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:

Fluid Replacement - IV solutions

1) Class : Crystalloids

Examples:

Dextrose

Saline

L.R.

Uses:

Replacement and maintenance of fluid levels

2) Colloids

Example:

Dextran

aminoacids

hetastarch

plasmanate

Uses: Volume expansion

3) Blood products

Example:

White blood

Packed RBC

Plasma

Albumin

Uses: Blood component replacement

4) Lipids

Example:

Fat emulsions

Uses: Supplementation of nutrients/needs

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Medications/IV

1) Cephalic vein is towards THUMB (Cephalic - Thumb)

Basillic vein is towards PINKY (Basillic - Pinky) BP like blood pressure to remmeber it.

2)

A) Deltoid Muscle :

IM

23-25 gauze

5/8 to 1 inch needle

Volume: average: 0.5 mL

Range : 0.5-2 mL

B) Ventrogluteal Muscle

IM

20-23 gauze

1.5 - 3 inch needle

Volume: average: 2 mL

Range: 1-5 mL

C) Dorsogluteal muscle

IM

20-23 Gauze

1.5 - 3 inch needle

Volume: Average: 2 mL

Range : 1-5 mL

Note: (Dorso and ventro gluteal same volume)

D) Vastus lateralis

IM

22-25 Gauze

5/8 to 1.5 inch needle

Volume: Average: 2 mL

Range: 1-5 mL

E) Sub Q

Sites : Arm, Abdomen, Thigh ...

25-27 gauze

1/2 to 5/8 inch needle

Volume: Average: 0.5 mL

Range: 0.5-1.5 mL

F) Site: Forearm

Intradermal

26-27 Gauze

3/8 inch needle

Volume: Average: 0.1 mL

Range: 0.001 to 1.0 mL

IM - 90 degree - muscle

Sub Q - 45 degree - sub Q tissue

I. Dermal 15 degree - Skin

Always clean site in CIRCULAR motion

3) Short term catheter: Central venous

Long term catheters: PICC, Hickman, Brovioc, Groshong catheter and Implanted port

Care:

Sterile gauze or occlusive transparrent dressing

Flush:

S - 1-2 mL Nacl

A

S- 1-2 mL Nacl

H - Heparin

SASH after each use or every 12-24 hours when not in use.

Note: Groshong catheter: No Heparin

IV push usually less than 5 minutes.

Source: Exam cram

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I believe with all my heart, though, that I will pass on Monday. :) I have no other choice, and though I haven't studied as much as I would have liked, I think I have SOME knowledge from every book I have read in the past few years, months, and weeks to know SOMETHING.

Anyway, good luck to rose143 on your NCLEX tomorrow!! :yeah:

Hey Mave, I am sure you studied more than enough. I was feeling the same the morning I went to the test center. I was saying to myself "How can I be so stupid of showing up this unprepared after all this time?" But beleive me you know more than you think.

Good Luck to you and to rose143 too

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Pharmacology: Page 20 onwards (Source - Exam cram)

1) Liver damage - anticoagulants, Tb Meds

Nursing care: Assess and monitor S/S of Jaundice: If yes S/S for jaundice, Medication/s will be D/C.

Antihypertensive :

Decrease BP

Increase blood flow to myocardium

Antidiarrheals :

Decrease gastric motility

Decrease water content in intestinal tract

Diuretics:

Decrease water absorption from loop of henle (loop diuretics)

OR

decrease ADH hormone (Potassium sparing diuretics)

Antacids:

Decrease hydrochloric acid in stomach

Side effects:

calicum and Aluminium based antacids = constipation

(To remember: CALcium = Constipation ( C=Calcium, Al = aluminium)

Magnesium based: Diarrhea

Antihistamines :

block histamine release in allergic reaction

Side effect: dry mouth, drowsy sedation

Bronchodilators:

Side effect: Tachycardia

Laxatives:

Enable stool passage

Types: Stool softeners, cathartics, fiber, lubricants, stimulants

Anticoagulants:

Action: decrease vitamin K levels = decreased clot formation

block clotting chain = decreased clot formation

block platelet aggregation = decreased clot formation

antanemic:

Increase RBC production

ex: B12, iron, Epogen (erythropoetin)

Narcotic/analgesic:

Moderate-severe pain

Opiods: (morphine, codiene)

Synthetic opiods: (meperidine)

NSAIDS

Anticonvulsants:

Seizure and bipolar management

example: Lorazepam (ativan), Phenobarbitol, phenytoin (dilantin)

Anticholinergic:

can't see, can't pee, can't spit (Oral secretions dry)

example: Atropine

administered preoperatively.

Mydriatics:

Dilate pupils - cataracts

Miotics:

Constrict pupils - Glaucoma - Ex. Pilocarpine HCL

------------------------------------

Do not crush time released drugs

DUR = duration release

SR - sustained release

CR - continuous release

SA - Sustained action

Contin - continuous action

LA - Long acting

Source: exam cram and some from this site.

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Medications

1) Angiotensin converting Enzyme Inhibitors

Action:

stop angiotensin I to II conversion

Antihypertensive

Side effects:

Decreased bp

Hacking cough

nausea/vomit

Resp s/s

Nursing care:

Monitor Vital signs, WBC, electrolyte levels frequently.

2) Beta adrenergic blockers

Action:

Decrease BP, pulse and Cardiac output

Blocks SYMPATHETIC vasomotor response

Side effect: Orthostatic hypotension, decrease heart rate, CHF

Nausea/vomit, diarrhea

Blood dyscrasia

Nursing care: Monitor Protein, BUN, Creatinine (Indicates nephrotic syndrome)

Monitor BP, Heart rate and rhythm

Monitor s/s edema

Teach: rise slowly

Report: decreased Heart rate, dizzy, confusion, depression, fever.

Note: taper off the medication.

3) Anti-infective - (Aminoglycosides) :

Action: Interfere with protein synthesis of bacteria and cause bacteria to die.

CIN

MYCIN

SE: ototoxicity, nephrotoxicity, seizure, blood dyscrasia, decreased BP, Rash

Nursing care: Monitor I & O, allergies history

Monitor Vital signs during infusion

Maintain IV site patent

Monitor S/S kidney and ear toxicity

Teach: Any changes in urinary elimination (nephrotoxicity), ototoxicity

Ex: used in MRSA treatment:

MRSA S/S : fever, malaise, redness, pain, swelling, perineal itiching, diarrhea, stomatitis, cough.

Source: Exam cram

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Medications

4) Benzodiazepines - Anticonvulsants and antianxiety

- sedative hypnotic

PAM

PATE

IAM

All meds contain AZO or AZE

SE: All S/S down (like parasympathetic response kind)

Nursing care: Monitor Resp. rate, liver, kindey function; bone marrow function; and S/S of chemical abuse.

5) Phenothiazines : Antipsychotics, neuroleptics/antiemetics

Tranquilizer, antiemetic

Ex. for Schizophrenia

IM - z-track (or else irritating to the tissue)

Note: If patient allergic to one phenothiazine - allergic to all phenothizines usually.

Antidote: Benadryl Or congentin (Benztropine mesylate).

ZINE

Se: Extrapyramidal effects, agranulocytosis, photosensitivity, neuroleptic malignant syndrome (extreme increased temp.), everything else Decreased (other s/s)

6) Glucocorticoids

Antiinflammatory, anti allergic, anti stress

Action: suppress immune system - post transplant

Addisons

SONE

CORT

SE: Depression (mood changes), flushing, sweat

Increase BP, osteoporesis, diarrhea, hemorrhage and others...

Nursing care: Monitor glucose levels; weight daily; BP, infection S/S

Source: Exam cram

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Specializes in Pedia Cardio--- 6 yrs ago!.
Oh my God. I'm crying here. Thank you God and all of you guys. I PASSED! I have to look at it again and again to make sure, it's me. Thank you so much. I cannot thank you all enough. Praise be to God and to all of you for believing in me, when I doubted myself. Oh my God! oH my God.

I want to specially thank:

genny

Mave

chichi

Janina

Or2ca

igmirmor

julezheart

riza,

rose,

missmykids,

lantueno,

steve

and everyone of you guys, every single one of you. Thank you so much from the bottom of my heart. I couldn't have done it without God's blessings and your support, positive vibes, prayers and luck. I have to go back and look at my name again and again on BON to be sure, it's me. Thank you so much guys. Amen!

Moments!!! I am soooo happy for you !!!!:yeah::anpom::yeah:

I knew you would pass!!! To God be the glory!!!:redpinkhe

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Medications

7)Antivirals

Action: stop viral growth

For: Herpes - zoster (shingles), simplex (fever blisters)

AIDS

Varicella (chicken pox)

encephalitis

cytomegalovirus (CMV)

RSV (Resp. S virus)

VIR

SE: Nausea, vomit, diarrhea

oliguria, preteinurea (kidney impaired s/s)

vaginitis

Less common SE: CNS: Tremors, confused, seizures, severe, sudden anemia

Nursing action: Teach patient to report rash - indicates allergic reaction

Monitor infection S/S, creatinine level frequently, liver profile, bowel pattern before and during therapy.

8) Cholesterol-lowering agents

Action: Decrease cholesterol, triglycerides and prevent CV diseases.

VASTATIN - (STATIN)

Note: (Do not confuse with statin drugs used for antifungal effects. example mystatin (mycostatin) or nilstat)

Note: NO: with grapefruit juice

NO: At night

Yes: regular liver studies

SE: Rash, alopecia, liver dysfunction, muscle weak (myalgia) - rhabdomyolysis (muscle wasting syndrome - report muscle weak and muscle sore to DR), headache and dyspnea.

Nursing care: Monitor cholesterol, liver profile, renal function.

Teach patient to report visual changes - cataracts can occur with this vastatins.

Monitor muscle pain + weakness.

9) Angiotensin Receptor Blockers

Action: Blocks vasoconstriction and aldosterone secreting angiotensin II

For increased BP, excellent for patients who complain coughing with ACE inhibitors.

SARTAN

They reduce Blood pressure and incrase Cardiac output

SE: Dizzy, depression

insomnia, impotence

angina pectoris and second degree AV block

Conjunctivitis

Diarrhea, nausea, vomit

muscle cramps

neutropenia,

cough

Nursing care: Monitor BP, pulse, BUN, Creatinine, electrolytes and hydration status

Report edema in feet and legs daily.

Source: Exam Cram

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Moments!!! I am soooo happy for you !!!!:yeah::anpom::yeah:

I knew you would pass!!! To God be the glory!!!:redpinkhe

Thank you , thank you , thank you so much Janina. I haven't still recovered from SHOCK :yeah: U know, before I went to test, I read your post that you had written for Mave, me, Chich and supernurse. I read it 2-3 times. During exam also I remembered and also how all were rooting. It really did wonders. Yayyyyy! to all of us. April family is doing GOOD :yeah: Yes, to God be the Gloryyyy! Thank you for keeping me in ur thoughts and prayers. Without prayers and good wishes and good luck, it would have been impossible :) that's y I want to pass the positive vibes to everyone in the group also, april and may,, to those testing today, to those wa iting on their results ( I am praying that all of u will have good news on monday) and to those testing soon.

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thank you for all the conratulations guys. you guys are amazing:yeah:

the med computations, please do make sure to take ur time to read them carefully, pay attention to every detail it is asking you. pay very close attention to the units, if it is mcg or mg or kg or lb, and if it is asking you the time in minutes or hour. yes, some are like the one we saw on nclex bulletin board (but not all). if you know ur formula and practice the questions u'll do fine hun. me, i practiced most of my computations on saunders 3rd edition cd in basic care (it gave me computations one after hte other while i was doing practice questions). i posted some f ormuals here yesterday, know that and if you know what values to put where? and if you pay very careful attention to your units, u'll be fine. try not to rush urself in exam. take ur time, but make sure all units are matching and same.

take 10 minutes to solve the question if it takes 10 minutes. and i did some questions 3 times calculated them to make sure i was gettting same answer each time. (i said to myself, this is something i knwo for sur eif i get right or wrong and i know it, so i'm not going to get it wrong as i wasn't sure about the question i would get next) focus on question at hand and dont' look back at the questions u left nor at the questions that will be coming. just the question u are doing. good luck hun

thank you!!!:) thanks for helping us, i told myself that once i pass, i'll help others pass too...

i cannot find the computations you posted...

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Specializes in Medical and general practice now LTC.

can i please remind everyone when posting material from another source that terms of service is followed

copyrighted material:

no "spreading of copyrighted material": please do not upload, attach or post anything that is copyright or licensed without prior consent of the owner. for example, if you want to post content from an online article, do not post the whole article, post a partial synopsis, and then a link to the source.

i know we are supporting each other for this exam but please if possible use your own notes that help you and if posting other sources think of the size, nothing too big please, and if possible just post a small section and link

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Medications

10) COX 2 Enzyme blockers

NSAIDS

For osteoarthritis

Rheumatoid Arthritis

COX

Antiinflammatory: Treat arthritis + pain a/s with condition

SE: Increased risk for strokes and heart attacks

Fatigue

anxiety

depression

dizzy, tachycardia

tinnitis

Nausea, gastroenteritis, stomatits, sudden GI bleed

Teach: report Gi bleed (report changes in bowel habits)

Monitor platelet count (report easy bruising)

12) Histamine 2 antagonists

GERD, Gastric ulcers

Action: Blocks histamine 2 receptor sites = decreased acid production

TIDINE

SE: Confused, reduced/increased heart rate

phsychosis

seizures

diarrhea

agranulocytosis

rash

alopecia

gynecomastia

Nursing care: Monitor BUN

with MEALS

If antacids inuse: take 1 hour before or after taking these drugs.

Maybe one large dose at time

SUCRAFATE decreases histamine 2 receptor blokcer effects.

12) Proton Pump inhibitors

decrease gastric secretions

For: gastric ulcers, esophagitis, indigestion, GERD

PRAZOLE

SE: Headache

Insomnia

diarrhea, flatulence

Rash

increased glucose

Nursing care: DO NOT CRUSH Pentaprazole (Drotonix)

Use filter when IV Pentaprazole

Before meals for best absorption

Monitor liver enzyme

Source: Exam cram

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I'll post some math formula's here: I know you all are aware of it, just for quick glance and revise:

IV flow rate:

1)

Flow rate in gtt/min=Total vol in (mL)xDrip factor(gtt/ml)/Time in min

So: gtt/min = ml x (gtt/ml) / minutes

Make sure to pay attention if the question is asking for the time or gtt/minute. and make sure to pay attention if the time is being asked in HOUR instead of minute.

2) Medication / dose

med/dose = desired dose x ml/available dose

3) Infusion rate (ml/hour)

Infusion rate = (dose/hr desired)/(concentration/ml)

concentraion/ml = known amount of med/ total volume of diluent (ml)

Pay attention to ur mcg and mg

Know what rounding to nearest tenth or one decimal place, whole number etc.

1 teaspoon = 5 ml

1 tablespoon = 15 ml

1 ounce = 30 ml

1 cup of fluid = 8 ounce, so (8x30 = 240 mL)

Now, I'm not sure if I got that gtt/min question right or wrong :l

Correct the information, if u find any error. thnks

This one december. About ped questions, not very much difference, except u consider WEIGHT (KG or LB) while doing these questions, Got me ;)

Guys, if you get a chance do look through EXAM cram MEDICATIONS/Pharmacology okay :yeah: Just go to the bookstore, and maybe spend couple of hours browsing thru it. Yeah the authors might sue, and I don't even have :twocents: in my name to pay for the lawyers right now :D:yeah:

Heparin and heparin derivatives: have PARIN

HCT and occult blood in stool check every 3 Months.

p.s. I posted these from my notes. Although, I copied most of it from Exam cram book to my notebook :yeah:

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