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:

Kernicterus - form of brain damage caused by excessive jaundice

Side effect:

Antifungal = low potassium

Penicillin = High potassium

As per Genny's notes. Thank you Genny.

I can't see my edit button, so I'm going to do it here again.

Meds. for Infections: Everything noted down is from Genny's note on meds for infections. Thanks

Empty stomach:

TMP-SMZ (UTI)

Penicillin : before meals or two hours after

Anti Tb meds

With food:

Cephalosporins

Liver toxicity:

tetracycline

INH (Anti Tb)

Ketakonazole (Antifungal)

No to pregnancy:

Tetracycline

TMP-SMZ (UTI)

Anti viral

Decrease the effect of OC (Oral contraception)

Tetracycline

Rifadine/rifampin (anti TB med)

P.s. Genny, I'm sorry, ididn't ask ur permisson before doing this. And I liked ur Flagyl memory note wave the flag one. Thanks again

If I made a mistake, please add/deduct/correct for the benefit of all of us. Thanks

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Specializes in ICU.

THANKS MOMENTS, this makes it easier to remember! Please feel free to add for the benefit of everyone! :)

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Specializes in ICU.

:thankya:medications affecting the immune system::thankya:

[color=maroon]child immunizations:

  • hep b- given at birth, 1-2 months, 6-18 months (don’t give hep b to people with allergy to baker’s yeast)


  • hib and pcv- given at 2,4,6,12-15 months


  • dtap and ipv- given at 2,4,6, 18 months, and 4-6 years (don’t give dtap if excessive crying)


  • tdap and meningococcal (mcv4)- given 11-12 years


  • mmr- given at 12-15 moths and 4-6 years (don’t give to pregnant or children w/ allergy to eggs, or to those with hx of thrombocytopenia)


  • tetnus booster- given everyb10 years


  • flu sot- annually after age 6 months (don’t give if allergy to eggs)


  • hep a- 12 months


  • varicella vaccine given at 12-18 months (don’t give to pregnant, cancer pts, or those with allergy to neomycin or gelatin)


[color=maroon]reminders:

  • for infants and young children, administer in vastus lateralis
  • don’t give aspirin to treat fever b/c of reyes syndrome

[color=maroon]adult immunizations:

  • flu vaccine- given yearly after 50 (risk of guillian barre)
  • ppv- give does at 65 and then every 6-8 years
  • give im in deltoid muscle

[color=maroon]immunoglobulin- igg given for passive immunity – don’t have live virus within 3 months of igg. used for cll, bone marrow suppression, hep a & b exposure and measles rubella and chicken pox exposure.

[color=maroon]immunostimulants

  • ex: interfeon alfa, interluken 2 are used for hairy cell leukemia, cml, malignant melanoma, and aids-related kaposi sarcoma.
  • may cause flu-like symptoms, hypotension and bone marrow suppression also alopecia, cadiotoxicity and neurotoxicity

[color=maroon]immunosuppressants include-

  • cyclosporines (monitor liver and kidneys, if given with antifungal then cyclosporine level will increase, mix w/ milk or organge juice), sandimmune, gengrat, neural, glucocorticoids (cause osteoporosis, fluid retention, hyperglycemia, adrenal insufficiency), cytotoxic-imuran (causes bone marrow suppression), prograf, methotrexate.
  • used to treat ra, sle, myasthenia gravis, organ rejection (with organs rejection life long therapy is necessary)
  • general side effects of immunosuppressants: tetrogenic, increase risk for infection

[color=maroon]antihistamines:

  • benadryl, phenergan (for n/v), dramamine (for n/v), (given for mild allergy, anaphylaxis, motion sickness, insomnia) may cause sedation, anticholinergic effects, gi discomfort, acute toxicity (flushed face, high fever, tachycardia)
  • claritan, zyrtec, allegra, clainex
  • remember due to anticholinergic effects give cautiously to people with asthma, urinary retention, glaucoma, hypertension and prostate hypertrophy.
  • (i don't really know why the ati book lumps antimetics like phenegran with antihistamines.... let me know if you have an idea.)

[color=maroon]chemotherapy:

  • cytoxan, cisplatin, methotrexate, rheutrex, purinethol, taxol, onxol, elspar, megace, lupron, tamoxifen, nolvadex etc….
  • destroys both cancer and good cells.
  • side effects- bone marrow suppression, gi discomfort, alopecia, mucosistis, reproductive toxicity, hyperuricemia

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

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Specializes in Cardiac/Telemetry.

thank you so much to the ladies who posted the meds information!!! :yeah: you guys are amazing! :) i'm going to print out your information and carry it around so that i can study it whenever i have a chance to look at it.

alright. so, we mostly voted that a lot of us have trouble with the cardiac system. it's one of the most interesting systems in the body, but one of the most complex too! so, i'm going to start with the basic things, and move on from there.

anatomy of the heart. :redbeathe

four chambered hollow muscular organ approximately the size of a fist; lies within the thorax between the lungs and the mediastinal space.

point of maximal impulse (pmi) which arises at the apex of the heart, can be palpated and auscultated at the fifth intercostal space approximately 2 inches left of the midline.

there are three layers that the heart is composed of: endocardium (the innermost layer of the heart), myocardium (a layer of muscle), and a fibrous outer layer (the epicardium).

the heart is surrounded by the pericardium.

****if you know your suffixes, you can pretty much figure where these layers are located.

1. endo- inner

2. myo- muscle

3. epi/extern- outer

4. peri- surrounds/around.

there's a small amount of pericardial fluid that lubricates the space between the pericardial layers and prevents friction between the surface as the heart beats.

four chambers:

1. right atrium

2. right ventricle

3. left atrium

4. left ventricle.

the heart is divided by the septum.

the walls of the chambers of the heart vary in thickness. the atrial myocardium is thinner than that of the ventricles, and the left ventricular wall is three times thicker than the right ventricular wall.

this is important because the thickness of the left ventricle provides force to pump the blood into the systemic circulation.

blood flow through the heart: :heartbeat

the right atrium receives blood from the superior and inferior venae cavae and the coronary sinus.

blood then passes through the tricuspid valve into the right ventricle.

right ventricle pumps blood through the pulmonic valve into the pulmonary artery.

left atrium receives oxygenated blood from the pulmonary veins.

then, it passes through the mitral valve and into the left ventricle. blood is pumped through the aortic valve into the aorta and thus enters the high-pressure systemic circulation.

bloodcirculation.jpg

***the four valves of the heart serve to keep blood flowing in a forward direction. the cusps of the mitral and the tricuspid valves are attached to thin strands of fibrous tissue termed chordae tendineae.

blood supply to the myocardium:

the coronary circulation is the myocardium's own supply of blood.

blood flow into the coronary arteries occurs primarily during diastole.

(when the heart/myocardium is at rest of a contraction.)

the right coronary artery usually supply the right atrium, ventricle, and a portion of the posterior wall of the left ventricle.

the left coronary artery (which include the left anterior descending artery (lad), and the left circumflex artery (lca)) supply the left atrium and the left ventricle.

conduction system: :redpinkhe

this is made up of the electrical impulses or action potential. this impulse initiates depolarization and therefore cardiac contraction.

the electrical impulse is initiated by the sinatrial (sa) node. this is the pacemaker of the heart.

impulses generated/started in the sa node travel fast through the muscle fibers of the atria by the internodal pathways and cell-to-cell conduction.

the conduction system goes like this:

sa--> av--> bundle of his--> right and left bundle branches--> purkinje fibers

electricalconductionofheart.gif

ekg/ electrocardiogram of the heart:

p wave: represents sa node and depolarization of the fibers of the atria.

qrs complex: represents depolarization from the av node throughout the ventricles.

t wave: represents repolarization of the ventricles.

u wave: this wave in an ekg is always abnormal. this wave may represent hypokalemia or repolarization abnormalities.

electrocardiogram.gif

mechanical system:

systole: contraction of myocardium

diastole: relaxation of the myocardium and it is the time when the filling of the chambers occur.

cardiac output: measurement of mechanical efficiency. (the amount of blood pumped by each ventricle in one minute.)

okay. i'm getting a headache. :lol: i'll post more in a little bit. i'm gonna take a break. :)

***references: medical-surgical nursing sixth edition; lewis et al. mosby: philadelphia, 2004.

encyclopedia britannica, community memorial online, evolve online.

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Specializes in Dialysis, Nephrology & Cosmetic Surgery.

Attached are some pharm flash cards you may find useful

[ATTACH]6205[/ATTACH]

[ATTACH]6206[/ATTACH]

[ATTACH]6207[/ATTACH]

[ATTACH]6208[/ATTACH]

[ATTACH]6209[/ATTACH]

[ATTACH]6210[/ATTACH]

[ATTACH]6211[/ATTACH]

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Specializes in Pedia Cardio--- 6 yrs ago!.
Attached are some pharm flash cards you may find useful

[ATTACH]6205[/ATTACH]

[ATTACH]6206[/ATTACH]

[ATTACH]6207[/ATTACH]

[ATTACH]6208[/ATTACH]

[ATTACH]6209[/ATTACH]

[ATTACH]6210[/ATTACH]

[ATTACH]6211[/ATTACH]

wow! thanks so much for these! :yeah:

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Specializes in Dialysis, Nephrology & Cosmetic Surgery.

One more that was missed

[ATTACH]6213[/ATTACH]

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One more that was missed

[ATTACH]6213[/ATTACH]

hi jane i cant seemed to open all the attachment for your drug flashcards..thanks

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Specializes in Dialysis, Nephrology & Cosmetic Surgery.

You will need adobe to open it as it is a PDF. If I click on it will open for me, if you want to send me your e-mail address by PM or my e-mail I can send them to you that way and see if that makes a difference?

Jane

hi jane i cant seemed to open all the attachment for your drug flashcards..thanks
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Hi Jane,me too I couldn't open ur attachment of pharmaco.

Thank u

You will need adobe to open it as it is a PDF. If I click on it will open for me, if you want to send me your e-mail address by PM or my e-mail I can send them to you that way and see if that makes a difference?

Jane

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Hi

Take me in. I am taking my exam in april end. Please help me out with some tips to pass NCLEX. Thanks

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Sorry I couldn't open these attachment.would you send them to my email please?

[email protected]

Thank u

wow! thanks so much for these! :yeah:
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