Viruz

Hi Yaliz, I am glad my posting has motivated you...I finally got to your post because I was busy orienting in my first new grad job this past week!!! For Saunders I skimmed the book and answered most of the questions at the end of the chapter. They are easier and its good review. I focused more on OB because it was my weakest area. Yeah, the letter did not really help me out at all. Just study everything again. Study as if it was your first time taking it. If you feel strong in some areas then just skim them and focus on your weak areas. For example, my weak area was also SATA's. So I would go to Barnes and Noble and use Lippencotts SATA's book and practice there without buying the book. Do about many as you can for a good hour. Doing 100-150 questions a day is really good. I feel I really benefited the most from doing the questions on that link I provided for NCLEX 3500. Even though I probably only did about 400 questions from there. I would have done more if I would have known how helpful they were (note: these questions are harder and don't feel bad if your not getting above 60%, just keep practicing). Exam Cram became easy after doing 3 tests because I felt the questions started to repeat themselves. So do about minimum 3 exams and don't feel bad if your not doing well at the beginning. As you do more tests you will do better on Exam Cram. Also, Lacharity really helped me out with prioritization. Good luck and never give up. Who cares if you bomb it again I am 100% sure you will do better the next time until you pass. Just keep trying and don't give up, you are not alone, trust me. :)

I have soft copies of all my letters of rec. (letters saved on my computer) and I just print them out. You should ask your professors for soft copies.

I have no idea about USC selection process. All I can do is hope for the best.

nursestudent2011, I got a call today as well and got my rejection, don't feel bad, we have to try USC now, UCLA's rival She told me she had 9 positions, but I did forget to ask how many applicants. Nevertheless, this was my first interview and I didn't feel it went well, I will take it as experience. Good luck to everyone else and hope you land a job in the CTICU. :)

It sure does look like it.

Thanks angel, Lacharity worked really well for me. Its highly recommended on this forum. As far as study schedule, I really did not have one. I just opened the Saunders Book first and went through the areas I was weakest and then went through most of that book. I then used exam cram, NCLEX 3500, and Lacharity for questions. I never went trough peds in my studying. I did go over L&D because it was my weakest. Book Editions: Saunders- 4th Exam Cram-3rd Lacharity- 2nd Hope that helps :)

Your welcome, I wish you the best! :)

Thanks to everyone for the kind words... I hope you knock it out, but keep fighting if you don't. Glad I could help. :) I am sorry but I pulled that study guide from another person and did not understand it either. Thank you, hopefully you did pass! The test became much easier my second time after I went through Lacharity. I felt that book really helped with the questions.

I dont have any ICU experience. Thanks, I completed it March 8 I think. :)

I applied for Neuro ICU, Cardiothoracic ICU, and Adult ICU (cant remember the last one. I have not checked my status. I will check right now. Ok just checked and it says "We have contacted you for an interview". So, I guess it did not change. Thanks for everything and good luck to you too!

I guess I passed my phone interview because UCLA called me this afternoon and left me a message to call them back for an scheduled April Interview. I wish everyone luck and hope I can make it!

Hey Goody, Good luck and hope you made it. Your right, there really was no way to prepare for the phone interview. I read somewhere they would notify us until May but I am not 100% sure. I was thinking of calling the HR department to ask them. Maybe someone can chime in and let us know.

PPHeeeewww! I just got done with my phone interview. I took a little less than an hour and a half. I will admit I started getting tired towards the end. I don't feel there is any way to prepare for it, they were all pretty easy straight forward questions. I hope I passed it so I can at least move on to an in person interview for experience. Good luck to everyone. :) I feel like celebrating for getting through this, haha.

I got called today from Talent Plus and scheduled my phone interview for next week. Wish me luck and good luck to everyone else. :)

This thread makes me laugh because people on here are so excited about just being able to apply. I am not trying to be a downer or anything but marvel at how hard we have all worked and how difficult it is to even be able to apply to a position. I applied as well and got a call from HR asking what I did to avoid the assessment. She explained there was a glitch and for some reason several candidates did not receive the assessment. I explained how I went through the process and said it never came up for me. I was then able to ask her how many applicants they had and she said about 1000 so far. So there had been 1000 applicants in a little over 24 hrs. I was amazed and she said if I did not hear anything by the end of the first week of April then my application had been overlooked, denied, or they had moved on to other applicants. So, if you don't hear from them by the end of April you did not get the job. I wish everyone luck and hope this gives everyone some anxiety relief.

Congrats!!!!!

No problem Thank you, wish you the best as well Your welcome. I took my second exam on Nov. 29, then did not really start studying until Late Decemeber early January. I then retook it my 3rd time on Feb. 18. So maybe 2 months of studying. Chin up and march forward, the sooner you do this, the sooner you will pass. :)

I am happy my story has inspired you. The key is to never give up, I see too many posts where people make it seem the NCLEX is impossible. I am here to tell you it is not and you will pass it. My family and friends looked more shocked and scared than I was when I would tell them I had failed. I would always shake my head and move on. I never let them or "it" get to me. However, I kept my poise because I was always confident I would pass it. Don't let them bring you down, believe in yourself because you will do it and its only a matter of time before you do. I averaged about 4-6 hrs a day. During the last three weeks I only worked 1 week and started studying 6-8 hrs a day. Sometimes I would be sick of studying that I would take the day off. Just be consistent and push yourself if you feel you need to. Keep in mind that I was working and studying.

myangel71, I never bought my exam cram books. Instead, I went to Barnes and Noble and borrowed them there. I would send you a pm but I don't send out messages.

I think you may need more questions... Lachairty helps you prioritize and exam cram might give you questions that can be similar to the real NCLEX since its made by Pearson Vue but as you keep testing on Exam Cram the questions will get easier because you have seen them before. You need NCLEX 3500, http://nursing.slcc.edu/nclexrn3500/mainMenu.do;jsessionid=20D721724A16FE55BB72B233991C0E6B And its free, I felt this site had the best questions and the hardest. They are harder than exam cram. Good luck.

Gold- I got your email. :) Thank you all for your compliments, it is gratifying to work so hard and finally pass. I still cant believe I passed. This had been weighing me down for about 6 months and now its finally off my back.

Hey myAngel, the most important thing to do is not give up and if you fail again, retake it. Its really that easy. Each time you take it will get easier if you study of course. Chin up and march forward.

Hi Gold and thanks, I cant reply via pm because I need about 10-20 posts. So, I will reply to you via email. :) Im at work right now so it may be within the next 2 hrs.

Just like the title says, I checked the BON this morning and finally saw my name! I am grateful to this site and all the contributions everyone has made. :) Since I am now an official RN I will tell you what worked and did not work for me during my 3 attempts at passing this test. First Exam Materials Used: Virtual ATI class ($300) Outcome: Waste of money and did not help, I would not recommend this class to anyone. I was stopped at 110 questions. The review information is overwhelming. You are much better using the Exam Cram review book or Saunders review book. Second Exam Materials Used: Lacharity, Prioritization and Delegation NSCBN: The questions are good practice but the review is horrible. I just used this for questions but only got through half of it because something came up and ran out of time. Sanders Q & A: Ok review for content, but the questions were too easy Outcome: I went to the end at 265 questions and failed. I stayed there the whole 6 hrs. Third Exam Sanders Review Book: Excellent Book for Content, I especially covered OB because it was my weakest. I think everyone should try and cover as much as they can in this book. I took about 3 weeks reviewing this book, I ignored the peds section. Exam Cram Review Book: Another excellent concise book that gives you only what you need to know. The med section was helpful. I think I went through this book in two days by skimming it. I also did the two 250 q practice tests. I feel it gave me endurance for the test. Exam Cram Practice questions Book: I used the CD and took about three 250 question practice exams and one practice exam. The questions on here got easier the more tests I took and since Pearson makes the Nclex I thought this was important to review. NCLEX 3500: http://nursing.slcc.edu/nclexrn3500/mainMenu.do;jsessionid=20D721724A16FE55BB72B233991C0E6B Works on Safari. Excellent for questions, I took the Pre-test and got about a 65%. The questions are harder than any review book I have taken and you can practice countless topics. I did not go through the whole thing but did as many questions as I could. I would score 65-75 on practice tests. I usually did 75 questions. I would say this is even better than NCBSN. Lacharity: I only went over the practice questions this time and not the case studies. Great book. Lippencotts SATA practice questions: I went through about 1/3 of this book and did not buy it, I would work on it during my visits to Barnes and Noble. This along with Nclex 3500 gave good SATA practice questions. Infection Control mneumonic- The high recommendations speak for themselves. Newgradq's Study Guide: Excellent study guide, I found a lot of the notes helpful during the exam and worked out great during my final week for review. 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) Outcome: Passed at 75 questions. During the exam I was hoping it would shut off at 75 questions. I did not want to go the distance like the 2nd attempt. When I was on question 75 I prayed hoping it would shut off and to my surprise it did. Right then I knew I had passed. Most importantly, never, never, never give up. I read a lot of people freaking out on this board because they did not pass the first, second, or third time. I personally think too many people overhype it and scare others. You can pass it you just have to be diligent about studying. Notice I never took the Kaplan review course? Each time I took the exam I felt it got easier and don't understand why people freak out about it so much. I understand its nerve racking but if you fail just retake it. I told people and family I failed it twice and have no shame in telling them because it is a hard exam but you have to get used to the questions and feel comfortable with them. I am a bad test taker and I was certain I was not going to pass it because I needed to first get a feel for the exam. Good luck to everyone and I hope I can help you out. Remember, who cares if you have to repeat over and over, you will pass it and it does not mean you will be a bad nurse. Good luck to everyone! Please feel free to ask me any questions on any of the review materials I used. I will be more than happy to share my experiences. :)

I hope you pass too...I just got the good pop up as well and it was so nerve racking. I am much more relieved now. :)