulse, oxygen sat,)

-range of motion &exercise

-transport of client

-assist (assisting for prep for sitz bath)

-collection of

-urine &

-stool

-groam (groaming & hygiene measure, bathing & checking water temp)

+

weighting

intake & output

feeding

+

- remind/reinforce: usually reminds pt. to do something rather than how to do it (skills previously taught by other health care professional or precaution measures)***

- they can detach suction and remove a foley but not connect or insert

- gather (equipment)

+

- measurement of ankle and bracial blood pressure for ankle brachial index calculation.(calculated already)

( calculation on the ankle-brachian index is responsibility of rn)

-experienced nsg assistant should have been taught how to..

monitor apical pulse, however, the rn should observe to be sure that s/he mastered this skills.

---la charity book---

new rn

-education and hospital orientation includes.. safe administration of iv meds.

-stable patients

some key points:

patients that require teaching about drugs or need procedures done are not rn priority.

physician

-informed consent

-medical diagnosis

-prescriptions

-order procedures

avoid these assignments for new/float/lvn/lpn/traveling

-new onset/sudden/acute

-new admission

-transfer

-newly diagnosed

-discharge

-require education/teaching (beyond basic skills -- tend to be complex and specific to patients on that particular unit)

- unstable (ie. high risk of sudden respiratory failure, or requires frequent assessments and changes in therapy(like electrolyte imbalances)

give:

- chronic

- routine meds/procedures

- stable

all healthcare workers

- responsible for knowing about and implementing standard precautions + airborne/droplet/contact --> therefore all can teach about it or prepare a room for it

[fmAtoZ&backagain]

addendum to delegation, prioritization

delegations rights

right task

right person

right time

right information

right supervision

right follow-up

5 rights of delegation

right task

right person

right circumstance

right communication

right feed back

do not delegate

total control

discipline issues

confidential tasks

technical tasks

controversial tasks

during a crisis

do not delegate what you can eat!

e - evaluate

a - assess

t - teach

only the RN should do this...hope that helps

lvn

-can determine normal and anormal

-knows how to make procedures.

-can be delegated care for stable pt's with expected outcomes

cna

- delegate tasks that involve standard unchanging non sterile procedures

if a RN comes from another unit, give that RN a pt who does not need to have a RN from specific unite care for him/her. ex. --post op mastectomy needs an onco nurse to take with.

for delegating: lvn / float RN = with stable pt with predictable outcome

assessment, teaching, meds, evaluation, unstable patient cannot be delegated to an unlicensed assistive personnel.

lvn/lpn cannot handle blood.

delegation--if you are assigning pt care to lpn/na, rank order the pt as to the ones who have the least acute problems/changes to the most

uap= unlicensed assistive personnel

ask yourself:

1) are the and rules in place which support the delegation?

a) yes---go to step 2

b) no--- do not delegate

2) is the task to be delegated within the scope of practice of the RN/lpn?

a) yes---got to step 3

b) no---do not delegate

3) is the RN/lpn has the knowledge and experience to make delegation decisions?

a) yes---go to step 4

b) no---do not delegate. action to take: provide education and document education provided

4) has there been assessment of the client's needs?

a) yes---move to step 5

b) no---assess client's needs first, then proceed with considerations to delegations

5) is the uap competent, has the experience to accept the delegation?

a) yes---move to step 6

b) no---do not delegate. action to take: provide education and document the education given to the uap

6) does the ability of the care giver match the care needs of the client?

a) yes---go to step 7

b) no---do not delegate

7) can the task to be delegated be performed without requiring nursing judgment?

a) yes---move to step 8

b) no---do not delegate

? are the results of the task reasonably predictable?

a) yes---move to step 9

b) no---do not delegate

9) can the task be safely performed according to exact, unchanging directions?

a) yes---move to step 10

b) no---do not delegate

10) can the task be safely performed without complex observations or decisions based on critical thinking?

a) yes---move to step 11

b) no---do not delegate

11) can the task be performed without repeated nursing assessments?

a) yes---move to step 12

b) no---do not delegate

12) is appropriate supervision available?

a) yes--- all other steps met, it is safe to delegate

b) no---do not delegate

delegation= transferring a selected nursing task in a situation to an individual who posses the knowledge, experience that makes the person competent to perform that specific task.

the nurse practice act and any practice limitation, such as been unfamiliar with the particular task which needs to be delegated, define which aspects of care can be delegated and which must be performed by the registered nurse.

only the task not the ultimate accountability may be delegated to another. the nurse who delegates maintains accountability for the overall nursing care of the client. the nurse must know what are her clients preferred outcomes in terms of health care delivery goals, so that the process of delegation is geared toward achieving desirable outcomes.

the RN must match the task to be delegated based on the nurse practice act and appropriate position descriptions.

task that which are the responsibility of the RN only:

a) unstable patients with the least predictable medical outcomes

b) central line care

c) any tasks involving teaching, observation, discharge of a patient, assessment and critical thinking based decisions

d) blood transfusions

e) parenteral nutrition

f) patient controlled analgesia

g) development of a plan of care

h) taking a medical history

I) taking phone doctor's orders for prescription and treatment

j) doing an admission assessment

k) initiate a care plan

task that can be delegated to lpn/lvn only

a) patients who are stable and with predictable outcomes and common, well-defined health problems

b) give meds, oral, topical and inhalants, can administer treatments such as sterile wound care, blood sugar testing, nasogastric tube insertion, tube feedings and charting

c) lpn/lvn can start an iv of saline and superimpose iv fluids with vitamins, nutrients and electrolytes by primary or secondary infusion lines, infuse blood and blood products with iv certification

d) give injections

e) monitor running iv

f) give enemas

g) monitor a urinary catheter

h) do simple wound dressing change

I) any task which does not require nursing judgment or complex observation, nurse can delegate to the lpn. RN must inform the parameters of what to report as abnormal

j) use sterile technique procedures such as putting a urinary catheter

k) can give intra muscular injections, subcutaneous, intradermal

l) cannot give iv push, infuse antibiotics or other medications via secondary iv line

m) can initiate teaching and a care plan

n) cannot infuse iv fluids such as tpn or other fluids via a central line and cannot do blood withdrawal via central line

o) can do blood withdrawal via venipuncture or peripheral line with blood withdrawal certification

https://www.bvnpt.ca.gov/pdf/vnregs.pdf

only RN & pn can delegate to uaps. one uap cannot delegate task to another uap

uap (unlincensed assisitive personnel) should be able to perform "routine" trach care

uap

a) bathing patient

b) ambulation

c) making beds

d) routine vital signs feeding patients

e) transferring patients

reverse delegation – occurs when a person with lower rank delegates to someone with authority.

overdelegation when a delegator loses control over a situation by providing delegate with too much authority or responsibility.

underdelegation: when full authority and responsibility are not trasferable.

incomplete delegation: delegator delegates a task and then due to fear or inexperience removes the task either while its being accomplished or before ist fully accomplished.

charge nurse responsibility = make assignments for nursing staff; assess critically ill pts and bed assignments for admissions.

[fmAtoZ&backagain]

Isolation review:

transmission-based precautions: adc

a - airborne

d - droplet

c – contact

Airborne

my – measles = rubeola

chicken - chicken pox = varicella – also contact

hez - herpes zoster – also contact

tb

Private room - negative pressure with 6-12 air exchanges/hr

mask, n95 for tb

- disseminated herpes zoster is airborne precautions, as to localized herpes zoster is contact precautions. a nurse with a localized herpes zoster can care for patients as long as the patients are not immunosuppressed and the lesions must be covered!

- sars (severe acute resp syndrome) airborne + contact (just like varicella)

- include all universal precautions and negative pressure single patient rooms, gown, goggles, mask on you, mask on pt. if leaving room which should only be done if absolutely necessary and wearing mask.

-used with: measles, varicella, disseminated varicella zoster, tuberculosis

- door closed, pt in room

**always check facilities policies when following isolation precautions/procedures

Droplet

think of s3p3iderm3an!

s - sepsis

s - scarlet fever

s - streptococcal pharyngitis

p - parvovirus b19

p - pneumonia

p - pertussis

I - influenza

d - diptheria (pharyngeal)

e - epiglottitis

r - rubella

m - mumps

m - meningitis

m - mycoplasma or meningeal pneumonia

an – adenovirus (requires contact precautions in addition)

private room or cohort

mask

- include all universal precautions, gown, goggles, masks on you before you enter, on pt. if leaving room, single pt. rooms, private room unless other pt has same organism, mask when transported.

- used with: majority of infectious diseases, involves contact conjunctive or mucous membranes of nose, mouth that happens during coughing, sneezing, talking or during procedure such as suctioning and bronchoscopy

- maintain spatial separation of 3 feet between infected patient and visitors.

- door may remain open.

Contact Precaution

Mrs. Wee

m - multidrug resistant organism – mrsa, vrsa

r - respiratory infection, rsv, parainfluenza

s - skin infections * diphteria

w - wound infxn (abscesses, decubitus

e - enteric infxn - clostridium difficile, e. coli 157:h7, salmonella, shigella, hep a, rota

e - eye infxn – hemorrhagic conjunctivitis

h – viral hemorrhagic feves (ebola, lassa, marburg)

RSV - child in private room...contact precautions..not droplet or airbone. (sometimes I get this mixed up because its called respiratory synctical virus..I used to pick droplet precautions but I have down now LOL!

- use universal precautions, gown, gloves, when contact with pt., single pt. room in most situations. clean non sterile gloves when entering the room

- room needs to be private unless same organism

- avoid skin-to-skin contact (turning pt, bathe, hand contact

- used with: any colonizing infections, msrv, fifths disease, rsv, infected wounds, skin, or eyes

- wear a gown before entering the room if clothing will have contact with patient, environment surfaces, or if patient is incontinent, has diarrhea, an ileostomy, colostomy or wound drainage

- remove the gown before leaving the room

- use dedicated equipment or clean and disinfect between patients

Skin infections

vchips

v - varicella zoster

c - cutaneous diphtheria

h - herpez simplex

I - impetigo

p - pediculosis

s – scabies, staphylococcus

Private room or cohort

gloves

gown

Airborne

*keep door closed*

In addition to droplet precaution:

*maintain spatial separation of 3 feet between infected patient and visitors. door may remain open.

Standard precautions

tetorifice, hepatitis b, hiv

rubella (german measles)- airbone contact precautions, 3 day rash, no pregnancy x 3 month (I kept forgetting which was dangerous when you're pregnant; regular measles (rubeola), or german measles (rubella), so remember:

-never get pregnant with a german (rubella)

rubeola (red measles)- droplet contact precautions, koplik’ spots in mouth, conjunctivitis, photophobia, muscle pain, cough

Entrance into the isolation room:

a) put the surgical mask or respirator around mouth and nose (type of mask depend on the type of isolation)

b) apply eyeware or goggles snugly around the face and eyes (when needed)

c) apply gown and make sure it covers all outer garments, pull sleeves down to wrist and tie the gown securely on the neck and waist

d) apply disposable globes to cover over the edge of the gown sleeves

e) enter the patient's room

f) equipment such as stethoscope, pressure cuff, thermometer--disposable--.

g) nondisposable equipment remains in the room... clean nondisposable equipment with alcohol before and after using it, place dedicated equipment on a clean surface

Leaving isolation room:

a) remove gloves, discard

b) untie top mask string and then bottom string pull mask away from face and do not touch the outer surface of the mask

c) untie waist and neck string of the the gown, allow the gown to fall from the shoulders

d) remove hands from sleeves without touching the outside of the gown

e) hold the gown inside at the shoulders seams and fold inside out and discard

f) remove eyeware or goggles

g) wash hands

h) leave the room and close the door if the patient is on airborne precautions

Putting gown, mask, gloves

1. wash hands

2. place mask on face

3. put on gown

4. put on clean or sterile gloves

Removing gown, glove, mask

1. remove gloves

2. remove mask

3. untie gown

4. wash hands

5. remove gown

6. fold it inside out and discard

7. wash hands again

Steps of the procedure of preparing and maintaining sterile field

equipment:

*flat work surface

*sterile drape.

*sterile supplies as needed (sterile gauze,sterile basin,solutions,scissors,foreceps),packed sterile gloves.

1.wash your hands

2.check for the integrity of the sterile package,expiration date etc.

3.during the entire procedure,never turn your back on the sterile field or lower your hands below the level of the field.

4.open the sterile drape

*start from the outer wrapper and place the inner drape in the center of the of the work surface with the outer flap facing away from you

*touching the outside of the flap only,reach around rather than over the sterile field to open the flap away from you first

*open the side flaps,in the same manner,using the right hand for the right flap and the left hand for the left flap.

5.lastly ,open the inner most flap that faces you,being careful that it does not touch your clothing or any object.

Adding sterile supplies to the the field.

General rule

*generally before opening the sterile package you want to assess the order in which supplies will be used during the procedure so that supplies used firstcan be added to the field last

1.prepackaged sterile supplies are open by peeling back the partially sealed edges with both hands or lifting up the unsealed edge,taking care not to touch the supplies with your hands.

2.hold supplies 10 to 12 inches above the field and allow them to fall to the middle of the sterile field.wrapped sterile supplies are added by grasping the sterile object with one hand and unwrapping the flaps with the other hand.

3.grasp the corners of the wrapper with the free hand and hold them against the wrists of the other hand while you carefully drop the subject onto the sterile field.

Adding sterile solutions to a sterile field1.read the solution labeland expirationdate

2.remove cap and place it within facing up on the flat surface.do not touch the inside of the cap or rim of the bottle.

3.hold bottle 6 inches above the container on the sterile field and pour slowly to avoid spills.

4.recap the solution bottle and label it with date and time of opening if the solution is to be reused.

5.add any additional supplies and don sterile gloves before starting the procedure.

[Claudiabrn]

Dilantin may cause gingival hypoplasia, advisable to have adequate oral hygiene and frequent visits, IVP 25-50 mg/min

[red_butterfly]

My FIVE RANDOM FACTS:

> Intravesical instillation of BCG commonly causes HEMATURIA.

> ORTHOSTATIC HYPOTENSION commonly occurs with TRICYCLIC ANTIDEPRESSANTS.

> Neonates born with FAS(Fetal Alcohol Syndrome) have upturned noses, flattened nasal bridges, and a thin upper lip.

> IRON DEXTRAN (InFed) is given using the Z-TRACK technique to prevent leakage into subcutaneous tissue and staining of the skin.

> The screening test for Syphilis is NONTREPONEMAL ANTIBODY TEST.

GOD BLESS!!!

[bezeley]

Hello All!

Take my NCLEX on 10/5....love this thread! Here's some random triads:

DVT - Virchow's Triad - Venous Stasis, Altered Coagulability, Intimal Changes

ICP - Cushing's Triad - Decreased Respirations, Decreased HR, Increased BP

Cardiac Tamponade - Beck's Triad - Decreased BP, JVD, Muffled heart sounds

Mulitple Sclerosis - Charcot's Triad - Nystagmus, Intention Tremor, Staccato speech

Fat Emboli - Bergman's Triad: Mental Status Changes, Petehiae - esp chest and axilla, dyspnea

That's it for now....back to reading threads....only on page 52! Thanks for everyone's hard work and for sharing your pearls of wisdom!

Bezeley