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ATI: NCLEX Live Review

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1.

bronchdilator

hyperglycemia, hypoK

2.

Nurse should administer lidocaine IV bolus for a


client who has ventricular dysrhythmia

CPR For a patient that is pulseless or not breathing

3.

Nurse should perform synchronized cardio version


for a client with supraventricular tacycardia

the nurse should defibrillate for ventricular tachycardia and ventricular


fibrillation

4.

1 unit of blood

4 hrs, stay first 15 min

5.

carbidopa/levodopa

orthostatic hypotension

6.

Crede's maneuver

technique used to void urine from the bladder , press on pubis symphasis

7.

insulin

NV, hypoglycemia, hangry, shaky, cold, clammy

8.

methotrexate

RA, psoriasis

9.

gabapentin

somnolence, dizziness, edema, most effective 3x day peaks, 2 hrs

10.

nitro and cialis

unsafe drop in BP

11.

no nitro without

IV

12.

tocolytic

relaxed uterus

13.

Protonix- PPI

alters gastric acid secretion, diarrhea, osteoporosis, pneumonia

14.

Risperidone- Risperdal

weight gain, dyslipidemia, EPS rate

15.

Solumedrol

N, headaches, cushings

16.

Lasix and gent together

even more ototoxic

17.

Cycline

skin infection, staph

18.

Antifungal

azole

19.

ARB's use when

ACE doesn't work

20.

BB=

decreased HR

21.

Calcium channel blockers

dipine,
Amlodipine norvasc
Diltiazem Cardizem, Tiazac
Verapamil (Calan, Verelan, Covera-HS)

22.

ED drugs afil

I feel you up, sildenafil

23.

CNS stimulant

phetamine

24.

Antidiuretic - pressin

increase BP

25.

Anemia

PRBC, hgb WDL 12-16

26.

Thrombocytopenia

platelets, 150-400K

27.

Burns-

Plasma protein fraction, albumin, 3.5-5

28.

Hemophilia

cryoprecipitate Factor VIII

29.

hemophilia tests

ptt 30-40 sec, therapeutic 45-80 sec, want increased clotting time 1.5-2

30.

1 unit PRBC

Hgb and Hct both raise 1% per unit

31.

Central venous catheter

aspirate, IV brisk blood return, no resistance when flush with NS, confirm
radiology report, should rest superior vena cava, dressing q2 days

32.

PICC

observe antecubital fossa for edema

33.

Triple lumen

1 meds, 1 blood draw etc, complications- pneumothorax, air embolism

34.

triple lumen dwelling complications

occlusion, infection

35.

TPN

change tubing q 24 hrs, dc lipid infusion after 12 hrs, clean iv port before and after

36.

insulin given via IV

regular

37.

DI

ADH deficient, polyuria, can give desmopressin intranasally

38.

Lantus

glargine, lonely lantus doesn't play well with others

39.

another word for A1C

glycosylated hgb

40.

inject 10U reg then 20U NPH

roll nph, clean stoppers, inject 20U air into NPH, inject 10U air into regular, WD 10U reg,
then 20U NPH

41.

lanoxin, digoxin

hypoK

42.

Ambien, zolpidem

caution in elderly, opposite effect

43.

MMR hold

allergy to gelatin or neomycin

44.

RH - mom

28 wks, 72h rs after birth rogham, baby should be RH +

45.

methylergonovine (Methergin)

stop contraction, hemorrhage

46.

aqua mephton

vit K

47.

statin take

at night

48.

glucophage / metformin

increase lactic acid levels

49.

glucocorticoid

osteoporitis, cushings, puffy moon face

50.

addison's

high and dry, hypoglycemia, dehydration, bronze skin

51.

budesonide formsterol

prevent asthma, COPD, GI upset, infection

52.

levothyroxine synthroid

take 30 min before breakfast

53.

flagyl and vancomycin

cdiffe

54.

give vanc and gent

over 1 hr

55.

fentanyl

duragesic, change 72 hrs, no heat over site

56.

lithium

0.6-1.2, fine tremors are normal, increase salt, thirst s/s toxicity, lithium and salt compete
for binding sites

57.

Clozapine- clozaril

2nd gen antipsychotic, agranulocytosis- dangerously low WBC, constipation, othro


Hypotn

58.

typical antispsychotic

SEATANS- sedation, EPS, antocholinergic, tradive dyskinesia, agranulocytosis, neuroleptic


malignant syndrome, seizures

59.

atypical like clozaril

decrease risk of eps, weight gain, diabetes, dyslipidemia, agrnaulocytosis, ortho htn

60.

benzo od

romazicon flumazenil

61.

avoid tyramine with MAOI

phenelzine or Nardil

62.

tyramine food

bacon eggs liver, pepperoni, bologna, sausage, pickeld herring, anchovies, shrimp,
caviar, yeast, chocolate, alcoholic drinks

63.

tyramine problems

hypertensive crisis, foods are pickled, aged, smoked, fermented, marinated

64.

new trach at bedside

bag valve, 20 set up, suction, two trach tubes

65.

weak legs

hypoK

66.

chron's

corticosteriods, cobblestone

67.

HHNS hyperglycemic hyperosmolar


nonketonic syndrom

> 600 CBG, dehydration, low grade temp, confusion, headaches

68.

normal IOP

10-21

69.

Ulcerative colitis

starts @ rectum, increased risk cancer, more women than meb

70.

PVD

painless ulceration

71.

HyperK

peaked tented T- wave

72.

Cane COAL

cane opposite affected limb, cane stron side

73.

radiation

visitors 6 ft, 30 min day, sign on door, educate r/t isolation, save linens in room

74.

propofol milk of anesthesia

allergy to eggs contact pharm

75.

vaccines

don't give if egg allergy

76.

brudinskis sign

lay down, tilt neck chich to chest, makes knee/hip flex

77.

Kernigs sign

lay down bend knee AT 90 angle, can't straighten leg, hamstring tight, pain

78.

meningitis

headache, stiff neck, photophobia, seizure precautions, private room, dehydration

79.

test to see if amnio fluid or pee

fern or nitrizine test

80.

smallpox

contact, face to face, body fluids, aerosol, dever, red spot tongue, rash, most
contagious

81.

sepsis

vascular changes, resp compromise, renal, CNS

82.

neonatal sepsis

low ax temp, lethargy, poor suck reflex

83.

nits

lindane no longer used, pretherin creme

84.

ED

can cause MI blood pools in penis

85.

external/internal hemmrhoid

streaks in stool

86.

3rd degree heart block

p & QRS not related

87.

problem after prolonged vomiting

hypoK

88.

parkland formula

4xkgxTBSA, 1st 1/2 in 8 hrs, rest remainint 16 hrs, deduct what previously given and
look at time

89.

assess buttocks in traction

never side to side, lift buttocks

90.

AV fistula

use after several weeks, BP in opposite arm, feel thrill no heavy carrying

91.

metabolic imbalance

usually throwing up diarrhea

92.

abrupto placentia

rigid abdomen

93.

mastitis

keep feeding affected side

94.

serotonin antagonist- serotonin tron to the


rescue

dolasetron, ondansetron

95.

Continuous bubbling in water seal chamber

means there is a leak

96.

Bubbling in suction chamber

means suction is working

97.

NEURO

...

98.

closed head injury

possible csf leak (yellow ring around a clear moist area seen on pillow)

99.

closed head injury with increaed ICP

instruct client to exhale when turning and moving in bed

100.

head trauma develops increased ICP

do this first-hyperventilate the pt(CO2 increased ICP-this will decrease CO2 and ICP)
-trendelenburg position will increase ICP-not a good position

101.

subdural hematoma, reduce the ICP


interventions

30 degrees semi fowler, trendelenburg contraindicated

102.

concussion discharge education

call dr if repeated episodes of vomiting occur-sign of ICP going up


no dietary restrictions
no activity restrictions unless HA develops
for pain, can give acetaminophen, but not sedating drugs

103.

pt taking antipsychotic drugs develops NMS

early sign of this: muscle stiffness, fever, sweating, tremors


late signs: dysphagia, unstable BP, respiratory depression
-this is an emergency

104.

pt scheduled for CT scan

tell pt that he might experience slight discomfort


not exposed to magnetic field

105.

post frontal craniotomy interventions

watch for increased ICP


fluids restricted to 1-2 L per day
space out activities, don't cluster
provide Oxygen at 2 LPM-will prevent hypoxia which can lead to cerebral edema
give Dexamethasone-reduce or prevent cerebral edema
raise HOB at 30 degrees
don't place in trendelenburg-can cause too much blood flow to the brain

106.

spinal cord injury-bladder management

urinate on a timed schedule, encourage fluids, no need to avoid carbonated drinksthey can have these

107.

suspected spinal cord injury, unconscious

avoid using chin-tilt maneuver during cpr


cpr-2 breaths for q 30 compressions

108.

complete C7 transection

plan of care might include ventilatory support


lesions above C6-risk of respiratory paralysis
C1-C8 injury-risk of quadriplegia

109.

stroke pt with L side weakness, in order to


avoid disuse syndrome

use boots to prevent foot drop, assist pt with passive and active ROM,

110.

stroke major risk factor

hypertension, diabetes mellitus, heart disease, nonvalvular Afib

111.

MRI contraindication

pacemaker, cerebral aneurysm clips, metal implants, orthopedic hardware,


intrauterine devices, pacemaker, internal surgical clips
remove jewelry before
give a mild sedative before, if pt is claustrophobic

112.

Myasthenia Gravis

fluctuating muscle weakness that worsens with effort and improves with rest
weakness
fatigue
drooling
ptosis
oropharyngeal weakness
have suction ready
administer Pyridostigmine
airway clearance-primary attention

113.

Parkinson

give Carbidopa/Levodopa
semisolid, thickened food
small frequent feedings
bath bars recommended
ROM and posture exercises

114.

Acute Bacterial Meningitis

complications: hearing impairment, photophobia-put pt in a dim light room


no specific diet
s/s: HA, fever, nuchal rigidity, altered mental status
rapid onset-develops oper hrs to 2 days
droplet precautions
start to on empiric antimicrobial therapy asap

115.

Meningitis

altered cerebral perfusion from ICP and inflammation


provide care for high ICP, seizures and hyperthermia
fever
HA
nuchal rigidity
Kernig's sign
Brudzinski's sign-flexion of the hip and knee in response to forward flexion of the neck
opisthotonos
-no seizures

116.

infratentorial craniotomy for a brain


tumor

keep HOB flat


place a small pillow under the nape of the patient's neck to promote venous return and
reduce ICP
post any craniotomy monitor q 30 min for neuro check
don't flex the neck
post procedure-strict I&O maintained, strict fluid intake
fluids at 175 ml/hr too much

117.

infratentorial craniotomy

elevate HOB at 30-45 degrees

118.

sustained severe brain injury

interventions are to maintain a low ICP


elevate HOB
relaxing atmosphere
limit suction
don't cluster activities
don't discuss pt status at bed side

119.

MS

double vision
visual loss
impaired sensation
mood swings
impaired motor function and cerebellar function
impaired urination
male-sexual impotence
weakness
numbness of hands
fatigue
tremors
s/s worsening over the past several months
nystagmus
scanning speech
ataxia
muscular weakness
incontinence
common between 20-40 yrs old women

120.

MS discharge instructions

exposure to heat and cold can exacerbate symptoms


teach how to avoid fatigue, infections
no restrictions in diet, just eat nutritious well balanced meals
hard exercise not recommended but physical therapy yes it is recommended
failure to store in bladder or failure to empty bladder-common problems
constipation-most common bowel complaint

121.

MS manifestations

urinary retention
hyperreflexia of the extremities
intestinal obstruction
ataxia
decreased concentration
constipation

122.

ALS

muscle weakness
atrophy
fasciculations
dysphagia
spasticity of the flexor muscles

123.

Parkinson's

mask like appearance to the face


drooling
slow speech
shuffling gate

124.

GBS

risk for respiratory muscles weakness-paralysis

125.

Bell's palsy

7th cranial nerve


priority: assess for pain experience
soft diet
apply an eye shield over the affected eye-corneal abrasion
with Bell's Palsy

126.

trigeminal neuralgia

nerve V

127.

swallowing and speaking

nerve X

128.

facial muscle movement and taste

VII

129.

brain tumor

HA, vomiting, papiledema, seizures, changes in mental status,


altered vision

130.

encephalitis

HA, fever, vomiting, menigeal signs

131.

cerebral arteriogram (angiogram of the blood vessels of the


brain) (femoral artery access)

pt just came back, interventions:


pressure dressing over the site for 4 hrs at least
flat for 4 to 24 hrs, bed rest
keep the affected extremity straight and immobilized
6 to 8 hrs before-NPO
assess for weak pulses after
give fluids to excrete dye

132.

lumbar puncture

lie flat after procedure for 4-6 hrs, depends on facility

133.

CN II (optic nerve) assessment

use a Snellen chart

134.

CN III-oculomotor, IV-trochlear and VI-abducens assessment

use penlight,note for nystagmus

135.

CN V (trigeminal nerve) assessment

corneal reflex

136.

CN VIII (acoustic nerve)

Weber test and Rinne test-assess conductive and


sensorineural hearing loss

137.

cerebellar and vestibular function

Romberg test

138.

visual acuity

Rosenbaun test

139.

Tonometry

measures intraocular pressure

140.

Glascow Coma Scale

eye opening, motor response, verbal response


coma=8 or less
lowest score is 3=deep coma
15=perfect score

141.

head injury pt, in order to monitor hypothalamic function

assess urinary output and temperature

142.

brainstem

control of heart rate/ HR, resp rate/ RR

143.

TIA

temporary loss of cognitive function that will probably resolve


warning sign of impending CVA
brief period of neurologic deficit such as loss of vision,
hemiparesis and slurred speech
does not have long term neurologic deficits

144.

CVA

may cause long term deficits

145.

Meniere's disease

vertigo
tinnitus
hearing loss
inner ear affected

146.

Acoustic neuroma

unilateral involvement
progress without improvement

147.

MATERNITY/OB

...

148.

Carboprost

used in OB bleeding
don't give in asthma-contraindicated
AE-wheezing

149.

INFECTIOUS

...

150.

airborne

tb, rubeola, chickenpox, varicella


door closed
negative air pressure room
mask-N95

151.

droplet

larger than 5 mcg


door can remain open,the droplets are larger so they don't spread
face mask for nurse
distance between client and family
pneumonia, meningococal meningitis

152.

contact

wound infection-like MRSA


Cdif
RSV-young children
secretions are not contained in these infections
private room
clean gloves when entering room
if contact with surfaces in room-wear gown
keep equipment in room

153.

chickenpox children

airborne, contact
direct contact
2 days before rash appears they are contagious
keep nails short
no aspirin in kids

154.

rubella

droplet
isolate these kids from pregnant women
antipyretics and analgesics
if its congenital rubella (newborn)-contact-until 12 months old or until negative swabs at 3 months of age

155.

mononucleosis

flu like fever


sore throat
lymph nodes enlarged
avoid contact with saliva 3 months
adolescents
risk for rupture spleen-no contact sports-danger of ruptured spleen

156.

tonsilitis

from strep infection->(risk for glomerulonephritis and rheumatic fever)


antibiotics

157.

TB

airborne-less than 5 mcg


fatigue
anorexia
nightsweats
low grade fever
sputum purulent
dyspnea
x ray
man 2 test/ppd-48-72 hrs induration (area hard, you feel the edges around it; greater than 10-pozitive-exposed and
infected)
immuncompromised patients-greater than 5-pozitive
quatiferon tb gold-blood test-fater than sputum cultures-within 24 hrs results available-treatment earlier
isolated 2-4 weeks if inpatient-isolated
cannot work, isolated
health dept notified
teaching important
dont isolate from family-impossible, already exposed, they should be tested and treated if necessary
-teach to cover mouth when coughing and how to dispose tissues
full range of meds-don't stop
3 negative sputum tests=go back to work
Ethambutol
Pyrazinamide-given to shorten treatment to 6 months
assess for SE-client might stop meds-assess for nausea (take at night)

158.

Hepatitis

acute inflamatory
jaundice
RUQ pain
tea color urine
light color stool
elevated ALT and AST
A-fecal oral route, contaminated water or food
B-parenteral, sexual
C-bodily fluids
mild or severe symptoms
flu like symptoms
rest liver to encourage regeneration, rest as much as possible, dont stop activities, but rest
contact or standard precautions
high carbs diet
moderate fats and protein
no alcohol
careful with meds-break down in liver
A-no treatment, just hand washing, their own towels
no meds given, but in B,C-antivirals given

159.

Lyme

erythematous lesion-bulls eye flu like symtoms


stage 2-cardiac and neuro problems
stage 3-large joint problems
3-4 weeks antibiotics

160.

syphillis

cupper color rash


contact spread, mucus membranes
congenital in baby
Penicillin

161.

gonorrhea

thick disharge
many times no symptoms in females-PID-sterility
doxycycline, rocemphin

162.

genital herpes

painful vesicular genital lesions


after outbreak, virus still there in skin, can reoccur with stress, menses
spread to infants
no vaginal birth
sitz bath
acyclovir-dont treat the virus, just decreases course
pap spears
oral antibiotics
no sex-while lesions present
use condoms in between

163.

chalamydia

urethritis-men
thich discarge, odor-women
mucus membrane contact
Doxycycline

164.

Hiv

aids-from deffective immune system


from opportunistic infection: sarcoma
contaminated blood or needles
sexual contact
placental transmission
breast milk transmission
prevention: no share of needles while drug use
standard precautions in hospital
high protein calorie diet
support of family and client important

165.

poison control

prevention
toddlers-common victims
meds in locked cabinets
check with the eyes of a children
don't take meds in front of them
dont keep meds in purses
accidental poison s/s-sudden change of child behaviour, empty container around the child
have number available for poison control
save vomitus and urine
contrai to vomiting-unconscious child, petroleum base substances, corrosive substances
poison control will decide what to do
dont give a large amount of fluids-will increase absorption

166.

led

neuro affection
irritability, increased icp
identify the source-nurse role
homes built before 70's, oil based, pottery with oil based

167.

hazardous waste
contamination

decontaminate-first thing
prevent spread
clean up contamination
monitor personnel that has been exposed
if you have a contaminated patient-dont know what they are contaminated with-first thing find out what
they are contaminated with,

168.

hemophyllia

mom transmits gene to her son


sex linked disorder
50% chance that mom will pass it to each children
affected male gets the gene from mother and can transmit it only to the doughter

169.

laryngotracheobronchitis

inspiratory stridor and restlessness


edema and inflammation of upper airways
elevated RR

170.

night terrors

normal between 4-7

171.

otitis meds
common
meds

antihistamines
steroids

172.

crushing meds
for children

what do you crush or not crush

173.

infant

safe crib
car seat-rear face, until 20 lbs, after front faced seat, back seat not front seat
bath temperature
small pieces toys-chicking
child proof home
plugs covered
plants that are poisonous-don't keep these

174.

preschoolers
and school
age

safety
helmet for bicycles-important
bikes and scooters- ride on sidewalk
sports safety-stay active cause of obesity, but have appropriate equipment, appropriate age group activities

175.

teenager

males-teach them how to deal with anger


safety while driving-ask if they wear seatbelt 100% of the time, no cell phone
drugs-teach about it

176.

adults safety

talk about guns


exercise
old adults-are they safe while ambulating? shoes-are they appropriate, walker-do they need one?, stairs-up and
down correct, hand rails, don't carry things upstairs, do they have a way to contact someone in case they fall

177.

disaster
planning

red-unstable, immediate attention


yellow-stable, ca wait
green-stable, can wait longer, the walking wounded
black-fatal injuries, unstable
---use these colors only if system is overwhelemed-question will say it

178.

bioterrorismanthrax

cutaneous/skin-skin contact, no person to person, animal workers; standard precautions


inhalation-spores; no person to person contact; resp failure, shock, hemorrhagic shock-doxycycline

179.

Tetralogy of
Fallow

Right ventricular hypertrophy


Overriding aorta
Pulmonary stenosis
Ventricular septal defect

180.

...

Right ventricular hypertrophy


Overriding aorta
Pulmonary stenosis
Ventricular septal defect

181.

infants

exploratory play

182.

todlers

imitation

183.

school age

working with otherrs


groups, collaborative play
hobbies

184.

erikson stages

infant-trust vs mistrust-stable caregiver


toddlers-18m-3 yrs-autonomy vs shame and doubt-toilet training, walking, muscular coordination, they want to do
things by themselves-autonomy
preschool-3-6 yrs-initiative vs guilt-constant discovery
school age-industry vs inferiority-tasks are imp-teams and groups are present-inferiority possible if role not met
adolescence-12-20 yrs-peers more important than parents-think of careers start; disease-cannot fit in with the
group; eg diabetic teenager cannot meet with friends and eat what they want
young adulthood-20-25-commitment, family start
45-64 yrs-middle adulthood-generativity vs stagnation
65 and over-integrity vs despair-progressing towards the end of life-feeling that their life was meaningful

185.

screening tests

Denver test-birth to 6 years

186.

growth and
development

...

187.

muscular
developmet

screen routine infant for muscular development


teach parents about milestones
progression

188.

1-2 months

poor head control


frequent feeding needed
gain 5-7 oz weekly first few months

189.

3-4 monts

head control
get up with head
smile
4 m-loose reflexes
become more social, eye contact

190.

5-6 m

double weight
grasping objects
weight slows down-4 oz a week
turn from back to stomach-dont leave alone on changing table-teach parents

191.

7-8 m

stranger anxiety
fear of stranger, wants mom
8 m-separation-stages
-protest
-dispair-they dont want to eat, play
-denial-when parent comes back-ignore

192.

9-10 m

more mobile
sitting position lift
can say gaga..
respond with anger
crawling starts possible
10m-pull to standing
house baby proof cause now they are more mobile

193.

11-12 m

weight triple
can sit from standing position
wat with fingers
babinski reflex changes from baby fanning
injury, failure to thrive, development problems
injury-most at risk
small pieces things-choking
dont give candy, nuts, hot dogs-small
falls-risk for injury
car seats-teach-completely restraint
burns-outlets, cords
failure to thrive-not enough growth, physical defects, not good parenting
nutritional feeding has to be met
age appropriate toys-nclex loves these
toys should stimulate, also think safety, no sharp edges
introduction of solid foods-variety but not too many at once, one q 2 weeks, starting with 6 m
rice cereal-first, can mix with formula or breast milk
no fruit juices in bottles-teeth problems
finger foods-watch for choking

194.

15-18 m-todler

lots of vocabulary
walking alone
anterior fontanelle closes at 18 m
tumb sucking
4 blocks together-15 m old
tantrums-18 start-normal-until 2

195.

24-30 m

increase vocabulary
tippytoe walk
sphincter control-2 1/2 around that time
30 m-4 times birth weight
they like push pull toys, stuffed animals, dolls
negativism-they say no, dont ask yes/no questions
-routine important
safety-active so risk for injuries; mva's-most at risk, car seat safety, restraint seat
drowning
abuse

196.

3-5 yrspreschooler

3-vocabulary exploring-1500 words; brushing teeth; discipline, limits important


5 yrs-2500 words-identity play, play like mom and dad; love to play; housekeeping toys-stoves, cars; trycicles; tolerate
separation from parents
fear of death at this age; give a shot showing on a doll; help with increasing separation from parents

197.

7 yrs

boys play with boys


girls play with boys

198.

seeking friends
starting conflict with parents
on the go

199.

10-12

love conversation
choosing friends more selectively
interested in other sex
reading
sowing
construction
sports
bicycle
industry vs inferiority-accomplishment important
should be dry at night-no bed wetting at 12
void before bedtime, there are meds available for bed wetting

200.

Verapamil

SVT

201.

CVA

corneal abrasion

202.

permethrin

for head lice


repeat the application of cream-rinse in 7 days if nits still present,
repeated only at 7 days after first application
comb hair daily with a nit comb
clean clothing with very hot water and RID special detergent

203.

ceftriaxone

its a cephalosporin
in pt for postop infection
monitor tongue and oral cavity for growth of microorganisms

204.

hiatal hernia and reflux

less likely to wake up at night from heartburn if stomach is emty

205.

hypothyroidism

client very sensitive to narcotics, barbiturates, anesthetics-avoid


narcotic sedatives

206.

type 2 diabetic pt going for surgery is subscribed insulin


postop instead of his usually oral meds-why

being npo inhibits blood sugar control

207.

pneumothorax, chest tube

lung has re-expanded=the fluid in the water seal chamber does


not fluctuate with respirations
air leak=continuous bubbling in the water chamber, gentle
bubbling is normal

208.

elderly type 1 diabetic

blood glucose tests are better than urine because the renal glucose
threshold in elevated in elderly

209.

US at 32 weeks

getting gestational age

210.

amniocentesis

LS ratio to assess baby's lungs


determines if there are any problems with spinal cord
determines early problems with baby's blood

211.

tracheostomy

...

212.

allnurses random facts

1. barium swallow for 3 month old infant - npo for three hours
2. temporary pacemaker for mi client - increase cardiac output is the primary purpose
3. plasma cholesterol screening - only sips of water for 12 hours
4. reminiscing group - primary goal is to review and share their life experience with the group member
5. miller-abbott tube - removes fluid and gas in the small intestine; provides intestinal decompression
6. levin or salem stump - decompresses the stomach; prevent fluid and gas accumulation in the stomach
7. promethazine hcl (phenergan) - check patency of the patient's vein before admin of drug, extravasation
will cause necrosis
8. insulin dependent diabetic, unable to urinate -- autonomic neuropathy
9. overdose of aspirin will produce parkinsons dse type sx
10. do not admin erythromycin to multiple sclerosis pt

213.

Chlordiazepoxide
(Librium)

-antianxiety used to tx symptoms of acute alcohol withdrawal

214.

terbutaline Brethine
mag sulfate

tx for preterm labor

215.

Benzatropine
(Cogentin)

-used to tx parkinsonian side effects of Chlorpromazine (Thorazine) (antipsychotic med)

216.

Methadone

hydrochloride-opiod analgesic; tx for narcotic withdrawal

217.

Nifedipine (Procardia)

antianginal med (CCB) decreases myocardial O2 demand.

218.

Digoxin

strengthens myocardial contractio0n & slows conduction thru AV node

219.

Warfarin (Coumadin)

inhibits prothrombin synthesis

220.

Aminocaproic acid
(Amicar)

antifibrinolytic
prevents recurrence of subarachnoid hemorrhage.

221.

Lithium

tx manic phase of bipolar

222.

Nimodipine

CCB
decreases spasm in cerebral blood vessels

223.

diltiazem

CCB
inhibits Ca+ influx vascular smooth muscle
reduces myocardial O2 demand &decreases force of ventricular contraction

224.

clotrimazole

antifungal; treats rashes.

225.

sphincter control

18 months

226.

Buerger's disease

digital sensitivity to cold


intermittent claudication (pain with exercise)

227.

aging

nocturia
increase need to frequent urination

228.

gastric ulcer

pain half and hr or 1 hr after a meal


pain rarely at night, not helped by ingestion of food

229.

duodenal ulcer

pain at night, 2-3 hrs after a meal, prior to ingestion of a meal

230.

lumbra laminectomy

Educate about exercise to strengthen the abdominal muscle

231.

promethazine

extravasation of vein, iv

232.

tetrahydrozoline

contrai in angle closure glaucoma

233.

recurrent uti

limit milk
ordered Mandelamine

234.

miller abot tube

used for decompression of onstruction

235.

aids pts

get dementia, many of them

236.

hypoparathyroidism

low calcium
be ready to deal with dysrhythmiaa

237.

iv placement

not close to joint

238.

rsv

...

239.

Bun

7-18 (older)

240.

Creatinine

0.7-1.4

241.

PT

9.5-12

242.

autonomic dysreflexia

...

243.

graves disease

heat intolerance
metabolic rate increased

244.

tetracycline

use sunscreen outdoors

245.

propanolol

s/e bronchospasm

246.

Transesophageal echocardiography (TEE)

npo-for several hrs


lidocaine-numb the esophagus-risk for for aspiration
possibly iv sedation

247.

Ankle brachial index

...

248.

Alteplase

...

249.

Ceftriaxone (Rocephin)

...

250.

Labs for Mi

...

251.

stress test

stop if pain

252.

Pepcid

report to dr if pt is about to be put on antiplatelets meds-it might not work

253.

Docusate

stool softner

254.

Omeprazole

makes the Clopidogrel not work

255.

30 months

able to jump

256.

18 months

walk up and down the stairs while holding self

257.

low K

risk for Dig toxicity


call doc

258.

PSA

draw before digital rectal exam

259.

tube feeding

rinse the bag and change formula q 4 hrs

260.

ng tube, before feeding

check ph-3 is good-for the aspirated contents

261.

Ciprofloxacin

rash-stop drug and call dr

262.

iv K

if burning-decrease rate

263.

aPTT

1.5-2 x the therapeutic value is ok

264.

cerebellar tumor

losing balance easily

265.

CN IX (glossopharyngeal)

can tell difference in taste

266.

CN VIII (acoustic)

loss of hearing
temporal lobe (auditory center)

267.

gravity drip IV

piggy bag has to be higher than primary bag

268.

before giving dopamine iv

check iv patency
risk for extravasation

269.

GEMFIBROZIL

...

270.

PERPHENAZINE

...

271.

TERBUTALINE

...

272.

ZIDOVUDINE

...

273.

PROCAINAMIDE

...

274.

PROCHLOPERAZINE

...

275.

BROMPHENIRAMINE

...

276.

PHENYLPROPANOLAMINE

...

277.

Random
meds

Carbamazepine therapeutic serum level is 4 - 12 mcg/dL


Cycloserine is an antituburculan and needs weekly drug levels
foscarnet (Foscavir) can be toxic to kidneys so creatinine is monitored.
Therapeutic serum digoxin is 0.5 - 2 mg/dL
morphine is contraindicated in acute pancreatitis because is causes the spasms but the demerol is the drug of choice.
Dantrium (dantroline) common drug kept in the OR for Malignant Hyperthermia
No birth control pills with antiseizure meds....lowers the BCP's effects
Metylergonovine-to contract uterus. before giving check BP. dont give if vascular diseases are present.
MgSo4-CNS Deppressant and Anticonvulsant
= normal range 4-7.5, effective if no seizures. Adverse reactions: Flushing, decrease in RR, Muscle weakness
filgrastim (neupogen) - increase neutrophil count
epoietin alfa (epogen) - increase rbc/erythrocytes
1. prozac, zoloft, paxil- tx of depression.
2. sodium nitroprusside- sheild from light. wrap in foil
3. cephalosporins- check for allergies to penicillins. pt could be hypersensitive.
4. pts recieving lasix should be assessed for tinnitus and hearing loss
5. anticoagulants cant dissolve a formed thrombus but tpas can.
PVC's -Lidocaine
Verapamil - treatment of supraventricular tachycardias, check heart rate
Clomiphene- induces ovulation by changing hormonal effect on the ovary
DO NOT give a pregnant laboring patient on methadone STADOL (precipitates withdrawal)
contractions > 90 seconds, FHR < after contraction peak. . .turn off the pitocin [oxytocin] (if running) give O2 by tight face
mask, reposition on left side, increase IV fluid rate, notify caregiver, document
Aminoglycosides (gentamycin, etc.) affect 8th cranial nerve function (hearing) and are nephrotoxic
he adverse effects of Anti psychotics can be remembered using this: SHANCE
S-SUNLIGHT SENSITIVITY( Use hats and sunscreen)
H-HEPATOTOXICITY( Monitor LFT)
A-AGRANULOCYTOSIS( Characterised by fever and sore throat)
N-NEUROLEPTIC MALIGNANT SYNDROME( Characterised by fever and muscular rigidity)
C-CIRCULATORY PROBLEMS( Leukopenia and orthostatic hypotension)
E-EXTRA PYRAMIDAL SYMPTOMS( Administer anticholinergics and anti parkinsonian agents)
SVT - Adenosine
Atrial Flutter - Anticoagulants
Atrial Fibrillation - Beta Blockers, Digoxin
PVC - Amiodarone
Ventricular Tachycardia - Amiodarone

Ventricular Fibrillation - Defibrillation


Torsades de Pointes - Magnesium Sulfate
1st Degree AV Block - No treatment usually
2nd Degree AV Block Type I - Atropine
2nd Degree AV Block Type II - Pacemaker
3rd Degree AV Block Complete - Emergent Pacemaker, Atropine, Epinephrine, Dopamine
Sinus Bradycardia - Atropine or Epinephrine
Sinus Tachycardia - Beta Adrenergic or Calcium Channel Blocker
digoxin 05-2.0 ng/ml
lithium 0.6-1.5 meq/l
dilantin 10-20 mcg/dl
theophylline 10-20 mcg/dl
lithium 0.5-1.5 meq/l
coumadin pt: 12-20 sec....therapeutic range 1.5-2 times the control inr: 2-3
heparin ptt: 30-60 sec...therapeutic range 1.5-2 times the control
278.

Electrolytes

Hyperkalemia = narrow, peaked T waves on cardiac monitor


Hypokalemia = Peaked P, Flat T, Depressed ST and Prominent U
HYPOCALCEMIA (not enough sedatives)
+ trouseau and + chovstek's sign
incr DTR
stridor, laryngospasm
swallowing problem=aspiration
ALDOSTERONE insufficiency -Hypo-Na-emia, Hyper-K-emia, hypo-Volemia. WHEN Na decrease,
K increase
addisons= hyponatremia, hypotension, decreased blood vol, hyperkalemia, hypoglycemia
cushings= hypernatremia, hypertension, incrased blood vol, hypokalemia, hyperglycemia
4. SIADH
Na <120
Hx of lung cancer
Specific gravity > 1.035
Diabetes Insipidus
Na> 160
head injury
Specific gravity <1.005

279.

Defense mechanisms

phobias include projection and displacement

280.

Delegation Rule of Thumb?

DO NOT delegate what you can EAT!


E - evaluate
A - assess
T - teach

281.

VV and AA?

EleVate Veins; dAngle Arteries for better perfusion

282.

Apgar Scoring?

A= appearance (color all pink, pink and blue, blue [pale])


P= pulse (>100, < 100, absent)
G= grimace (cough, grimace, no response)
A= activity (flexed, flaccid, limp)
R= respirations (strong cry, weak cry, absent)

283.

Airborne Transmission?

My - Measles
Chicken - Chicken Pox/Varicella
Hez - Herpez Zoster/Shingles
TB

284.

Protocol for Airborne


Transmission?

Private Room - negative pressure with 6-12 air exchanges/hr


Mask, N95 for TB

285.

Droplet Precautions Transmission?

DROPLET
think of SPIDERMAN!
S - sepsis
S - scarlet fever
S - streptococcal pharyngitis
P - parvovirus B19
P - pneumonia
P - pertussis
I - influenza
D - diptheria (pharyngeal)
E - epiglottitis
R - rubella
M - mumps
M - meningitis
M - mycoplasma or meningeal pneumonia
An - Adenovirus

286.

Protocol for Droplet Precautions?

Private Room or cohort mask

287.

Contact transmission precautions

CONTACT PRECAUTION
MRS.WEE
M - multidrug resistant organism
R - respiratory infection
S - skin infections *
W - wound infxn
E - enteric infxn - clostridium difficile
E - eye infxn - conjunctivitis

288.

What to do in the case of- an Air/Pulmonary


Embolism?

S&S: chest pain, difficulty breathing, tachycardia, pale/cyanotic,


sense of impending doom --> turn pt to left side and lower the head of
the bed.

289.

What to do in the case of- A woman in labor with UnReassuring FHR?

(late decels, decreased variability, fetal


bradycardia, etc) --> turn on left side (and give O2, stop Pitocin, increase
IV fluids)

290.

What to do in the case of tube feeding with decreased


LOC?

position pt on right side promotes emptying of the


stomach with the HOB elevated to prevent aspiration

291.

During epidural puncture?

Side lying

292.

After lumbar puncture?

e (and also oil-based Myelogram)--> pt lies in flat supine (to prevent


headache and leaking of CSF)

293.

What to in the case of- Pt with heat stroke?

Lie flat with legs elevated

294.

During CBI (continuous bladder irrigation)

(CBI) --> catheter is taped to thigh so leg should be


kept straight. No other positioning restrictions.

295.

After Myringotomy?

Position on the side of the AFFECTED EAR after surgery to allow drainage
of secretions

296.

After Cataract surgery?

pt will sleep on unaffected side with a night shield for 1-4


weeks.

297.

After Thyroidectomy?

low or semi-Fowler's, support head, neck and shoulders.

298.

Infant with Spina Bifida?

position prone (on abdomen) so that sac does not rupture

299.

Buck's Traction?

(skin traction) --> elevate foot of bed for counter-traction

300.

After Total Hip Replacement?

don't sleep on operated side, don't flex hip more than 4560 degrees, don't elevate HOB more than 45 degrees. Maintain hip
abduction by separating
thighs with pillows.

301.

Prolapsed Cord?

knee-chest position or Trendelenburg

302.

Infant with Cleft lip?

position on back or in infant seat to prevent trauma to suture line.


While feeding, hold in upright position.

303.

To prevent dumping syndrome?

(post-operative ulcer/stomach surgeries) --> eat in


reclining position, lie down after meals for 20-30 minutes (also restrict
fluids during meals, low
CHO and fiber diet, small frequent meals)

304.

Above the knee amputation?

elevate for first 24 hours on pillow, position prone daily to


provide for hip extension.

305.

Below the knee amputation?

foot of bed elevated for first 24 hours, position prone daily to


provide for hip extension.

306.

Detached Retina?

area of detachment should be in the dependent position-- dependent


meaning supported by something

307.

Enema positioning?

position pt in left side-lying (Sim's) with knee flexed

308.

After Supratentorial Surgery?

(incision behind hairline) --> elevate HOB 30-45 degrees

309.

After Infratentorial Surgery?

(incision at nape of neck)--> position pt flat and lateral on


either side.

310.

During internal radiation?

on bedrest while implant in place

311.

Autonomic Dysreflexia/ Hyperreflexia?

S&S: pounding headache, profuse sweating, nasal


congestion, goose flesh, bradycardia, hypertension place client in sitting
position elevate
HOB first before any other implementation.

312.

Shock?

bedrest with extremities elevated 20 degrees, knees straight, head


slightly
elevated (modified Trendelenburg)

313.

Head Injury?

elevate HOB 30 degrees to decrease intracranial pressure

314.

Peritoneal Dialysis when outflow is inadequate?

turn pt from side to side BEFORE


checking for kinks in tubing (according to Kaplan)

315.

Lumbar Puncture?

AFTER the procedure, the client should be placed in the supine


position for 4 to 12 hrs as prescribed. (Saunders 3rd ed p. 229)

316.

The difference between Myasthenia Gravis, Myastenia


Crisis, and Cholinergic Crisis?

Myasthenia Gravis: worsens with exercise and improves with rest.


Myasthenia Crisis: a positive reaction to Tensilon--will improve
symptoms
Cholinergic Crisis: caused by excessive medication-stop med-giving
Tensilon will make it worse

317.

Prior to liver biopsy?

Its important to be aware of the lab result for prothrombin time

318.

From the ass? From the Mouth?

From the a** (diarrhea)= metabolic acidosis


From the mouth (vomitus)=metabolic alkalosis

319.

Myxedema/ hypothroidism?

slowed physical and mental function, sensitivity to cold, dry skin


and hair

320.

Graves disease/ Hyperthyroidism?

accelerated physical and mental function; sensitivity to


heat, fine/soft hair

321.

Thyroid storm?

increased temp, pulse and HTN

322.

Post Thyroidectomy?

semi-Fowler's, prevent ncek flexion/hyperextension, trach at bedside

323.

Hypo-parathyroid?

CATS - convulsions, arrhythmias, tetany, spasms, stridor (decreased


calcium), high Ca, low phosphorus diet

324.

Hyperparathyroid?

fatigue, muscle weakness, renal calculi, back and joint pain (increased
calcium), low Ca, high phosphorus diet

325.

Hypovolemia?

incrased temp, rapid/weak pulse, increase respiration, hypotension, anxiety,


urine specific gravity >1.030

326.

Hypervolemia?

bounding pulse, SOB, dyspnea, rares/crackles, peripheral edema, HTN, urine


specific gravity <1.010; Semi-Fowler's

327.

Diabetes Insipidus?

(decreased ADH): excessive urine output and thirst, dehydration,


weakness, administer Pitressin

328.

SIADH?

(increased ADH): change in LOC, decreased deep tendon reflexes, tachycardia, n/v/a,
HA; administer Declomycin, diuretics

329.

HypoKalemia?

muscle ewakness, dysrhythmias, increase K (raisins, bananas, apricots, oranges,


beans, potatoes, carrots, celery)

330.

HyperKalemia?

MURDER - muscle weakness, urine (oliguria/anuria), respiratory depression,


decreased cardiac contractility, ECG changes, reflexes

331.

Hyponatremia?

nausea, muscle cramps, increased ICP, muscular twitching, convulsion; osmotic


diuretics, fluids

332.

Hypernatremia?

increased temp, weakness, disorientation/delusions, hypotension, tachycardia;


hypotonic solution

333.

Hypocalemia?

CATS - convulsions, arrhythmias, tetany, spasms and stridor

334.

Hypercalemia?

muscle weakness, lack of coordination, abdominal pain, confusion, absent


tendon reflexes, sedative effect on CNS

335.

HypoMg?

tremors, tetany, seizures, dyrshythmias, depression, confusion, dysphagia; dig toxicity

336.

HyperMg?

depresses the CNS, hypotension, facial flushing, muscle ewakness, absent deep
tendon reflexes, shallow respirations, emergency

337.

Addisons?

hypoNa, hyperK, hypoglycemia, dark pigmentation, decreased resistance to stress,


fractures, alopecia, weight loss, GI distress

338.

Cushings?

hyperNa, hypoK, hyperglycemia, prone to infection, muscle wasting, weakness,


edema, HTN, hirsutism, moonface/buffalo hump

339.

Addisonian Crisis?

n/v, confusion, abdominal pain, extreme weakness, hypoglycemia,


dehydration, decreased BP

340.

Pheochromocytoma?

hypersecretion of epi/norepi, persistent HTN, increased HR,


hyperglycemia, diaphoresis, tremor, pounding HA; avoid stress, frequent bating and rest
breaks,
avoid cold and stimulating foods, surgery to remove tumor

341.

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

342.

Dangerous thing to get during


pregnancy?

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)

343.

Tetraology of Fallot?

Tetralogy of fallot; remember HOPS


Think DROP(child drops to floor or squats) or POSH
Defect, septal
Right Ventricular hypertrophy
Overriding aorts
Pulmonary stenosis

344.

Autonomic Dysreflexia?

Autonomic dysreflexia: potentially life threatening emergency


- elevate head of bed to 90 degree
- loosen constrictive clothing
- assess for bladder distention and bowel impaction (triger)
- Administer antihypertensive meds (may cause stroke, MI, seisure )

345.

FHR patterns in ob?

Have trouble remembering fhr patterns in OB? Think VEAL CHOP


VC
EH
AO
LP
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

346.

For cord compression in OB?

For cord compression, place the mother in the TRENDELENBERG position because this removes
pressure of the presenting part off the cord. (If her head is down, the baby is no longer being
pulled out of hte body by gravity)
If the cord is prolapsed, cover it with sterile saline gauze to prevent drying of the cord and to
minimize infection.

347.

Late Decels?

For late decels, turn the mother to her left side, to allow more blood flow to the placenta.

348.

Before Epidural?

Hydration is a big priority!

349.

Major risks of epidural?

Hypotension and bradypnea / bradycardia are major risks and emergencies.

350.

OB secret?

NEVER check the monitor or a machine as a first action. Always assess the patient first; for
exmaple listen to the fetal heart tones with a stethoscope in NCLEX land. Sometimes it's hard to
tell who to check on first, the mother or the baby; it's usually easy to tell the right answer if the
mother or baby involves a machine. If you're not sure who to check first, and one of the choices
involves the machine, that's the wrong answer.

351.

Hearing the baby in OB?

If the baby is a posterior presentation, the sounds are heard at the sides.
If the baby is anterior, the sounds are heard closer to midline, between teh umbilicus and where
you would listen to a posterior presentation.
If the baby is breech, the sounds are high up in the fundus near the umbilicus. If the baby is
vertex, they are a little bit above the symphysis pubis.

352.

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

353.

To remember blood sugar?

hot and dry-sugar high (hyperglycemia)


cold and clammy-need some candy (hypoglycemia)

354.

ICP and Shock have?

ICP AND SHOCK HAVE OPPOSITE V/S


ICP-increased BP, decreased pulse, decreased resp.
shock- decreased BP, increased pulse, increased resp.

355.

Cor Pulmonae?

right sided heart failure caused by left ventricular failure (so pick edema, jvd, if
it is a choice.)

356.

Heroin withdrawl in a
neonate?

Irritable, and poor sucking

357.

Jews?

No meat and milk together

358.

Brachial Pulse?

Pulse area cpr on infant

359.

What to check children for at age 12


months?

always check lead posioning levels

360.

Sources of potassium?

Bananas, potatoes, citrus fruits

361.

What is obtained before starting any iv


antibiotic?

Cultures

362.

Why would a pt with leukemia have


epistaxis?

b/c of low platelets

363.

Best way to warm a newborn?

skin to skin contact on mom with a blanket

364.

When a pt comes in and she is in active


labor?

nurses FIRST action is to listen to fetal rate/tone

365.

How to treat phobic disorders?

systematic desensitization

366.

Best way to tube feed or feed kids?

small frequent is better than large

367.

With lower amputations?

place in prone position

368.

LVN/LPN cant?

Handle any blood

369.

Cardinal signs of ARDS?

Cardinal sign of ARDS is hypoxemia (low oxygen level in tissues).

370.

Best indicator of dehydration?

weight

371.

Besides sodium, water also follows?

Glucose

372.

Use of cold and hot?

Use cold for acute pain (sprained ankle) and heat for chronic pain (arthritis)

373.

Guided imagery is great for?

CHRONIC pain

374.

When patient is in distress?

Med administration is rarely a good choice

375.

Pneumonia?

pneumonia, fever and chills are usually present. For the elderly
confusion is often present.

376.

COPD and Pneumonia?

COPD is chronic, pneumonia is acute. Emphysema and bronchitis are


both COPD.
in COPD patients the baroreceptors that detect the CO2 level are
destroyed. Therefore, O2 level must be low because high O2 concentration blows the
patient's stimulus for breathing.

377.

4 options for cancer?

chemo, radiation, surgery, allow to


die with dignity.

378.

Nuetropenic patients?

no live vaccines, no fresh fruits, no flowers should be used for


neutropenic patients.

379.

Where are chest tubes placed?

chest tubes are placed in the pleural space.

380.

Diff between angina and MI?

angina (low oxygen to heart tissues) = no dead heart tissues. MI=


dead heart tissue present.

381.

Preload and Afterload?

Preload affects amount of blood that goes to the R ventricle.


Afterload is the resistance the blood has to overcome when leaving the heart.

382.

CABG?

for a CABG operation when the great saphenous vein is taken it is


turned inside out due to the valves that are inside.

383.

1 tsp= how many ml ?

1 t (teaspoon)= 5 ml

384.

1 tablespoon = how many ml?

1 T(tablespoon)= 3 t = 15 ml

385.

How many oz in a ml?

30 ml = 1 oz

386.

1 cup= how many oz?

1 cup= 8 oz

387.

1 quart = how many pints?

1 quart = 2 pints

388.

1 pint = how many cups?

1 pint= 2 cups

389.

1 gr= how many mg?

1 gr (grain)= 60 mg

390.

1 g = how many mg?

1 gram = 1000 mg

391.

1 kg= how many pounds?

2.2

392.

1 lb = how many ozs?

one pound equals 16 0z

393.

Temp conversion?

* To convert Centigrade to F. F= C+40, multiply 9/5 and substract 40


* To convert Fahrenheit to C. C= F+40, multiply 5/9 and substract 40.

394.

After Endoscopy?

after endoscopy check gag reflex.

395.

TPN is given in ?

TPN(total parenteral nutrition) given in subclavian line.

396.

Low Residue diet?

low residue diet means low fiver

397.

Diverticulitis?

diverticulitis (inflammation of the diverticulum in the colon) pain is


around LL quadrant.

398.

Appendicitis

Appendicitis (inflammation of the appendix) pain is in RL quadrant with


rebound tenderness.

399.

Cause of Ascites?

portal hypotension + albuminemia= Ascites.

400.

Who produces insulin?

beta cells of pancreas produce insulin

401.

s3 heart sound is normal? not?

Normal in CHF from the squishin'.. NOT normal in an MI patient

402.

Signs observed in hypocalemia?

Trousseau and Tchovoski signs observed in hypocalcemia

403.

DKA?

Diabetic ketoacidosis (DKA)= when body is breaking down fat instead of


sugar for energy. Fats leave ketones (acids) that cause pH to decrease.
71. DKA is rare in diabetes mellitus type II because there is enough
insulin to prevent breakdown of fats.

404.

s/s of a fat embolism?

petechiae. Treated with heparin.

405.

Knee replacement?

for knee replacement use continuous passive motion machine.

406.

Glaucoma patients loose?

glaucoma patients lose peripheral vision. Treated with meds

407.

c02 builds up and causes?

Co2 causes vasoconstriction.

408.

Where are most spinal cord injuries?

most spinal cord injuries are at the cervical or lumbar regions

409.

autonomic dysreflexia

autonomic dysreflexia ( life threatening inhibited sympathetic response


of nervous system to a noxious stimulus- patients with spinal cord injuries
at T-7 or above is usually caused by a full bladder.

410.

Myasthenia gravis?

myasthenia gravis= decrease in receptor sites for acetylcholine. Since


smallest concentration of ACTH receptors are in cranial nerves, expect fatigue
and weakness in eye, mastication, pharyngeal muscles.

411.

Guillian Barre?

Guillain-Barre syndrome= ascending paralysis. Keep eye on respiratory


system.

412.

Parkisons?

parkinson's = RAT: rigidity, akinesia (loss of muscle mvt), tremors.


Treat with levodopa.

413.

TIA?

TIA (transient ischemic attack) mini stroke with no dead brain tissue

414.

CVA?

CVA (cerebrovascular accident) is with dead brain tissue.

415.

Hodgkins disease?

Hodgkin's disease= cancer of lymph is very curable in early stage.

416.

Rule of nines?

Rule of NINES for burns


Head and Neck= 9%
Each upper ext= 9%
Each lower ext= 18%
Front trunk= 18%
Back trunk= 18%
Genitalia= 1%

417.

Peds weight ?

Birth weight doubles by 6 month and triple by 1 year of age.

418.

Dig rule for kids?

if HR is <100 do not give dig to children.

419.

First sign of cystic fibrosis?

first sign of cystic fibrosis may be meconium ileus at birth. Baby is


inconsolable, do not eat, not passing meconium.

420.

Heart Defects?

heart defects. Remember for cyanotic -3T's( Tof, Truncys arteriosus,


Transposition of the great vessels). Prevent blood from going to heart. If
problem does not fix or cannot be corrected surgically, CHF will occur
following by death.
94. with R side cardiac

421.

Heart problems?

with R side cardiac cath=look for valve problems


with L side in adults look for coronary complications

422.

What disease leads to cardiac valve malfunctions?

Rhematic fever

423.

Cerebral palsy?

poor muscle control due to birth injuries and/or


decrease oxygen to brain tissues

424.

ICP?

ICP (intracranial pressure) should be <2. measure head circonference.

425.

Signs to look for in meningitis?

for Meningitis check for Kernig's/ Brudzinski's signs.

426.

Wilms tumor?

Wilm's tumor is usually encapsulated above the kidneys causing flank


pain.

427.

Facts about hemophilia?

It is X-linked. Mother passes the disease to her son

428.

What happens when phenylalanine increases?

brain problems occur

429.

Bucks traction =

knee immobility

430.

Russel Traction =

femur or lower leg instability

431.

Dunlap traction=

Skeletal or skin

432.

Bryant's traction=

Children <3yoa, <35 lbs with femur fx

433.

How to put on traction?

Place the apparatus first then place the weight (der)

434.

Where should placenta be?

Upper part of the uterus

435.

Eclampsia is a ?

seizure>

436.

A patient with vertical c- section will likely have?

another c section with any more kids

437.

Amniocentesis is performed? and why?

perform amniocentesis before 20 weeks gestation to check for cardiac


and pulmonary abnormalities.

438.

Rh?

mothers receive rhogam to protect next baby.

439.

Fontanelles?

anterior fontanelle closes by 18 months. Posterior 6 to 8 weeks.

440.

caput succedaneum=

caput succedaneum= diffuse edema of the fetal scalp that crosses the
suture lines. Swelling reabsorbs within 1 to 3 days.

441.

Pathological jaundice?

pathological jaundice= occurs before 24hrs and last7 days.


Physiological jaundice occurs after 24 hours.

442.

Diff between placenta previa and placenta abrupto?

placenta previa = there is no pain, there is bleeding. Placenta


abruption = pain, but no bleeding.

443.

Bethamethasone?

bethamethasone (celestone)=surfactant. Med for lung expansion.

444.

Dystocia?

dystocia= baby cannot make it down to canal

445.

Therapies?

milieu therapy= taking care of patient/environment


cognitive therapy= counseling
crisis intervention=short term.

446.

Rule of thumb for obsessions/distractions?

Osession is to thought. Compulsion is to action

447.

Rule of thumb for assisting pysch patients?

if patients have hallucinations redirect them. In delusions distract


them.

448.

Alzheimers?

Alzheimer's disease is a chronic, progressive, degenerative cognitive


disorder that accounts for more than 60% of all dementias

449.

Hyperthyroidism?

HYPERthyroidism think of MICHAEL JACKSON in THRILLER!


SKINNY, NERVOUS, BULDGING EYES, Up all night, heart beating fast

450.

Awesome remembering for cranial nerves?

Cranial Nerves: *I am sorry if this vulgar for some, but hey, it sticks
Sensory=S Motor=M Both=B
Oh (Olfactory I) Some
Oh (Optic II) Say
Oh (Oculomotor III) Marry
To (Trochlear IV) Money
Touch (Trigeminal V) But
And (Abducens VI) My
Feel (Facial VII) Brother
A (Auditory VIII) Says
Girls (Glossopharyngeal IX) Big
Vagina (Vagus X) Bras
And (Accessory XI) Matter
Hymen (Hypoglassal XII) More

451.

Hypernatremia? SALT?

Hyper natremia (greater than 145) SALT!


Skin flushed
Agitation
Low grade fever
Thirst

452.

Developmental milestones?

Developmental
2-3 months: turns head side to side
4-5 months: grasps, switch & roll
6-7 months: sit at 6 and waves bye-bye
8-9 months: stands straight at eight
10-11 months: belly to butt (phrase has 10 letters)
12-13 months: twelve and up, drink from a cup

453.

Hepatitis?

Hepatitis
Hepatitis: -ends in a VOWEL, comes from the BOWEL (Hep A)
Hepatitis B=Blood and Bodily fluids
Hepatitis C is just like B

454.

Apgar scores/scoring?

Apgar measures HR,RR,Muscle tone, Reflexes,Skin color


each 0-2 point. 8-10 OK. 0-3 RESUSCITATE.

455.

Cute way to remember glascow coma?

GLASGOW COMA SCALE. EYES, VERBAL,MOTOR!


It is similar to measuring dating skills...max 15 points -one can do it
if below 8 you are in Coma.
So, to start dating you gotta open your EYES first, if you albe to do
that spontaneously and use them correctly to SEE whom you dating you earn 4.
But if she has to
scream on you to make you
open them it is only 3....and 1 you dont care to open even if she tries to hurt you.
if you get good EYE contact (4 points) then move to VERBAL.
talk to her/ him! if you can do that You are really ORIENTED in
situation she/he uncontiously gives you 4 points! if you like her try not to be
CONFUSED (3), and
of cause do not use
INAPPROPRIATE WORDS (3), she will not like it)), try not to RESPOND WITH
INCOMPREHENSIBLE
SOUNDS (2), if you do not like herjust
show no VERBAL RESPONSE(1)
Since you've got EYE and VERBAL contact you can MOVE now using your Motor
Response Points.
THis is VERY important since Good moves give you 6!

456.

What to do for addisons/cushings?

Addison's disease (need to "add" hormone)


Cushing's syndrome (have extra "cushion" of hormones)

457.

Dumping syndrome?

Dumping syndrome: increase fat and protein, small frequent meals, lie down after
meal to
decrease peristalsis, wait 1 hr after meals to drink.

458.

Blood typing?

For blood types: "O" is the universal donor (remember "o" in donor)
"AB" is the universal receipient

459.

Gross things to remember about nurses with


herpes!!!!

Disseminated Herpes Zoster is AIRBORNE PRECAUTIONS, as to Localized Herpes


Zoster is
CONTACT PRECAUTIONS. A nurse with a localized herpes zoster CAN care for
patients as long as
the patients are NOT immunosuppressed and the lesions must be covered!

460.

Birth control- Diaphram?

Diaphragm must stay in place 6 hours after intercourse. They are also fitted so
must be refitted
if you lose or gain a significant amount of weight.

461.

Cushing ulcers and cushings triad?

Cushings ulcers r/t BRAIN injury


*Cushings triad r/t ICP in BRAIN (htn, bradycard, irr. resp)

462.

Thyroid storm and myxedema?

Thyroid storm is HOT (hyperthermia)


*Myxedema coma is COLD (hypothermia)

463.

Nondairy sources of calcium?

Non dairy sources of calcium include RHUBARB, SARDINES, COLLARD GREENS

464.

Whats petaling?

You can petal the rough edges of a plaster cast with tape to avoid skin irritation.

465.

How do you teach someone to reduce back


aches?

With low back aches, bend knees to relieve

466.

Koplick's spots?

* Koplick's spots are red spots with blue center characteristic of PRODROMAL
stage of Measles.
Usually in mouth.

467.

Pancreatitis pts>?

* Pancreatitis patients but them in fetal position, NPO, gut rest, prepare
antecubital site for PICC
cuz they'll probably be getting TPN/Lipids

468.

Trendelenberg's test?

Trendelenburg test - for varicose veins. If they fill proximally = varicosity.

469.

What can't you give to immunosupressed pts?

Yogurt has live cultures- dont give to immunosuppressed pt

470.

How to itch under a cast?

Itching under cast area- cool air via blow dryer, ice pack for 10- 15 minutes. NEVER use
qtip or anything to scratch area

471.

Murphy's sign?

Murphy's sign - pain with palpation of gall bladder area seen with cholecystitis

472.

Cullens sign?

Cullen's sign - ecchymosis in umbilical area, seen with pancreatitis

473.

Turner's sign?

Turner's sign - flank grayish blue (turn around to see your flanks) pancreatitis

474.

Mcburney's point?

McBurney's Point - pain in RLQ indicative of appendicitis--RLQ - appendicitis, watch for


peritonitis

475.

Pain in the LLQ indicative of?

LLQ - diverticulitis , low residue, no seeds, nuts, peas

476.

Guthrie test?

Guthrie Test - Tests for PKU, baby should have eaten source of protein first

477.

Shilling test?

Shilling Test - test for pernicious anemia/ how well one absorbs Vit b12

478.

Allen's test?

Allen's test - occlude both ulnar and radial artery until hand blanches then release ulnar. If the
hand pinks up, ulnar artery is good and you can carry on with ABG/radial stick as planned.
ABGS
must be put on ice and whisked to the lab.

479.

Tenkhoff cath?

oIt's ok to have abdominal craps, blood tinged outflow and leaking around site if the Peritoneal
Dialysis cath (tenkhoff) was placed in the last 1-2 wks. Cloudy outflow NEVER NORMAL.

480.

Meconium stained protocol?

oAmniotic fluid yellow with particles = meconium stained`

481.

Hyper reflexive? Absent


reflexsive?

oHyper reflexes (upper motor neuron issue "your reflexes are over the top")
oAbsent reflexes (lower motor neuron issue)

482.

When is Rhogam given and how?

oRhogam : given at 28 weeks, 72 hours post partum, IM. Only given to Rh NEGATIVE mother.

483.

Coomb's test?

Also if indirect Coomb's test is positive, don't need to give Rhogam cuz she has antibody only give
if negative coombs

484.

Order of assessment?

Order of assessment: Inspection, Palpation, Percussion and Ausculation. EXCEPT with abdomen
cuz you don't wanna mess with the bowels and their sounds so you Inspect, Auscultate, Percuss
then Palpate (same with kids, I suppose since you wanna go from least invasive to most invasive
sine they will cry BLOOD MURDER ! Gotta love them kids !)

485.

Latex allergies?

Latex allergies => Assess for allergies to bananas, apricots, cherries, grapes, kiwis, passion fruit,
avocados, chestnuts, tomatoes, peaches

486.

ALS?

Amyotrophic lateral sclerosis ( ALS ) is a condition in which there is a degeneration of motor


neurons in both the upper & lower motor neuron systems.

487.

TEF?

Transesophageal Fistula (TEF) - esophagus doesn't fully develop (this is a surgical emergency)
The 3 C's of TEF in the newborn:
1) Choking
2) Coughing
3) Cyanosis

488.

MMR SHot?

The MMR vaccine is given SQ not IM.

489.

Color codes?

Red--unstable, ie, occluded airway, actively bleeding, see first


Yellow---stable, can wait up to an hour for treatment, ie burns, see second
Green---stable, can wait even longer to be seen, "walking wounded"
Black--unstable clients that will probably not make it, need comfort measures

490.

Greeks?

Greek heritage - they put an amulet or any other use of protective charms around their baby's
neck to avoid "evil eye" or envy of others

491.

4 year olds?

4 year old kids cannot interpret TIME. Need to explain time in relationship to a known COMMON
EVENT (eg: "Mom will be back after supper").

492.

Hep B vaccine always ask?

Anaphylactic reaction to baker's yeast is contraindication for Hep B vaccine.

493.

Flu shot always ask?

allergic to eggs??? (Tristan D. ) !

494.

Before giving MMR>?

** Ask for anaphylactic rxn to eggs or neomycin before MMR

495.

If kid has a cold?

**If kid has cold, can still give immunizations

496.

SARS?

**SARS (severe acute resp syndrome) airborne + contact (just like varicella)

497.

Disease precautions?

** Hepatitis A is contact precautions


** Tetanus, Hepatitis B, HIV are STANDARD precautions

498.

Willam's position?

** William's position - Semi Fowlers with knees flexed (inc. knee gatch) to relieve lower back
pain.

499.

Signs of a hip fracture?

SIGNS of a Fractured hip: EXTERNAL ROTATION, SHORTENING, ADDUCTION

500.

S/S of a fat embolism?

Fat Embolism: Blood tinged sputum (r/t inflammation), inc ESR, respiratory alkalosis (not
acidosis r/t tachypnea), hypocalcemia,increased serum lipids, "snow storm" effect on CXR.

501.

Complications of
mechanical
ventilation?

Complications of Mechanical Ventilation: Pneumothorax, Ulcers

502.

Paget's disease?

Paget's Disease - tinnitus, bone pain, enlargement of bone, thick bones.

503.

Intravenous Pylogram
requires?

** IVP requires bowel prep so they can visualize the bladder better

504.

ACID ash diet?

Acid Ash diet - cheese, corn, cranberries, plums, prunes, meat, poultry, pastry, bread

505.

Alkaline Ash diet?

Alk Ash diet- milk, veggies, rhubarb, salmon

506.

Orange tag in pysch

Orange tag in triage is non emergent Psych

507.

Greenstick fracture?

Greenstick fractures, usually seen in kids bone breaks on one side and bends on the other

508.

Side effects of thyroid


hormones?

Insomnia is a side effect of thyroid hormones. Saunders confirms it. Makes sense though!Increased met.
rate, your body is "too busy to sleep" as opposed to the folks with hypothyroidism
who may report somnolence (dec. met rate, body is slow and sleepy).

509.

Botox?

** BOTOX for strabismus. Patch the GOOD eye so that the weaker eye can get stronger. Found a
cool link about its use in peds pt with strabismus. I had to look it up cuz I heard it was important
ah hem ah hem

510.

Tidal volume?

** TIDAL VOLUME is 7 - 10ml / kg

511.

COPD patients?

** COPD patients REMEMBER: 2LNC or less (hypoxic NOT hypercapnic drive), Pa02 of 60ish and
Sa02 90% is normal for them b/c they are chronic CO2 retainers. ...

512.

Stranger Danger>?!?

Stranger anxiety is greatest 7 - 9 months, Separation anxiety peaks in toddlerhood

513.

Lymes mostly found in

Lymes is found mostly in Conneticuts

514.

Asthma and arthritis


best excercise?

swimming

515.

What is a bad sign in


asthma?

intercostal retractions=bad!

516.

ABG drawin?

When drawing an ABG, you need to put the blood in a heparinized tube, make sure there are no
bubbles, put on ice immediately after drawing, with a lable indicating if the pt was on room air or
how many liters of O2.
Remember to preform the Allen's Test prior to doing an ABG to check for sufficient blood flow

517.

Before a pft?

Before going for Pulmonary Fuction Tests (PFT's), a pt's bronchodilators will be with-held and they
are not allowed to smoke for 4 hrs prior

518.

For a lung biopsy?

For a lung biopsy, position pt lying on side of bed or with arms raised up on pillows over bedside
table, have pt hold breath in midexpiration, chest x-ray done immediately afterwards to check for
complication of pneumothorax, sterile dressing applied

519.

For a lumbar puncture?

For a lumbar puncture, pt is positioned in lateral recumbent fetal position, keep pt flat for 2-3 hrs
afterwards, sterile dressing, frequent neuro assessments

520.

For an EEG test?

EEG, hold meds for 24-48 hrs prior, no caffine or cigarettes for 24 hrs prior, pt can eat, pt
must
stay awake night before exam, pt may be asked to hyperventilate and watch a bright
flashing
light, after EEG, assess pt for seizures, pt's will be at increased risk

521.

Munchhausen Syndrome?

-Munchausen Syndrome is a psychiatric disorder that causes an individual to self-inflict


injury
or illness or to fabricate symptoms of physical or mental illness, in order to receive medical
care
or hospitalization. In a variation of the disorder, Munchausen by proxy (MSBP), an
individual,
typically a mother, intentionally causes or fabricates illness in a child or other person
under her
care.

522.

MS?

-Multiple Sclerosis is a chronic, progressive disease with demyelinating lesions in the CNS
which
affect the white matter of the brain and spinal cord.
Motor S/S: limb weakness, paralysis, slow speech
Sensory S/S: numbness, tingling, tinnitus
Cerebral S/S: nystagmus, ataxia, dysphagia, dysarthria

523.

Huntington's Chorea?

Huntington's Chorea: 50% genetic, autosomal dominant disorder


S/S: chorea --> writhing, twisting, movements of face, limbs and body
-gait deteriorates to no ambulation
-no cure, just palliative care

524.

Shift to the left means?

WBC shift to the left in a patient with pyelonephritis neutrophils kick in to fight infection

525.

How to Dx a AAA?

Definitive diagnosis for abd. aortic aneurysm (AAA) --> CT scan

526.

Uremic Fetor?

Uremic fetor --> smell urine on the breath

527.

Hirschsprungs?

-Hirschsprung's --> bile is lower obstruction, no bile is upper obstruction; ribbon like
stools.

528.

No Cantalope?

Thank you, I finally realize why a person shouldn't have cantaloupe before a occult stool
test,
because cantaloupe is high in vit c and vit c causes a false + for occult blood. Now I just
need to
figure out why they can't have fish.

529.

Penis Problems?

Hypospadias: abnormality in which urethral meatus is located on the ventral (back)


surface of
the penis anywhere from the corona to the perineum (remember hypo, low (for lower
side or
under side)
Epispadias: opening of the urethra on the dorsal (front) surface of the penis
Priapism: painful erection lasting longer than 6 hrs.

530.

When you see coffee brown emesis


think?>

Peptic ulcer

531.

For PVD remember?

For PVD remember DAVE (Legs are Dependent forArterial & for Venous Elevated)

532.

Traction rule?

Never release traction unless you have an order from an MD to do so

533.

Halo?

Questions about a halo? Remember safety first, have


a screwdriver nearby.

534.

Compartment syndrome?

Remember compartment syndrome is an emergency situation. Paresthesias and


increased pain
are classic symptoms. Neuromuscular damage is irreversible 4-6
hours after onset.

535.

Behavior/Developmental-Peds

Behavior motivated by need to avoid anxiety and satisfy needs


1. Infancy 0-18 months others will satisy needs
2. childhood >6yrs learn to delay need gratification
3. juvenile 6-9 years learn to relate to peers
4. preadolescence 9-12 yrs learns to relate to friends of of opposite sex
5. early adolescence12-14yrs:learn independence and how to relate to opposite sex
6. late adolecence 14-21yrs: develop intimate relationship with person of opposite sex
is this not about communication?....

536.

Fetal alcohol sydrome?

Fetal alcohol syndrome


-upturned nose
-flat nasal bridge
-thin upper lip
-SGA

537.

Immunizations rules?

vastus lateralis is IM administration site for 6month infants


For toddlers above 18 months ventrogluteal
The deltoid and gluteus maximus are appropriate sites for children`

538.

Eyes?

OU- both eyes


OS- left eye
OD- right eye ( dominent Right eye- just a tip to remember)

539.

Cane walking?

1. COAL (cane walking):


C - cane
O - opposite
A - affected
L - leg

540.

In depth- Color codes??

Red- Immediate: Injuries are life threatening but survivable with minimal intervention. Ex:
hemothrax, tension pneumothorax, unstable chest and abdominal wounds, INCOMPLETE
amputations, OPEN fx's of long bones, and 2nd/3rd degree burn with 15%-40% of total body
surface, etc.
Yellow- Delayed: Injuries are significant and require medical care, but can wait hrs without threat
to life or limb. Ex: Stable abd wounds without evidence of hemorrhage, fx requiring open
reduction, debridement, external fixation, most eye and CNS injuries, etc.
Green- Minimal: Injuries are minor and tx can be delayed to hrs or days . Individuals in this group
should be moved away from the main triage area. Ex: upper extremity fx, minor burns, sprains,
sm. lacerations, behavior disorders.
Black- Expectant: Injuries are extensive and chances of survival are unlikely. Seperate but dont
abandoned, comfort measures if possible. Ex: Unresponsive, spinal cord injuries, woulds with
anatomical organs, 2nd/3rd degree burn with 60% of body surface area , seizures, profound
shock with multipe injuries, no pulse, b.p, pupils fixed or dilated.

541.

Thoracentesis?

Thoracentesis prep- Take v.s., shave area around needle insertion, position patient with arms
on pillow on over bed table or lying on side, no more than 1000cc at a one time. Post- listen
for bilateral breath sounds, v.s., check leakage, sterile dressing.

542.

Cath lab?

Cardiac cath- npo 8-12hr, empty bladder, pulses, tell pt may feel heat palpitations or desire to
cough with dye injection. Post- Vital signs keep leg straight bedrest 6-8hr.

543.

MRI?

MRI- claustrophobia, no metal, assess pacemaker

544.

Cerebral angio prep?

cerebral angio prep- well hydrated, lie flat, sire shaved, pulses marked
post- keep flat 12-14hr, check site, pulses,force fluids.

545.

More info on lumbar puncture?

Lumbar puncture- fetal postion. post- nuero assess q15-30 until stable, flat2-3hr, encourage
fluids, oral anlgesics for headache, observe dressing

546.

More info on EEG?

EEG- no sleep the night before, meals not withheld, no stimulants for 24hr before,
tranquilizer/stimulant meds held 24-48hr before, may be asked to hyperventilate 3-4min and
watch a bright flashing light.

547.

Myelogram?

Myelogram- Npo 4-6hr, allergy hx, phenothiazines, cns depressants, and stimulants withheld 48hr
prior, table will be moved to various postions during test. Post- neuro q2-4, water soluble HOB
up, oil soluble HOB down, oral analgesics for h/a, encourage po fluids, assess for distended
bladder, inspect site.

548.

Liver biopsy?

Liver biopsy- Adm vit k , npo morning of exam 6hr, give sedative, Teach pt that he will be
asked to hold breath for 5-10sec, supine postion, lateral with upper arms elevated.
Post- postion on right side, frequent v.s., report severe ab pain stat, no heavy lifting 1wk.

549.

Paracentesis?

Paracentesis- semi fowlers or upright on edge of bed, empty bladder.


Post- v.s., report elevated temp, observe for signs of hypovolemia.

550.

Laparoscopy?

Laparoscopy- CO2 used to enhances visual, general anesthesia, foley. Post- walk patient to
decrease CO2 build up used for procedure.

551.

Sengstaken blakemore tube ?

Sengstaken blakemore tube used for tx of esophageal varices, keep scissors at bedside.

552.

Hemovac?

Hemovac- used after mastectomy, empty when full or q8hr, remove plug, empty contents, place
on flat surface, cleanse opening and plug with alcohol sponge, compress evacuator completely
to remove air, release plug, check system for operation.

553.

Common S/S of PTB?

Common Signs and Symptoms


01. PTB - low-grade afternoon fever.

554.

Common S/S of pneumonia?

Rusty sputum

555.

Common S/S of asthma

Wheezing on EXPIRATION

556.

Common S/S of emphysema?

Barrel chest

557.

Common S/S of Kawasaki


syndrome?

Strawberry tongue

558.

Common S/S of pernicious


anemia

red beefy tongue

559.

Common S/S of down


syndrome

protruding tongue

560.

Common S/S of Cholera?

Rice watery stool

561.

Common S/S of Malaria?

Stepladder like fever with chills

562.

Common S/S of Thypohiod

Rose spots on abdomen

563.

Common S/S of Diptheria?

Psuedo membrane formation

564.

Common S/S of measles?

Kopliks spots

565.

Common S/S of SLE?

Butterfly rashes

566.

Common S/S of Liver


cirrhoisis?

Spider like varices- Varices can be in stomach, esophagus or the skin! They are just spider/varicose
veins! Ithcy on the skin

567.

Common S/S of leprosy?

Lioning face

568.

Common S/S of Bulimia?

chipmunk face

569.

Common S/S of appendicitis

rebound tenderness

570.

Common S/S of Dengue

petechiae or + Herman's sign

571.

Common S/S of Meningitis?

Kernigs Sign (leg flex then leg pain on extension) Brudinzski sign (neck flex= lower leg flex)

572.

Common S/S of Tetany?

Risus Sardonicus

573.

Common S/S of pancreatitis?

Cullens sign ( ecchymosis of umbilicus) (+) Grey Turner spots

574.

Common S/S of pyloric


stenosis?

olive like mass

575.

Common s/s of PDA

Machine like murmur

576.

Common S/S of addisions?

bronze like skin pigmentation

577.

Common S/S of Cushings syndrome?

Moon face appearance and buffalo hump

578.

Common S/S of Intusseption?

Sausage shaped mass , Dance sign (empty portion of RLQ)

579.

Common S/S of MS>?

Charcot's Triad (IAN)

580.

Common S/S of MG?

Descending muscle weakness

581.

Common S/S of guillian Barre


Syndrome

Ascending muscle paralysis.. dont confuse with MG

582.

Common S/S of chicken pox?

Vesicular rash (central to distal) dew drop on rose petal

583.

Common S/S of LTB?

inspiratory stridor.. LTB = croup!!!!

584.

Common S/S of TEF?

4 C'S- Coughing, Choking, Cyanosis and continuous droolings

585.

Common S/S of epiglottitis?

3 D'S --Drooling, Dysphonia, Dysphagia

586.

Common S/S of Hodgkins


Disease/Lymphoma?

Painless, progressive englargement of spleen and lymph tissues, and Reedstenberg cells!

587.

Common S/S of Infectious


Mononucleosis?

Hallmark= Sore throat, cervical lymph adenopathy, fever

588.

Common S/S of parkinsons?

Pilling rolling tremors

589.

Cmmon S/S Fibrin Hyalin?

Expiratory grunt-- Causes Infant respiratory distress!

590.

Common S/S of cystic fibrosis?

Salty skin

591.

Common S/S of DKA

Kussmauls breathing (deep rapid RR)

592.

Common S/S of Bladder Cancer?

painless hematuria... CA=Cancer ! Duhh

593.

Common S/S of BPH?

reduced size and force of urine

594.

Common S/S of Pemphigus Vulgaris?

Nilosky's sign (seperation of epidermis caused by rubbibng of the skin)

595.

Common S/S of retinal detachment?

Visual floaters, flashes of light, curtain vision

596.

Common S/S of glaucoma?

Painful vision loss, tunnel/gun barrel/ halo vision (peripheral vision loss)

597.

Common S/S of Cataract?

PainLESS vision loss, opacity of lens, blurring of the vision

598.

Common S.S of Retino Blastoma?

Cat's eye reflex (grayish discoloration of the pupil)

599.

Common S/S Acromegaly?

Coarse facial features

600.

Common S/S Duchennes Muscular


Dystrophy?

Gower's sign (use of the hands to push ones self from the floor_) Looks EXACTLY like the
Pilates Downward dog!!!!!!!

601.

Common S/S of GERD?

Barrets Esophagus (erosion of the lower portion of the esophageal mucosa)

602.

Common S/S Hepatic


Encephalopathy ?

Flapping tremors

603.

Common S/S of Hydrocephalosis?

Bossing Sign (prominent forehead)

604.

Common S/S of Increased ICP?

HYPERTENSION, BRADYpnea, BRADYcardia (cushings triad)!

605.

Common S/S of Shock?

HYPERtension TACHYpnea and TACHYcardia

606.

Common S/S Meniere's Disease?

Vertigo, Tinnitus

607.

Common S/S of Cystitis?

Burning on urination

608.

Common S/S of hypocalcemia?

Chvostek and Trosseaus sign! Also hypomag!

609.

Common S/S of Ulcerative Colitis?

Recurrent bloody diarrhea

610.

Common S/S of Lyme's disease

Bull's eye rash

611.

Common S/S of Basilar Fracture?

Ottorhea

612.

Common S/S of orbital fracture?

Battles Sign and Racoon's eyes

613.

Osteomyeltitis?

Osteomyletitis is an infectious bone dz. Give blood cultures and antibiotics, then if
necessary
surgery to drain abscess.

614.

Nephrotic syndrome?

Nephrotic syndrome s/s edema + hypotension. Turn and reposition (risk for
impaired skin
integrity)

615.

Renal impairment labs?

Renal impairment: serum creatinine elevated and urine clearance decreased

616.

Normal Hemoglobin?

Hemoglobin
Neonates 18-27
3 mos 10.6-16.5
3 yrs 9.4-15.5
10 yrs 10.7-15.5

617.

Glomerulonephritis?

Glomerulonephritis: take vs q 4 hrs + daily weights

618.

Age 4=5 year shots?

Age 4 to 5 yrs child needs DPT/MMR/OPV

619.

Cystic fibrosis?

Cystic Fibrosis give diet low fat, high sodium, fat soluble vitamins ADEK. Aerosal
bronchodilators,
mucolytics and pancreatic enzymes.

620.

More info on droplet precautions?

Droplet Precautions:sepsis, scarlet fever, streptococcal pharyngitis, parovirus B19,


pnuemonia,
pertusis, influenza, diptheria, epiglottis, rubella, mumps, meningitis, mycoplasma
and adenovirus.
Door open, 3 ft distance, private room or cohort, mask

621.

Meningeal irriatation>?

Meningeal irritation S/s nuchal rigidity, positive Brudzinski + Kernig signs and
PHOTOPHOBIA too!

622.

Babinski sign?

toes curl= GREAT Toes fan = BAD

623.

GTT for preggos?

Glucose Tolerance Test for preggies result of 140 or highter needs further
evaluation.

624.

Cranial nerves for Assessing extraocular eye


movements?

3,4,6

625.

Stomas?

Stomas
dusky stoma means poor blood supply, protruding means prolapsed, sharp pain
+ rigidity means
peritonitis, mucus in ileal conduit is expected.

626.

Tension Pneumothorax?

Trachea shifts to the opposite side

627.

Change in color is ?

a LATE sign! Always~!

628.

Incentive Spirometry steps?

Incentive Spirometry steps:1) Sit upright 2) Exhale 3) Insert mouthpiece 4) Inhale


for 3
seconds, and then HOLD for 10 seconds

629.

MRSA and VRSA precautions?

*MRSA - Contact precaution ONLY


*VRSA - Contact AND airborne precaution (Private room, door closed, negative
pressure)

630.

Thrombocyopenia- bleeding precautions

*Thrombocytopenia -Bleeding precautions!


1)Soft bristled toothbrush
2)No insertion of anything! (c/i suppositories, douche)

631.

Burn Degrees?

1st Degree - Red and Painful


2nd Degree - Blisters
3rd Degree - No Pain because of blocked and burned nerves

632.

Menieres's disease?

*Meniere's Disease - Admin diuretics to decrease endolymph in the cochlea, restrict Na, lay
on
affected ear when in bed. Triad:
1)Vertigo
2)Tinnitus
3)N/V

633.

Gastric ulcer pain

*Gastric Ulcer pain occurs 30 minutes to 90 minutes after eating, not at night, and doesn't go
away with food

634.

Med that can't be infused Intra


osseously?

One medication that cannot be administered by intraosseous infusion


is isoproterenol, a beta agonist.

635.

Sickle cell crisis?

During sickle cell crisis there are two interventions to prioritize: fluids and pain relief.

636.

Glomerulonephritis considerations

With glomerulonephritis you should consider blood pressure to be your most important
assessment parameter. Dietary restrictions you can expect include fluids, protein, sodium,
and
potassium.

637.

Labs for congenital heart disease?

Remember yesterday when I mentioned how congenital cardiac defects result in hypoxia
which
the body attempts to compensate for (influx of immature rbc's)? Labs supporting this would
show
increased hematocrit, hemoglobin, and rbc count.

638.

Kidneys and ears?

Did you know there is an association between low-set ears and renal anomalies? Now you
know what to look for if down's isn't there to choose. (just to expand on it a little, the kidneys
and
ears develop around the same time in utero. Hence, they're shaped similarly. Which is why
when
doing an assessment of a neonate, if the nurse notices low set or asymmetrical ears, there is
good reason to investigate renal functioning. Knowing that the kidneys and ears are similar
shapes helped me remember this).

639.

School aged kids and five year olds?

School-age kids (5 and up) are old enough, and should have an explanation of what will
happen
a week before surgery such as tonsillectomy.

640.

What if a toddler says no to


medication?

If you gave a toddler a choice about taking medicine and he says no, you should leave the
room
and come back in five minutes, because to a toddler it is another episode. Next time, don't
ask.

641.

First sign of pyloric stenosis in a


baby?

The first sign of pyloric stenosis in a baby is mild vomiting that progresses to projectile
vomiting. Later you may be able to palpate a mass, the baby will seem hungry often, and
may
spit up after feedings.

642.

Kawasaki disease causes?

We know Kawasaki disease causes a heart problem, but what specifically? Coronary artery
aneurysms d/t the inflammation of blood vessels.

643.

A child with a ventriculoperitoneal


shunt

A child with a ventriculoperitoneal shunt will have a small upper-abdominal incision. This is
where the shunt is guided into the abdominal cavity, and tunneled under the skin up to the
ventricles. You should watch for abdominal distention, since fluid from the ventricles will be
redirected
to the peritoneum. You should also watch for signs of increasing intracranial pressure,
such as irritability, bulging fontanels, and high-pitched cry in an infant. In a toddler watch
lack of
appetite and headache. Careful on a bed position question! Bed-position after shunt
placement
is flat, so fluid doesn't reduce too rapidly. If you see s/s of increasing icp, then raise the hob to
15-30 degrees.

644.

What could cause bronchopulmonary


dysplasia?

What could cause bronchopulmonary dysplasia? Dysplasia means abnormality or


alteration.
Mechanical ventilation can cause it. Premature newborns with immature lungs are
ventilated
and over time it damages the lungs. Other causes could be infection, pneumonia, or
other
conditions that cause inflammation or scarring.

645.

How do children less than one breathe?

It is essential to maintain nasal patency with children < 1 yr. because they are
obligatory
nasal breathers.

646.

Milk for kids?

Watch out for questions suggesting a child drinks more than 3-4 cups of milk each
day. (Milks
good, right?) Too much milk reduces intake of other essential nutrients, especially iron.
Watch for
anemia with milk-aholics. And don't let that mother put anything but water in that
kid's bottle
during naps/over-night. Juice or milk will rott that kids teeth right out of his head.

647.

Traction in kids?

What traction is used in a school-age kid with a femur or tibial fracture with extensive
skin
damage? Ninety, ninety. Huh? I never heard of it either. The name refers to the
angles of the
joints. A pin is placed in the distal part of the broken bone, and the lower extremity is
in a boot
cast. The rest is the normal pulleys and ropes you're used to visualizing with balanced
suspension. While we're talking about traction, a kid's hinder should clear the bed
when in
Bryant's traction (also used for femurs and congenial hip for young kids).

648.

Yeast infection in a babys mouth?

If you can remove the white patches from the mouth of a baby it is just formula. If you
can't, its
candidiasis.

649.

MMR and Varicella?

Just know the MMR and Varicella immunizations come later (15 months).

650.

Cryptoorchidism?

Undescended testis or cryptorchidism is a known risk factor for testicular cancer later
in life.
Start teaching boys testicular self exam around 12, because most cases occur during
adolescence.

651.

Maslow for a guy who lost his house in a


fire?

- A guy loses his house in a fire. Priority is using community


resources to find shelter, before assisting with feelings about the tremendous loss.
(Maslow).

652.

Kids pain relief in NCLEX land?

No aspirin with kids b/c it is associated with Reye's Syndrome, and also no nsaids such
as
ibuprofen. Give Tylenol.

653.

How will CSF look in meningitis?

CSF in meningitis will have high protein, and low glucose.

654.

Suctioning is good--except

No nasotracheal suctioning with head injury or skull fracture.

655.

Peds positioning for GERD?

Position prone w hob elevated with gerd. In almost every other case, though, you
better lay that
kid on his back (Back To Sleep - SIDS).

656.

When instilling eardrops?

Pull pinna down and back for kids < 3 yrs. when instilling eardrops.

657.

Kids with RSV?>

Kids with RSV; no contact lenses or pregnant nurses in rooms where ribavirin is being
administered by hoot, tent, etc.

658.

Positioning with pneaumonia?

Positioning with pneumonia - lay on the affected side to splint and reduce pain. But if
you are
trying to reduce congestion the sick lung goes up. (Ever had a stuffy nose, and you lay
with the
stuff side up and it clears?)

659.

TB test confirmation?

A positive ppd confirms infection, not just exposure. A sputum test will confirm active
disease.

660.

Asthmas and wheezers?

Coughing w/o other s/s is suggestive of asthma. Speaking of asthma, watch out if your
wheezer stops wheezing. It could mean he is worsening.

661.

What treats tet spells?

Tet spells treated with morphine.

662.

Group-A strep?

Group-a strep precedes rheumatic fever. Chorea is part of this sickness (grimacing,
sudden
body movements, etc.) and it embarrasses kids. They have joint pain. Watch for
elevated
antistreptolysin O to be elevated. Penicillin!

663.

Tylenol poisioining ?

Tylenol poisoning - liver failure possible for about 4 days. Close observation required
during
this time-frame, as well as tx with Mucomyst.

664.

Radioactive iodine?

Radioactive iodine - The key word here is flush. Flush substance out of body w/3-4
liters/day
for 2 days, and flush the toilet twice after using for 2 days. Limit contact w/patient to 30
minutes/day. No pregnant visitors/nurses, and no kids.

665.

Main hypersensitivity for antiplatelet


drugs?

broncospasm (anaphylaxis)

666.

Common sites for metastatsis?

liver, brain, lung, bone, and lymph

667.

Orthostatis is verfied by?

a drop in presssure with increasing heart rate... Orthostatis= orthostatic hypotension

668.

Bence Jones protein in urine?

confirms multiple myeloma

669.

How do you treat a small bowel


obstruction?

Don't fall for 'reestablishing a normal bowel pattern' as a priority with small bowel
obstruction.
Because the patient can't take in oral fluids 'maintaining fluid balance' comes first.

670.

G tube and J tubes are usually?

Other than initially to test tolerance, G-tube and J-tube feedings are usually given as
continuous feedings.

671.

Side rail rules?

Four side-rails up can be considered a form of restraint. Even in LTC facility when a
client is a
fall risk, keep lower rails down, and one side of bed against the wall, lowest position,
wheels
locked.

672.

Post spleenectomy?

Pneumovax 23 gets administered post splenectomy to prevent pneumococcal sepsis.

673.

Potassium lab importance?

Let's say every answer in front of you is an abnormal value. If potassium is there you
can bet it
is a problem they want you to identify, because values outside of normal can be life
threatening. Normal potassium is 3.5-5.0. Even a bun of 50 doesn't override a potassium
of 3.0
in a renal patient in priority.

674.

Every new admission needs?

You will ask every new admission if he has an advance directive, and if not you will
explain it,
and he will have the option to sign or not.

675.

Potassium and acid base balance?

A little trick regarding potassium:


ALKALOSIS: K is LOW
Acidosis is just the opposite: K is High
The vital sign you should check first with high potassium is pulse (due to
dysrhythmias).

676.

What is bleeding considered in ADPIE?

Bleeding is part of the 'circulation' assessment of the ABCD's in an emergent


situation.
Therefore, if airway and breathing are accounted for, a compound fracture
requires assessment
before Glasgow coma scale and a neuro check (D=disability, or neuro check)

677.

What to do in a sucking stab wound?

The immediate intervention after a sucking stab wound is to dress the


wound and tape it on
three sides which allows air to escape. Do not use an occlusive dressing,
which could convert the
wound from open pneumo to closed one, and a tension pneumothorax is
worse situation. After
that get your chest tube tray, labs, iv.

678.

What to do if your patients chest tube accidently


getes removed?

An occulsive dressing is used

679.

Labs in DKA>?

Serum acetone and serum ketones rise in DKA. As you treat the acidosis and
dehydration
expect the potassium to drop rapidly, so be ready, with potassium
replacement.
Fluids are the most important intervention with HHNS as well as DKA, so get
fluids going first.
With HHNS there is no ketosis, and no acidosis. Potassium is low in HHNS (d/t
diuresis).

680.

Decorticate and Decerebrate?

Decorticate positioning in response to pain = Cortex involvement.


Decerebrate in response to
pain = Cerebellar, brain stem involvement

681.

Other S/S of MS?

Hyperactive deep tendon reflexes, vision changes, fatigue and spasticity are
all symptoms of MS

682.

After removal of the pituitary gland what should


you watch for?

After removal of the pituitary gland you must watch for hypocortisolism and
temporary
diabetes insipidus.

683.

After appendectomy?

position on the RIGHT side with legs flexed

684.

Hirschsprungs is dx how?

Hirschsprung's diagnosed with rectal biopsy looking for absence of


ganglionic cells. Cardinal
sign in infants is failure to pass meconium, and later the classic ribbon-like
and foul smelling
stools.

685.

More info on intussception?

Intussusception common in kids with CF. Obstruction may cause fecal emesis,
currant jellylike
stools (blood and mucus). A barium enema may be used to hydrostatically
reduce the
telescoping. Resolution is obvious, with onset of bowel movements.

686.

Omphalocele?

With omphalocele and gastroschisis (herniation of abdominal contents) dress


with loose saline
dressing covered with plastic wrap, and keep eye on temp. Kid can lose heat
quickly.

687.

Hydrocele?

After a hydrocele repair provide ice bags and scrotal support.

688.

PKU ?

No phenylalanine with a kid positive for PKU (no meat no dairy no aspartme

689.

When to test urine for ketones and


glucose?

Second voided urine most accurate when testing for ketones and glucose.

690.

Nepphrotic syndrome?

Nephrotic syndrome is characterized by massive proteinuria (looks dark and frothy)


caused by
glomerular damage. Corticosteroids are the mainstay. Generalized edema common.

691.

Western blot test?

A positive Western blot in a child <18 months (presence of HIV antibodies) indicates only
that
the mother is infected. Two or more positive p24 antigen tests will confirm HIV in kids <18
months. The p24 can be used at any age.

692.

Kids with HIV?

For HIV kids avoid OPV and Varicella vaccinations (live), but give Pneumococcal and
influenza.
MMR is avoided only if the kid is severely immunocompromised. Parents should wear
gloves for
care, not kiss kids on the mouth, and not share eating utensils.

693.

What will alter the accuracy of o2 sats?

Hypotension and vasoconstricting meds

694.

Room air is?

Ambient air (room air) contains 21 % o2

695.

The first s/s of ards?

The first sign of ARDS is increased respirations. Later comes dyspnea, retractions, air
hunger,
cyanosis.

696.

PCWP

Normal PCWP (pulm capillary wedge pressure) is 8-13. Readings of 18-20 are considered
high.

697.

First sign of pe?

First sign of PE is sudden chest pain, followed by dyspnea and tachypnea.

698.

Carbon dioxide narcosis?

High potassium is expected with carbon dioxide narcosis (hydrogen floods the cell forcing
potassium out). Carbon dioxide narcosis causes increased intracranial pressure.

699.

Pulmonary sarcoidosis?

Pulmonary sarcoidosis leads to right sided heart failure..Sarcidosis is basically scar tissue
build up

700.

NG tube rules?

An NG tube can be irrigated with cola, and should be taught to family when a client is
going
home with an NG tube.

701.

If your patient starts seeing bugs?

If your normally lucid patient starts seeing bugs you better check his respiratory status
first.
The first sign of hypoxia is restlessness, followed by agitation, and things go downhill from
there
all the way to delirium, hallucinations, and coma. So check the o2 stat, and get abg's if
possible.

702.

Cold stress in a newborn?

The biggest concern with cold stress and the newborn is respiratory distress.

703.

A preggo in a minus station?

If your laboring mom's water breaks and she is any minus station you better know there
is a
risk of prolapsed cord.

704.

CPR in a five year old?

In a five-year old breathe once for every 5 compressions doing cpr.

705.

After Gtube placement?

After g-tube placement the stomach contents are drained by gravity for 24 hours before
it can
be used for feedings.

706.

Cephalhematoma (caput
succinidanium)?

Cephalhematoma (caput succinidanium) resolves on its own in a few days. This is the
type of
edema that crosses the suture lines.

707.

Hep A precautions?

During the acute stage of Hep-A gown and gloves are required. In the convalescent stage it
is
no longer contagious.

708.

More labs suggestive of renal failure?

Low magnesium and high creatinine signal renal failure.

709.

Hightest priority for RA?

Pain is usually the highest priority with RA

710.

TB health risk?

If a TB patient is unable/unwilling to comply with tx they may need supervision (direct


observation). TB is a public health risk.

711.

Highest priortiy in status elipticus?

Level of consciousness is the most important assessment parameter with status epilepticus.

712.

Crackles most likely are?

Crackles suggest pneumonia, which is likely to be accompanied by hypoxia, which would


manifest itself as mental confusion, etc.

713.

Anorexia sucks because?

Absence of menstruation leads to osteoporosis in the anorexic.

714.

Low crit/hemoglobin?

A patient with a low hemoglobin and/or hematocrit should be evaluated for signs of
bleeding, such as dark stools.

715.

More IVP info?

A laxative is given the night before an IVP in order to better visualize the organs.

716.

Pt with edema and walking?

A patient with liver cirrhosis and edema may ambulate, then sit with legs elevated to try to
mobilize the edema.

717.

High priority in Addisons?

Managing stress in a patient with adrenal insufficiency (Addison's) is paramount, because if


the adrenal glands are stressed further it could result in Addisonian crisis. While we're on
Addison's, remember blood pressure is the most important assessment parameter, as it
causes
severe hypotension.

718.

Pancreatitis prioritys?

After pain relief, cough and deep breathe is important in pancreatitis, because of fluid
pushing up in the diaphragm.

719.

Likely cause of cardiac arrest in child?

Prolonged hypoxemia is a likely cause of cardiac arrest in a child.

720.

What can also cause an s3 heart


sound?

Fluid volume overload caused by IVC fluids infusing too quickly (or whatever reason) and
CHF
can cause an S3

721.

coarctation of the aaorta causes?

Coarctation of the aorta causes increased blood flow and bounding pulses in the arms

722.

If you THINK a patient has new HTN?

A newly diagnosed hypertension patient should have BP assessed in both arms

723.

Depression manifests itself?

Depression often manifests itself in somatic ways, such as psychomotor retardation, gi


complaints, and pain.

724.

Chief concern in CF

Respiratory problems!

725.

More info on TB testing a positive


result?

speaking of TB... PPD is positive if area of induration is:


>5 mm in an immunocompromised patient
>10 mm in a normal patient
>15 mm in a patient who lives in an area where TB is very rare.

726.

Hba1c?

HbA1c - test to assess how well blood sugars have been controlled over the past 90-120
days. 46 corresponds to a blood sugar of 70-110; 7 is ideal for a diabetic and corresponds to a
blood
sugar of 130.

727.

Most accurate
way to test
kids for
medication
accuracy?

BSA is considered the most accurate method for medication dosing with kids. (I though it was
weight, but apparently not)

728.

Placement of a
wheelchair?

Place a wheelchair parallel to the bed on the side of weakness

729.

If you see a
nurse make a
mistake? Chain
of command?

If one nurse discovers another nurse has made a mistake it is always appropriate to speak to
her before going to management. If the situation persists, then take it higher.

730.

Besides meds
and congenital
problems ..
what can lead
to decreased
preload ?

Sepsis and anaphylaxis (along with the obvious hemorrhaging) reduce circulating volume by
way of increased capillary permeability, which leads to reduced preload (volume in the left
ventricle at the end of diastole). This is a toughie...think about it.

731.

Nitrazine
paper?

Amniotic fluid is alkaline, and turns nitrazine paper blue. Urine and normal vaginal discharge
are acidic, and turn it pink.

732.

STD=
gonnorrhea?

Gonorrhea is a reportable disease

733.

Crutch use?

Remember the phrase "step up" when picturing a person going up stairs with crutches. The
good leg goes up first, followed by the crutches and the bad leg. The opposite happens going
down. The crutches go first, followed by the good leg.

734.

MORE info on
DKA? ugh!

While treating DKA, bringing the glucose down too far and too fast can result in increased
intracranial pressure d/t water being pulled into the CSF.
Polyuria is common with the hypercalcemia caused by hyperparathyroidism.

735.

Nonfat milk?

Nonfat milk reduces reflux by increasing lower esophageal sphincter pressure

736.

Gerd again?

Patients with GERD should lay on their left side with the HOB elevated 30 degrees.

737.

To prevent
dumping
syndrome?

Unusual positional tip - Low-fowlers recommended during meals to prevent dumping


syndrome. Limit fluids while eating.

738.

Emphysema?

In emphysema the stimulus to breathe is low PO2, not increased PCO2 like the rest of us, so
don't slam them with oxygen. Encourage pursed-lip breathing which promotes CO2
elimination, encourage up to 3000mL/day fluids, high-fowlers and leaning forward.

739.

Kernigs sign?

One of the physically demonstrable symptoms of meningitis is Kernig's sign. Severe stiffness of the hamstrings
causes an inability to straighten the leg when the hip is flexed to 90 degrees.

740.

Brudzinski's
sign?

One of the physically demonstrable symptoms of meningitis is Brudzinski's sign. Severe neck stiffness causes a
patient's hips and knees to flex when the neck is flexed ( The kid knees will fly up and he lift his bum off the table
cause it hurts his neck)

741.

Phenalalanine?

It is an amino acid that is BAD for people with PKU. It is found in food only and is also found in aspartame

742.

Vertical C
section?

Used in plus sized women or risky or emergency c sections. less chance of harm for the baby

743.

Dystocia?

Just means a difficult or abnormal delivery or birth... example.. shoulder dystocia

744.

Peritoneal
dialysis?

On the other hand, peritoneal dialysis does not require that the patient's blood be pumped outside of his body.
Instead, the blood is cleaned while still inside the body. The organs in the abdomen are surrounded by the
peritoneum, which is a membrane that allows waste products to pass through it. Peritoneal dialysis uses a Tenckhoff
catheter to run the dialysis fluid, a sugar solution with some salts, into the abdominal, or peritoneal, cavity. This allows
the patient's blood to be filtered without pumping it through a dialysis machine. A Tenkhoff catheter is usually used
in peritoneal dialysis

745.

Why would
somone who is
allergic to latex be
allergic to food
too?

CROSS REACTION! People who have a latex allergy may be allergic to some foods, as well. This is called a cross
reaction. When this happens, your body responds with the same allergic symptoms that you would have if you
were exposed to latex. Cross reactions differ from one person to another. Someone may have a reaction to all the
foods noted to cause cross reaction while another may have no reaction at all. Likewise, if you are allergic to any of
these foods, you may also be allergic to latex:
apples, bananas, kiwi, peaches, plums, figs, grapes, melons, papaya, passion fruit, cherries, nectarines, pears,
pineapple and strawberries;
carrots, celery, raw potatoes, avocados and tomatoes;
chestnuts and hazelnuts;
wheat and rye.

746.

Acid/ ASH diet?

The acid ash diet has nothing to do with weight loss. It is a diet intended for health and may be prescribed by
your physician to control illness or disease. Once your liver has metabolized the food you ingest, it leaves a
mineral deposit, known as ash, which can be acidic or alkaline depending on its effect on the pH of your urine.
Eating foods that create an acid ash may help to balance your system or create a hostile environment to inhibit
bacterial growth.
.... Acid/ ash diet is used to BALANCE the acid/alkaline ash in the body... Ash wiill affect the urinary system and
even the nervous system. Imbalance will be diet modified

747.

PTB means?

Pumonary tuberculosis

748.

Psuedomembrane
in DIptheria?

Diptheria is an upper respiratory tract infection. It is characterized by sore throat, low fever and the
psuedomembrane! Which is just a capsule around the tonsils that you can see with your penlight... It just looks
like a whiteish yellow capsule around the tonisils

749.

SLE?

Systemic Lupus Ethramoutus.... (Lupus)

750.

Dengue
hemorrhagic
fever?

Hermans sign= flushes and redness of skin with lighter color at the center of the rash.... It is a disease that comes
from tropical and subtropical areas that are spread by misquotos

751.

Risus Sardonicus?

Risus sardonicus is a highly characteristic, abnormal, sustained spasm of the facial muscles that appears to
produce grinning--- From Tetany! Sad and scary looking! Never Google image it again, Megan! Nightmares!

752.

Grey Turners sign?

Purple bruises around the belly button... Pancreatitis!

753.

PDA?

patent ductuous arteriousus in infants! Valve doesn't close!

754.

Dance Sign?

Dance's sign: RUQ mass (intussusception) with RLQ empty space (movement of cecum out of normal position).

755.

Charcots sign?

A. Charcot's triad for multiple sclerosis


1. Nystagmus
2. Intention tremor
3. Scanning or staccato speech

756.

MG and Guillian
Barre?

Opposites! Nursing connection! Think about it!

757.

Chvostek and
Trosseaus sign

Chvostek= Tapping on the face above the cheek bone will cause spams! Trosseaus= using a BP cuff and inflating
it, and it will cause spasms of the wrist

758.

VRSA?

Staph infection that is resistant to Vancomycin treatement! Worse than MRSA

759.

Tet spells?

Children with tetralogy of Fallot may develop "tet spells". The precise mechanism of these episodes is in doubt,
but presumably results from a transient increase in resistance to blood flow to the lungs with increased
preferential flow of desaturated blood to the body. Tet spells are characterized by a sudden, marked increase in
cyanosis followed by syncope, and may result in hypoxic brain injury and death. Older children will often squat
during a tet spell, which increases systemic vascular resistance and allows for a temporary reversal of the shunt.

760.

HHNS Vs DKA

Diabetic ketoacidosis (DKA) is a condition


of DKA=insulin deficiency resulting in
acidemia due to altered metabolism.
Hyperosmolar hyperglycemic nonketotic
syndrome (HHNS) is primarily a disorder
of dehydration due to hyperglycemia

761.

Pancreatitis

NPO, TPN May be used

762.

Diverticulitis

Clear liquids to high fiber

763.

Cholecystis

Low-fat diet

764.

Liver disease

Decreased protein intake

765.

Celiac disease

Avoid glutens

766.

Nausea and vomiting

Clear liquids

767.

Gout

Avoid purines

768.

Dumping syndrome

Small frequent meals

769.

GERD

Avoid large meals, eating late, alcohol


caffeine

770.

Monitor for digoxin

Potassium

771.

Monitor for acetaminophen

Temperature

772.

Monitor for glipizide

Blood glucose

773.

Monitor for morphine

Respiratory rate

774.

Monitor for prednisone

Delayed wound healing

775.

Monitor for warfarin

INR

776.

Monitor for zolpidem

Sleep patterens

777.

Monitor for Olanzapine

Mood

778.

Monitor for Levoflaxacin

Culture and sensitivity

779.

Erikson stage 0-1, posterior fontanelle closes at 2 to 3 months, 1 to 5 m grasp rattle 6


m transfer between hands, 8-9 m uses pincer grasps, nine months bangs toys
together, 3 m holds head, 5-6 m rolls, 9m sits up on own, 12 m stands alone

Trust vs mistrust, meet social and


developemental needs

780.

Erikson stage 1-3, feeds self, anterior fentanyl closes, steady gait, draw stick figure,
potty train, need routines and rituals

Autonomy vs shame and doubt, provide


acceptable options

781.

Erikson stage 3-6, hopping, draws shapes, walking heel to toe

Initiative vs. guilt, provide age appropriate


activities, stranger danger

782.

Erikson stage 6-12 or games, rides bicycle, build models, organize sports, puzzles
games, video games

Industry vs inferiority, encourage


participation in care

783.

Erikson stage 12-20 pure activities, music interest, career training, sexual
maturiation, STI's, pregnancy, substance abuse

Identity vs role confusion, Provide


support groups of same age

784.

Erikson stage 20-35 leaves families and seeks relationships, growth ends
childbearing, established career,

Intimacy vs isolation, provide private time


with partner

785.

Erikson stage 35-65 bouncing life, aging parent, adult children, grandchildren,
career transition, retirement, menopause, osteoporosis, decrease in visual and
hearing

Generativity vs stagnation

786.

Erikson stage 65+, decreased skin elasticity, decreased cough reflects, lower cardiac
output, peridontal disease

Integrity vs despair, use personal items


were not home

787.

Antidote for opoids

Naloxone

788.

Antidote for warfarin

Vitamin K

789.

Antidote for acetaminophen

Acetylcystiene

790.

Antidote for heparin

Protamine sulfate

791.

Antidote for benzodiazepine

Flumaxenil

792.

Antidote for digitalis

Digoxin immune fab

793.

Antidote for lead

Succimer

794.

Antidote for magnesium

Calcium gluconate

795.

When mixed with regular insulin draw this medication up last, 4-6 hr peak time

NPH

796.

Have client eat as soon as this medication is given

Lispro

797.

Hold this medication 48 hours before and after use of contrast dye

Metformin

798.

Given subcutaneously and has no peak time

Glargine

799.

May be used to lower potassium levels, can be given IV, also for DKA

Regular insulin

800.

Type of solution for TPN

Hypertonic

801.

Routes TPN can be given

Picc line, tunneled catheter

802.

TPN is prepared how often

Daily

803.

TPN is hung every_ hours

24

804.

Standard precaution requirements

Nothing, gloves prn

805.

Contact precaution requirements (body fluids)

Gloves and gown

806.

Droplet precaution requirements (air)

Mask

807.

Airborne precaution requirements (air)

Mask

808.

Normal sodium level

135-145

809.

Normal potassium level

3.5-5

810.

Normal calcium level

9-10.5

811.

Normal carbon dioxide level

35-45

812.

Normal hydrochloride level

21-28

813.

Normal hemoglobin level

14-18

814.

Normal Hct level

37-52%

815.

Normal WBC level

5,000-10,000

816.

Normal cholesterol level

<200

817.

Normal platelets

150,000-400,000 (enoxaparin sodium)

818.

Normal P T

11-12.5 sec, rx: 1.5-2x (Coumadin)

819.

normal aptt

30-40 sec rx 1.5-2x (heparin)

820.

Normal INR

0.7-1.8, rx 2-3x (Coumadin)

821.

Normal glucose fasting

70-105

822.

Normal HbA1c (glycosylated hgb)

4-6%

823.

Normal BUN level

10-20

824.

Normal creatinine level

0.5-1.2

825.

Arterial supply

Goes down in legs

826.

Venous supply

Goes up in legs

827.

Red tag

Emergent

828.

Yellow tag

Urgent within 1 to 2 hours

829.

Green tag

Non-urgent 2 to 4 hours

830.

Black tag

Not seen don't have survival potential

831.

LPNs cannot what

Evaluate Assess teach, can reinforce or reteach, iv therapy, blood therapy rhogam

832.

Medication to
hold prior to ECT

Dilantin or other medications that alter brain activity

833.

How long post


surgery to be on
blood thinners

30 days

834.

Priority if chest
tube comes out

Cover with Vaseline soaked gauze

835.

Ebola

Hemorrhagic fever, w/ out symptoms quarenteen for 21 days

836.

System affected
by methotrexate
(steroid)

Immune system, decreased white blood cells and decreased platelets

837.

System affected
by sodium levels

Neurological system, seizures occur with low levels

838.

Anti-cholinergic
drugs side effects

No see no Pee no stool no drool

839.

Versed

Pt cannot sign for anything after recieving

840.

16 y.o can be a
majority if

Married, emancipated, or has child

841.

ED triage

Treat most severe injury first

842.

Mass casualty
triage

Do the greatest good for the greatest number

843.

Magnesium

drip needs to have one-to-one, due to side effects (absent deep tendon reflexes), monitor BP, resp, DTR, used for
preclampsia

844.

Meningitis

symptoms: Headache, Stiff neck and photosynthesis, Diagnostics: spinal fluid (lumbar puncture) blood cultures,
Prevention: Hand washing, immunization, Assessments: Brudzinski (pain with Head to breast bone) Kernigs (Pain
with knee up to chest) Living in close spaces can cause this.

845.

Priority for MI

Apply oxygen first

846.

2 pt gait

Partial weight-bearing on extremity walking with crutches right leg left crutch as if they were skiing

847.

3 pt gait

Nonweightbearing swing through crutches

848.

4 pt gait

Stability partial weight-bearing on both extremities right leg right crutch

849.

Walker

Step into it, arm's-length away, don't pull self up with device

850.

Cane

Always on the strong side

851.

Up stairs

Strong leg first

852.

Down stairs

Weak leg first

853.

Yogurt

Form of calcium for lactose intolerant patients

854.

Diet for
Christianity

Don't eat meat on ash Wednesday or Fridays of light may have days of fasting

855.

Diet for
Buddhism

Avoid beef pork seafood

856.

Judaism diet
(Muslims)

Kosher- can't mix milk and meat no pork avoid fish that don't have scales

857.

Hinduism diet

No beef, may fast, many are vegetarian

858.

Interventions for dumping


syndrome

Lay down after eating, avoid drinking one hour before and one hour after eating, avoid sugar
and milk

859.

Interventions for eternal


nutrition

Start slow increase rate every 8 to 12 hours, greater than 100 residue fluid hold fluid, head of bed
30 or higher, assess for signs of intolerance, first feeding have x-ray every other check pH.

860.

Lithium toxicity

Can occur if greater than two

861.

Zolpidem

(Ambien) sleepwalk and cannot remember

862.

Side affects of anti-psychotics


(typical)

Sedation, EPS, and anti-cholinergic effects

863.

Adverse affects of
antipsychotics

Tardive dyskinesia,such as thumb rolling And eye emovements, Agranulocytosis, neuroleptic


malignment syndrome, siezures

864.

Risedronate

Don't lay down right away

865.

Fentanyl patch

Remove with temperature, one for three days, don't put heating pad over it

866.

Gentamicin

Don't use if damage to kidneys when used with furosemide can cause hearing loss at high doses

867.

Amoxicillin

Be aware with cephalosporins allergy

868.

Ceftriaxone

Can create C diff

869.

Adverse effects

Life-threatening

870.

varenicline

Only use up to 12 weeks for smoking cessation

871.

Calcium channel blocker's, beta


blockers, ARBs, ace inhibitors

Blood-pressure medications

872.

Calcium channel blocker's side


effects

Bradycardia, decreased contractility, peripheral edema

873.

Ace inhibitor side effects

Dry hacking cough, angioedema

874.

20 gauge catheter

Can be used for packed RBCs, dextrose 5%, 9% sodium chloride, not used for TPN, amirodone,
vancomycin

875.

Clean wound with _ before


getting culture

Saline or sterile water

876.

V tach

First action drug Amerodone then lidocaine then prepare for cardioversion

877.

CAGE

Screening tool for alcoholism, cutdown use of alcohol, ever felt anger when people tell you to cut
down, ever feel guilty about how much you drink, eye-opener to quit

878.

Wilms tumor

On adrenal gland needs to be removed prior to bursting

879.

1 pound

3500 calories

880.

Intropic agents

Increases myocardial contraction, and cardiac output, digoxin, dopamine, dubotamine

881.

Digoxin toxicity

Halos around everything, <6

882.

Dopamine and dubotamine

Monitor heart rate urine output and blood pressure

883.

BNP

Diagnostic test for CHF, normal is lower than 100, 100 to 300 heart failure is possible, 300 to 600
heart failure is mild, 600-900 moderate heart failure, severe hf > 900

884.

Packed RBCs

Treat anemia, monitor hemoglobin

885.

Platelets

Treats thrombocytopenia, monitor platelets

886.

Plasma

Treats Burns, monitor albumin, 3.5-5

887.

Factor 8

Treats hemophilia, monitor ptt

888.

1 unit of blood

Expect 1g/dl increase in hgb ex. 7.8-8.8

889.

Kidneys

Monitor I&O, electrolytes, BUN, creatinine, Hgb, BP (BUN & creatinine increases with kidney
failure)

890.

Complications with
central lines

Pneumothorax, air embolism, occlusion, infection, with air embolism lay on left side and Trendelenburg
position with insertion

891.

Hyperthyroidism

PTU & Tapazole, or remove thyroid (calcium at bedside) Think of Tigger orange and hyper

892.

Hypothyroidism

Levothyroxine, Think of eeyore, slow moving, depressed

893.

Affected system of
potassium

Cardiac, cardiac arrest with severe levels

894.

Insulin withdrawal
when mixing

Clear to cloudy (regular-NPH)

895.

Oxytocin

Monitor fhr, contractions, BP, hr, rr

896.

Quetiaphine fulmarate

Bipolar, monitor for suicidal thinking, dizziness, leukopenia

897.

Risperidone

Bipolar, monitor for sedation insomnia pseudoparkinsonism,

898.

Lithium carbonate

Bipolar, no levels of lithium,

899.

SSRI

Antidepressant that blocks reuptake of serotonin

900.

SNRI and tricyclics

Antidepressant that box reuptake of serotonin and norepinepherine

901.

MAOI

Focus on diet

902.

Atypical
antidepressants

Selectively inhibits dopamine and stimulates CNS, side effects: seizures psychotic symptoms, Buproprion

903.

Developing cancer
with birth control

Only with smoking

904.

Naegeles rule

1st day menstrual cycle-3 months, +7 days

905.

First stage of labor

Latent 0 to 3 cm, active 4 to 7, transition 8 to 10,

906.

Second stage of labor

Pushing stage

907.

Third stage of labor

Delivery of placenta

908.

Fourth stage of labor

Bonding with newborn

909.

Taking in phase

It's all about me

910.

Taking hold phase

It's all about the baby

911.

Letting go phase

Getting back to the new normal

912.

Anemia side effects

Weakness paler fatigue

913.

Anemia interventions

Food sources that contain red meat, organ meat, egg yolks, leafy green vegetables, use z track method for
Iran dextran

914.

Blood compatibility

Remember this by what factor they have a or B or both AB or neither o patient doesn't have that factor they
can't receive the blood,

915.

Hemophilia signs and


symptoms

Risk for bleeding, Hematomas, G.I. and G you bleeding, brain hemorrhage, and bleeding mucous
membranes

916.

Hemophilia nursing
interventions

Assess for joint pain, monitor vitals, admonister factor replacement, avoid injections and NSAIDs, assess LOC
and bleeding

917.

MI diagnostic labs

Troponins

918.

Sickle cell anemia and


crisis

Most common in African Americans, blood comes and causes severe pain, oxygen is limited to the cells of the
body because cells cannot carry oxygen as well, don't do well in cold weather or high altitude

919.

Signs and symptoms of


sickle cell anemia

Anemia, hypoxic damaged tissue, dehydration, susceptibility to infection, knowledge deficit and
powerlessness

920.

Nursing interventions
for sickle cell anemia

Oxygen as needed, manage pain, and her vitals, monitor H&H, Mr. fluids as needed, assess for signs and
symptoms of infection, teach self-care, causes and prevention of crisis

921.

Cervical cancer

Contributing factors: HPV/ multiple partners, manifestations: abnormal bleeding,


Dianosing: pap/DNA test, prevention: Gardisil

922.

Breast cancer

Contributing factors: family history, lifestyle, Manifestations: Lumps, thickening,


Diagnosing: mammogram, Prevention: Diet, weight, excercise

923.

When is a colposcopy used?

abnormal pap test

924.

Stable angina

pt is awake and doing something when having chest pain. Pain is able to be treated
with first nitro

925.

Unstable angina/ preinfarction

Moving around but not relieved with nitro.

926.

Prinemetal/ Coronary spasm

Sound asleep and woken up by pain in chest

927.

Protocol for American Heart Association


regarding MI

Sit down take a nitro, wait 5 min, call 911, take another nitro, wait 5 min and take
final nitro.

928.

Nursing interventions for MI

Morphine (decreases preload & afterload)


Oxygen (First, treats ischemic myocardium)
Nitro (increases coronary perfusion)
Aspirin- (decreases clot formation)
MONA

929.

Aortic femoral Bypass (restoring blood supply


to blocked area) interventions

peripheral pulses, skin temp, anticoags, avoid crossing legs, monitor site, KEEP BP
LOW

930.

Heart sounds mnemonic

Ape to man
Aortic, pulmonic, erbs point, tricuspid, mitral

931.

Where do I listen to S2?

aortic and pulmonic

932.

Where do I listen to S1?

tricuspid and mitral

933.

S3 and S4 sounds

kentucky (going into CHF) Tennessee (Angina)

934.

Angioplasty

NI: cardiac diet, check vitals every 15 min, cardiac monitor, pressure @ site.
Complications: dysrhithmias, bleeding, hypovolemia

935.

P wave

atrium are contracting

936.

QRS

ventricles contract

937.

T wave

ventricles relax, Don't want PVC's to hit T wave

938.

Cardioversion

Use with unstable v tach, machine synchronizes with the heart rhythm because
you do not want to hit the t wave

939.

v fib

whole ventricles are shaking like jello and not firing

940.

Common heart rhythm with anemia

Sinus tachycardia

941.

Left sided heart failure

Fluid backs up into lungs, crackles in lungs, dyspnea

942.

Right sided heart failure

Fluid backs up into heart, S3 gallop, peripheral edema

943.

Normal pulmonary wedge pressure

4-12

944.

Heart failure

NI: O2, fowlers, lung sounds, I&O, fluid restriction, daily weights, diuretics, ACE
inhibitors, digitalis

945.

DKA

Symptoms include: kussmaul respirations, fruity breath

946.

Thyroidectomy

Check for positive Chvotesek sign

947.

Hyponatremia

Causes: Diuretics, renal disease, Treatment: SIADH, Symptoms: confusion->


seizures, muscle weakness, cramping

948.

Hypernatremia

Causes: Water deficit, Cushings, Symptoms: Confusion->siezures, muscle weakness

949.

Hypokalemia

Causes: Diuretics, corticosteriods, suctioning, diarhea. Symptoms: muscle weakness,


shallow respirations, Dysrrhithmias

950.

Hyperkalemia

Causes: salt substitutes, renal failure, packed RBCs, Addisons Symptoms: Dysrhythmias, peaked T waves

951.

Addisons

Low cortisol

952.

Cushings

High cortisol (steroid symptoms)

953.

Kayexalate
enema

pulls off potassium

954.

Hypocalcemia

Causes: hypoparathyroidism, renal failure, malabsorption Symptoms: Changes in HR, prolonged ST, tetany,
changes in LOC, siezures

955.

Hypercalcemia

Causes: Hyperthyroidism, Excessive intake


Symptoms: Dysrhithmias, cardiac arrest

956.

Isotonic

No fluid crosses the cell membrane 0.9%NS

957.

Hypotonic

fluid moves into the cell 0.45% NS

958.

Hypertonic

fluid moves out of the cell D5 NS

959.

Cirrhoises

Symptoms: hypertension, esophageal carices, clotting abnormalities, hepate encephalopathy, ascites, peritonitis.
NI: Assess fluid balance, assess bleeding, safety precaustions, high calorie diet, fluid restrictions, low protien

960.

Rule of 9's

Each arm= 9%, Anterior leg=9%, Posterior leg=9% Head=9%, Back=18% Chest=18%, Perineum=1%

961.

Parkland
formula

used for determining amount of lactated ringersfor burn patient. Begin time at time of burn. Administer through
central line and have foley cath. 4mL x kg x %TBSA= 1/2 total in first 8 hrs, 1/2 in remaining 16 hours

962.

Head injury

Signs: Changes in LOC, Increased ICP, Brady, tachypnea, hypo/hypertension, hyperthermia, bradycardia,
posturing. Interventions: Assess neurostatus w/ glascow coma scale (higher the better), I & O, Elevate HOB, monitor
electrolytes, decrease stimulation, monitor ICP, vitals, nutritional support.

963.

Spinal shock

occurs right away, hypotension,

964.

Autnomic
dyreflexia

Spinal injury, can occur after several weeks only in T6 or higher, hypertension, flushing, headache Treatment:
lower BP and treat cause.

965.

Cervical spine

Top 8, worry about breathing

966.

Thoracic spine

Middle 12, quadroplegic

967.

Lumbar spine

Bottom 5, paraplegic

968.

Spinal cord
injury

Intervention: Immobilization, assess respiratory status, assess vital signs, institue bowel sounds and bladder
program, prevent DVT, urinary retention, constipation, skin break down.

969.

VEAL CHOP
MINE

Menomic for decelerations


Variable Cord compression Move patient
Early Head compression Identify labor progress
Accelearate Okay No action
Late Placental insufficiency Execute STAT

970.

Precalampsia

NI: Monitor BP, protein in urine, weight, watch edema


eclampsia occurs with seixures

971.

Uncompensated

pH is off and 1 other is off

972.

Partially
compensated

pH is off as well as other two are off

973.

fully
compensated

pH is normal other two are off

974.

Metabolic
alkalosis

Vomiting loose acid and left with base

975.

Metabolic
acidosis

Diarrhea loose base and left with acid

976.

High pressure with


mechanical ventilation

NI: assess for need to suction, pt needs tomlet machine breath for them.

977.

Low pressure with


mechanical ventilation

check tubes for leaks

978.

Cancer internal
radiation

NI: visitors should maintain 6 feet away and visit no longer then 30 min, staff needs a dosimeter badge.

979.

Carseat

Middle of backseat for 2 years or 20 lbs

980.

Donning order

Gown-Mask- goggles-gloves-enter

981.

Doffing order

gloves- gown- goggles-mask

982.

Nasal Cannula

1-6 L/min over 2 needs humidifyer

983.

Simple face mask

6-8L/ min

984.

Venturi face mask

4-8L/min

985.

Non- Rebreather

12L/min

986.

RSV

contagious for 1 week after antibiotic

987.

C-Diff and VRE

use soap and water

988.

Droplet (infections)

measles, influenza, can cohort

989.

Airborne(infections)

chicken pox, TB, cant cohort

990.

Contact (infections)

MRSA, C-diff can cohort

991.

Abuse phases

Tension building-> battering-> honeymoon-> tension building

992.

PTSD

symptoms are delayed, assess for irritibility, difficulty sleeping and concentration, decrease excessive
stimulus, help evaluate coping mechanisms

993.

Bipolar disorder

Depression and mania, inflated self esteem, flight of ideas, buying sprees, decreased needs for sleep,
coexist with substance abuse.

994.

Borderline personality
disorder

Manipulative behavior

995.

Depression

R/f: female, unmarried, low socialeconomic class, postpartum period, medical illness, early child hood
trauma. Symptoms: Insomnia, anergia, feelings of worthlessness decreased concentration.

996.

Grief

Denial-> Anger-> Bargaining-> Depression-> Acceptance

997.

Cluster A

Paranoid, schizoid, Schizotypal

998.

Cluster B

Antisocial, Borderline, Histronic, Narcissistic

999.

Cluster C

Avoidant, Dependent, Obsessive Compulsive

1000.

When patient hears


voices

"What are the voices saying to your?"

1001.

What does clubbing of


the fingers mean?

chronic hypoxia

1002.

Cap refill reveals what?

end-organ perfusion

1003.

#1 thing to do with
edema

elevate

1004.

Where to check for


skin turgor?

Adult - chest
child - abdomen/thigh

1005.

HR over what is
tachycardic

100

1006.

In acid/base balance,
poop is? vomit is?

Poop is base
Vomit is acid

1007.

Where is apex of heart found

6th intercostal space mid-axillary

1008.

Where is PMI found

4th intercostal space mid-clavicular

1009.

Where is 6 month fetal heart rate found

halfway between umbilicus and symphysis pubis

1010.

What cannot be taken with CCBs

Grapefruit juice

1011.

What does digoxin do

Makes the heart pump harder

1012.

How many cc's is 1 ounce

30 cc (30 ml)

1013.

LPN ramifications

No vents, can't do initial assessment, can't do initial teaching, can't discharge


Can take phone orders, can do f/u assessment, can do reinforcement teaching, can do
dry dressings

1014.

Hurts with eating/feels better with eating

Hurts with eating = gastritis


Feels better with eating = PUD

1015.

Zantac and -dines are what?

H2 blocker

1016.

Prilosec, Prevacid, Nexium, and Protonix


are what?

PPI

1017.

What to do with metabolic acidosis

...

1018.

What to do with metabolic alkalosis

...

1019.

What to do with respiratory acidosis

...

1020.

What to do with respiratory alkalosis

...

1021.

Aquamephytin

vitamin K

1022.

secretes vitamin K

liver

1023.

secretes bile

liver

1024.

bile stores

gallbladder

1025.

S/S of hepatitis

jaundice, foamy-tea colored urine (bile in urine - bile is soap), clay colored stool (no bile
in stool)

1026.

Hepatitis needs in diet

increased protein and decreased fat

1027.

ESLD is caused by..

Liver dying, has lots of scar tissue, closing off biliary tree (same symptoms as hepatitis,
but will not regenerate)

1028.

ESLD needs in diet

decreased protein (this creates more ammonia)

1029.

Secretes amylase/lipase

Pancrease

1030.

Crohn's

diarrhea
inflammation of entire colon
tx = anti-inflammatory drugs (steroids)
malnourished

1031.

Ulcerative colitis

bloody diarrhea
No steroids
tx = complete removal of lg bowel w/ ileostomy
malnourished

1032.

Why no morphine with bowel surgery or


biliary pain

morphine can cause spasm at sphincter of Odi


Give Demerol

1033.

RA

inflammatory response
red, hot, swollen, bad deformities
anti-inflammatories (NSAID, steroids)
Rest joint when inflamed

1034.

OA

Joint is wearing out - DJD


Pain meds (tylenol, NSAIDS, narcotics)
likes temp extremes (hot better)
Keep joint moving even when painful or will freeze

1035.

weight bearing for hip replacement

TOUCH weight bearing

1036.

weight bearing for hip fracture

NON weight bearing

1037.

Instructions when taking Fosamax

Empty stomach
sit up for 30 minutes

1038.

Anterior pituitary gland

Growth hormone
Too much = acromegaly
Too little = Dwarfism

1039.

Posterior pituitary gland

ADH
Too much = SIADH
Too little = DI (DDAVP)

1040.

Thyroid gland

T3/T4
Too much = Increased metabolism (Graves)
Too little = Decreased metabolism (thick nails, course hair, myxedema coma)

1041.

Parathyroid gland

Calcium
Too much = hypercalcemia (somnolent) - tx diuretics/dialysis
Too little = hypocalcemia (jittery, seizure, mouth tetany)

1042.

Adrenal gland

glucocorticoids
Too much = like too many steroids (weight gain, increase infection, increase glucose, skinny
limbs, moon face, buffalo hump)
Too little = Addison's disease - tx is life long steroids (which causes Cushings)

1043.

Addisonian crisis

Not enough steroids


Bronze pigment to skin d/t mineral corticoid steroids

1044.

Pancreas

Insulin
Too much = hyperglycemia (dry, hot)
Too little = hypoglycemia (pale, cold, clammy)

1045.

Diet for renal patient

Low protein, fluid restriction, low potassium, low phosphorus


Phosphate binder given with meals

1046.

Bronchodilators

increased oxygen demand-myocardial

1047.

Intermittent claudication

think arterial vs venous-this is arterial-position leg dependently

1048.

arterial

skin shines

1049.

arterial issues

put your legs down-so blood flows down-like an A (artery)

1050.

venous issues

like a V-put them up-so blood can go up

1051.

Heart Failure

-pumping issue; give Lasix and Digoxin (help with pumping)

1052.

V tach

electrical conduction system issue

1053.

INFILTRATION

IV site painful and swollen

1054.

blood reaction

send blood and tubing to the lab

1055.

New Trach

DO NOT remove the ties before cleaning the tracheostomy-wrong-stoma is not formed yetrisk of stoma closing and airway impacted

1056.

all tracheostomies

dont cut the gauze; need a pre cut gauze

1057.

C3 spinal fracture

airway is your issue

1058.

if you see a presenting part for a baby


for a labor pt in ER

prepare delivery room-priority

1059.

pt found on the floor

assess vital signs and LOC first, not injuries assessment first (if pt was conscious before the fall-vitals will
tell us the most about the client; unconscious pt would not have been found on the floor-they cannot
get up-most likely they rails are up)

1060.

NCLEX wont test

chemo drugs

1061.

NCLEX will test

Eriksson but not Piaget, high pressure alarms

1062.

obese client that vomits


after surgery-will increase
pressure in the abdomen,
at more risk for

Adhehicence

1063.

Disaster prioritization

Priority pt-pt with burns on the face, with respiratory stridor; fixed pupil and agonal respirations-will
not live, so not a priority

1064.

LPN

can give report during a transfer


can take VS in a transfusion client, after RN has stayed with client for first 15 min or the necessary initial
time

1065.

pt after MVA on balanced


suspension traction

disorientation is a priority; not shallow respirations

1066.

ECT

before: withhold Dilantin; Atropine IS given- for its anticholinergic effects-will lower the secretions in
the mouth; ECT causes seizures-we don't want them to have fluids in mouth-risk for aspiration;
Methohexital- possible given for amesthesia; also Succinylcholine-possible given

1067.

knee arthroplasty-1 week


ago

post op-for 4 to 6 weeks blood thinners are given throughout the recovery; also if pt was on blood
thinners prior to arthroplasty, he won't be taken off these meds, because they are lying down (postop)
so they are at risk for cloths; they won't be taking NSAIDs-they are on blood thinners; Motrin vs
Lortab?

1068.

pt that had a catheter in


before, now catheter is out
and pt cannot peeintervention

assessment FIRST-so do a bladder scan first; (full bladder-dull sounds when you percuss); anesthesia
can cause decreases ability to urinate

1069.

if chest tube is
disconnected

immerse the end of chest tube in a bottle of sterile water-this will prevent the air going into the chestcreates a water sill

1070.

new dx of RA-Methotrexate
order

this drug is used in CA patients as well-but its not a chemo drug


associated with this drug: WBC low- possible 1200, stomatitis-sores and difficulty in the mouth-hard to
eat, fever above 101 can be caused (fever is only above 101 F), increased urine specific gravity-they
are not eating or drinking-dehydration occurs; low platelets; also pts are advised to take Folic Acid with
this drug-it causes a depletion of dolic acid

1071.

three point crutches

unaffected leg first, then crutches 6 inches forward

1072.

2 point leg

R foot and the L crutch go first together; L foot and the R crutch after at same time-m0ve pass the other
ones

1073.

swing through gait

crutches forward, lift both feet and swing forward

1074.

Tetralogy of Fallot

4 issues here: ventricular septal defect, right ventricular hypertrophy, pulmonic stenosis, overriding
aorta, there is a whole in the septum; this will impact blood getting around the body

1075.

TPN pt- to prevent fluid


volume deficit

monitor glucose q 4-6 hrs-if the glucose is up-dehydration (osmotic diuresis)

1076.

incident reports

risk management investigates these, they are not shared with non involved staff, include description
of incidents in the reports

1077.

medication reconciliation

contains documented meds taken by client, comparrison of current and past meds list; this list is done
at any change in care..not only at admission and discharge; the purpose is to avoid errors of
duplication, missing some meds etc; also the pharmacy has a role in this, not only the RN

1078.

Autocratic manager

"do this, don't ask any questions"; employees have little to say; these managers are good in critical
situations

1079.

Laissez Faire manager

disorganized floor, chaotic environment, employees make the decisions

1080.

Democratic manager

decisions are made as a group , employees ARE asked their opinions

1081.

UAP

CANNOT encourage to share feelings-this requires therapeutic communications-RN has the skills to
do this
CANNOT get a urine specimen from a indwelling catheter-this is sterile
CAN assist with ambulating the client;
CAN empty the suction container, but RN has to assess the fluid collected

1082.

LPN

CANNOT administer Rogham-its a blood product;


they CAN hang the second bag for TPN, not the first one-RN
they CANNOT do anything with titration
they CANNOT stick the pt-no IV's start
CAN hang a piggy pag as long as its not a titration and as long as its a second bag; always RN has to
hang the first bag; LPN CAN give IM injections, they CAN hang the bag of fluid; when LPN hangs the
second bag, she does not need the RN there
CAN do wound care-dressing changes, irrigations, sterile techniques
CAN listen for the lung sounds-for data collection only-not as an assessment-RN will go in there and
listen to those heart sounds

1083.

UAP

new admission or post of fresh pt-RN has to do the vitals, not the UAP
CAN do specimen collection but not something that require sterile specimens

1084.

IV antibiotics

30 min window

1085.

antidiarrheals

always PRN

1086.

acute glomerulonephritis

can lead to acute kidney failure-watch for decreased urine output

1087.

these CAN be
disclosed/reported to DMV

uncontrolled seizure disorder of a school bus driver, if it is not controlled


dx of TB or HIV
someone with a gun in the hospital can be called to the cups right away

1088.

nonmaleficence

do not insert a contaminated catheter in after not sterile anymore

1089.

implied consent

unless you have a DNR, you do everything for them

1090.

living will WITHOUT a DNR


order

you have resuccitate in a code

1091.

in an outbreak for STD's

tell sexually active students to trace outbreaks-in a high school (when addressing the community
outbreak)

1092.

phone triage for a client


exposed to EBOLA-client
has no symptoms

tell client: "we will have to notify the health dept, HIPPA does not apply in this case"

1093.

Fire disaster

evacuate the ones can ambulate first-smoke kills before fire

1094.

NCLEX

increased number of questions about religions and cultures practices

1095.

when you need a translator

call a certified one; no family member should translate-HIPPA

1096.

Ebola

report immediately-fever, epistaxis, vomiting

1097.

AMA client

no need to call security but DO inform about possible complications if they leave

1098.

Amiodarone

should be given through a central line, not peripherally- because ph < 5

1099.

Vacomyocin

ph is <5-not given peripherally but PICC line ok

1100.

TPN

not given peripherally

1101.

narcotics (eg. Morphine)

can be taken out without a witness signature BUT needs second nurse when wasting it
never take out a narcotic if drower count is incorrect
LPN CAN sign a waste for narcotics

1102.

SEIZURES (precautions before a


seizure, after an aura)

roll them on their side only if they lost consciousness; if not they CAN maintain their airway
time it during a seizure-needs to be documented
after: report it, document, determine LOC
postdictal state: drowsy; ok for them to sleep on their side

1103.

chemo treatment

if it spills you call the biohazard, not the housekeeping-you put them at danger (not the
housekeeping, not the laundry department)
incident report done as well

1104.

smoking client on non smoking


campus

give hime a patch

1105.

cane use left side weakness

cane opposite affected leg (COLL)-move cane and the bad leg forward first

1106.

crutches

arms flexed; 2-3 inches to underarmed


cannot rest on crutches (underarm)

1107.

Parkinson client

walker with wheels-not ok for this client-safety problem


should use the walker with tennis balls-he is shuffling
he needs smooth sole shoes- not the non skid ones-he will fall

1108.

Shingles and TB

cannot share room

1109.

neutropenic pt

needs private room

1110.

DONT isolate

an HIV pt UNLESS he is neutropenic or he has an opportunistic infections

1111.

private room

productive cough and possible TB


rash with possible varicella
only airborne needs private room
C-dif is contact-does not need private room but its recommended (its only in the stool-only
way to get it-if you touch the stool)

1112.

Laryngectomy client with fresh


trach, Hep C and HIV

need gloves, gown, mask, googles-all of these needed because the new tracheostomy

1113.

client with MRSA


+
client who's post op total knee
replacement

you dont want them in the same room-knee rejection risk-MRSA might get in the knee

1114.

mammogram

after 40 annually

1115.

colorectal exam

should start at age of 50

1116.

prostate

discuss with pcp at 50

1117.

pap test

every 3 years starting at 21


if there is an abnormal pap->annual exam recommended

1118.

vaginal exam

has to be done annual in all patients

1119.

analgesia

cold and hot

1120.

hot

relaxes

1121.

emergency numbers

should be next to the phone, not the exit door

1122.

progressive macular degeneration

room free of clutter


call light within rich

1123.

fall history

have bed alarm for client

1124.

purulent exudate drainage from


wound

clean site first with sterile saline and water


place specimen in biohazard bag

1125.

who is at risk for falls

over 65 yrs old


bifocal glasses
pt on Lasix

1126.

hypotonic pulls fluid INTO the cell

hypertonic pulls it OUT of the cell

1127.

to check for JVD

place in semi fowler

1128.

if you see JVD when client


is standing

CHF R side

1129.

Calculate output

Assume-0.5 ml per kg output per hour


if we dont know the weight then is 30 ml per hr

1130.

the lower the Na it goes

the higher the risk for seizures it is

1131.

kidney function decreased

creatinine increased

1132.

hyperventilation

blowing out CO2-give rebreather bag-client is in respiratory alkalosis

1133.

Atropine

metabolic acidosis

1134.

Narcan

risk for respiratory acidosis-they are not breathing

1135.

pt on Zofran

risk for metabolic alkalosis-they are vomiting

1136.

Insulin

metabolic acidosis-K is high

1137.

Dilaudid

respiratory acidosis or alkalosis

1138.

sputum specimen

collect in the morning- also provide oral care for this pt

1139.

bronchoscopy

they are looking for lung cancer


assess gag reflex
asks client if he has night sweats-lung CA pts has this particular symptom

1140.

Quantiferon Gold-TB

blood test definitive for TB


results within 24 hrs
ask for night sweats

1141.

Thoracentesis

place a chest tube in the room- pt at risk for pneumothorax during procedure
check lung sounds on that side

1142.

pulmonary hygiene

CPT
turn and cough
bronchodilators
steroids
use bronchodilator first

1143.

suctioning

3 rounds before you hyper oxygenate again, max 15 secs rounds


suction on exiting

1144.

TB

mucopurulent sputum, low grade fever, chest tightness, decreased appetite

1145.

chronic bronchitis

copious sputum
cough for few months

1146.

emphysema

pursed lip breathing

1147.

asthma

bronchospasms
careful with beta blockers

1148.

lung cancer

non specific s/s

1149.

pneumonia

pleuritic chest pain-that does not go down when you sit/lay down, movement hurts

1150.

anginal pain

pain goes away when you lay down

1151.

pneumothorax

O2 decreases, put pt on O2, semi high fowler position; give anxiolytics- if anxious they won't be
breathing ok; give analgesics- because it hurts
chest tube placed as well

1152.

Chest tubes
components

right container-this is the drainage


water seal-middle-red
suction bubbles on the left
if no bubbling- possible kick in the tube
if drainage becomes purulent-check for fever, check when CBC was done last time, look at the insertion side for
infection
in case of crackles-these are in the pleural space-crackles mean fluid; check to see if a chest xray was done this
morning
1153.

intubated
client

nurse should do frequent hand wash


provide oral decontamination
clean oral suction device
turn client q 2 hrs
high fowler

1154.

preop clients

might take half of insulin

1155.

post op

respiratory, circulation, neuro, GU, GI, pain-these are all impaired by the surgery

1156.

dehisscence

put some stitches on


high fowler

1157.

evisceration

lay pt down, bend knees, call for help, cover with sterile dressing
1158.

acute
cholecystitis

low fat diet


have rich in HDL food sources

1159.

NG tube

verify with x-ray first, gastric ph later


empty when 1.5 to 3/4 full
check residual in continuous feeding-check in q 4 hrs; if less than 100 ml-put it back; if more than 200-call provider;
if more than 200 is taken out-metabolic alkalosis risk
meds through NG tube are given liquid, if crushed you give the meds 1 at a time-you don't know how they interact
when crushed and mixed in all together-also flush in between
you don't give extended release meds through ng tube-they need liquid or non extended released

1160.

GERD

prokinetic agents- Reglan

1161.

Peptic ulcer

...

1162.

IBS

diarrhea and constipation


LLQ pain
cramps

1163.

Inflammatory bowel disorders


(UC and Crohn's)

give immune modulators


with the Ulcerative colitis-stool gets into the tissues?

1164.

Diverticulitis

they always have diverticulosis, but if something gets in a diverticula-then it becomes diverticulitis
fluids only, rest the bowel
later-low fiber and after, transition to high fiber

1165.

Dumping syndrome

dizziness, sweating, tachicardia post bariatric surgery-avoid lactose and high concentrated sugar,
high fat and protein foods, turn to the L side not supine

1166.

Bariatric clients

they are obese- so high risk clients

1167.

Colostomy care teaching

include cranberry juice and yogurt to the diet-this will help with the odor
empty bag when one third full
clip hair surrounding the peristomal site

1168.

post up stoma care

pink and red is good


the further in the colon the stoma is, the more solid the stool is
emotional support, lots of teaching required
they will have an NG tube initially in for feeding
stoma care and assessment-priorities

1169.

pancreatitis

need for intervention: 1.042 Urine specific gravity-severe dehydration (osmotic diuresis-started on
TPN, sugar elevates)
amylase, lipase, related to the exocrine function of the endocrine system

1170.

acute pancreatitis

possible hypocalcemia (Tressou sign)-hand spasms occurs during blood pressure monitoring
with the auto digestion-Ca ends up in the bloodstream

1171.

Cirrhosis

low protein diet


bleeding-esophageal varices
they are breaking down protein-so they have high ammonia-this is toxic to neuro system

1172.

Hepatitis

liver impairment

1173.

Pancreatitis-malnutrition

put them far away from nurses station-so when food comes the smell wont create pancreatic
enzymes

1174.

pancreatic cancer

immunosuppression present
treatment: Whipple procedure and chemo
many times its mehtastazied

1175.

OA

weather changes-barometric pressure


chronic unilateral pain
pain worsen after activity

1176.

Rheumatoid A

bilateral joint inflammation


morning stiffness and pain

1177.

Gout

men usually get it


cannot put pressure on foot during acute episode
multiple tophi
excruciating pain with acute episode
bed rest, avoid touch, increase fluids
Allopurinol

1178.

SIADH

low sodium level


seizure precautions

1179.

Arterial line

...

1180.

Clonidine

change position slowly, this is a BP drug


take at night
in case of a cough->don't stop the med, just call the dr

1181.

VTac

obtain VS
don't defibrillate but cardiovert (if hemodynamically stable don't cardiovert)
check carotid pulse
give Amiodarone

1182.

Progressive MS

get rest and avoid stress


major personality changes
need speech therapist
might lose ability to empty bladder
eye patch given

1183.

Palliative care

improve quality of life


meet physical and emotional needs

1184.

mental health ptsremember to

treat based on developmental age, not chronologic age

1185.

amputation

first reaction-many times denial

1186.

Olanzepine/Zyprexa
for Anxiety

antipsychotic-causes hyperglycemia and weight gain


they can't eat whatever they want
for the first two months-risk for agranulocytosis

1187.

Agoraphobia

intervention-desensitation-this is a slow process

1188.

OCD

intervention-allow the ritual-we are not allow to stop it without a physician order-we will send them into a
panic attack

1189.

PTSD

intervention-support groups

1190.

Hypochondriasis

intervention-limit rumination-will help them not thinking of it

1191.

Social Phobia

Intervention-GAD?
intervention-reinforce coping

1192.

Schizophrenia

Paranoid-auditory hallucinations-know what the voices are telling them


Disorganized-flat affect, disorganized behavior and speech
Catatonic-stupor or extreme agitation, bizarre body posture-they can be in same position for a long timealteration of skin break down can happen

1193.

Prolixin

targets dyskenisia-repetitive involuntary facial and tongue motion

1194.

Aripiprazole

reduce daily delusional thoughts

1195.

Aricept

increase mental cognition

1196.

Haloperidol/Haldol

highest risk of EPS

1197.

Clozapine

agranulocytosis

1198.

Seroquel (for
depression)

slipineess

1199.

Congentin

manages EPS

1200.

Risperdal

lowest risks
gynecomastia is a major risk in young boys

1201.

Olanzapine/Zyprexa

hyperglicemia

1202.

Autism-alterations in

social skills-interventions-structured routines


language-might talk late-interventions-foster independence
behaviors-anger, frustration; intervention-safety
cognition-depends where they fall-intervention-family support
health-frequent GI disorders-advised to be on gluten free diet-intervention-offer community resources

1203.

Niacin

flushing-normal

1204.

Rifampin (TB drug)

orange body fluids

1205.

Adenosine

flushing and chest pain, iv push

1206.

Protonix (PPI class)

antiulcer med

1207.

Pitocin

decreases bleeding
uterine stimulant

1208.

Fentanyl (narcotic)

reversible agent is Nalaxone

1209.

Metothrexate

...

1210.

Palivizunab

prevents RSV

1211.

Methylprednisolone sodium succinate

given orally or IV
IV push

1212.

Selective Estrogen Receptor Modulator (Evista)

given for postmenapausal osteoporosis

1213.

Lipitor

no grapefruit

1214.

Prostaglandin-Xalatan-Lantanoprost

...

1215.

Geodon

...

1216.

Indocin

administer with food, milk

1217.

Singulair, montelukast

bronchodilator

1218.

anti inflamatory-Nasonex

dont administer in clients with milk


allergy

1219.

Flagyl-no alcohol first 3 days

...

1220.

Viagra-dont give with nitrates

...

1221.

slows osteoporosis-Premarin

...

1222.

avoid foods with tyramine-antibiotic-ZyvoxNeurontin-partial seizure and neuralgia


given for these

...

1223.

-Methadone-monitor respiratory

...

1224.

-adminster sq with evening meal or HS-Levemir; dont mix with other insulins (long
acting insulin); doses must be 12 hrs apart

...

1225.

-antimicrobial-Zocyn-check allergy for penicillin

...

1226.

-for ADHD-available in po form only, taken once daily-Vyvanse-Lisdexamfetamine


dimesylate

...

1227.

Coumadin

anticoagulant, intake of greens important


for vitamin K

1228.

Ariprippazole

avoid grapefruit, alcohol, overheating,


dehydration

1229.

Nemanda/Nemantine

avoid diet in fruits and vegetables

1230.

antibiotic

caution in colitis

1231.

Hydrochloride

administer po-moderate to severe


dementia such as Alzheimer
fresh fruits will cause alkalinity-low
excretion of drug

1232.

Actonel

CI with esophageal disorder


remain uprights for 30 min
take with a full glass of water

1233.

Cardizem

...

1234.

Avodart

BPH drug
females of age that might have kids
should not handle this

1235.

Chantix-

nicotinic blocker

1236.

Paxil

antidepressant
don't take St John Worth
take at night time

1237.

Depression

Anhedonia-maintain ADLs
sleep alteration-bedtime routine
anergia-encourage exercise
worthlessness-monitor safety
poor concentration-clear directions
suicidal ideation-giving away things

1238.

Severe Mania

Anorexia-provide finger foods


Accelerated speech-calm demeanor
Fragmented thoughts-redirect
no impulse control-monitor safety

1239.

SSRI

weight gain
therapeutic effect after 1 week

1240.

Lithium

AE with diuretics
therapeutic effect after 1 week

1241.

MAOI-

therapeutic effect after 1 week

1242.

TCA

therapeutic effect after 1 week


monitor for dysrhythmias

1243.

detoxification of
cocaine

s/s several hrs later-poor concentrations

1244.

hypertention
crisis

hrs after opiods

1245.

alcohol
withdrawal

dont leave them alone


Diaphoresisfluid replacement
hallucinations-decrease stimuli
Wernicke-Korsakoff-Infuse IV Thiamine

1246.

Oxazepam (Serax)

Delirium Tremens
Tachycardia-monitor VS

1247.

stages of Alzeimer

4 only, not 6
stage 2 is moderate-cannot balance checkbook, decline in daily basic hygiene needs,; leave the stove after
cooking; stage 1 (mild)-discuss meaning of client's framed photo: integrity vs dispair stage; you want them to
have personal things around

1248.

Dementia

decrease in cognition-safety is major problem


they need their routine
provide education to the whole team taking care of this pt dont rationalize with them

1249.

Anorexia

we don't focus on their weight, they do


prepare fluid therapy and enteral feeding for them

1250.

Clozapine

...

1251.

mental health
miscellaneous

pt can leave facility if at will


involuntary admission occurs if people are deemed a threat to themselves or others
clients can communicate with their attorney
nurse cannot open postal packages prior to giving to client

1252.

Hcg test-why is
important before
surgery

a positive pregnancy test may require canceling surgery

1253.

Hcg

rises during pregnancy and maintains the pregnancy raises until about 12 weeks of pregnancy, then body
recognizes it and then it drops again

1254.

prenatal examination

report if pt is on a vegetarian diet; usually they are pseudo anemic until 32 weeks, then
the iron should become normal again

1255.

first semester

nausea, vomiting, nutrition

1256.

2nd semester

dyspnea, heartburn

1257.

3rd trimester

make sure she know how to recognize false vs true labor signs

1258.

prenatal care

assess at each exam-VS, weight, fundal height...

1259.

Mag Sufate IV

resp 10-priority

1260.

Chronic HTN

mom had HTN prior to pregnancy


this pt may develop preeclampsia

1261.

Gestational HTN

mom gets HTN after 20th week of gestation


NO protenuria

1262.

STI

higher risk for ectopic pregnancy

1263.

Placenta previa

no vaginal exam
painless, bright red bleeding

1264.

abruption placenta

painful dark red bleeding

1265.

hyperemesis

whatch the weight and electrolytes

1266.

hydatidiform mole

avoid pregnancy until hCG returns to normal


she can pass a grape like structure...
ideally avoid pregnancy for 4 years ?
she is at risk for cancer as well
usually this only happens once

1267.

Cerclage

cervical insufficiency

1268.

ectopic pregnancy

unilateral, stabbing, abdominal pain


ectopic pregnancy is never a livable pregnancy

1269.

danger signs during pregnancy

fever and chills (infection)


decreased or absent fetal movement
sudden weight gain (preeclampsia)
severe HA
ROM prior to 37 weeks gestation
vaginal bleeding

1270.

Isotonic IV fluids

...

1271.

If contractions frequency is 90 secs

stop Pitocin
check FHR
assess pain and fatigue

1272.

severe back pain labor

give back massage


place on all fours (legs and nands)

1273.

If baby has a longitudinal lie, with FHR


above the umbilicus

prepare for US
need to evaluate for breech

1274.

pain

associated with labor

1275.

stage 1 of labor

keep her active


after 3-7 cm-help her breath
assess FHR and UC
comfort

1276.

stage 2 of labor

check FHR q 15 min


assist pushing

1277.

stage 3 stage of labor

placenta delivered
do newborn care

1278.

stage 4 of labor

priority-prevent bleeding

1279.

fetal monitoring
late deceleration

reposition first on L side

1280.

fetal monitoring

VEAL CHOP (what causes it) MINE (what you do about it)-make sure you know where they
are in the process

1281.

Late decels

uteroplacental insufficiency

1282.

Lenght of contractions

maximum length of contraction should be 90 secs


if 90 secs or longer or FHR is lower than 11-stop Pitocin if a mom is on it

1283.

L&D meds
tocolytics-Indomethacin and
Terbutaline

stops labor

1284.

Pitocin

used to augment labor/assist labor

1285.

Beamethasone

2 doses 24 hrs apart


help to mature fetal lungs

1286.

breastfeeding

don't feed if discomfort is present


schedule feeding for breastfeeding q 2-3 hrs
meds might transfer to milk if mom is breastfeeding

1287.

Rhogham administration

monitor labs:
Indirect Coomb's for baby
Direct Coomb's for mom

1288.

PP hemorrhage

priority

1289.

mom breastfeeding on heparin


therapy

breast milk will not be affected, after breast feeding is over she can go back to Coumadin

1290.

Initial Newborn Care

at 1 and 5 min check Apgar


after drying him off put him skin to skin with mom for thermoregulation
evaporation when baby is wet
when baby is dry-heat is loss through..

1291.

baby assessment

reflexes check-premie will not demonstrate all the reflexes

1292.

fetal alcohol syndrome

high pitch cry


hard to console
cognitive disabilities

1293.

tobacco/nicotine

vasoconstricor
decreased O2 for baby-increased SIDS risk, asthma

1294.

hypoglycemia in babies

check glucose w/o an order; it takes some time for the baby to get used with the insulin
production

1295.

phototerapy

cover eye with mask


reposition newborn q 2 hrs
cover scrotum
take them off light only for feeding

1296.

Kernisterus

yellow baby, we only take the baby out of the light for feeding

1297.

Womens Health

...

1298.

cancers

...

1299.

menopause

hot flashes
night sweats
palpitations vaginal atrophy
osteoporosis

1300.

over 35

increased risk of DVT with oral contraception

1301.

all these matter when choosing oral contraception

history of hypertension
severe PMS
hist of DVT

1302.

Diflucan

...

1303.

Rocephin

...

1304.

Flagyl

...

1305.

postmenaupausal- 57 yrs old- (on Climara)monitor BP, yearly mammogram,


take with food, call provider if bleeding occurs

...

1306.

Methergine

CI in HTN and cardiac disease


promotes uterine contractions

1307.

lyrics (Pregabalin)

dont stop abruptly, monitor for edema

1308.

Plavix

Prilosec and Nexium will decrease the effects of


this

1309.

Synthroid

give in the morning


increases HR

1310.

complicated UTI

give antibiotics
CI with sensitivity to cephalosporins-Maxipime

1311.

Gentamicin

antibiotic for bacterial infections


monitor UO and renal function

1312.

Antipshychotic-Risperdal

dont mix oral solution with cola or tea

1313.

Aricept

monitor for bradicardia, dont interupt abrutptly

1314.

Lidocaine

not effective against SVT, given IV

1315.

Bystolic

don't stop abrupt, weight daily, can impair


thinking and reaction time

1316.

Oxycontin

highly abused-should not be taken within 2


weeks of administration of an MAOI

1317.

Dilaudid

causes spasms of sphincter of odi

1318.

Levaquin

can alter glucose level in diabetic client

1319.

Vancomycin

antibiotic for MRSA


risk for Red man syndrome

1320.

Digoxin

assess AP for one min


hypokalemia can lead to toxicity

1321.

Inderal

check BP and pulse before administration

1322.

PPI-Nexium (GERD)

don't crush or chew

1323.

Effexor

can increase ptinr, don't discontinue abruptly

1324.

Lithium

mantain Na levels normal

1325.

Lovenox

hold if platelets are less than 100,000


administer sq

1326.

Pradaxa

avoid use with drugs that prolong bleeding


keep dry and in a dark bottle

1327.

Varivax vaccine

prevents chicken pox

1328.

Lasix

Diuretic
monitor HR, BP
monitor weight

1329.

Amiodarone

first line drug for...

1330.

Dilantin

therapeutic level 10-20

1331.

Novolog

...

1332.

Advair
(Fluticasone)

long term for asthma

1333.

Concerta

contra with MAOI

1334.

Simvastatin and
Zetia-Vytorin

its a combination drug

1335.

Gardasil

prevents HPV
administered to both male and female-

1336.

Nitro

onset 1-3 min


sublingual

1337.

regular Insulin

the only one administered IV

1338.

Haldol

monitor for EPS


causes dry mouth

1339.

Ambien

rapid onset
given for short term insomnia

1340.

PEDS-know

infants and children-common causes of death


incorrect car seat placement or not being in the seat

1341.

Ritalin

side effects-Tics, nervousness, increased BP; can cause insomnia, don't give in the evening

1342.

pt that is on
radiation

no lotion on the side, no scrubbing, just warm water

1343.

know
back/spine
safety for nurse

upper bod mechanics, position client in the correct way

1344.

1hr oral glucose


tolerance test

positive results 145mg/dl, report to provider, adv. pt to avoid caffeine the morning of test because it can increase
glucose levels

1345.

Abstract
Thinking

Asking questions about similarities between objects or to explain a common proverb or saying

1346.

Acarbose

oral antidiabetic agent that postpones the absorption of glucose

1347.

Acute hemolytic
reaction

low back pain due to passage of hemolyzed blood cell through kidneys, increased respirations, tachycardia

1348.

Administer
regular and NPH
insulin steps

swab top of both insulin bottles with alcohol wipe, insert air into NPH insulin equal to dose, remove and insert air
in regular insulin equal to dose, then withdraw dose from regular insulin and administer then withdraw correct
dose from NPH insulin and admin subcutaneously

1349.

Advance
directives

allow client to make decisions and provide written instructions regarding end of life care

1350.

Agoraphobia

behavioral therapy technique pt teaching includes modeling, systematic desensitization, flooding...

1351.

Air travel

2nd trimester, airplane cabin humidity is low (approx.. 8%), which can result in water loss, teach pt to maintain
increased hydration with water to compensate for loss

1352.

Akathisia

responds to anti-parkinsonian medication

1353.

Albuterol
(Proventil)

activates beta2-adrenergic receptors in the heart, increase in heart rate is a side effect

1354.

Alcohol
anonymous (AA)

helps support abstinence and sobriety

1355.

Alcoholism

causes CNS depression, drowsiness, slurred speech, and impaired coordination, s/s withdrawal elevated BP/HTN

1356.

Alendronate
(Fosamax)

admin on empty stomach with 8oz water, may cause esophageal ulcerations if lodged in esophagus, remain
upright for 30min after admin

1357.

Altruism

helping meet the needs of others who have experienced similar loss

1358.

Amitriptyline (Elavil)

tricyclic antidepressant must be taken within 3hr of missed dose if not wait til next dose,

1359.

Amniocentesis

evaluate fetal lung maturity

1360.

Amphetamine
intoxication

stimulant use, adv. Effect; paranoia

1361.

Amphotericin B

adverse reaction is ototoxicity (vertigo, tinnitus, hearing loss)

1362.

Ampicillin (Principen)

signs of allergic reaction hypotension, pruritus, flushing, wheezing

1363.

Anabolic steroids

in adolescence can lead to premature epiphyseal closure thus reducing height potential

1364.

Anaphylaxis
Behavioral signs

apprehension, uneasiness, restlessness and anxiety

1365.

Anti-Hypertensives
meds

contraindications caffeine

1366.

Antisocial personality
disorder

impulse control, reminding client about expectations and providing clear boundaries and consequences of
action will help promote client adherence

1367.

Atorvastatin (Lipitor)
and fenofibrate
(TriCor)

treats hypercholesterolemia, both meds may cause myopathy, pt has increased risk for myopathy than if
either taken alone

1368.

Aversion therapy

uses punishment techniques to reduce inappropriate behaviors (alcoholism, aggression)

1369.

Avolition

lack of motivation

1370.

Baclofen (Lioresal)

antispasmodic, decreased muscle spasticity in client w/ MS, can cause urinary retention, drowsiness in early
phase of therapy, hypotension

1371.

Benzodiazepine
(Lorazepam)

withdrawal causes tremors and dizziness making ADL's difficult to perform

1372.

Bethanechol

muscarinic agonist that increases GI motility leading to abdominal cramps and diarrhea

1373.

Bi-Polar Disorder

increased energy and pressured speech, manic phase is treated with electroconvulsive therapy (ECT) if a
course of medication is ineffective

1374.

Bladder distention

pushes uterus out of pelvis, can palpate fundus above umbilicus and to the right of midline,

1375.

Borderline
personality disorder

development of manipulative behaviors that make establishing a meaningful relationship difficult

1376.

Boundary violation

when nurse engage in social relationship with client

1377.

Breastfeeding

baby should have at least 2 stools/day, may eat 8-12 times/ day, milk can be stored in freezer for up to
6mths, should have at least 6wet diapers per day, pt teaching; wake baby Q4hr at night for first 24-48 hr
after birth

1378.

Bronchoscopy

post op; check for gag reflex,

1379.

Bulimia Nervosa

s/s tooth erosion, hand calluses, parotid swelling

1380.

Buprenorphrine

prevents withdrawal associated with opiate use, taking during pregnancy can improve maternal and
neonatal outcomes

1381.

Bupropion

for nicotine use disorder

1382.

Caffeine (pregnancy)

consuming more than 200mg of caffeine/day increases risk of miscarriage and intrauterine growth
restriction

1383.

Calcium carbonate
(Tums)

...

1384.

Captopril
(Capoten)

treat HTN, greatest risk to pt is infection r/t neutropenia therefore unexplained fever, sore throat, and fatigue
can indicate and infection and provider should be notified, avoid ibuprofen or any other nonsteroidal antiinflammatory medication as it can reduce anti-hypertensive effects of medication

1385.

Carboprost

adv. effect fever

1386.

CD4 T-cell count

indicates the status of the pts immune system, a rise indicates return of immune function for HIV pt

1387.

CD4-T cell count

indicates the status of clients immune system, rise in cd4 counts indicates return of immune function of client w/
HIV

1388.

Cefotetan
(Cefotan)

a cephalosporin, group of antibiotics hat are similar to penicillins (PCN), should be avoided in pt who is allergic to
PCN

1389.

Celecoxib
Celebrex

cyclo-oxygenase (COX-2) inhibitors act by suppressing inflammation and relieving pain, will allow pt to move
more easily, increases risk of MI because of increased vasoconstriction and unimpeded platelet aggregation

1390.

Cervical
laceration

is a slow, oozing trickle of blood, during which fundus can remain firm

1391.

Chest tube
drainage device

may ambulate, keep collection device below the level of the pt chest to ensure drainage, only clamp device when
checking for air leaks or changing drainage system

1392.

Chlordiazepoxide
(Librium)

admin for alcohol use disorder, avoid getting pregnant, teratogenic to developing fetus

1393.

Chlorpromazine
(Thorazine)

increases skins sensitivity to UV light pt should apply sunblock to counteract adverse effect

1394.

Chlorpromazine
(Thorazine)

orthostatic hypotension risk for falls, treats schizophrenia

1395.

Chorionic villus
sampling

involves removal of small amount of tissure from the fetal section of the placenta to detect genetic conditions

1396.

Cimetidine
(Tagamet)

should be taken 1hr before or 2hr after antacid

1397.

Ciprofloxacin
(Cipro)

pt should avoid products with cations such as antacids, iron salts, milk and other dairy products because they
reduce the absorption of ciprofloxacin, in allergic reaction check for wheezing, admin diphenhydramine
(Benadryl), possibly prep for IV catheter insertion, collect VS to determine pt status

1398.

Clang association

use of rhyming words

1399.

Clozapine
(Clozaril)

can cause agranulocytosis, pt should have WBC evaluation

1400.

Cocaine
intoxication

tachycardia, elevated BP, dilated pupils, display grandiosity and euphoria

1401.

Cocaine

CNS stimulant, may cause vomiting, dilated pupils and tachycardia

1402.

Coughing

support incision with interlocked hands, pillow, towel or blanket to prevent excess stress on the incision when
coughing

1403.

C-section

ambulate several times/day to increase circulation in lower extremities and prevent thrombophlebitis

1404.

Cystic Fibrosis

can have constipation should eat diet high in fiber, high calorie diet due to decreased intestinal absorption and
increased work of breathing

1405.

Deep Vein
Thrombosis (DVT)

bed rest with affected limb elevated to reduce swelling, fit with elastic stockings, to prevent venous congestion
once pt can ambulate

1406.

Delusions

belief that one's thoughts can be heard by someone else, common w/schizophrenia

1407.

Dementia

memory impairment and loss of speech

1408.

Depression

lethargy and slowed speech

1409.

Digoxin and
chlorothiazide

increase pt risk of developing digoxin toxicity due to chance of developing hypokalemia

1410.

Digoxin toxicity

nausea, vomiting, anorexia, and fatigue

1411.

Dimenhydrinate
(Dramamine)

an antihistamine, has anticholinergic properties, anticholinergic meds can cause urinary retention thus
compounding urinary tract symptoms associated with prostatic hypertrophy, is contraindicated in pt with
benign prostatic hypertrophy (BPH)

1412.

Displacement

defense mechanism, emotionally transferring anger for one person to innocent victim

1413.

Disulfiram

for alcohol use disorder

1414.

Doxycycline
(Vibramycin)

should be taken with a full glass of water to ensure it passes into the stomach which will prevent esophageal
ulcerations

1415.

Electroconvulsive
therapy (ECT)

pt awake 15min after ECT, likely to be confused and disoriented, reorient frequently

1416.

Eplerenone

treat HTN, adverse effects; diarrhea, decreased sodium levels, vaginal bleeding, increased potassium levels
cause of potassium retention effect

1417.

Erythromycin

apply medication starting from inner canthus to outer canthus, instill 1cm ribbon of medication in lower
conjunctiva to ensure proper delivery of medication, admin medication prophylactically to protect newborn
from ophthalmia neonatorum

1418.

Exenatide

treat DM, monitor for abd pain pt at risk for pancreatitis

1419.

Expected
anticipatory
grieving

statements indicating shock and disbelief, needing to get away from situation, anger against dying person or
caregivers,

1420.

Eyedrop
instillation

advise pt to look up during admin to protect cornea and decrease change of blinking, clean eyes starting from
inner canthus moving outward,

1421.

Felodipine
(Plendil)

grapefruit juice can inhibit metabolism raising level of medication in blood increasing risk of toxicity

1422.

Ferrous sulfate

treat iron deficiency anemia, improvement in hemoglobin levels increases oxygen transport to the tissues and
increases activity tolerance

1423.

Fine crackles

continuous, musical sounds which are caused by narrowing of airways

1424.

Fluoxetine
(Prozac)

monitor sleeping patterns, insomnia common side effect,

1425.

Fluoxetine

contraindicated with sumatriptan put pt at risk for serotonin syndrome causing tremors, confusion,
hallucinations

1426.

Fluphenazine
(Prolixin)

avoid sun exposure causes photosensitivity

1427.

Fundal Height

in pregnancy should be approximately the same as the number of weeks gestation plus or minus 2cm

1428.

Furosemide
(Lasix)

loop diuretic, can lead to hypokalemia, can cause BP to drop, medication should be withheld if BP 85/60,

1429.

Gemfibrozil
(Lopid)

myopathy is an adverse effect, report muscle weakness or tenderness

1430.

Gentamicin
(Garamycin)

is nephrotoxic, monitor BUN and serum creatinine levels

1431.

Ginkgo Biloba

herbal supplement to treat a variety of conditions (dementia, vascular disease), may interfere with platelet
production and increase the risk of bleeding in clients on anticoagulation therapy (warfarin/antiplatelet
medications)

1432.

Glipizide

oral antidiabetic agent that stimulates insulin secretion

1433.

Gonorrhea

STI, can lead to pelvic inflammatory disease and tubal scarring which can result in infertility

1434.

Grief

community bereavement group may help cope with feelings of grief

1435.

Haloperidol
(Haldol)

typical antipsychotic that decreases symptoms of psychosis and anxiety, adverse reactions tremors, shuffling
gait, drooling pseudoparkinsonism

1436.

Heel stick in
newborn

1st warm newborns heel

1437.

Heroin

causes CNS depression, drowsiness and slurred speech, pupillary constriction, effective treatment strategy is
participation in a methadone maintenance program

1438.

Histrionic
personality disorder

impulsive behavior, inappropriate sexual behavior

1439.

Human
papillomavirus
vaccine (HPV2)

3 doses of immunization over 6mths,

1440.

Hydrochlorothiazide
(Hydrodiuril)

can cause hypokalemia from excessive potassium excretion, other adverse effects are hyperchloremia,
hypernatremia, hypercalcemia.

1441.

Hyperemesis
gravidarum

S/S persistent vomiting and ketonuria

1442.

Hypoglycemia
(newborn)

hypothermia, twitching, tachypnea (respiratory distress)

1443.

Inhalants
intoxication

s/s incoordination, nystagmus, blurred vision

1444.

Ipratropium
(Atrovent)

an anticholinergic, contraindicated in pt who is allergic to peanuts or soybeans because medication may


contain peanut oil and soy lecithin

1445.

Iron (foods)

beef liver, lentils, oysters

1446.

Isoniazid (INH)

can cause liver damage, important for nurse to determing the clients daily alcohol intake because alcohol use
increase risk, pt should reduce or avoid all use of alcohol

1447.

Isotretinoin

pt teaching will need to have triglyceride levels monitored, may cause nosebleeds, due to nature of severe
birth defects pt will need 2 negative pregnancy test prior to starting medication

1448.

IV Meds

medication that are water soluble can only be administered intravenously

1449.

Jaundice

should be reported within first 24hrs of life, physiologic jaundice can lead to severe cognitive disorders

1450.

Ketorolac (Toradol)

is nephrotoxic and can cause renal impairment, monitor serum creatinine level

1451.

Kosher dietary laws

avoid eating meat and dairy product together

1452.

Lactation
suppression

frequent application of cold cabbage leaves to breast can prevent engorgement

1453.

Levodopa/carbidopa
(Sinemet)

dopaminergic medication, works by activating dopamine receptors, restoring nerve transmission in the basal
ganglia for pt with Parkinsons disease, allows client to move freely and resume ADL's

1454.

Lisinopril (Zestril)

ACE inhibitor, can result in buildup in bradykinin, resulting in nonproductive cough, pt should withhold
medication and follup with provider for further evaluation, contraindicated w/ ibuprofen can decrease
antihypertensive effect

1455.

Lithium Carbonate
(Eskalith)

monitor lithium levels if dosage is changed

1456.

Lower extremity
amputee

anchor residual limb dressing at the nearest joint proximal to the amputation, cleanse residual limb with mild
soap and carefully rinse and dry, maintain compression dressing following amputation in order to promote
proper fit of prosthesis and reduce edema, wrap 3x day and prn

1457.

Lumbar
laminectomy

pt teaching; involves removing a portion of vertebra to expose spinal cord which produces a sense of
instability in spine, avoid twisting and bending, sit in straight back chair, sleep on firm mattress

1458.

Magnesium sulfate

depresses neuromuscular activity, leading to muscle weakness and paralysis

1459.

Magnesium toxicity

bradycardia, hyporeflexia, oliguria (urine output 30ml or less), respirations less than 12/min, increased BUN
indicating renal impairment which can decrease excretion and cause magnesium to accumulate to toxic levels

1460.

Major Depression

monitor elevated mood, may be indication the pt plan to commit suicide

1461.

Maladaptive grieving

statements indicating shame and guilt, feelings of being overwhelmed

1462.

Manic behavior

unable to focus on a solitary activity w/o direction from another person, impacts other clients
negatively,

1463.

MAOI

contraindications aged cheese

1464.

Marijuana

a hallucinogen, has depressant properties, euphoria, relaxation and paranoia

1465.

Maslow's Hierarchy

Physiological (hunger, thirst, bodily comforts, etc.), Safety/security (out of danger), Belongingness and
Love (affiliate with others, be accepted, loved), Esteem (to achieve, be competent, gain approval and
recognition), Self-Actualization (morality, creativity, problem solving)

1466.

Mastitis

pump affected breast frequently

1467.

Meconium

develops in utero, first stool passed by newborn w/I first 24 hr, dark green and viscous, contains
components of amniotic fluid, cells, intestinal secretions, occult blood

1468.

Medroxyprogesterone

adv effect; loss of bone mineral density advise pt to increase calcium intake while on medication

1469.

Mesalamine (Asacol)

maintenance therapy for inflammatory bowel disease and pt should take daily for at least 3-6 weeks

1470.

Metformin (Glucophage)

oral antidiabetic agent, used to treat DM II by decreasing glucose production in the liver, facilitates
decreased glucose production; monitor for adverse effects muscle pain, agitation, GI manifestation
such as bitter or metallic taste

1471.

Methamphetamine

expect high fever with overdose of CNS stimulant

1472.

Methotrexates
(Rheumatrex)

pt should avoid alcohol due to risk for hepatic fibrosis and liver toxicity

1473.

Metoprolol (Lopressor)

slows the conduction through AV node therefore is contraindicated in pt who have AV block that is
greater than first degree, caution in pt with diabetes mellitus because it can mask the manifestations
of hypoglycemia

1474.

Milieu therapy

creates therapeutic community in which client has opportunities for learning and healing, inpatient
therapy

1475.

Nasogastric tube (NG)

place pt in high fowlers position, determine which naris has greatest airflow, measure appropriate
tube length, lubricate 3-4inches of end of tube, instruct client to hyperextend neck

1476.

Negligence

failing to respond to escalating behavior and prevent harm from others

1477.

Neologisms

words made up by the client

1478.

Nephrotic syndrome

with peripheral edema, low sodium diet to assist with diuresis of extracellular fluid

1479.

Nifedipine

causes vasodilation, resulting in decreased BP, can increase orthostatic hypotension and dizziness,
change position slowly

1480.

Nitrates

cause relaxation of vascular smooth muscle, resulting in pooling of blood in veins and decreased
venous return to heart, decreases cardiac output which causes blood pressure to fall and orthostatic
hypotension to occur with change in position

1481.

Nitroglycerin (Nitrostat)

sublingual tablets, treat angina, can take up to 3doses 5min apart if chest pain persist

1482.

Nitroglycerin (TransdermNitro)

advise pt to place patch on different site for each application to prevent skin irritation, medication may
cause orthostatic hypotension/dizziness should change position slowly to avoid injury

1483.

NonMaleficence

ethical concept of avoiding harm

1484.

Nonstress test (NST)

admin orange juice to increase the clients blood sugar and stimulate fetal movement, 2 FHR
acceleration of 15/min over 20min period lasting at leatst 15 seconds indicate reactive non-stress test

1485.

Ondansetron (Zofran)

side effects headache and dizziness, pt should avoid driving or using heavy machinery

1486.

Operant conditioning

type of behavior modification that use positive reinforcement to promote a desired behavior

1487.

Oral contraceptives

contraindicated in pt who experience frequent headaches w/vision changes (can indicate


cardiovascular condition) because combination can increase risk of CVA, MI, and thromboembolism

1488.

Orientation/preorientation
relationship

plan for interactions with the pt

1489.

Oxycodone
(OxyContin)

opioid analgesic, pain reliever, can cause CNS depression, contraindicated with diphenhydramine (Benadryl)
put pt at risk for sedation, respiratory depression and injury

1490.

Paranoid
schizophrenia

dominant symptoms hallucinations and delusions

1491.

Phenylephrine
(NeoSynephrine)

may cause tachycardia and other cardiac arrhythmias

1492.

Phenytoin
(Dilantin)

stimulates synthesis of hepatic drug metabolizing enzymes, can decrease effects of warfarin, providers (titration
of medication) base dosage on therapeutic blood levels

1493.

Phytonadione

is administer via IM to newborn,

1494.

Pioglitazone
(Actos)

oral antidiabetic agent, works by increasing the body's sensitivity to insulin, 8-12wks to experience full
therapeutic effects of medication

1495.

Pleural rub
sounds

loud grating sound caused by pleurisy

1496.

Postpartum
diuresis

should begin 12hr after delivery, expected urine output of 3000ml/24hr

1497.

Prednisone
(glucocorticoids)

suppress the body's immune response increasing risk of infections, pt should notify provider if they experience
the following symptoms sore throat, black tarry stools (indicates GI bleed) due to the increased risk GI ulcers,
white patches on tongue (increased risk for candida infections due to immunosuppression), hyperglycemia,
weight gain

1498.

Propranolol
(Inderal)

beta blocker, bradycardia is a common adverse effect, advice pt to withhold med if pulse rate less than 60bpm,
can suppress tachycardia a warning sign of hypoglycemia in pt with DM, advise to rely on other signs

1499.

Propylthiouracil
(Propyl-Thyracil)

desired effect HR WNL, reduction in serum T4 level, improved sleep patterns, increased attention span

1500.

PTSD

experience disrupted sleep

1501.

Quetiapine

pt at risk for abnormal glucose metabolism which may result in DM, serum glucose testing regularly

1502.

Reflection

communication technique that lets the client know that their concerns and feeling are heard and understood

1503.

Regular Insulin

clear in appearance, discard if appear cloudy

1504.

Religiosity

obsession with religious ideas and actions

1505.

Repaglinide
(Prandin)

HbA1c lab test should be review to obtain information about long term therapeutic, measures blood glucose
levels over past 2-3mths; glycosylated HbA1c

1506.

Repression

pt excludes unwanted ideas from conscious awareness

1507.

Respiratory
distress
(newborn)

S/S; nasal flaring, tachypnea, substernal retractions, grunting

1508.

Retention of
placental
fragments:

...

1509.

Rho(D)
immunoglobin

given to Rh neg. mother who has Rh pos. newborn to prevent mother from developing antigens against the Rh
factor

1510.

Risperidone

treat schizophrenia, atypical antipsychotic help to improve/minimize pt w/schizophrenia with difficulty interacting
with others/maintaining relationships, put client at risk for developing diabetes due to metabolic effects of
medication, obtain fasting glucose baseline prior to administration of first dose, and again, 12wks later, then
annually

1511.

Schizophrenia

multiple pos & neg symptoms, flat affect & tangential speech, delusions (delusions of grandeur), appears
stuporous, little to no movement at all, pt/family teaching; manage client stress to help control symptoms of illness

1512.

Schizotypal
personality
disorder

suspicious attitude

1513.

Scopolamine
patch

treat motion sickness, should be placed behind the ear

1514.

Signs of Allergic
reaction

hypotension, pruritus, flushing, wheezing

1515.

Simvastatin

notify provider if muscle pain or tenderness develops could indicate rhabdomyolysis

1516.

Social worker

help client build a support structure to help promote and preserve mental health, including arrangements for
employers, day treatments, financial and other community resources

1517.

Spironolactone
(aldactone)

potassium sparing diuretic, salt substitutes are high in potassium can place pt at risk for hyperkalemia

1518.

Sumatriptan

contraindicated with use of fluoxetine can lead to excessive stimulation of serotonin receptor putting pt at risk for
serotonin syndrome s/s tremor, confusion, hallucinations

1519.

Systematic
desensitization

form of behavior modification that employs relaxation techniques in response to specific phobias

1520.

Tardive
dyskinesia

lip smacking, tongue rolling, spastic facial expressions

1521.

Tetanus

booster recommended every 10yrs or sooner if injury occurs from a potentially contaminated object

1522.

Tetracycline
hydrochloride
(Sumycin)

causes photosensitivity and increased severity of sunburn

1523.

Therapeutic
lithium level

1.2 meq/L serum lithium level

1524.

Therapeutic
relationship:

...

1525.

Timolol
eyedrops

treat glaucoma, press the nasolacrimal duct to prevent the medication from absorbing into systemic circulation

1526.

Tolbutamide
(Orinase)

treat DM, contraindicated in pt with hypersensitivity to sulfonamide antibiotics that might also be allergic to
sulfonylureas

1527.

Tonsillectomy

pt/child can chew gum to prevent throat and ear pain post-op

1528.

Topical
decongestants

rebound congestion can occur with prolonged use congestion can become progressively severe

1529.

Tracheostomy
child care

allow child to rest for 30-60 seconds after each aspiration to allow oxygen saturation to return to expected levels,
suction as needed when there is indication of excessive secretion in airway, suction for no more than 5 sec w/each
pass, hyperventilate w/100% oxygen before and after suctioning

1530.

Triamterene
(Dyrenium)

inhibits exchange of (Na) and (K) in the distal nephron retaining (K) and excreting (Na) leading to hyperkalemia

1531.

Triple marker
screening

done at 16-18wks gestation, identify chromosomal abnormalities

1532.

Uterine
bleeding

relaxed, distended uterus with presence of blood and clots,

1533.

Vancomycin
(Vancocin)

adverse reaction ototoxicity

1534.

Varicella
(chickenpox
vaccine)

hypersensitivity to neomycin is contraindicated for receiving vaccine

1535.

Veracity

duty to tell the truth

1536.

Vesicular sounds

soft, rustling sounds that occur as normal breath sounds

1537.

Vitamin K

needs to be admin at least 2hr after birth to prevent risk for hemorrhagic disease

1538.

Wheezes

continuous, musical sounds which are caused by narrowing of the airways