Published
Hello to everyone
Everyone is welcome to join this group. lets study together share views and give each other support and encouragement.
Who had passed exam your views, encouragement, advice would be appreciated.
By God grace we will pass this exam.
I am doing content write now. I did questions before I did not pass . So now going to concentrate more on content.
Any advise or tips .
Thank u 2 u 2!!!!!!!!!we all inthe same plate.....lol........good luck to everybody.!!! I was doing my tests(4000 quest) 75 & above , sometimes even 85% & now(a couple of days) i did as low as 67-70%. Im i overstuded?! Plz , anybody respond!!!!!!!!!
I wonder if you don't over guess at times. I was online reviewing Qs and noticed many that I would have gotten right if I'd gone with my 1st choice. I find too that I have difficulty choosing between 2 seemingly right answers and pick the wrong one at times. Maybe it's just the content or a certain type of question for you? Maybe relax more . .. Keep going!! Sounds like you'll do well!
I got that way when I was getting ready to take my LPN boards the closer it got my scores started dropping my instructor told me to take a break i was over analyzing the questions and studying to much. take a break and do something fun and then go back to doing your questions and see if it helps
Thank u 2 u 2!!!!!!!!!we all inthe same plate.....lol........good luck to everybody.!!! I was doing my tests(4000 quest) 75 & above , sometimes even 85% & now(a couple of days) i did as low as 67-70%. Im i overstuded?! Plz , anybody respond!!!!!!!!!
OMG. Me too... I thought its only me.. As my exam date is getting closer, My scores are dropping and I thought OMG, this is not a good sign and thinking to move my exam date again.. And sometimes it makes me so frustrated that makes me got too lazy do all these practice questions..
This whole thing is my everything and I cant afford to fail this again.
By the way what material are u using for your practice questions?
omg. Me too... I thought its only me.. As my exam date is getting closer, my scores are dropping and i thought omg, this is not a good sign and thinking to move my exam date again..And sometimes it makes me so frustrated that makes me got too lazy do all these practice questions..
This whole thing is my everything and i cant afford to fail this again.
By the way what material are u using for your practice questions?
hi there...........i think we got tired , thats the reason. I deside to give a break for questions, & just read some info. For reading i us kaplan book, & some notes that i made for rationals. For questions 4000 , sometimes 3500, or alternate type by silvestri, also lacharity book. What about u?
I am using the same material as yours, but right now I am using Saunders, and alternate it with the NclexRN3500 that someone gave me here in this site. My friend also recommend me the 4000? -in relation to that, is it the same thing as the 3500?
I did the La charity a month ago, and planning to review it again this week, but for some strange reason I couldn't find it.. I hope I didn't lose it..
I would also like to share that we need to do some form of exercise everyday coz our brain needs oxygen everytime(for me, I go to the gym) and eat a balance diet..
I am using the same material as yours, but right now I am using Saunders, and alternate it with the NclexRN3500 that someone gave me here in this site. My friend also recommend me the 4000? -in relation to that, is it the same thing as the 3500?I did the La charity a month ago, and planning to review it again this week, but for some strange reason I couldn't find it.. I hope I didn't lose it..
I would also like to share that we need to do some form of exercise everyday coz our brain needs oxygen everytime(for me, I go to the gym) and eat a balance diet..
hi jadecn read your thread. thanks for sharing..when is your exam?
I am using the same material as yours, but right now I am using Saunders, and alternate it with the NclexRN3500 that someone gave me here in this site. My friend also recommend me the 4000? -in relation to that, is it the same thing as the 3500?I did the La charity a month ago, and planning to review it again this week, but for some strange reason I couldn't find it.. I hope I didn't lose it..
I would also like to share that we need to do some form of exercise everyday coz our brain needs oxygen everytime(for me, I go to the gym) and eat a balance diet..
I'm finding that I want a change every few days and some days off here and there works wonders for me. While reviewing Saunders (should I say trudging through it?) I'm doing some note taking (writing memory review cards), reviewing study helps I've collected, doing questions/rationals from a few sources. Today I got out LaCharity and didn't do so good (a bit discouraged) but the rationale makes sense, so I'm wanting to work further on it now.
Ah yes, exercise! Green smoothies are great too, for energy.
NEVER STOP SMILING
132 Posts
HEY GUYS. HOW IS STUDYING GOING ON? I HAVE SOME NOTES THAT I MADE FOR QUICK "READING", THAT I WANT TO SHARE. IT MIGHT BE HELPFUL
PHOSPHORUS - 2.7 - 4.5 mg/dl
CFH glucose level – 50 mg/dl – 75 mg/dl
WBC - 5000 - 10000 mm
ESR – 15-20 mm/h
0-15 mm/h for men
0-20 mm/h for women
PLATELETS – 150000-350000 mm
CHOLESTEROL – 140-200 mg/dl
Most adults need 1,500 – 2,500 kcal /day& 1,500 – 2,500 ml/day (force 3,000ml/day).
Characteristic of urine:
1. COLOR - yellow
2. CONSISTENCY – clear, transparent
3. SPECIFIC GRAVITY – 1.010 - 1.030(higher than normal-very concentrated, lower than normal – very dilute).
4. PH – 4.5 – 8.0
5. 24 hr production – 1.000 – 2000(1.500)
SERUM CHANGES:
BUN – 7 – 18 mg/dl
CREATININE – 0.7 – 1.4 mg/dl
ELECTROLYTES:
POTASSIUM K – 3.5 – 5.0 mEq/L
SODIUM NA – 135-145 mEq/L
CALCIUM CA – 4.5 - 5.2 mEq/L
8.5 – 10.5 mEq/L
MAGNESIUM MG – 1.5 – 2.5 mEq/L
PHOSPHORUS PH – 2.7- 4.5 mg/dl
CHLORIDE – 100 – 110 mEq/L
Normal CVP(central venous pressure) – 3-7 mm Hg
Each unit of packed red blood cells contains 250 ml
Normal blood sugar for newborn – 50-90 mg/dl
Normal blood sugar for adult 70-110 mg/dl
PPD ( Mantoux Test ) resd 48-72 hr, 10 mm or higher ( hard area under the skin)- significant + reaction. In pt with HIV higher than 5 mm + read
Multiple puncture test read in 48 -72 hr vesicle formation + reaction
STOMACH PH - 1-3.5
NORMAL THYROID FUNCTION TEST:
T4 – 5-12 mg/dl
T3 – 65- 195 mg/dl
TSH- 0.3 – 5.4 mIU/dl
HASHIMOTO’S THYROIDITIS – T3 &T4 levels low & TSH high.
PRIMARY HYPERTHYROIDIDSM – T3 & T4 levels high & TSH low
HYPOTHYROIDISM – T4 low, T3 & TSH high
HASHIMOTO’S THYROIDITIS- is the most common cause of hypothyroidism
DRIP FACTOR - # of drops in 1 ml
DRIP RATE - # of drops infused/min
FLOW RATE - # of ml/hr
1 grain(gr)= 60 mg
TRANSMISSION OF HEP:
1. Hep Afecal/oral
2. Hep B – parenteral/sexual
3.HepC – blood/body fluids
4. Delta Hep - co-infects with Hep B
URINERY ALBUMIN > 30 ml /24 hr
IN TRAOCULAR PRESSURE (IOP)10- 21 mm Hg- if higher position pt 30 , no more
ALBUMIN – 3.5 – 5.5 best indicator for nutrition
ABG PH 7.35 – 7.45 ROMA - respiratory opposite,
PCO2(carbon dioxide) – 35-45 metabolic alike
HCO3 – 22-27 mEq/L
PO2 – 80-100 mmHg
O2 – 96% - 100%
BNP – it’s a diagnostic test for a heart. If it’s high – pt is @ risk for heart failure.
PT – Coumadin
PTT – Heparin
INR – 0.8 – 1.2 2 - 3
ANION GAP TEST–to specify cause of metabolic acidosis.NA–(Cl + HCO3)
GLASGOW COMA SCALE- scoring 1-15. Less than 8-indicates coma.
No suctioning before drawing ABG!
UREA BREATH TEST-to determine peptic ulcer.
Antibiotics or Bismuth Subsalicylate(Pepto-Bismol) disc. for 1 month before the test
Sucralfate(Carafate)&Omeprazole(Prilosec)disc.for 1 week bef. test
Cimetidine(Tagamet),Famotidine(Pepcid),Ranitidine(Zantac),Nizatidine (Axid) disc. for 24 hr before the test.
Water seal chamber–excessive bubbling–air leak in the chest tube sytem
An A1c – is a blood test that reflects average blood glucose levels over a period of 2-3 months;(normal 6-7-%for ct with diabetes) Drugs for bradycardia & low BP
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TPN –most import.- monitor for sterile technique for dressing change @ IVsite
LEAD POISONING- edetate calcium disodium(Ca EDTA)- 1 st check urinary output . Do not give to a child who can’t maintain adequate intake of fluids & adequate kidney function. Elevation of serum creatinine – signal renal involvement.
Mix the IODINE SOLUTION with fruit juice or other liquids ti disguise the unpleasant taste & give with meals or @ bedtime.
CHOLECYSTOGRAPHY- check allergies to iodine or seafood. POSTPROCEDURE- dysuria is common(contrast agent is excreted in the urine).
With PARTIAL REBREATHER MASK the respiratory alkalosis will be minimized.
CARDIAC DYSRHITHMIAS such as severe bradycardia can occur from vagal nerve stimulation during fecal impaction removal.
A ct postop T* should be @ least 95*.
BASOPHILS are responsible for releasing histamine during an allergic reaction.
Hg & HCT are typically performed 1 st in ct with upper GI bleeding to evaluate the extent of blood loss.
RENAL FAILURE- metabolic acidosis , high potassium levels.
MALLORY-WEISS TEAR is associated with massive bleeding after a tear occurs in the mucous membrane @ the junction of the esophagus & stomach . there is a strong relationship between forceful vomiting, & a Mallory-Weiss Tear. The bleeding is common from the stomach.
COLLES FRACTURE occurs in the distal radium. Falling with outstretched arms & hands may increase the risk of this type of fracture.
A history of undescended testis or cryptorchidism is a known risk factor of TESTICULAR CANCER.
OSTEOARTHRITIS- clinical findigs: joint pain, crepitus, Heberden’s nodes(bony growths at the distal interphalangeal joints), Bouchard’s nodes (growths involving the proximal interphalangeal joints),& enlarged joints.Regular exercise is beneficial .
The intrinsic rate of the AVnode is within the range of 40-70 beats/min
1 U of insulin = 15 g carb
The normal glucose levels for CSF ranges from 50mg/dl – 75 mg/dl.Low level of glucose may indicate a condition such as bacterial meningitis.
INTUSSUSCEPTION – treatm. BARIUM ENEMA
SINUS BRADYCARDIA – ATROPINE SULFATE
HIP FRACTURE – the affected leg is shorter , adducted, & externally rotated.
LOWER BRAIN STEM INJURY – HYPOXIA
For extravasation during DOPAMIN(INTROPIN) – elevate the affected limb, apply warm compress, & admin.Phentolamine(Regitine)
Terbutaline adverse reaction – HYPOKALEMIA
ATROPINE SULFATE dosage 0.5 – 1 mg IV . drug isn’t admin.IM for the treatm. of bradycardia
RUSSELL TRACTION-skintraction applied to a lower extremity , with the extremity suspended above the bed.
DUNLOP SCELETAL TRACTION is a traction of the upper extremity to where the arm elevated with the elbow being @ 90 *. N should observe for correct body positioning with emphasis on alignment of shoulders, hips, &legs.
KAWASAKI DISEASE(mucocuteneous lymph node syndrome)- lead to CORONARY ARTERY ANEURYSMS.
SICLE CELL CRISIS:O2,hydration,bed rest,electrolyte replacement, analgesics,blood replacement,antibiotics to treat any existing infections
The average dwell time (peritoneal dialysis) aprox. 20 min. The fluid infuses within 10 min, dwells for 20 min, & then drains in about 20
Alvimopan(Entereg)- peripherally acting opioid antagonist for prevention of postop ileus after partial bowel resection surgery
Bendamustine(Treanda)- alkylating agent for treatment of chronic lymphocytic leukemia &certain types of non-Hodkins lymphoma
Certlizumab(Cimzia)-a tumor necrosis factor (TNF blocker) for resistant Crohn’s disease
Cinryze- prevention of angioedema attack in pt’s with hereditary angioedema
Clevidipine(Cleviprex)-an injectible Ca channel blocker for hypertention
Desvenlafaxine(Pristiq) – an SNRI(serotonin norepinephrine reuptake inhibitor)for treatment of depression
Eltrombopag(Promacta)- a thrombopoetinreceptor agonist for treatment of idiopathic thrombocytopenia purpura
Etravirine(Intelence)- a non-nucleoside reverese transcriptase inhibitor for treatment of advanced HIV-1 infection
Fenofibric acid (Trilipix)- treatment of mixed dyslipidemia in combination with a statin
Fesoterodine(Toviaz) – an antimuscarinic for treatment of overactive bladder
Fospopofol(Lusedra) – a sedative to induce anesthesia
Lacosamide(Vimpat)- an anticonvulsant for treatment of partial onset seizures in adults
Methylnaltrexone(Rlistor)- a peripherally acting opioid antagonist for severe opioid induced constipation
Plerixafar(Mozobil)stem cell mobilize used before stem transplantation
Rilonacept(Arcalyst)- an interleukin-1 blocker to reduceinflammation in pt’s with cryopyrin- associated periodic syndrome
Romiplostim(Nplate) – a thrombopoeiet in receptor agonist to increase platelet production in pt’s with idiopathic thrombocytopenic purpura (ITP).
Rufinamide (Banzel)- an anticonvulsant for treatment of seizures associated with Lennox- Gastaut syndrome
Silodosin(Rapaflo)- an alpha-blocker for treatment of beningn prostastasic hypertrophy.
Tapendtadol(brand name pending)-treatment of pain
Tetrabenazine(Xenazine)-a monoaminedepletor for involuntary movement of Huntigton’s disease
Lactulose(Cephulac)- is adm to promote ammonia excretion in the stool & thus improve cerebral function. Because LOC is an accurate indicator of cerebral function , the N evaluate the effectiveness of lactulose by monitoring the ct LOC
BONE MARROW suppression becomes noticeable 7 -14 days after floxuridine admin.
Injury fromC1 -C8 – QUADRIPLEGIA- paralysis involving all 4 extrem
Injury from T1-L4 -PARAPLEGIA-paralysis involving only lower extreme
Injury C2- C3 usually fatal
Involvment above C4- respiratory difficult.& paralysis of all 4 extrem. Ct may have movement in the shoulder if the injury is at C5 or below.
Acute nephritis- give MG*
Pap test- class 1 – normal; 2-inflammation , repeat in 3 months;3-mild to moderate dysplasia, repeat in 6 weeks to 3 months; 4- possible cervical cancer; 5- warrants a biopsy A.S.A.P.
CARDIAC DISORDER- n o T* rectal rout
Dilantin-schedule follow-up visits with physician for blood test
Prinzmetal’s angina results from or artery spasm
Kayexalate removes potassiumfrom the body through the GI system
Hypovolemic shock from fluid shifts is a major factor in ACUTE PANCREATITIS
Dantrolene(Dantrium)-decrease muscle spastisity.Most common adverse effect – muscle wealness.
Amyotrophic lateral sclerosis-elecromyography (EMG)
Oligohydramnios – renal malformations in the neonate
Neostigmine(Prostigmine)-give before meals with a small amount of food
Pancreatic cancer-more common in African Americans, males, & smokers. Other associated factors incl. alcohol use, diabetes, obesity, history of pancreatitis, exposure to organic chemicals, consumption of a high-fat diet , & previous abdominal irradiation
Air embolism-turn ct Left side&in Trendelenburgs position.
Fat embolism- O2
Glucagone interacts adversely only with oral anticoagulants, increasing their anticoagulant effect
Ectopic pregnancy- history of pelvic inflammatory disease; intrauterine device for 2 years or more
Metronidazole(Flagyl)- cause metallic taste.Other adverse reac. Nausea, anorexia, headache , & dry mouth.
Modafinil(Provigil)- promotes wakefulness for narcolepsy
Oxytocin(Pitocin)-causes H2O intoxication
Amniotic fluid – nitrazine paper turns BLUE
Normal lady partsl discharge or urine-PINK
Periorbital edema-classic sign of acute glomerulonephritis
Nurse – client relationship & Therapeutic regimen 2 major clinical characteristics affect ct complients
Viral meningitis-s/s fever, nuchial rigidity, irritability, & photophobia
Bulging anterior fontanel is a sign of HYDROCEPHALUS
Petechial , purpuric rash may be seen with BACTERRIAL MMENINGITIS
COPD- high protein diet
Srevens-Johnson Syndrome (SJS)triggered by a reaction to meds. s/s conjctival burning , fever, cough, sore throat, headache, aches & pains, & rythema & mucous membr. As the disease progresses, large portions of the epidermis are shed , exposing the dermis &causing tender skin & a weeping surface. Keeping the tissue intact is the main priority for this ct. N/D Impaired tissue integrity- Priority
Jimsonweed- anticholinergic agent- hot , dry skin
Admin. Of ketamine hydrochloride (Ketalar)& the opioids-monitor for hallucination
Droperidol-extrapyramidal reactions
Thiopental, etomidate,& propofol can produce airway reflex hyperactivity with hiccups , coughing, &muscle twitching& jerking
Glipizide(Glucotrol)- may cause adverse skin reactions, such as rash, purities, & photosensitivity
Epidural hematoma is contraindicated. By an initial loss of consciousness followed by transient consciousness leading to
unconsciousness
Subdural hematoma results in rapid deterioration in level of consciousness
Subarachnoid hemorrhage causes irritability
Concussion may result in a brief loss of consciousness
To reverse arrhythmias , bradycardia , or sinus arrest , the usual adult dosage of atropine – 0.5-1mg IV Q 3-5 min PRN
Flumazenil(Romazicon)reverses the effects of benzodiazepins such as Midazolam
Naloxone (Narcan)-used to reverse the effects of opioids such as morphine
Phentolamine(Regitine)- is injected into the tissue to minimize the damaging effects of Dopamine(Inotropine) infiltration
Anergy testing determines the level of immune response an individual has to common microbes
CNS stimulants produce mood swings, anorexia &weight loss,& tachycardia
CNS depressants –hyperpyrexia,slow pulse, weight gain, hypotension, listlessness, increased appetite, slowing of sensorium, & arrhythmias
To determine CPP: subtract the ICP from the mean arterial pressure (MAP).
MAP=( ( diastolic blood pressure* 2)+systolic P ) : 3
Amphetamines – CNS - stimulants – cause sympathetic stimulation incl. hypertension,tachycardia, vasoconstriction & hyperthermia. Pupils dilated
IM injection of Digoxin isn’t recommended because it causes severe pain@ the injection site & increased serum creatinine kinase (CK) , which complicates interpretation of enzyme levels.
Blood transfusions- 18 or 19 G needle
Hypoactive bowel sounds–diarrhea, hunger,or early intestinal obstruction
Left sided heart falure- increased pulmonary artery diastolic pressure
Central venous pressure increases in heart failure rather than decreases
Heart index decreases in heart failure. The mean pulmonary artery pressure increases heart failure.
S/S multiple Myeloma (bone cancer)
C - alcium (elevation)
R – enal failure
A – nemia
B – one lesions
Snellen’s test – diagnose amblyopia(“lazy eye”)
Resuscitation of the neonatal with asphyxia- head in the “sniff”, position(extending the neck slightly)
Absolute neutrophil count(ANC)=
Total WBC count *(% neutrophils+%bands):100
If ct is > than 1000/mm3-no increased riskfor infection is higher with an ANC or less than 500/mm3 & the risk of infection is almost certain if the ANC is less than 100/mm/3
An early sigh of Digoxin toxicity- bradycardia. Other s/s of dig. Tox.- arrhythmias, vomithing, hypotension, fatigue, drowsiness, &visual halos around object.(Higher than 90 beats/min- notify the physician), do not take with meals( slows the absorption rate)
Aortic insufficiency- diastolic, murmur is high-pitched & blowing & is heard @the 3rd or 4 th intercostals space @ the left sterna border.
Aortic stenosis- systolic, harsh,loud & rough, crescendo-decresendo murmur, heard over the aortic area.
Mitral stenosis-diastolic, low-pitched rumbling murmur heard @ the apex
Mitral insufficiency- pansystolic ,high-pitched, blowing murmur @ the apex
MI can be: 1.anterior 2.posterior 3.lateral 4.inferior
An anterior MI causes left ventricular dysfunction & can lead to manifestations of heart failure , which include pulmonary crackles & dyspnea. Posterior, lateral,& inferior MI aren’t usually associated with heart failure.
Fetal tachycardia & excessive fetal activity -1st signs of fetal hypoxia
Uremia, anemia & acidosis- consistent clinical manifestations of chronic renal failure
Adverse reaction to OXYTOCIN(PITOCIN)- in the mother incl. hypertension, fluid overload,& uterine tetaning. The antidiuretic effect of oxytocyn increases renal reabsorbtion of H2O, leading to fluid overload- not dehydration. Jundice & bradycardia are adverse reactions that may occur in the neonate. Tachycardia is reported as a maternal adverse reaction.
Lithium toxicity- muscle twitching, mental confusion, incoordination, &coorifice hand tremors.
Severe Lithium toxicity- ataxia(luck of muscle movement), giddiness(dizziness), blurred vision, &severe low BP.
Monitoring PaO2 levels(partial pressure)& reducing the O2 concentration to keepPO2 within normal limits decrease risk of RETINOPATHY OF PREMATURITY in a premature neonate receiving O2.
MAOIs have an onset of action aprox 3-5 days.Full clinical response may be delayed for 3-4 weeks. The therapeutic effects may continue for 1-2 weeks after discontinuation.
Conversion disorder is characterized by alteration or loss of physical function with no physiological basis.
It takes up to 2 hrs for Lidocaine-prilocaine cream(EMLA cream) to anesthetize an insertion site.
Paralytic ileus-hypoactive or absent bowel sounds
About 75% of ANEURYSMS occur in the abdominal aorta, just below the renal arteries.
Congenital hip dislocation (infant)-assessment- Ortolanis sign- asymmetrical thigh &gluteal folds, limited hip abduction, femoral shortening, & Trendelenburg’s sign
Tension pneumothorax-decreased cardiac output, decr. tension,tracheal deviation to the opposite site.
Lichtheim’s sign – inability to speak associated with subcortical aphasia
Kernig’s sign +, Brudzinski’s sign + = meningitis
Babinski’s reflex -indicator of corticospinal damage
Acetaminophen overdose-gastriclavage &activated charcoal
Pril(ACE inhibitors)-dizziness,headache, &hypotension common adverse effects; may cause diarrhes
Frontal lobe damage-affects personality, memory,reasoning, concentration,&motor control of speech
Brain steam damage- hearing & speech problems
Temporal lobe damage- hearing&speech problems
Occipital lobe damage-vision disturbances
MI- T-wave inversion; ST – segment elevation,& pathologic Q-wave-signs of tissue hypoxia
The Hemovac must be compressed to establish suction
Retinal Detachment- light flashes & floaters in front of the eye
Glaucoma-gradual loss of peripheral vision
Acute (angle-closure)glaucoma-headache,nausea , &redness of the eyes
Cataracts-double vision is common
Intraosseous infusion(infusion in the bone marrow)in an emergency, intraosseous drug admin. Is typically used when a child is critically ill & younger than age 3
LOOP DIURETICS adverse reaction: weakness, irregular pulse, hyperactive bowel sounds, decreased muscle tone , hypokalemia,ventricular arrhythmias
TOXOPLASMOSIS OTHER RUBELLA VIRUS CYTOMAGALOVIRUS HERPES SIMPLEX VIRES (TORSH) may affect fetus or neonate.
Rear –facing car seat (infants)-until 20lbs or 1 y.o.
Labor- 4 stages, 3 phases:
1st stage onset of labor to full dilation(1st phase-early(0-3 cm),2nd phase active(3-7 cm),3rd phase transition(7-10cm) )
2nd stage full dilation to birth of the baby
3rd stage birth of the placenta
4th stage 1 hr postpartum
Bence Jones protein in the urine almost always confirms multiple myeloma
Arterial (peripheral)insufficiency of the lower extremities- lower the legs to dependent position
Pulmonary embolism –sudden tachypnea , dyspnea, & chest pain
Addison’s disease- s/s hyponatremia,hyperkalemia, dehydration, low BP, metabolic acidosis
Toddler- separation anxiety
Etnocentrism-universal unconscious tendency of human beings to think that their ways of thinking, acting, &believing are the only right, proper & natural ways
Aspirin – pt who takes daily- monitor for serum albumin to prevent aspirin toxicity
SIDH-s/s overproduction of antidiuretic hormone , fluid retention.Severe cases- vascular fluid overload , signated by jugular vein distention
Discharge planning begins upon admission
Cillen’s sign –blue black bruising of the area around the umbilicus.the sign takes 24-48 hr to appear& predicts a severe attack of ACUTE PANCREATITIS.it may be accomp. By Grey Turner’s sign( bruising of the flank), which may then be indicative of pancreatic necrosis with retroperitoneal or intraabdominal bleeding
Measels- koplik spots
Kaolin &pectin mixture(Kaopectate)-antydihrreal meds
Sudoriferous glands secrets SWEAT
Plug the opening of the trach tube in pt who doesn’t require continuous mechanical ventilation should be 5-20 min
Joint abnormalities –most obvious manifestations of rheumatoid arthritis
Vesicular lesions – impetigo
If Ascites presentin ct with cirrhosis of the liver, potassium-sparing diuretics such as Aldactone, should be admin., because it inhibits the action of aldosterone in kidneys
Dilantin-child should brush & floss the teeth , because it causes lymphoid hyperplasia(gums)(gingival hyperplasia)
NSAIDs taken for long period of times-bleeding in GI
IM injectons for infants&toddlers should not exceed volume of 1.0 ml
Crede method-done by gently pressing down on bladder
Endoscopy-hoorificeness is normal; watch for laryngospasm or bronchospasm
Barium contrast(test)-low residue diet or clear liquid diet for 2 days
EEG(electroencephalogram)- do not stop anticoagulants before test
Dextrocardia-heart in the right side
Dressler’s syndrome- postmyocardial infarction syndrome-pleuratic chest pain,pericarditis, fever,&leukosytosis
Syncope-transient loss of consciousness resulting from an inadequate blood flow to the brain
RIGHT SIDE HEART FAILURE:
1. NOCTURIA
2. BULGING NECK VEINS
3. ANKLE &FOOT EDEMA
4.HEPATOMEGALY
LEFT SIDE HEART FAILURE:
1. RESTLESSNESS, IRRITABILITY, HOSTILITY,AGITATION
2. ANXIETY
3. SHORTNESS OF BREATH, AIR HUNGER
4. COUGH, OFTHEN DRY INITIALLY
5. TACHYPNEA
6. CRACKLES
7. PULMONARY EDEMA
8. “FROTHY”, SPUTUM-MAY BE BLOOD TINGED
9. DIAPHORESIS
10. CYANOSIS
11. WEIGHT GAIN
Cardiac tamponade is a medical emergency!Classic s/s :1.Hypotension
2. muflled heart sounds with high jugular venous pressure(increased CVP).
SHOCK-DO NOT! Elevate or lower the head of the bed.maintain complete bed rest in FLAT POSITION or legs slightly raised to increase venous return.DO NOT! Move ct; no commode. Keep ct warm.
Open pneumothorax:hole in the chest wall, communication with lungs
Closed pneumothorax:hole in the lung; chest wall intact.air forced into the pleural space with a continued pressure build up.shifts mediastinum away from affected sidenwith results of a compressed heart .Treated with chest tube insertion.Cardiac &respiratory arrest if not treated.
Tension pneumothorax:A NURSING &MEDICAL EMERGENCY!
All of these musculoskeletal disorders, exept Guillian-Barre feature the letter m:1. Myasthenia gravis 2.Poliomyelitis 3. Amyotropic Lateral Sclerosis 4.Muscular Dystrophies
Guillian-Barre syndrome-follows a viral infection. Ascending paralysis that may affect muscles of respiration as paralysis ascends.
Cor Pulmonale- right ventricular hypertrophy & subsequent chronic heart failure
Asthma-avoid aspirin & other NSAIDs
Ct with anemia may be severely hypoxemic & never turn blue, but rather “ashen”
Low pressure alarm sounds- the ventilator tube disconnects.
High pressure alarm sounds-check for obstruction or occlusion of the airway :mucousplugs,bitting of the tube by ct, tube slips into right main stembronchus, or increased secretions.
Communications difficulties of a ct with CVA usually indicate involvement of the dominant hemisphere, usually the left brain.
Multiple sclerosis-early changes:vision& motor sensation; late change:cognition& bowel control
Epinephrine eye drops NO!to ct with heart condition
Acute closed –angle glaucoma(shallow, narrow-angle,or congested glaucoma)-MEDICAL EMERGENCY!Blindness may occur in 2-5 days if left untreated.s/s:Sudden onset of blurred vision, halos or colored rings around white lights; sudden frontal headache; sudden severe eye pain , reddening of the eye , nausea& vomiting.
Alkaline substances(lye,ammonia,some powdered detergents,drain cleaner,&battery fluid)in the eye Priority to treat for.Acids in the eye- reversible damage.
Retinal detachment-sense of a “curtain being pulled over the eye
Cystocele-hernia (bladder into lady parts)
Chronic renal failure-low protein diet,low potassium,low carbonated drinks.
Acute renal failure- regular protein intake,high carb, restrict fluid high in potassium, phosphorus & sodium.
Bromocriptine(Parlodel)-growth hormone suppressant
Physical changes of Acromegaly are irreversible
VDRL becomes reactive 2-6 weeks after the primary infection;syphilis is treated with penicillin G IM or erythromycin for 10-15 day if allergic to PCN.Chlamidia & Gonorrhea may be asymptomatic in females , pelvic inflammatory disease can develop if left untreated