Newgradq

Glad it's helping.... Tessa about the 311 take 120-160 as the general base, so take 120-30 = 90 then 160-130 = 130 so the HR range for an infant is 90-130 (that's the 3 of the 311 formula) then take 90-10 = 80 and 130-10=120 so the HR range for a toddler is 80-120 then subtract 10 from 80 and 120 to get a HR range for a preschooler of 70-110 and the other #s written next to these figures, are the RR for these age groups... hopefully that doesn't confuse you more.. Think: 311 (Fetal HR 120-160) HR RR -[30] 90-130 Infant 30-60 -[10] 80-120 Toddler 20-30 -[10] 70-110 Preschooler 16-22

OK .. SO I passed NCLEX on the 1st try with the dedication and devotion other NCLEX takers/preparers have helped with on this site...so I thought I'd do my part by designing a study guide to help lessen the burden and frustrations of studying for NCLEX for future test takers... and to those of u taking the test soon...just try and your best, breathe, and pray!! Oh and I borrowed some material from other people's postings, my NCLEX review class, and Nursing classes... And don't listen to what other ppl say ... it is a totally COMPREHENSIVE test... I heard there wasn't much pharm and didn't study as well as I should have and out of 75 questions I had like 35-40 pharm ?s and well let's just say it's a miracle I passed!! Lov ya all ....happy studying!! (PS sorry for random order but content will def help) :dancgrp::dncgcpd: Cardiac Rate- Peds Remember: 311 (Fetal HR 120-160) RR -30 90-130 Infant 30-60 -10 80-120 Toddler 20-30 -10 70-110 Preschooler 16-22 Temperature ºF = (1.8 * ºC) + 32 (Think of them as being ~ 2º apart) 37ºC = 98.6º F 38ºC=100.4º F 39ºC=102.2º F 40ºC =104 º F Labs á BUN/CR = Dehydration â BUN/CR = Overhydration El: Na (135-145) K (3.5-5) Mg (1.5-2.5) Ca (9-11) Cl (96-106) Phos (3-4.5) Endocr: BUN (7-22 or to remember put the buns in the oven for 10-20 min) Cr (0.5-1.5) Urine Spec Gravity (1.005-1.030) Glucose: Nml 80-110 Fasting Infant BG 50-90 ( HgbA1c= 4-6% (or Thyroid: T3 (60-180) T4 (5-11) TSH (0.5-5) or 0.5-2 for hypothyroid pts Free T4: 0.8-2.7 ( I remember it .8-2.8 easier to memorize) Hypothyroid: ­ TSH ;- T3 & T4 Hyperthyroid: - TSH ;­ T3 &T4 ABGs: PH 7.35-7.45 pO2 80-100 pCO2 35-45 HCO3 22-26 ROME: With Acidosis the PH is always - and PH is always ­ in Alkalosis Respiratory Opposite; Metabolic Equal RESP OPP: PH - PCO2 ­ = Resp Acidosis PH ­ PCO2 - = Resp Alkalosis METABOLIC = PH - HCO3 -= Metabolic Acidosis PH­ HCO3 ­ = Metabolic Alkalosis Blood: RBC 4.2-6.1 million WBC 5000-10000 (or 4500-11000) Plt 150,000 - 450,000 Hgb F: 12-16 M: 14-18 Hct F: 37-47% M: 42-52% Amylase: 53-123 Albumin: 3-4.3 Alk Phosphate: 14-100 NH3 (35-65) Blood Osmol 280-300 Lipase 14-280 Bilirubin (Total: 0.3-1; Indirect: 0.2-0.8; Direct 0.1-0.3) Phenylalanine: Newborn Antidotes Digoxin ® Digiband Tylenol ® Mucomist (17 doses + loading dose) Heparin® Protamine Sulfate Benzodiazepine ® Flumzaemil (Romazicon) Coumadin®Vit K DI ® - ADH, ­ u/o, - Urine Specific Gr, ­ Na (think ­ Na = ­ urine spec gr) SIADH® think syndrome of ­ed diuretic hormone ­ ADH, - u/o, ­urine spec gr Insulins Rapid Reg Interm Very Long Long Acting 5-15m 30-60m 1-3h 1h 6-8h 1-2h 2-4h 6-12h peakless action 12-16h 4-6h 5-7h 16-20h 18-24h 20-30 Novolog Novolin R NPH Lantus Ultra Lente \ Humalog Humulin R Lente Vaccines Hep B 0, 1-2, 6-18mo Hib 2, 4, 6, 12-15 Pneumo 2, 4, 6,12-15 Dtap 2, 4, 6, 15-18, 4-6yrs; Td q 10 yrs IPV 2, 4, 6-18, 4-6yr Varicella 12-15, 4-6yr MMR 12-15, 4-6yr Hep A 12-23 mo (2 doses, 6 mo apart) Mening 9-11 yrs Rota 2, 4, 6 Influenza at 6 mo and then yearly after Random Stuff Thiazides ­ BG Neupogen = ­ Neutrophil Epogen = ­ RBC/Erythocyte Lofenalac Formula = for PKU infants Ototoxic drugs = loop diuretics (Lasix) and Platinol-AO TB Meds (RISE) Rifampin INH Streptomycin Ethambutol GCS Eyes (4 points) Verbal (5 points) Motor (6 points) Max = 15 ( APGAR Score At 1 and 5 min after birth (1st score is the transitional score and 2nd is planning care of newborn) 8-10 = ok 2 1 0 Appearance [All pink, pink&blue, blue/pale] Pulse [> 100, Grimace [cough, grimace, no response] Activity [flexed, flaccid, limp] Resp [strong cry, weak cry, no cry] INFECTION CONTROL Contact Precautions: MRS WEE VCHIPS Alex Hez 5 Coins HeRe M-MRSA R-Resp Infections (those not listed in other categories below) S-Skin Infections W-Wound Infections E-Enteric Infections (C.Diff, Shigella) E-Eye Infections (Conjunctivitis) SKIN INFECTIONS: V-Varicella C-Cutaneous Diptheria H-Herpes Simplex I- Impetigo P- Pediculosis (lice) S-Scabies Alex = AIDS Hez= Herpes Zoster 5=5th Dx Coins=Croup HeRe= Hepatitis and RSV Droplet Precautions: SPIDERMAN Sepsis Scarlet Fever Streptococcal Pharyngitis Parovirus B19 (virus that causes 5th dx) Pertussis Pneumonia Influenza Diptheria Epiglottidis Rubella (Measles) Measles Meningitis Mycoplasma AdeNovirus Also Rhinovirus and RSV FETAL © Strips REMEMBER: VEAL CHOP Variable is Cord Early is Head Acceleration is Ok Late is Placental Insufficiency Hypoventilation => Resp Acidosis (­ CO2) "Retain CO2" Hyperventilation=> Resp Alkalosis (- CO2) "Blow off CO2" (think of preg breathing) Lasix/Bumex = K+ Wasting (can cause hypokalemia) Aldactone = K+ Sparing (can cause hyperkalemia) Tx of DIC = Heparin (safe during preg) Post Masectomy Care: BREAST BP NOT on affected side Reach Recovery Elevate affected side Abduction and external rotation - no initial exercise (initial is extension/flexion) Self Breast Exam (1x month - 7 day after period) Try to promote a (+) self-image Autosomal Recessive: Cystic Fibrosis, PKU, Tay-Sachs, Albinism, Sickle Cell Dx, Alpha Anti-Trypsin Deficiency, Galactetsemia Autosomal Dominant: Huntington's Disease, Marfan's, Polydactly, Achandrophic Dwarfism, Polycystic Kidney Disease X-Linked Recessive: Duchenne's Muscle Dystrophy, Hemophilia A (Females are carriers in these diseases and males are affected by the disease) At Term: Nml = wt: 6-9lbs, head circumference: ¼ body length, 13-14 in, chest: 12-13in Umbilical cord falls off in 1-2 weeks Stool: 1st stool (Mecconium) - black + tarry (passes w/in 12-24 hrs), thin/green/brown day 3, formula feedings (1-2 pale yellow/light brown stools) or breast feeding (loose golden yellow stools with sour milk odor) Hypokalemia: Flat T wave, Depressed ST, and Prominent U wave Hyperkalemia: Tall T wave, Wide QRS, Long PR Wave 5 P's of Fracture: Pain, pallor, pulseless, paresthesia, paralysis Cushing's Triad: (Indicates ­ed ICP) - HR, -RR,­ BP CONVERSIONS: 1 lb = 16 oz 1 T = 3 tsp = 15 mL 1c = 8 oz = 240 mL 1 t = 5 mL 1 lb = 454 g = 16 oz 2 c = 1 pt = 16 oz 1 oz = 30 mL= 8 drams 1 mg = 1000 mcg 2 pt = 1 qt= 32 oz 1 g = 15 gr 4 qt =1 gal=128 oz 1 gr = 60 mg Med Trivia Talwan and Stadol=> Avoid (opoid agonist antagonists) - much less effective then opoid agonists No Tagamet with Warfarin Erogostat => For Migraine No Quinolones/Tetracyclines with pregnancy No ASA/NSAIDS in Hemophilia A patients Lipitor = PM ONLY, no grapefruit juice tPA= dissolves clots (heparin does not) SLE Tx o Cytotax, Imuran (Immunosupressants) o NSAIDs o Plaquinil (also an anit-malarial drug) More Maternity Fundal Height o Top of Symphis Pubis to top of fundus o Gross estimate of dates o Use a non-stretchable tape measure o 12-14 wks (at level of symphis) o show after week 14 (can tell preg) o 20 wks (~ 20cm) at level of umbilicus o rises 1 cm/wk till 36 weeks then varies Quickening = fetal movement; 16-20 weeks Fetal Heartbeat = 8-12 weeks (by Doppler) and 18-20 weeks by auscultating with stethoscope Preterm: 20-37 weeks Term: 38-42 weeks Post-term: 42 weeks plus Total preg weight gain: 11-14 kg (25-35 lb) ­ 300 cal during preg (DAILY) and ­ 200-500 cal during breastfeeding (DAILY) Caffeine ­ risk of spontaneous abortion or fetal intrauterine growth restriction Uterine contractions can be felt after 4th month = Braxton Hicks Contractions facilitate uterine blood flow through placenta and promote O2 delivery to fetus Amniotic Fluid: o Nml: 800-1200 mL (transparent/clear, no odor) o Kidney problems o Polyhydrimanos (too much amniotic fluid) Umbilical Cord: 2 arteries and 1 vein Placenta: Fetal lungs in utero Alcohol, caffeine, nicotine, meds = easily cross placenta (viruses can cross, bacteria cannot; exs of viruses (HIV, AIDS, Herpes, Measles, Toxoplasmosis, Hep) AFP Test: measured at 16-18 weeks o ­ed Levels = ­ risk of neural tube/abd wall defects (ex. spina bifida) o -ed Levels: ­ risk of Down Syndrome Fetal Distress o HR 160 o Fetal hyperactivity or no activity o Fetal Blood pH Other Stuff Immed after put pt on a Mech Vent check BP (hypotension) Lesions of midbrain = decerebrate positioning Morphine Toxicity = Pinpoint pupils Corticosteroid Effects: Acne, Hirituism, Mood Swings, ostoporosis and adrenal suppression (in kids = delayed growth) No Paxil with MAOI) Beta Blockers = Mask Effect Of Hypoglycemia SOMogyi Effect = BG sometimes up and sometimes down Dawn Phenomenon = high BG in DAWN hrs (5-8am) AFTER o Post tracheostomy: keep O2 and Suction at bedside o Post pleural biopsy: chest tube and drainage system at bedside o Post parathyroidectomy: tracheostomy at bedside o Tonic Clonic Seizures: Suction apparatus at bedside o Paracentesis: BP Cuff at Bedside RACE-Priority in a fire o R-Rescue o A-Alarm o C-Confine o E-Extinguish PASS - To use a fire extinguisher o P-Pull Pin o A-Aim at Base Fire o S-Squeeze Handle o S-Sweep fire from side to side Folic Acid Rich Foods (FOL) o F= Fish o O=Organ Meats, Oranges o L=Leafy green veggies K+ Foods (ROYGBIV-Rainbow colors) o Red= Strawberries, Tomatoes (not apples) o Orange= Oranges o Yellow=Banana o Green= Avocado, green veggies o Blue= Fish from the BLUE sea o Indigo/Violet= Raisins Cretenism = Congential Hypothyroidism (appears 3-6 mo in bottlefed infants and later in breastfed infants) Hepatitis: low fat, high cal/carbs/protein, no alcohol Hypothryoid: High Protein, low cal diet Cystic Fibrosis: High Protein Diet and Pancr enzyme replacement Hital Hernia: Fundopliction (tighten cardiac sphincter on stomach) don't lie down for 1 hr after meals, ­ HOB 4-8 in when sleepy, no food before bed Papable olive shaped tumor in epigastrim = pyloric stenosis (projectile vomiting) o In adults from peptic ulcers; in infants from hypertrophy of pylorous (symp 2nd-4th wk after birth) Toddler: Fear of separation (give simple directions) Preschooler: Fear mutilation (Allow to play with equipment) School Agers: Fear loss of control (allow to play with equipment) Adol: Fear loss of independence Pneumothorax Symp (P-Thorax) o P-Pleurtic Pain o T-Trachea Deviation o H-Hyperresonance o O-Onset Sudden o R-Reduced breath sounds (dyspnea) o A-Absent Fremitus o X-X-Rays show collapse Pul Edema Tx (MAD DOG) o M-Morphine o A-Aminophylline o D-Digitalis o D-Diuretics o O-O2 o G-Gasses in blood (ABGs) Cholecystisis: Gallbladder inflammation (RUQ pain) Cholelithiasis: Gall Stones Pancreatitis o TURNER'S SIGN: Flank echymosis o CULLAN's SIGN: Bluish periumbical (around the belly button) Who needs Dialysis? Vowels: AEIOU A: Acid/Base Problems E: Electrolyte Problems I: Intoxications O: Overload of fluids U: Uremic Symptoms Cushing's Dx o (Cushion - too much Cortisone) o (3 S's = high Steriods, high Sugars (hyperglycemia), high Sodium o Moon Face, Buffalo Hump, Trunkal obesity, thin skinny extremities, slow wound healing, osteoporosis, HTN, muscle wasting o - K+ Addison's Dx o Need to ADD steroids o (3 S's = Low Steroids, Low Sugars, Low Sodium) o Low vascular volume (Not holding salt and H20 like in Cushing's), low BP o Hyperkalemia (­ K+) o Bronze Skin, Hyperpigmentation ALLEN TEST o B4 drawing ABGs do an Allen's Test o Compress both radial and ulnar arties (wrist) at same time on 1 hand o Release the ULNAR side (pinky side) and hand should turn discolored and should be able to see blood flow back into it (Radial - is located on the thumb side and ulnar is on the pinky side) o Minutes of press on the ABG site after drawing blood? 5-10 min or 15-20 min if on anti-coagulants After a liver biopsy place patient on the RIGHT Side Mobility o Cane COAL = Cane Opp Affected Leg o 2 point gait One leg and 1 crutch touch ground at same time Weight bearing o 3 point gait Both crutches and 1 foot are on the ground Non-weight bearing o 4 point gait Both legs and both crutches touch the ground Weight bearing o Swing through gait Advancing both crutches, then both legs, and requires weight bearing Not as stable as other gaits Laminectomy = removal of 1 or more vertebral laminae - need straight back after = LOGROLL and KEEP BACK STRAIGHT (so flat bed) Intussceptation o Seen in Non-Hodgkin's Lymphoma o Hot dog mass in RUQ o Red Currant Jelly Like mucous and bloody stool Sweat Chol o > 60 = CF o 40-60 = Borderline CF Ostomy = pouch opening 1/8 in larger than stoma Macule = flat and round Papule = rounded and red Vesicle = filled with fluid Impetigo = 1:20 Burrow's Soln, honey colored crusts Permethrin [NIX] => 10% for lice tx and 5% for Scabies tx o (Scabies = mites bury under skin) RUQ: Right upper quadrant Cholelithiasis (gallstones) Cholecystitis (inflamm of gallbladder) Hepatitis Pancreatitis (severe knifelike pain; worse with eating/lying down; some relief with fetal position) RLQ: Crohn's Dx (Ileum, Rt Colon; pain after meals) Appendicitis o Pain at McBurney's Point (1/2 b/w umbilicus and right iliac crest) LLQ: Ulcerative Colitis (Rectum, left colon; pain pre-defecation) Diverticulitis o Relieved by passage of stool/flatulus Duodenal Ulcer: Pain 2-3 hrs after meals and nighttime (relieve pain with FOOD INTAKE) Gastric Ulcer: Pain 1 hr after meal/when fasting; relieve pain with vomiting, not with food intake (Starve the gastric ulcer and feed the duodenal) Diverticular Dx: Cramping in LLQ relived by passage of stool and flatus (constipation alternates with diarrhea (from def in diet fiber) high fiber diet Meckel's Diverticulum: congen sac or pouch in ileum, symp seen by age 2; painless rectal bleeding, abd, hematechezia, (currant jelly like stool), s/s of appendicitis (tx = remove diverticulum) Cirrhosis: Biliary obstruction, alcohol, Hepatitis Early stage: high protein/carbs and Vit B Adv stage: low fiber/salt/fat/protein, high cal, fluid restriction Esophageal Varices o Sengstaken Blakemore Tube or Minnesota Tube Balloon on Esophagus and stomach to apply direct press on bleeding veins o TIPS (transesophegal intrahepatic post systemic shunt) Balloon Catheter inserted via jugular vein with angiography to create a metal stent b.w portal vein to vena cava channel (provides a pathway for blood b/w portal vein and hepatic vein = bypasses cirrhotic liver) and relieves press on esoph varicies Jaundice (Icterus) Hemolytic o RBCs are destroyed (release bilirubin) Hemolytic transfusion rxn Hemolytic Anemia Sickle Cell Crisis Hepatocellular o The impaired liver cell (hepatocyte) doesn't allow bilirubin to convert from the unconjugated to the conjugated form Obstructive o Bile flow is obstructed Cholelithias (Gall Stones) Tumors EKGS Nml Sinus o 60-100 o PQRST nml EKG Strip Sinus Brady o o Tx: Atropine o (can be nml in physically fit/trainer person = then no tx needed) 1st degree AV © Block o Prolonged PR interval o Nml PR interval: 0.12-0.20 o Conduction Problem o Drugs (Dig, Beta Blockers, Ca Channel Blockers) can cause by slowing conduction system (slows conduction from SA node to AV node to Purnjee Fibers = see slowed PR (Atrial Response) o Usu don't see symp, so usu not treated Atrial Flutter o Saw Tooth Appearance o Atrium racing away, blood pools and can throw a clot => stroke o Treat with Cardioversion 20-50 Jules (NURSE must hit Synchronize button) o Ventricle beats are regular Atrial Fib o Ventricle beats are irregular o Atrium quivers, not good pump o Cardiovert 50-100 Jules o If in hospital and were stable b4 going into a fib = give cardizem drip and beta blockers b4 cardioversion V-Tach o Wide QRS complexes o V Tach and awake drugs I must take (Amiodarone or Lidocaine) o V Tach and a nap (unconscious) zap zap zap (defibrillate) o Can only stay in for 2-3 min (can die) V Fib o Irreg makes no sense o Only way to tx = defribillate start at 360 Jules o Epi (to ­ HR) Stroke Right Sided: Impatient, easily distracted, impulsive, less concerned about life events, safety is a big issue (impulse) Left Sided: Slow, cautious, particular, very aware of deficits, greater depression/anxiety (Think rt brain = creative, left brain = logical, math, science)

Thanks guys for all your support!! I really appreciated it... I took my NCLEX last week and I couldn't believe it but I PASSED!! OMG I am so excited!! Anyways I'm working on a studyguide that'll def help you all out a ton... and hopefully I can get it to u soon...thanks again and I know what your going through ... you can do it!! :dancgrp::prdnrs::hpygrp::heartbeat

Thanks so much everyone... it sounds kinda odd but it's good to know other ppl feel the same way...i really appreciate the feedback... and hey we're all kinda in the same boat...just gotta look at the hope of getting a tiny square paper in the mail that says ur name and RN.. SOMEDAY!! LOV ya and this website... really helps when u feel closed in.!! good luck everyone ... i feel ya!

Ok ... so I woke up today and realized i have my test in 7 days... I pretty much had a panic attack and felt like crying and throwing up a little.. i tend to get a bit nervous on tests and make stupid mistakes and blank out... I feel like I know nothing and have to re-learn everything b/c now when I'm looking at the material I can't remember anything and feel like I know nothing... sorry for the venting ...but I don't know what to do.. how should I study? If I don't pass the first time ..everyone in my family will taunt me for life...trust me... they already have a count down and 1/2 my family isolated me the last 4 years b/c I went to nursing school not med school and now want to see me fail...ok breathing now... PLEASE ANY ADVICE AT ALL IS APPRECIATED!!

Thanks everyone that really helps!!

Ok so I'm taking my NCLEX soon...and as the date gets closer I feel like I don't remember anything or know anything... anyways,... I was just wondering if anyone has any tips on memorizing meds... it seems like all the meds combine and ugh!! Any tricks to the categories besides like pines, prils, olols?? thanks oh and how do u guys remember the timelines for the immunizations?? thanks!!

Ok, so I just graduated in May in WI and have to take my NCLEX in a couple weeks (Cringe)... so scared...anyways... but I want to move to another state after getting my license (but the state I want to move to isan't in the nursing compact.. .the 13 states)... how do I go about transferring the license from Wi to say NJ or FL ?? Thanks... And if you have any tips on NCLEX??