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Comprehensive NCLEX review
Terms in this set (105)
"The number of banana's you buy at the store"
"The perfect weather for swimming"
(females usually hit puberty first)
"Think magnum condoms..."
For men at least 1.5-2.5 bigger
"how many packs of hamburger buns do i need?"
"These fossils are at least 2.5-4.5 million years old"
"he's such a creature.... on a scale of 1-10 he's a...."
"Kids from ages ___ to ___ are always getting sick"
"This can of soda only costs me...."
CO2: > 60
Strict hand hygiene
No fresh food/plants
Keep door closed
Disinfect wipes for equipment
No sick visitors
PaO2: 80-100% >60 for COPD pt
PaCO2: 35-45 (acidic= 45, alkalotic= 35)
Abnormal ABG causes
spiderman! sepsis, scarlet fever, streptococcal pharyngitis, parvovirus, pneumonia, pertussis,
mumps, meningitis, mycoplasma or meningeal pneumonia, adeNovirus
(Private room and mask)
MTV or My chicken hez tb measles, chickenpox (varicella) Herpes zoster/shingles TB
N95 mask and neg pressure room, preferably priv room
Very good hand hygiene
Taking off (think alphabetical)
Does the same as the prefix
HR and Urine.
everything except HR/UO
everything except HR/UO
*Never do IV push
Calcium and Mag do opposite of their prefix.
Hyper: ↓, everything (HR, BP, RR, etc)
Hypo: ↑, everything
Pay attention to prefix letters in Sodium
hypErnatremia: E for dehydration
hypOnatremia: O for overload of fluid
Must be two finger breaths below the axilla
Always move affected (weak) side first
Right crutch and left foot forward
Left crutch and right foot forward
Always move weak side first
Both crutches forward with weak leg
move strong leg forward
always move weak side first
resembles normal walking
Stairs with assistive devices
When you go up the stairs, use your good leg
When you go down the stairs, use your bad leg
Think, good people go to heaven; Bad people go to heck.
Restraints (amt of time)
<9 yrs old: 1 hr
9-17 years old: 2 hrs
18+: 4 hrs
*Need an MD order within 1 hr of applying restraints on a pt.
6 rights of medication administration
think My Parents Drove Me Right To Dairyqueen
Type 1 diabetes
remember your K's
Keep insulin nearby. Insulin dependent.
Kids. Adolescent onset.
Ketosis. DKA in type 1.
Type 2 diabetes
Remember your A's
Absent ketones, no ketosis.
Avoid excess carbs and calories. (developed from unhealthy lifestyle)
They should continue to take insulin even if they are feeling sick.
Type 2 diabetes treatment
Diet, avoid excess carbs/cals
Resources, provide education on prevention and management.
Exercise 30 min/5 days a week.
Additional insulin if needed.
Metformin, oral hypoglycemic medication.
Polyuria (excessive urine) and Polydipsia (excessive thirst) =
Urine specific gravity
High urine output: LOW USG
Low urine output:
DKA (Type 1 diabetic)
Causes: Acute infection, too much caloric intake, or not enough exercise.
(BS is above 250)
Symptoms: (remember DKA)
H: Ketones, Kussmaul breathing, High K (potassium)
A: Acidosis, Acetone breath
Treatment: IV fluids w insulin
Remember the D's
Decreased BS <70
Drunk symptoms (slurred speech, delayed reactions, increased HR/RR, decreased BP, cold)
Drink juice. rapid carbs like juice or crackers first.
Drug injection of Glucagon.
High BS of >600
Hot, flushed, dry skin due to dehydration
Hand the client water. IV fluids with insulin is treatment.
RAPID acting Insulin
Think R for rapid
Onset: 15 min
Peak: 30 min
Duration: 3 hours
Timed with meals
Short acting insulin
Regular (Humulin R)
only one that can run IV, timed with meals
Onset: 1 hr
Peak: 2 hrs
Duration: 4 hrs
Onset: 6 hrs
Peak: 8 hrs
Duration: 12 hrs
not fast and usually used for noncompliant pts
Long acting insulin
Long lantus (glargine)
Duration: 12-24 hrs
Give 1-2x per day. Also can be given at night.
You do not need to fast for your A1C.
<6 is normal, if diabetic <8
Presumptive (maybe) signs of pregnancy
Breast enlargement, urinary frequency, quickening.
Probable (probably) signs of pregnancy
Goodells sign (cervical softening), chadwicks sign (Cyanosis of the cervix), Positive pregnancy test, period stops
POSITIVE signs of pregnancy
Fetal heart tones present and fetal skeleton.
When can you palpate the fundus?
When should the fundus be at the umbilical?
When should the fundus be at the same height as the number of weeks the woman
when is quickening felt?
Whats best for nausea?
Dry carbohydrates (crackers)
What common medication is a category X?
Ibuprofen, they need to take acetaminophen
Stages of labor
Stage 1: Cervix dilates from 0-10 cm
latent phase: 1-3 cm dilated. contractions 5-30 min apart.
active phase: 4-7 cm dilated. contractions 3-5 min apart.
transition phase: 8-10 cm dilated. contractions 2-3 min apart.
Stage 2: Delivery of baby
Stage 3: Delivery of placenta
Stage 4: Postpartum
what does Turbuterline do?
Slows the progression of labor.
What does Oxytocin/Pitocin do?
Induces labor and used to control postpartum hemorrhage.
Painless, bright red vaginal bleeding, soft, relaxed, nontender uterus, fundal height ^for gestational age
give fluids, blood, and emergency C-sec.
Placenta is separated from uterus. Dark, painful bleeding.
O2, bedrest, deliver.
hypertension, edema, and proteinuria during pregnancy
preeclampsia: seizure precaution
Remember phrase 'LION' for OB complication
Lie on side
Increase IV fluids
What do you do for fetal bradycardia? (<100)
Stop pitocin and do 'LION'
what is VEAL CHOP?
Intervention not necessary
No intervention needed
Evaluate for why- Stop pitocin, give O2, give fluid, reposition mom, possible C-Sec if persist
What do you do for a Displaced fundus?
Massage the fundus
Where should the fundus be after 24 hrs?
Back at the umbilicus
Most common fetal position (Most wanted)
LOA (left occiput anterior)
ROA (Right occiput anterior)
Most dangerous fetal position?
OP (occiput posterior)
Put pt in Knee to chest position and push.
bipolar 1 disorder
More severe, mania, thinks they are invincible
bipolar 2 disorder
less severe, more focused on depression
NEVER say 'why'
Acknowledge a patients feelings or concern
Use "I statements". DO NOT say, "YOU did this wrong or YOU should have done this"
Use open ended questions like: "Tell me how you are feeling? Can you explain this?"
Acknowledge their feelings, present reality.
What is Tetralogy of Fallot? what does VORP mean?
Heart defect (pediatric) that causes chronic hypoxemia.
Blood is not oxygenating at VORP speed to supply the body.
Ventricular septal defect
Right ventricular hypertrophy (enlarged)
Pulmonary outflow tract obstruction
What are normal bilirubin levels?
1 month: Grasp reflex
4 months: roll from back, smiles
6 months: roll back to front, first sounds, teeth erupt, solid foods are introduced
8 months: sits unsupported
9-12 months: starting to walk
24 months: kick ball, walk up and down stairs
3 yrs: runs, draws circles
4 yrs: uses scissors, pours beverages
Pain scale for infants
Face, legs, activity, cry, consolability (0, 1, 2)
what age does physiologic anorexia occur? what is it?
4-6, their growing begins to slow and they just do not have the need to eat.
Toxic drug levels
TOXIC OVER 2
TOXIC OVER 2
TOXIC OVER 20
TOXIC OVER 20
BP medications: (pine, lol, pril, sartan, mide/nide
PINE: Calcium channel blocker: ⇩ BP
LOL: Beta blocker: ⇩ HR/BP
PRIL: ACE inhibitor: ⇩BP ⬆️Potassium
SARTAN: ARBs: ⇩ BP/Workload of heart
MIDE/NIDE: Diuretics: ⇩ BP
Psych drugs effects (ABCDEFG)
Anticholinergic effects (dry mouth)
Psych drug affects (abc's) (zine, il, pam, SSRI (prozac/zoloft), mar/nar/par
SSRI (prozac/zoloft): ABCDE
lithium toxicity symptoms (3 t's)
Too much pooping (diarrhea)
serotonin syndrome (SAD)
Looks a lot like panic/anxiety
what medication CANNOT be mixed with nitro?
Warfarin: Vitamin K
Aspirin: Sodium bicarbonate
Magnesium sulfate: Calcium gluconate
Heparin: Protamine sulfate
Who is the universal donor?
Who is the universal recipient?
IV fluid types:
isotonic, hypotonic, hypertonic
isotonic: Replaces fluid losses. 0.9% NS (burns, shock)
hypotonic: Pulls fluid into cells. 0.45% NS
hypertonic: Pulls fluid out of cells. 3% saline (fluid overload)
Burns rule of nines
What does the P wave represent?
What does the QRS complex represent?
ventricular depolarization (contraction)
What does the ST segment represent?
early ventricular repolarization
What does the T wave represent?
What does a lack of QRS mean?
How do you treat ayststole?
"sawtooth" appearance on ECG
Chaotic on ECG
Bizarre on ECG
How do you treat Atrial Arrhythmias with ABCDs?
Calcium Channel Blockers
How do you treat ventricular arrhythmias?
Amiodarone or Lidocaine
HR > 100 bpm
Calcium channel blockers
Atropine/ pace maker
Treated with adenosine, vagal maneuver, or cardio vert
Shock pt for which rhythm disorders?
Asystole, V fib, V tach
"DEFIB for VFIB"
the rapid, irregular, and useless contractions of the ventricles
drug withdrawl symptoms (remember opposite)
IF a pt is on a STIMULANT and having withdrawal, they go LOW. SX: low HR/BP/RR, fatigue, depression.
IF a pt is on a DEPRESSANT and having withdrawal, then they go HIGH. SX: high HR/BP/RR, tremors, n/v, irritability, seizures, diaphoresis.
What CANT an LPN do?
THE LPN MAY NOT BEGIN BLOOD, BLOOD PRODUCTS/COMPONENTS
HYPERALIMENTATION OR CHEMOTHERAPEUTIC AGENTS. THE LPN MAY NOT GIVE
MEDICATIONS DIRECTLY INTO THE VEIN (INTRAVENOUS PUSH) OR INSERT
MEDICATION VIA AN EXTERNAL CATHETER SITE
NOT the first thing (i.e first dressing change)
UAP cannot do..?
Charting, education, planning, meds, treatments (exception is enemas) and firsts (first ambulation)
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