April 2008 NCLEX test takers, COME ON IN!

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Per the request of janina08 ;) I've started the April NCLEX takers support group. When do you take it? What are you using to study? Would anyone like to review any of the systems/meds that he/she feels weakest on? Let's keep each other in our prayers and good thoughts as we go through one of the biggest experiences of our lives. :) :nurse:

Specializes in ICU.

Medications used to treat infections

  • most of them can cause hypersensitivity reactions.
  • most cause renal toxicity. tb drugs cause heptatoxicity. so if you get a question with choices related to heptatoxicity or nephrotoxicity, just remember that most of them will be renal!
  • instruct patient to complete the prescribed course of therapy

Penicillin or anything that ends in “cillin” (also zosyn and augemtin)

  • first choice for meningitis and syphilis, prophylaxis for bacterial endocarditis
  • side effect: renal impairment, hyperkalemia
  • don’t mix penicillin and aminoglycosides in the same iv
  • take oral w/ a full glass of water before meals or two hours after
  • give erythromycin if there is a penicillin allergy

Cephalosporins or anything beginning with “cef”, “ceph”

  • cross allergy to penicillin
  • bleeding tendencies thrombophlebitis
  • notify dr. if diarrhea
  • disulfurm reaction so don’t take with alcohol (most/all meds shouldn’t be taken with alcohol so lets just assume that no meds should ever be taken w/ alcohol)
  • take oral “cephs” w/ food

Vancomycin

  • used for mrsa
  • administer slowly over 60 mins
  • causes renal impairement, thrombophlebitis, ototoxicity

Tetracycline:

  • used for acne vulgaris and gi infections caused by h. pylori
  • yellow brown tooth discoloration (don’t give to pregnant women), liver toxicity, photosensitivity
  • don’t give w/ milk, calcium, iron, magnesium, laxatives or antacids—causes chelates
  • decreases the effect of oral contraception’s (oc)
  • doxycycline and minocycline can be given to people with renal impairment

Gentamicin- ototoxicity, nephrotoxicity, respiratory depression.

Streptomycin causes neuro disorders like peripheral neuritis, tingling in hands and feet

Tmp-smz

  • used for uti
  • take on empty stomach with glass of water
  • don’t take if folate deficiency or pregnant
  • causes blood dyscrasis, crystaluria, kernicturs, photosensitivity

Macrodantin:

  • causes blood dyscrasis, peripheral neuropathy, gi discomfort,
  • don’t give to clients with renal impairment
  • urine will be brown

Anti-tb drugs (isoniazid, ethambutol, pyrazinamide

  • most are given for at least 6 months
  • causes peripheral neuropathy (if this occurs give b6), heptatoxicity,
  • take inh on empty stomach but take with meals if gastric problems occur

Rifadin/rifampin: used to treat leprosy, masks body fluids orange, causes heptatoxicity, decreases the efficacy of oc

Antiviral- has the letter “vir” in it ex: acyclovir, ribavirn, also amantadine

  • used for herpes, cmv, varicella zoster
  • causes nephrotoxicity, granulocytopenia and thrombocytopenia, reproductive toxicity (don’t give pregnant women), phlebitis

Ciprofloxacin- causes achilles tendon rupture- if this happens then refrain from exercise, causes supra infection. aluminum, magnesium, milk and dairy products decrease the absorption.

Antiprotozoals- flagyl- causes gi discomfort and metallic taste, dark urine (wave a flag to let the client know that he will have dark urine:yeahthat:), numb extremities, seizures

Antifungal- many end in “zole”, also fungizone aka amphotericin b

  • causes thromboplebitis, nephrotoxicity, hypokalemia, gynocomastia and irregular menstrual flow
  • discard if you see percipitation
  • ketakonazole causes heptotoxicity

If anyone notices any major errors, or any additional information that you think we should know for the exam, please post on thread.

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Specializes in Pedia Cardio--- 6 yrs ago!.
MomenTs said:
I still have problem connecting immune system and WBC's in your body.

When a patient has a high amount of glucorticoid in their body, it brings their immune system down, something we see in Cushing's syndrome. A/C to Saunders, with Cushings, WBC's is elevated.

So, weaker the immune system = More elevated the WBC's? And, stronger the immune system = Less amount of WBC's?

Some of you said, it depends from condition to condition. If I could just get this connection between WBC's and immune system, life would be little bit more simpler understanding somethings. PHew

Thank you for trying to make me understand guys. I still am not getting this conecept and can't connect the dots together.

Jus trying to help...check out this link if this could, one way or the other, answer your query... http://www.germstop.net/immunesystem.html

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Specializes in Psychiatric Nursing.
hi in Saunders its says hypokalemia...dont confused us..

sorry for this, I was just trying to justify the question and rationale at saunder's too because its so hard to just say that its a typo error everytime we see this type of questions. i know that cushing's causes hypokalemia but, in the question, only the potassium level has an abnormal value...when you try to use the process of elimination with the said question, its definitely the Potassium right? If for example this type of question will be given in the actual NCLEX, are we still going to justify our answer based on our understanding that there was a typo error???

it wasn't my intention to confuse anyone...I was just trying to analyze things...besides, there must be a reason why this question was in the Analysis portion of nursing assessment right?...

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OR2CA said:
sorry for this, I was just trying to justify the question and rationale at saunder's too because its so hard to just say that its a typo error everytime we see this type of questions. i know that cushing's causes hypokalemia but, in the question, only the potassium level has an abnormal value...when you try to use the process of elimination with the said question, its definitely the Potassium right? If for example this type of question will be given in the actual NCLEX, are we still going to justify our answer based on our understanding that there was a typo error???

it wasn't my intention to confuse anyone...I was just trying to analyze things...besides, there must be a reason why this question was in the Analysis portion of nursing assessment right?...

it is okay ORCA..

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3rd shot on April 3rd coming up. I'll be coming here often to read the thread before the test.

Ive taken NCSBN 3 times, done Saunders and Mosbys and Lipincot's. Still have FEAR in my head over this test. Oh, also did Kaplans.

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Specializes in Pedia Cardio--- 6 yrs ago!.
Jtejas said:
3rd shot on April 3rd coming up. I'll be coming here often to read the thread before the test.

Ive taken NCSBN 3 times, done Saunders and Mosbys and Lipincot's. Still have FEAR in my head over this test. Oh, also did Kaplans.

pray, pray, pray and have faith. be positive that you will make it this time. God bless you! ?

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Information on Myasthenia gravis

not contagious/not inherited

Muscle weakness disease in which the body's own immune system produces antibodies that BLOCKS the acetylcholine from attaching to the receptors in the muscles.

Acetylcholine action : muscle contraction.

Points:

Autoimmune disease

seen mostly in young adults, but can affect anyone of any age/race.

Muscles esp. effected:

eye muscles (double vision)

swallowing

chewing

talking

facial expression

muscles controlling the neck and breathing movements.

Risk for complication: Respiratory failure (monitor)

Cardinal s/s : muscle weakness with activity and goes away after rest.

Intervention: plenty of rest - Well balanced diet, esp. high in potassium to ease fatigue.

Potassium rich foods: orange , bananas

Meds:

cholinesterase inhibitors: Neostigmine and pyridostigmine.

Action: improve nerve signals to muscles and increase muscle strength

Immunosuppressive drugs: Prednisone, cyclosporine and azathioprine

Action: supress the production of abnormal antibodies.

Monitor carefully: major side effects

"What is the role of the thymus gland in MG?

The thymus gland, found in the upper chest area beneath the breastbone, is a part of the body's normal immune system. In most adults with MG, the thymus gland is abnormal. Some people with MG develop thymomas or tumors on the thymus gland. Generally thymomas are benign, but they can become malignant (cancerous). The relationship between the thymus gland and MG is not yet fully understood."

S/S myasthenia gravis:

  • Drooping of one or both eyelids (ptosis)


  • Blurred or double vision (diplopia) due to weakness of the muscles that control eye movements


  • Unstable or waddling gait


  • Weakness in arms, hands, fingers, legs, and neck


  • Change in facial expression


  • Difficulty in swallowing and shortness of breath


  • Impaired speech (dysarthria)


  • Shortness of breath


Source: http://www.4woman.gov/faq/mgravis.htm

thanks

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Multiple sclerosis:

Autoimmune disease in which body's immune system attacks its own Central nervous system. So, we will see demyelination in the nerves.

Autoimmune disorders:

Myasthenia gravis

Multiple sclerosis

Rheumatoid arthritis

lupus

pernicious anemia

autoimmune thyroiditis

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Specializes in ICU.

Moments, thanks! Great summary!!!

Also Tensilon test differentiates myasthenia gravis from cholinergic crisis.... symptoms will temporarily improve (for 30 minutes) if you give Tensilon to someone who has myasthenia gravis. Symptoms will worsen if you give it to someone with cholinergic crisis.

Also important to note that symptoms of myasthenia gravis are normally exacerbated due to lack of med administration.... so advice your patients to take meds on time.... on the other hand, cholinergic crisis is normally exacerbated due to medication overdose... so tell your patients to take meds as prescribed...

please let me know if I said something wrong b/c I didn't look it up... I am just typing what I remember. :specs:.

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Specializes in ICU.

Rule of Nines

Rule of Nines.JPG
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Kernicterus - form of brain damage caused by excessive jaundice

Antifungal = cause low potassium

Penicillin = High potassium

As per Genny's notes. Thank you Genny.

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Specializes in Pedia Cardio--- 6 yrs ago!.
Rule of Nines

this one's cool! :) loved it! thanks genny!

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