aspiRiNgpediatric

My Scores: Kaplan Scores Diagnostic 70% QT 1 60% QT 2 71% QT 3 53% QT 4 65% QT 5 65% QT 6 71% QT 7 71% Readiness 68% Qbank (100% complete) 69% - I redid all my incorrect questions til I had 0 left Kaplan Sample NCLEX tests Test 1 56% Second time 88% Test 2 56% Second time 70% Test 3 80% Hurst Sample Tests (only did 3 out of the 6) Test 1 64% (80/125) Test 2 72% (90/125) Test 3 67% (84/125) I started test 4 but never came back to them cause I was doing Kaplan, NCLEX 4000, Saunders and Mosby. I played around for a month after grad doing some mini studying. But when I got serious I did strickly contect for two weeks while taking Kaplan then I did question with the Kaplan content videos. After that purely questions for two weeks. I got the good pop-up so hopefully the PVT hasn't changed. I memorized some bible verse and just said them over and over when I felt like I was failing. It help calm me down alot.

You're all welcome! I took the exam today and got the good pop-up! I sure hope I'm not the exception to the rule. And here are some more it found on the website so you all can have them in one thread. Signs and symptoms of cardiac tamponade (Beck's Triad): The Three D's Distant heart sounds Distended jugular veins Decreased pulse pressure (think of a narrow pulse pressure as opposed to a wide one) Atrial Arrhythmias: ABCDE Adenosine/amiodorone or anticoagulate (if Afib/Flutter has been present >48h) Beta blockers Calcium channel blockers Digoxin Electrocardiovert (if For ventricular arrhythmias: AL Amiodorone Lidocaine Tricyclics E ach = Elavil V ictoms = Vivactil A = Aventyl T ough = Tofranil N eurotic = Norpramin Pulmonary Edema M=Morphine A=aminophylline D=digoxin D=diuretic O=O2 G=Gases (ABG's) Anti-Anxiety L= Librium E= Equanil A= atarax V= valium S= serax (smell the flowers with leaves) S/E of Pitocin Think of the titanic sinking in the pit of the ocean (pit ocin) P= pressure is elevated I= intake and output T= tetanic contractions O=O2 decreases in fetus C=cardiac arrhythmia I=Irregularity in fetal heart rate N=N/V ACE Inhibitor Side Effects – CRAP PILOT C ough R enal impairment A naphylaxis P alpitations P otassium elevated I mpotence L eukocytosis O rthostatic hypotension T aste Anti-Epileptic Side Effect – ABC 2D EF 2G 2H A taxia B lood dyscrasia C left lip D upuytrens Vit D deficiency E xfoliation of skin & Stevens Johnson's F its G I upset G um hypertrophy H epatitis H airy Barbiturate Side Effects – AB 2C 3D A taxia B ehavioral disturbance C oncentration decreased C oma D epression D rowsy D iplopia Cholinergic OD Side Effects – BLESS DUMB MW B radycardia L acrimation E mesis S alivation S weating D iarrhea U rination M iosis B ronchorrea Muscle Weakness Cyclosporin Side Effects – G4HRT G um Hypertrophy H yperkalemia H ypertension Hair R enal toxicity T remor Gynacomastia Causing Drugs - DISCO 2MTV D igoxin I soniazid S pironolactone C imetidine O estrogens M ethyldopa M etronidazole T CAD V erapamil MAOI Side Effects - The 3Hs H epatocellular jaundice H yperthermia H ypertension Propranolol, contra-indications - ABCDE A sthma B lock (heart) C ardiac failure D iabetes Mellitus (hypoglycemic shock) E xtremities (occlusive arterial disease) Pulmonary Edema, Non-Cardiac – POOP PNS P hosgene O pioids O rganophosphates P araquat P henothiazines N itrous dioxide S alicylate TCAD Side Effects – NO A COW N euro O thers A nticholinergic C VS O verdose W ithdrawal Rat Poison - RATS PANIC or CRAP PANTS PIC R ed squill A rsenic T hallium S trychnine P NU/Phosphorus/ZN Phosphide A lpha naphtha thiurea (ANTU) N orbormide I ndanediones C oumarin/Cholecalciferol Rat Poison - CRAP PANTS PIC C holecalciferol R ed squill A lpha naphtha thiurea (ANTU) ZN Phosphide P hosphorus A rsenic N orbormide T hallium S trychnine P NU I ndanediones C oumarin Steroid Side Effects - WITCH MOP GAGS CHAMP W ound Healing Poor I mmunosuppresion T hin skin C ushingoid H eartburn M yopathy O steoporosis P ath # G astric ulcer (bleeding) A ppetite increased G lucose Altered S tress Response Reduced C ataract H ypertension A cne M uscle weakness P sychosis Steroid Side Effects - A HIBISCUS MOOCHED WIG A cne H ypertension I mmunosuppression B ruising I nsomnia S triae C ushingoid U lcers S kin thinning M yopathy O besity O steoporosis C ataract H airy E dema D epression W eakness (proximal muscle) I nfection G lycosuria Warfarin - WEPT W arfarin E xtrinsic pathway Measure PT Class IC Antiarrhythmics - FEP F lecainide E ncainide P ropafenone Class III Antiarrhythmics - BIAS B retylium I butilide A miodarone S otalol Beta 1 Selective Blockers – A BEAM A cebutalol B etaxolol E smolol A tenolol M etoprolol Gynacomastia, Drugs That Cause - "Some Drugs Create Awesome Knockers” S pironolactone D igistalis C isplatin A lcohol K etoconozole Drugs Causing Pulmonary Fibrosis - BABE B leomycin A miodarone B usulfan E (empty) Drugs that Cause Hepatic Necrosis - HAVE H alothane A cetaminophen (liquefactive necrosis) V alproic acid E (empty) Drugs Causing Agranulocytosis - The 3Cs C lozapine C olchicine C arbamazepine Drugs for All Types of Seizures (except petit mal) - CAPHE CA rbamazepine PHE nytoin/phenobarbital Drugs for Petit Mal Seizures - VALET VAL proic acid ET hosuximide Vancomycin - "A Red Van Drove Into The Wall" A ntihistamines (prevents redman syndrome) R ed man syndrome V ancomycin D -ala D-ala I nhibitor T hrombophlebitis W all (as in cell wall) Tuberculosis Drugs - SPIRE S treptomycin P yrazinamide I soniazid R ifampin E thambutol Short Acting Benzodiazepines - TOM thumb T riazolam O xazepam M idazolam Beta 2 Agonists - SMART S almeterol M etaproterenol A lbuterol R itodrine T erbutaline Stevens-Johnson Syndrome - LESS L amotrigine E thosuximide S ulfonamides S tevens-Johnson Fluconazole - The 3Cs C andidiasis C occidiomycosis C ryptocococcal meningitis Class IB Antiarrhythmics - "Medical Lab Technician" M exilietine L idocaine T ocainide Lithium - LITHIUM L eukocytosis I nhibits PIP2, cAMP and 5' deiodinase T eratogenic/Thiazide contraindicated H ypothyroidism/Hyponatremia increases toxicity I nsipidus (nephrogenic diabetes) visUal dysfunction M ovement disorders: CATS (Choreoathetosis, Ataxia, Tremors, Seizures) Drugs Contraindicated During Pregnancy - FACETS F louroquinolones A minoglycoside C larithromycin E rythromycin T etracycline S ulfonamide Benzodiazepines Metabolized Outside the Liver - "Outside The Liver” O xazepam T emazepam L orazepam Drugs Cuasing Megaloblastic Anemia - MAPLE M ethotrexate A ZT = zidovudine P henytoin (causes folate deficiency) L iver disease E thanol Amphotericin Toxicities - AMPHOTERICIN B A nemia M uscle spasms P hlebitis H eadaches/Hypotension/Hypokalemia T hrombocytopenia E mesis/Encephalopathy R espiratory strida I ncreased temperature (fever) C hills I mmediate hypersensitivity (anaphylaxis) N ephrotoxicity--important! B ronchospasm Amphotericin Toxicities – THE BRASH PAN CHEF T hrombocytopenia H eadaches E mesis B ronchospasm R espiratory strida A nemia S pasms H ypotension P hlebitis A naphylaxis N ephrotoxicity--important! C hills H ypokalemia E ncephalopathy F ever CNS Effects of Morphine – ME CAN’T SCREAM M ydriasis in doses causing asphyxia E mesis C onvulsions A sphyxia N ausea T runcal rigidity (especially with fentanyl) S edation C ough suppression R espiratory depression E uphoria A nalgesia M yosis (but may cause mydriasis in doses causing asphyxia) Crash Cart Meds – LEAN L idocaine E pinepherine A tropine N arcan RN - Invasive procedure = I AM RN EDUCATED - Initial/Comprehensive/Baseline (assessments) - Assess (FREQUENT/ONGOING =UNSTABLE Patients) - MANAGING and LEADING client care environment Ex. Clients who are in severe and Refusing Meds (needs more assessment) - Review - NSG Process/ NSG Judgement Use (APIE= Assessment,Planning, Implementation,Evaluation) - Encourage - Develop - Use Of IV meds (ex. plasma, blood products-- these and IV are done by RN only) - Consult/Counsel/Suggest & Update - ADMISSION .. NEW & POST OP - Teach - Educate - DISCHARGE & ADMISSION Preparation LPN/LVN- -Certain Invasive Task =I-SOUND STAR CROSS ++ - IM adm - SQ adm. - ORAL meds adm - URINARY CATHETERIZATION - Nitroglycerin - DREASSING of WOUND (CHANGING & IRRIGATING) very commonly seen Q. - SUCTIONING - TUBE FEEDING - Auscultate/Listen - Routine/Standard - Check(s) - Reinforce/remind - Observe - Set up (basic equipment) - Specimen Collection & Data Colletion + -Blood glucose readings -Monitor -Review/Teach-- Usually standard practices (hand washing/hygiene) or med administration (ie. eye drops) -- RN mostly teaches/educated and LPNs Reinforce + CAST & TOE Amputation are stable clients and need on going assessment and pain mgt./La Charity Book(Don’t know too..just dont deprive with it.. just follow the book Data Collection such as LISTENING to LUNG SOUNDS & CHECKING for PERIPHERAL EDEMA_Part of LPN scope of practice: /LaCharity Book ** Don't assign LVN/LPN to do a task an nurse assistant can complete** NURSING ASSISTANT/UAP- Unlicense assistive personnel - Non Invasive procedure/Basic Care =SPARRTACUS GROAM +++ -SKIN CARE (ex. bed rest with a skin tear and hematoma from a fall 2 days ago, Apply and care for a client’s rectal pouch ) -POSITIONING-- Special positioning-- requires initial education by RN -- assistant will assist not teach -AMBULATION/ Assisting with ADL (AMBULATION of FRACTURED HIP only RN& PT) ( Patienst with CHESTUBE ambulating the hall-LPN/LVN) -RECORDING & MONITORING of V/S (BP,Pulse, Oxygen sat,) -RANGE OF MOTION &EXERCISE -TRANSPORT OF CLIENT -ASSIST (Assisting for Prep for SITZ Bath) -COLLECTION OF -URINE & -STOOL -GROAM (Groaming & Hygiene Measure, Bathing & checking water temp) + WEIGHTING INTAKE & OUTPUT FEEDING + - Remind/Reinforce: usually reminds pt. TO do something rather than HOW to do it (skills previously taught by other health care professional or precaution measures)*** - They can detach suction and remove a foley but not connect or insert - Gather (equipment) + - Measurement of ankle and bracial blood pressure for ankle brachial index calculation.(Calculated already) ( Calculation on the ankle-brachian index is responsibility of RN) -Experienced Nsg Assistant should have been taught how to.. Monitor Apical Pulse, However, the RN should observe to be sure that s/he mastered this skills. ---La Charity Book--- NEW RN -Education and hospital orientation includes.. SAFE administration of IV meds. -STABLE PATIENTS SOME KEY POINTS: Patients that require teaching about drugs or need procedures done are NOT RN priority. PHYSICIAN -Informed Consent -Medical diagnosis -Prescriptions -Order procedures Avoid These Assignments for New/Float/LVN/LPN/Traveling -New onset/sudden/acute -New admission -Transfer -Newly diagnosed -Discharge -Require education/teaching (beyond basic skills -- tend to be complex and specific to patients on that particular unit) - Unstable (ie. High risk of sudden respiratory failure, or requires frequent assessments and changes in therapy(like electrolyte imbalances) Give: - Chronic - Routine meds/procedures - Stable ALL HEALTHCARE WORKERS - Responsible for knowing about and implementing standard precautions + airborne/droplet/contact --> therefore all can teach about it or prepare a room for it

Here are some from a study guide via someone on here. It has helped me alot with pratice question, hopefully it won't let me down on my "big day" 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 (This is dirty but think "Oh Oh Oh to touch and feel a girl's lady parts, So happy!" I didn't make that up! its a well known pnemonic lol) 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 Hypercalcemia: GROANS (constipation) MOANS (psychic moans = fatigue, lethargy, depression) BONES (bone pain) STONES (kidney stones) Psychiatric OVERTONES (including depression and confusion) Can't pick up the PHONE! (muscle weakness, lack of coordination) Hypocalcemia = CATS go numb: C = Convulsions A = Arrhythmias T = Tetany (+Trousseau and +Chvostek's) S = Spasms, Seizures, & Stridor Numbness in the fingers Hypernatremia Signs and Symptoms of Hypernatremia - FRIED Fever, flushed skin Restless Increased fluid retention Edema Decreased urine output, dry mouth Causes of Hypernatremia: MODEL Medications, meals Osmotic diuretics Diabetes insipidus Excessive water loss Low water intake Hyponatremia: SALT/ LOSS Signs and Symptoms Stupor/coma Anorexia Lethargy Tendon reflexes decreased Limp muscles Orthostatic hypotension Seizures/headache Stomach cramps The HYPERKALEMIA "Machine" - Causes of Increased Serum K+ M - Medications - ACE inhibitors, NSAIDS A - Acidosis - Metabolic and respiratory C - Cellular destruction - Burns, traumatic injury H - Hypoaldosteronism, hemolysis I - Intake - Excesssive N - Nephrons, renal failure E - Excretion - Impaired Hyperkalemia Signs and Symptoms: MURDER Muscle weakness Urine - oliguria, anuria Respiratory distress Decreased cardiac contractility ECG changes Reflexes - hyperreflexia, areflexia Treatment: KIND Kayexalate - oral/rectal Insulin Na HCO3 (sodium bicarb) Diuretics Hypokalemia Signs and Symptoms 6 L's Lethargy Leg cramps Limp muscles Low, shallow respirations Lethal cardiac dysrhythmias Lots of urine (polyuria) Alkalosis and Acidosis Alkalosis - has a 'k' - Kicking the pH up Acidosis - has a 'd' - Dropping the pH down DO NOT delegate what you can EAT! E - evaluate A - assess T - teach Addison's disease (need to "add" hormone) Cushing's syndrome (have extra "cushion" of hormones) addisons= down, down down up down cushings= up up up down up addisons= hyponatremia, hypotension, decreased blood vol, hyperkalemia, hypoglycemia cushings= hypernatremia, hypertension, incrased blood vol, hypokalemia, hyperglycemia No Pee, no K (do not give potassium without adequate urine output) EleVate Veins; dAngle Arteries for better perfusion A= appearance (color all pink, pink and blue, blue [pale]) P= pulse (>100, G= grimace (cough, grimace, no response) A= activity (flexed, flaccid, limp) R= respirations (strong cry, weak cry, absent) Hypo-parathyroid: CATS Convulsions Arrhythmias Tetany Spasms Stridor (decreased calcium) high Ca, low phosphorus diet Hyper-parathyroid: fatigue, muscle weakness, renal calculi, back and joint pain (increased calcium), low Ca, high phosphorus diet Hypokalemia: muscle ewakness, dysrhythmias, increase K (raisins, bananas, apricots, oranges, beans, potatoes, carrots, celery) Neuroleptic malignant syndrome (NMS): -NMS is like S&M; -you get hot (hyperpyrexia) -stiff (increased muscle tone) -sweaty (diaphoresis) -BP, pulse, and respirations go up & -you start to drool Parkinson's=R.A.T. R- rigidity A- akinesia (loss of muscle mvt) T- tremors Txt: Levodopa Hypoglycemia - T.I.R.E.D T- tachycardia I- irritability R- restless E- excess hunger D- diaphoresis I kept forgetting which was dangerous when you're pregnant; regular measles (rubeola), or German measles (rubella), so remember: -never get pregnant with a German (rubella) When drawing up regular insulin & NPH together, remember: - Nicole Richie RN (regular comes before NPH) Tetralogy of fallot Think DROP(child drops to floor or squats) or POSH Defect, septal Right Ventricular hypertrophy Overriding aorts Pulmonary stenosis MAOI's that are used as antidepressants: weird way to remember, I know. pirates say arrrr, so think; pirates take MAOI's when they're depressed. - explanation; MAOI's used for depression all have an arrr sound in the middle (Parnate, Marplan, Nardil) easy way to remember MAOI'S! think of PANAMA! PA - parnate NA - nardil MA - marplan Have trouble remembering fhr patterns in OB? Think VEAL CHOP V C E H A O L P V = variable decels; C = cord compression caused E = early decels; H = head compression caused A = accels; O = okay, not a problem! L = late decels = placental insufficiency, can't fill Also for ventilator alarms HOLD High alarm- Obstruction due to incr. secretions, kink, pt. coughs, gag or bites Low press alarm- Disconnection or leak in ventilatior or in pt. airway cuff, pt. stops spontaneous Breathing Immediate tx of MI, think MONA: M Morphine sulfate O Oxygen N Nitroglycerin A ASA Treatment of CHF, think UNLOAD FAST: U sit Upright N Nitro L Lasix O Oxygen A Aminophylline-for lungs clear wheezing D Digoxin F Fluids- decrease A Afterload - decrease S Sodium - decrease T Tests: dig level, ABG, K+

What type of questions did they ask??

I applied to a med/surg floor and recieved a call today Good luck everyone!!!