NCLEX Tips to NOT FORGET

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Do not delegate
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Terms in this set (316)
Do not delegate
What you can EAT E-evaluate A-assess T-teach
Addison's & Cushings
Addison's = down down down up down
Cushings= up up up down up
hypo/hypernatremia, hypo/hypertension, blood volume, hypo/hyperkalemia, hypo/hyperglycemia
Better peripheral perfusion?
EleVate Veins, DAngle Arteries
APGAR
Appearance (all pink, pink and blue, blue (pale)
Pulse (>100, <100, absent)
Grimace (cough, grimace, no response)
Activity (flexed, flaccid, limp)
Respirations (strong cry, weak cry, absent)
Airborne precautions
MTV or My chicken hez tb measles, chickenpox (varicella) Herpes zoster/shingles TB
Airborne precautions protective equip
private room, neg pressure with 6-12 air exchanges/hr mask & respirator N95 for TB
Droplet precautions
spiderman! sepsis, scarlet fever, streptococcal pharyngitis, parvovirus, pneumonia, pertussis,
influenza,
diptheria,
epiglottitis,
rubella,
mumps, meningitis, mycoplasma or meningeal pneumonia, adeNovirus
(Private room and mask)
Contact precaution
MRS WHISE
protect visitors & caregivers when 3 ft of the pt.
Multidrug-resistant organisms
RSV, Shigella, Wound infections, Herpes simplex, Impetigo, Scabies, Enteric diseases caused by micro-organisms (C diff),

Gloves and gowns worn by the caregivers and visitors
Disposal of infectious dressing material into a single, nonporous bag without touching the outside of the bag

PMGG= Private room/ share same illness, mask, gown and gloves
Skin infection
VCHIPS
Varicella zoster
Cutaneous diptheria
Herpes simplez
Impetigo
Peduculosis
Scabies
Air or Pulmonary Embolism
S/S chest pain, dyspnea, tachycardia, pale/cyanotic, sense of impending doom. (turn pt to LEFT side and LOWER the head of bed.)
Woman in labor (un-reassuring FHR)(late decels, decreased variability, fetal bradycardia, etc) Turn pt on Left side, give O2, stop pitocin, Increase IV fluids!Tube feeding with decreased LOCPt on Right side (promotes emptying of the stomach) Head of bed elevated (prevent aspiration)After lumbar puncture and oil based myelogrampt is flat SUPINE (prevent headache and leaking of CSF)Pt with heat strokeflat with legs elevatedduring Continuous Bladder Irrigation (CBI)catheter is taped to the thigh. leg must be kept straight.After Myringotomyposition on the side of AFFECTED ear, allows drainage.After Cateract surgerypt sleep on UNAFFECTED side with a night shield for 1-4 weeksafter Thyroidectomylow or semi-fowler's position, support head, neck and shoulders.Infant with Spina BifidaProne so that sac does not ruptureBuck's Traction (skin)elevate foot of bed for counter tractionAfter total hip replacementdon't sleep on side of surgery, don't flex hip more than 45-60 degress, don't elevate Head Of Bed more than 45 degrees. Maintain hip abduction by separating thighs with pillows.Prolapsed cordKnee to chest or Trendelenburg oxygen 8 to 10 LCleft Lipposition on back or in infant seat to prevent trauma to the suture line. while feeding hold in upright position.To prevent dumping syndrome(post operative ulcer/stomach surgeries) eat in reclining position. Lie down after meals for 20-30 min. also restrict fluids during meals, low CHO and fiber diet. small, frequent meals.AKA (above knee amputation)elevate for first 24 hours on pillow. position prone daily to maintain hip extension.BKA (below knee amputation)foot of bed elevated for first 24 hours. position prone to provide hip extension.detached retinaarea of detachment should be in the dependent positionadministration of enemapt should be left side lying (Sim's) with knee flexed.After supratentorial surgery(incision behind hairline on forhead) elevate HOB 30-40 degreesAfter infratentorial surgery(incision at the nape of neck) position pt flat and lateral on either side.During internal radiationon bed rest while implant in placeAutonomic Dysreflexia/HyperreflexiaS/S pounding headache, profuse sweating, nasal congestion, chills, bradycardia, hypertension. Place client in sitting position (elevate HOB) FIRST!Shockbedrest with extremities elevated 20 degrees. knees straight, head slightly elevated (modified Trendelenberg)Head Injuryelevate HOB 30 degrees to decrease ICPPeritoneal Dialysis (when outflow is inadequate)turn pt from side to side BEFORE checking for kinks in tubingLumbar PunctureAfter the procedure, the pt should be supine for 4-12 hours as prescribed.Myesthenia Gravisworsens with exercise and improves with restMyesthenia Gravisa positive reaction to Tensilon---will improve symptomsCholinergic CrisisCaused by excessive medication ---stop giving Tensilon...will make it worse.Liver biopsy (prior)must have lab results for prothrombin timeMyxedema/ hypothyroidismslowed physical and mental function, sensitivity to cold, dry skin and hair.Grave's Disease/ hyperthyroidismaccelerated physical and mental function. Sensitivity to heat. Fine/soft hair.Thyroid stormincreased temp, pulse and HTNPost-Thyroidectomysemi-fowler's. Prevent neck flexion/hyperextension. Trach at bedsideHypo-parathyroidCATS---Convulsions, Arrhythmias, Tetany, Spasms, Stridor. (decreased calcium) give high calcium, low phosphorus dietHyper-parathyroidfatigue, muscle weakness, renal calculi, back and joint pain (increased calcium) give a low calcium high phosphorous dietHypovolemiaincreased temp, rapid/weak pulse, increase respiration, hypotension, anxiety. Urine specific gravity >1.030Hypervolemiabounding pulse, SOB, dyspnea, rales/crackles, peripheral edema, HTN, urine specific gravity <1.010. semi fowler'sDiabetes insipidus (decreased ADH)excessive urine output and thirst, dehydration, weakness, administer PitressinSIADH (increased ADH)change in LOC, decreased deep tendon reflexes, tachycardia. N/V HA administer Declomycin, diureticshypokalemiamuscle weakness, dysrhythmias, increase K (rasins bananas apricots, oranges, beans, potatoes, carrots, celery)HyperkalemiaMURDER Muscle weakness, Urine (olig, anuria) Resp depression, decreased cardiac contractility, ECG changes, reflexesHyponatremianausea, muscle cramps, increased ICP, muscular twitching, convulsions. give osmotic diuretics (Mannitol) and fluidsHypernatremiaincreased temp, weakness, disorientation, dilusions, hypotension, tachycardia. give hypotonic solution.HypocalcemiaCATS Convulsions, Arrythmias, Tetany, spasms and stridorHypercalcemiamuscle weakness, lack of coordination, abdominal pain, confusion, absent tendon reflexes, shallow respirations, emergency!Hypo MgTremors, tetany, seizures, dysthythmias, depression, confusion, dysphagia, (dig toxicity)Hyper Mgdepresses the CNS. Hypotension, facial flushing, muscle weakness, absent deep tendon reflexes, shallow respirations. EMERGENCYAddison'sHypo Na, Hyper K, Hypoglycemia, dark pigmentation, decreased resistance to stress fx, alopecia, weight loss. GI stress.CushingsHyper Na, Hypo K, hyperglycemia, prone to infection, muscle wasting, weakness, edema, HTN, hirsutism, moonface/buffalo humpAddesonian crisisN/V confusion, abdominal pain, extreme weakness, hypoglycemia, dehydration, decreased BPPheochromocytomahypersecretion of epi/norepi. persistent HTN, increased HR, hyperglycemia, diaphoresis, tremor, pounding HA; avoid stress, frequent bathing and rest breaks, avoid cold and stimulating foods (surgery to remove tumor)Tetrology of FallotDROP (Defect, septal, Right ventricular hypertrophy, Overriding aortas, Pulmonary stenosis)Autonomic Dysreflexia(potentially life threatening emergency!) HOB elevate 90 degrees, loosen constrictive clothing, assess for full bladder or bowel impaction, (trigger) administer antihypertensives (may cause stroke, MI, seizure)FHR patterns for OBThink VEAL CHOP! V-variable decels; C- cord compression caused E-early decels; H- head compression caused A-accels; O-okay, no problem L- late decels; P- placental insufficiency, can't fillwhat to check with pregnancyNever check the monitor or machine as a first action. Always assess the patient first. Ex.. listen to fetal heart tones with stethoscope.Position of the baby by fetal heart soundsPosterior --heard at sides Anterior---midline by unbilicus and side Breech- high up in the fundus near umbilicus Vertex- by the symphysis pubis.Ventilatory alarmsHOLD High alarm--Obstruction due to secretions, kink, pt cough etc Low alarm--Disconnection, leak, etcICP and ShockICP- Increased BP, decreased pulse, decreased resp Shock--Decreased BP, increased pulse, increased respCor pumonaeRight sided heart failure caused by left ventricular failure (edema, jugular vein distention)Heroin withdrawal neonateirritable, poor suckingbrachial pulsepulse area on an infantlead poisoningtest at 12 months of ageBefore starting IV antibioticsobtain cultures!pt with leukemia may haveepistaxis due to low plateletswhen a pt comes in and is in active laborfirst action of nurse is to listen to fetal heart tones/ratefor phobiasuse systematic desensitizationNCLEX answer tipschoose assessment first! (assess, collect, auscultate, monitor, palpate) only choose intervention in an emergency or stress situation. If the answer has an absolute, discard it. Give priority to the answers that deal with the patient's body, not machines, or equipment.ARDS and DICare always secondary to another disease or traumaIn an emergencypatients with a greater chance to live are treated firstCardinal sign of ARDShypoxemiaEdema is locatedin the interstitial space, not the cardiovascular space (outside of the circulatory system)the best indicator of dehydration?weight---and skin turgorheat/coldhot for chronic pain; cold for accute pain (sprain etc)When pt is in distress....medication administrationis rarely a good choicepneumoniafever and chills are usually present. For the elderly confusion is often present.before IV antibiotics?check allergies (esp. penicillin) make sure cultures and sensitivity has been done before first dose.COPD and O2with COPD baroreceptors that detect CO2 level are destroyed, therefore, O2 must be low because high O2 concentration takes away the pt's stimulation to breathe.Prednisone toxicityCushings (buffalo hump, moon face, high blood sugar, HTN)Neutropenic ptsno fresh fruits or flowersChest tubes are placedin the pleural spacePreload/AfterloadPreload affects the amount of blood going into Right ventricle. Afterload is the systemic resistance after leaving the heart.CABGGreat Saphenous vein in leg is taken and turned inside out (because of valves inside) . Used for bypass surgery of the heart.Unstable Anginanot relieved by nitroPVC'scan turn into V fib.1 tsp5 mL1 oz30 mL1 cup8 oz1 quart2 pints1 pint2 cups1 g (gram)1000 mg1 kg2.2 lbsI lb16 ozcentigrade to Fahrenheit conversionF= C+40 multiply 5/9 and subtract 40 C=F+40 multiply 9/5 and subtract 40Angiotenson IIIn the lungs...potent vasodialator, aldosterone attracts sodium.Iron toxicity reversaldeferoxamineS3 soundnormal in CHF. Not normal in MIAfter endoscopycheck gag reflexTPN given insubclavian linepain with diverticulitislocated in LLQappendicitis painlocated in RLQTrousseau and Chvostek's signs observed inHypocalcemianever give K+ inIV pushDKA is rarein DM II (there is enough insulin to prevent fat breakdown)Glaucoma patients loseperipheral vision.Autonomic dysreflexiapatients with spinal cord injuries are at risk for developing autonomic dyreflexia (T-7 or above)Spinal shock occursimmediately after injurymultiple sclerosismyelin sheath destruction. disruptions in nerve impulse conductionMyasthenia gravisdecrease in receptor sites for acetylcholine. weakness observed in muscles, eyes mastication and pharyngeal musles. watch for aspiration.Gullian -Barre syndromeascending paralysis. watch for respiratory problems.TIAtransient ischemic attack....mini stroke, no dead tissue.CVAcerebriovascular accident. brain tissue dies.Hodgkin's diseasecancer of the lymph. very curable in early stagesburns rule of Nineshead and neck 9% each upper ext 9% each lower ext 9% front trunk 18% back trunk 18% genitalia 1%birth weightdoubles by 6 months triples by 1 yearif HR is <100 (children)Hold Digearly sign of cystic fibrosismeconium in ileus at birthMeningitis--check forKernig's/ brudinski's signswilm's tumorencapsulated above kidneys...causes flank painhemophilia is x linkedpassed from mother to sonwhen phenylaline increasesbrain problems occurbuck's tractionknee immobilityrussell tractionfemur or lower legdunlap tractionskeletal or skinbryant's tractionchildren <3 y <35 lbs with femur fxeclampsia isa seizureperform amniocentesisbefore 20 weeks to check for cardiac and pulmonary abnormalitiesRh mothers receive Rhogamto protect next babyanterior fontanelle closes by...posterior by..18 months, 6-8 weekscaput succedaneumdiffuse edema of the fetal scalp that crosses the suture lines. reabsorbes within 1 to 3 dayspathological jaundice occurs: physiological jaundice occurs:before 24 hours (lasts 7 days) after 24 hoursplacenta previa s/s placental abrution s/sthere is no pain, but there is bleeding there is pain, but no bleeding (board like abd)bethamethasone (celestone)surfactant. premature babiesmilieu therapytaking care of pt and environmental therapycognitive therapycounselingfive interventions for psych patientssafety setting limits establish trusting relationship meds least restrictive methods/environmentSSRI'stake about 3 weeks to workpatients with hallucinations patients with delusionsredirect them distract themThorazine and Haldolcan cause EPSAlzheimer's60% of all dementias, chronic, progressive degenerative cognitive disorder.draw up regular and NHP?Air into NHP, air into Regular. Draw regular, then NHPCranial nervesS=sensory M=motor B=both Oh (Olfactory I) Some Oh (Optic II ) Say Oh (Oculomotor III) Marry To (trochlear IV) Money Touch (trigeminal V) But And (Abducens VI ) My Feel (facial VII) Brother A (auditory VIII) Says Girl's (glossopharyngeal IX) Big Vagina (vagus X) Bras And (accessory XI) Matter Hymen (Hypoglossal XII) MoreHypernatremiaS (Skin flushed) A (agitation) L (low grade fever ) T (thirst)Developmental2-3 months: turns head side to side 4-5 months: grasps, switch and roll 6-7 months: sit at 6 and waves bye bye 8-9 months: stands straight at 8 10-11 months: belly to butt 12-13 months: 12 and up, drink from a cupHepatitis AEnds in a vowel, comes from the bowelHepatitis bB= blood and body fluids (hep c is the same)Apgar measuresHR RR Muscle tone, reflexes, skin color. Each 0-2 points. 8-10 ok, 0-3 resuscitateGlasgow coma scaleeyes, verbal, motor Max- 15 pts, below 8= comaAddison's disease: Cushing's syndrome:"add" hormone have extra "cushion" of hormoneDumping syndromeincrease fat and protein, small frequent meals, lie down after meal to decrease peristalsis. Wait 1 hr after meals to drinkDisseminated herpes zoster localized herpes zosterDisseminated herpes=airborne precautions Localized herpes= contact precautions. A nurse with localized may take care of patients as long as pts are not immunosuppressed and the lesions must be covered!Isoniazidcauses peripheral neuritisWeighted NI (naso intestinal tubes)Must float from stomach to intestine. Don't tape right away after placement. May leave coiled next to pt on HOB. Position pt on RIGHT to facilitate movement through pylorisCushings ulcersr/t brain injuryCushing's triadr/t ICP (HTN, bradycardia, irritability, sleep, widening pulse pressure)Thyroid stormHOT (hyperthermia)Myxedema comaCOLD (hypothermia)GlaucomaNo atropineNon Dairy calciumRhubarb sardines collard greensKoplick's spotsprodomal stage of measles. Red spots with blue center, in the mouth--think kopLICK in the mouthINH can cause peripheral neuritisTake vitamin B6 to prevent. Hepatotoxicpancreatitis ptsput them in fetal position, NPO, gut rest, Prepare anticubital site for PICC, they are probably going to get TPN/LipidsMurphy's signPain with palplation of gall bladder (seen with cholecystitis)Cullen's signecchymosis in umbilical area, seen with pancreatitisTurner's signFlank--greyish blue. (turn around to see your flanks) Seen with pancreatitisMcBurney's pointPain in RLQ with appendicitisLLQDiverticulitisRLQappendicitis watch for peritonitisGuthrie testTests for PKU. Baby should have eaten protein firstshilling testTest for pernicious anemiaPeritoneal dialysisIts ok to have abd cramps, blood tinged outflow and leaking around site if the cath (tenkoff) was placed in the last 1-2 weeks. Cloudy outflow is never okHyper reflexes absent reflexesupper motor neuron issue (your reflexes are over the top) Lower motor neuron issueLatex allergiesassess for allergies to bananas, apricots, cherries, grapes, kiwis, passion fruit, avocados, chestnuts, tomatoes and peachesTensilonused in myesthenia gravis to confirm diagnosisALS(amyotrophic lateral sclerosis) degeneration of motor neurons in both upper and lower motor neuron systemsTransesophageal fistulaesophagus doesn't fully develop. This is a surgical emergency (3 signs in newborn: choking, coughing, cyanosis)MMRis given SQ not IMcodes for pt careRed- unstable, ie.. occluded airway, actively bleeding...see first Yellow--stable, can wait up to an hour for treatment Green--stable can wait even longer to be seen---walking wounded Black--unstable, probably will not make it, need comfort care DOA--dead on arrivalContraindication for Hep B vaccineanaphylactic reaction to baker's yeastwhat to ask before flu shotallergy to eggswhat to ask before MMRallergy to eggs or neomycinwhen on nitroprusside monitor:cyanide. normal value should be 1.William's positionsemi Fowler's with knees flexed to reduce low back painS/S of hip fxExternal rotation, shortening adductionFat embolismblood tinged sputum r/t inflammations. Increase ESR, respiratory alkalosis. Hypocalcemia, increased serum lipids.complications of mechanical ventilationpneumothorax, ulcersPaget's diseasetinnitus, bone pain, elnargement of bone, thick boneswith allopurinolno vitamin C or warfarin!IVP requiresbowel prep so bladder can be visualizedacid ash dietcheese, corn, cranberries, plums, prunes, meat, poultry, pastry, breadalk ash dietmilk, veggies, rhubarb, salmonorange tag in psychis emergent psychthyroid med side effectsinsomnia. body metabolism increasesTidal volume is7-10 ml/kgCOPD patients and O22LNC or less. They are chronic CO2 retainers expect sats to be 90% or lessKidney glucose threshold180Stranger anxiety is greatest at what age?7-9 months..separation anxiety peaks in toddlerhoodwhen drawing an ABGput in heparinized tube. Ice immediately, be sure there are no bubbles and label if pt was on O2Munchausen syndrome vs munchausen by proxyMunchausen will self inflict injury or illness to fabricate symptoms of physical or mental illness to receive medical care or hospitalization. by proxy mother or other care taker fabricates illness in childmultiple sclerosismotor s/s limb weakness, paralysis, slow speech. sensory s/s numbness, tingling, tinnitis cerebral s/s nystagmus, atazia, dysphagia, dysarthiahungtington's50% genetic autosomal dominanat disorder.. s/s uncontrolled muscle movements of face, limbs and body. no cureWBC left shiftpt with pyelo. neutrophils kick in to fight infectionspancreatic enzymes are takenwith each meal!infants IM siteVastus lateralisToddler 18 months+ IM siteVentroglutealIM site for childrendeltoid and gluteus maximusThoracentesis:position pt on side or over bed table. no more than 1000 cc removed at a time. Listen for bilateral breath sounds, V.S, check leakage, sterile dressingCardiac cathNPO 8-12 hours. empty bladder, pulses, tell pt may feel heat, palpitations or desire to cough with injection of dye. Post: V.S.--keep leg straight. bedrest for 6-8 hrCerebral angio prepwell hydrated, lie flat, site shaved, pulses marked. Post--keep flat for 12-14 hr. check site, pulses, force fluids.lumbar puncturefetal position. post-neuro assess q15-30 until stable. flat 2-3 hour. encourage fluids, oral analgesics for headache.ECGno sleep the night before, meals allowed, no stimulants/tranquilizers for 24-48 hours before. may be asked to hyperventilate 3-4 min and watch a bright flashing light. watch for seizures after the procedure.MyelogramNPO for 4-6 hours. allergy hx phenothiazines, cns depressants and stimulants withheld 48 hours prior. Table moved to various positions during test. Post--neuro assessment q2-4 hours, water soluble HOB UP. oil soluble HOB down. oralanalgesics for HA. No po fluids. assess for distended bladder. Inspect siteLiver biopsyadminister Vitamin K, NPO morning of exam 6 hrs. Give sedative. Teach pt to expect to be asked to hold breath for 5-10 sec. supide position, lateral with upper arms elevated. Post--position on RIGHT side. frequent VS. report severe ab pain STAT. no heavy lifting 1 wkParacentesissemi fowler's or upright on edge of bed. Empty bladder. post VS--report elevated temp. watch for hypovolemialaparoscopyCO2 used to enhance visual. general anesthesia. foley. post--ambulate to decrease CO2 buildupPTBlow grade afternoon feverpneumoniarusty sputumasthmawheezing on expirationemphysemabarrel chestkawasaki syndromestrawberry tonguepernicious anemiared beefy tonguedowns syndromeprotruding tonguecholerarice watery stoolmalariastepladder like fever--with chillstyphoidrose spots on the abdomendiptheriapseudo membrane formationmeasleskoplick's spotssle (systemic lupus)butterfly rashpyloric stenosisolive like massAddison'sbronze like skin pigmentationCushing'smoon face, buffalo humphyperthyroidism/ grave's diseaseexophthalmosmyasthenia gravisdescending musle weaknessgullian-barre syndromeascending muscle weaknessanginacrushing, stabbing chest pain relieved by nitroMIcrushing stabbing chest pain unrelieved by nitrocystic fibrosissalty skinDMpolyuria, polydipsia,polyphagiaDKAkussmal's breathing (deep rapid)Bladder CApainless hematuriaBPHreduced size and force of urineretinal detachmentfloaters and flashes of light. curtain visionglaucomapainful vision loss. tunnel vision. haloretino blastomacat's eye reflexincreased ICPhypertension, bradypnea,, bradycarday (cushing's triad)shockHypotension, tachypnea, tachycardiaLymes diseasebullseye rashintraosseous infusionoften used in peds when venous access can't be obtained. hand drilled through tibia where cryatalloids, colloids, blood products and meds are administered into the marrow. one med that CANNOT be administered IO is isoproterenol, a beta agonist.sickle cell crisistwo interventions to prioritize: fluids and pain relief.glomuloneprhitisthe most important assessment is blood pressurechildren 5 and upshould have an explanation of what will happen a week before surgeryKawasaki disease(inflammation of blood vessles, hence the strawberry tongue) causes coronary artery aneurysms.ventriculoperitoneal shuntwatch for abdominal distention. watch for s/s of ICP such as high pitch cry, irritability and bulging fontanels. In a toddler watch for loss of appetite and headache. After shunt is placed bed position is FLAT so fluid doesn't reduce too rapidly. If presenting s/s of ICP then raise the HOB 15-30 degrees3-4 cups of milk a day for a child?NO too much milk can reduce the intake of other nutrients especially iron. Watch for ANEMIAMMR and varicella immunizaionsafter 15 months!cryptorchidismundescended testicles! risk factor for testicular cancer later in life. Teach self exam for boys around age 12--most cases occur in adolescenceCSF meningitisHIGH protein LOW glucoseHead injury or skull fxno nasotracheal suctioningotitis mediafeed upright to avoid otitis media!positioning for pneumonialay on affected side, this will splint and reduce pain. However, if you are trying to reduce congestion, the sick lung goes up! (like when you have a stuffy nose and you lay with that side up, it clears!)for neutropenic ptsno fresh flowers, fresh fruits or veggies and no milkantiplatelet drug hypersensitivitybronchospasmbowel obstructionmore important to maintain fluid balance than to establish a normal bowel pattern (they cant take in oral fluids)Basophils reliease histamineduring an allergic responseIatragenicmeans it was caused by treatment, procedure or medicationTamoxifenwatch for visual changes--indicates toxicitypost spelectomypneumovax 23 is administered to prevent pneumococcal sepsisAlkalosis/ Acidosis and K+ALKalosis=al K= low sis. Acidosis (K+ high)No phenylalanineto a kid with PKU. No meat, dairy or aspartamenever give potassiumto a pt who has low urine output!nephrotic syndromecharacterized by massive proteinuria caused by glomerular damage. corticosteroids are the mainstaythe first sign of ARDSincreased respirations! followed by dyspnea and tachypneanormal PCWC (pulmonary capillary wedge pressure)is 8-13 readings 18-20 are considered highfirst sign of PEsudden chest pain followed by dyspnea and tachypneaDigitalisincreases ventricular irritability ----could convert a rhythm to v-fib following cardioversionCold stress and the newbornbiggest concern resp. distressParathyroid relies onvitamin D to workGlucagon increases the effects of?anticoagulantsSucking stab woundcover wound and tape on 3 sides to allow air to escape. If you cover and occlude it--it could turn into a closed pneumo or tension pneumo!chest tube pulled out?occlusive dressingPENeeds O2!DKAacetone and keytones increase! once treated expect postassium to drop! have K+ readyHirschprung'sdiagnosed with rectal biopsy. S/S infant-failure to pass meconium and later the classic ribbon-like/foul smelling stoolsIntussusceptionCommon in kids with CF. Obstruction may cause fecal emesis, current jelly stools. enema---resolution=bowel movementslaboring mom's water breaks?first thing--worry about prolapsed cord!Toddlers need to expressindependence!Addison'scauses sever hypotension!pancreatitisfirst pain relief, second cough and deep breatheCF chief concern?Respiratory problemsa nurse makes a mistake?take it to him/her first then take up the chainnitrazine paperturns blue with alkaline amniotic fluid. turns pink with other fluidsup stairs with crutches? down stairs with crutches?good leg first followed by crutches(good girls go to heaven) crutches with the injured leg followed by the good leg.dumping syndrome?use low fowler's to avoid. limit fluidsTB drugs arehepatotoxic!clozapine, Clozarilantipsychotic anticholinergicclozapine s/eweight gain, hypotension, hyperglycemia, agranulocytosisdehydration-hypovolemia - elevated urine specific gravityflumazenil, Romaziconbenzo overdoseumbilical cord compressionreposition side to side or knee-chestshort corddiscontinue pictocinTBA positive Mantoux test indicates pt developed an immune response to TB. Acid-fast bacilli smear and culture:(+suggests an active infection) the diagnosis is CONFIRM by a positive culture for M TB A chest x-ray may be ordered to detect active lesions in the lungs QuantiFERON-TB Gold: DIAGNOSTIC for infection, whether it is active or latentBatteryperforming procedure without consentAssaultThreatening to give pt. medication putting another person in fear of a harmful or an offensive contact.ImprisonmentTelling the client you cannot leave the hospitalDefamationis a false communication or careless disregard for the truth that causes damage to someone's reputation. in writing(Libel) or Verbally(Slander)Sprain or StrainRICE Rest Ice Compress Elevate