Heather0688

i took my nclex-rn on tuesday and passed with 75 questions . i wanted to share with everyone what helped me. i did not take kaplan or any other review course. i wouldn't have been able to pay attention and sit through the class and may as well spend my time studying at my own pace at home. i used saunders and prentice hall review books. i made a study plan and each day went over two chapters (say one day was cardiology and then the chapter on cardiac meds) until i had went over all the areas i felt i was weak in. i also did 100-250 questions per day depending on how close i was to test day. i used mostly saunders review questions from the cd, but i also used exam master, and la charity, which i felt was the most helpful book of them all. it had questions about which pt to see first, who to delegate to, and so on. having done those questions helped me feel so much more comfortable when i was taking the nclex. also, i made a little study guide of stuff i had read on here, and found in books that i felt was basic and went over mostly this the last couple days, so i had something to focus on rather than focusing on all the things i "forgot" to study. i'm going to try and copy/paste it here. this is all stuff i wrote down before taking nclex, so it is not guaranteed you will see all these things, but i did find it extremely helpful. wish you all the best of luck! chest tubes -continuous bubbling= air leak -bubbling with inspiration= okay -continuous bubbling in suction chamber= okay -up and down in water seal= okay types of insulin -rapid acting (lispro, humalog) -onset= 5 minutes -peak= 30 minutes -short acting (novolog, regular) -onset= 30 minutes -peak= 2 hours -intermediate acting (nph) -onset= 1 hour -peak= 6-12 hours -long acting (humulin) -onset= 4 hours -peak= 16-18 hours -maslows= physiologicàsafetyàlove & belongingàesteem & recognitionàself actualization -piaget= sensorimotor (birth-2)àpreoperational(2-7)àconcrete operational(7-11)àformal operations(11-death) -eriksons=trust vs. mistrust(birth-1)àautonomy vs. shame and doubt(1-3)àinitiative vs. guilt(3-6)àindustry vs. inferiority(6-12)àidentity vs. role confusion(12-18)àintimacy vs. isolation(early adulthood)àgenrativity vs. stagnation(middle adult)àego integrity vs. despair(older adult) airborne precaution (sars is airborne/contact) my - measles chicken - chickenpox hez - herpes zoster (disseminated) tb - tb -private room -negative pressure with 6-12 air exchanges per hour -uv -mask, standard precautions (gown,gloves) -n95 mask for tb -put own eyewear-->mask-->gown-->gloves and take off in opposite order (this applies to all infection control) droplet precaution think of spiderman! s - sepsis s - scarlet fever s - streptococcal pharyngitis p - parvovirus b19 p - pertussis p - pneumonia i - influenza d - diptheria (pharyngeal) e - epiglottitis r - rubella m - mumps m - meningitis m - mycoplasma or meningeal pneumonia an - adenovirus -private room -mask and standard precautions contact precaution- standard precautions mrs.wee m - multidrug resistant organism r - respiratory infection - rsv s - skin infections w - wound infections e - enteric infections - clostridium defficile e - eye infections skin infections private room, gloves, gown v - varicella zoster c - cutaneous diptheria h - herpes simplex i - impetigo p - pediculosis s - scabies, staphylococcus cranial nerves 1) olfactory 2) optic 3) oculomotor 4) trochlear 5) trigeminal 6) abduchens 7) facial 8) acoustic 9) glossopharyngeal 10) vagus 11) spinal accessory 12) hypoglossal triage red-unstable, but fixable, see first yellow-stable, can wait for up to an hour for treatment, see second green- stable, can wait for a while, "walking wounded" black- unstable clients that probably won't make it, comfort measures doa- dead on arrival antidotes -heparin- protamine sulfate -coumadin- vitamin k -meg sulfate- calcium gluconate -morphine- narcan -anaphylaxis- epinephrine -tensilon-atropine sulfate -tylenol= mucomist -benzodiazapines= romazicon lab values coagulation -pt = 10-13 seconds, 1.5-2 times the control for coumadin therapy -aptt= 20-35 seconds, 1.5-2.5 times the control for heparin therapy -ptt = 60-70, 1.5-2.5 times control in anticoagulant therapy -inr= 2-3 electrolytes -na+ = 135-145 -k+ = 3.5-5.0 -cl- = 95-105 -ca+ = 8-10 -mg+ = 1.5-2.0 -protein = 3.5-5.5 hematology -wbc = 5000-11000 -neutrophils = 45-75% -rbc = 4.5-6 million -hgb = 12-16 (women), 13-18 (men) -hct- 36-46% -platelet = 150000-400000 renal function -bun= 7-20 -creatinine= 0.5-1.5 -urine specific gravity= 1.010-1.030 cholesterol -total= -ldl = liver -ast = 10-40 -alt= 5-35 electrolytes -hyponatremia- hypervolemia, edema, increased urine output, lethargy, dizziness, diarrhea, use isotonic solutions, give loop diuretics(excess water) -hypernatremia- tachycardia, hypertension, hypovolemia, seizures, decrease na+ intake, assess i&o, loop diuretics( excess sodium) hypokalemia- flattened t wave, u wave appearance, weak shallow respiratations, paresthesias, give k+ hyperkalemia-bradycardia, narrow/peaked t waves, widened qrs, flattened p waves, muscle cramps, diarrhea, give k+ wasting diuretics hypocalcemia-chvostek's sign (cheek twitching), trousseau's sign , diarrhea, bone fractures, give calcium gluconate, multivitamin hypercalcemia- decreased deep tendon reflexes, lethargy, coma, nausea/vomiting, give loop diuretics hypomagnesemia- chronic alcoholics, laryngeal stridor, inverted t wave,confusion, associated with hypokalemia hypermagnesemia- decreased deep tendon reflexes, hypotension, bradycardia, elevated t wave, weakness hpochloremia- tremors/twitching, shallow breaths, associated with hyponatremia/hypokalemia, give oral salt tablets hyperchloremia- weakness, lethargy, seen with cystic fibrosis, renal failure, diabetes insipidus hypophosphatemia- associated with hypercalcemia, slurred speech, tetany, parathesias, increased breathing rate, hypoactive bowel sounds hyperphosphatemia- associated with hypocalcemia, oliguria, corneal haziness, tachycardia, circumoral parathesias, tetany acid-base imbalances respiratory acidosis- copd, hypoventilation, etc. respiratory alkalosis- hyperventilation metabolic acidosis- dka, lactic acidosis, starvation, diarrhea, renal failure, shock metabolic alkalosis- vomiting, nasogastric suctioning, diuretic therapy, excess licorice intake iv solutions isotonic- normal saline, lactated ringers, 5% dextrose in water hypotonic- 0.45% ns, 0.225% ns hypertonic- 5% dextrose in 0.45% ns, 5% dextrose in 0.9% ns med-calc vol (ml) / time (minutes) x drop factor = flow rate dose order / dose on hand x amount available = amount to give random -vasopressin is for diabetes insipidus -duodenal ulcers= pain relieved by eating -gastric ulcers-pain exacerbated/unrelieved by food -hypoparathyroid- low calcium, high phosphorus, s/s: parathesias -hyperparathyroid- high calcium, low phosphorus, s/s: decreased deep tendon reflexes -5 rights of delegation- right task, right circumstance, right person, right direction/communication, right supervision/evaluation -normal serum osmolality= 275-295 -therapeutic digoxin level= 0.5-2 -therapeutic theophylline level= 10-20 -therapeutic lithium level = 1-1.5 -fetal heart strips: veal chop (variable is cord, early is head, accelerations is ok and late is placental insuffenciency) - 60 mg= 1 gr -autonomic dyreflexia- check foley first! -mi treatment= mona (morphine, oxygen, nitro, aspirin) -hyperglycemia = dry and drowsy, hypoglycemia = wet and wild -pulse paradoxus- pulse is weak on inspiration and strong on expiration -hypothyroidism: decreased t3 +t4, but increased tsh -hypertyroidism: increased t3 + t4, but decreased tsh