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
