March 2008 NCLEX support group

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A thread for all those in March who are planning to take the NCLEX offering both support and any hints or tips that help

Good luck to all :D

Specializes in OB/GYN/OR.

Hi....

I would like to add something ....

First line

Oxygen, aspirin, glyceryl trinitrate (nitroglycerin) and analgesia (usually morphine, hence the popular mnemonic MONA, morphine, oxygen, nitro, aspirin) are administered as soon as possible. In many areas, first responders can be trained to administer these prior to arrival at the hospital. Morphine is the preferred pain relief drug due to its ability to dilate blood vessels, which aids in blood flow to the heart as well as its pain relief properties.

Of the first line agents, only aspirin has been proven to decrease mortality.[88]

Once the diagnosis of myocardial infarction is confirmed, other pharmacologic agents are often given. These include beta blockers,[89][90] anticoagulation (typically with heparin),[75] and possibly additional antiplatelet agents such as clopidogrel.

Patients who present with suspected acute myocardial infarction and ST segment elevation (STEMI) or new bundle branch block on the 12 lead ECG are presumed to have an occlusive thrombosis in an epicardial coronary artery. They are therefore candidates for immediate reperfusion, either with thrombolytic therapy, percutaneous coronary intervention (PCI) or when these therapies are unsuccessful, bypass surgery.

THROMBOLYTIC THERAPY

Depending on the results of the ECG, certain patients may be given blood thinners within 12 hours of when they first felt the chest pain. This is called thrombolytic therapy. The medicine is first given through an IV. Blood thinners taken by mouth may be prescribed later to prevent clots from forming.

Thrombolytic therapy is not appropriate for people who have:

  • Bleeding inside their head (intracranial hemorrhage)
  • Brain abnormalities such as tumors or blood vessel malformations
  • Stroke within the past 3 months (or possibly longer)
  • Head injury within the past 3 months

Thrombolytic therapy is extremely dangerous in women who are pregnant or persons who have:

  • Severe high blood pressure
  • Had major surgery or a major injury within the past 3 weeks
  • Internal bleeding within the past 2-4 weeks
  • Peptic ulcer disease
  • A history of using blood thinners such as coumadin

One more thing to remember is

If patient had a MI and went into cardiac arrest and CPR was administered ..then Tpa is not given or is contraindicated

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Specializes in OB/GYN/OR.

Hi guys,

always find this difficult to remember so researched and:idea:

the following has drugs to be taken on an empty stomach or with food

http://www.globalrph.com/drugfoodrxn.htm

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Specializes in PACU.

great add iminginor! I just learned about CPR and tpa in my kaplan class. I still forgot to mention it. you cant give Tpa to a cpr patient because CPR is considred traumatic! thanks for the post

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Specializes in OB/GYN/OR.

Hi guys,

I have a question ...this is about diets and nutrition... say a question asks which foods are rich in say, calcium.... are we supposed to know how much amount of calcium is present in say one cup of milk?? or say in case of a iron rich diet... the amount of iron in a cup of spinach??? are we asked to calculate these amounts... or say i serving of fat=9cals so are these numbers to be studied?? ...I used to know them when I was in school...but though I do know the various foodstuffs and kinds of diets generally ...I dont remember individual amounts .... is it necessary to study them?????

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Specializes in PACU.
Hi guys,

I have a question ...this is about diets and nutrition... say a question asks which foods are rich in say, calcium.... are we supposed to know how much amount of calcium is present in say one cup of milk?? or say in case of a iron rich diet... the amount of iron in a cup of spinach??? are we asked to calculate these amounts... or say i serving of fat=9cals so are these numbers to be studied?? ...I used to know them when I was in school...but though I do know the various foodstuffs and kinds of diets generally ...I dont remember individual amounts .... is it necessary to study them?????

thats a good question. i dont think we need to know how much calcium or whatever is in a particular food. rather, i think its more important to know which foods are the best source of the nutrient. i cant think of any examples right now.....

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Specializes in Psychiatric Nursing.
thats a good question. i dont think we need to know how much calcium or whatever is in a particular food. rather, i think its more important to know which foods are the best source of the nutrient. i cant think of any examples right now.....

exactly, you need to identify which among the choices have the highest or the lowest of that particular nutrient...which among these have the highest in potassium:

1. Pineapple

2. Peaches

3. Kiwi

4. Apples

Answer in my next post:)

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Specializes in Psychiatric Nursing.
exactly, you need to identify which among the choices have the highest or the lowest of that particular nutrient...which among these have the highest in potassium:

1. Pineapple

2. Peaches

3. Kiwi

4. Apples

Answer in my next post:)

and the answer is....Kiwi. All the rest are low in potassium. Hope this helps:)

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Specializes in OB/GYN/OR.

Hi OR2CA,

would you be interested in making a list of topics to revise ?.... any suggestions would be welcome..

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Specializes in Psychiatric Nursing.
Hi OR2CA,

would you be interested in making a list of topics to revise ?.... any suggestions would be welcome..

im not so sure what you mean...can you please explain??? sorry im quite slow these days:) maybe this is information overload hehehe:)

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Specializes in OB/GYN/OR.

i noticed you mentioned that you find renal/cardio.. a little tough...i do find cardiac topics tough.... so like if we made a list say like renal.. revise ARF, CRF, dialysis etc... then each of us could post matter or tips or mnemonics to study....and probably these would help us in areas we are weak in.. like i find endocrine difficult too....pharm is another area a lot of us find difficult.... so if we made alist of say common drugs for each subject or even classifications i think everybody would find those helpful...

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Specializes in Psychiatric Nursing.
i noticed you mentioned that you find renal/cardio.. a little tough...i do find cardiac topics tough.... so like if we made a list say like renal.. revise ARF, CRF, dialysis etc... then each of us could post matter or tips or mnemonics to study....and probably these would help us in areas we are weak in.. like i find endocrine difficult too....pharm is another area a lot of us find difficult.... so if we made alist of say common drugs for each subject or even classifications i think everybody would find those helpful...

hmmm...i like that. as for endocrine, for me its not as difficult as renal/cardio...but im not sure where to start. im doing the pharma chapters now and its really really challenging. how bout ABGs? are you fine with it??? so would you like to start with renal first or cardio? maybe we start with cardio first, do you think??? then proceed to renal?

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Specializes in OB/GYN/OR.

thats great!!....maybe anyone of us:cheers: .. make a list of system wise topics and post it everyday... and then everybody could add anything they have to add... or... we could say give a couple of days to revise and then we could put up things to remember for commonly asked topics...pharm .... how about doing it system wise with the classifications and important stuff to remember for each?? sounds like a lot but if we do it diligently... maybe it could be of help.....

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