BIG ATI

ATI: NCLEX Live ReviewStudy online at quizlet.com/_253wzq 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 in order to avoid disuse syndrome use boots to prevent foot drop. unconscious avoid using chin-tilt maneuver during cpr cpr-2 breaths for q 30 compressions 108. Parkinson give Carbidopa/Levodopa semisolid. 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. thickened food small frequent feedings bath bars recommended ROM and posture exercises 114. stroke pt with L side weakness. 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. metal implants. if pt is claustrophobic 112. nonvalvular Afib 111. fever. Acute Bacterial Meningitis complications: hearing impairment. intrauterine devices. orthopedic hardware. cerebral aneurysm clips. internal surgical clips remove jewelry before give a mild sedative before. stroke major risk factor hypertension. pt scheduled for CT scan tell pt that he might experience slight discomfort not exposed to magnetic field 105. photophobia-put pt in a dim light room no specific diet s/s: HA. diabetes mellitus. MRI contraindication pacemaker. no need to avoid carbonated drinksthey can have these 107.104. assist pt with passive and active ROM. nuchal rigidity. 110. encourage fluids. pacemaker. altered mental status rapid onset-develops oper hrs to 2 days droplet precautions start to on empiric antimicrobial therapy asap . complete C7 transection plan of care might include ventilatory support lesions above C6-risk of respiratory paralysis C1-C8 injury-risk of quadriplegia 109. spinal cord injury-bladder management urinate on a timed schedule. post frontal craniotomy interventions watch for increased ICP fluids restricted to 1-2 L per day space out activities. heart disease. suspected spinal cord injury. 115. 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. 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. MS discharge instructions exposure to heat and cold can exacerbate symptoms teach how to avoid fatigue. MS manifestations urinary retention hyperreflexia of the extremities intestinal obstruction ataxia decreased concentration constipation . infections no restrictions in diet. Meningitis altered cerebral perfusion from ICP and inflammation provide care for high ICP. infratentorial craniotomy elevate HOB at 30-45 degrees 118. 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. strict fluid intake fluids at 175 ml/hr too much 117. 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. 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. brainstem control of heart rate/ HR.note for nystagmus 135. in order to monitor hypothalamic function assess urinary output and temperature 142. resp rate/ RR 143. head injury pt. visual acuity Rosenbaun test 139. CN III-oculomotor. vomiting. cerebral arteriogram (angiogram of the blood vessels of the brain) (femoral artery access) pt just came back. ALS muscle weakness atrophy fasciculations dysphagia spasticity of the flexor muscles 123. GBS risk for respiratory muscles weakness-paralysis 125. Glascow Coma Scale eye opening. IV-trochlear and VI-abducens assessment use penlight. menigeal signs 131. cerebellar and vestibular function Romberg test 138. 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. fever. encephalitis HA. trigeminal neuralgia nerve V 127. altered vision 130. seizures. swallowing and speaking nerve X 128. lumbar puncture lie flat after procedure for 4-6 hrs. depends on facility 133. 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. CN II (optic nerve) assessment use a Snellen chart 134. Tonometry measures intraocular pressure 140. Parkinson's mask like appearance to the face drooling slow speech shuffling gate 124. 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. brain tumor HA.122. changes in mental status. interventions: pressure dressing over the site for 4 hrs at least flat for 4 to 24 hrs. CN V (trigeminal nerve) assessment corneal reflex 136. motor response. vomiting. facial muscle movement and taste VII 129. CN VIII (acoustic nerve) Weber test and Rinne test-assess conductive and sensorineural hearing loss 137. papiledema. verbal response coma=8 or less lowest score is 3=deep coma 15=perfect score 141. hemiparesis and slurred speech does not have long term neurologic deficits . 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. INFECTIOUS .. Carboprost used in OB bleeding don't give in asthma-contraindicated AE-wheezing 149. 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. rubeola. airborne tb. tonsilitis from strep infection->(risk for glomerulonephritis and rheumatic fever) antibiotics . 148.. varicella door closed negative air pressure room mask-N95 151.. meningococal meningitis 152.the droplets are larger so they don't spread face mask for nurse distance between client and family pneumonia. Meniere's disease vertigo tinnitus hearing loss inner ear affected 146. Acoustic neuroma unilateral involvement progress without improvement 147. 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. MATERNITY/OB .. contact direct contact 2 days before rash appears they are contagious keep nails short no aspirin in kids 154. droplet larger than 5 mcg door can remain open. CVA may cause long term deficits 145. 150. chickenpox children airborne. chickenpox.144. C-antivirals given 159. 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. dont stop activities.157. rest as much as possible. syphillis cupper color rash contact spread. Lyme erythematous lesion-bulls eye flu like symtoms stage 2-cardiac and neuro problems stage 3-large joint problems 3-4 weeks antibiotics 160. 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. 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. gonorrhea thick disharge many times no symptoms in females-PID-sterility doxycycline. mucus membranes congenital in baby Penicillin 161. 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. but in B. 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. you feel the edges around it. their own towels no meds given. just hand washing. rocemphin . already exposed. isolated health dept notified teaching important dont isolate from family-impossible. sexual C-bodily fluids mild or severe symptoms flu like symptoms rest liver to encourage regeneration. can reoccur with stress. menses spread to infants no vaginal birth sitz bath acyclovir-dont treat the virus. oil based. 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 . 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.162. genital herpes painful vesicular genital lesions after outbreak. virus still there in skin. 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. odor-women mucus membrane contact Doxycycline 164. chalamydia urethritis-men thich discarge. corrosive substances poison control will decide what to do dont give a large amount of fluids-will increase absorption 166. petroleum base substances. led neuro affection irritability. empty container around the child have number available for poison control save vomitus and urine contrai to vomiting-unconscious child. 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. pottery with oil based 167. increased icp identify the source-nurse role homes built before 70's. 168. just decreases course pap spears oral antibiotics no sex-while lesions present use condoms in between 163. after front faced seat. todlers imitation 183. preschoolers and school age safety helmet for bicycles-important bikes and scooters. hand rails. do they have a way to contact someone in case they fall 177. shock. animal workers. unstable ---use these colors only if system is overwhelemed-question will say it 178. resp failure. can wait longer. teenager males-teach them how to deal with anger safety while driving-ask if they wear seatbelt 100% of the time. no person to person. otitis meds common meds antihistamines steroids 172. infant safe crib car seat-rear face. standard precautions inhalation-spores. until 20 lbs. stairs-up and down correct. no person to person contact. but have appropriate equipment. . don't carry things upstairs. immediate attention yellow-stable. adults safety talk about guns exercise old adults-are they safe while ambulating? shoes-are they appropriate. crushing meds for children what do you crush or not crush 173. walker-do they need one?. night terrors normal between 4-7 171. 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. Right ventricular hypertrophy Overriding aorta Pulmonary stenosis Ventricular septal defect 181. disaster planning red-unstable. hemorrhagic shock-doxycycline 179. collaborative play hobbies .. no cell phone drugs-teach about it 176. ca wait green-stable.170. bioterrorismanthrax cutaneous/skin-skin contact.. appropriate age group activities 175. school age working with otherrs groups. Tetralogy of Fallow Right ventricular hypertrophy Overriding aorta Pulmonary stenosis Ventricular septal defect 180. the walking wounded black-fatal injuries. infants exploratory play 182.ride on sidewalk sports safety-stay active cause of obesity. 9-10 m more mobile sitting position lift can say gaga.. eg diabetic teenager cannot meet with friends and eat what they want young adulthood-20-25-commitment.. 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. 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. 7-8 m stranger anxiety fear of stranger.. 187. erikson stages infant-trust vs mistrust-stable caregiver toddlers-18m-3 yrs-autonomy vs shame and doubt-toilet training. 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. disease-cannot fit in with the group. eye contact 190. walking. muscular developmet screen routine infant for muscular development teach parents about milestones progression 188. play -denial-when parent comes back-ignore 192. 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. respond with anger crawling starts possible 10m-pull to standing house baby proof cause now they are more mobile . wants mom 8 m-separation-stages -protest -dispair-they dont want to eat. growth and development . screening tests Denver test-birth to 6 years 186.184. trycicles. give a shot showing on a doll. love to play. cords failure to thrive-not enough growth. mva's-most at risk. restraint seat drowning abuse 196. physical defects. housekeeping toys-stoves. 11-12 m weight triple can sit from standing position wat with fingers babinski reflex changes from baby fanning injury. one q 2 weeks. development problems injury-most at risk small pieces things-choking dont give candy. 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.193. limits important 5 yrs-2500 words-identity play. tolerate separation from parents fear of death at this age. not good parenting nutritional feeding has to be met age appropriate toys-nclex loves these toys should stimulate. starting with 6 m rice cereal-first. failure to thrive. nuts. hot dogs-small falls-risk for injury car seats-teach-completely restraint burns-outlets. car seat safety. dolls negativism-they say no. 3-5 yrspreschooler 3-vocabulary exploring-1500 words. help with increasing separation from parents 197. can mix with formula or breast milk no fruit juices in bottles-teeth problems finger foods-watch for choking 194. 9 seeking friends starting conflict with parents on the go . discipline. no sharp edges introduction of solid foods-variety but not too many at once. stuffed animals. dont ask yes/no questions -routine important safety-active so risk for injuries. 7 yrs boys play with boys girls play with boys 198. play like mom and dad. brushing teeth. also think safety. cars. 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. 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. 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. tracheostomy . there are meds available for bed wetting 200. 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. Verapamil SVT 201. permethrin for head lice repeat the application of cream-rinse in 7 days if nits still present. pneumothorax. US at 32 weeks getting gestational age 210. 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... . 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. barbiturates. CVA corneal abrasion 202. elderly type 1 diabetic blood glucose tests are better than urine because the renal glucose threshold in elevated in elderly 209. hypothyroidism client very sensitive to narcotics. anesthetics-avoid narcotic sedatives 206.199. gentle bubbling is normal 208. miller abot tube used for decompression of onstruction 235. Lithium tx manic phase of bipolar 222. diltiazem CCB inhibits Ca+ influx vascular smooth muscle reduces myocardial O2 demand &decreases force of ventricular contraction 224. prevent fluid and gas accumulation in the stomach 7. Chlordiazepoxide (Librium) -antianxiety used to tx symptoms of acute alcohol withdrawal 214. levin or salem stump .primary goal is to review and share their life experience with the group member 5. hypoparathyroidism low calcium be ready to deal with dysrhythmiaa . miller-abbott tube . terbutaline Brethine mag sulfate tx for preterm labor 215. unable to urinate -. clotrimazole antifungal. allnurses random facts 1. tetrahydrozoline contrai in angle closure glaucoma 233. Warfarin (Coumadin) inhibits prothrombin synthesis 220.increase cardiac output is the primary purpose 3. 218. tx for narcotic withdrawal 217. duodenal ulcer pain at night. plasma cholesterol screening . not helped by ingestion of food 229. Nifedipine (Procardia) antianginal med (CCB) decreases myocardial O2 demand. sphincter control 18 months 226. many of them 236. promethazine hcl (phenergan) .212. 2-3 hrs after a meal. gastric ulcer pain half and hr or 1 hr after a meal pain rarely at night.removes fluid and gas in the small intestine. Benzatropine (Cogentin) -used to tx parkinsonian side effects of Chlorpromazine (Thorazine) (antipsychotic med) 216. prior to ingestion of a meal 230. Digoxin strengthens myocardial contractio0n & slows conduction thru AV node 219. provides intestinal decompression 6. 221. overdose of aspirin will produce parkinsons dse type sx 10. aging nocturia increase need to frequent urination 228. Buerger's disease digital sensitivity to cold intermittent claudication (pain with exercise) 227.autonomic neuropathy 9. aids pts get dementia. do not admin erythromycin to multiple sclerosis pt 213. temporary pacemaker for mi client .npo for three hours 2. extravasation will cause necrosis 8. lumbra laminectomy Educate about exercise to strengthen the abdominal muscle 231. treats rashes. promethazine extravasation of vein. reminiscing group . Nimodipine CCB decreases spasm in cerebral blood vessels 223. recurrent uti limit milk ordered Mandelamine 234. barium swallow for 3 month old infant . Aminocaproic acid (Amicar) antifibrinolytic prevents recurrence of subarachnoid hemorrhage.check patency of the patient's vein before admin of drug. iv 232.only sips of water for 12 hours 4.decompresses the stomach. Methadone hydrochloride-opiod analgesic. 225. insulin dependent diabetic. . Pepcid report to dr if pt is about to be put on antiplatelets meds-it might not work 253. GEMFIBROZIL . Ankle brachial index ... iv K if burning-decrease rate 263. Labs for Mi . .. 271.. 249.237.. before feeding check ph-3 is good-for the aspirated contents 261.. ng tube. ZIDOVUDINE .. graves disease heat intolerance metabolic rate increased 244. 270.. stress test stop if pain 252. Ciprofloxacin rash-stop drug and call dr 262.. PSA draw before digital rectal exam 259. 248. low K risk for Dig toxicity call doc 258.5-2 x the therapeutic value is ok 264. TERBUTALINE . Transesophageal echocardiography (TEE) npo-for several hrs lidocaine-numb the esophagus-risk for for aspiration possibly iv sedation 247. before giving dopamine iv check iv patency risk for extravasation 269. Docusate stool softner 254. 243.7-1. 18 months walk up and down the stairs while holding self 257.. cerebellar tumor losing balance easily 265. Omeprazole makes the Clopidogrel not work 255. rsv . 250. 272... iv placement not close to joint 238. autonomic dysreflexia .. CN IX (glossopharyngeal) can tell difference in taste 266..5-12 242. Ceftriaxone (Rocephin) .4 241. Alteplase . tetracycline use sunscreen outdoors 245.. CN VIII (acoustic) loss of hearing temporal lobe (auditory center) 267.. 30 months able to jump 256. Bun 7-18 (older) 240. PERPHENAZINE . 251. PT 9.. aPTT 1. propanolol s/e bronchospasm 246. 239... gravity drip IV piggy bag has to be higher than primary bag 268. Creatinine 0. tube feeding rinse the bag and change formula q 4 hrs 260. 274.... . PHENYLPROPANOLAMINE .. PROCAINAMIDE ..273... PROCHLOPERAZINE . 275. 276. BROMPHENIRAMINE .. 5 . PVC's -Lidocaine Verapamil .. cephalosporins.277. Random meds Carbamazepine therapeutic serum level is 4 .Anticoagulants Atrial Fibrillation . 4.lowers the BCP's effects Metylergonovine-to contract uterus. 2. etc.Beta Blockers.sheild from light.12 mcg/dL Cycloserine is an antituburculan and needs weekly drug levels foscarnet (Foscavir) can be toxic to kidneys so creatinine is monitored. pts recieving lasix should be assessed for tinnitus and hearing loss 5.check for allergies to penicillins. document Aminoglycosides (gentamycin.increase rbc/erythrocytes 1. anticoagulants cant dissolve a formed thrombus but tpas can. paxil. dont give if vascular diseases are present.increase neutrophil count epoietin alfa (epogen) . .. Dantrium (dantroline) common drug kept in the OR for Malignant Hyperthermia No birth control pills with antiseizure meds.induces ovulation by changing hormonal effect on the ovary DO NOT give a pregnant laboring patient on methadone STADOL (precipitates withdrawal) contractions > 90 seconds.) 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 .treatment of supraventricular tachycardias. effective if no seizures. FHR < after contraction peak..2 mg/dL morphine is contraindicated in acute pancreatitis because is causes the spasms but the demerol is the drug of choice. pt could be hypersensitive. before giving check BP. Muscle weakness filgrastim (neupogen) .tx of depression.Amiodarone Ventricular Tachycardia . Digoxin PVC .5. increase IV fluid rate. reposition on left side. zoloft. check heart rate Clomiphene. sodium nitroprusside. Adverse reactions: Flushing. .Adenosine Atrial Flutter . prozac. wrap in foil 3.Amiodarone . decrease in RR.turn off the pitocin [oxytocin] (if running) give O2 by tight face mask. notify caregiver. MgSo4-CNS Deppressant and Anticonvulsant = normal range 4-7. Therapeutic serum digoxin is 0. 5-2 times the control inr: 2-3 heparin ptt: 30-60 sec. absent) 283.0 ng/ml lithium 0. hypokalemia. weak cry.Defibrillation Torsades de Pointes .teach 281.5 meq/l coumadin pt: 12-20 sec.therapeutic range 1. absent) G= grimace (cough.Herpez Zoster/Shingles TB 284. Epinephrine.035 Diabetes Insipidus Na> 160 head injury Specific gravity <1.Chicken Pox/Varicella Hez .Atropine 2nd Degree AV Block Type II . no response) A= activity (flexed. hypertension. Airborne Transmission? My . SIADH Na <120 Hx of lung cancer Specific gravity > 1.Emergent Pacemaker. Electrolytes Hyperkalemia = narrow. Dopamine Sinus Bradycardia . hypotension. VV and AA? EleVate Veins.evaluate A .5-1. laryngospasm swallowing problem=aspiration ALDOSTERONE insufficiency -Hypo-Na-emia.Ventricular Fibrillation . < 100.No treatment usually 2nd Degree AV Block Type I . N95 for TB . dAngle Arteries for better perfusion 282.5 meq/l dilantin 10-20 mcg/dl theophylline 10-20 mcg/dl lithium 0. hypoglycemia cushings= hypernatremia. Apgar Scoring? A= appearance (color all pink. Defense mechanisms phobias include projection and displacement 280. blue [pale]) P= pulse (>100.005 279. Atropine. Depressed ST and Prominent U HYPOCALCEMIA (not enough sedatives) + trouseau and + chovstek's sign incr DTR stridor. K increase addisons= hyponatremia. limp) R= respirations (strong cry. peaked T waves on cardiac monitor Hypokalemia = Peaked P. Hyper-K-emia. WHEN Na decrease. flaccid..6-1. decreased blood vol. Protocol for Airborne Transmission? Private Room .Measles Chicken .Atropine or Epinephrine Sinus Tachycardia .5-2 times the control 278. Delegation Rule of Thumb? DO NOT delegate what you can EAT! E ..Pacemaker 3rd Degree AV Block Complete . hyperkalemia. grimace. hypo-Volemia.. Flat T.Beta Adrenergic or Calcium Channel Blocker digoxin 05-2.therapeutic range 1.Magnesium Sulfate 1st Degree AV Block .assess T .. incrased blood vol.. hyperglycemia 4.negative pressure with 6-12 air exchanges/hr Mask. pink and blue. 295. What to do in the case of. During CBI (continuous bladder irrigation) (CBI) --> catheter is taped to thigh so leg should be kept straight.skin infections * W .WEE M . What to do in the case of.scarlet fever S . etc) --> turn on left side (and give O2.pertussis I . After Cataract surgery? pt will sleep on unaffected side with a night shield for 1-4 weeks. 297.wound infxn E .multidrug resistant organism R . .mycoplasma or meningeal pneumonia An . neck and shoulders. support head. Protocol for Droplet Precautions? Private Room or cohort mask 287. After Thyroidectomy? low or semi-Fowler's. What to in the case of.285. 298.clostridium difficile E .A woman in labor with UnReassuring FHR? (late decels. don't flex hip more than 4560 degrees.parvovirus B19 P .eye infxn . stop Pitocin.mumps M . tachycardia.meningitis M . After lumbar puncture? e (and also oil-based Myelogram)--> pt lies in flat supine (to prevent headache and leaking of CSF) 293.sepsis S . Buck's Traction? (skin traction) --> elevate foot of bed for counter-traction 300.Pt with heat stroke? Lie flat with legs elevated 294. sense of impending doom --> turn pt to left side and lower the head of the bed.epiglottitis R .influenza D . increase IV fluids) 290. No other positioning restrictions.an Air/Pulmonary Embolism? S&S: chest pain.rubella M . 289. 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. Maintain hip abduction by separating thighs with pillows.Adenovirus 286. pale/cyanotic.pneumonia P . After Myringotomy? Position on the side of the AFFECTED EAR after surgery to allow drainage of secretions 296. Droplet Precautions Transmission? DROPLET think of SPIDERMAN! S . Infant with Spina Bifida? position prone (on abdomen) so that sac does not rupture 299. decreased variability. After Total Hip Replacement? don't sleep on operated side.streptococcal pharyngitis P . Contact transmission precautions CONTACT PRECAUTION MRS. During epidural puncture? Side lying 292.respiratory infection S . difficulty breathing. fetal bradycardia.enteric infxn .conjunctivitis 288. don't elevate HOB more than 45 degrees.diptheria (pharyngeal) E . From the ass? From the Mouth? From the a** (diarrhea)= metabolic acidosis From the mouth (vomitus)=metabolic alkalosis 319. 312. 306. Myxedema/ hypothroidism? slowed physical and mental function. Graves disease/ Hyperthyroidism? accelerated physical and mental function. After Supratentorial Surgery? (incision behind hairline) --> elevate HOB 30-45 degrees 309. Head Injury? elevate HOB 30 degrees to decrease intracranial pressure 314. knees straight. lie down after meals for 20-30 minutes (also restrict fluids during meals. Myastenia Crisis. After Infratentorial Surgery? (incision at nape of neck)--> position pt flat and lateral on either side. Autonomic Dysreflexia/ Hyperreflexia? S&S: pounding headache.301. arrhythmias. prevent ncek flexion/hyperextension. Below the knee amputation? foot of bed elevated for first 24 hours. goose flesh. head slightly elevated (modified Trendelenburg) 313. Infant with Cleft lip? position on back or in infant seat to prevent trauma to suture line. and Cholinergic Crisis? Myasthenia Gravis: worsens with exercise and improves with rest. 303. low phosphorus diet . The difference between Myasthenia Gravis. Above the knee amputation? elevate for first 24 hours on pillow. tetany. Detached Retina? area of detachment should be in the dependent position-. low CHO and fiber diet. During internal radiation? on bedrest while implant in place 311. Hypo-parathyroid? CATS . Shock? bedrest with extremities elevated 20 degrees. profuse sweating. sensitivity to cold. the client should be placed in the supine position for 4 to 12 hrs as prescribed. hypertension place client in sitting position elevate HOB first before any other implementation. pulse and HTN 322. dry skin and hair 320. position prone daily to provide for hip extension. Prior to liver biopsy? Its important to be aware of the lab result for prothrombin time 318. Lumbar Puncture? AFTER the procedure.convulsions. To prevent dumping syndrome? (post-operative ulcer/stomach surgeries) --> eat in reclining position. Enema positioning? position pt in left side-lying (Sim's) with knee flexed 308. bradycardia. 305. Post Thyroidectomy? semi-Fowler's. Thyroid storm? increased temp. Prolapsed Cord? knee-chest position or Trendelenburg 302. nasal congestion. high Ca. spasms. Peritoneal Dialysis when outflow is inadequate? turn pt from side to side BEFORE checking for kinks in tubing (according to Kaplan) 315. trach at bedside 323.dependent meaning supported by something 307. 229) 316. fine/soft hair 321. 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. position prone daily to provide for hip extension. hold in upright position. While feeding. 310. small frequent meals) 304. (Saunders 3rd ed p. sensitivity to heat. stridor (decreased calcium). reflexes 331. abdominal pain. tremor. sedative effect on CNS 335. increased ICP. high phosphorus diet 325. muscular twitching. dyspnea.010. Hypovolemia? incrased temp. dark pigmentation. decreased BP 340. hypotension. decreased cardiac contractility. hypotension. hypoK. edema. confusion.030 326. HyperMg? depresses the CNS. weakness.muscle weakness. Hypercalemia? muscle weakness. tachycardia. dehydration. pulse. Hyperparathyroid? fatigue. disorientation/delusions. back and joint pain (increased calcium). fluids 332. hypotonic solution 333. moonface/buffalo hump 339. Addisonian Crisis? n/v. HypoMg? tremors. weakness. urine (oliguria/anuria). GI distress 338. or German measles (rubella). arrhythmias. Cushings? hyperNa. increased HR. dig toxicity 336. dehydration. fractures. beans. Hyponatremia? nausea. apricots. increase respiration. diaphoresis. NMS? -NMS is like S&M. Hypervolemia? bounding pulse. prone to infection. confusion.convulsions.324. bananas. dysrhythmias. avoid stress. abdominal pain. confusion. peripheral edema. decreased deep tendon reflexes. depression. hyperK. diuretics 329. renal calculi. n/v/a. absent deep tendon reflexes. HyperKalemia? MURDER . absent tendon reflexes. ECG changes. administer Declomycin. Addisons? hypoNa. osmotic diuretics. muscle wasting. anxiety. urine specific gravity <1. Diabetes Insipidus? (decreased ADH): excessive urine output and thirst. -you get hot (hyperpyrexia) -stiff (increased muscle tone) -sweaty (diaphoresis) -BP. Hypocalemia? CATS . tachycardia. increase K (raisins. Dangerous thing to get during pregnancy? I kept forgetting which was dangerous when you're pregnant. Pheochromocytoma? hypersecretion of epi/norepi. convulsion. rares/crackles. seizures. avoid cold and stimulating foods. muscle cramps. tetany. carrots. oranges. respiratory depression. hypotension. persistent HTN. hirsutism. emergency 337. dyrshythmias. pounding HA. shallow respirations. urine specific gravity >1. spasms and stridor 334. hypoglycemia. SOB. celery) 330. so remember: -never get pregnant with a German (rubella) . low Ca. hyperglycemia. HypoKalemia? muscle ewakness. alopecia. HTN. Semi-Fowler's 327. surgery to remove tumor 341. lack of coordination. muscle ewakness. frequent bating and rest breaks. and respirations go up & -you start to drool 342. hyperglycemia. HA. rapid/weak pulse. administer Pitressin 328. HTN. extreme weakness. Hypernatremia? increased temp. tetany. regular measles (rubeola). hypoglycemia. dysphagia. facial flushing. potatoes. decreased resistance to stress. muscle weakness. SIADH? (increased ADH): change in LOC. weakness. weight loss. pt. shock. If you're not sure who to check first.343. decreased pulse. coughs. the sounds are heard closer to midline. Sometimes it's hard to tell who to check on first. turn the mother to her left side. Heroin withdrawl in a neonate? Irritable. and poor sucking .Obstruction due to incr. OB secret? NEVER check the monitor or a machine as a first action.loosen constrictive clothing . not a problem! L = late decels = placental insufficiency.Disconnection or leak in ventilatior or in pt. increased resp. Late Decels? For late decels. Major risks of epidural? Hypotension and bradypnea / bradycardia are major risks and emergencies. septal Right Ventricular hypertrophy Overriding aorts Pulmonary stenosis 344. C = cord compression caused E = early decels. 348.) 356. that's the wrong answer. 350. between teh umbilicus and where you would listen to a posterior presentation. increased pulse. Hearing the baby in OB? If the baby is a posterior presentation. 351. If the baby is anterior.decreased BP. airway cuff. Cor Pulmonae? right sided heart failure caused by left ventricular failure (so pick edema. MI. Always assess the patient first. secretions. for exmaple listen to the fetal heart tones with a stethoscope in NCLEX land. If the baby is vertex. 347. Autonomic Dysreflexia? Autonomic dysreflexia: potentially life threatening emergency . (If her head is down. H = head compression caused A = accels. kink. the sounds are high up in the fundus near the umbilicus. For cord compression in OB? For cord compression. and one of the choices involves the machine. they are a little bit above the symphysis pubis. cover it with sterile saline gauze to prevent drying of the cord and to minimize infection. can't fill 346. Ventilator Alarms? HOLD High alarm. FHR patterns in ob? Have trouble remembering fhr patterns in OB? Think VEAL CHOP VC EH AO LP V = variable decels. the sounds are heard at the sides. if it is a choice.Administer antihypertensive meds (may cause stroke. If the baby is breech. the mother or the baby. the baby is no longer being pulled out of hte body by gravity) If the cord is prolapsed. Tetraology of Fallot? Tetralogy of fallot.assess for bladder distention and bowel impaction (triger) . decreased resp. ICP and Shock have? ICP AND SHOCK HAVE OPPOSITE V/S ICP-increased BP. 355. seisure ) 345. stops spontaneous breathing 353. O = okay. jvd. it's usually easy to tell the right answer if the mother or baby involves a machine. place the mother in the TRENDELENBERG position because this removes pressure of the presenting part off the cord.elevate head of bed to 90 degree . Before Epidural? Hydration is a big priority! 349. pt. gag or bites Low press alarm. to allow more blood flow to the placenta. To remember blood sugar? hot and dry-sugar high (hyperglycemia) cold and clammy-need some candy (hypoglycemia) 354. remember HOPS Think DROP(child drops to floor or squats) or POSH Defect. 352. pneumonia is acute. 370. citrus fruits 361. 379. How many oz in a ml? 30 ml = 1 oz 386. Therefore. Brachial Pulse? Pulse area cpr on infant 359. How to treat phobic disorders? systematic desensitization 366. Pneumonia? pneumonia. 376. Besides sodium. CABG? for a CABG operation when the great saphenous vein is taken it is turned inside out due to the valves that are inside.357. no fresh fruits. Diff between angina and MI? angina (low oxygen to heart tissues) = no dead heart tissues. MI= dead heart tissue present. Best way to warm a newborn? skin to skin contact on mom with a blanket 364. radiation. O2 level must be low because high O2 concentration blows the patient's stimulus for breathing. fever and chills are usually present. 382. What to check children for at age 12 months? always check lead posioning levels 360. Best indicator of dehydration? weight 371. Sources of potassium? Bananas. Preload and Afterload? Preload affects amount of blood that goes to the R ventricle. in COPD patients the baroreceptors that detect the CO2 level are destroyed. 380. When patient is in distress? Med administration is rarely a good choice 375. surgery. 1 quart = how many pints? 1 quart = 2 pints . Afterload is the resistance the blood has to overcome when leaving the heart. Guided imagery is great for? CHRONIC pain 374. allow to die with dignity. With lower amputations? place in prone position 368. 1 tsp= how many ml ? 1 t (teaspoon)= 5 ml 384. Use of cold and hot? Use cold for acute pain (sprained ankle) and heat for chronic pain (arthritis) 373. 1 cup= how many oz? 1 cup= 8 oz 387. Jews? No meat and milk together 358. Why would a pt with leukemia have epistaxis? b/c of low platelets 363. Nuetropenic patients? no live vaccines. For the elderly confusion is often present. Best way to tube feed or feed kids? small frequent is better than large 367. What is obtained before starting any iv antibiotic? Cultures 362. potatoes. Where are chest tubes placed? chest tubes are placed in the pleural space. Emphysema and bronchitis are both COPD. 381. Cardinal signs of ARDS? Cardinal sign of ARDS is hypoxemia (low oxygen level in tissues). 383. water also follows? Glucose 372. When a pt comes in and she is in active labor? nurses FIRST action is to listen to fetal rate/tone 365. LVN/LPN cant? Handle any blood 369. 378. COPD and Pneumonia? COPD is chronic. 4 options for cancer? chemo. 1 tablespoon = how many ml? 1 T(tablespoon)= 3 t = 15 ml 385. 377. no flowers should be used for neutropenic patients. 413. Low Residue diet? low residue diet means low fiver 397. Since smallest concentration of ACTH receptors are in cranial nerves. Keep eye on respiratory system. Glaucoma patients loose? glaucoma patients lose peripheral vision. Temp conversion? * To convert Centigrade to F. akinesia (loss of muscle mvt). F= C+40. 1 kg= how many pounds? 2. Treated with heparin. NOT normal in an MI patient 402. pharyngeal muscles. Fats leave ketones (acids) that cause pH to decrease. Treat with levodopa. DKA is rare in diabetes mellitus type II because there is enough insulin to prevent breakdown of fats. multiply 5/9 and substract 40. Cause of Ascites? portal hypotension + albuminemia= Ascites.patients with spinal cord injuries at T-7 or above is usually caused by a full bladder. 395. DKA? Diabetic ketoacidosis (DKA)= when body is breaking down fat instead of sugar for energy. Knee replacement? for knee replacement use continuous passive motion machine. 408. TPN is given in ? TPN(total parenteral nutrition) given in subclavian line. . Treated with meds 407. CVA? CVA (cerebrovascular accident) is with dead brain tissue. 405. Hodgkins disease? Hodgkin's disease= cancer of lymph is very curable in early stage. Parkisons? parkinson's = RAT: rigidity. mastication. 1 pint = how many cups? 1 pint= 2 cups 389. 394. 396. tremors. 412. autonomic dysreflexia autonomic dysreflexia ( life threatening inhibited sympathetic response of nervous system to a noxious stimulus. After Endoscopy? after endoscopy check gag reflex. multiply 9/5 and substract 40 * To convert Fahrenheit to C. 1 g = how many mg? 1 gram = 1000 mg 391. Guillian Barre? Guillain-Barre syndrome= ascending paralysis. TIA? TIA (transient ischemic attack) mini stroke with no dead brain tissue 414. 400. s/s of a fat embolism? petechiae. expect fatigue and weakness in eye. Who produces insulin? beta cells of pancreas produce insulin 401. 410. Appendicitis Appendicitis (inflammation of the appendix) pain is in RL quadrant with rebound tenderness. 398.. 1 gr= how many mg? 1 gr (grain)= 60 mg 390. Myasthenia gravis? myasthenia gravis= decrease in receptor sites for acetylcholine. 404. Signs observed in hypocalemia? Trousseau and Tchovoski signs observed in hypocalcemia 403. c02 builds up and causes? Co2 causes vasoconstriction. 399. Diverticulitis? diverticulitis (inflammation of the diverticulum in the colon) pain is around LL quadrant. 415. Where are most spinal cord injuries? most spinal cord injuries are at the cervical or lumbar regions 409. 406.2 392. s3 heart sound is normal? not? Normal in CHF from the squishin'. 411.388. C= F+40. 1 lb = how many ozs? one pound equals 16 0z 393. 71. Prevent blood from going to heart. Cerebral palsy? poor muscle control due to birth injuries and/or decrease oxygen to brain tissues 424. Fontanelles? anterior fontanelle closes by 18 months. 439. How to put on traction? Place the apparatus first then place the weight (der) 434. 425. Pathological jaundice? pathological jaundice= occurs before 24hrs and last7 days. not passing meconium. 419. Where should placenta be? Upper part of the uterus 435. Heart Defects? heart defects.416. Dunlap traction= Skeletal or skin 432. 442. Baby is inconsolable. Peds weight ? Birth weight doubles by 6 month and triple by 1 year of age. Swelling reabsorbs within 1 to 3 days. measure head circonference. caput succedaneum= caput succedaneum= diffuse edema of the fetal scalp that crosses the suture lines. Wilms tumor? Wilm's tumor is usually encapsulated above the kidneys causing flank pain. Bryant's traction= Children <3yoa. Bucks traction = knee immobility 430.section will likely have? another c section with any more kids 437. Remember for cyanotic -3T's( Tof. Amniocentesis is performed? and why? perform amniocentesis before 20 weeks gestation to check for cardiac and pulmonary abnormalities. with R side cardiac 421. ICP? ICP (intracranial pressure) should be <2. Transposition of the great vessels). Physiological jaundice occurs after 24 hours. 443. Facts about hemophilia? It is X-linked. 420. but no bleeding. First sign of cystic fibrosis? first sign of cystic fibrosis may be meconium ileus at birth. A patient with vertical c. Heart problems? with R side cardiac cath=look for valve problems with L side in adults look for coronary complications 422. 426. 94. there is bleeding. Russel Traction = femur or lower leg instability 431. 418. Mother passes the disease to her son 428. Truncys arteriosus. 441. 427. 440. If problem does not fix or cannot be corrected surgically. 438. Rh? mothers receive rhogam to protect next baby. Dig rule for kids? if HR is <100 do not give dig to children. Med for lung expansion. Eclampsia is a ? seizure> 436. Bethamethasone? bethamethasone (celestone)=surfactant. do not eat. CHF will occur following by death. . Diff between placenta previa and placenta abrupto? placenta previa = there is no pain. 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. Signs to look for in meningitis? for Meningitis check for Kernig's/ Brudzinski's signs. What happens when phenylalanine increases? brain problems occur 429. Placenta abruption = pain. Posterior 6 to 8 weeks. What disease leads to cardiac valve malfunctions? Rhematic fever 423. <35 lbs with femur fx 433. 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 Asthma and arthritis best excercise? swimming 515. frequent neuro assessments . corn. respiratory alkalosis (not acidosis r/t tachypnea). make sure there are no bubbles. 512. hypocalcemia. thick bones.Semi Fowlers with knees flexed (inc. enlargement of bone. Before a pft? Before going for Pulmonary Fuction Tests (PFT's). pt is positioned in lateral recumbent fetal position.495. Hepatitis B. Remember to preform the Allen's Test prior to doing an ABG to check for sufficient blood flow 517. Disease precautions? ** Hepatitis A is contact precautions ** Tetanus. 501. your body is "too busy to sleep" as opposed to the folks with hypothyroidism who may report somnolence (dec. rate. meat. ABG drawin? When drawing an ABG. usually seen in kids bone breaks on one side and bends on the other 508. Makes sense though!Increased met. I had to look it up cuz I heard it was important ah hem ah hem 510. SARS? **SARS (severe acute resp syndrome) airborne + contact (just like varicella) 497. . met rate. 503. Complications of mechanical ventilation? Complications of Mechanical Ventilation: Pneumothorax. 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.. position pt lying on side of bed or with arms raised up on pillows over bedside table. Patch the GOOD eye so that the weaker eye can get stronger. For a lumbar puncture? For a lumbar puncture. chest x-ray done immediately afterwards to check for complication of pneumothorax. HIV are STANDARD precautions 498. What is a bad sign in asthma? intercostal retractions=bad! 516. put on ice immediately after drawing. body is slow and sleepy). bread 505.tinnitus. Found a cool link about its use in peds pt with strabismus. Separation anxiety peaks in toddlerhood 513. you need to put the blood in a heparinized tube. inc ESR. Saunders confirms it. Botox? ** BOTOX for strabismus. Tidal volume? ** TIDAL VOLUME is 7 . Alkaline Ash diet? Alk Ash diet. Orange tag in pysch Orange tag in triage is non emergent Psych 507. ACID ash diet? Acid Ash diet . sterile dressing. Greenstick fracture? Greenstick fractures. salmon 506.10ml / kg 511. with a lable indicating if the pt was on room air or how many liters of O2. sterile dressing applied 519. veggies. 509. plums. If kid has a cold? **If kid has cold. bone pain. "snow storm" effect on CXR. SHORTENING. Stranger Danger>?!? Stranger anxiety is greatest 7 . 499. ADDUCTION 500. can still give immunizations 496. Paget's disease? Paget's Disease . S/S of a fat embolism? Fat Embolism: Blood tinged sputum (r/t inflammation). pastry.cheese. Signs of a hip fracture? SIGNS of a Fractured hip: EXTERNAL ROTATION. knee gatch) to relieve lower back pain. Ulcers 502. cranberries. Intravenous Pylogram requires? ** IVP requires bowel prep so they can visualize the bladder better 504. For a lung biopsy? For a lung biopsy. poultry. keep pt flat for 2-3 hrs afterwards.milk. Side effects of thyroid hormones? Insomnia is a side effect of thyroid hormones. Willam's position? ** William's position . rhubarb.increased serum lipids. have pt hold breath in midexpiration. a pt's bronchodilators will be with-held and they are not allowed to smoke for 4 hrs prior 518.. Lymes mostly found in Lymes is found mostly in Conneticuts 514.9 months. prunes. 522. movements of face. assess pt for seizures. typically a mother. Uremic Fetor? Uremic fetor --> smell urine on the breath 527. paralysis. limbs and body -gait deteriorates to no ambulation -no cure.520. ataxia. because cantaloupe is high in vit c and vit c causes a false + for occult blood. Munchausen by proxy (MSBP). aortic aneurysm (AAA) --> CT scan 526. 528. just palliative care 524. MS? -Multiple Sclerosis is a chronic. 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. 534. no bile is upper obstruction. 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. dysarthria 523. twisting. pt must stay awake night before exam. pt's will be at increased risk 521. I finally realize why a person shouldn't have cantaloupe before a occult stool test. Halo? Questions about a halo? Remember safety first. 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. Shift to the left means? WBC shift to the left in a patient with pyelonephritis neutrophils kick in to fight infection 525. after EEG. Hirschsprungs? -Hirschsprung's --> bile is lower obstruction. Motor S/S: limb weakness. hold meds for 24-48 hrs prior. Now I just need to figure out why they can't have fish. slow speech Sensory S/S: numbness. autosomal dominant disorder S/S: chorea --> writhing. in order to receive medical care or hospitalization. ribbon like stools. In a variation of the disorder. 529. For PVD remember? For PVD remember DAVE (Legs are Dependent forArterial & for Venous Elevated) 532. Compartment syndrome? Remember compartment syndrome is an emergency situation. pt can eat. Traction rule? Never release traction unless you have an order from an MD to do so 533. tinnitus Cerebral S/S: nystagmus. tingling. pt may be asked to hyperventilate and watch a bright flashing light. . have a screwdriver nearby. When you see coffee brown emesis think?> Peptic ulcer 531. no caffine or cigarettes for 24 hrs prior. For an EEG test? EEG. Neuromuscular damage is irreversible 4-6 hours after onset. How to Dx a AAA? Definitive diagnosis for abd. progressive disease with demyelinating lesions in the CNS which affect the white matter of the brain and spinal cord. No Cantalope? Thank you. an individual. Paresthesias and increased pain are classic symptoms. Huntington's Chorea? Huntington's Chorea: 50% genetic. intentionally causes or fabricates illness in a child or other person under her care. 530. dysphagia. force fluids. Seperate but dont abandoned.leg 540. INCOMPLETE amputations. etc. COAL (cane walking): C . pupils fixed or dilated. meals not withheld. comfort measures if possible. MRI? MRI. preadolescence 9-12 yrs learns to relate to friends of of opposite sex 5. woulds with anatomical organs.both eyes OS.affected L . fx requiring open reduction. shave area around needle insertion. profound shock with multipe injuries. no pulse.s. early adolescence12-14yrs:learn independence and how to relate to opposite sex 6. Ex: Unresponsive. tell pt may feel heat palpitations or desire to cough with dye injection. 536. sire shaved. 2nd/3rd degree burn with 60% of body surface area .keep flat 12-14hr. Post.Vital signs keep leg straight bedrest 6-8hr.cane O . etc. unstable chest and abdominal wounds.left eye OD.Immediate: Injuries are life threatening but survivable with minimal intervention. Infancy 0-18 months others will satisy needs 2. More info on lumbar puncture? Lumbar puncture. tranquilizer/stimulant meds held 24-48hr before. Ex: upper extremity fx. post.s. and 2nd/3rd degree burn with 15%-40% of total body surface.. 545.no sleep the night before. check leakage.well hydrated. v.nuero assess q15-30 until stable. minor burns. 541. external fixation. Cerebral angio prep? cerebral angio prep. Post. spinal cord injuries. observe dressing 546.opposite A . Ex: hemothrax.Color codes?? Red. Behavior/Developmental-Peds Behavior motivated by need to avoid anxiety and satisfy needs 1.right eye ( dominent Right eye. 543..npo 8-12hr. lacerations.listen for bilateral breath sounds. debridement.Minimal: Injuries are minor and tx can be delayed to hrs or days . b. sprains. 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.fetal postion.Take v.Delayed: Injuries are significant and require medical care.just a tip to remember) 539. pulses marked post. late adolecence 14-21yrs: develop intimate relationship with person of opposite sex is this not about communication?. Yellow. sterile dressing. behavior disorders. Eyes? OU. pulses. sm. encourage fluids. tension pneumothorax. . no more than 1000cc at a one time. Black. 542. Green. childhood >6yrs learn to delay need gratification 3. Thoracentesis? Thoracentesis prep. OPEN fx's of long bones. no stimulants for 24hr before. oral anlgesics for headache.claustrophobia.535.Expectant: Injuries are extensive and chances of survival are unlikely. check site. Fetal alcohol sydrome? Fetal alcohol syndrome -upturned nose -flat nasal bridge -thin upper lip -SGA 537.p. Individuals in this group should be moved away from the main triage area. Cath lab? Cardiac cath. most eye and CNS injuries. assess pacemaker 544. Cane walking? 1. juvenile 6-9 years learn to relate to peers 4. position patient with arms on pillow on over bed table or lying on side... pulses. seizures.. flat2-3hr. but can wait hrs without threat to life or limb. lie flat. In depth. Ex: Stable abd wounds without evidence of hemorrhage. More info on EEG? EEG. no metal. empty bladder. may be asked to hyperventilate 3-4min and watch a bright flashing light. encourage po fluids. inspect site. empty bladder.. Hemovac? Hemovac.. place on flat surface. 548. table will be moved to various postions during test. Common S/S of pancreatitis? Cullens sign ( ecchymosis of umbilicus) (+) Grey Turner spots 574.Adm vit k . Common S/S of Cholera? Rice watery stool 561. report severe ab pain stat. assess for distended bladder. frequent v. Post.semi fowlers or upright on edge of bed. Myelogram? Myelogram. Common S/S of leprosy? Lioning face 568.used after mastectomy. Common S/S of pernicious anemia red beefy tongue 559. Common S/S of SLE? Butterfly rashes 566. oral analgesics for h/a.Npo 4-6hr. Common S/S of Meningitis? Kernigs Sign (leg flex then leg pain on extension) Brudinzski sign (neck flex= lower leg flex) 572. observe for signs of hypovolemia. check system for operation. Common S/S of Tetany? Risus Sardonicus 573.Varices can be in stomach. Common S/S of Kawasaki syndrome? Strawberry tongue 558. Post. Common S/S of Bulimia? chipmunk face 569. and stimulants withheld 48hr prior. water soluble HOB up. Common S/S of Diptheria? Psuedo membrane formation 564.s. Sengstaken blakemore tube ? Sengstaken blakemore tube used for tx of esophageal varices. Common S/S of measles? Kopliks spots 565. general anesthesia. report elevated temp. cleanse opening and plug with alcohol sponge. Common S/S of down syndrome protruding tongue 560. 554. Common S/S of Dengue petechiae or + Herman's sign 571. Liver biopsy? Liver biopsy.547.CO2 used to enhances visual.postion on right side. PTB . Common S/S of asthma Wheezing on EXPIRATION 556. 552. cns depressants.walk patient to decrease CO2 build up used for procedure. Common S/S of pyloric stenosis? olive like mass 575. 550. Common S/S of Liver cirrhoisis? Spider like varices. foley. Common S/S of emphysema? Barrel chest 557. npo morning of exam 6hr. Post. Post. Paracentesis? Paracentesis. Common S/S of PTB? Common Signs and Symptoms 01. oil soluble HOB down. Common S/S of addisions? bronze like skin pigmentation . Common S/S of Malaria? Stepladder like fever with chills 562. phenothiazines. 553. 549. give sedative.s. Laparoscopy? Laparoscopy. Common s/s of PDA Machine like murmur 576. Common S/S of Thypohiod Rose spots on abdomen 563. release plug.neuro q2-4.low-grade afternoon fever. compress evacuator completely to remove air. empty contents. supine postion. remove plug. empty when full or q8hr.v. esophagus or the skin! They are just spider/varicose veins! Ithcy on the skin 567. Teach pt that he will be asked to hold breath for 5-10sec. 551. lateral with upper arms elevated. keep scissors at bedside. Common S/S of appendicitis rebound tenderness 570. Common S/S of pneumonia? Rusty sputum 555. no heavy lifting 1wk. allergy hx. Common S/S of parkinsons? Pilling rolling tremors 589.. Common S/S of Ulcerative Colitis? Recurrent bloody diarrhea 610. fever 588. flashes of light.. Common S/S of Cataract? PainLESS vision loss. Choking. blurring of the vision 598. Common S/S of Bladder Cancer? painless hematuria. tunnel/gun barrel/ halo vision (peripheral vision loss) 597. Common S/S of Pemphigus Vulgaris? Nilosky's sign (seperation of epidermis caused by rubbibng of the skin) 595. Common S/S of cystic fibrosis? Salty skin 591. progressive englargement of spleen and lymph tissues. Common S/S of Basilar Fracture? Ottorhea 612. opacity of lens. curtain vision 596.S of Retino Blastoma? Cat's eye reflex (grayish discoloration of the pupil) 599. Tinnitus 607. BRADYcardia (cushings triad)! 605.. Common S/S of Shock? HYPERtension TACHYpnea and TACHYcardia 606. Common S/S of Increased ICP? HYPERTENSION. Common S/S of Lyme's disease Bull's eye rash 611. cervical lymph adenopathy. Cmmon S/S Fibrin Hyalin? Expiratory grunt-. BRADYpnea. Common S/S of retinal detachment? Visual floaters. Common S/S of Intusseption? Sausage shaped mass . Common S/S of chicken pox? Vesicular rash (central to distal) dew drop on rose petal 583. Common S/S of MG? Descending muscle weakness 581. Dance sign (empty portion of RLQ) 579. Common S/S of Cystitis? Burning on urination 608. Common S/S of Hodgkins Disease/Lymphoma? Painless. Common S/S Meniere's Disease? Vertigo. Common S/S of Infectious Mononucleosis? Hallmark= Sore throat. dont confuse with MG 582. Cyanosis and continuous droolings 585. LTB = croup!!!! 584. Dysphonia.. Dysphagia 586. Common S/S of Cushings syndrome? Moon face appearance and buffalo hump 578. Common S/S of DKA Kussmauls breathing (deep rapid RR) 592. Common S/S of hypocalcemia? Chvostek and Trosseaus sign! Also hypomag! 609. Common S/S of MS>? Charcot's Triad (IAN) 580. Common S/S of Hydrocephalosis? Bossing Sign (prominent forehead) 604.Causes Infant respiratory distress! 590. Common S/S of guillian Barre Syndrome Ascending muscle paralysis. Common S/S Hepatic Encephalopathy ? Flapping tremors 603. Common S/S of TEF? 4 C'S. Common S/S of GERD? Barrets Esophagus (erosion of the lower portion of the esophageal mucosa) 602. Common S/S of glaucoma? Painful vision loss. Common S/S of orbital fracture? Battles Sign and Racoon's eyes . Common S/S Acromegaly? Coarse facial features 600. Common S.577. Common S/S of epiglottitis? 3 D'S --Drooling. Common S/S of LTB? inspiratory stridor.Coughing. Common S/S of BPH? reduced size and force of urine 594. CA=Cancer ! Duhh 593. and Reedstenberg cells! 587. 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. Give blood cultures and antibiotics. Normal Hemoglobin? Hemoglobin Neonates 18-27 3 mos 10. streptococcal pharyngitis. scarlet fever. Change in color is ? a LATE sign! Always~! 628.No Pain because of blocked and burned nerves .613.4-15.5 3 yrs 9. then if necessary surgery to drain abscess.bleeding precautions *Thrombocytopenia -Bleeding precautions! 1)Soft bristled toothbrush 2)No insertion of anything! (c/i suppositories. Glomerulonephritis? Glomerulonephritis: take vs q 4 hrs + daily weights 618. Turn and reposition (risk for impaired skin integrity) 615.6 625. 3 ft distance. Meningeal irriatation>? Meningeal irritation S/s nuchal rigidity. positive Brudzinski + Kernig signs and PHOTOPHOBIA too! 622. protruding means prolapsed. door closed. 626. Babinski sign? toes curl= GREAT Toes fan = BAD 623. mumps. Stomas? Stomas dusky stoma means poor blood supply.7-15. Renal impairment labs? Renal impairment: serum creatinine elevated and urine clearance decreased 616. negative pressure) 630. mycoplasma and adenovirus.Contact AND airborne precaution (Private room. 620. fat soluble vitamins ADEK. Age 4=5 year shots? Age 4 to 5 yrs child needs DPT/MMR/OPV 619.4. mucus in ileal conduit is expected.5 10 yrs 10. Incentive Spirometry steps? Incentive Spirometry steps:1) Sit upright 2) Exhale 3) Insert mouthpiece 4) Inhale for 3 seconds. high sodium. GTT for preggos? Glucose Tolerance Test for preggies result of 140 or highter needs further evaluation. rubella. Cranial nerves for Assessing extraocular eye movements? 3. pnuemonia. meningitis. diptheria. Nephrotic syndrome? Nephrotic syndrome s/s edema + hypotension.Red and Painful 2nd Degree . douche) 631. and then HOLD for 10 seconds 629. Cystic fibrosis? Cystic Fibrosis give diet low fat. MRSA and VRSA precautions? *MRSA . mask 621. 614. pertusis.6-16. private room or cohort.Contact precaution ONLY *VRSA . Thrombocyopenia. More info on droplet precautions? Droplet Precautions:sepsis. mucolytics and pancreatic enzymes. Osteomyeltitis? Osteomyletitis is an infectious bone dz.Blisters 3rd Degree . sharp pain + rigidity means peritonitis. Burn Degrees? 1st Degree . epiglottis. Tension Pneumothorax? Trachea shifts to the opposite side 627. 624. parovirus B19. influenza. Door open. Aerosal bronchodilators.5 617. You should watch for abdominal distention.Admin diuretics to decrease endolymph in the cochlea. Dietary restrictions you can expect include fluids. 638. School aged kids and five year olds? School-age kids (5 and up) are old enough. hemoglobin. What if a toddler says no to medication? If you gave a toddler a choice about taking medicine and he says no. and potassium. restrict Na. but what specifically? Coronary artery aneurysms d/t the inflammation of blood vessels. and may spit up after feedings. and tunneled under the skin up to the ventricles. Later you may be able to palpate a mass. Glomerulonephritis considerations With glomerulonephritis you should consider blood pressure to be your most important assessment parameter. In a toddler watch lack of appetite and headache. and rbc count. bulging fontanels. not at night. 640. the kidneys and ears develop around the same time in utero. Kawasaki disease causes? We know Kawasaki disease causes a heart problem. a beta agonist. 642. so fluid doesn't reduce too rapidly. If you see s/s of increasing icp.632. you should leave the room and come back in five minutes. Careful on a bed position question! Bed-position after shunt placement is flat. This is where the shunt is guided into the abdominal cavity. (just to expand on it a little. sodium. 637. and should have an explanation of what will happen a week before surgery such as tonsillectomy. 639. Sickle cell crisis? During sickle cell crisis there are two interventions to prioritize: fluids and pain relief. Triad: 1)Vertigo 2)Tinnitus 3)N/V 633. they're shaped similarly. . Med that can't be infused Intra osseously? One medication that cannot be administered by intraosseous infusion is isoproterenol. protein. since fluid from the ventricles will be redirected to the peritoneum. lay on affected ear when in bed. because to a toddler it is another episode. Menieres's disease? *Meniere's Disease . A child with a ventriculoperitoneal shunt A child with a ventriculoperitoneal shunt will have a small upper-abdominal incision. and high-pitched cry in an infant. such as irritability. Gastric ulcer pain *Gastric Ulcer pain occurs 30 minutes to 90 minutes after eating. and doesn't go away with food 634. then raise the hob to 15-30 degrees. Knowing that the kidneys and ears are similar shapes helped me remember this). 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. 643. Hence. 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. if the nurse notices low set or asymmetrical ears. Next time. there is good reason to investigate renal functioning. You should also watch for signs of increasing intracranial pressure. the baby will seem hungry often. 635. 641. 636. Which is why when doing an assessment of a neonate. don't ask. 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. The name refers to the angles of the joints. Watch for anemia with milk-aholics.644. 657. Other causes could be infection. 648. (Milks good. especially iron. Kids with RSV?> Kids with RSV. Premature newborns with immature lungs are ventilated and over time it damages the lungs. While we're talking about traction. because they are obligatory nasal breathers.SIDS). before assisting with feelings about the tremendous loss. How will CSF look in meningitis? CSF in meningitis will have high protein. Suctioning is good--except No nasotracheal suctioning with head injury or skull fracture. 651. 655. pneumonia. A pin is placed in the distal part of the broken bone. 645. tent. In almost every other case. Maslow for a guy who lost his house in a fire? . Huh? I never heard of it either. or other conditions that cause inflammation or scarring. How do children less than one breathe? It is essential to maintain nasal patency with children < 1 yr. Milk for kids? Watch out for questions suggesting a child drinks more than 3-4 cups of milk each day. and low glucose. Give Tylenol. Peds positioning for GERD? Position prone w hob elevated with gerd. Yeast infection in a babys mouth? If you can remove the white patches from the mouth of a baby it is just formula. Start teaching boys testicular self exam around 12. and also no nsaids such as ibuprofen. MMR and Varicella? Just know the MMR and Varicella immunizations come later (15 months). 647. its candidiasis. 652. . When instilling eardrops? Pull pinna down and back for kids < 3 yrs. 646. (Maslow). though. Priority is using community resources to find shelter. etc. Juice or milk will rott that kids teeth right out of his head. because most cases occur during adolescence. no contact lenses or pregnant nurses in rooms where ribavirin is being administered by hoot. What could cause bronchopulmonary dysplasia? What could cause bronchopulmonary dysplasia? Dysplasia means abnormality or alteration.A guy loses his house in a fire. Traction in kids? What traction is used in a school-age kid with a femur or tibial fracture with extensive skin damage? Ninety. ninety. you better lay that kid on his back (Back To Sleep . a kid's hinder should clear the bed when in Bryant's traction (also used for femurs and congenial hip for young kids). Kids pain relief in NCLEX land? No aspirin with kids b/c it is associated with Reye's Syndrome. 653. when instilling eardrops. 650. and the lower extremity is in a boot cast. 654. And don't let that mother put anything but water in that kid's bottle during naps/over-night. right?) Too much milk reduces intake of other essential nutrients. 649. Cryptoorchidism? Undescended testis or cryptorchidism is a known risk factor for testicular cancer later in life. If you can't. The rest is the normal pulleys and ropes you're used to visualizing with balanced suspension. Mechanical ventilation can cause it. 656. . Chorea is part of this sickness (grimacing. 661. Every new admission needs? You will ask every new admission if he has an advance directive. No pregnant visitors/nurses. 673. Flush substance out of body w/3-4 liters/day for 2 days. They have joint pain. Watch for elevated antistreptolysin O to be elevated. 662. and flush the toilet twice after using for 2 days. and lymph 667. and no kids. Main hypersensitivity for antiplatelet drugs? broncospasm (anaphylaxis) 666. lowest position. But if you are trying to reduce congestion the sick lung goes up. 664. and you lay with the stuff side up and it clears?) 659. wheels locked. Penicillin! 663. lung. 674. Tylenol poisioining ? Tylenol poisoning . (Ever had a stuffy nose. What treats tet spells? Tet spells treated with morphine. If potassium is there you can bet it is a problem they want you to identify. G-tube and J-tube feedings are usually given as continuous feedings. Group-A strep? Group-a strep precedes rheumatic fever. Limit contact w/patient to 30 minutes/day.658. because values outside of normal can be life threatening.The key word here is flush.liver failure possible for about 4 days. watch out if your wheezer stops wheezing. Asthmas and wheezers? Coughing w/o other s/s is suggestive of asthma. Normal potassium is 3. and he will have the option to sign or not. 660. Common sites for metastatsis? liver. Radioactive iodine? Radioactive iodine . Post spleenectomy? Pneumovax 23 gets administered post splenectomy to prevent pneumococcal sepsis. A sputum test will confirm active disease. and if not you will explain it. Positioning with pneaumonia? Positioning with pneumonia . Bence Jones protein in urine? confirms multiple myeloma 669. Side rail rules? Four side-rails up can be considered a form of restraint. as well as tx with Mucomyst. How do you treat a small bowel obstruction? Don't fall for 'reestablishing a normal bowel pattern' as a priority with small bowel obstruction. Speaking of asthma. and one side of bed against the wall. Potassium lab importance? Let's say every answer in front of you is an abnormal value. keep lower rails down.0 in a renal patient in priority.0. It could mean he is worsening. Even a bun of 50 doesn't override a potassium of 3. 672. sudden body movements.5-5. 671. Orthostatis= orthostatic hypotension 668. brain.. Because the patient can't take in oral fluids 'maintaining fluid balance' comes first. Close observation required during this time-frame. G tube and J tubes are usually? Other than initially to test tolerance. TB test confirmation? A positive ppd confirms infection. 670. Even in LTC facility when a client is a fall risk. Orthostatis is verfied by? a drop in presssure with increasing heart rate. etc. . not just exposure. 665.lay on the affected side to splint and reduce pain. bone.) and it embarrasses kids. vision changes. 683. 686. Potassium is low in HHNS (d/t diuresis). labs. brain stem involvement 681. Omphalocele? With omphalocele and gastroschisis (herniation of abdominal contents) dress with loose saline dressing covered with plastic wrap. Resolution is obvious. 680. Do not use an occlusive dressing. . Other S/S of MS? Hyperactive deep tendon reflexes. and keep eye on temp. which could convert the wound from open pneumo to closed one. with potassium replacement.675. a compound fracture requires assessment before Glasgow coma scale and a neuro check (D=disability. A barium enema may be used to hydrostatically reduce the telescoping. fatigue and spasticity are all symptoms of MS 682. Decerebrate in response to pain = Cerebellar. and a tension pneumothorax is worse situation. Cardinal sign in infants is failure to pass meconium. 687. 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). 678. 676. More info on intussception? Intussusception common in kids with CF. What to do if your patients chest tube accidently getes removed? An occulsive dressing is used 679. Therefore. After that get your chest tube tray. iv. Labs in DKA>? Serum acetone and serum ketones rise in DKA. As you treat the acidosis and dehydration expect the potassium to drop rapidly. Hydrocele? After a hydrocele repair provide ice bags and scrotal support. if airway and breathing are accounted for. Kid can lose heat quickly. Decorticate and Decerebrate? Decorticate positioning in response to pain = Cortex involvement. After appendectomy? position on the RIGHT side with legs flexed 684. 685. and later the classic ribbon-like and foul smelling stools. Obstruction may cause fecal emesis. with onset of bowel movements. so get fluids going first. 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. so be ready. Hirschsprungs is dx how? Hirschsprung's diagnosed with rectal biopsy looking for absence of ganglionic cells. With HHNS there is no ketosis. currant jellylike stools (blood and mucus). or neuro check) 677. Fluids are the most important intervention with HHNS as well as DKA. and no acidosis. What is bleeding considered in ADPIE? Bleeding is part of the 'circulation' assessment of the ABCD's in an emergent situation. 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. PCWP Normal PCWP (pulm capillary wedge pressure) is 8-13. Pulmonary sarcoidosis? Pulmonary sarcoidosis leads to right sided heart failure. 697. CPR in a five year old? In a five-year old breathe once for every 5 compressions doing cpr. and should be taught to family when a client is going home with an NG tube. Generalized edema common. After Gtube placement? After g-tube placement the stomach contents are drained by gravity for 24 hours before it can be used for feedings. retractions. Readings of 18-20 are considered high. 705. When to test urine for ketones and glucose? Second voided urine most accurate when testing for ketones and glucose. NG tube rules? An NG tube can be irrigated with cola. If your patient starts seeing bugs? If your normally lucid patient starts seeing bugs you better check his respiratory status first. and get abg's if possible. 704. 696. 706. 703. air hunger. Cold stress in a newborn? The biggest concern with cold stress and the newborn is respiratory distress. and coma. Carbon dioxide narcosis causes increased intracranial pressure. followed by dyspnea and tachypnea. Parents should wear gloves for care. PKU ? No phenylalanine with a kid positive for PKU (no meat no dairy no aspartme 689. and things go downhill from there all the way to delirium. 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. What will alter the accuracy of o2 sats? Hypotension and vasoconstricting meds 694. The first sign of hypoxia is restlessness. MMR is avoided only if the kid is severely immunocompromised. 698. Western blot test? A positive Western blot in a child <18 months (presence of HIV antibodies) indicates only that the mother is infected. 693. cyanosis. 701. The first s/s of ards? The first sign of ARDS is increased respirations. not kiss kids on the mouth. hallucinations. So check the o2 stat. Cephalhematoma (caput succinidanium)? Cephalhematoma (caput succinidanium) resolves on its own in a few days. 692. Corticosteroids are the mainstay. but give Pneumococcal and influenza. Carbon dioxide narcosis? High potassium is expected with carbon dioxide narcosis (hydrogen floods the cell forcing potassium out). Two or more positive p24 antigen tests will confirm HIV in kids <18 months. followed by agitation.688.. Nepphrotic syndrome? Nephrotic syndrome is characterized by massive proteinuria (looks dark and frothy) caused by glomerular damage. 699. 691. 690. This is the type of edema that crosses the suture lines. Kids with HIV? For HIV kids avoid OPV and Varicella vaccinations (live). and not share eating utensils.Sarcidosis is basically scar tissue build up 700. The p24 can be used at any age. . First sign of pe? First sign of PE is sudden chest pain. Room air is? Ambient air (room air) contains 21 % o2 695. 702. Later comes dyspnea. Highest priortiy in status elipticus? Level of consciousness is the most important assessment parameter with status epilepticus. 715. . Likely cause of cardiac arrest in child? Prolonged hypoxemia is a likely cause of cardiac arrest in a child. Pancreatitis prioritys? After pain relief. 719. because of fluid pushing up in the diaphragm. 717. etc. 726. gi complaints. 46 corresponds to a blood sugar of 70-110. 7 is ideal for a diabetic and corresponds to a blood sugar of 130. 713. Anorexia sucks because? Absence of menstruation leads to osteoporosis in the anorexic. Depression manifests itself? Depression often manifests itself in somatic ways. Pt with edema and walking? A patient with liver cirrhosis and edema may ambulate. Hep A precautions? During the acute stage of Hep-A gown and gloves are required. High priority in Addisons? Managing stress in a patient with adrenal insufficiency (Addison's) is paramount..test to assess how well blood sugars have been controlled over the past 90-120 days. Crackles most likely are? Crackles suggest pneumonia. TB is a public health risk. More info on TB testing a positive result? speaking of TB.. 708. More labs suggestive of renal failure? Low magnesium and high creatinine signal renal failure. 712.707. coarctation of the aaorta causes? Coarctation of the aorta causes increased blood flow and bounding pulses in the arms 722. 718. In the convalescent stage it is no longer contagious. Chief concern in CF Respiratory problems! 725. More IVP info? A laxative is given the night before an IVP in order to better visualize the organs. 724. such as psychomotor retardation. as it causes severe hypotension. If you THINK a patient has new HTN? A newly diagnosed hypertension patient should have BP assessed in both arms 723. because if the adrenal glands are stressed further it could result in Addisonian crisis. such as dark stools. Hightest priority for RA? Pain is usually the highest priority with RA 710. which would manifest itself as mental confusion. 716. Hba1c? HbA1c . 711. Low crit/hemoglobin? A patient with a low hemoglobin and/or hematocrit should be evaluated for signs of bleeding. which is likely to be accompanied by hypoxia. remember blood pressure is the most important assessment parameter. and pain. 709. then sit with legs elevated to try to mobilize the edema. cough and deep breathe is important in pancreatitis. TB health risk? If a TB patient is unable/unwilling to comply with tx they may need supervision (direct observation). 714. 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. While we're on Addison's. 720. 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. Limit fluids while eating. A Tenkhoff catheter is usually used in peritoneal dialysis . The organs in the abdomen are surrounded by the peritoneum. shoulder dystocia 744.. Encourage pursed-lip breathing which promotes CO2 elimination. Vertical C section? Used in plus sized women or risky or emergency c sections. Polyuria is common with the hypercalcemia caused by hyperparathyroidism.. Gerd again? Patients with GERD should lay on their left side with the HOB elevated 30 degrees. Instead. and turn it pink. STD= gonnorrhea? Gonorrhea is a reportable disease 733. which leads to reduced preload (volume in the left ventricle at the end of diastole). 735. not increased PCO2 like the rest of us. Dystocia? Just means a difficult or abnormal delivery or birth. Urine and normal vaginal discharge are acidic. and turns nitrazine paper blue. It is found in food only and is also found in aspartame 742. Peritoneal dialysis? On the other hand. 737. Peritoneal dialysis uses a Tenckhoff catheter to run the dialysis fluid. or peritoneal. so don't slam them with oxygen. bringing the glucose down too far and too fast can result in increased intracranial pressure d/t water being pulled into the CSF. high-fowlers and leaning forward. 730. (I though it was weight. followed by the crutches and the bad leg. followed by the good leg. Emphysema? In emphysema the stimulus to breathe is low PO2.. encourage up to 3000mL/day fluids. 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. This allows the patient's blood to be filtered without pumping it through a dialysis machine. what can lead to decreased preload ? Sepsis and anaphylaxis (along with the obvious hemorrhaging) reduce circulating volume by way of increased capillary permeability. 740. Nitrazine paper? Amniotic fluid is alkaline. 732. Kernigs sign? One of the physically demonstrable symptoms of meningitis is Kernig's sign. the blood is cleaned while still inside the body. Severe stiffness of the hamstrings causes an inability to straighten the leg when the hip is flexed to 90 degrees. into the abdominal. example. Crutch use? Remember the phrase "step up" when picturing a person going up stairs with crutches. Besides meds and congenital problems . cavity. 734. less chance of harm for the baby 743. a sugar solution with some salts. This is a toughie. 731. Placement of a wheelchair? Place a wheelchair parallel to the bed on the side of weakness 729.think about it. which is a membrane that allows waste products to pass through it.. The good leg goes up first. If the situation persists. MORE info on DKA? ugh! While treating DKA.727. 738. The opposite happens going down. Brudzinski's sign? One of the physically demonstrable symptoms of meningitis is Brudzinski's sign. peritoneal dialysis does not require that the patient's blood be pumped outside of his body.. Nonfat milk? Nonfat milk reduces reflux by increasing lower esophageal sphincter pressure 736. Most accurate way to test kids for medication accuracy? BSA is considered the most accurate method for medication dosing with kids. then take it higher. 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. Phenalalanine? It is an amino acid that is BAD for people with PKU. To prevent dumping syndrome? Unusual positional tip .. 739. The crutches go first. but apparently not) 728.Low-fowlers recommended during meals to prevent dumping syndrome. Pancreatitis! 753. passion fruit. Charcots sign? A. Ash wiill affect the urinary system and even the nervous system. abnormal.. (Lupus) 750. Someone may have a reaction to all the foods noted to cause cross reaction while another may have no reaction at all. pears. cherries. Grey Turners sign? Purple bruises around the belly button. avocados and tomatoes. Nystagmus 2. if you are allergic to any of these foods.. Dengue hemorrhagic fever? Hermans sign= flushes and redness of skin with lighter color at the center of the rash. celery.. The precise mechanism of these episodes is in doubt. known as ash. PTB means? Pumonary tuberculosis 748. Likewise. VRSA? Staph infection that is resistant to Vancomycin treatement! Worse than MRSA 759. 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..745. MG and Guillian Barre? Opposites! Nursing connection! Think about it! 757.. grapes.. It just looks like a whiteish yellow capsule around the tonisils 749. Psuedomembrane in DIptheria? Diptheria is an upper respiratory tract infection. SLE? Systemic Lupus Ethramoutus. and it will cause spasms of the wrist 758. which can be acidic or alkaline depending on its effect on the pH of your urine. 755.. •carrots. kiwi. Acid/ ash diet is used to BALANCE the acid/alkaline ash in the body. It is characterized by sore throat. figs. you may also be allergic to latex: •apples. It is a diet intended for health and may be prescribed by your physician to control illness or disease. This is called a cross reaction. pineapple and strawberries. •wheat and rye.. Intention tremor 3. your body responds with the same allergic symptoms that you would have if you were exposed to latex.. Scanning or staccato speech 756. Acid/ ASH diet? The acid ash diet has nothing to do with weight loss. melons. bananas. . Eating foods that create an acid ash may help to balance your system or create a hostile environment to inhibit bacterial growth. Chvostek and Trosseaus sign Chvostek= Tapping on the face above the cheek bone will cause spams! Trosseaus= using a BP cuff and inflating it. Cross reactions differ from one person to another. PDA? patent ductuous arteriousus in infants! Valve doesn't close! 754. raw potatoes. Megan! Nightmares! 752. Dance Sign? Dance's sign: RUQ mass (intussusception) with RLQ empty space (movement of cecum out of normal position). Risus Sardonicus? Risus sardonicus is a highly characteristic. Imbalance will be diet modified 747. Charcot's triad for multiple sclerosis 1. peaches. Once your liver has metabolized the food you ingest.. Older children will often squat during a tet spell. nectarines.. as well. sustained spasm of the facial muscles that appears to produce grinning--..From Tetany! Sad and scary looking! Never Google image it again. Tet spells are characterized by a sudden. low fever and the psuedomembrane! Which is just a capsule around the tonsils that you can see with your penlight. which increases systemic vascular resistance and allows for a temporary reversal of the shunt. •chestnuts and hazelnuts. It is a disease that comes from tropical and subtropical areas that are spread by misquotos 751. marked increase in cyanosis followed by syncope. Tet spells? Children with tetralogy of Fallot may develop "tet spells". papaya. 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. 746. plums.. . and may result in hypoxic brain injury and death. it leaves a mineral deposit. When this happens... provide acceptable options 781. anterior fentanyl closes. substance abuse Identity vs role confusion. Erikson stage 3-6. video games Industry vs inferiority. Erikson stage 20-35 leaves families and seeks relationships. · Hyperosmolar hyperglycemic nonketotic syndrome (HHNS) is primarily a disorder of dehydration due to hyperglycemia 761. Liver disease Decreased protein intake 765. osteoporosis. Antidote for opoids Naloxone . decreased skin elasticity. Gout Avoid purines 768. 9m sits up on own. meet social and developemental needs 780. walking heel to toe Initiative vs. encourage participation in care 783. decreased cough reflects. nine months bangs toys together. posterior fontanelle closes at 2 to 3 months. Monitor for acetaminophen Temperature 772. feeds self. career training. 3 m holds head. Monitor for zolpidem Sleep patterens 777. decrease in visual and hearing Generativity vs stagnation 786. Intimacy vs isolation. music interest. career transition. Celiac disease Avoid glutens 766. Monitor for prednisone Delayed wound healing 775. Erikson stage 12-20 pure activities. Pancreatitis NPO. Erikson stage 35-65 bouncing life. 1 to 5 m grasp rattle 6 m transfer between hands. stranger danger 782. Nausea and vomiting Clear liquids 767. Erikson stage 0-1. Diverticulitis Clear liquids to high fiber 763. HHNS Vs DKA · Diabetic ketoacidosis (DKA) is a condition of DKA=insulin deficiency resulting in acidemia due to altered metabolism. hopping. retirement. Monitor for Olanzapine Mood 778. potty train. Cholecystis Low-fat diet 764. pregnancy. provide private time with partner 785. Monitor for morphine Respiratory rate 774. growth ends childbearing. Dumping syndrome Small frequent meals 769. steady gait. lower cardiac output. Erikson stage 65+. 5-6 m rolls. menopause. 8-9 m uses pincer grasps. STI's. eating late. Provide support groups of same age 784. Erikson stage 1-3. Monitor for warfarin INR 776. established career. build models. peridontal disease Integrity vs despair. Erikson stage 6-12 or games. aging parent. rides bicycle. 12 m stands alone Trust vs mistrust. Monitor for glipizide Blood glucose 773. guilt. alcohol caffeine 770. GERD Avoid large meals. Monitor for digoxin Potassium 771. draw stick figure. Monitor for Levoflaxacin Culture and sensitivity 779. adult children. grandchildren. organize sports. provide age appropriate activities. use personal items were not home 787. need routines and rituals Autonomy vs shame and doubt. draws shapes. TPN May be used 762.760. puzzles games. sexual maturiation. 5-5 810.788. tunneled catheter 802. Hold this medication 48 hours before and after use of contrast dye Metformin 798. Antidote for warfarin Vitamin K 789. can be given IV. Routes TPN can be given Picc line. Antidote for lead Succimer 794. Antidote for magnesium Calcium gluconate 795. also for DKA Regular insulin 800. Antidote for heparin Protamine sulfate 791. Standard precaution requirements Nothing. Given subcutaneously and has no peak time Glargine 799.000-400.2 825.5-1. Normal sodium level 135-145 809. Type of solution for TPN Hypertonic 801. Normal potassium level 3. Normal glucose fasting 70-105 822. Normal calcium level 9-10. TPN is hung every_ hours 24 804. Normal creatinine level 0. Venous supply Goes up in legs 827. Contact precaution requirements (body fluids) Gloves and gown 806. Normal hemoglobin level 14-18 814. May be used to lower potassium levels. 4-6 hr peak time NPH 796. Have client eat as soon as this medication is given Lispro 797.5 811. gloves prn 805. Normal platelets 150. Antidote for digitalis Digoxin immune fab 793. normal aptt 30-40 sec rx 1.000 (enoxaparin sodium) 818. TPN is prepared how often Daily 803. Normal HbA1c (glycosylated hgb) 4-6% 823.5 sec. Normal BUN level 10-20 824. rx: 1. Droplet precaution requirements (air) Mask 807.5-2x (heparin) 820.5-2x (Coumadin) 819. Red tag Emergent 828.8. Normal cholesterol level <200 817. Normal INR 0.7-1. Yellow tag Urgent within 1 to 2 hours . When mixed with regular insulin draw this medication up last. Arterial supply Goes down in legs 826. rx 2-3x (Coumadin) 821.000-10.000 816. Antidote for benzodiazepine Flumaxenil 792. Normal Hct level 37-52% 815. Normal carbon dioxide level 35-45 812. Normal WBC level 5. Airborne precaution requirements (air) Mask 808. Normal P T 11-12. Antidote for acetaminophen Acetylcystiene 790. Normal hydrochloride level 21-28 813. Medication to hold prior to ECT Dilantin or other medications that alter brain activity 833. DTR. 2 pt gait Partial weight-bearing on extremity walking with crutches right leg left crutch as if they were skiing 847. resp. or has child 841. iv therapy. System affected by methotrexate (steroid) Immune system. Assessments: Brudzinski (pain with Head to breast bone) Kernigs (Pain with knee up to chest) Living in close spaces can cause this. arm's-length away. 4 pt gait Stability partial weight-bearing on both extremities right leg right crutch 849. Meningitis symptoms: Headache. monitor BP. Up stairs Strong leg first 852. Versed Pt cannot sign for anything after recieving 840. Magnesium drip needs to have one-to-one. don't pull self up with device 850. decreased white blood cells and decreased platelets 837. immunization. w/ out symptoms quarenteen for 21 days 836. How long post surgery to be on blood thinners 30 days 834. 3 pt gait Nonweightbearing swing through crutches 848. Diet for Buddhism Avoid beef pork seafood 856. Black tag Not seen don't have survival potential 831. seizures occur with low levels 838. Down stairs Weak leg first 853. Judaism diet (Muslims) Kosher. LPNs cannot what Evaluate Assess teach. Hinduism diet No beef. Diagnostics: spinal fluid (lumbar puncture) blood cultures. many are vegetarian . Diet for Christianity Don't eat meat on ash Wednesday or Fridays of light may have days of fasting 855.829. Green tag Non-urgent 2 to 4 hours 830. Mass casualty triage Do the greatest good for the greatest number 843. Walker Step into it.can't mix milk and meat no pork avoid fish that don't have scales 857. used for preclampsia 844. can reinforce or reteach. System affected by sodium levels Neurological system. may fast. Stiff neck and photosynthesis. Anti-cholinergic drugs side effects No see no Pee no stool no drool 839. ED triage Treat most severe injury first 842. Cane Always on the strong side 851. 845.o can be a majority if Married. Prevention: Hand washing. Priority for MI Apply oxygen first 846. blood therapy rhogam 832. due to side effects (absent deep tendon reflexes). Ebola Hemorrhagic fever. 16 y. Priority if chest tube comes out Cover with Vaseline soaked gauze 835. emancipated. Yogurt Form of calcium for lactose intolerant patients 854. electrolytes. monitor hemoglobin 885. 9% sodium chloride. 300 to 600 heart failure is mild. Digoxin toxicity Halos around everything. dubotamine 881.858. Amoxicillin Be aware with cephalosporins allergy 868. and anti-cholinergic effects 863. dopamine. <6 882. avoid sugar and milk 859. beta blockers. varenicline Only use up to 12 weeks for smoking cessation 871. Zolpidem (Ambien) sleepwalk and cannot remember 862. ever felt anger when people tell you to cut down. Risedronate Don't lay down right away 865. creatinine. dextrose 5%. Factor 8 Treats hemophilia. Dopamine and dubotamine Monitor heart rate urine output and blood pressure 883. Hgb. vancomycin 875. BUN. greater than 100 residue fluid hold fluid. Calcium channel blocker's. cutdown use of alcohol. Fentanyl patch Remove with temperature. and cardiac output.5-5 887. Ceftriaxone Can create C diff 869. Interventions for dumping syndrome Lay down after eating. Clean wound with _ before getting culture Saline or sterile water 876. monitor platelets 886. ARBs. Kidneys Monitor I&O. 3. head of bed 30° or higher. Packed RBCs Treat anemia. V tach First action drug Amerodone then lidocaine then prepare for cardioversion 877. BP (BUN & creatinine increases with kidney failure) . Intropic agents Increases myocardial contraction. EPS. Ace inhibitor side effects Dry hacking cough. ever feel guilty about how much you drink. decreased contractility. CAGE Screening tool for alcoholism. one for three days. not used for TPN. 20 gauge catheter Can be used for packed RBCs. digoxin. 1 pound 3500 calories 880. Gentamicin Don't use if damage to kidneys when used with furosemide can cause hearing loss at high doses 867.8-8. avoid drinking one hour before and one hour after eating. Lithium toxicity Can occur if greater than two 861. peripheral edema 873. Agranulocytosis. assess for signs of intolerance. BNP Diagnostic test for CHF. severe hf > 900 884. normal is lower than 100. monitor albumin. ace inhibitors Blood-pressure medications 872. 100 to 300 heart failure is possible. eye-opener to quit 878.8 889. 1 unit of blood Expect 1g/dl increase in hgb ex. neuroleptic malignment syndrome. 7. angioedema 874. don't put heating pad over it 866. siezures 864. Adverse effects Life-threatening 870. Plasma Treats Burns. first feeding have x-ray every other check pH. Calcium channel blocker's side effects Bradycardia. Platelets Treats thrombocytopenia.such as thumb rolling And eye emovements. amirodone. monitor ptt 888. Adverse affects of antipsychotics Tardive dyskinesia. 600-900 moderate heart failure. Interventions for eternal nutrition Start slow increase rate every 8 to 12 hours. 860. Wilms tumor On adrenal gland needs to be removed prior to bursting 879. Side affects of anti-psychotics (typical) Sedation. side effects: seizures psychotic symptoms. Nursing interventions for sickle cell anemia Oxygen as needed. Affected system of potassium Cardiac. fluids as needed. air embolism. Mr. +7 days 905. 898. contractions. First stage of labor Latent 0 to 3 cm. or remove thyroid (calcium at bedside) Think of Tigger orange and hyper 892. assess for signs and symptoms of infection. Letting go phase Getting back to the new normal 912. use z track method for Iran dextran 914. and her vitals. Insulin withdrawal when mixing Clear to cloudy (regular-NPH) 895. assess LOC and bleeding 917. occlusion. dizziness. transition 8 to 10. Risperidone Bipolar. Fourth stage of labor Bonding with newborn 909. Hypothyroidism Levothyroxine. and bleeding mucous membranes 916. Third stage of labor Delivery of placenta 908. 906. 899. SNRI and tricyclics Antidepressant that box reuptake of serotonin and norepinepherine 901. Oxytocin Monitor fhr. blood comes and causes severe pain. leafy green vegetables. monitor for suicidal thinking. oxygen is limited to the cells of the body because cells cannot carry oxygen as well. Think of eeyore. no levels of lithium.890. knowledge deficit and powerlessness 920.I. Taking hold phase It's all about the baby 911. leukopenia 897. admonister factor replacement. with air embolism lay on left side and Trendelenburg position with insertion 891. Sickle cell anemia and crisis Most common in African Americans. Anemia side effects Weakness paler fatigue 913. monitor vitals. Taking in phase It's all about me 910. Lithium carbonate Bipolar. G. brain hemorrhage. Hyperthyroidism PTU & Tapazole. monitor for sedation insomnia pseudoparkinsonism. manage pain. hr. slow moving. organ meat. Developing cancer with birth control Only with smoking 904. egg yolks. susceptibility to infection. hypoxic damaged tissue. Second stage of labor Pushing stage 907. infection. Atypical antidepressants Selectively inhibits dopamine and stimulates CNS. Anemia interventions Food sources that contain red meat. rr 896. depressed 893. Complications with central lines Pneumothorax. 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. active 4 to 7. cardiac arrest with severe levels 894. Hemophilia nursing interventions Assess for joint pain. monitor H&H. BP. SSRI Antidepressant that blocks reuptake of serotonin 900. causes and prevention of crisis . dehydration. Naegeles rule 1st day menstrual cycle-3 months. and G you bleeding. Hemophilia signs and symptoms Risk for bleeding. Hematomas. don't do well in cold weather or high altitude 919. Signs and symptoms of sickle cell anemia Anemia. avoid injections and NSAIDs. Buproprion 903. teach self-care. MI diagnostic labs Troponins 918. Quetiaphine fulmarate Bipolar. MAOI Focus on diet 902. 915. ACE inhibitors. shallow respirations. Cushings. daily weights. crackles in lungs. Stable angina pt is awake and doing something when having chest pain. weight. Normal pulmonary wedge pressure 4-12 944. Nursing interventions for MI Morphine (decreases preload & afterload) Oxygen (First. take another nitro. Hyponatremia Causes: Diuretics. digitalis 945. Manifestations: Lumps. Symptoms: muscle weakness. Protocol for American Heart Association regarding MI Sit down take a nitro.(decreases clot formation) MONA 929. muscle weakness 949. Hypokalemia Causes: Diuretics. prevention: Gardisil 922. erbs point. I&O. Prinemetal/ Coronary spasm Sound asleep and woken up by pain in chest 927. Heart failure NI: O2. Dysrrhithmias . wait 5 min and take final nitro. Don't want PVC's to hit T wave 938. Cervical cancer Contributing factors: HPV/ multiple partners. lifestyle. Where do I listen to S2? aortic and pulmonic 932. Thyroidectomy Check for positive Chvotesek sign 947. hypovolemia 935. avoid crossing legs. Common heart rhythm with anemia Sinus tachycardia 941. DKA Symptoms include: kussmaul respirations. Prevention: Diet. pulmonic. anticoags. Where do I listen to S1? tricuspid and mitral 933. muscle weakness. Unstable angina/ preinfarction Moving around but not relieved with nitro. bleeding. manifestations: abnormal bleeding. fowlers. S3 and S4 sounds kentucky (going into CHF) Tennessee (Angina) 934. fruity breath 946. thickening. tricuspid. wait 5 min. v fib whole ventricles are shaking like jello and not firing 940. check vitals every 15 min. treats ischemic myocardium) Nitro (increases coronary perfusion) Aspirin. 928. monitor site. corticosteriods. Left sided heart failure Fluid backs up into lungs. 926. Treatment: SIADH. skin temp.921. Heart sounds mnemonic Ape to man Aortic. T wave ventricles relax. Symptoms: Confusion->siezures. S3 gallop. machine synchronizes with the heart rhythm because you do not want to hit the t wave 939. Dianosing: pap/DNA test. Pain is able to be treated with first nitro 925. suctioning. Angioplasty NI: cardiac diet. Diagnosing: mammogram. Symptoms: confusion-> seizures. dyspnea 942. P wave atrium are contracting 936. excercise 923. diuretics. Cardioversion Use with unstable v tach. diarhea. QRS ventricles contract 937. lung sounds. call 911. renal disease. cramping 948. peripheral edema 943. Hypernatremia Causes: Water deficit. cardiac monitor. Breast cancer Contributing factors: family history. mitral 931. fluid restriction. When is a colposcopy used? abnormal pap test 924. pressure @ site. Right sided heart failure Fluid backs up into heart. Complications: dysrhithmias. KEEP BP LOW 930. Aortic femoral Bypass (restoring blood supply to blocked area) interventions peripheral pulses. headache Treatment: lower BP and treat cause. Administer through central line and have foley cath. Hypercalcemia Causes: Hyperthyroidism. Anterior leg=9%. renal failure. assess respiratory status. decrease stimulation. Begin time at time of burn. low protien 960. Rule of 9's Each arm= 9%. urinary retention. packed RBCs. prevent DVT. paraplegic 968. Head injury Signs: Changes in LOC. Elevate HOB. tachypnea. NI: Assess fluid balance. hypertension. Spinal cord injury Intervention: Immobilization.9%NS 957. Kayexalate enema pulls off potassium 954. Hypotonic fluid moves into the cell 0. siezures 955. Increased ICP. renal failure. Brady. peritonitis. worry about breathing 966.950. ascites. Cervical spine Top 8. prolonged ST. Autnomic dyreflexia Spinal injury. 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. skin break down. constipation. changes in LOC. Cirrhoises Symptoms: hypertension. Metabolic alkalosis Vomiting loose acid and left with base 975. Precalampsia NI: Monitor BP. Isotonic No fluid crosses the cell membrane 0. hypo/hypertension. Lumbar spine Bottom 5. watch edema eclampsia occurs with seixures 971. high calorie diet. 1/2 in remaining 16 hours 962. hepate encephalopathy. assess vital signs. 963. Hypertonic fluid moves out of the cell D5 NS 959. flushing. Parkland formula used for determining amount of lactated ringersfor burn patient. 4mL x kg x %TBSA= 1/2 total in first 8 hrs. Hypocalcemia Causes: hypoparathyroidism. peaked T waves 951. protein in urine. nutritional support. fluid restrictions. bradycardia. hyperthermia. hypotension. esophageal carices. malabsorption Symptoms: Changes in HR. Perineum=1% 961. I & O. Addisons Symptoms: Dysrhythmias. quadroplegic 967. assess bleeding. Hyperkalemia Causes: salt substitutes. fully compensated pH is normal other two are off 974. 964. monitor ICP. Metabolic acidosis Diarrhea loose base and left with acid . Partially compensated pH is off as well as other two are off 973. Thoracic spine Middle 12. Excessive intake Symptoms: Dysrhithmias. Addisons Low cortisol 952. Interventions: Assess neurostatus w/ glascow coma scale (higher the better). 965. cardiac arrest 956. 969. Cushings High cortisol (steroid symptoms) 953. clotting abnormalities. posturing. institue bowel sounds and bladder program. Posterior leg=9% Head=9%. Spinal shock occurs right away. monitor electrolytes. Uncompensated pH is off and 1 other is off 972. can occur after several weeks only in T6 or higher. tetany. vitals. safety precaustions. weight.45% NS 958. Back=18% Chest=18%. Cluster B Antisocial. Airborne(infections) chicken pox. Depression R/f: female. Carseat Middle of backseat for 2 years or 20 lbs 980. poop is? vomit is? Poop is base Vomit is acid . Low pressure with mechanical ventilation check tubes for leaks 978. Borderline. early child hood trauma. Nasal Cannula 1-6 L/min over 2 needs humidifyer 983. HR over what is tachycardic 100 1006. pt needs tomlet machine breath for them. Cap refill reveals what? end-organ perfusion 1003. 994. Donning order Gown-Mask.goggles-mask 982. Borderline personality disorder Manipulative behavior 995. Non. High pressure with mechanical ventilation NI: assess for need to suction. Narcissistic 999. unmarried. decrease excessive stimulus. Where to check for skin turgor? Adult . Histronic. Dependent. cant cohort 990. Cancer internal radiation NI: visitors should maintain 6 feet away and visit no longer then 30 min. Contact (infections) MRSA. When patient hears voices "What are the voices saying to your?" 1001.goggles-gloves-enter 981. TB. postpartum period. 977. flight of ideas. low socialeconomic class. C-diff can cohort 991. RSV contagious for 1 week after antibiotic 987. Simple face mask 6-8L/ min 984. What does clubbing of the fingers mean? chronic hypoxia 1002. C-Diff and VRE use soap and water 988. Droplet (infections) measles. anergia. Schizotypal 998. Abuse phases Tension building-> battering-> honeymoon-> tension building 992. staff needs a dosimeter badge. Symptoms: Insomnia. difficulty sleeping and concentration.chest child . #1 thing to do with edema elevate 1004.Rebreather 12L/min 986. 996. feelings of worthlessness decreased concentration. Doffing order gloves.976. decreased needs for sleep. can cohort 989. influenza. help evaluate coping mechanisms 993. coexist with substance abuse. buying sprees. Cluster A Paranoid. medical illness. Venturi face mask 4-8L/min 985. In acid/base balance. assess for irritibility. schizoid. inflated self esteem.gown. Obsessive Compulsive 1000.abdomen/thigh 1005. Bipolar disorder Depression and mania. Grief Denial-> Anger-> Bargaining-> Depression-> Acceptance 997. 979. PTSD symptoms are delayed. Cluster C Avoidant. . 1019. LPN ramifications No vents. bad deformities anti-inflammatories (NSAID. steroids) Rest joint when inflamed . Where is PMI found 4th intercostal space mid-clavicular 1009. can do dry dressings 1014. Prilosec. Liver dying. Hurts with eating/feels better with eating Hurts with eating = gastritis Feels better with eating = PUD 1015. swollen. but will not regenerate) 1028.. What does digoxin do Makes the heart pump harder 1012. foamy-tea colored urine (bile in urine . What to do with respiratory alkalosis .. can do f/u assessment. 1020.. can't do initial assessment. can do reinforcement teaching. Crohn's diarrhea inflammation of entire colon tx = anti-inflammatory drugs (steroids) malnourished 1031. Why no morphine with bowel surgery or biliary pain morphine can cause spasm at sphincter of Odi Give Demerol 1033. ESLD needs in diet decreased protein (this creates more ammonia) 1029. Zantac and -dines are what? H2 blocker 1016. Aquamephytin vitamin K 1022. What cannot be taken with CCBs Grapefruit juice 1011. bile stores gallbladder 1025. Secretes amylase/lipase Pancrease 1030. What to do with respiratory acidosis . Ulcerative colitis bloody diarrhea No steroids tx = complete removal of lg bowel w/ ileostomy malnourished 1032. Where is 6 month fetal heart rate found halfway between umbilicus and symphysis pubis 1010. hot. RA inflammatory response red.. secretes vitamin K liver 1023. closing off biliary tree (same symptoms as hepatitis. Hepatitis needs in diet increased protein and decreased fat 1027.bile is soap).. What to do with metabolic acidosis . S/S of hepatitis jaundice. What to do with metabolic alkalosis . Prevacid. ESLD is caused by. and Protonix are what? PPI 1017. Where is apex of heart found 6th intercostal space mid-axillary 1008. 1021.. secretes bile liver 1024... Nexium. has lots of scar tissue. clay colored stool (no bile in stool) 1026. 1018. How many cc's is 1 ounce 30 cc (30 ml) 1013. can't do initial teaching. can't discharge Can take phone orders.1007. Addisonian crisis Not enough steroids Bronze pigment to skin d/t mineral corticoid steroids 1044. 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. hot) Too little = hypoglycemia (pale. low phosphorus Phosphate binder given with meals 1046. OA Joint is wearing out .tx is life long steroids (which causes Cushings) 1043. blood reaction send blood and tubing to the lab 1055. cold. Intermittent claudication think arterial vs venous-this is arterial-position leg dependently 1048. fluid restriction. buffalo hump) Too little = Addison's disease . course hair. seizure. need a pre cut gauze 1057. venous issues like a V-put them up-so blood can go up 1051. clammy) 1045. weight bearing for hip replacement TOUCH weight bearing 1036. low potassium. narcotics) likes temp extremes (hot better) Keep joint moving even when painful or will freeze 1035. arterial skin shines 1049. mouth tetany) 1042. Heart Failure -pumping issue. Parathyroid gland Calcium Too much = hypercalcemia (somnolent) . Posterior pituitary gland ADH Too much = SIADH Too little = DI (DDAVP) 1040.DJD Pain meds (tylenol.1034. arterial issues put your legs down-so blood flows down-like an A (artery) 1050. myxedema coma) 1041. increase infection. Pancreas Insulin Too much = hyperglycemia (dry. Diet for renal patient Low protein.tx diuretics/dialysis Too little = hypocalcemia (jittery. skinny limbs. C3 spinal fracture airway is your issue 1058. Instructions when taking Fosamax Empty stomach sit up for 30 minutes 1038. Bronchodilators increased oxygen demand-myocardial 1047. give Lasix and Digoxin (help with pumping) 1052. Thyroid gland T3/T4 Too much = Increased metabolism (Graves) Too little = Decreased metabolism (thick nails. Anterior pituitary gland Growth hormone Too much = acromegaly Too little = Dwarfism 1039. INFILTRATION IV site painful and swollen 1054. NSAIDS. increase glucose. moon face. weight bearing for hip fracture NON weight bearing 1037. if you see a presenting part for a baby for a labor pt in ER prepare delivery room-priority . V tach electrical conduction system issue 1053. Adrenal gland glucocorticoids Too much = like too many steroids (weight gain. not only the RN 1078. medication reconciliation contains documented meds taken by client. anesthesia can cause decreases ability to urinate 1069. obese client that vomits after surgery-will increase pressure in the abdomen. swing through gait crutches forward. don't ask any questions". at more risk for Adhehicence 1063. the purpose is to avoid errors of duplication. they won't be taking NSAIDs-they are on blood thinners. right ventricular hypertrophy. also the pharmacy has a role in this. Tetralogy of Fallot 4 issues here: ventricular septal defect. knee arthroplasty-1 week ago post op-for 4 to 6 weeks blood thinners are given throughout the recovery. this list is done at any change in care. (full bladder-dull sounds when you percuss). fever above 101 can be caused (fever is only above 101 F). L foot and the R crutch after at same time-m0ve pass the other ones 1073. include description of incidents in the reports 1077. because they are lying down (postop) so they are at risk for cloths. he won't be taken off these meds. missing some meds etc. 2 point leg R foot and the L crutch go first together.for its anticholinergic effects-will lower the secretions in the mouth. Autocratic manager "do this. also pts are advised to take Folic Acid with this drug-it causes a depletion of dolic acid 1071. there is a whole in the septum. also if pt was on blood thinners prior to arthroplasty. with respiratory stridor. unconscious pt would not have been found on the floor-they cannot get up-most likely they rails are up) 1060. so not a priority 1064.. then crutches 6 inches forward 1072. stomatitis-sores and difficulty in the mouth-hard to eat. three point crutches unaffected leg first. not shallow respirations 1066. they are not shared with non involved staff. ECT before: withhold Dilantin. Disaster prioritization Priority pt-pt with burns on the face. pt found on the floor assess vital signs and LOC first. high pressure alarms 1062. lift both feet and swing forward 1074. also Succinylcholine-possible given 1067. pt after MVA on balanced suspension traction disorientation is a priority. LPN can give report during a transfer can take VS in a transfusion client.1059. pt that had a catheter in before. this will impact blood getting around the body 1075. TPN pt. Methohexital. increased urine specific gravity-they are not eating or drinking-dehydration occurs. low platelets. Atropine IS given. not injuries assessment first (if pt was conscious before the fall-vitals will tell us the most about the client. ECT causes seizures-we don't want them to have fluids in mouth-risk for aspiration. incident reports risk management investigates these. these managers are good in critical situations .possible given for amesthesia. overriding aorta. pulmonic stenosis. NCLEX will test Eriksson but not Piaget.to prevent fluid volume deficit monitor glucose q 4-6 hrs-if the glucose is up-dehydration (osmotic diuresis) 1076. fixed pupil and agonal respirations-will not live. 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.not only at admission and discharge. Motrin vs Lortab? 1068. after RN has stayed with client for first 15 min or the necessary initial time 1065. comparrison of current and past meds list. 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. NCLEX wont test chemo drugs 1061. employees have little to say. now catheter is out and pt cannot peeintervention assessment FIRST-so do a bladder scan first. 1079. phone triage for a client exposed to EBOLA-client has no symptoms tell client: "we will have to notify the health dept. chaotic environment. irrigations. they CAN hang the second bag for TPN. Fire disaster evacuate the ones can ambulate first-smoke kills before fire 1094. living will WITHOUT a DNR order you have resuccitate in a code 1091. antidiarrheals always PRN 1086. LPN CANNOT administer Rogham-its a blood product. CAN empty the suction container. vomiting 1097. AMA client no need to call security but DO inform about possible complications if they leave 1098. epistaxis. Amiodarone should be given through a central line. always RN has to hang the first bag. employees make the decisions 1080. 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. in an outbreak for STD's tell sexually active students to trace outbreaks-in a high school (when addressing the community outbreak) 1092. 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. she does not need the RN there CAN do wound care-dressing changes. NCLEX increased number of questions about religions and cultures practices 1095. TPN not given peripherally 1101. when you need a translator call a certified one. these CAN be disclosed/reported to DMV uncontrolled seizure disorder of a school bus driver.because ph < 5 1099. implied consent unless you have a DNR. Ebola report immediately-fever. you do everything for them 1090. not peripherally. when LPN hangs the second bag. 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. nonmaleficence do not insert a contaminated catheter in after not sterile anymore 1089. LPN CAN give IM injections. employees ARE asked their opinions 1081. 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. Laissez Faire manager disorganized floor. UAP new admission or post of fresh pt-RN has to do the vitals. acute glomerulonephritis can lead to acute kidney failure-watch for decreased urine output 1087. not the UAP CAN do specimen collection but not something that require sterile specimens 1084. HIPPA does not apply in this case" 1093. narcotics (eg. no family member should translate-HIPPA 1096. but RN has to assess the fluid collected 1082. Democratic manager decisions are made as a group . IV antibiotics 30 min window 1085. 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 . they CAN hang the bag of fluid. Vacomyocin ph is <5-not given peripherally but PICC line ok 1100. pap test every 3 years starting at 21 if there is an abnormal pap->annual exam recommended 1118. after an aura) roll them on their side only if they lost consciousness. prostate discuss with pcp at 50 1117. cane use left side weakness cane opposite affected leg (COLL)-move cane and the bad leg forward first 1106. colorectal exam should start at age of 50 1116. gown. document. if not they CAN maintain their airway time it during a seizure-needs to be documented after: report it. hot relaxes 1121. Shingles and TB cannot share room 1109. Hep C and HIV need gloves. ok for them to sleep on their side 1103. Laryngectomy client with fresh trach.not the non skid ones-he will fall 1108. googles-all of these needed because the new tracheostomy 1113. neutropenic pt needs private room 1110. not the exit door 1122. 2-3 inches to underarmed cannot rest on crutches (underarm) 1107. not the housekeeping-you put them at danger (not the housekeeping. analgesia cold and hot 1120. 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. not the laundry department) incident report done as well 1104. vaginal exam has to be done annual in all patients 1119. progressive macular degeneration room free of clutter call light within rich 1123. smoking client on non smoking campus give hime a patch 1105. mask. purulent exudate drainage from wound clean site first with sterile saline and water place specimen in biohazard bag 1125. hypotonic pulls fluid INTO the cell hypertonic pulls it OUT of the cell . 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. emergency numbers should be next to the phone. fall history have bed alarm for client 1124. crutches arms flexed.1102. DONT isolate an HIV pt UNLESS he is neutropenic or he has an opportunistic infections 1111. 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. chemo treatment if it spills you call the biohazard. SEIZURES (precautions before a seizure. who is at risk for falls over 65 yrs old bifocal glasses pt on Lasix 1126. determine LOC postdictal state: drowsy. pulmonary hygiene CPT turn and cough bronchodilators steroids use bronchodilator first 1143. the lower the Na it goes the higher the risk for seizures it is 1131. chronic bronchitis copious sputum cough for few months 1146. Quantiferon Gold-TB blood test definitive for TB results within 24 hrs ask for night sweats 1141. hyperventilation blowing out CO2-give rebreather bag-client is in respiratory alkalosis 1133.if anxious they won't be breathing ok. 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. sputum specimen collect in the morning. max 15 secs rounds suction on exiting 1144. low grade fever. movement hurts 1150. TB mucopurulent sputum.also provide oral care for this pt 1139. pt on Zofran risk for metabolic alkalosis-they are vomiting 1136.because it hurts chest tube placed as well . Insulin metabolic acidosis-K is high 1137. kidney function decreased creatinine increased 1132. put pt on O2. Narcan risk for respiratory acidosis-they are not breathing 1135. anginal pain pain goes away when you lay down 1151. asthma bronchospasms careful with beta blockers 1148. give anxiolytics. pneumothorax O2 decreases. lung cancer non specific s/s 1149. chest tightness. give analgesics. semi high fowler position. Thoracentesis place a chest tube in the room. Dilaudid respiratory acidosis or alkalosis 1138. if you see JVD when client is standing CHF R side 1129. to check for JVD place in semi fowler 1128.5 ml per kg output per hour if we dont know the weight then is 30 ml per hr 1130.pt at risk for pneumothorax during procedure check lung sounds on that side 1142. Calculate output Assume-0.1127. Atropine metabolic acidosis 1134. pneumonia pleuritic chest pain-that does not go down when you sit/lay down. suctioning 3 rounds before you hyper oxygenate again. decreased appetite 1145. emphysema pursed lip breathing 1147. look at the insertion side for infection in case of crackles-these are in the pleural space-crackles mean fluid. Peptic ulcer . IBS diarrhea and constipation LLQ pain cramps . acute cholecystitis low fat diet have rich in HDL food sources 1159. GI. intubated client nurse should do frequent hand wash provide oral decontamination clean oral suction device turn client q 2 hrs high fowler 1154. check when CBC was done last time. GERD prokinetic agents. 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 1160.5 to 3/4 full check residual in continuous feeding-check in q 4 hrs. if less than 100 ml-put it back. neuro. bend knees. GU. check to see if a chest xray was done this morning 1153.. cover with sterile dressing 1158. 1162. NG tube verify with x-ray first. preop clients might take half of insulin 1155. circulation.. call for help.possible kick in the tube if drainage becomes purulent-check for fever.Reglan 1161. post op respiratory. gastric ph later empty when 1.1152. pain-these are all impaired by the surgery 1156. evisceration lay pt down. if more than 200-call provider. dehisscence put some stitches on high fowler 1157. Chest tubes components right container-this is the drainage water seal-middle-red suction bubbles on the left if no bubbling. Bariatric clients they are obese.1163. acute pancreatitis possible hypocalcemia (Tressou sign)-hand spasms occurs during blood pressure monitoring with the auto digestion-Ca ends up in the bloodstream 1171. 1180. sweating. the more solid the stool is emotional support. Diverticulitis they always have diverticulosis. increase fluids Allopurinol 1178. SIADH low sodium level seizure precautions 1179. turn to the L side not supine 1166. Gout men usually get it cannot put pressure on foot during acute episode multiple tophi excruciating pain with acute episode bed rest. lipase. Rheumatoid A bilateral joint inflammation morning stiffness and pain 1177.. Dumping syndrome dizziness. rest the bowel later-low fiber and after. Cirrhosis low protein diet bleeding-esophageal varices they are breaking down protein-so they have high ammonia-this is toxic to neuro system 1172. tachicardia post bariatric surgery-avoid lactose and high concentrated sugar. 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. OA weather changes-barometric pressure chronic unilateral pain pain worsen after activity 1176. Hepatitis liver impairment 1173. Clonidine change position slowly. high fat and protein foods. pancreatic cancer immunosuppression present treatment: Whipple procedure and chemo many times its mehtastazied 1175. 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. related to the exocrine function of the endocrine system 1170. Inflammatory bowel disorders (UC and Crohn's) give immune modulators with the Ulcerative colitis-stool gets into the tissues? 1164. Pancreatitis-malnutrition put them far away from nurses station-so when food comes the smell wont create pancreatic enzymes 1174. sugar elevates) amylase. just call the dr . Arterial line . post up stoma care pink and red is good the further in the colon the stoma is. but if something gets in a diverticula-then it becomes diverticulitis fluids only.so high risk clients 1167. this is a BP drug take at night in case of a cough->don't stop the med. transition to high fiber 1165.. avoid touch.042 Urine specific gravity-severe dehydration (osmotic diuresis-started on TPN. 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. Prolixin targets dyskenisia-repetitive involuntary facial and tongue motion 1194. Olanzapine/Zyprexa hyperglicemia 1202. PTSD intervention-support groups 1190. Palliative care improve quality of life meet physical and emotional needs 1184. Risperdal lowest risks gynecomastia is a major risk in young boys 1201. Autism-alterations in social skills-interventions-structured routines language-might talk late-interventions-foster independence behaviors-anger. bizarre body posture-they can be in same position for a long timealteration of skin break down can happen 1193. frustration. VTac obtain VS don't defibrillate but cardiovert (if hemodynamically stable don't cardiovert) check carotid pulse give Amiodarone 1182. 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. Seroquel (for depression) slipineess 1199.1181. mental health ptsremember to treat based on developmental age. amputation first reaction-many times denial 1186. Aripiprazole reduce daily delusional thoughts 1195. Hypochondriasis intervention-limit rumination-will help them not thinking of it 1191. Aricept increase mental cognition 1196. Rifampin (TB drug) orange body fluids 1205. Congentin manages EPS 1200. Clozapine agranulocytosis 1198. Social Phobia Intervention-GAD? intervention-reinforce coping 1192. Progressive MS get rest and avoid stress major personality changes need speech therapist might lose ability to empty bladder eye patch given 1183. 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. Schizophrenia Paranoid-auditory hallucinations-know what the voices are telling them Disorganized-flat affect. disorganized behavior and speech Catatonic-stupor or extreme agitation. Haloperidol/Haldol highest risk of EPS 1197. not chronologic age 1185. Agoraphobia intervention-desensitation-this is a slow process 1188. iv push . Adenosine flushing and chest pain. Niacin flushing-normal 1204. Chantix- nicotinic blocker . 1221. dont mix with other insulins (long acting insulin).. Selective Estrogen Receptor Modulator (Evista) given for postmenapausal osteoporosis 1213. 1225.. Viagra-dont give with nitrates ... Nemanda/Nemantine avoid diet in fruits and vegetables 1230.. 1215. Lipitor no grapefruit 1214.. Hydrochloride administer po-moderate to severe dementia such as Alzheimer fresh fruits will cause alkalinity-low excretion of drug 1232. taken once daily-Vyvanse-Lisdexamfetamine dimesylate . 1216. intake of greens important for vitamin K 1228. 1234. Methylprednisolone sodium succinate given orally or IV IV push 1212. doses must be 12 hrs apart .. Ariprippazole avoid grapefruit. alcohol. 1210. anti inflamatory-Nasonex dont administer in clients with milk allergy 1219. Cardizem .. slows osteoporosis-Premarin .. Geodon . -for ADHD-available in po form only.. Palivizunab prevents RSV 1211. -antimicrobial-Zocyn-check allergy for penicillin .. Prostaglandin-Xalatan-Lantanoprost . -adminster sq with evening meal or HS-Levemir. milk 1217.. Flagyl-no alcohol first 3 days . Fentanyl (narcotic) reversible agent is Nalaxone 1209. antibiotic caution in colitis 1231. 1223. 1224... Pitocin decreases bleeding uterine stimulant 1208. 1220. Indocin administer with food.... montelukast bronchodilator 1218. 1227..1206. Avodart BPH drug females of age that might have kids should not handle this 1235... overheating... Metothrexate . Singulair. 1222. dehydration 1229. avoid foods with tyramine-antibiotic-ZyvoxNeurontin-partial seizure and neuralgia given for these . 1226.. -Methadone-monitor respiratory . Coumadin anticoagulant.. Actonel CI with esophageal disorder remain uprights for 30 min take with a full glass of water 1233. Protonix (PPI class) antiulcer med 1207. then body recognizes it and then it drops again . leave the stove after cooking. decline in daily basic hygiene needs. stage 1 (mild)-discuss meaning of client's framed photo: integrity vs dispair stage. 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. 1251. Hcg rises during pregnancy and maintains the pregnancy raises until about 12 weeks of pregnancy. Lithium AE with diuretics therapeutic effect after 1 week 1241. Depression Anhedonia-maintain ADLs sleep alteration-bedtime routine anergia-encourage exercise worthlessness-monitor safety poor concentration-clear directions suicidal ideation-giving away things 1238. they do prepare fluid therapy and enteral feeding for them 1250. Severe Mania Anorexia-provide finger foods Accelerated speech-calm demeanor Fragmented thoughts-redirect no impulse control-monitor safety 1239. hypertention crisis hrs after opiods 1245. detoxification of cocaine s/s several hrs later-poor concentrations 1244. MAOI- therapeutic effect after 1 week 1242.. alcohol withdrawal dont leave them alone Diaphoresis—fluid replacement hallucinations-decrease stimuli Wernicke-Korsakoff-Infuse IV Thiamine 1246. 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.. not 6 stage 2 is moderate-cannot balance checkbook. TCA therapeutic effect after 1 week monitor for dysrhythmias 1243. Oxazepam (Serax) Delirium Tremens Tachycardia-monitor VS 1247. Anorexia we don't focus on their weight. Clozapine . Hcg test-why is important before surgery a positive pregnancy test may require canceling surgery 1253.1236. stages of Alzeimer 4 only. you want them to have personal things around 1248. SSRI weight gain therapeutic effect after 1 week 1240.. Paxil antidepressant don't take St John Worth take at night time 1237. prenatal care assess at each exam-VS. hydatidiform mole avoid pregnancy until hCG returns to normal she can pass a grape like structure.1254. Placenta previa no vaginal exam painless. usually they are pseudo anemic until 32 weeks.. bright red bleeding 1264. stage 3 stage of labor placenta delivered do newborn care .. nutrition 1256. 3rd trimester make sure she know how to recognize false vs true labor signs 1258. 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. with FHR above the umbilicus prepare for US need to evaluate for breech 1274. Chronic HTN mom had HTN prior to pregnancy this pt may develop preeclampsia 1261. first semester nausea. severe back pain labor give back massage place on all fours (legs and nands) 1273. STI higher risk for ectopic pregnancy 1263. Isotonic IV fluids . weight. heartburn 1257. ideally avoid pregnancy for 4 years ? she is at risk for cancer as well usually this only happens once 1267. stabbing. stage 2 of labor check FHR q 15 min assist pushing 1277.. 1271. If contractions frequency is 90 secs stop Pitocin check FHR assess pain and fatigue 1272.. abdominal pain ectopic pregnancy is never a livable pregnancy 1269. Gestational HTN mom gets HTN after 20th week of gestation NO protenuria 1262. ectopic pregnancy unilateral. Mag Sufate IV resp 10-priority 1260. vomiting. hyperemesis whatch the weight and electrolytes 1266. If baby has a longitudinal lie. pain associated with labor 1275. Cerclage cervical insufficiency 1268. then the iron should become normal again 1255. 1259. 2nd semester dyspnea. stage 1 of labor keep her active after 3-7 cm-help her breath assess FHR and UC comfort 1276... fundal height. abruption placenta painful dark red bleeding 1265. prenatal examination report if pt is on a vegetarian diet. Beamethasone 2 doses 24 hrs apart help to mature fetal lungs 1286. L&D meds tocolytics-Indomethacin and Terbutaline stops labor 1284.1278.. fetal monitoring late deceleration reposition first on L side 1280. 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.. fetal monitoring VEAL CHOP (what causes it) MINE (what you do about it)-make sure you know where they are in the process 1281. hypoglycemia in babies check glucose w/o an order. 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. we only take the baby out of the light for feeding 1297. 1299. Womens Health . phototerapy cover eye with mask reposition newborn q 2 hrs cover scrotum take them off light only for feeding 1296. 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. fetal alcohol syndrome high pitch cry hard to console cognitive disabilities 1293. Late decels uteroplacental insufficiency 1282. tobacco/nicotine vasoconstricor decreased O2 for baby-increased SIDS risk. PP hemorrhage priority 1289. 1298. stage 4 of labor priority-prevent bleeding 1279. Pitocin used to augment labor/assist labor 1285. menopause hot flashes night sweats palpitations vaginal atrophy osteoporosis 1300.. baby assessment reflexes check-premie will not demonstrate all the reflexes 1292. cancers . it takes some time for the baby to get used with the insulin production 1295. Rhogham administration monitor labs: Indirect Coomb's for baby Direct Coomb's for mom 1288.. mom breastfeeding on heparin therapy breast milk will not be affected. after breast feeding is over she can go back to Coumadin 1290. Kernisterus yellow baby. asthma 1294.. over 35 increased risk of DVT with oral contraception . Synthroid give in the morning increases HR 1310. Rocephin . 1305. Methergine CI in HTN and cardiac disease promotes uterine contractions 1307. Diflucan . Digoxin assess AP for one min hypokalemia can lead to toxicity 1321. take with food. 1304. PPI-Nexium (GERD) don't crush or chew 1323. Lidocaine not effective against SVT. 1303..57 yrs old. monitor for edema 1308.(on Climara)monitor BP.1301. .. call provider if bleeding occurs . Bystolic don't stop abrupt. don't discontinue abruptly 1324. Flagyl . dont interupt abrutptly 1314.. lyrics (Pregabalin) dont stop abruptly.000 administer sq 1326. Lovenox hold if platelets are less than 100.. weight daily. Pradaxa avoid use with drugs that prolong bleeding keep dry and in a dark bottle 1327. all these matter when choosing oral contraception history of hypertension severe PMS hist of DVT 1302. Vancomycin antibiotic for MRSA risk for Red man syndrome 1320. yearly mammogram.. complicated UTI give antibiotics CI with sensitivity to cephalosporins-Maxipime 1311. Aricept monitor for bradicardia. 1306... Gentamicin antibiotic for bacterial infections monitor UO and renal function 1312. Effexor can increase ptinr. Varivax vaccine prevents chicken pox 1328. given IV 1315. postmenaupausal. BP monitor weight 1329. Levaquin can alter glucose level in diabetic client 1319.. Dilaudid causes spasms of sphincter of odi 1318. can impair thinking and reaction time 1316. Lithium mantain Na levels normal 1325. Antipshychotic-Risperdal dont mix oral solution with cola or tea 1313.. Amiodarone first line drug for. Lasix Diuretic monitor HR. Inderal check BP and pulse before administration 1322. Oxycontin highly abused-should not be taken within 2 weeks of administration of an MAOI 1317.. Plavix Prilosec and Nexium will decrease the effects of this 1309. . Concerta contra with MAOI 1334. insert air into NPH insulin equal to dose.1330. just warm water 1343. regular Insulin the only one administered IV 1338. remove and insert air in regular insulin equal to dose. Air travel 2nd trimester. know back/spine safety for nurse upper bod mechanics. airplane cabin humidity is low (approx. tachycardia 1348. Novolog . adv. Administer regular and NPH insulin steps swab top of both insulin bottles with alcohol wipe. increased respirations. then withdraw dose from regular insulin and administer then withdraw correct dose from NPH insulin and admin subcutaneously 1349. Simvastatin and Zetia-Vytorin its a combination drug 1335.. Alcoholism causes CNS depression. can cause insomnia. Acarbose oral antidiabetic agent that postpones the absorption of glucose 1347. report to provider. 1351. pt that is on radiation no lotion on the side. Abstract Thinking Asking questions about similarities between objects or to explain a common proverb or saying 1346. s/s withdrawal elevated BP/HTN . increase in heart rate is a side effect 1354. Advance directives allow client to make decisions and provide written instructions regarding end of life care 1350.. drowsiness. don't give in the evening 1342. 1hr oral glucose tolerance test positive results 145mg/dl. Gardasil prevents HPV administered to both male and female- 1336. systematic desensitization. which can result in water loss. flooding. Advair (Fluticasone) long term for asthma 1333. Albuterol (Proventil) activates beta2-adrenergic receptors in the heart. PEDS-know infants and children-common causes of death incorrect car seat placement or not being in the seat 1341. 8%).. Ritalin side effects-Tics. teach pt to maintain increased hydration with water to compensate for loss 1352. 1332. Ambien rapid onset given for short term insomnia 1340. and impaired coordination. nervousness. Agoraphobia behavioral therapy technique pt teaching includes modeling. slurred speech. pt to avoid caffeine the morning of test because it can increase glucose levels 1345. Haldol monitor for EPS causes dry mouth 1339. Dilantin therapeutic level 10-20 1331. increased BP.. Acute hemolytic reaction low back pain due to passage of hemolyzed blood cell through kidneys. Alcohol anonymous (AA) helps support abstinence and sobriety 1355. Nitro onset 1-3 min sublingual 1337. no scrubbing. Akathisia responds to anti-parkinsonian medication 1353. position client in the correct way 1344. pruritus. should have at least 6wet diapers per day. 1379. Altruism helping meet the needs of others who have experienced similar loss 1358. Anabolic steroids in adolescence can lead to premature epiphyseal closure thus reducing height potential 1364. can palpate fundus above umbilicus and to the right of midline. Avolition lack of motivation 1370. Amitriptyline (Elavil) tricyclic antidepressant must be taken within 3hr of missed dose if not wait til next dose. Atorvastatin (Lipitor) and fenofibrate (TriCor) treats hypercholesterolemia. wake baby Q4hr at night for first 24-48 hr after birth 1378. restlessness and anxiety 1365. Aversion therapy uses punishment techniques to reduce inappropriate behaviors (alcoholism. flushing. Effect. milk can be stored in freezer for up to 6mths. can cause urinary retention.1356. Borderline personality disorder development of manipulative behaviors that make establishing a meaningful relationship difficult 1376. Caffeine (pregnancy) consuming more than 200mg of caffeine/day increases risk of miscarriage and intrauterine growth restriction 1383. 1359. may cause esophageal ulcerations if lodged in esophagus. drowsiness in early phase of therapy. hearing loss) 1362. remain upright for 30min after admin 1357. Amniocentesis evaluate fetal lung maturity 1360. Bi-Polar Disorder increased energy and pressured speech. Boundary violation when nurse engage in social relationship with client 1377. check for gag reflex. . Benzodiazepine (Lorazepam) withdrawal causes tremors and dizziness making ADL's difficult to perform 1372. wheezing 1363.. Antisocial personality disorder impulse control. parotid swelling 1380.. Bladder distention pushes uterus out of pelvis. Anti-Hypertensives meds contraindications caffeine 1366. Alendronate (Fosamax) admin on empty stomach with 8oz water. pt teaching. aggression) 1369. tinnitus. Amphetamine intoxication stimulant use. Anaphylaxis Behavioral signs apprehension. hypotension 1371. decreased muscle spasticity in client w/ MS. Ampicillin (Principen) signs of allergic reaction hypotension. adv. 1375. Buprenorphrine prevents withdrawal associated with opiate use. paranoia 1361. Calcium carbonate (Tums) . Amphotericin B adverse reaction is ototoxicity (vertigo. Bethanechol muscarinic agonist that increases GI motility leading to abdominal cramps and diarrhea 1373. Baclofen (Lioresal) antispasmodic. both meds may cause myopathy. reminding client about expectations and providing clear boundaries and consequences of action will help promote client adherence 1367. pt has increased risk for myopathy than if either taken alone 1368. Bronchoscopy post op. taking during pregnancy can improve maternal and neonatal outcomes 1381. Bulimia Nervosa s/s tooth erosion. uneasiness. Bupropion for nicotine use disorder 1382. may eat 8-12 times/ day. manic phase is treated with electroconvulsive therapy (ECT) if a course of medication is ineffective 1374. hand calluses. Breastfeeding baby should have at least 2 stools/day. admin diphenhydramine (Benadryl). Cimetidine (Tagamet) should be taken 1hr before or 2hr after antacid 1397. sore throat. Delusions belief that one's thoughts can be heard by someone else. only clamp device when checking for air leaks or changing drainage system 1392. CD4 T-cell count indicates the status of the pts immune system. keep collection device below the level of the pt chest to ensure drainage. Cystic Fibrosis can have constipation should eat diet high in fiber. Cocaine CNS stimulant. Chest tube drainage device may ambulate. avoid ibuprofen or any other nonsteroidal antiinflammatory medication as it can reduce anti-hypertensive effects of medication 1385. to prevent venous congestion once pt can ambulate 1406. iron salts. Chorionic villus sampling involves removal of small amount of tissure from the fetal section of the placenta to detect genetic conditions 1396.1384. Chlorpromazine (Thorazine) increases skins sensitivity to UV light pt should apply sunblock to counteract adverse effect 1394. Depression lethargy and slowed speech 1409. possibly prep for IV catheter insertion. dilated pupils. Carboprost adv. Clang association use of rhyming words 1399. and fatigue can indicate and infection and provider should be notified. Dementia memory impairment and loss of speech 1408. milk and other dairy products because they reduce the absorption of ciprofloxacin. towel or blanket to prevent excess stress on the incision when coughing 1403. greatest risk to pt is infection r/t neutropenia therefore unexplained fever. oozing trickle of blood. in allergic reaction check for wheezing. avoid getting pregnant. Chlordiazepoxide (Librium) admin for alcohol use disorder. Coughing support incision with interlocked hands. teratogenic to developing fetus 1393. group of antibiotics hat are similar to penicillins (PCN). C-section ambulate several times/day to increase circulation in lower extremities and prevent thrombophlebitis 1404. a rise indicates return of immune function for HIV pt 1387. Celecoxib Celebrex cyclo-oxygenase (COX-2) inhibitors act by suppressing inflammation and relieving pain. Digoxin and chlorothiazide increase pt risk of developing digoxin toxicity due to chance of developing hypokalemia . Chlorpromazine (Thorazine) orthostatic hypotension risk for falls. pillow. Cocaine intoxication tachycardia. increases risk of MI because of increased vasoconstriction and unimpeded platelet aggregation 1390. display grandiosity and euphoria 1401. Cervical laceration is a slow. common w/schizophrenia 1407. effect fever 1386. should be avoided in pt who is allergic to PCN 1389. collect VS to determine pt status 1398. rise in cd4 counts indicates return of immune function of client w/ HIV 1388. Clozapine (Clozaril) can cause agranulocytosis. dilated pupils and tachycardia 1402. high calorie diet due to decreased intestinal absorption and increased work of breathing 1405. may cause vomiting. Deep Vein Thrombosis (DVT) bed rest with affected limb elevated to reduce swelling. Ciprofloxacin (Cipro) pt should avoid products with cations such as antacids. elevated BP. Captopril (Capoten) treat HTN. will allow pt to move more easily. CD4-T cell count indicates the status of clients immune system. during which fundus can remain firm 1391. fit with elastic stockings. pt should have WBC evaluation 1400. treats schizophrenia 1395. Cefotetan (Cefotan) a cephalosporin. 1425. Fluoxetine (Prozac) monitor sleeping patterns. Gemfibrozil (Lopid) myopathy is an adverse effect. is contraindicated in pt with benign prostatic hypertrophy (BPH) 1412. adverse effects. has anticholinergic properties. adverse reactions tremors. 1420. medication should be withheld if BP 85/60. musical sounds which are caused by narrowing of airways 1424. Fluphenazine (Prolixin) avoid sun exposure causes photosensitivity 1427. can cause BP to drop. vaginal bleeding. Digoxin toxicity nausea. Fundal Height in pregnancy should be approximately the same as the number of weeks gestation plus or minus 2cm 1428. Fine crackles continuous. can lead to pelvic inflammatory disease and tubal scarring which can result in infertility 1434. Doxycycline (Vibramycin) should be taken with a full glass of water to ensure it passes into the stomach which will prevent esophageal ulcerations 1415. confusion. diarrhea. clean eyes starting from inner canthus moving outward. vomiting. Gonorrhea STI. reorient frequently 1416. anger against dying person or caregivers. likely to be confused and disoriented. anorexia. hallucinations 1426. instill 1cm ribbon of medication in lower conjunctiva to ensure proper delivery of medication. emotionally transferring anger for one person to innocent victim 1413. Eplerenone treat HTN. Glipizide oral antidiabetic agent that stimulates insulin secretion 1433. vascular disease). 1429. Expected anticipatory grieving statements indicating shock and disbelief. shuffling gait. increased potassium levels cause of potassium retention effect 1417. Eyedrop instillation advise pt to look up during admin to protect cornea and decrease change of blinking. monitor BUN and serum creatinine levels 1431. Dimenhydrinate (Dramamine) an antihistamine. Ginkgo Biloba herbal supplement to treat a variety of conditions (dementia. Exenatide treat DM. improvement in hemoglobin levels increases oxygen transport to the tissues and increases activity tolerance 1423. Gentamicin (Garamycin) is nephrotoxic. drooling pseudoparkinsonism . can lead to hypokalemia. Ferrous sulfate treat iron deficiency anemia. insomnia common side effect. may interfere with platelet production and increase the risk of bleeding in clients on anticoagulation therapy (warfarin/antiplatelet medications) 1432. Disulfiram for alcohol use disorder 1414.1410. monitor for abd pain pt at risk for pancreatitis 1419. Fluoxetine contraindicated with sumatriptan put pt at risk for serotonin syndrome causing tremors. report muscle weakness or tenderness 1430. Felodipine (Plendil) grapefruit juice can inhibit metabolism raising level of medication in blood increasing risk of toxicity 1422. Grief community bereavement group may help cope with feelings of grief 1435. and fatigue 1411. decreased sodium levels. Electroconvulsive therapy (ECT) pt awake 15min after ECT. needing to get away from situation. Furosemide (Lasix) loop diuretic. admin medication prophylactically to protect newborn from ophthalmia neonatorum 1418. Erythromycin apply medication starting from inner canthus to outer canthus. Haloperidol (Haldol) typical antipsychotic that decreases symptoms of psychosis and anxiety. Displacement defense mechanism. 1421. anticholinergic meds can cause urinary retention thus compounding urinary tract symptoms associated with prostatic hypertrophy. allows client to move freely and resume ADL's 1454. Lithium Carbonate (Eskalith) monitor lithium levels if dosage is changed 1456. nystagmus. hypercalcemia. Isoniazid (INH) can cause liver damage. can result in buildup in bradykinin. blurred vision 1444. Magnesium sulfate depresses neuromuscular activity. Ipratropium (Atrovent) an anticholinergic. wrap 3x day and prn 1457. Hyperemesis gravidarum S/S persistent vomiting and ketonuria 1442. oliguria (urine output 30ml or less). effective treatment strategy is participation in a methadone maintenance program 1438. lentils. Isotretinoin pt teaching will need to have triglyceride levels monitored. physiologic jaundice can lead to severe cognitive disorders 1450. 1441. works by activating dopamine receptors. restoring nerve transmission in the basal ganglia for pt with Parkinsons disease. avoid twisting and bending. contraindicated w/ ibuprofen can decrease antihypertensive effect 1455. Ketorolac (Toradol) is nephrotoxic and can cause renal impairment. Heroin causes CNS depression. tachypnea (respiratory distress) 1443. oysters 1446. sleep on firm mattress 1458. drowsiness and slurred speech. inappropriate sexual behavior 1439. feelings of being overwhelmed . Hypoglycemia (newborn) hypothermia. Histrionic personality disorder impulsive behavior. Heel stick in newborn 1st warm newborns heel 1437. important for nurse to determing the clients daily alcohol intake because alcohol use increase risk. Inhalants intoxication s/s incoordination. involves removing a portion of vertebra to expose spinal cord which produces a sense of instability in spine. due to nature of severe birth defects pt will need 2 negative pregnancy test prior to starting medication 1448.1436. Lumbar laminectomy pt teaching. contraindicated in pt who is allergic to peanuts or soybeans because medication may contain peanut oil and soy lecithin 1445. maintain compression dressing following amputation in order to promote proper fit of prosthesis and reduce edema. Lactation suppression frequent application of cold cabbage leaves to breast can prevent engorgement 1453. hypernatremia. Major Depression monitor elevated mood. respirations less than 12/min. Levodopa/carbidopa (Sinemet) dopaminergic medication. Lower extremity amputee anchor residual limb dressing at the nearest joint proximal to the amputation. twitching. pt should reduce or avoid all use of alcohol 1447. IV Meds medication that are water soluble can only be administered intravenously 1449. may cause nosebleeds. sit in straight back chair. cleanse residual limb with mild soap and carefully rinse and dry. Hydrochlorothiazide (Hydrodiuril) can cause hypokalemia from excessive potassium excretion. pt should withhold medication and follup with provider for further evaluation. pupillary constriction. hyporeflexia. monitor serum creatinine level 1451. Human papillomavirus vaccine (HPV2) 3 doses of immunization over 6mths. resulting in nonproductive cough. Jaundice should be reported within first 24hrs of life. may be indication the pt plan to commit suicide 1461. Kosher dietary laws avoid eating meat and dairy product together 1452. Iron (foods) beef liver. Maladaptive grieving statements indicating shame and guilt. 1440. Magnesium toxicity bradycardia. Lisinopril (Zestril) ACE inhibitor. leading to muscle weakness and paralysis 1459. other adverse effects are hyperchloremia. increased BUN indicating renal impairment which can decrease excretion and cause magnesium to accumulate to toxic levels 1460. Medroxyprogesterone adv effect. Milieu therapy creates therapeutic community in which client has opportunities for learning and healing. problem solving) 1466. Orientation/preorientation relationship plan for interactions with the pt . occult blood 1468.1462. Belongingness and Love (affiliate with others. facilitates decreased glucose production. inpatient therapy 1475. dark green and viscous. etc. gain approval and recognition). first stool passed by newborn w/I first 24 hr. agitation. can increase orthostatic hypotension and dizziness. lubricate 3-4inches of end of tube. treat angina. MAOI contraindications aged cheese 1464. 2 FHR acceleration of 15/min over 20min period lasting at leatst 15 seconds indicate reactive non-stress test 1485. Marijuana a hallucinogen. thirst. Self-Actualization (morality. contains components of amniotic fluid. caution in pt with diabetes mellitus because it can mask the manifestations of hypoglycemia 1474. determine which naris has greatest airflow. creativity. be accepted. Safety/security (out of danger). be competent. Nitrates cause relaxation of vascular smooth muscle. low sodium diet to assist with diuresis of extracellular fluid 1479. Meconium develops in utero. Nitroglycerin (TransdermNitro) advise pt to place patch on different site for each application to prevent skin irritation. Esteem (to achieve. has depressant properties. loved). measure appropriate tube length. NonMaleficence ethical concept of avoiding harm 1484. resulting in decreased BP. used to treat DM II by decreasing glucose production in the liver. Maslow's Hierarchy Physiological (hunger. pt should avoid driving or using heavy machinery 1486. Mastitis pump affected breast frequently 1467.). loss of bone mineral density advise pt to increase calcium intake while on medication 1469. and thromboembolism 1488. euphoria. Manic behavior unable to focus on a solitary activity w/o direction from another person. Operant conditioning type of behavior modification that use positive reinforcement to promote a desired behavior 1487. Nasogastric tube (NG) place pt in high fowlers position. medication may cause orthostatic hypotension/dizziness should change position slowly to avoid injury 1483. Nitroglycerin (Nitrostat) sublingual tablets. relaxation and paranoia 1465. can take up to 3doses 5min apart if chest pain persist 1482. Nephrotic syndrome with peripheral edema. Ondansetron (Zofran) side effects headache and dizziness. monitor for adverse effects muscle pain. bodily comforts. GI manifestation such as bitter or metallic taste 1471. Metoprolol (Lopressor) slows the conduction through AV node therefore is contraindicated in pt who have AV block that is greater than first degree. Nifedipine causes vasodilation. MI. change position slowly 1480. Nonstress test (NST) admin orange juice to increase the clients blood sugar and stimulate fetal movement. Oral contraceptives contraindicated in pt who experience frequent headaches w/vision changes (can indicate cardiovascular condition) because combination can increase risk of CVA. Methotrexates (Rheumatrex) pt should avoid alcohol due to risk for hepatic fibrosis and liver toxicity 1473. cells. Metformin (Glucophage) oral antidiabetic agent. instruct client to hyperextend neck 1476. impacts other clients negatively. resulting in pooling of blood in veins and decreased venous return to heart. Mesalamine (Asacol) maintenance therapy for inflammatory bowel disease and pt should take daily for at least 3-6 weeks 1470. Neologisms words made up by the client 1478. 1463. decreases cardiac output which causes blood pressure to fall and orthostatic hypotension to occur with change in position 1481. Negligence failing to respond to escalating behavior and prevent harm from others 1477. intestinal secretions. Methamphetamine expect high fever with overdose of CNS stimulant 1472. expected urine output of 3000ml/24hr 1497. serum glucose testing regularly 1502. can cause CNS depression. pt/family teaching. then annually 1511. and again.. obtain fasting glucose baseline prior to administration of first dose. mother who has Rh pos. nasal flaring.1489. providers (titration of medication) base dosage on therapeutic blood levels 1493. Phenylephrine (NeoSynephrine) may cause tachycardia and other cardiac arrhythmias 1492. measures blood glucose levels over past 2-3mths. Paranoid schizophrenia dominant symptoms hallucinations and delusions 1491. advice pt to withhold med if pulse rate less than 60bpm. discard if appear cloudy 1504. 1509. Schizophrenia multiple pos & neg symptoms. Prednisone (glucocorticoids) suppress the body's immune response increasing risk of infections. reduction in serum T4 level. bradycardia is a common adverse effect. substernal retractions. manage client stress to help control symptoms of illness . little to no movement at all. works by increasing the body's sensitivity to insulin. newborn to prevent mother from developing antigens against the Rh factor 1510. contraindicated with diphenhydramine (Benadryl) put pt at risk for sedation. Religiosity obsession with religious ideas and actions 1505. Repression pt excludes unwanted ideas from conscious awareness 1507. hyperglycemia. atypical antipsychotic help to improve/minimize pt w/schizophrenia with difficulty interacting with others/maintaining relationships. respiratory depression and injury 1490. Pioglitazone (Actos) oral antidiabetic agent. can suppress tachycardia a warning sign of hypoglycemia in pt with DM. Retention of placental fragments: . Repaglinide (Prandin) HbA1c lab test should be review to obtain information about long term therapeutic. PTSD experience disrupted sleep 1501. 8-12wks to experience full therapeutic effects of medication 1495. Pleural rub sounds loud grating sound caused by pleurisy 1496. Propranolol (Inderal) beta blocker. Rho(D) immunoglobin given to Rh neg. Oxycodone (OxyContin) opioid analgesic. Quetiapine pt at risk for abnormal glucose metabolism which may result in DM. pt should notify provider if they experience the following symptoms sore throat. weight gain 1498. Respiratory distress (newborn) S/S. Phytonadione is administer via IM to newborn. glycosylated HbA1c 1506. 12wks later. Reflection communication technique that lets the client know that their concerns and feeling are heard and understood 1503. 1494. black tarry stools (indicates GI bleed) due to the increased risk GI ulcers. Propylthiouracil (Propyl-Thyracil) desired effect HR WNL. put client at risk for developing diabetes due to metabolic effects of medication. tachypnea. Regular Insulin clear in appearance. white patches on tongue (increased risk for candida infections due to immunosuppression). increased attention span 1500. improved sleep patterns. advise to rely on other signs 1499. Postpartum diuresis should begin 12hr after delivery. pain reliever. grunting 1508. delusions (delusions of grandeur).. Risperidone treat schizophrenia. flat affect & tangential speech. can decrease effects of warfarin. appears stuporous. Phenytoin (Dilantin) stimulates synthesis of hepatic drug metabolizing enzymes. Tracheostomy child care allow child to rest for 30-60 seconds after each aspiration to allow oxygen saturation to return to expected levels. Tonsillectomy pt/child can chew gum to prevent throat and ear pain post-op 1528.. Schizotypal personality disorder suspicious attitude 1513. Simvastatin notify provider if muscle pain or tenderness develops could indicate rhabdomyolysis 1516. distended uterus with presence of blood and clots. Signs of Allergic reaction hypotension. wheezing 1515.. Varicella (chickenpox vaccine) hypersensitivity to neomycin is contraindicated for receiving vaccine . salt substitutes are high in potassium can place pt at risk for hyperkalemia 1518. pruritus. Tolbutamide (Orinase) treat DM. confusion. Tetanus booster recommended every 10yrs or sooner if injury occurs from a potentially contaminated object 1522. press the nasolacrimal duct to prevent the medication from absorbing into systemic circulation 1526.1512. Social worker help client build a support structure to help promote and preserve mental health. identify chromosomal abnormalities 1532. Tetracycline hydrochloride (Sumycin) causes photosensitivity and increased severity of sunburn 1523. suction as needed when there is indication of excessive secretion in airway. Triamterene (Dyrenium) inhibits exchange of (Na) and (K) in the distal nephron retaining (K) and excreting (Na) leading to hyperkalemia 1531. Therapeutic lithium level 1. tongue rolling. Scopolamine patch treat motion sickness. hyperventilate w/100% oxygen before and after suctioning 1530.2 meq/L serum lithium level 1524. spastic facial expressions 1521. should be placed behind the ear 1514. contraindicated in pt with hypersensitivity to sulfonamide antibiotics that might also be allergic to sulfonylureas 1527. Systematic desensitization form of behavior modification that employs relaxation techniques in response to specific phobias 1520. 1525. Topical decongestants rebound congestion can occur with prolonged use congestion can become progressively severe 1529. Vancomycin (Vancocin) adverse reaction ototoxicity 1534. Timolol eyedrops treat glaucoma. Uterine bleeding relaxed. Tardive dyskinesia lip smacking. Spironolactone (aldactone) potassium sparing diuretic. hallucinations 1519. Therapeutic relationship: . including arrangements for employers. suction for no more than 5 sec w/each pass. flushing. Sumatriptan contraindicated with use of fluoxetine can lead to excessive stimulation of serotonin receptor putting pt at risk for serotonin syndrome s/s tremor. Triple marker screening done at 16-18wks gestation. day treatments. financial and other community resources 1517. 1533. 1535. Wheezes continuous. Veracity duty to tell the truth 1536. Vitamin K needs to be admin at least 2hr after birth to prevent risk for hemorrhagic disease 1538. musical sounds which are caused by narrowing of the airways . rustling sounds that occur as normal breath sounds 1537. Vesicular sounds soft.