NCLEXI. SATA 1. CERVICAL CA Risk Factors: • African- American/ Native women • Behavior (Sexual promiscuity) • Chronic instrumentation of cervix • Disease –STD • Early age of Sex • High Parity • Poor Hygiene • Low economic status • Multiple sexual partners • Partner with Prostate CA Sx: • Post-coital bleeding • Painful sex • Menstrual irregularities 2. OVARIAN CA Risk factors: • Ovarian dysfunction • Vaginal use of talcum powder • Alcohol • Race - White women & family history • Infertility • Age - Peak=5th decade of life • Nulliparity • Genetic predisposition 3. DM FOOT CARE • Meticulous care to feet • Wash feet with warm water not hot & dry • Can use lotion but No lotion in between toes • Wear socks to keep feet warm • Avoid thermal baths, heating pads • Do not soak feet • Inspect feet daily • Do not treat corns, blisters • Wear loose socks and no barefoot • Change into clean cotton socks daily • Break in new shoes gradually • Use emery board • Do not smoke • Do not wear same pair of shoes 2 days in a row • Check shoes for cracks before using leather instead of plastic 4. BLOOD TRANSFUSION REACTION • Transfusion Reactions Hemolytic Reaction Allergic Reaction • Circulatory Overload • Septicemia • Iron Overload • Hypocalcemia • Disease Transmission • Hyperkalemia • Citrate Intoxication 5. HYPERTHYROIDISM • Soft smooth skin & hair • Mood swings • HPN • Diaphoresis • Intolerance to heat • PTU drug to block thyroid synthesis 6. LUNG CA • Bronchogenic Carcinoma • 1st leading cause of death • From asbestos, bacterial invasion, cigarette • Sx: Nagging cough, hoarseness of voice, dyspnea, diminished breath sounds 7. SX OF PARKINSONS • Tremors, akinesia, rigidity • Weakness, “motorized propulsive gait • Slurred speech, dysphagia, drooling • Monotonous speech • Mask like expression • Teach ambulation modification: goose stepping walk (marching), ROM exercises • Meds—Artane, Cogentin, L-Dopa, Parlodel, Sinemet, Symmetrel • Activities should be scheduled for late morning when energy level is highest • Encourage finger exercises. • Promote family understanding of disease intellect/sight/ hearing not impaired, 8. ACUTE PANCREATITIS • Abdominal Pain severe –acute sx pain radiating to the back • Complication : Shock,Hypovolemia • Limited fat & protein intake 9. CAST CARE Don’t rest on hard surface Don’t cover until dry 48+ hours Handle with palms of hands not with fingers Keep above level of heart Check for CSM 10. HYDROCEPHALUS • Anterior fontanel bulges & nonpulsating • Bones of head separated (cracked pot sound) Macewen sound • Check for sun-setting eyes • D’ Increase ICP • Evidence of Frontal Bossing • Failure to thrive • Irritability • High-pitched cry 11. ESRD DIET • Restricted protein intake • Increase CHO • Low K, P • Restrict Na 12. NORMAL IN 8 MONTH OLD CHILD - can sit with out support - can roll from front to back - can hold a bottle - closure of ant. fontanel - can say mama and dada - 2 teeth present 8-6=2) - stranger anxiety peak 13. SUPERIOR VENA CAVA OCCLUSION • Sx occur in the morning • Edema of face, eyes & tightness of shirt/ (Stoke’s sign) • Late sx: edema of arms, hands, dyspnea, erythema, epistaxis 14. ULCERATIVE COLITIS Sx: • Severe diarrhea with blood & mucus • Abdominal tenderness & cramping • Anorexia • Wt. Loss • Vit. K deficiency • Anemia • Dehydration • Electrolyte imbalance • Low residue & high protein diet 15. DILANTIN • do not floss throughout the day • do not use hard bristled toothbrush • Gingivitis S/E purple glove syndrome 16. ANAPHYLACTIC REACTION (steps) • Stop medication • Maintain airway • Notify MD • Maintain IV access of 0.9 NSS • Place in supine position with legs elevated • Monitor VS • Administer prescribed emergency drugs 17. BLADDER CA Risk Factors: • Hx of smoking • Exposure to radiation • Working in industrial Factory 18. S/S OF DKA • Fruity breath Odor (fetor hepaticus) • Oliguria • Kusmaull'’s (deep & nonlabored) 19. SITE FOR IM INJECTION ADULT • Deltoid • Ventrogluteal • Vastus Lateralis • Gluteus Maximus 20. S/S OF BACTERIAL MENINGITIS •N&V • Seizures • Stiff Neck • Photophobia • Positive Brudzinski sign decrease glucose in csf 21. TB • Waking up sweating at night • Low grade fever • Dull aching chest pain • Cough streaked with blood • Weight loss • Anorexia • Fatigue 22. LIVER CIRRHOSIS •N&V • Edema • Ascites 23. PULMONARY EMBOLISM Sx: • Blood-tinged sputum • Distended neck vein • Chest Pain / Hypotension / Cyanosis • Cough / Shallow respirations • Rales on auscultation • Tachypnea / Tachycardia 24. COLON CA Risk Factors: • Family HX • Age above 50 • Jewish • Male 25. DIGOXIN THERAPY • Do not administer in infants if < …100bpm • Do not give to older children if <70 bpm • Sx of toxicity to a child – N &V weight. Low Calorie. carbohydrate. High Protein. COPD • Rhythmic. purpura • Presence of occult blood • Low fibrinogen level. PLACENTA PREVIA • Check Hematocrit level • External fetal monitor not internal • No vaginal examination • Assess for bleeding • Improperly implanted placenta at lower uterine • Painless bright red. at night • Intermittent claudication/ • Thickened toenails • Cold & gray-blue color of skin • Decreased or absent peripheral pulses • Instruct pt. platelet • Increased PT.) Avoid Strenuous 3. DIC • Bruising. to walk to point of claudication.26. before. warm. cortisol increase secretion of gastric acid – Peptic ulcer & GI bleeding • C/I to Aspirin. relaxed.) Avoid Individuals with Infection 4. TPN COMPLICATIONS • Air Embolism • Fluid Overload • Hyperglycemia • Hypoglycemia • Infection • Pneumothorax 41. ABRUPTIO PLACENTA • Premature separation of placenta from uterine wall • Painful dark red bleeding • Uterine rigidity • Severe abdominal pain • Maternal shock • Fetal distress 33. nontender uterus • Fundal height greater than expected 32. CUSHING’S SYNDROME • Osteoporosis • Muscle wasting • Hypertension • Purple skin striations • Moon face • Truncal obesity • Decreased resistance to infection • Low Carbohydrate. beefy red tongue • Slight jaundice • Paresthisias of hands & feet • Disturbances with gait & balance 39. Low potassium diet Teach life-long hormone replacement • Glucocorticoids (sugar) .) Avoid Stress 2. rigidity & rebound tenderness • Cannot take a deep breath when . HEMODIALYSIS • Palpate for a bruit or thrill • Weigh client daily. Low sodium • Monitor glucose level • Check for color of stool. stop & rest & walk a little farther 43. S/S OF CAD • Chest Pain • Palpitations • Dyspnea / Syncope • Hemoptysis • Excessive Fatigue 27. increased bleeding 30. hydrocortisone • Monitor VS /Absolute bedrest 31. DUMPING SYNDROME • Occurs 30 minutes after eating • Abdominal fullness & cramping • Diarrhea • Tachycardia • Perspiration • Weakness / dizziness • Borborygmi sound 40. vasopressors.) A lifelong Glucocorticoids Therapy 6. PERIPHERAL ARTERIAL DISEASE • Dry scaly skin on lower extremities • Rest Pain. ADDISONS DISEASE Fatigue Weakness Dehydration Eternal tan Decreased resistance to stress Low Sodium Low Blood Sugar High Potassium High protein. prior to prevent vomiting & aspiration • Feel a flush. palpitations in introduction of dye • Shave & Clean insertion site with antiseptic solution 38. SEEN IN 15 MONTH OLD CHILD • Speaks 6 words • Sits w/o support • Builds a tower of 5 blocks • Strong palmar grasp 29. High K.SoluMedrol (succinate) to prevent addisonian crisis • Mineralocorticoids (salt) – Florinef 6 A's of Addison's disease 1. diaphragmatic breathing • If restless.) Always wear medic alert bracelet Addisonian Crisis • Hypotension • Extreme weakness • Nausea vomiting • Abdominal pain / • Severe hypoglycemia • Dehydration • Administer NaCl IV. finger stick • Monitor vital signs. hct. POLYCYTHEMIA VERA • Increased RBC • Leukocytosis / Thrombocytosis • Angina • Intermittent claudication • Dyspnea /HPN • Lethargy / Syncope / Paresthesia 46. Sodium. reposition client • Side effects: constipation 35. PERITONEAL DIALYSIS • Weight before and after treatment • Monitor BP • Monitor breath sounds • Use sterile technique • If problem w/ outflow. PERNICIOUS ANEMIA • Severe pallor • Smooth. After treatment. vaginal bleeding • Soft. perform purse-lip breathing not more than 1 minute • Perform deep breathing with mouth held together during expiration 28.) Avoid OTC meds 5. during & after • Hold antihypertensive drugs b4 dialysis • Check for thrill and bruit q 8 hours • Don’t use extremity for BP. TYPE 1 IDDM • Test blood glucose every 4 hrs if no feeling well • Eat fruit or cheese sandwich before exercise • Do not exercise if blood glucose is >250mg/dl & urinary ketones present • Administer regular insulin 30 minutes before meals 36. desire to cough. breath sounds • Monitor for hemorrhage 34. PRIMARY HPN Risk Factors: • Aging • Black race • Chronic stress • Family Hx • Obesity • Smoking • Men 47. CARDIAC CATHETERIZATION • NPO 6-8 hrs. after eating fatty food • Pain localized in RLQ • Guarding. COMPARTMENT SYNDROME • Increased pain & swelling • Pain with passive motion • Loss of sensation • Inability to move joints • Pulselessness most characteristic – pain unrelieved by mdication 37. PTT • Complication: RENAL FAILURE 42. patient must be retested to make sure disease is gone 45. fluttery feeling. CHOLECYSTITIS Sx: •N&V • Belching • Indigestion • Flatulence • Epigastric pain that radiates to the scapula 2 hrs. THROMBOPHLEBITIS • Avoid pressure behind legs • Avoid prolonged sitting • Avoid constrictive clothing • Avoid crossing the legs • Avoid massaging the legs 44. & no liquid for 4 hrs. SYPHILIS Painless chancre fades after 6 weeks Low grade fever Copper-colored rash on palms and soles of feet Spread by contact of mucous membranes Treat with Penicillin G IM If patient has penicillin allergy. will use erythromycin for 10-15 days. NA/ UAP/CN/ Senior nursing student . with tracheostomy: • Instruct pt. Schilling’s Test • For pernicious anemia 32. Prior To MUGA SCAN: • Informed consent • Allergy not a concern 33.fingers are pressed below hepatic margin (Murphy’s Sign) II. LPN-Can give meds except IV. PRIORITIZATION Remember the rule of stable vs.005 12. pulse oximetry. first think EXPECTED in asthma so this will be considered stable. insertion of NG tube. only low residue • Introduce soft high-fiber foods when inflammation has resolved 22. 20. turning unconscious patient. castration) 37. walk unto walker 18. almonds. Action in pt. Patient w/ DM & HPN. assist in ambulation. avoid caffeine. corn. Finger stick with gestational diabetes. urinalysis. unstable. AIDS 2.you consider this unstable. Input & Output. Testing occult blood. Adverse Effect of Anti-metabolite 5FU • Stomatitis 10. Example. TSB. low fat 27. COMPUTATION 1. Stock is 500mg in 500ml of NSS. Patient Hx C/I for MRI : • Mitral Valve Replacement 5. TOPICS 1. monitoring.gloves.D. Fear of 3 y/o child • Injury (abandonment. Infection control: a. Neonates in nursery developed diarrhea • Meconium stool study w/in 24 hrs. Short-term goal for anti-social patient • Follow unit rules 17. fruits • Give cranberries. Circumcision of a new infant: • Diaper fasted loosely 15. Cardio disease 2. Diet for Diverticulitis • Avoid high-fiber foods when inflammation occurs. Nausea • Oral candidiasis • Pancythopenia 30. diet teaching: • Should be acid-ash diet & avoid oxalate rich & Ca rich food such as tea. terminally ill because of comfort only needed. Asthma with wheezing. .Newly admitted. Pancrease in Cystic Fibrosis • Give with meals. High K 13.5mcg/kg/min. Client passing stones with calcium. patient weights 176 lbs.goggles) Conjunctivitis Open wounds /drainage Lesions MRSA / VRSA / CDAD RSV/ VRE DROPLET : Surgical Mask Scarlett Fever Diphtheria Meningitis Strep. change perineal pad.IV meds. ABC. post cardiac catherization • Check pulse in lower extremities 21. BT. get the rate at ml per hour. Md with IV order for patient 3. then invasive & shld. 3. spinach. Glaucoma : • Halos around light 6. legumes I 28.URTI) • Diarrhea. Although you consider the client unstable but if it expected in him. to cough prior to obtaining sputum 11. Peptic ulcer disease • Avoid stressful situation to prevent exacerbation 31. sterile techniques like wound dressing. Nsg. dilute in applesauce 26. Dobutamine drip: Order is 2. Use of walker • Partial weight bearing • Stand in front. prunes. pre op teaching and post op. this is stable. DELEGATION RN . plums. theophylline) 24. rhubarbs beans. BS. Compute for ml/hr? Formula: Stock (mg) x 1000 mcg/mg Quantity (ml) Flow rate: Dose (mcg/kg/min) x wt (kg) x 60 min/hr Concentration (mcg/ml) Answer: 12ml/hr 3. Solution: 3000/24 = 125 ml/hr 4. clean with clean for example patients with CVA. SAFETY INFECTION CONTROL AIRBORNE : Hepa Filter Mask / N95 Particulate MASK PTB Measles / Rubella Chicken Pox/ Varicella SARS Anthrax CONTACT : GGG (gown. Pharyngitis Pneumonia ENTERIC: Gown . Acute Pancreatitis • Increase lipase/amylase 16. -Isolation precautions. Maximum injection on 10 month old infant • 1 ml . Persantine. A Salmonella Acute Gastroenteritis Peptic H. What will you ask on pt for cardiac stress test (Thallium stress test)? • Is he on beta-blocker? (if with radionuclide already. Normal respiratory changes in elderly • Decreased cough reflex 41. calcium channel blockers. Action of Lipitor • Anti-lipimec 35.WBC & albumin.Stable expected outcome. catheterization. testing occult blood. abduction & external rotation 36. Patient with Dumping Syndrome: • Avoid cheese 9. question if • Given beta-blocker (causes bronchospasm ) 42. tomatoes. basic hygiene ADL. Positioning of Hip Spica Cast in children • Maintain flexion. remove sutures. how many tablets? Solution: 20/5 x 1 = 4 tablets III. discharge tomorrow. Frostbite • Soak in warm water 40. nsg. Obtaining sputum specimen from pt. Judgment & discharge planning . Paget’s Disease • Bowing of bones 29. U waves : • Hypokalemia 7. Action of Aquamephyton • Prevention of hypoprothrobinemia 34. To prevent ureteral stones • Increase 38. Universal precaution: Hep B. Patient with CHF cor pulmonale S & S • Jugular vein distention & peripheral edema 14.All “-ing” ex bathing. cocoa. Diet for Hypothyroidism • Low sodium. MDI • Hold breath 39. Client post-CVA. Report if: • Specific Gravity of 1..Routinary Procedure 4. Gloves Diarrhea Hep. diet teaching • Low salt. Same precaution techniques: a. Side Effect of Ansef (Cefazolin) • Antibiotic (RTI. Patient with arterial insufficiency • Elevate the affected leg 8. -Stable v/s. soap sud enema. Highest risk of accident • 9 month infant eating grapes & apricot 25. Tablets : Dose of 20 mg per dose in stock dose of 5 mg per tablet. reading v/s in long term pt. vegetables. Borderline patient • Splitting 19. b-blockers. cereals.000ml in 24 hrs. what type? • Nutritional deficit (malnutrition) 23. reading. needs assessment. Dopamine 2. Low iron. DM. Pylori Shigella / Rotavirus Giardiasis / Cryptosporidium Muris FROTECTIVE: Blood dyscrasias Aplastic anemia Leukemia Major burns (50%) Organ transplant Aids Multiple Myeloma Prolong Steroid Therapy Concepts: 1. unstable . Post-hypophysectomy pt. 43. Nsg. Pt. SIADH • Sodium 128 only (Normal: 135-145) 53. What should the nurse question? • St. swimming • Apply to flat. S/S of Kawasaki • Desquamation of skin • Joint pain • Mucocutaneous lymph node syndrome 89. Seizures 71. Normal for a 3 day old infant • Describe normal tonic neck reflex 60. Check 1st before tonsillectomy • Bleeding time 95. 104. with calcium oxalate stones • Diet with fig & wheat germs 106.azithromycin (Penicillin & Cephalosporins the same) 99. Mg SO4 given to PIH pt. G & D of a 2 y/o • Combines 2 words • Kicks a ball • 50 word vocabulary 87. Activity for Alzheimer disease • Reading magazine 63. Watch out for in lumbar puncture • Increased ICP • Brain Herniation 90. Pt. taking lithium • Watch out for sodium serum 85. should the nurse question the order: • Patient on insulin (B-blockers may mask signs of hypoglycemia) 98. Pt. Side effect of Garamycin • Ototoxicity • Nephrotoxic • Hypomagnesimea • Muscular paralysis • Hypersensitivity 75. Type 1 IDDM post renal test 48 hrs ago. before meals & antacids after meals 101. Increasing pulse pressure • Widening pulse pressure (late sign) • Decreased LOC. 72. Physician orders beta-blockers. Diet for patient with ileostomy • Post opt 4 wks -. 1st intervention in prolapsed cord • Positioning – knee chest/trendelenberg 82. Diet for patient with colostomy • DAT • Low residue food 1-2 days postopt • Avoid gas-forming foods 79. 51. GBS. RSV • Droplet precaution 52. 2nd Stage of labor • Cervical dilatation to delivery of baby 83. Signs of increase ICP in pt. proper body mechanics • Sit with knees higher than hips 70. restlessness (Early) 102. Side Effect of Theophylline • Tremors & tachycardia • Insomnia 76. low fat cheese should be given • Low fat diet • Normal stool is liquid 86. rapid breathing • Abdominal pain • Dyspnea & difficulty eating • Orthopnea 73. Pre-menopausal syndrome experiencing hot flashes • Black Cohosh for menoposh 49. back • Overdose : difficulty in breathing 66. priority nursing diagnosis • Aspiration 57. side effect? • Headache • Hypokalemia • Hypotension 46. with Hemophilia & Leukemia • Can lead to DIC 103. Manifestation of Paranoid Schizophrenia • Inappropriate anxiety with delusion 61. for w/c pt. in labor with crusted popular . 62. Obsessive Compulsive Behavior • To alleviate anxiety 69. Sign of Alcohol withdrawal • Feeling of euphoria in 1st 24 hrs. PEG 55. Nurse should watch out for? • Epigastric pain & headache 105. Pt. • Carafate 1 hr. with endometriosis takes Danocrine. Patient hypersensitivity • Give macrolides like erythromycin. upper arm. Sign of Scoliosis • Asymmetry of the iliac crest 59. after can tolerate high fiber diet already • Foods that thicken stool like boiled rice. is taking 54. what to watch out for? • Potassium 84. with carafate & antacids order. Correct understanding of antidepressant • Anti-depressant takes effect after 1 week 65. Patient with autonomic dysreflexia • Pounding headache . watch out for: • Hematuria 64. S/S of DVT • Edema • Calf or groin tenderness • Pain with or w/o swelling • + Homan’s Sign • Warm skin 91. showering. Sclerotherapy • Application of pressure dressing for 12-48 hrs. Digitalis + Lasix = Weight Loss 74. action of the drug? • Suppress menstruation/ ovulation 44. What to check prior administration of EPOETEN • BP • S/E : HPN. nonirritated. best communication: • Use picture language 78. Developmental Milestone of 10 month old • Pincer grasp 92. Patient with testicular cancer. lessen effect) 97. Patient allergic to Pseudoephedrine. nonirradiated area like chest. piloerection 100. ALS • Decreased sensation of touch • Muscle weakness • Excess glutamate 88. Manic pt. Thiazide diuretic. Management for cleft palate infant • Enlarged nipple for feeding • Stimulate sucking • Swallow • Rest • Burp frequently 77. Positive outcome for Calcium Channel blockers • Decrease chest pain 68. with close head injury • Increase systolic pressure & weak bounding pulse 67. Post NSD with epidural anesthesia with bladder distension • Offer bedpan 45. Patient with expressive aphasia. What is contraindicated? • Patient taking Ma Huang 80. Pt. Patient with back pain. Cancer & Sepsis can lead to DIC • low platelet count 107. correct understanding? • Testicular CA is painless 81. What medicine if given shld be monitored for bleeding • Indomethacin (NSAID) 56. Patient with pancreatitis if developing ascites would manifest: • Cullen’s Sign (bluish discoloration of abdomen or peri-umbilical hematoma) • Turner’s Sign (gray-blue discoloration of flank) • Shallow. Discharge teaching for Bell’s Palsy • Provide eye care at bedtime 58. Abdominal Assessment • Inspection • Auscultation • Percussion • Palpation 50. flank. Effective teaching to DM patient • Peak of NPH insulin 8 hrs. Need to consider anti-coagulant therapy • If taking Gingko Biloba 94. DUROGESIC PATCH / FENTANYL • For chronic pain lasts 3 days • Maybe worn while bathing. Apmhotericin B. Risk for breast CA • 38 y/o female on oral contraceptive 93. Complication of CAST • Compartment syndrome • Fat embolism • Shock • Avascular necrosis 96. PT. select the schedule.LOW FIBER non-irritant diet to decrease fast movement of liquid stool. John’s Wort to a kidney transplant (C/I to anti-neoplastic drugs. with angina unrelieved by 3 nitroglycerin • Administer O2 47. Patient on Halo Vest • Tape the wrench to the vest (Torque screw) 48. Dementia of Alzheimer Type • Check what the pt. • Transmitted parenterally • Common to drug users • Major cause of post-transfusion hepatitis • Universal Precaution same with Hep. see if infant’s body move towards the stimulated area 135. what to administer 1st? • Start IV line 0. using aerosol sprays • Teach client clean suction technique 113. cracking • Wear cotton clothing • Administer antiemetics • Do not pose any hazard to anyone Internal radiation sealed source • Lead container and longhandled forceps in room • Save all dressings. Coumadin Therapy. pre-malignant lesion) 124. Adverse effect of 5FU (Fluoronacil) • Antagonistic to iron – Anemia 151. care • Force fluid from 3 . Heroin addicted mother in labor. DKA patient.4 L/day to offset hypercalcemia. DVT on Heparin therapeutic goal • Ambulate ASAP ( Prevent thrombus formation) 125. B 155. Hepatitis C. hyperurecemia • Encourage ambulation to prevent renal stones 129. • Mother can be in the tent with the child 149. Signs of Heroin intoxication? • Euphoria • Decrease response to pain • Respiratory depression • Apathy 110. HELLP • Nausea • Epigastric Pain • Tx: FFP / Platelets 145. WOF • Tingling sensation in the cheek (complication) 118. Correct understanding? • Ask MD before taking OTC drugs 142. Signs of acute angle glaucoma • Eye pain / headache 140.9 NaCl 132. shallow (PANT) breathing 152. abdominal girth. Bipolar manic patients. with anorexia nervosa. Ventricular Fibrillation • Do chest compression 119. Patient taking garlic supplements should take precaution when on aspirin therapy 131. Direct Coomb’s test (-) • Give Rhogram 153. cell phones <3 watts. Scarlett Fever isolation precaution • Respiratory precaution • droplet until 24 hrs. Legionnaire’s disease • Type of pneumonia • Droplet precaution • Sx: Fever. Post pace maker transplant. Above the knee amputation. Brain injury • Decorticate rigidity 116. Side effect of Haldol • EPS. Influenza Vaccine indicated for: • Anyone 50 y/o & above annually • Age 6 months & up with risk like asthma • Immunocompromised patients • Pts with cardiac & pulmonary disease 121. Sx of Furosemide • Decreased edema. Colchicines Toxicity • Anti-gout drug • Nausea & Diarrhea • Vomiting . Transition phase of labor • Do short. Herpes Simplex I & II • 2 strains of herpes virus family • HSV I – cold blisters / fever blisters • HSV II – in STD /Genital Herpes/Shingles & varicella zoster infection same with chicken pox 122. Signs & sx • Same with Hep B. NMS 147. Diarrhea • Middle age & older persons • Treated with antibiotics . bed linen until source removed • Urine and feces not radioactive • Don’t stand close or in line with source • Patient on bed rest Cancer Implementation: Internal Radiation • Time and distance important • Private room sign on door • Nurse wears dosimeter at all times • Limit visitors and time spent in room • Rotate staff • Self-care when can do Internal radiation unsealed source • All body fluids contaminated • Greatest danger first 24-96 hours 148. priority? • Eye prophylaxis of the newborn 108. Venorofaxen 111. cough. metal detectors 130. chills. microwave ovens. 18 day old infant. what to do? • Limit group activities 128. Diet for hepatic encephalopathy • Adequate caloric intake in form of glucose 143. macrolides 154. nursing action? • Avoid withdrawal in active stage 109. how to assess trunk curvature • Place in prone position & stroke spinal colum. Sign of Abdominal Aortic Aneurysm • Pulsation between umbilicus & pubis 137. correct understanding: • Position—lung segment to be drained is uppermost • Drink a glass of water before PD to loosen secretions 136. keep dry • Ear mold is the only part that may be washed w/ soap & water • Cannula is cleaned with small pipe cleaner device or toothpick 133. showering. Pregnant 39 weeks. Mother (-). in crutches. Echinacea • To boost immune system • Use only up to 8 weeks 138. patient shld • Prevent internal or external rotation of the limb • Place sandbag or rolled towel along side of thigh to prevent rotation 123. correct understanding • Patient CAN USE electric blankets. Esophageal varices. Correct understanding. HIV suspect patient • Hairy tongue and leukoplakia (Leukoplakia. CA (Internal & External Radiation) External Radiotherapy • Leave markings on skin • Avoid use of creams. correct teaching: • Turn off & remove battery when not in use • Avoid excessive wetting of hearing aid. Hearing aid. Multiple Myeloma. Pt. nurse should check • Check armpits to see if there is pressure secondary to crutch (Pressure shld be on the hands not on the axilla) 120. start of treatment 112. LTB (Croup). BP & calcium • Increased urinary output 156. muscle aches. Pt. refer pt if • Cold clammy skin ( sx of shock) 126. PEEP 134. Liver cirrhosis. Watch out for: • Gum Bleeding 141. Signs of renal failure • Urine output less than 100ml/hr 117. Laryngectomy • Avoid swimming. Phenytoin for seizure. Drugs that can produced Hyperglycemia • Prednisone 146.eruption. signs • Tachycardia 115. Post-thyroidectomy patient. External irradiation therapy • Time & distance shielding 114. baby (+). What to assess before nasotracheal suctioning? • Platelet (risk for bleeding) 150. Action of PILOCARPINE • Increase outflow of aqueous humor • For OPEN ANGLE GLAUCOMA 139. knows true labor if • Contractions from back going to abdomen 127. lotions • Only vitamin A&D =ointment) • Check for redness. ataxia. Postural drainage. Side effect of TCA • Urinary retention 144. Burn Assessments • Superficial partial thickness—pink to red. LABORATORY VALUES 178. no cereals. Isoniazid (INH) • S/E: peripheral neuropathy (administer pyridoxine) • Rash. Obstruction: “milk” tube in direction of drainage 3. blisters. no citrus fruits Low Phenylalanine diet Prevents brain damage from imbalance of amino acids Fats. Laminectomy 181. rice. 189. HERBAL MEDS 187. soybeans & potatoes 171. Rifampicin • Hepatotoxic 174. PEAK FLOW METER vs. white. Cataract Assessments Distorted. does valsalva maneuver • Clamp chest tube. Death to an adolescent • Universal 163. lips. Rheumatoid vs. Osteoporosis vs Gouty 194. potassium and sodium low No beans. Chest Tubes 1. 198. painful • Deep partial thickness—red to white. and Iron TPN maybe Prevent contractures 195. CANE • COAL (cane opposite affected leg) 168. CEFTRIAXONE/ROCIPHEN • Monitor tongue & oral cavity 165. Pt with uncomplicated cholelithiasis. ABC 175. PCA 184. and eyelids. No junk food Renal Keeps protein. PROBENECID • Treat gout /hyperurecemia • Increase uric acid removal in the urine 159.C. Myasthenia gravis • Ptosis 182. not IM circulation impaired Medicate patient before wound care Silver nitrate (warn patient skin will turn black) High calorie. insert sterile connector and reinsert • Tube becomes disconnected from drainage system. roast beef sandwich. High carbohydrate. cut off contaminated tip. jams allowed No meats eggs bread 179. waxy. Spinal Cord Injury 176. expect elevated? • Alkaline Phosphotase 167. dilated without lens Eye drops / Night shield Sleep on unaffected side 197. Chills • Hematuria • Proteinuria • Edema • Hypertension • Abdominal or flank pain • Occurs 10 days after beta hemolytic streptococcal throat infection Implementation • Antibiotics. Patient with Testicular CA • Undescended testes 170. team. painless Wound Care for Burns Never break blisters Isotonic fluids (Lactated Ringer’s) Closed method (Silvadene) covered with dressings Open method (Sulfamylon) that are not covered with dressings IV pain medication initially: not PO takes too long. Hep A. METERED DOE INHALER vs. Primary. But kung E. Lumbar puncture 180. Meaning of death to a 5 y/o • Magical thinking • Death as temporary 160. INCENTIVE SPIROMETER 193. painful • Full thickness—charred. passive modality 158. Influenza Vaccine. straining of stool Mydriatics C/I with glaucoma. Aspirin 172. corticosteroids • Antihypertensives. Reflexes 177. Triage (External)• Treat first the stable before the unstable.• Sore gums • Metallic taste 157. Nephrotic syndrome • PROTEINURIA – frothy urine 186. how to explain procedure • Use for chronic nerve pain • Uses only electrodes • Painless • Non-invasive. Glomerulonephritis • HEMATURIA • cola/tea urine Glomerulonephritis Assessment • Fever. 173. High protein diet Vitamin B. urticaria • Swelling of the face. DIET Clear liquid No milk No juice with pulp Full liquid No jam No fruit No nuts Low Fat /Cholesterol Can eat lean meat No avocado. fruits. high fiber No white bread without fiber Low Residue Diet Minimize intestinal activity Buttered rice white processed food No whole wheat corn bran High Protein diet Reestablish anabolism to raise albumin levels Egg. Consent and Advance Directives 190. Detached Retina Flashes of light . Multiple sclerosis • Fatigue / Ataxia /Vertigo 183. C/I? • Allergy to eggs 185. blurred vision Milky white pupil Cataracts Postop: check for hemorrhage Check pupil—constricted with lens implanted.R. • Remove quickly • Apply occlusive dressing 4. TENS. Glaucoma Abnormal increase in intraocular pressure that leads to blindness Blurred vision Lights with halos Decreased peripheral vision Pain Headache Glaucoma Administer miotics (constrict pupil) Carbonic anhydrase inhibitors Surgery Avoid heavy lifting. bacon. functional Nsg. Low protein 192. Removal of chest tube: • Pt. Diet teaching for Celiac Disease (SPrue) • Gluten free diet • C/I wheat/rye/oats/barley) • Give corn. Glasgow coma scale 191. • Emergent first before urgent. Meaning of death to a 7 y/o • Death as punishment 161. Dislodged • Apply tented dressing • Tube becomes disconnected from drainage system. Meaning of death to 9 y/o • Death as irreversible 162. immunosuppressive agents • Restrict sodium and water intake • Bedrest • I&O • Daily weight • High Calorie. egg yolks butter Sodium restricted No cheese High roughage. predisposing factor? • From day care centers 169. unstable muna before stable. Infant sounds • 1 – 3 months = Cooing • 4 -6 months = Babbling • 6 -8 months – interest in sounds • 9 -12 months = use of gestures 164. immerse in 2cm of water Jackson-Pratt: • Notify physician if drainage increases or becomes bright red • Penrose: Expect drainage on dressing 196. milk. AUTONOMIC DYSREFLEXIA • C6 injury 188. Air-leak if bubbling in water-seal chamber (middle chamber) 2. EMG • Stop all CNS meds 240 prior procedure • Skin prep on site • To be stimulated with needles 166. warm. Shock 205. reinstall residual • Hold feeding if >50% residual from previous hour (adults) or >25% (children) • Flush tube with water before and after feeding • Use pump to control rate of tube feeding • Administer fluid at room temperature • Change bag Q8 hours for continuous feeding • Elevate head of bed while feeding is running • Check patency Q4 hours • Good mouth care NG Irrigation Tubing: • Verify placement of tube • Insert 30-50 cc of normal saline into tube • If feel resistance. NORMAL AGING PROCESS 206. cramp-like colicky pain after meals • Abdominal distention • Diarrhea (semi-solid) • Anorexia. used for bleeding esophageal varices • Linton-Nachlas—4-lumen. leukocytosis • Implementation—discontinue IV. Mill-Abbott. open airway. leakage of blood • Implementation—discontinue IV. start IV in opposite extremity Hematoma • Assessment—ecchymosis. 203. used for long-term feedings • Cantor—single lumen with mercuryfilled balloon and suction port • Miller-Abbott—double-lumen with mercury-filled balloon and suction port • Harris—single lumen with mercuryfilled balloon and suction port NG tube placement: “BEST WAY” to check is to aspirate for gastric contents and check for pH of aspirate <4 Implementation of feeding: • Check residual before intermittent feeding. ice bag 24 hours. elevate arm. apply pressure. 24hour urine VMA test • Avoid emotional and physical stress • Encourage rest • Avoid coffee and stimulating foods • Postop care after adrenalectomy 209. Immunizations 208. start new site proximal to infiltrated site IV Phlebitis. continuous pull Intestinal Tubes (Cantor. have patient lie on right side. do not milk. Chron’s Disease • Fever. chest compression . then left side o Gravity helps to position tube o Coil excess tube loosely on bed. swelling. affected eye in dependent position Eye patched (one or both) Surgery Sedatives and tranquilizers Avoid stooping. Informed Consent • Valium IV • Synchronizer on • 25-360 joules • Check monitor between rhythm CPR Shake. 215. warm moist compresses. IV SIDE EFFECTS Change tubing Q72 hours Change bottle Q24 hours Infiltration • Assessment: cool skin. swelling. summon help. CARDIOVERSION Defibrillation • Start CPR first • 1st attempt – 200 joules • 2nd attempt – 200 to 300 joules • 3rd attempt – 360 joules • Check monitor between shocks for rhythm Cardioversion • Elective procedure. Thrombophlebitis • Assessment—redness. ARTERIOGRAPHY. reinstall residual • Check residual Q4 hours with continuous feeding. COLONOSCOPY. Sengstaken tube Nasogastric Tubes: • Levin-single—single-lumen. Russell’s Traction Sling is used Check for popliteal pulse Place pillow below lower leg and heel off the bed Don’t turn from waist down Lift patient. CIALIS 214. causes PUD • Causes Cushing-like syndrome 200. listen. PNST. strenuous activity 199. reposition) Adults 12/min check carotid. pinch nose. Harris) o After tube is in stomach. do not irrigate. if used for scoliosis will use 40 lbs of weight. chest compressions 80-100/min 1. give 2 full breaths (if no rise. Use 8-20 lbs of weight.5 inches Infants 20/min check brachial pulse. until reaches the stomach. FLORINEF (fludrocortisones acetate) • For Addison’s Disease • Given AM with meals. Fractured Hip Assessments Leg shortened Adducted Externally rotated Care after a total hip replacement • Abduction pillows • Crutch walking with 3-point gait • Don’t sleep on operated side • Don’t flex hip more than 45-60 degrees • Don’t elevate head of the bed more than 45 degrees 202. decrease in flow rate • Implementation: discontinue IV. warm compresses. look. then back in Fowler’s position. bloody first 2 hours Penrose: expect drainage on dressing 207. If used for fracture treatment. N & V 210. Traction Buck’s Traction Use to relieve muscle spasm of leg and back If used for muscles spasms only. Regitine Test. Salem vs. they can turn to either side. back flow of blood into tubing • Implementation—discontinue. used for bleeding esophageal varices • Keofeed/Dobhoff—soft silicone. check for kinks • Withdraw solution or record amount as input NG removal: • Clamp tube • Remove tape • Instruct patient to exhale • Remove tube with smooth. pain. inject Urokinase. PIH. SANDIMMUNE. 217. EVISTA 212. CST. D/C and start on other site. APGAR 211. feel for signs of breathing. straining at stool. do not increase rate of flow or hang solution higher.Loss of vision Particles moving in line of vision confusion a Implementations Bedrest. then remove completely with smooth. SAW PALMETTO 213. CELESTONE 216. swelling. continuous pull T-Tube: 500-1000 cc/day. CPR. shout. Lung Sounds 204. used for decompression or tube feeding • Sengstaken-Blakemore—triple-lumen. change patient position. do not tape o Position of tube verified by x-ray o Measure drainage QShift • Removal o Clamp tube o Remove tape o Deflate balloon or aspirate contents of intestinal tube balloon o Instruct patient to exhale o Remove 6” every 10 min. only can turn to unaffected side. do not aspirate cannula. restart IV in opposite extremity IV Clotting • Assessment—decreased flow rate. not the leg Cervical Tongs Never lift the weights No pillow under head during feedings Balanced Suspension Traction For femur realignment Maintain weights hanging free and not on floor Maintain continuous pull Halo Jacket Maintain pin cleansing 201. used for decompression or tube feeding • Salem sump—double-lumen. PHEOCHROMOCYTOMA • Persistent hypertension • Hyperglycemia • Pounding headache • Palpitations • Visual disturbances • Histamine Test. Elevate head of bed for counter traction or foot bed Place pillow below leg not under heel or behind knee. tender. Levin vs. Early deceleration 256. Total thyroidectomy d/c teaching? • Monitor pulse rate and temp 266. should be with relatives 237. px taking iron supplement. • pt is reacting to the food recently taking 247. Jewish orthodox dead? • dont leave body alone..Instruct the patient to imagine that he is in the beach-.what precaution? DROPLET 263. 257. Gastrochisis? • put soaked gauze with nss to abdomen 228. giving the radiation bandage/band to the nurse for the next shift 225. muscle weakness/pain – b. NST 255. food rich in Ca? • broccoli 241. lung expansion High Fowler’s—60-90 Fowler’s—45-60 Semi-Fowler’s—30-45 Low Fowler’s—15-30 Modified Trendelenburg—used for shock. Diet for Addison’s? a.inhibit estrogen production 265. Tamoxifen.1 220. knees straight. 24-hour urine collection. Arthralgias Enlarged. Tapazole? • with meals 234. Vanillylmandelic acid 1. Huntington's dse 253. headache.C/I? • chicken bullion and cheese 239. trunk flat. Feet elevated 20 degrees. parents plan to buy/purchase an electronic door that sings open when there is weight. used to diagnose pheochromocytoma which is a tumor in the adrenal gland. which among the ff psych meds is . total knee replacement immdtly post op what is the correct statement? • ill put an abduction pillow 233. he suddenly feels severe headache and goes to er. head slightly elevated Elevation of extremity—increases blood to extremity and venous return Lithotomy—used for vaginal exam 219. sickle cell crisis advice to give to teenager? • lessen physical activity Sickle Cell Anemia • Pain /Swelling/Fever • Sclera jaundiced • Cardiac murmurs / Tachycardia • Check for signs of infection (prevent crisis) • Check joint areas for pain and swelling • Encourage fluids • Provide analgesics with PCA pump c crisis 248. Cushing what will you expect? a. Na of 142 b. what does the nurse do first? • fhr external monitoring 235. Multiple sclerosis-. Break confidentiality? • nurses talking in the hallway 227. Save all the urine in 24 hours. Cardiac conduction defects Neurologic disorders (Bell’s palsy. IDDM advice lifestyle change? a. conjunctivitis) Can develop over 1 to several months Stage 2 Develop after 1 to 6 months if disease untreated. high calcium 222. There are three stages. 258. K of 3. Stress management-. sealed radiation what will be the safety to the nurse? a. a nurse giving Celebrex to an RA pt who has an allergy to aspirin b.41 c. Mycoplasma pneumonia-. temporary paralysis) Stage 3 Develops after 1 to several months.this is correct. ff statements is correct for malpractice? a. ph 7. pls. Avoid strenuous ex b. Increase insulin dose if involved to sports 269. if reached at this stage may persist for several years. Digoxin +Quinidine? 268.100/min ½ . A pt with pneumonia will go to radiology for x-ray? • pt will wear a surgical mask while traveling in the hallway. suctioning pt needs further teaching? • my wife have shortness of breath during my suctioning. How many ml is 1/2 banana? 264. a pt taking captopril what will check or concern? im having cough at night 236. Herpes zoster/shingles • will the pt experience acute pain? YES 261. Which is the wrong statement in Addison’s disease? • Administer potassium. limit exposure for 30mins close contact to pt during shift b. what statement by px shld you be cautioned? • will crush the tablet before i drink it 250. Maoi. Arcabose is given to px health tx? • helps pancreas to release insulin 244. Position after liver biopsy? • sidelying on rt side with pillow under right side of ribs 251. 3 month old baby. 230. POSITIONING Therapeutic Positions Supine—avoids hip flexion Dorsal recumbent—supine with knees flexed Prone—extension of hip joint(after amputation) Side lateral—drainage of oral secretions Knee-chest—visualization of rectal area Sim’s—decreases abdominal tension (side lying with legs bent) Fowler’s—increases venous return. what is the health tx? • delay purchase of electronic device 246. px with myasthenia gravis what will you monitor? •k 245. a nurse telling the pt not to take zafirlukast during an asthma attack ( C/I DURING ASTHMA ATTACK USE AS PROPHYLAXIS FOR & TX FOR CHRONIC BRONCHIAL ASTHMA) 221. Reglan? • take 30mins before meals 238. pt taking nardil has stopped taking the drug for 5 days and began taking chocolate and cheeseburger.1 inch 15:2 Adult 4 cycles Infant 20 cycles Reassess pulse and breathing Continue CPR until: • Victim responds • Someone else takes over • Victim is transferred • Rescuer is unable to continue 218. what food to give to a child? • Crackers 240. pt is constipated what health teaching? • increase intake of fruits and veggies 243. a 28yrs old pt 35wks pregnant is having internal bleeding was rushed to ED. adverse effect: myalgia & rhabdomyositis 226. 224. this is guided imagery wherein the patient imagines or fantasizes to reduce stress. What is the purpose of swimming in arthritis? 262. 3rd degree burn 267. Stage 1 Erythematous papule develops into lesion with clear center (Bull’s-eye) Regional lymphadenopathy Flu-like symptoms (fever. how are you going to irrigate ileostomy? • with nss 249. a pt with pneumonia safety precaution? • wear mask while bathing the pt. 223. LYME’S DISEASE Multi-system infection caused by a tick bite.low bed position-. Clostridium deficille? private rm 229. fracture of arm what position? • place pillow under arm 242. Lipitor what will be the concern? a. dysphagia pt how to feed? • put head of bed to 60degrees before feeding 232. Osteoporosis 254. sickle cell crisis what is your concern? • i still have joint pain even though im taking analgesic daily 231. inflamed joints Teaching Cover exposed areas when in wooded areas Check exposed areas for presence of ticks Antibiotics 3-4 weeks Stage 1 use Doxicillin IV penicillin with later stages 252. 259.think safety 260. red wine is ok 270. 284. Prednisone (Deltasone)—a corticosteroid. Take pulse before administration & gradually decrease when discontinuing. warm area noted around insertion site or on path of vein. Lantus understanding • I will avoid OTC with chromium 295. Corticosteroids to decrease inflammatory response. Complications of TURP • Sterility may or may not occur • Bleeding is normal. High-Calorie. If dose is missed. use Tigan or (Dramamine). What is the transmission of Hepatitis A? Fecal/Oral Consume contaminated food or water Travelers to developing countries at risk Clients with hepatitis A should not prepare food for others 288. Morphine Sulfate—decreases blood return to the right side of the heart. enhance effect of Coumadin 277. flushing. Gantrisin • Drink 2-3 L for the whole day 314. The antibiotic is mixed in D5W. 296. mimics action of acetylcholine. effective? • Increase awareness 310. major side effects: palpitations. Orinase • 30 minutes before meals 311. Drug therapy for Rheumatoid Arthritis • Salicylates • Gold salts IV. and fainting. nausea. Do not give to asthmatic pts Glipizide (Glucotrol)—an oral hypoglycemic that decreases blood sugar by stimulating insulin release from the beta cells of the pancreas. Diabeta (Glipizide) • 30 minutes before meals 312. dialysis. Propanolol (inderal)—a beta-adrenergic blocker used as antihypertensive. and seizure. AquaMephyton for bleeding problems. It increases the antiplatelet effect! 279. PT WITH GLOMENOLEPHRITIS URINE RESULT • BLOOD 283. Cotrimoxazole • Yellow sclera 305. rapid pulse. Do not take garlic if you are receiving aspirin. nervousness. tea-colored urine Pruritis (bile salts eliminated through skin) Elevated ALT. S/E: bronchospasm. and vomiting. Colchicine • With meals 307. severe headache. Intermiettent claudication intervention • Lower the legs 297. What nursing care are recommended for Hepatitis? Rest (mainly for liver) Contact and standard precautions Low-fat. check BP q2 minutes until stabilized. Antihistamine and chemotactic receptor Inotropin (Dopamine)—vasoactive medication are given IV to restore BP in hypotensive states. Toddler • Playing side by side w/o sharing pf toys 294. dizziness. causes vasodilation and pooling of fluid in extremities. What are symptoms of hepatitis? Inflammation of Liver Jaundice Anorexia RUQ pain Clay-colored stools. Fluoxetine (Prozac)—a selective serotonin reuptake inhibitor (SSRI) used to treat depression and obsessive compulsive disorder. Discharge teaching for postcholecystectomy client. Where to put 4 y/o child in a car • Booster seat 293. moniot for hemorrhage • Bladder spasms common postopt. then q5 minutes TPN—hang no longer than 24 hours. site of catheter changed every 4 weeks. 282. Schizo pt. dry mouth. etc. healthcare workers Vaccine developed 289. may cause aplastic anemia and photosensitivity. depression. Mannitol. The nurse determines that a post-infusion phlebitis has occurred if which of the following is observed? . Rattle snake bite 280. How long should a client with tuberculosis be on medication? • 6-9 Months 286. Antiemetic – no compazine. DRUGS Ethacrynic Acid (Edecrin)—are considered loop diuretics and are potassium wasting. Fosamax • 30 minutes before meals 304. Multiple Sclerosis • Baclofen 300. tachycardia. What is the transmission of Hepatitis B? Parenteral/Sexual contact Blood or body fluids At risk individuals are the one’s that abuse IV drugs. SEROQUEL? 273. notify md • Painful knee 301. Dilantin detoxified by liver. Osteoporosis history taking at risk • Taking wine or beer 302.lalabas? Wear long sleeves 278. dysrhythmias. Metformin HCL • Take with food to decrease GI upset 313. In other words. Side effects: hyperglycemia Bethanechol (Urecholine)—a cholinergic or parasympathomimetic used to treat functional urinary retention. decreases preload and afterload pressures and cardiac workload. LASIX SIGNS THAT IT IS WORKING = DECREASE PERIPHERAL EDEMA. dysrhythmias. encourage client to increase intake of potassium-rich foods. Earliest sign of magnesium sulfate toxicity 271. Diagnostic test for Renal Failure • Monitor BUN. weight loss. rapid heartbeat. Antivert • 1 hour before travel 309. The nurse cares for a client receiving IV antibiotics every 8 hours for the past 4 days.incorrect statement? • White wine is not ok with maoi. restart IV at new site 285. Aminophylline (Truphylline)—is a xanthine bronchodilator. headache. What is the transmission of Delta Hepatitis? • Co-infects with hepatitis B 292. Femoral fracture. omit dose & instruct client to return to regular dosing schedule. severe hypertension. Tegretol • With meals 306. IV tubing and filters every 24 hours. and decrease peripheral resistance. Orange Juice/Bananas. Internal disaster drill? 274. S/E: headache. 281. and High Protein diet (needed for organ healing) No alcoholic beverages Medications (Vitamin K. Increases blood return to the right side of the heart. bradycardia. Sickle cell crisis • Increased reticulocyte count 299. anorexia. indicate complication • Petechiae 298. electrolyte • Monitor for acidosis 318. Seen in patients with hemophilia • (unable to clot) 291. what is normal for a 2 days old baby? 276. AST Prolonged PT (liver involvement with clotting factor) 287. Ventricular Tachycardia—causes chest pain. • Reporting of complication (pale stool & dark urine) 317. S/E: postural hypotension. Receptive aphasia? Picture board 272. Car safety in children less than 20 lbs. Valium • Monitor liver function 308. • reddened. provides relief from anxiety. and antihistamines. . Start to assess radial pulse • 2 y/o 316. Amaryl (Glimiperide) • With or w/o breakfast 315. What is the transmission of Hepatitis C? Blood or body fluids Can become chronic disease 290. Wilm’s Tumor • Flank pain 303. discontinue IV. Creatinine. Post-arthroscopy. Toxic effects: confusion. and increase peripheral resistance. external disaster drill 275. moist compresses. apply warm. will use lotions or baths than systemic ones. ant-spasmodics are prescribed 319. urticaria & swelling of the face. naproxen (Aleve) or Motrin) can reduce the effect of feverfew. anorexia. the nurse must communicate clearly about each delegated task with specific instructions on what must be reported. Doxycycline (Vibramycin)—a tetracycline that is taken at regular intervals but not within 1 hour of bedtime because it may cause esophageal irritation. orthopnea • Cough • Pulmonary edema • Weakness/Changes in mental status Right-Side CHF • Dependent edema • Liver enlargement • Abdominal pain/Nausea/Bloating • Coolness of extremities CHF Implementations • Administer digoxin. low-calorie. and sleep disorders. If patch used be cautious around microwaves results in burns. It is technically known as Hypericum perforatum. Wait one minute between puffs of the inhalers for best effect. S/E: headaches.containing medications. sulfa. Side effects: bright orange urine.5 hours Peak: 2. liver toxicity. bradycardia.infections. which may cause gastrointestinal ulcers. pallor. and discomfort. Reactions: Feverfew can cause allergic reactions. Nonsteroidal antiinflammatory drugs (NSAIDs such as ibuprofen (Advil). Close monitoring is recommended for patients who are taking medications to prevent blood clotting (anticoagulants) such as warfarin. may have to take iron pills Carbidopa/Levodopa (Sinemet)—used to treat symptoms of Parkinson’s disease. Echinacea Uses: Largely because white blood cells in the laboratory can be stimulated to eat particles. which prevents adrenaline from causing symptoms and glycogenolysis. especially in persons who are allergic to chamomile. tongue thickness. Beesix. and decrease effects of hormonal contraceptives. Propranolol (Inderal)—a beta-blocker that takes up beta-adrenergic receptor sites. apply warm soaks to decrease inflammation. A history of severe depression is a contraindication to the use of neuroleptics. Garlic Uses: lower blood pressure and cholesterol S/E: Allergic reactions. When applying the nursing process. Side effects: orthostatic hypotension. Bad breath . Side effects: photosensitivity. skin inflammation. Autologous blood—may give blood 5 weeks before surgery. orthostatic hypotension. In infants and small children. formation of neurotransmitters & sythesis of heme. and other arrhythmias. St. . Albuterol (Proventil)—a bronchodilator. 3. Reactions: Allergic reactions can occur. Phlebitis—tenderness. Antacids most effective after digestion has started. Bretylium. removing the body’s early warning system. isoniazide (Nizoral). ocular symptoms. swelling. bradycardia. Pyridoxine (Vitamin B6. The 5 "Ps" of vascular impairment can be used as a guide (pain. neutralizes hydrochloric acid and reduces pepsin activity. methotrexate (Rheumatrex). John's Wort Uses: depression. Leave nerve changes in sunburned areas. In toddlers. and Amiodarone increases serum dig levels. paresthesia. Phenazopyridine (Pyridium)—acts on urinary tract mucosa to produce analgesic or local anesthetic effects. Use first before steroid medication so opens up bronchioles for steroid to get in. pulse. possibly causing Digitalis Toxicity Signs/Symptoms of Digital Toxicity: f1st sx include abdominal pain. assessment is the first step in providing care. Trimethoprim-sulfamethoxazole (Bactrim)—most common side effect mild to moderate rash (urticaria) Aminoglycosides are ototoxic. Chamomile Uses: Chamomile is often used in the form of a tea as a sedative. tightness in the throat. and blockage of the breathing passages. Use another method of birth control. 5. C/I: tetracycline/Achromycin. throat and eyes. rash. and eyelids. and agitation when used in combination with serotonin reuptake inhibitor medications such as fluoxetine (Prozac) and paroxetine (Paxil). Used in the transport of amino acids. yellowish discoloration of skin or sclera indicates drug accumulation due to renal impairment. ages 1 to 3. Reported reactions include abdominal cramps. the 1st sx of overdose are usually cardiac arrhythmias. heat will increase medication absorption leading to toxicity. Side effects: tremors. Echinacea has been touted to be able to boost the body's ability to fight off infection. Infant normal resting heart rate: 120-140 Salt substitutes contain potassium When directing a UAP. Butorphanol Tartrate (Stadol)—analgesic used for moderate to severe pain. carbohydrate & lipid metabolism. grinding of teeth and "fly catching" tongue movements. vomiting. dry mouth. 2. only implementation tasks should be assigned because they do not require independent judgment. separation anxiety is at its peak Signs of tardive dyskinesia include smacking lips. Carbamazepine (Tegretol)—prevention of seizures & relief of pain in trigeminal neuralgia.1 grain = 60mg Levothyroxine (Synthroid) —thyroid preparation should be administered at breakfast to prevent insomnia. sedation. sweating. The nurse instructs the client taking dexamethasone (Decadron) to take it with food or milk because Decadron increases the production of hydrochloric acid. Take immediately before meals and highprotein meals may impair effectiveness of medication. nausea. Isoniazid (INH)—S/E: peripheral neuropathy (administer pyridoxine). do not take antacids within 1-3 hours of taking medication. throat.5-5 hours Topiramate (Topamax)—is an anticonvulsant. headache. can give 2 to 4 units of blood. Feverfew Uses: Most commonly used for migraine headaches. Trigeminal neuralgia is an agonizing pain result in severe depression & suicide. Prevention of neuropathy. anxiety. Left-Side CHF • Dyspnea. Verapamil. The protest phase of separation anxiety is a normal response for a child this age (2 yearold hospitalized child). Should drink 2000-3000ml of fluid daily to prevent kidney stones. and may cause photosensitivity. or yarrow. tachycardia. Clonidine (Catapres-TTS)—is a centrally acting alpha-adrenergic used to treat HPN S/E: drowsiness. Aluminum Hydroxide (Amphojel) —an antacid. itching all over the body. remove iv. ragweed. Side effects include change in BP. piroxicam (Feldend). blindness. hives. take one hour before and hour of sleep. C/I: ketaconazole. paralysis) Rash and blood dyscrasias are side effects of anti-psychotic drugs. Beclomethasone (Vanceril)—a steroid medication. low-residue diet • Oxygen therapy • Daily weight • Teach about medications and diet Herbs: Toxicities and Drug Interactions 1. diuretics • Low-sodium. hyperactivity. Carbamazepine (Tegretol) —interferes with action of hormonal contraceptives. Inderal may mask symptoms of Hypoglycemia. Because the RN is responsible for all care-related decisions. S/E: fungal infections. and stomach upset . respiratory depression. heart failure. but prior to the emptying of the stomach. dizziness. visual disturbances. particularly in persons allergic to ragweed.5 hours Peak: 4-12 hours Regular Onset: 0. S/E: sun sensitivity which causes burning of the skin. lips. Reduces rigidity and bradykinesis & facilitates client’s mobility. redness. 4. swelling of the lips. leflunomide (Arava). Doxine)—required for amino acid. S/E : unpleasant tastel. Insulin —NPH Onset: 1. decrease normal blood clotting and should be used with caution in patients taking medications to prevent blood clotting (anticoagulants) such as warfarin /Coumadin. Ginko should be avoided in patients with epilepsy taking seizure medicines. Ginseng may affect the action of the normal blood clotting element (platelets). Its use in pregnancy is not recommended. tiredness. Ginko seems to have blood thinning properties. Ginseng may also cause headaches. or medications to prevent blood clotting (anticoagulants) such as warfarin (Coumadin). It also may have some beneficial effect on reducing blood sugar . joint pain.. It should be avoided in patients taking medications to prevent blood clotting (anticoagulants) such as warfarin (Coumadin). It should be avoided in patients taking aspirin. Bottom Line: Little is known about its benefits and its risks. and sleeplessness. Reactions: Mild stomach upset and headache have been reported. Ginko Biloba Uses: This herb is very popular as a treatment for dementia (a progressive brain dysfunction) and to improve thinking. Feverfew can impair the action of the normal blood clotting element (platelets). or medications to prevent blood clotting (anticoagulants) such as warfarin (Coumadin).") Black Cohosh Claims. Therefore.. Miller states that "While no drug-herb interactions have been documented to date. The infant of a diabetic mother may be slightly hyperglycemic immediately after birth because of the high glucose levels that cross the placenta from mother to fetus. During pregnancy. carbamazepine (Tegretol). it is not recommended to be taken with aspirin. and nose bleeding.g. nonsteroidal antiinflammatory drugs (Advil). tremors. rye. it would be prudent to avoid concomitant use with other hormonal therapies (e. . nervousness. and phenobarbital. Ginseng can also cause falsely abnormal blood tests for digoxin level. or barley. It is unclear whether ginseng may affect female hormones. Dr. oats. thereby reducing sexual drive or performance.A condition called "postfeverfew syndrome" features symptoms including headaches. vomiting. (Dr. estrogen replacement therapy and oral contraceptives.") Reactions: Ginseng can cause elevation in blood pressure. nervousness. such as phenytoin (Dilantin). naproxen (Aleve) or Motrin). the fetal pancreas secretes increased levels of insulin in response to this increases glucose amount that crosses the placenta from the mother. Reactions: Ginger may lead to blood thinning.in patients with diabetes mellitus. Miller emphasized that there is substantial variation in the chemical components of substances branded as "Ginseng. malted milk. Ginger Uses: Ginger has been used as a treatment for nausea and bowel spasms. It should be avoided in persons with manic disorder and psychosis. Saw palmetto has also been touted as a diuretic and urinary antiseptic to prevent bladder infections. Reactions: This herb may affect the action of the sex hormone testosterone. and all food and beverages containing wheat. nonsteroidal antiinflammatory drugs (such as ibuprofen (Advil). and nervousness. naproxen (Aleve) or Motrin). Saw Palmetto Uses: Saw palmetto has been most commonly used for enlargement of the prostate gland. Ginseng Uses: Ginseng has been used to stimulate the adrenal gland. commercially prepared ice cream. insomnia. It is not recommended to be taken with medications that prevent blood clotting (anticoagulants) such as warfarin (Coumadin). headache. and thereby increase energy. A child with celiac disease mustn’t consume foods containing gluten and therefore should avoid prepared puddings.. stiffness. Benefits: A natural way to treat menopausal symptoms.