Printable: Random Notes

[david.cummiskey]

it helps me to type things out and read through them a few times so here are a few notes i've made today.

chicken pox- puritic (itchy) rash – macule (red) – papule (raised)- vesicle (fluid filled) spread by direct contact, communicable 2 days before rash, isolation until all vesicles crusted, topical calamine lotion, avoid aspirin use tylenol. not aspirin with children

rubella- measles- macularpapular rash (red-raised) on face, then rest of body. spread by droplet, contact precautions, isolate from pregnant women, antipyretics (tylenol not aspirin) and analgesics

reyes syndrome- caused by aspirin- cerebral edema and fatty liver

mononucleosis- kissing disease- flulike aches, fever, enlarged lymph nodes, sore throat, 15-30 yr olds, spread by direct contact with oral secretions, avoid saliva for 3 months, rest and good nutrition. rest rest rest risk for ruptured spleen.

tonsilitis- fever, white exudate on tonsils, treated with antibiotics, potential complications: rheumatic fever, glomerular nephritis

tb- skin test mantoux (ppd) induration or hardness 10mm or greater (5 mm or greater in aids pt) or tine test looking for vesicles. symptoms include: fatigue, anorexia, low-grade fever, night sweats, cough with mucopurulent sputum streaked with blood, dyspnea nursing care: isolation for 2-4 weeks (3 negative sputum cultures), notify health dept. to evaluate contacts, teaching. medication: always on more than one to prevent drug resistance. isoniazid (inh), rifampin, ethambutol, stretomycin (im). on meds 6-9 months.

hepatitis: jaundice, anorexia, ruq pain, clay-colored stools, tea-colored urine, pruritis, elevated alt, ast, prolonged pt.

hep a-fecal/oral- do not prepare food

hep b-parenteral/sexual- vaccine

hep c-blood/body/fluids

hep d-co-infects with hep b

hepatitis nursing care: rest, contact and standard precautions, low-fat, high calorie, high-protein diet, no alcohol, medications (vit k, antiemetic, corticosteroids, antihistamines)

lyme’s disease

stage 1- red area with papule develops into lesion with clear center (bull’s eye), regional lymphadenopathy, flu-like symptoms

stage 2- cardiac conduction defects, neurologic disorders (bells palsy-temporary paralyisis)

stage 3- arthralgias, enlarged, inflamed joints

prevention- cover exposed areas in wooded areas, check exposed areas for ticks

nursing care- antibiotics for 3-4 wks (doxycillin)

stds

syphilis- painless chancre fades within 6 weeks, copper-colored rash on palms and soles, spread mucous membranes, congenital, treat with penicillin g im or erythromycin if patient has penicillin allergy

gonorrhea- thick discharge from urethra, asymptomatic in females, spread by mucous membranes, congenital, im rocephin doxycycline po, im aqueous penicillin with po probenecid (gout med) increased effectiveness of penicillin. complication pid

genital herpes- painful vesicular genital lesions, reoccurs with stress, infection, menses, spread mucous membranes, congenital, acyclovir, sitz bath, monitor pap smears regularly due to high cervical cancer risk

chlamydia- men: urethritis, dysuria. women: thick lady partsl discharge and acrid odor. spread mucous membranes, congenital, tetracyline or doxycycline po may cause sterility if left untreated. notify sexual contacts.

venereal warts- single, small papillary lesion spreads into large cauliflower cluster on perineum, lady parts, member, spread mucous membranes, congenital, curettage, cryotherapy with liquid nitrogen, kerotolytic agents. avoid intimate contact until healed. strong correlation with cancer.

aids, hiv positive

hiv (+)-presence of hiv in blood

aids- defects in immune function, associated with positive hiv virus, opportunistic infections, cd4 counts below 200.

opportunistic infections associated with aids:

p. carnii pneumonia- sob, dry non productive cough

c. albicans stomatitis- difficulty swallowing, white exudate back of throat

c. neoformans- deabilitating type of meningitis

cytomegalovirus (cmv)- lymphadenopathy, visual impairment

kaposi’s sarcoma- most common, small purple brown, nonpainful, nonpuritic palpable lesions on body.

aids transmitted by blood, body fluids, sharing iv needles, sex, transplacental, breast milk. clean blood spill up with bleach.

elisa

confirm with western blot

decrease in wbcs

contact and standard precautions, high protein, high calorie diet. symptomatic relief, support.

stomatitis (inflammation of mouth), do not share toothbrush or razor.

poison control- treat pt first then poison. call poison control center with what substance, when, how much, route of ingestion, condition now, age and wt.

do not induce vomiting if danger of aspiration ( decreased loc or gag reflex) if child ingested pain thinner, lighter fluid, (petroleum distillate). corrosive.

if wasn’t corrosive give ipecac (emetic) with small amount (4-8oz) of clear fluid to induce vomiting. position head lower than chest. don’t give large amount of fluid. don’t use milk, have a bottle of ipecac for everyone in household, 1 bottle per person.

lead toxicity- blocks formation of hgb and toxic to the liver. irritability, decreased activity, increased icp. metal retardation in children. nursing care: chelating agents.

accident prevention

newborn: rear facing care seat, crib safety, no smoking, lead free paint

infant: check water temp, avoid small objects (choking)

toddlers: child proof home, 20 lb front facing car seat in back seat of car

children: bicycle helmet, sports safety, swimming pool safety

adolescents: teach ways to deal with anger, driving safety

adults: handgun control, responsible sexual behavior, smoke and carbon monoxide detector

elderly- higher risk for injury poor balance, slow reaction time, exercise and assistive devices, sufficient lighting, up and down stairs, good shoes, cleaning pathways

triage- red- unstable, yellow-stable can wait, green- stable can wait longer, black- unstable, probably fatal. doa.

bells palsy- tape eye shut at night, frequently use artificial tears to protect cornea from drying due to inability to close eye, place food in unaffected side of mouth, protect face from cold

myelomeningocele- no pressure on back

licorice can increase potassium loss

set up field before donning gloves, above waist, outer inch is contaminated

induration is area of hardened tissue, positive sign of tb on mantoux test, 5mm or> on hiv pt 10mm or> on reg pt. measure induration not redness

eye drops- do put drops in middle inner cantus, push on inner angle of eye to prevent systemic contamination, and blink between drops, do not touch dropper, allow to flow to other eye or squeeze eye tightly

aminophylline-xanthine bronchodilator-may cause rapid pulse and dysrythmias

right side elevated- promotes emptying of stomach and prevents aspiration

look for jaundice on posterior palate in asians. may be result of inh hepatotoxicity

ileostomy- very irritating to skin, should empty at 1/3 full, keep bag on at all times, record output, do not use moisturizers prevents a good seal around stoma

narcan causes signs and symptoms of opiate withdrawl (heroin) – n&v, restlessness, abd cramping, htn, tachycardia

unintentional wrong- negligence (doing something bad, not doing something good)

malpractice- duty, breach of duty, injury, causation of duty

intentional wrong- assault- intentional threat

battery- intentional touching of pt without consent

invasion of privacy- release of information w.out client consent

hep a- anorexia, malaise, lethargy, easily fatigued

fundus at level of umbilicus then one finger down per day

validate feelings and present reality

menieres disease- stick to low sodium to avoid vertigo

septic shock- dic- mini clots everywhere until clotting factors used up then hemmoraging. look for blood at venipuncture site and around iv catheter.

acute glomerularnephritis is caused by strep

ace inhibitors- blocks release of aldosterone causing potassium retention

[jolena_75]

Wow!! Thank You!!

[ShannyRN]

This is great!! I'm like you. It helps me to write out everything. Especially when I'm reading rationales. Thanks for the assistance!!

[mochi6]

Yay! Thanks for sharing! This is great!

[nursetobe4]

Wow...this is awesome! Thank you so much for sharing your notes David! I took the NCLEX 2 weeks ago and didn't pass But studying again to retake on Aug. 24th and this helps BIG TIME!

[beachbutterfly]

Thank you David,I'm printing this out,everything that you posted so far has been a great help!!!!!!!!!!!!!!!!!!!!!1

[spongebob6286, BSN, RN]

i wish i was able to study that. nice.

[joycee8]

HI david! thanks for the kind and effort in posting! it will be a great help. i will read this later....GOD BLESS!!!

[KAYBDT6, BSN, RN]

:yeah::yeah::yeah: