Study sets, textbooks, questions
Upgrade to remove ads
ATI RN Predictor Study 2019- Me
Terms in this set (334)
Testing for TB
- A Mantoux skin test is the most accurate and valuable screening tool available for TB. A positive result means only that the client has been exposed to TB; it does not meant that the client has active TB.
Testing for TB continue
- A sputum culture for acid fast bacillus (AFB) is used to confirm the diagnosis of pulmonary TB after a screening test and chest x-ray come back positive.
Teaching instructions for the use of a cane:
(1) The cane is moved forward about 12 inches.
(2) Then, the weak leg is moved even with the cane.
(3) Finally, the strong leg is brought forward and ahead of the cane and weak leg.
- Cane is held on stronger side.
- The gripper of the cane should be level with the trochanter of the femur.
- Recommended that this vaccine be given to children who are 11 through 12 years of age and then given a booster dose at age 16.
When should the single dose of Herpes zoster vaccine be given?
- To adults 60 years or older whether or not they report a previous episode of herpes zoster.
Rotavirus should be given at what age?
- During the child's first year of life.
- This medication is used to prevent and treat postmenopausal osteoporosis and Paget's Disease.
- Alendronate-taken in morning on an empty stomach.
- The patient must be instructed to wait at least 30 minutes after taking Alendronate before eating, drinking, or taking other medications.
What to expect with a patient having a chest tube?
- Continuous gentle bubbling in the suction control chamber.
- Crepitus (with a pneumothorax, this will persist for several hours depending)
- Oscillations-tidaling in the water seal chamber upon respiration are expected.
What is a potential complication of a thyroidectomy?
- Hypocalcemia: numbness and tingling in the hands, soles of the feet and around the lips.
What is Chvostek's sign? And how is it done?
Tap on the pt's face at a point just anterior to the ear and just below the zygomatic bone. A positive response would be twitching of the ipsilateral (same side only) facial muscles, suggestive of neuromuscular excitability caused by hypocalcemia.
- Is an indication of meningeal irritation, which may be positive in patient's with meningitis.
- To perform this, the client needs to be supine. The nurse: -places one hand behind patient's head.
-places the other hand on the client's chest.
Brudzinski's sign continue
-raises the clients head (with the hand behind the head) while the hand on the chest restrains the clients and prevents the client from rising. Flexion of the clients lower extremities constitutes a positive sign.
- Is an indication of meningeal irritation. The maneuver is usually performed with the client supine with hips and knees in flexion. Extension of the knees is attempted and the inability to extend the clients knee beyond 135 degrees w/out causing pain constitutes a positive test.
- This is used to test for brain damage or upper motor neuron damage. It is considered positive if the toes flare up upon stroking the plantar aspect of the foot.
Cataract surgery discharge instructions
- Do not lift anything heavier than 10lbs for at least one week
- Sleep on your back or unaffected side to lessen the pressure.
- Need to report any pain, decrease in vision or increase in discharge in the eye.
- It is normal to feel itching and mild discomfort after surgery, but the pt should be instructed not to rub or place pressure on the eye.
Exposure or possible exposure to anthrax
- Administer an antibiotic prophylaxis to all pt's newly exposed
Those exposed to anthrax do not require decontamination and are not considered contagious
- Give an antitoxin
Why would lidocaine (Xylocaine) be given to someone following cardiac arrest?
- Lidocaine is an antiarrhythmic med that is commonly used to restore a regular heartbeat in a client who has arrhythmia. This effect is produced by delaying abnormal nerve pulses to the heart and reducing irritability of the heart tissue.
Factors that can trigger an exacerbation of SLE?
- Infection (especially a strep or viral infection. This can be a major stressor and can trigger an exacerbation)
- Pregnancy (due to hormonal changes. The pt should be advised of the risks and must be monitored closely for effects on the renal and cardiovascular system if she decides to get pregnant)
- Sunlight (Exposure to sunlight and artificial UV light is the leading cause of SLE exacerbation manifestations, especially the characteristic skin manifestations of lesions and butterfly rash)
What diagnostic test would help the nurse monitor and evaluate the effectiveness of the aspirin medication for an Rhematoid arthritis patient?
- Erythrocyte sedimentation rate (ESR)
RA is a chronic inflammatory disease. ESR is useful in detecting and monitoring tissue inflammation in clients with RA.
Antinuclear antibody (ANA)
- ANAs are frequently present in pts who have systemic lupus erythematosus and other autoimmune disorders such as RA and scleroderma.
Rheumatoid factor (RF) diagnostic test
This is helpful in diagnosing RA, but the levels do not always correlate with the severity of the disease activity.
- Is characterized by a rhythmic increase (to the point of hyperventilation) and decrease (to the point of apnea) in the rate and depth of respirations.
- It is commonly seen in pts who are unconscious, comatose or moribund (approaching death).
- Clients with hemophilia (deficiency of clotting factor), are given cryoprecipitate to replace the deficient factor as a prophylactic measure before any invasive procedure, surgery or when actively bleeding.
- Cryoprecipitate provides therapeutic amounts of Facto 8, Factor 13, von Willebrand factor and fibrinogen. These concentrates are made with recombinant DNA technology and are the treatment of choice with hemophilic A and von Willebrands disease.
- Treatment for cancer.
- If a client has reported fatigue it is important to check the patients most recent CBC. The client I likely to be anemic as a result of myelosuppression (bone marrow suppression) from the chem.
The pt may require tx for the anemia (transfusion, medications) and further chemo may be need to be delayed until the blood counts are higher.
Jerking movements of the extremities
- Such as ataxia, may be seen with many neurologic conditions affecting the clients ability to produce a smooth movement.
Jerky movements of the extremities
Spasm of the extremities
- Involuntary spasms may be found with such conditions as cerebral palsy, trauma, cerebral infection and certain degenerative disorders.
- Is a neurological disorder resulting from damage to the peripheral nerves. It may be caused by diseases of the nerves, systemic illness or a side-effect from chemo.
Peripheral neuropathy continue
If sensory nerve is damaged, the client is likely to experience pain, numbness, tingling, burning or a loss of feeling in the extremities.
- Involves measuring the quantity of IgE present in the serum after exposure to specific antigens that are selected based on the pts symptom hx. An elevated IgE indicates a positive response to RAST testing and is seen in pts who have a hx of allergic manifestations, anaphylaxis and asthma.
If clear drainage is coming out of a patient and you suspect that it could be CSF, first action is to?
- Test it for glucose, then notify doctor
What is a complication that you should frequently assess if a patient is suspected of having diabetes insipidus?
A pt who has diabetes insipidus will continue to excrete urine even though there is no intake. Hypovolemia, with resulting hypotension is possible.
Active TB treatment duration?
- Active TB is usually treated with the simultaneous administration of a combo of meds to which the organisms are susceptible. Such therapy is continued until the disease is controlled. A 6-9 month regimen consisting of two meds is frequently used.
- Chlorpromazine is used to treat psychotic disorders such as schizophrenia or manic-depression, and severe behavioral problems in children ages 1 through 12. Chlorpromazine is also used to treat nausea and vomiting, anxiety before surgery, chronic hiccups, acute intermittent porphyria, and symptoms of tetanus.
- This medication can cause photo-phobic skin reactions and damage to the retina of the eye if exposed to direct sunlight. Patients taking this should be reminded to wear protective clothing, apply sunscreen and wear sunglasses when they are outside.
- It is used to divert urine outside of the body when the urinary bladder has been removed. The conduit cannot store urine the way the bladder did; therefore, urine will be flowing continuously and an appliance must be worn as a collection device.
Ileal conduit continue
The bag should be emptied approx. every 2 hours to prevent leakage, skin irritation and infection.
Manifestations of tardive dyskinesia
- Tongue thrusting and lip smacking
- Facial grimacing and eye blinking
- Repetitive involuntary movements
- Is a chronic, episodic, inflammatory disease of the large intestines and rectum characterized by bloody diarrhea.
- Maintaining fluids and electrolyte balance is one of the most important nursing goals.
To assess for cyanosis in a patient with dark skin where is the most appropriate areas to assess for this?
- Examine body areas with the least melanin, such as the underarm, soles of the feet, conjunctiva and mucous membranes.
Post operative tx of arthroscopy
- This is used to visualize, diagnose and treat problems inside a joint. Applying ice to the affected area in the immediate postop period reduces pain and swelling. Pt may be allowed to walk as tolerated, but joint used should be minimizes for the first few days to reduces pain and swelling.
Patient with Gout
- Gout is a painful and potentially disabling form of arthritis that is caused by an excess of uric acid in the body.
- Pt should remain well hydrated (this will minimize uric acid stones)
- Should avoid foods high in purines
- Should limit alcohol consumption (too much alcohol can inhibit excretion of uric acid, leading to its build up and causes an onset of gout.
- Pt's should not take aspirin and/or salicylates (this can interfere with uric acid excretion and may precipitate an acute onset.
Colostrum is secreted from the mother's breasts during postpartum days 1 to 3. It contains the IgA immunoglobulin that provides passive immunity to the newborn.
- Newborns should be breastfed every 2 to 3 hr. Parents should awaken the newborn to feed at least every 3 hr during the day and at least every 4 hr during the night until the newborn is feeding well and gaining weight adequately. Breastfeeding should occur 8 to 12 times within a 24-hr window. Then, a feed-on-demand schedule may be followed.
- Tell the mother how to tell if her newborn is receiving adequate feeding (gaining weight, voiding 6 to 8 diapers a day, and contentedness between feedings).
- Calcium channel blocker
- Used to Tx angina, hypertension & arrhythmias
- Dominant for language
- Could have some aphasia and would need speech therapy
- Will also demonstrate hemiplegia of the right side
Right-sided Lesion (CVA)
- Most likely to have impulsive like behaviors
Late signs of ICP
- Alterations in VS (Including increased systolic pressure)
- Widening pulse pressures
Early signs of ICP
- Neck pain
- Generalized muscle aches
- Head lice
Nits shed into the environment and are able to hatch up to 7-10 days
- Appear as grayish brown, threadlike burrows on the skin
- Dilated pupils
Blindness in one half of the field, a functional defect that can affect the right or left side.
Hypothyrdoism expected lab results
- Elevated TSH levels
- Decreased T4, T3 & free thyroxine
Specific & Sensitive indicator for renal function
males 0.6 - 1.2 mg/dL
Emphysema expected findings
- Barrel chested
- Clubbing of the fingers
- Shallow respirations
- When someone is not breathing but has a pulse
Deliver a breath every 5 seconds for a adult
Addison's Disease Treatment:
- High protein, high carb diet
- Weigh daily
- Injectable IV fast acting steroid may be ordered or indicated for a patients experiencing an Addisonian crisis until the pt is no longer at risk for dehydration, hypotension and shock.
- Citalopram (Celexa) an example of an SSRI
- Used to treat depression
- Can take 3-4 weeks before patients starts to experience signs of improvement and in some cases up to 8 weeks.
- Fear of being in places in which help may not be available
- Caused by a lack of intrinsic factor, a substance needed to absorb Vit B12 from the GI tract.
- Often has a red beefy looking tongue
- Vit B12 is needed for the formation of RBCs.
Iron deficiency Anemia
- Is a condition in which RBCs contain decreased level of hemoglobin
- Caused by a failure of the bone marrow to produce sufficient number of RBC's.
- Hemolytic anemia involves erythrocyte destruction and maybe medication induced or caused by sickle cell disease, transfusion reaction or kidney disease.
Hematuria (blood in the urine) or hemoglobin present in the urine may indicate hemolytic anemia
Diphenhydramine's such as Benadryl can also be given to treat what?
- They also have an anticholinergic effect that can help control tremors in the early stages of Parkinson's.
Is a rare adverse reaction to Clozapine (Clozaril) in which WBC's drop causing pt to become susceptible to acute infections.
Haloperidol (Haldol) can cause what?
- This med can cause neuroleptic malignant syndrome which is a rare and potentially fatal adverse effect that requires emergency medical intervention.
Haloperidol (Haldol) adverse effect?
Neuroleptic malignant syndrome:
- Other manifestations associated with NMS are sudden onset of rigidity, tremor, stupor, incontinence, elevated serum enzymes, hyperkalemia, renal failure, elevated temp, BP & HR.
Clozapine (Clozaril) can cause?
- Is a form of exercise involving static (no movement) contractions of a muscle w/out any movement of the joint. Isometrics may help to prevent muscle atrophy in pts who are on complete bedrest.
EX: Instruct the pt to hold a muscle tight for approx. 5 seconds then relax
Clozapine can cause?
- Agranulocytosis, therefore WBC count of < 3000 is contraindicated.
- Is prescribed to morbidly obese pts to lose weight. It prevents absorption of some of the fat in the pts diet.
- The med should be taken 3 times/day within 1 hour of a meal
- Its a lipase inhibitor, not an appetite suppressor.
- Relaxed uterus
- Painless, vaginal bleeding
- Fundal height > expected gestation age
- Hyperactive deep-tendon reflexes 4+
- Also referred to as Molly or Ecstasy
- Should expect diaphoresis
- Also might experience increased tactile sensitivity, lowered inhibition, chills, muscle cramping, teeth clenching & mild hallucinations.
- Patient needs to be assessed every 15-30 minutes and document findings, check for a new prescription every 4 hrs for clients >18 years, every 2 hrs for children 9-17 & every 1 hr for children younger than 9 years.
- A finding in which systolic BP is 10 mmHg or greater on expiration than inspiration. Pt also may present with JVD, bradycardia & hypotension.
A symptom of cardiac tamponade
- Estradiol is used to treat symptoms of menopause such as hot flashes, and vaginal dryness, burning, and irritation. Other uses include prevention of osteoporosis in postmenopausal women, and replacement of estrogen in women with ovarian failure or other conditions that cause a lack of natural estrogen in the body. Estradiol is sometimes used as part of cancer treatment in women and men.
- Adverse effect of a headache needs to be reported as medication can cause thromboembolism. Monitor for swelling & tenderness of the calf, monitor for hypertension and report as well.
Hemolytic transfusion reaction
- Back pain is an adverse reaction, hypotension, tachycardia
Stages of Kawasakis Disease
Acute phase of Kawasakis
- Beginning stage
- Starts with high fever uncontrolled by antipyretics
- Strawberry tongue
- Conjunctival redness
Sub-acute phase of Kawasakis
- Pain in childs weight bearing joints
- Peeling of soles of feet and hands
Post-op of Tonsillectomy
- Should position pt so that the head is lower than the chest.
- Avoid having pt cough & clear throat, avoid using straw in the first 24-48 hours.
- Administer analgesics q4hours for the first 24-48 hours.
- No red liquids (including red-popsicles)
- No diary products
- Persistent uterine contractions
- Placenta separates from the uterus
- Bleeding inside the uterus
- Life-threatening to the fetus
Herbal supplement Saw Palmetto
- This can result in a false low prostrate specific antigen level
Herbal supplement Valerian
- Can lower BP
- Used to stimulate mental activity and increase appetite
- This can interact with caffeine and cause irritability
- This can be used for migraine prophylaxis can lead to GI symptoms such as bloating, abd pain and flatulence
Lithium expected side/adverse effects (non-urgent)
Signs of lithium toxicity (Urgent)
- Coarse hand tremors
- ECG change
- Decrease in central vision
- Can be a symptom of cataracts
Floating dark spots
- Retinal detachment
- This med reduces gastric acid secretions so that ulcers can heal.
- Pt's taking this should avoid taking magnesium containing antacids as this will increase the risk of diarrhea.
- Misoprostol tends to cause diarrhea.
- This can induce uterine contractions, so women of childbearing age must r/o pregnancy.
Want lots of Vit A
- 1 medium raw carrot
- program that provides adult daycare services along with in home assessments and supportive services
- Schizophrenia medication
- One of the greatest risks for a pt taking this is neuroleptic syndrome. It is a potentially life threatening adverse effect of this medication, which can show symptoms of a high fever, dysrhymias, decreased LOC
and labile BP.
- Headaches, constipation & vomiting are common side effects of this medication.
- Coughing up blood
- If the amount is greater than 275 mL/24 hours this indicates a risk for hemorrhage and needs to be reported.
Sickle cell anemia
- A common manifestation of a vaso-occlusion in a sickle cell crisis can be hematuria (blood in the urine) resulting from ischemia of the kidneys
- Potentially life threatening emergency
- Spinal cord injury @ T6 or higher
- Facial flushing, nasal congestion, severe headache.
Autonomic dysreflexia continue
Tx: Elevate head of bed to 90 degrees, loosen constrictive clothing, assess for bladder distention and bowel impaction, administer antihypertensive meds (as this may cause stroke, MI, seizures)
Obtaining temp or giving ear drops to a child
- Up & back
True or False ? Methadone can be taken while pregnant?
- True, it can be taken for opioid withdrawl
- Normal Saline ONLY!
- Only collect one unit of blood @ a time.
- Want a 20 gauge needle or larger.
- Initiate blood transfusion 30 minutes or less after obtaining blood.
- Daily blood draws are needed for the 1st 5 days of starting this medication.
- Pt should not take calcium supplements
- Do not take acetaminophen for headaches (increases risk for bleeding)
Permanent Trach Care Steps
1st: Remove inner cannula.
2nd: Remove soiled dressing.
3rd: Clean stoma.
4th: Change collar.
- dry newborn 1st
unless suction mouth is there as AIRWAY is most important, then dry!
Safety Teachings for parents
- No more than 120 degrees for water heater
- Crib slates should be no more than 2.25 in apart
- Car seat should face the rear until 2 years of age
- Newborn car seat should be at 45 degree angle.
Myasthenia gravis care (with attention to improving nutrition)
- Monitor weight each week
- Take your anticholinesterase medications 45-60 minutes before meals to prevent aspiration
- Cut food into small bites & eat slowly
- Choose snacks that are high in calorie
- These bands can be worn on the wrists and can help alleviate nausea and vomiting.
- An alternative therapy option for pregnancy n/v.
Rheumatoid Arthritis (RA)
- Want to balance exercise/activity and rest
- Pain, stiffness and swelling are worse in the morning
B = Bananas
R = Rice
A = Applesauce
T = Toast
This may be suggested if the child is having a hard time keeping things down from vomiting or GI upset. This is high in carbs but has little nutritional value
Infectious Gastroenteritis (Diarrhea) rehydration
- Should initiate oral rehydration therapy that should contain sodium, potassium, chloride, citrate or bicarb and glucose.
With PTSD, type of alternative therapy
- Guided imagery
Upper chest petechiae after a long bone fracture
- Purple/red small dots that are caused by minor bleeding from capillary blood vessels.
- This indicates that the pt is at great risk for a fat emboli a life-threatening complication of fractures.
- A deficiency in antidiuretic hormone
- Increase in urine output (polyuria)
If a pt has a hx of a stroke and we want to decrease risk of ICP while caring for them, what are some interventions to reduce the risk?
- Keep the bed no more than 25 degrees
- Place pt in a quiet room
Fluoxetine nursing manifestations
- This can cause serotonin syndrome within 2-72 hours of starting treatment.
- Pt could experience tremors, agitation, confusion, anxiety and hallucinations and need to be reported.
- Educate pt to monitor and report any black tarry stools.
- Weight gain is an adverse effect and can cause a rash.
Pressure ulcer stage 2
- Partial thickness (some skin loss or blistering)
Pressure ulcer stage 3
- Subcutaneous tissue visible
Pressure ulcer stage 4
- Muscle damage, tendon exposure
True Labor signs & symptoms
- The cervix transitions to the anterior position
- Contractions increase with ambulation
- Contractions in true labor should be felt in the lower abdomen and back
- Cervix shortens and thins
- Medication for tx of depression
- Pts should watch out for reactions like dry mouth & constipation
- Pts should avoid overheating because of the lack of an ability to sweat while taking this med.
- Should take at night before bedtime.
Ulcerative Colitis medications
- Pts with this should take glucocorticoids such as prednisone to decrease the inflammation
Caution with a patient that has an ileostomy
- Should avoid taking enteric-coated medications
Implementing an emergency preparedness plan, what do you need to do FIRST?
- FIRST you want to notify the incident commander to initiate the command hierarchy and maintain order
- Decrease amount of platelets
- Decreased amount of WBC's ( <4000)
- Initiate precaution for infection
wear masks when going in patients room, limit visitors, no flowers & no fresh veggies or fruit
Ice is contraindicated with what disease?
Type 1 DM
Drinking water can lower blood sugar levels by diluting the amount of glucose (sugar) in the blood stream. Indirectly it will reduce insulin resistance and help a person reduce their hunger.
Signs of Stevens-Johnson Syndrome
- A vesicular crusty rash
- This should be reported
- Sulfamethazazole can cause this as well as many others
- Is a nonsteroidal anti-inflammatory that reduces pain and inflammation
- Adverse effects of this med: Dizziness, vertigo, muscle weakness, n/v, anorexia that leads to weight loss
- Can constrict blood vessels causing an increase in BP & HR, so want to caution anyone that has hypertension or on cardiac meds
Clonidine may be prescribed for some experiencing?
- Alcohol withdrawal, this will help diaphoresis
- This med is used to prevent delirium tremens for someone experiencing alcohol withdrawal
- This is a med used for open angle glaucoma
- Adverse effect of this med is tingling of fingers and hyperglycemia
- Used for Alzheimer's
- Side Effects: Dyspepsia, diarrhea, dizziness
- Adverse effect: Dyspnea (NEED TO REPORT TO PROVIDER)
- Puts pt at risk for hypokalemia, dizziness (can cause drop in BP which leads to the dizziness) & urinary frequency
Decreased LOC signs
- Depressed deep tendon reflexes
- Decreased BP
- This med is an immune suppressant and can cause bone marrow suppression. Should advised pt about monitoring for fever or sore throat.
- Can cause GI upset, suggest to take with applesauce.
- Should advise pt to take med in the morning to prevent esophageal ulceration.
- Do not take with antacids, will alter absorption
- Used for Benzo reversal (antidote)
- Used for acute asthma attacks
Long-term tx of asthma
- Montelukast (Leukotine)
- Beclomethasone (corticoseteriod)
- Nedocromil (Mast-cell)
- Medication for seizures (anticonvulsant)
- Should not take with other calcium containing foods.
- Commonly causes gingival hyperplasia
- Nystagmus-a serious reaction and should be reported.
- Levels less than 10 mcg/mL are sub therapeutic and can result in seizure activity. Levels more than 20 mcg/mL can produce toxic effects.
- Should monitor for hyperkalemia (due to potassium retention by the kidneys)
- This should NOT be mixed in a syringe with any other insulins
- This med should be injected once a day and does not cause peaks, instead it maintains a steady blood level for 24 hours, which reduces the risk of hypoglycemia
- Bronchodilator that is used to treatment exercise induced bronchospasm, prevention of asthma attacks, COPD and chronic bronchitis & emphysema
Helps improve breathing
- Med is used for treatment of urinary incontinence
- Can expect these common side effects: Tachycardia, constipation, dry mouth, blurred vision, photophobia
Common medication given for Graves Disease
- This medication increases the ability to focus which is a symptom of graves disease (inability to focus).
- An increase in ability to focus would indicate that this medication is working.
- This medication is used to tx of Graves Disease (hyperthyroidism), but should not be of first choice with this disease. (In patients with Graves' disease with hyperthyroidism or toxic multinodular goiter who are intolerant of methimazole and for whom surgery or radioactive iodine therapy is not an appropriate treatment option)
- Should not be used if patient has liver failure, or pregnant
- Watch out for and report : Black tarry stools, chills, chest pain, fever, cough, sore throat or SOB.
Medication used for Diabetes Insipidus
Rhogam is given when mom and baby are what?
- Mom is negative and baby is positive
Medication to induce labor?
- Misoprostol suppositories
Used to stop labor
- Tocolytic medication = Terbutaline
Med for osteoporosis
Antiepileptic (seizure) medications
- Valproic acid
For status epilepticus (Diazepam, Lorazepam)
Rheumatoid arthritis meds
- Prednisone (Glucocorticoid)
- Adalimumab (DMARD)
Med to tx Mysathena gravis
- Neostigmine (its a anticholinesterase)
Liver failure medication (to eliminate ammonia levels)
- Lactulose (causes diarrhea)
Medication specifically for migraines
- End in "zole"
- Also nystatin (used for mouth)
- Antibiotic: Macrolide
- No cross allergy with penicillins
Medication for UTI's that causes urine and contacts to turn orange?
Medications prescribed for UTI's:
Medications to fight bone marrow suppression (typically due to cancer treatment)
- Watch for muscle pain (stop med & contact provider)
- Watch liver enzymes
- Cardiac glycoside
- Common side effect: Bradycardia
- Watch Potassium levels (if too low=toxicity)
- Check HR & hold if under 60 bpm
- Toxicity symptoms: Anorexia, N/V, blurred/yellow haze vision
- Normal Dig levels: 0.5-0.8
Digoxin Toxicity manifestations
- Blurred vision
- Yellow haze
- Normal Dig levels: 0.5-0.8
Reasons to hold BP meds
- HR <60 bpm
- Systolic BP <90
- Watch for dry cough (discontinue and report)
- Increased K+ levels (can cause hyperkalemia)
- Common meds: Captopril, Enalapril (Ends in "pril")
- End in "olol"
- Metoprolol, propranolol
- Watch for bradycardia & hypotension
- Metroprolol can decrease cardiac output and needs to be cautioned with CHF. No grapefruit.
- Propranolol can cause bronchoconstriction (so don't want to give to someone with asthmatics)
- This med is used to tx adverse effect of chemo ( low platelet count)
- This med is a thrombopoletic growth factor and therefore a platelet count within the expected range would mean it is therapeutic
- This medication can be used to treat bipolar as well as seizures
- This med can affect oral contraceptives
- This medication is used to treat myasthenia gravis
- An adverse effect of this med is nausea, bradycardia, and salvation at the mouth.
- Valproic acid is used to treat various types of seizure disorders. It is also used to treat manic episodes related to bipolar disorder (manic depression), and to prevent migraine headaches.
- This medication can cause liver failure so watch for jaundice
Side effects of inhaled corticosteroids
- Oral candidiasis
Pt will need spacer and need to rinse the mouth after inhalation, this will help reduce the risk
- This is a calcium channel blocker used to decrease workload and lower BP. So changing positions slowly will prevent orthostatic hypotension and dizziness.
- Should take with food
- Palpitations should be discussed with pcp but not stopped w/out addressing with doc first
- Metronidazole is used to treat bacterial infections of the vagina, stomach, skin, joints, and respiratory tract. This medication will NOT treat a vaginal yeast infection.
- This should not be taken with alcohol
When a patient is taking epoetin alfa, what should you watch for?
- Increase in BP if the patient hematocrit levels rise too rapidly, hypertension and seizures could result
- An antibiotic
- This should NOT be given to someone who is pregnant, due to the adverse effects on developing bones and teeth)
What is the greatest risk for someone receiving mannitol IV?
- Developing HF, so the nurse should watch for peripheral edema and report any findings of this STAT!
Adverse effects of glucocorticoids are?
- Osteoporosis, which needs to be monitored regularly w/bone density scans
- It is a mucous protectant that forms a gel-like substance coating the ulcer, creating a barrier.
- It works mainly in the lining of the stomach by adhering to ulcer sites and protecting them from acids, enzymes, and bile salts.
- Sucralfate is used to treat an active duodenal ulcer. Sucralfate can heal an active ulcer, but it will not prevent future ulcers from occurring.
- Is an SSRI and used to Tx depression
- This medication suppresses platelet aggregation which increases risk for bleeding when used with NSAIDs & anticoagulants. Want to advise patient to use Tylenol instead of ibuprofen for headaches.
- Want to take on an empty stomach
- This is a medication given for nausea
- It increases gastric motility and can cause sedation
- Medication that should be taken on onset of a migraine
- It should be taken upon aura of headache and a max of 3 tablets should be taken in a 24 hour period.
- Inhibits production of uric acid
- Used to treat gout and/or kidney stones of that nature
- Watch for kidney toxicity
- Contraindicated with Warfarin & oral hypoglycemic (increases effects of meds)
- Want to watch for nephro & Otto toxicity
- They also interfere with diuretics, skeletal muscle relaxants and anticoagulant meds.
- Watch for renal insufficiency
- Decreases contraceptives, warfarin
Better perfusion: EleVate
Better perfusion: DAngle
V= Varicella-Chicken pox/herpes Zoster-Shingles
S = Sepsis, scarlet fever, streptococcal pharyngitis
P = Parvovirus B19, pneumonia, pertussis
I = Influenza
D = Diptheria
E = Epiglottitis
M = Mumps, meningitis, mycoplasma or meningeal pneu.
AN= Adenovirus (private room, mask)
Droplet requires mask, gown, gloves, mask & goggles
M= Multidrug resistant organism
R= Respiratory infection
S= Skin infections
W= Wound infection
E= Enteric infection (C.diff)
E= Eye infection (conjunctivitis)
Gloves and gown
S/S: Chest pain, difficulty breathing, tachycardia, pale/cyanotic, sense of impending doom, bloody sputum
Tx: Heaprin, d-dimer lab, O2
Women in labor with un-reassuring FHR
- This would include late decels, decreased variability, fetal bradycardia.
- Turn patient on left side, give O2, stop Pitocin (if running) and increase fluids
Tube feedings with decreased LOC
- Position patient on right side (this promotes emptying of the stomach) and head of bed elevated (to prevent aspiration)
- Myringotomy is a surgical procedure in which a tiny incision is created in the eardrum to relieve pressure caused by excessive buildup of fluid, or to drain pus from the middle ear.
- Patient should be positioned on affected ear after surgery (this allows drainage of secretions)
After cataract surgery
- Patient will sleep on UNAFFECTED side with a night shield for 1-4 weeks
Positioning of a pt after total hip replacement
- Don't sleep on operated side
- Don't flex hip more than 45-60 degrees
- Don't elevate HOB more than 45 degrees
- Maintain hip abduction by separating thighs with pillows.
Prevention of dumping syndrome
- Eat in reclining position
- Lie down after meals for 20-30 minutes
- Restrict fluids during meals
- Low carb and fiber diet
- Small frequent meals
With peritoneal dialysis outflow is inadequate
- Turn patient from side to side BEFORE checking kinks in tubing (according to Kaplan)
Before a liver biopsy it is important to check what lab?
- Lab results for prothrombin time
S= Spasms, stridor
- Decreased calcium
- Want to have high Calcium, low phosphorus diet
- Muscle weakness
- Renal calculi
- Back and joint pain
- High levels of calcium
- Want patient to have a diet high in phosphorus and low in Calcium
SIADH (Increased ADH)
- Holding on to fluids and not releasing (little output)
- Change in LOC, decreased deep tendon reflexes, tachycardia, n/v/a, headache
- Administer Declomycin, diuretics
Neuroleptic malignant syndrome (NMS)
- NMS is like S & M
- You get hot (hyperpyrexia)
- stiff (increased muscle tone)
- Sweaty (diaphoresis)
- BP, pulse and resp go up
- Start to drool
- Dangerous when you are pregnant
- German measles (rubella)....Never get pregnant with a German (rubella)
Tetralogy of fallot
Think of DROP
D= Defect, septal
R= Right ventricular hypertrophy
O= Overriding aorta
P= Pulmonary stenosis
- Treatment of GERD and kidney stones
- Watch out for constipation
- Treatment of anxiety and also itching
- Watch out for dry mouth, given preop commonly
PTU and Tapazole
Prevention of thyroid storm
- Used for tx of parkinsons
- Sweat, saliva, urine may turn reddish brown occasionally
- Causes drowsiness
- A med used for Parkinson's
- Sedative effect
- Treatment of Parkinson and extrapyramidal effects of other drugs
Treatment of glaucoma
- Don't take if allergic to sulfas
- Diarrhea is a common side effect
- Drink plenty of fluids
Antidote for Tylenol
- Used for treatment of alcohol w/d
- Don't drink alcohol with this as very bad n/v can occur
- This is used for the tx of scabies and lice
- For scabies: apply lotion once and leave on for 8-12 hours
- For lice: Use the shampoo and leave on for 4 minutes with hair uncovered, then rinse with warm water and comb with a fine tooth comb.
Think VEAL CHOP
V= Variable decels; C= Cord Compression
E= Early decels; H= Head compression caused
A= Accels; O= Okay, not a problem
L= Late decels; P= Placental insufficiency
For cord compression
- Trendelenberg position (this removes pressure off the cord)
- If the cord is prolapsed, knee to chest, cover it with sterile saline gauze to prevent drying of the cord and to minimize infection.
To test lead poisoning in a child?
- Around 12 months of age
High in potassium
- Citrus fruits
Aspirin can cause what in children?
- Reye's Syndrome
Morphine is contraindicated in what?
- It causes spasms of the sphincter of Oddi, therefore Demerol should be given
- Cancer of the lymph and is very curable in early stages
- Doubles by 6 months
- Triples by 1 year
First sign of cystic fibrosis
- May be meconium ileus at birth
- Baby is inconsolable, do not eat, not passing meconium
Can lead to cardiac valve dysfunctions
- A blood disorder. Is x-linked. Mother passes disease onto son.
Fontanelle closure timeframe
- Anterior (front) fontanelle closed by 18 months
- Posterior (back) close within 6-8 weeks.
- Diffuse edema of the fetal scalp that crosses the suture lines. Swelling reabsorbs within 1-3 days
- Surfactant. Med for lung expansion
Baby cannot make it down to canal
- Used to halt preterm labor
- Is contraindicated if deep tendon reflexes are ineffective
- If the pt experiences a seizure during Mg admission, get the baby out STAT! It's an emergency!
Oh, Oh, Oh, To, Touch, And, Feel, A, Girls, Vagina, And, Hymen
Oh= Olfactory #1 (Smell)
Oh= Optic #2 (Vision)
Oh= Oculomotor #3 (Motor control of some eye muscles and eyelid)
To= Trochlear #4 (motor control of some eye muscles)
Touch= Trigeminal #5 (Chewing & facial sensation)
And= Abducens #6 (Motor control of some eye muscles)
Feel= Facial #7 ( Motor control of facial muscles, salivation, tastes and cutaneous sensations)
A= Auditory #8 (Hearing, equilibrium)
Girls= Glossopharyngeal #9 (Salivation, sensations of skin, taste)
Vagina= Vagus #10 (Motor control of the heart, sensation from the thorax)
And= Accessory #11 (Motor impulses to pharynx and shoulder)
Hymen= Hypoglassal #12 (Motor control of the tongue, some skeletal muscles, some viscera, sensation from skin and viscera)
-15 max points
- 8 and below you are in a coma
When taking Dig and k-supplements avoid this?
- Salt substitutes because many are potassium based
Universal donor blood
Bronchodilator inhaler before glucocorticoid inhaler. True or False?
True, you want to open up the alveoli to maximize the medications.
Diaphragms must stay in place for how long after intercourse?
- 6 hours
- In addition these contraceptive devices are also fitted so must be refitted if you lose weight or gain a significant amount of weight.
- Pain with palpation of gall bladder area. Seen with cholecystitis
- Ecchymosis in umbilical area, seen with pancreatitis
- Flank grayish blue (turn around to see your flanks)
- Indicates pancreatitis
- This is a test for pernicious anemia, to see how well one absorbs Vit B12
- This tests for PKU. The baby should have eaten source of protein first
- Pockets within the intestine. Low residue, no seeds, nuts or peas
Rhogam is given when?
- Given at weeks, & 72 hours post partum, IM.
- Only needs to be given to Rh NEGATIVE mother
If someone has a latex allergy, you should also assess if the patient is allergic to what?
- Bananas, apricots, cherries, grapes, kiwis, passion fruit, avocados, chestnuts, tomatoes and peaches
- This is used in myasthenia gravis to confirm the diagnosis.
Myasthenia gravis is caused by a disorder in the transmission of impulses from nerve to muscle cell
Transesophageal Fistula (TEF)
- Esophagus doesn't fully develop and is a surgical emergency
- The 3 C's of TEF in the newborn are: Choking, Coughing, Cyanosis
MMR vaccines is given
Also ask about anaphylactic reaction to eggs or neomycin before MMR
- Botox may be given for this.
- Patch the GOOD eye so that the weaker eye can get stronger.
A 12 month old infant recently had a fever, runny nose, cough and white spots in the mouth for 3 days. A rash developed that started on the face and spread to the whole body. What should you suspect that the child has?
- Rubeola (Measles)
- Measles is a highly contagious infection caused by the measles virus. Initial signs and symptoms typically include fever, often greater than 40 °C, cough, runny nose, and inflamed eyes. Two or three days after the start of symptoms, small white spots may form inside the mouth, known as Koplik's spots.
A red, flat rash which usually starts on the face and then spreads to the rest of the body typically begins three to five days after the start of symptoms. Symptoms usually develop 10-12 days after exposure to an infected person and last 7-10 days.
- Is greatest in ages 7-9 months
- Peaks in toddlerhood
- Motor restlessness, person needs to keep going
- Tx with antiparkinsons meds
- Can be mistaken for agitation
Before a Pulmonary Function Test (PFT)
- A pt's bronchodilator will be withheld
- And not allowed to smoke 4 hours before the test
- This is to assess a pt for seizure activity
- Need to hold meds for 24-48 hours
- No caffine or cigarettes for 24 hrs prior.
- Pt is able to eat
- Pt must stay awake the night before the exam, pt may be asked to hyperventilate and watch a bright flashing light.
- After EEG, assess pt for seizures, pt will be at increased risk
Antipsychotics are incompatible with
- Caffeine and apple juice
- Adverse effects of anti-psychotic meds
- Tarditive dyskinesia
- Tightening of the jaw
- Stiff neck
- Swollen tongue
- Later on swollen airway
- Is an anti-psychotic med
- Doses over 6mg can cause tarditive dyskinesia
- This is the first line anti-psychotic for children
- This is used for sickle cell
- Report GI symptoms immediately this could be a sign of toxicity
Simvastatin - Zocor
- Tx of hyperlipidemia
- Should be taken on an empty stomach to enhance absorption, report any unexplained muscle pain, especially fever
- Is pointing toward the "cord"
- Hands are pointing out.
- To "celebrate"
- Ribbon like stools
- Enlarged colon
IM administration site for an infant-6 months
- Vastus lateralis
IM administration site for a toddler above 18 months of age?
IM site for children above 18 months
- Deltoid and gluteus maximus are appropriate sites
What is the max amount that can be taken out at one time with a thoracentesis?
Preparation for cardiac cath:
- NPO 8-12 hours (incase surgery is needed)
- Empty bladder, pulses
- Tell pt that they may feel heat palpitations or desire to cough with dye injection.
Post cardiac cath:
- Monitor vital signs, pulses distal to site
- Apply pressure to cath site for at least 15 minutes
- Keep leg straight, bedrest for 6-8 hrs.
- Semi fowlers or upright on edge of bed
- Empty bladder
- Post procedure: VS, report elevated temp, observe for signs of hypovolemia
- Used after a mastectomy
- Empty when full or q8h, remove plug, empty contents, place on flat surface, cleanse opening and plug with alcohol sponge.
- Compress evacuator completely to remove air, release plug, check system for operation.
- Butterfly rash
- Projectile vomiting
- Olive like mass
- Flapping tremors of the hands
- Caused by an increased amount of toxins in the blood stream (ammonia)
- Bulls eye rash
- NEVER take with milk
- Take with juice or water
Leads to cardiac problems
- Edema (begins in the face)
- Weight gain, edema in the face and limbs
- Foamy/frothy urine
- Protein in the urine
- R/t recent strep infection
- Elevated BP
- Preorbital edema
- Decreased GFR
- Protein & blood in urine (cola-colored urine)
- Painful (dysuria) & oliguria (little urine)
- Vaccines needed for ages 4-5 years
- Is an inherited autosomal recessive trait that involves exocrine (non hormonal) gland dysfunction.
- Increased viscosity of secretions
- Increased electrolyte levels in sweat
Cystic fibrosis continue
- Lungs become filled with mucus that is thick like glue
- A sweat test is used to diagnose
It "gums up" the ducts: spleen, gall bladder and lungs
Treatment for Cystic Fibrosis
- "CF cleanout" medications to clean ducts, suction them out.
- Helrom vest: Shakes them to knock secretions loose
- Enzymes, insulin if glucose is high, antibiotics (antibiotics may seem high, but this is typical for a child with CF)
- CF pt's don't absorb nutrients well, so they will be given AQUADEX, fat soluble vitamins A,D,E, & K.
- Diet consists of high fats, high calorie/low sugar diet
Common symptoms of a cystic fibrosis pt:
- Large, bulky, frothy, foul-smelling stools
- Barrel chest
- Life expectancy is 30-40's
- Respiratory distress
- Thick secretions
- Side effects are agitation, sleep disturbances and dry mouth, constipation, ortho hypotension, possible urinary retention, blurred vision
- Antipsychotic medication
- Want to watch for tachycardia and seizures
- May cause severe agranulocytosis (weekly blood draws)
Glucose Tolerance Test while pregnant
- A result of 140 or higher needs further evaluation
When assessing extra ocular eye movement what cranial nerves are you assessing?
- 3,4 &6
- Trachea shifts to opposite side
- Hydrate, drinking 2-3 L of water/day
- Maintain sodium intake of 2-3g/day
- Toxic level is 2-3 (n/v, diarrhea, tremors)
1st degree: Red and painful
2nd degree: Blisters
3rd degree: No pain because of blocked and burned nerves
After a shunt placement, what is the bed position?
- Flat (so fluid doesn't reduce too rapidly)
- If you see signs of increasing ICP, then raise the HOB to 15-30 degrees.
- Specific protein in the urine that confirms multiple myeloma
- Is used for short-term neuromuscular blocking agents for procedures like intubation and ECT
Glucagon increases the effects of what?
- Oral anticoagulants
- Common in kids with CF
- Obstruction may cause fecal emesis
- Currant jelly-like stools (blood and mucus)
- A barium enema may be used to hydrostatically reduce the telescoping.
- Resolution is obvious with onset of bowel movements.
Positive for PKU
- No phenylalanine (no meat, no diary, no aspartame)
Antacids should be given ?
- When mechanically ventilated
- With an NG tube if the pH of the aspirate is <5.0. Aspirate should be checked every 12 hrs.
Amniotic fluid is?
- Alkaline, it will turn nitrazine paper blue. Urine and normal vaginal discharge are acidic and turn it pink.
- Blue is positive for amniotic fluid
Using crutches while going up stairs
GCB (Good leg, crutches, Bad leg)
- Good leg goes up first
- Crutches next
- Bad leg
Using crutches going down stairs
CGB (Crutches, Good leg, bad leg)
- Good leg
- Bad leg
Steroids such as Prednisone can increase what?
- Increase glucose, so monitor blood sugar levels
A big cue with lithium toxicity is what?
- If a pt complains of metallic taste in mouth.
- Barking cough
- Difficulty breathing, fast breathing, noisy breathing, SOB or wheezing
- Fatigue or fever
- Hoarseness or impaired voice
Antidote for Magnesium Toxicity
- Calcium Gluconate
Magnesium Sulfate Toxicity S/S:
- Hyporefexia (absence of deep tendon reflexes)
- Respiratory depression
- Decrease in LOC
- Urine output is decreased
Sets with similar terms
PEPU TEST 5
NCLEX Musculoskeletal & Neurological disorders
Sets found in the same folder
ATI Comprehensive Predictor :)
ATI RN Predictor Study
ATI RN COMPREHENSIVE EXIT EXAM
Virtual ATI Comprehensive Predictor
Other sets by this creator
Adult Medical Surgical Practice A
RN Nursing Care of Children
Other Quizlet sets
9 Plasma Membrane- 3) Membrane Potential
ANTH 205 wk14 American Diet
The American Revolution Chapter 4 study guide.
Science Quiz study questions
What is the duration of anticoagulation therapy?
how do you treat a tar burn?
How many calories does propofol provide?
how many days does it take for the umbilical stump to fall off?