When does the posterior fontanel close?

Within the first 3 months

What age range is Trust vs Mistrust?

0-12 months

When do infants teeth emerge?

Within the first 6 months

At 6 months of age what can the nurse expect the infants weight to be relative to its birth
weight?
Double

At what age can a nurse expect the infants weight to be triple that of its birth weight?
1 year

At what age does an infant begin to fear separation from its mother?
6-9 months

At what age does the anterior fontanelle close?

18 months

When does an infant begin to start using words?

9-12 months

What age range is Autonomy vs Shame and doubt?

1-3 years

A child demonstrating parallel play is assumed to be in what age range?

1-3 years

When does a childs teeth completely emerge?

3-6 years

What age range is Initiative vs Guilt?

3-6 years (preschool)

When does a childs conscience develop?

3-6 years (preschool)

At what age does a child learn to tie his/her shoes?

6 years

At what age range does a child begin to lose its baby teeth?
6-12 years (school age)

At what age does a child begin to discard parental standards

6-12 years (school age)

What age range is Industry vs Inferiority?

6-12 years (school age)

When does a child begin to develop a rational sense of self?

12-18 years (Adolescent)

What age range is Identity vs Inferiority (Role Confusion)?

12-18 (Adolescent)

What age range is Intimacy vs Isolation?

18-35 (young adult)

At what age range is Generativity vs Stagnation?

36-65 (Middle age)

At what age range is Ego Integrity vs Despair?

65 (Older adult)

Performing an act that a reasonable and prudent person would not perform under similar
conditions is defined as
Negligence

In order to be guilty of malpractice the following 4 things must be present:

Duty (obligation to maintain a nursing standard)
Breach of duty (failure to maintain standard)
Injury
Proximate cause (connection between the breach of duty and the injury)

Mental or physical threat to touch or harm without permission

Assault

Touching or harming without permission, with or without the intent to cause harm.
Battery

Detaining a competent person against his or her will, confinement, or use of restraints
without clients consent
False imprisonment

Exposure or discussion of the clients case (even after death)

Exposure of a person

Written statement that may cause harm to a persons reputation

Libel

Verbal statement that may cause harm to a persons reputation

Slander

Before the administration of medication or taking of blood the following must be performed
every time
Identity must be verified through 2 different sources

In order for verbal consent to be valid what must be documented?

Full detail how and why the verbal consent was obtained in addition to 2 witnesses who are
not directly related to the treatment or procedure

Most states limit involuntary commitment to an institution to what time period?

90 days

A person declared legally incompetent loses which freedoms?

Freedom to vote, drive, make contracts, sue or be sued, or hold a professional license

If a nurse believes a physicians prescription is wrong the nurse should

Notify physician and nursing supervisor, document it, and refuse to carry out the perscription

If the nurse believes that a physicians prescription was made with poor judgment the nurse
should
Question the order with the physician, document it, and carry out the prescription regardless.

If the nurse is asked to perform a task for which he/she has not been prepared educationally
or does not have the necessary experience the nurse should

Inform the physician, refuse the order, and arrange to have supervisor or other nurse perform
it.

When can a nurse reduce a medication dose without a physicians prescription?

Never

Clients may be restrained only under which circumstances?

In an emergency
For a limited time
For the limited purpose fo client safety or safety of others

A restraint order must be renewed within

24 hours

A nurse checks frequently on a restraint patient observing for

proper circulation and pressure sores/injuries

HIPAA stands for

Health Insurance Portability and Accountability Act of 1996

What tasks can an LPN delegate to others?

Tasks that do not require nursing judgment (Assessment, Diagnosis, Planning, Evaluation)

The 4 aspects of nursing judgment are

Assessment
Diagnosis
Planning
Evaluation

What are the 4 colors used in the triage system, in order from most urgent to least?
Red -> Yellow -> Green -> Black

How is Anthrax spread?

Inhalation of spores or powder and eating undercooked meat of infected animals.
CANNOT be spread from person to person

What is the Anthrax incubation period?

Within 7 days (inhalation can take up to 42 days)

What are the S/S of Anthrax?

Cutaneous: Sores that develop into painless blisters, then ulcers with black centers.
GI: severe stomach pain, bloody diarrhea, anorexia
Inhalation: Cold and flue symptoms, muscle aches, chest discomfort, S.O.B.

What is the Tx for Anthrax?

60 day course of antibiotics

How is Pneumonic plague transmitted?

Spread by bacteria found in rodents and their fleas. Can also be transmitted via aerosol release
or respiratory droplets from infected person

What is the incubation period for Pneumonic plague?

1-6 days

What are the S/S for Pneumonic Plague?

Rapidly developing pneumonia, bloody or watery sputum, and abdominal pain. Without early
Tx: shock, respiratory failure and death

What is the Tx for Pneumonic Plague?

Antibiotics for 7 days

How is Botulism transmitted?

Eating toxic food or contact of an open wound with C. botulinum.
Cannot be spread person to person

What is the incubation period for Botulism?

A few hours to a few days. Foodborne can take up to 2 weeks.

What are the S/S of Botulism?

Diplopia, slurred speech, descending muscle weakness, dysphasia.

What is the Tx for Botulism?

Antitoxins to reduce severity. May require mechanical ventilation.

How is Smallpox transmitted?

Contact with infected person, Aerosol release, body fluids, contaminated objects.

What is the incubation period for Smallpox?

1-2 weeks

What are the S/S of Smallpox?

High fever, head and body aches, rash that progresses to raised bumps and pus-filled blisters
that crust and scab.

What is the Tx for Smallpox?

None

How is Inhalation Tularemia transmitted?

Insect bites (usually tick/deerfly), handling sick animals, contaminated food/water.
Cannot be spread person to person

What is the Incubation period for Inhalation Tularemia?

3-5 days but can take 2 weeks

What are the S/S for Inhalation Tularemia?

Skin ulcers, swollen/painful lymph gland, mouth sores, pneumonia.

What is the Tx for Inhalation Tularemia?

Antibiotics for 2 weeks

How is Viral Hemorrhagic Fever transmitted?

Rodents/animal hosts as well as body fluids.

What is the incubation period for Viral Hemorrhagic Fever?

2-21 days

What are the S/S of Viral Hemorrhagic Fever?

Exhaustion, fever, muscle aches, bleeding under skin and body orifices (mouth,eyes, ears),
shock, CNS malfunction, seizures, coma, renal failure.

What is the Tx for Viral Hemorrhagic Fever?

No cure. Supportive therapy only.

How is radiation transmitted?

x-rays, nuclear bombs/disasters, the sun. Small quantities in air, water, and food cause
internal exposure.

What are the S/S of radiation exposure?

ARS (Acute radiation syndrome): N/V/Diarrhea, bone marrow depletion, weight loss, loss of
appetite, infection, bleeding.
May lead to cancer

What does ARDS stand for?

Acute Respiratory Distress Syndrome

What is ARDS?
unexpected, catastrophic pulmonary complication occurring in a person with no previous
pulmonary problems. High mortality rate (50%). You will see Hypoxemia and Hypercapnia.

What is hypercapnia?
Elevated CO2 levels in the body.

What is shock?
Widespread, serious reduction of tissue perfusion

What are the early signs of shock?

Agitation and restlessness resulting from cerebral hypoxia

What is cardiogenic shock?

Related to ischemia from MI, serious arrythmia, or CHF. If cardiogenic shock exists with the
presence of pulmonary edema then position the client to REDUCE venous return (High
fowlers w/legs down) to decrease venous return further to the left ventricle.

What is the Tx for shock?

Rapid infusion of volume-expanding fluids and then Tx of underlying condition. Drugs are
usually withheld until circulating volume normalizes.

What are the S/S of Acute Hemolytic Reaction?

Fever, low back pain, chills, tachcardia, hypotension progressing to acute renal failure, shock
and cardiac arrest

What is the intervention if a patient on transfusion therapy presents with Acute Hemolytic
Reaction?
Stop the transfusion, change tubing and continue saline IV. Treat for shock if present. Monitor
hourly urine output.

What are the S/S of Febrile nonhemolytic reaction?

Sudden chills and fever, headache, anxiety and muscle pain

What is the treatment for Febrile nonhemolytic reaction?

Antipyretics

What are the S/S of mild allergic reaction to transfusion therapy?

Flushing, itching, urticaria (hives)

What is urticaria?
Hives

What is the treatment for mild allergic reaction to transfusion therapy?

Antihistamines

What are the S/S of Anaphylactic reaction to transfusion therapy?

Anxiety, urticaria, wheezing, progressive cyanosis leading to shock and possible cardiac arrest.

What is the intervention for a patient who suffers an Anaphylactic reaction to transfusion
therapy?
Initiate CPR

What are the S/S of Circulatory overload reaction to transfusion therapy?

Cough, dyspnea, pulmonary congestion, headache, hypertension

What is the intervention for a patient who suffers circulatory overload reaction from
transfusion therapy?
Place the client in upright position with feet in dependent positions and administer diuretics,
oxygen, and morphine

What are the S/S of sepsis related to transfusion therapy?

Rapid onset of chills, high fever, vomiting, marked hypotension, and shock

What is the intervention for sepsis related to transfusion therapy?

Ensure a patent airway, obtain blood culture, administer prescribed antibiotics and monitor
vitals.

What does DIC stand for?

Disseminated Intravascular Coagulation

What is Disseminated Intravascular Coagulation?

A coagulation disorder with paradoxical thombosis and hemorrhage.

What are the S/S of Disseminated Intravascular Coagulation?

Petechiae, purpura, hematoma's
Bloody oozing from two or more unexpected sites
Hemoptysis
Hpotension, tachycardia, and mental status changes

What are the nursing interventions for a patient with Disseminated Intravascular
Coagulation?
Provide gentle oral care with mouth swabs, turn frequently to eliminate pressure points,
minimize number of BP's taken by cuff, minimize needle sticks and use smallest gauge needle
possible.

What causes septic shock?

Release of endotoxins from bacteria that act on nerves in vascular space in periphery, causing
vascular pooling, reduced venous return, decreased CO, and poor systemic perfusion.

It is important to differentiate between hypovolemic and cardiogenic shock. How might the
nurse determine the existence of cardiogenic shock?
History of MI with left ventricular failure or possible cardiomyopathy, with symptoms of
pulmonary edema

If a client is in cardiogenic shock, what might result from administration of volume

expanding fluids?
Pulmonary edema

List 5 assessment findings found in most shock victims

Tachycardia
Tachypnia
Hypotension
Cool clammy skin
Decrease in urinary output

What is the normal central venous pressure for an adult?

4-10 cm of H20

What is the established minimum renal output per hour?

30 ml/hr

List four measurable criteria that are the major expected outcomes of a shock crisis

BP mean of 80-90 mmHg

PO2 more than 50 mmHg
CVP above 6 cm of H2O
Urine output at least 30 mL/hr

What drug is used in the treatment of DIC?

Heparin

What causes Cardiopulmonary arrest?

Miocardial Infarction

What are the S/S of a patient immediately preceding an MI?

Chest pain at rest or with moderate activity
Described as crushing, pressing or heavy pain (elephant sitting on chest)
Tends to increase in intensity over a few minutes
May be substernal or more diffused - radiating to shoulder, neck/jaw, or back.

What are the steps to preforming CPR?

Position person in supine position, shake and call out "Are you okay?"
If no response call 911
Establish airway be extending neck with the head/tilt, chin/lift, clear airway of foreign body if
visible
Look, listen, and feel for breathing
If no breathing ventilate 2 breaths, assess circulation and if no pulse begin compressions

What causes hyponatremia?

Diuretics
GI fluid loss
D5W or hypotonic IV fluids
Diaphoresis

What are the S/S of hyponatremia?

Anorexia, N/V, weakness, lethargy, confusion, seizures.

What is the Tx for Hyponatremia?

Restrict fluids

What causes hypernatremia?

Water deprivation, renal failure, cushings syndrome, diabetes insipidus

What are the S/S of hypernatremia?

Thirst, hyperpyrexia, dry mouth, irritability, seizures.

What is the Tx for hypernatremia?

restrict sodium in diet and increase water intake

What causes hypokalemia?

Diuretics, hyperaldosteronism, bulimia, cushing syndrom

What are the S/S of hypokalemia?

Fatigue, anorexia, N/V, muscle weakness, dysrhythmias, paresthesia, flat T waves

What is the Tx for hypokalemia?

Potassium supplements (potassium IV should NEVER be given as a bolus)

What causes hyperkalemia?

Oliguria, acidosis, renal failure, addison disease

What are the S/S of hyperkalemia?

Muscle weakness, bradycardia, dysrhythmias, tall T waves

What is the Tx for hyperkalemia?

Kayexalate, glucose, and insulin

What causes hypocalcemia?

Renal failure, hypoparathyroidism, alkalosis

What are the S/S of hypocalcemia?

numbness, tingling of extremities, Trousseau sign, Chvostek sign

What is the Tx for hypocalcemia?

Administer calcium suppliments

What causes hypercalcemia?

Hyperparathyroidism, prolonged immobilization, excess calcium suppliments

What are the S/S of hypercalcemia?

Constipation, anorexia, polyuria, polydipsia, dysrhythmia

What is the treatment for hypercalcemia?

Loop diuretics, calcitonin, avoid calcium based antacids

What causes hypomagnesemia?

Alcoholism, DKA, diuretics

What are the S/S of hypomagnesemia?

Anorexia, distention, depression, disorientation

What causes hypermagnesemia?

Renal failure, adrenal insufficiency

What are the S/S of hypermagnesemia?

Flushing, hypotension, depressed respirations, bradycardia, hypoactive reflexes

What causes hypophosphatemia?

Refeeding after starvation, alcohol withdrawl, DKA

What are the S/S of hypophosphatemia?

Paresthesias, muscle weakness/pain, respiratory failure

What causes hyperphosphatemia?

Renal failure

What is the lab value range for phosphorus?

2-4.5 mEq/L

What is the lab value range for magnesemia?

1.5-2.5

What is the lab value range for Calcium?

8.5-10.5

What is the lab value range for potassium?

3.5-5

What is the lab value range for sodium?

135-145

What type of solution is 0.9% normal saline?

Isotonic

What type of solution is Lactated Ringers?

Isotonic

What type of solution is D5W

Isotonic

What are isotonic solutions used for?

To expand the intravascular space

What are hypotonic solutions used for?

To move fluid from ECF to ICF

What type of solution is 0.45% normal saline?

hypotonic

What type of solution is 2.5% dextrose in 0.45% saline?

hypotonic

What do hypertonic solutions do?

Pull fluid out of the intracellular space

What type of solution is 5% dextrose in lactated ringers?

Hypertonic

What type of solution is 5% dextrose in 0.45% saline?

Hypertonic

What type of solution is 5% dextrose in 0.9% saline?

Hypertonic

How often should IV tubing and dressing be changed?

Every 72 hours

When an IV is discontinued, pressure should be applied to the site for

1-3 minutes