NCLEX I. SATA 1. CERVICAL CA Risk Factors: African- American/ American/ Native women Behavior (Sexual promiscuity !hronic instrumentation of cervix "isease #S$" %arly a&e of Sex 'i&h arity oor 'y&iene )ow economic status *ultiple sexual partners artner with rostate !A Sx: ost-coital +lee,in& ainful sex *enstrual irre&ularities 2. OVARIAN CA Risk factors: varian ,ysfunction .a&inal use of talcum pow,er Alcohol Race - hite women 0 family history 1nfertility A&e - eak23th eak23th ,eca,e of life Nulliparity 4enetic pre,isposition 3. DM FOOT CARE *eticulous care to feet ash feet with warm water not hot 0 ,ry !an use lotion +ut No lotion in +etween toes ear socks to keep feet warm Avoi, thermal thermal +aths5 heatin& pa,s "o not soak feet 1nspect feet ,aily "o not treat corns5 +listers ear loose socks an, no +arefoot !han&e into clean cotton socks ,aily Break in new shoes &ra,ually 6se emery +oar, "o not smoke "o not wear same pair of shoes 7 ,ays in a row !heck shoes for cracks +efore usin& leather instea, of plastic 4. BLOOD TRANSFUSION REACTION $ransfusion Reactions 'emolytic Reaction Aller&ic Reaction !irculatory verloa, Septicemia 1ron verloa, 'ypocalcemia "isease $ransmission $ransmission 'yperkalemia !itrate 1ntoxication 5. HYPERTHYROIDISM Soft smooth skin 0 hair *oo, swin&s 'N "iaphoresis 1ntolerance to heat $6 ,ru& to +lock thyroi, synthesis 6. LUNG CA Broncho&enic !arcinoma 8st lea,in& cause of ,eath From as+estos5 +acterial invasion5 •
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ci&arette Sx: Na&&in& cou&h5 hoarseness of voice5 ,yspnea5 ,iminishe, +reath soun,s 7. SX OF PARKINSONS $remors5 akinesia5 ri&i,ity eakness5 9motorie, propulsive &ait Slurre, speech5 ,yspha&ia5 ,roolin& *onotonous speech *ask like expression $each am+ulation mo,ification: &oose steppin& walk (marchin&5 R* exercises *e,s;Artane5 *e,s;Artan e5 !o&entin5 )-"opa5 arlo,el5 Sinemet5 Symmetrel Activities shoul, shoul, +e sche,ule, for late mornin& when ener&y level is hi&hest %ncoura&e fin&er exercises< romote family un,erstan,in& of ,isease intellect/si&ht/ hearin& not impaire,5 . ACUTE PANCREATITIS A+,ominal ain severe #acute sx pain ra,iatin& to the +ack !omplication : Shock5'ypovolemia Shock5'ypovolemia )imite, fat 0 protein intake !. CAST CARE "on=t rest on har, surface "on=t cover until ,ry >?@ hours 'an,le with palms of han,s not with fin&ers eep a+ove level of heart !heck for !S* 1". HYDROCEPHALUS Anterior fontanel fontanel +ul&es 0 nonpulsatin& nonpulsatin& Bones of hea, separate, (cracke, pot soun, *acewen soun, !heck for sun-settin& eyes "= 1ncrease 1! %vi,ence of Frontal Bossin& Failure to thrive 1rrita+ility 'i&h-pitche, cry 11. ESRD DIET Restricte, protein intake 1ncrease !' )ow 5 Restrict Na 12. NORMAL IN MONTH OLD CHILD - can sit with out support - can roll from front to +ack - can hol, a +ottle - closure of ant< fontanel - can say mama an, ,a,a - 7 teeth present ?-27 - stran&er anxiety peak •
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13. SUPERIOR VENA CAVA OCCLUSION Sx occur in the mornin& %,ema of face5 eyes 0 ti&htness of shirt/ (Stoke=s si&n )ate sx: e,ema of arms5 han,s5 ,yspnea5 erythema5 epistaxis 14. ULCERATIVE COLITIS Sx: Severe ,iarrhea with +loo, 0 mucus A+,ominal ten,erness ten,erness 0 crampin& Anorexia t< )oss .it< ,eficiency Anemia • •
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"ehy,ration %lectrolyte im+alance )ow resi,ue 0 hi&h protein ,iet 15. DILANTIN ,o not floss throu&hout the ,ay ,o not use har, +ristle, tooth+rush 4in&ivitis S/% purple &love syn,rome 16. ANAPHYLACTIC REACTION #$%&'$( Stop me,ication *aintain airway Notify *" *aintain 1. access of C
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26. S)S OF CAD !hest ain alpitations "yspnea / Syncope 'emoptysis %xcessive Fati&ue 27. COPD Rhythmic5 ,iaphra&matic +reathin& 1f restless5 perform purse-lip +reathin& not more than 8 minute erform ,eep +reathin& with mouth hel, toðer ,urin& expiration 2. SEEN IN 15 MONTH OLD CHILD Speaks wor,s Sits w/o support Buil,s a tower of 3 +locks Stron& palmar &rasp 2!. CUSHING+S SYNDROME K steoporosis K *uscle wastin& K 'ypertension K urple skin striations K *oon face K $runcal o+esity K "ecrease, resistance to infection K )ow !ar+ohy,rate5 )ow !alorie5 'i&h rotein5 'i&h 5 )ow so,ium K *onitor &lucose level !heck for color of stool5 cortisol increase secretion of &astric aci, # eptic ulcer 0 41 +lee,in& !/1 to Aspirin5 increase, +lee,in& 3". ADDISONS DISEASE Fati&ue eakness "ehy,ration %ternal tan "ecrease, resistance to stress )ow So,ium )ow Bloo, Su&ar 'i&h otassium 'i&h protein5 car+ohy,rate5 So,ium5 )ow potassium ,iet $each l ife-lon& hormone replacement 4lucocorticoi,s (su&ar - Solu*e,rol (succinate to prevent a,,isonian crisis *ineralocorticoi,s (salt # Florinef AEs of A,,isonEs ,isease 8< Avoi, Stress 7< Avoi, Strenuous L< Avoi, 1n,ivi,uals with 1nfection >< Avoi, $! me,s 3< A lifelon& 4lucocorticoi,s $herapy < Always wear me,ic alert +racelet A,,-$/-0/ C-$-$ K 'ypotension K %xtreme weakness K Nausea vomitin& K A+,ominal pain / K Severe hypo&lycemia K "ehy,ration K A,minister Na!l 1.5 vasopressors5 hy,rocortisone K *onitor .S /A+solute +e,rest 31. PLACENTA PREVIA !heck 'ematocrit level %xternal fetal monitor not internal No va&inal examination Assess for +lee,in& • • • • •
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1mproperly implante, placenta at lower uterine ainless +ri&ht re,5 va&inal +lee,in& Soft5 relaxe,5 nonten,er uterus Fun,al hei&ht &reater than expecte, 32. ABRUPTIO PLACENTA remature separation of placenta from uterine wall ainful ,ark re, +lee,in& 6terine ri&i,ity Severe a+,ominal pain *aternal shock Fetal ,istress 33. HEMODIALYSIS alpate for a +ruit or thrill ei&h client ,aily5 +efore5 ,urin& 0 after 'ol, antihypertensive ,ru&s +> ,ialysis K !heck for thrill an, +ruit M ? hours K "on=t use extremity for B5 fin&er stick K *onitor vital si&ns5 wei&ht5 +reath soun,s K *onitor for hemorrha&e 34. PERITONEAL DIALYSIS K ei&ht +efore an, after treatment K *onitor B K *onitor +reath soun,s K 6se sterile techniMue K 1f pro+lem w/ outflow5 reposition client K Si,e effects: constipation 35. TYPE 1 IDDM $est +loo, &lucose every > h rs if no feelin& well %at fruit or cheese san,wich +efore exercise "o not exercise if +loo, &lucose is 73Cm&/,l 0 urinary ketones present A,minister re&ular insulin LC minutes +efore meals 36. COMPARTMENT SYNDROME 1ncrease, pain 0 swellin& ain with passive motion )oss of sensation 1na+ility to move Ooints ulselessness most characteristic # pain unrelieve, +y m,ication 37. CARDIAC CATHETERIATION N -? hrs< 0 no liMui, for > hrs< prior to prevent vomitin& 0 aspiration Feel a flush5 warm5 fluttery feelin&5 ,esire to cou&h5 palpitations in intro,uction of ,ye Shave 0 !lean insertion site with antiseptic solution 3. PERNICIOUS ANEMIA Severe pallor Smooth5 +eefy re, ton&ue Sli&ht Oaun,ice aresthisias of han,s 0 feet "istur+ances with &ait 0 +alance 3!. DUMPING SYNDROME ccurs LC minutes after eatin& A+,ominal fullness 0 crampin& "iarrhea $achycar,ia erspiration •
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eakness / ,iiness Bor+ory&mi soun, 4". TPN COMPLICATIONS Air %m+olism Flui, verloa, 'yper&lycemia 'ypo&lycemia 1nfection neumothorax 41. DIC Bruisin&5 purpura resence of occult +loo, )ow fi+rino&en level5 hct5 platelet 1ncrease, $5 $$ !omplication: R%NA) FA1)6R% 42. PERIPHERAL ARTERIAL DISEASE "ry scaly skin on lower extremities Rest ain5 at ni&ht 1ntermittent clau,ication/ $hickene, toenails !ol, 0 &ray-+lue color of skin "ecrease, or a+sent peripheral pulses 1nstruct pt< to walk to point of clau,ication5 stop 0 rest 0 walk a little farther 43. THROMBOPHLEBITIS Avoi, pressure +ehin, le&s Avoi, prolon&e, sittin& Avoi, constrictive clothin& Avoi, crossin& the le&s Avoi, massa&in& the le&s 44. SYPHILIS ainless chancre fa,es after weeks )ow &ra,e fever !opper-colore, rash on palms an, soles of feet Sprea, +y contact of mucous mem+ranes $reat with enicillin 4 1* 1f patient has penicillin aller&y5 will use erythromycin for 8C-83 ,ays< After treatment5 patient must +e reteste, to make sure ,isease is &one 45. POLYCYTHEMIA VERA 1ncrease, RB! )eukocytosis / $hrom+ocytosis An&ina 1ntermittent clau,ication "yspnea /'N )ethar&y / Syncope / aresthesia 46. PRIMARY HPN Risk Factors: A&in& Black race !hronic stress Family 'x +esity Smokin& *en 47. CHOLECYSTITIS Sx: N0. Belchin& 1n,i&estion Flatulence %pi&astric pain that ra,iates to the scapula 7 hrs< after eatin& fatty foo, ain localie, in R)P 4uar,in&5 ri&i,ity 0 re+oun, ten,erness !annot take a ,eep +reath when • •
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fin&ers are presse, +elow hepatic mar&in (*urphy=s Si&n II. COMPUTATION 8< "opamine 7< "o+utamine ,rip: r,er is 7<3mc&/k&/min5 patient wei&hts 8J l+s< Stock is 3CCm& in 3CCml of NSS5 !ompute for ml/hrQ Formula: Stock (m& x 8CCC mc&/m& Puantity (ml Flow rate: "ose (mc&/k&/min x wt (k& x C min/hr !oncentration (mc&/ml Answer: 87ml/hr L< *, with 1. or,er for patient L5CCCml in 7> hrs<5 &et the rate at ml per hour< Solution: LCCC/7> 2 873 ml/hr >< $a+lets : "ose of 7C m& per ,ose in stock ,ose of 3 m& per ta+let5 how many ta+letsQ Solution: 7C/3 x 8 2 > ta+lets III. TOPICS 1. SAFETY INFECTION CONTROL AIRBORNE : 'epa Filter *ask / ND3 articulate *AS $B *easles / Ru+ella !hicken ox/ .aricella SARS Anthrax CONTACT GGG #/8&$&$( !onOunctivitis pen woun,s /,raina&e )esions *RSA / .RSA / !"A" RS./ .R% DROPLET Sur&ical *ask Scarlett Fever "iphtheria *enin&itis Strep< haryn&itis neumonia ENTERIC: 4own 5 4loves "iarrhea 'ep< A Salmonella Acute 4astroenteritis eptic '< ylori Shi&ella / Rotavirus 4iar,iasis / !ryptospori,ium *uris FROTECTIVE Bloo, ,yscrasias Aplastic anemia )eukemia *aOor +urns (3C r&an transplant Ai,s *ultiple *yeloma rolon& Steroi, $herapy !oncepts: 8< 1nfection control: a< clean with clean for example patients with !.A5 "*5 !ar,io ,isease 7< Same precaution techniMues: a< 6niversal precaution: 'ep B5"5 A1"S 2. PRIORITIATION Remem+er the rule of sta+le vs< unsta+le< Althou&h you consi,er the
client unsta+le +ut if it expecte, in him5 this is sta+le< %xample< Asthma with wheein&- you consi,er this unsta+le< AB!5 unsta+le 5 first think %%!$%" in asthma so this will +e consi,ere, sta+le< 3. DELEGATION RN - Newly a,mitte,5 nee,s assessment5 pre op teachin& an, post op5 ns&< Gu,&ment 0 ,ischar&e plannin& 51. me,s5 B$< )N-!an &ive me,s except 1.5 sterile techniMues like woun, ,ressin&5 catheteriation5 insertion of N4 tu+e5 remove sutures hrs< 2". Ns&< Action in pt< post car,iac catheriation !heck pulse in lower extremities 21. "iet for "iverticulitis Avoi, hi&h-fi+er foo,s when •
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inflammation occurs5 only low resi,ue 1ntro,uce soft hi&h-fi+er foo,s when inflammation has resolve, 22. )ow iron<B! 0 al+umin5 what typeQ Nutritional ,eficit (malnutrition 23. hat will you ask on pt for car,iac stress test ($hallium stress testQ 1s he on +eta-+lockerQ (if with ra,ionucli,e alrea,y5 ersantine5 then invasive 0 shl,< avoi, caffeine5 calcium channel +lockers5 +-+lockers5 theophylline 24. 'i&hest risk of acci,ent D month infant eatin& &rapes 0 apricot 25. ancrease in !ystic Fi+rosis 4ive with meals5 ,ilute in applesauce 26. !lient post-!.A5 ,iet teachin& )ow salt5 low fat 27. !lient passin& stones with calcium5 ,iet teachin&: Shoul, +e aci,-ash ,iet 0 avoi, oxalate rich 0 !a rich foo, such as tea5 almon,s5 rhu+ar+s +eans5 spinach5 cocoa5 ve&eta+les5 fruits 4ive cran+erries5 prunes5 plums5 tomatoes5 cereals5 corn5 le&umes 1 2. a&et=s "isease Bowin& of +ones 2!. Si,e %ffect of Ansef (!efaolin Anti+iotic (R$156R$1 "iarrhea5 Nausea ral can,i,iasis ancythopenia 3". eptic ulcer ,isease Avoi, stressful situation to prevent exacer+ation 31. Schillin&=s $est For pernicious anemia 32. rior $o *64A S!AN: 1nforme, consent Aller&y not a concern 33. Action of AMuamephyton revention of hypoprothro+inemia 34. Action of )ipitor Anti-lipimec 35. ositionin& of 'ip Spica !ast in chil,ren *aintain flexion5 a+,uction 0 external rotation 36. Fear of L y/o chil, 1nOury (a+an,onment5 castration 37. $o prevent ureteral stones 1ncrease 3. *"1 'ol, +reath 3!. Frost+ite Soak in warm water 4". Normal respiratory chan&es in el,erly "ecrease, cou&h reflex 41. atient w/ "* 0 'N5 Muestion if 4iven +eta-+locker (causes +ronchospasm 42. *aximum inOection on 8C month ol, infant 8 ml •
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43. t< with en,ometriosis takes "anocrine5 action of the ,ru&Q Suppress menstruation/ ovulation 44. ost NS" with epi,ural anesthesia with +la,,er ,istension ffer +e,pan 45. Apmhotericin B5 si,e effectQ 'ea,ache 'ypokalemia 'ypotension 46. $< with an&ina unrelieve, +y L nitro&lycerin A,minister 7 47. atient on 'alo .est $ape the wrench to the vest ($orMue screw 4. re-menopausal syn,rome experiencin& hot flashes Black !ohosh for menoposh 4!. A+,ominal Assessment 1nspection Auscultation ercussion alpation 5". Sclerotherapy Application of pressure ,ressin& for 87->? hrs< 51. RS. "roplet precaution 52. S1A"' So,ium 87? only (Normal: 8L3-8>3 53. "ementia of Alheimer $ype !heck what the pt< is takin& 54. %4 55. hat me,icine if &iven shl, +e monitore, for +lee,in& 1n,omethacin (NSA1" 56. 4BS5 priority nursin& ,ia&nosis Aspiration 57. "ischar&e teachin& for Bell=s alsy rovi,e eye care at +e,time 5. Si&n of Scoliosis Asymmetry of the iliac crest 5!. Normal for a L ,ay ol, infant "escri+e normal tonic neck reflex 6". *anifestation of aranoi, Schiophrenia 1nappropriate anxiety with ,elusion 61. Si&n of Alcohol with,rawal Feelin& of euphoria in 8st 7> hrs< 62. Activity for Alheimer ,isease Rea,in& ma&aine 63. $ype 8 1""* post renal test >? hrs a&o5 watch out for: 'ematuria 64. !orrect un,erstan,in& of anti,epressant Anti-,epressant takes effect after 8 week 65. DUROGESIC PATCH ) FENTANYL For chronic pain lasts L ,ays *ay+e worn while +athin&5 showerin&5 swimmin& Apply to flat5 nonirritate,5 nonirra,iate, area like chest5 flank5 upper arm5 +ack ver,ose : ,ifficulty in +reathin& 66. Si&ns of increase 1! in pt< with close hea, inOury 1ncrease systolic pressure 0 weak +oun,in& pulse 67. ositive outcome for !alcium !hannel •
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+lockers "ecrease chest pain 6. +sessive !ompulsive Behavior $o alleviate anxiety 6!. atient with +ack pain5 proper +o,y mechanics Sit with knees hi&her than hips 7". hat to check prior a,ministration of %%$%N B S/% : 'N5 Seiures 71. 72. atient with pancreatitis if ,evelopin& ascites woul, manifest: !ullen=s Si&n (+luish ,iscoloration of a+,omen or peri-um+ilical hematoma $urner=s Si&n (&ray-+lue ,iscoloration of flank Shallow5 rapi, +reathin& A+,ominal pain "yspnea 0 ,ifficulty eatin& rthopnea 73. "i&italis @ )asix 2 ei&ht )oss 74. Si,e effect of 4aramycin totoxicity Nephrotoxic 'ypoma&nesimea *uscular paralysis 'ypersensitivity 75. Si,e %ffect of $heophylline $remors 0 tachycar,ia 1nsomnia 76. Ns&< *ana&ement for cleft palate infant %nlar&e, nipple for fee,in& Stimulate suckin& Swallow Rest Burp freMuently 77. atient with expressive aphasia5 +est communication: 6se picture lan&ua&e 7. "iet for patient with colostomy "A$ )ow resi,ue foo, 8-7 ,ays postopt Avoi, &as-formin& foo,s 7!. atient aller&ic to seu,oephe,rine5 hat is contrain,icate,Q atient takin& *a 'uan& ". atient with testicular cancer5 correct un,erstan,in&Q $esticular !A is painless 1. 8st intervention in prolapse, cor, ositionin& # knee chest/tren,elen+er& 2. 7n, Sta&e of la+or !ervical ,ilatation to ,elivery of +a+y 3. $hiai,e ,iuretic5 what to watch out forQ otassium 4. *anic pt< takin& lithium atch out for so,ium serum 5. "iet for patient with ileostomy ost opt > wks -- ) F1B%R non-irritant ,iet to ,ecrease fast movement of liMui, stool5 after can tolerate hi&h fi+er ,iet alrea,y Foo,s that thicken stool like +oile, rice5 low fat cheese shoul, +e &iven )ow fat ,iet Normal stool is liMui, 6. 4 0 " of a 7 y/o •
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!om+ines 7 wor,s icks a +all 3C wor, voca+ulary 7. A)S "ecrease, sensation of touch *uscle weakness %xcess &lutamate . S/S of awasaki "esMuamation of skin Goint pain *ucocutaneous lymph no,e syn,rome !. atch out for in lum+ar puncture 1ncrease, 1! Brain 'erniation !". S/S of ".$ %,ema !alf or &roin ten,erness ain with or w/o swellin& @ 'oman=s Si&n arm skin !1. "evelopmental *ilestone of 8C month ol, incer &rasp !2. Risk for +reast !A L? y/o female on oral contraceptive !3. Nee, to consi,er anti-coa&ulant therapy 1f takin& 4in&ko Bilo+a !4. !heck 8st +efore tonsillectomy Blee,in& time !5. !omplication of !AS$ !ompartment syn,rome Fat em+olism Shock Avascular necrosis !6. hat shoul, the nurse MuestionQ St< Gohn=s ort to a ki,ney transplant (!/1 to anti-neoplastic ,ru&s5 lessen effect !7. hysician or,ers +eta-+lockers5 for w/c pt< shoul, the nurse Muestion the or,er: atient on insulin (B-+lockers may mask si&ns of hypo&lycemia !. atient hypersensitivity 4ive macroli,es like erythromycin5aithromycin (enicillin 0 !ephalosporins the same !!. atient with autonomic ,ysreflexia oun,in& hea,ache 5 piloerection 1"". t< with carafate 0 antaci,s or,er5 select the sche,ule< !arafate 8 hr< +efore meals 0 antaci,s after meals 1"1. 1ncreasin& pulse pressure i,enin& pulse pressure (late si&n "ecrease, )!5 restlessness (%arly 1"2. t< with 'emophilia 0 )eukemia !an lea, to "1! 1"3. %ffective teachin& to "* patient eak of N' insulin ? hrs< 1"4. *& S> &iven to 1' pt< Nurse shoul, watch out forQ %pi&astric pain 0 hea,ache 1"5. t< with calcium oxalate stones "iet with fi& 0 wheat &erms 1"6. !ancer 0 Sepsis can lea, to "1! low platelet count 1"7. t< in la+or with cruste, popular • • •
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eruption5 priorityQ %ye prophylaxis of the new+orn 1". 'eroin a,,icte, mother in la+or5 nursin& actionQ Avoi, with,rawal in active sta&e 1"!. Si&ns of 'eroin intoxicationQ %uphoria "ecrease response to pain Respiratory ,epression Apathy 11". .enorofaxen 111. Scarlett Fever isolation precaution Respiratory precaution ,roplet until 7> hrs< start of treatment 112. )aryn&ectomy Avoi, swimmin&5 showerin&5 usin& aerosol sprays $each client clean suction techniMue 113. %xternal irra,iation therapy $ime 0 ,istance shiel,in& 114. t< with anorexia nervosa5 si&ns $achycar,ia 115. Brain inOury "ecorticate ri&i,ity 116. Si&ns of renal failure 6rine output less than 8CCml/hr 117. ost-thyroi,ectomy patient5 F $in&lin& sensation in the cheek (complication 11. .entricular Fi+rillation "o chest compression 11!. t< in crutches5 nurse shoul, check !heck armpits to see if there is pressure secon,ary to crutch (ressure shl, +e on the han,s not on the axilla 12". 1nfluena .accine in,icate, for: Anyone 3C y/o 0 a+ove annually A&e months 0 up with risk like asthma 1mmunocompromise, patients ts with car,iac 0 pulmonary ,isease 121. 'erpes Simplex 1 0 11 7 strains of herpes virus family 'S. 1 # col, +listers / fever +listers 'S. 11 # in S$" /4enital 'erpes/Shin&les 0 varicella oster infection same with chicken pox 122. A+ove the knee amputation5 patient shl, revent internal or external rotation of the lim+ lace san,+a& or rolle, towel alon& si,e of thi&h to prevent rotation 123. '1. suspect patient 'airy ton&ue an, leukoplakia ()eukoplakia5 pre-mali&nant lesion 124. ".$ on 'eparin therapeutic &oal Am+ulate ASA ( revent throm+us formation 125. %sopha&eal varices5 refer pt if !ol, clammy skin ( sx o f shock 126. re&nant LD weeks5 knows true la+or if !ontractions from +ack &oin& to a+,omen 127. Bipolar manic patients5 what to ,oQ •
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)imit &roup activities 12. *ultiple *yeloma5 care Force flui, from L - > )/,ay to offset hypercalcemia5 hyperurecemia %ncoura&e am+ulation to prevent renal stones 12!. ost pace maker transplant5 correct un,erstan,in& atient !AN 6S% electric +lankets5 cell phones HL watts5 microwave ovens5 metal ,etectors 13". atient takin& &arlic supplements shoul, take precaution when on aspirin therapy 131. "A patient5 what to a,minister 8stQ Start 1. line C
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E9%&/0 R0,-%:&0'; )eave markin&s on skin Avoi, use of creams5 lotions nly vitamin A0" 2ointment !heck for re,ness5 crackin& ear cotton clothin& A,minister antiemetics "o not pose any haar, to anyone I/%&/0 0,-0%-/ $&0&, $<=& K )ea, container an, lon&han,le, forceps in room K Save all ,ressin&s5 +e, linen until source remove, K 6rine an, feces not ra,ioactive K "on=t stan, close or in line with source K atient on +e, rest !ancer 1mplementation: 1nternal Ra,iation K $ime an, ,istance important K rivate room si&n on ,oor K Nurse wears ,osimeter at all times K )imit visitors an, time spent in room K Rotate staff K Self-care when can ,o I/%&/0 0,-0%-/ -D hours 14. )$B (!roup< !orrect un,erstan,in&< *other can +e in the tent with the chil, 14!. )iver cirrhosis< hat to assess +efore nasotracheal suctionin&Q latelet (risk for +lee,in& 15". A,verse effect of 3F6 (Fluoronacil Anta&onistic to iron # Anemia 151. $ransition phase of la+or "o short5 shallow (AN$ +reathin& 152. *other (-5 +a+y (@5 "irect !oom+=s test (- 4ive Rho&ram 153. )e&ionnaire=s ,isease $ype of pneumonia "roplet precaution Sx: Fever5 chills5 cou&h5 ataxia5 muscle aches5 "iarrhea *i,,le a&e 0 ol,er persons $reate, with anti+iotics 5 macroli,es 154. 'epatitis !5 Si&ns 0 sx Same with 'ep B< $ransmitte, parenterally !ommon to ,ru& users *aOor cause of post-transfusion hepatitis 6niversal recaution same with 'ep< B 155. Sx of Furosemi,e "ecrease, e,ema5 a+,ominal &irth5 B 0 calcium 1ncrease, urinary output 156. !olchicines $oxicity Anti-&out ,ru& Nausea 0 "iarrhea .omitin& • • • • • • •
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Sore &ums *etallic taste 157. $%NS5 how to explain proce,ure 6se for chronic nerve pain 6ses only electro,es P0-/&$$ Non-invasive5 passive mo,ality 15. PROBENECID $reat &out /hyperurecemia 1ncrease uric aci, removal in the urine 15!. *eanin& of ,eath to a 3 y/o *a&ical thinkin& "eath as temporary 16". *eanin& of ,eath to a J y/o "eath as punishment 161. *eanin& of ,eath to D y/o "eath as irreversi+le 162. "eath to an a,olescent 6niversal 163. 1nfant soun,s 8 # L months 2 !ooin& > - months 2 Ba++lin& -? months # interest in soun,s D -87 months 2 use of &estures 164. CEFTRIAXONE)ROCIPHEN *onitor ton&ue 0 oral cavity 165. %*4 Stop all !NS me,s 7>C prior proce,ure Skin prep on site $o +e stimulate, with nee,les 166. t with uncomplicate, cholelithiasis5 expect elevate,Q Alkaline hosphotase 167. !AN% !A) (cane opposite affecte, le& 16. 'ep A5 pre,isposin& factorQ From ,ay care centers 16!. atient with $esticular !A 6n,escen,e, testes 17". "iet teachin& for !eliac "isease (Srue 4luten free ,iet !/1 wheat/rye/oats/+arley 4ive corn5 rice5 soy+eans 0 potatoes 171. Aspirin 172. I$/-0>-, #INH( S/%: peripheral neuropathy (a,minister pyri,oxine Rash5 urticaria Swellin& of the face5 lips5 an, eyeli,s< 173. Rifampicin 'epatotoxic 174. $ria&e (%xternal$reat first the sta+le +efore the unsta+le< %mer&ent first +efore ur&ent< But kun& %
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!an eat lean meat No avoca,o5 milk5 +acon5 e&& yolks +utter So,ium restricte, No cheese 'i&h rou&ha&e5 hi&h fi+er No white +rea, without fi+er L R&$-,<& D-&% *inimie intestinal activity Buttere, rice white processe, foo, No whole wheat corn +ran H-: P%&-/ ,-&% Reesta+lish ana+olism to raise al+umin levels %&&5 roast +eef san,wich5 No Ounk foo, Renal eeps protein5 potassium an, so,ium low No +eans5 no cereals5 no citrus fruits L P:&/;00/-/& ,-&% revents +rain ,ama&e from im+alance of amino aci,s Fats5 fruits5 Oams allowe, No meats e&&s +rea, 17!. )um+ar puncture 1". )aminectomy 11. *yasthenia &ravis tosis 12. *ultiple sclerosis Fati&ue / Ataxia /.erti&o 13. !A 14. 1nfluena .accine5 !/1Q Aller&y to e&&s 15. Nephrotic syn,rome R$%1N6R1A # frothy urine 16. '%RBA) *%"S 17. A6$N*1! "TSR%F)%1A ! inOury 1. rimary5 team5 functional Ns&< 1!. !onsent an, A,vance "irectives 1!". 4las&ow coma scale 1!1. 4lomerulonephritis '%*A$6R1A cola/tea urine G@&</&':-%-$ A$$&$$@&/% K Fever5 !hills K 'ematuria K roteinuria K %,ema K 'ypertension K A+,ominal or flank pain K ccurs 8C ,ays after + eta hemolytic streptococcal throat infection 1mplementation K Anti+iotics5 corticosteroi,s K Antihypertensives5 immunosuppressive a&ents K Restrict so,ium an, water intake K Be,rest K 10 K "aily wei&ht K 'i&h !alorie5 )ow protein 1!2. %A F) *%$%R vs< *%$%R%" "% 1N'A)%R vs< 1N!%N$1.% S1R*%$%R 1!3. Rheumatoi, vs< steoporosis vs 4outy 1!4. B</ A$$&$$@&/%$ K Superficial partial thickness;pink to re,5 painful K "eep partial thickness;re, to white5 +listers5 painful K Full thickness;charre,5 waxy5 white5 •
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painless < "islo,&e, Apply tente, ,ressin& $u+e +ecomes ,isconnecte, from ,raina&e system5 cut off contaminate, tip5 insert sterile connector an, reinsert $u+e +ecomes ,isconnecte, from ,raina&e system5 immerse in 7cm of water Gackson-ratt: Notify physician if ,raina&e increases or +ecomes +ri&ht re, enrose: %xpect ,raina&e on ,ressin& 1!6. C0%00=% A$$&$$@&/%$ "istorte,5 +lurre, vision *ilky white pupil !ataracts ostop: check for hemorrha&e !heck pupil;constricte, with lens implante,5 ,ilate, without lens %ye ,rops / Ni&ht shiel, Sleep on unaffecte, si,e 1!7. G0<=@0 A+normal increase in intraocular pressure that lea,s to +lin,ness Blurre, vision )i&hts with halos "ecrease, peripheral vision ain 'ea,ache 4laucoma A,minister miotics (constrict pupil !ar+onic anhy,rase inhi+itors Sur&ery Avoi, heavy liftin&5 strainin& of stool *y,riatics !/1 with &laucoma< 1!. D&%0=:&, R&%-/0 Flashes of li&ht • • • •
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)oss of vision articles movin& in line of vision confusion a 1mplementations Be,rest5 affecte, eye in ,epen,ent position %ye patche, (one or +oth Sur&ery Se,atives an, tranMuiliers Avoi, stoopin&5 strainin& at stool5 strenuous activity 1!!. FLORINEF (flu,rocortisones acetate For A,,ison=s "isease 4iven A* with meals5 causes 6" !auses !ushin&-like syn,rome 2"". $raction B<=+$ T0=%-/ 6se to relieve muscle spasm of le& an, +ack 1f use, for muscles spasms only5 they can turn to either si,e< 1f use, for fracture treatment5 only can turn to unaffecte, si,e< 6se ?-7C l+s of wei&ht5 if use, for scoliosis will use >C l+s of wei&ht< %levate hea, of +e, for counter traction or foot +e, lace pillow +elow le& not un,er heel or +ehin, knee< R<$$&+$ T0=%-/ Slin& is use, !heck for popliteal pulse lace pillow +elow lower le& an, heel off the +e, "on=t turn from waist ,own )ift patient5 not the le& C&8-=0 T/$ Never lift the wei&hts No pillow un,er hea, ,urin& fee,in&s B00/=&, S<$'&/$-/ T0=%-/ For femur reali&nment *aintain wei&hts han&in& free an, not on floor *aintain continuous pull H0 *0=&% *aintain pin cleansin& 2"1. F0=%<&, H-' A$$&$$@&/%$ )e& shortene, A,,ucte, %xternally rotate, !are after a total hip replacement K A+,uction pillows K !rutch walkin& with L-point &ait K "on=t sleep on operate, si,e K "on=t flex hip more than >3-C ,e&rees K "on=t elevate hea, of the +e, more than >3 ,e&rees 2"2. IV SIDE EFFECTS !han&e tu+in& PJ7 hours !han&e +ottle P7> hours I/-%0%-/ K Assessment: cool skin5 swellin&5 pain5 ,ecrease in flow rate K 1mplementation: ,iscontinue 1.5 warm compresses5 elevate arm5 start new site proximal to infiltrate, site IV P:&-%-$ T:@':&-%-$ K Assessment;re,ness5 warm5 ten,er5 swellin&5 leukocytosis K 1mplementation;,iscontinue 1.5 • •
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warm moist compresses5 start 1. in opposite extremity H&@0%@0 K Assessment;ecchymosis5 swellin&5 leaka&e of +loo, K 1mplementation;,iscontinue 1.5 apply pressure5 ice +a& 7> hours5 restart 1. in opposite extremity IV C%%-/ K Assessment;,ecrease, flow rate5 +ack flow of +loo, into tu+in& K 1mplementation;,iscontinue5 ,o not irri&ate5 ,o not milk5 ,o not increase rate of flow or han& solution hi&her5 ,o not aspirate cannula5 inOect 6rokinase5 "/! an, start on other site< 2"3. )un& Soun,s 2"4. Shock 2"5. NR*A) A41N4 R!%SS 2"6. L&8-/ 8$. S0&@ 8$. S&/$%0&/ %<& N0$0$%-= T<&$ K )evin-sin≤sin&le-lumen5 use, for ,ecompression or tu+e fee,in& K Salem sump;,ou+le-lumen5 use, for ,ecompression or tu+e fee,in& K Sen&staken-Blakemore;triple-lumen5 use, for +lee,in& esopha&eal varices K )inton-Nachlas;>-lumen5 use, for +lee,in& esopha&eal varices K eofee,/"o+hoff;soft silicone5 use, for lon&-term fee,in&s K !antor;sin&le lumen with mercuryfille, +alloon an, suction port K *iller-A++ott;,ou+le-lumen with mercury-fille, +alloon an, suction port K 'arris;sin&le lumen with mercuryfille, +alloon an, suction port NG %<& '0=&@&/%: 9B%S$ AT to check is to aspirate for &astric contents an, check for p' of aspirate H> I@'&@&/%0%-/ &&,-/ K !heck resi,ual +efore intermittent fee,in&5 reinstall resi,ual K !heck resi,ual P> hours with continuous fee,in&5 reinstall resi,ual K 'ol, fee,in& if 3C resi,ual from previous hour (a,ults or 73 (chil,ren K Flush tu+e with water +efore an, after fee,in& K 6se pump to control rate of tu+e fee,in& K A,minister flui, at room temperature K !han&e +a& P? hours for continuous fee,in& K %levate hea, of +e, while fee,in& is runnin& K !heck patency P> hours K 4oo, mouth care NG I-0%-/ T<-/: K .erify placement of tu+e K 1nsert LC-3C cc of normal saline into tu+e K 1f feel resistance5 chan&e patient position5 check for kinks K ith,raw solution or recor, amount as input NG &@80: K !lamp tu+e K Remove tape K 1nstruct patient to exhale
K Remove tu+e with smooth5 continuous pull I/%&$%-/0 T<&$ #C0/% M-A%% H0-$ o After tu+e is in stomach5 have patient lie on ri&ht si,e5 then +ack in Fowler=s position5 then left si,e o 4ravity helps to position tu+e o !oil excess tu+e loosely on +e,5 ,o not tape o osition of tu+e verifie, +y x-ray o *easure ,raina&e PShift K Removal o !lamp tu+e o Remove tape o "eflate +alloon or aspirate contents of intestinal tu+e +alloon o 1nstruct patient to exhale o Remove every 8C min< until reaches the stomach5 then remove completely with smooth5 continuous pull TT<&: 3CC-8CCC cc/,ay5 +loo,y first 7 hours P&/$&: expect ,raina&e on ,ressin& 2"7. 1mmuniations 2". PHEOCHROMOCYTOMA K ersistent hypertension K 'yper&lycemia K oun,in& hea,ache K alpitations K .isual ,istur+ances K 'istamine $est5 Re&itine $est5 7>hour urine .*A test K Avoi, emotional an, physical stress K %ncoura&e rest K Avoi, coffee an, stimulatin& foo,s K ostop care after a,renalectomy 2"!. !hron=s "isease Fever5 cramp-like colicky pain after meals A+,ominal ,istention "iarrhea (semi-soli, Anorexia5 N 0 . 21". 1'5 A4AR 211. %.1S$A 212. SA A)*%$$ 213. !1A)1S 214. SAN"1**6N%5 215. !%)%S$N% 216. NS$5 !S$5 !)NS!T5 AR$%R14RA'T5 217. !R5 !AR"1.%RS1N D&--0%-/ K Start !R first K 8st attempt # 7CC Ooules K 7n, attempt # 7CC to LCC Ooules K Lr, attempt # LC Ooules K !heck monitor +etween shocks for rhythm C0,-8&$-/ K %lective proce,ure5 1nforme, !onsent K .alium 1. K Synchronier on K 73-LC Ooules K !heck monitor +etween rhythm CPR Shake5 shout5 summon help5 open airway5 look5 listen5 feel for si&ns of +reathin&5 pinch nose5 &ive 7 full +reaths (if no rise5 reposition A,ults 87/min check caroti,5 chest compressions ?C-8CC/min 8<3 inches 1nfants 7C/min check +rachial pulse5 chest compression •
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8CC/min U - 8 inch 13:7 A,ult > cycles 1nfant 7C cycles Reassess pulse an, +reathin& !ontinue !R until: K .ictim respon,s K Someone else takes over K .ictim is transferre, K Rescuer is una+le to continue 21. POSITIONING T:&0'&<%-= P$-%-/$ Supine;avoi,s hip flexion "orsal recum+ent;supine with knees flexe, rone;extension of hip Ooint(after amputation Si,e lateral;,raina&e of oral secretions nee-chest;visualiation of rectal area Sim=s;,ecreases a+,ominal tension (si,e lyin& with le&s +ent Fowler=s;increases venous return5 lun& expansion 'i&h Fowler=s;C-DC Fowler=s;>3-C Semi-Fowler=s;LC->3 )ow Fowler=s;83-LC *o,ifie, $ren,elen+ur&;use, for shockV Feet elevate, 7C ,e&rees5 knees strai&ht5 trunk flat5 hea, sli&htly elevate, %levation of extremity;increases +loo, to extremity an, venous return )ithotomy;use, for va&inal exam 21!. !ushin& what will you expectQ a< Na of 8>7 +< ph J<>8 c< of L <8 22". ff statements is correct for malpracticeQ a< a nurse &ivin& !ele+rex to an RA pt who has an aller&y to aspirin +< a nurse tellin& the pt not to take afirlukast ,urin& an asthma attack ( !/1 "6R1N4 AS$'*A A$$A! 6S% AS R'T)A1S FR 0 $ FR !'RN1! BRN!'1A) AS$'*A 221. "iet for A,,ison=sQ a< hi&h calcium 222. A pt with pneumonia will &o to ra,iolo&y for x-rayQ pt will wear a sur&ical mask while travelin& in the hallway< 223. a pt with pneumonia safety precautionQ wear mask while +athin& the pt< 224. seale, ra,iation what will +e the safety to the nurseQ a< limit exposure for LCmins close contact to pt ,urin& shift +< &ivin& the ra,iation +an,a&e/+an, to the nurse for the next shift 225. )ipitor what will +e the concernQ a< muscle weakness/pain # +< a,verse effect: myal&ia 0 rha+,omyositis 226. Break confi,entialityQ nurses talkin& in the hallway 227. 4astrochisisQ put soake, &aue with nss to a+,omen 22. !lostri,ium ,eficilleQ private rm 22!. suctionin& pt nee,s further teachin&Q my wife have shortness of +reath ,urin& my suctionin&< 23". sickle cell crisis what is your •
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concernQ i still have Ooint pain even thou&h im takin& anal&esic ,aily 231. ,yspha&ia pt how to fee,Q put hea, of +e, to C,e&rees +efore fee,in& 232. total knee replacement imm,tly post op what is the correct statementQ ill put an a+,uction pillow 233. $apaoleQ with meals 234. a 7?yrs ol, pt L3wks pre&nant is havin& internal +lee,in& was rushe, to %"5 what ,oes the nurse ,o firstQ fhr external monitorin& 235. a pt takin& captopril what will check or concernQ im havin& cou&h at ni&ht 236. Gewish ortho,ox ,ea,Q ,ont leave +o,y alone5 shoul, +e with relatives 237. Re&lanQ take LCmins +efore meals 23. *aoi- !/1Q chicken +ullion an, cheese 23!. what foo, to &ive to a chil,Q !rackers 24". foo, rich in !aQ +roccoli 241. fracture of arm what positionQ place pillow un,er arm 242. pt is constipate, what health teachin&Q increase intake of fruits an, ve&&ies 243. Arca+ose is &iven to px health txQ helps pancreas to release insulin 244. px with myasthenia &ravis what will you monitorQ k 245. L month ol, +a+y< parents plan to +uy/purchase an electronic ,oor that sin&s open when there is wei&ht< what is the health txQ ,elay purchase of electronic ,evice 246. pt takin& nar,il has stoppe, takin& the ,ru& for 3 ,ays an, +e&an takin& chocolate an, cheese+ur&er< he su,,enly feels severe hea,ache an, &oes to er< pt is reactin& to the foo, recently takin& 247. sickle cell crisis a,vice to &ive to teena&erQ lessen physical activity S-=& C& A/&@-0 K ain /Swellin&/Fever K Sclera Oaun,ice, K !ar,iac murmurs / $achycar,ia K !heck for si&ns of infection (prevent crisis K !heck Ooint areas for pain an, swellin& K %ncoura&e flui,s K rovi,e anal&esics with !A pump c crisis 24. how are you &oin& to irri&ate ileostomyQ with nss 24!. px takin& iron supplement5 what statement +y px shl, you +e cautione,Q will crush the ta+let +efore i ,rink it •
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25". osition after liver +iopsyQ si,elyin& on rt si,e with pillow un,er ri&ht si,e of ri+s 251. LYME+S DISEASE *ulti-system infection cause, +y a tick +ite< $here are three sta&es< S%0& 1 %rythematous papule ,evelops into lesion with clear center (Bull=s-eye Re&ional lympha,enopathy Flu-like symptoms (fever5 hea,ache5 conOunctivitis !an ,evelop over 8 to several months S%0& 2 "evelop after 8 to months if ,isease untreate,< !ar,iac con,uction ,efects Neurolo&ic ,isor,ers (Bell=s palsy5 temporary paralysis S%0& 3 "evelops after 8 to several months5 if reache, at this sta&e may persist for several years< Arthral&ias %nlar&e,5 inflame, Ooints T&0=:-/ !over expose, areas when in woo,e, areas !heck expose, areas for presence of ticks Anti+iotics L-> weeks Sta&e 8 use "oxicillin 1. penicillin with later sta&es 252. 'untin&tonEs ,se 253. steoporosis 254. NS$ 255. %arly ,eceleration 256. .anillylman,elic aci, 8< use, to ,ia&nose pheochromocytoma which is a tumor in the a,renal &lan,< 7>-hour urine collection< Save all the urine in 7> hours<< 257. hich is the wron& statement in A,,ison=s ,iseaseQ A,minister potassium< 25. Stress mana&ement-- 1nstruct the patient to ima&ine that he is in the +each-- this is correct< this is &ui,e, ima&ery wherein the patient ima&ines or fantasies to re,uce stress< pls< 25!. *ultiple sclerosis-- low +e, position-- think safety 26". 'erpes oster/shin&les will the pt experience acute painQ T%S 261. hat is the purpose of swimmin& in arthritisQ 262. *ycoplasma pneumonia-- what precautionQ "R)%$ 263. 'ow many ml is 8/7 +ananaQ 264. $amoxifen- inhi+it estro&en pro,uction 265. $otal thyroi,ectomy ,/c teachin&Q *onitor pulse rate an, temp 266. Lr, ,e&ree +urn 267. "i&oxin @Puini,ineQ 26. 1""* a,vice lifestyle chan&eQ a< Avoi, strenuous ex +< 1ncrease insulin ,ose if involve, to sports 26!. which amon& the ff psych me,s is •
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incorrect statementQ hite wine is not ok with maoi5 re, wine is ok 27". %arliest si&n of ma&nesium sulfate toxicity 271. Receptive aphasiaQ icture +oar, 272. S%RP6%)Q 273. 1nternal ,isaster ,rillQ 274. external ,isaster ,rill 275. what is normal for a 7 ,ays ol, +a+yQ 276. enhance effect of !ouma,in 277. Schio pt- lala+asQ ear lon& sleeves 27. "o not take &arlic if you are receivin& aspirin< 1t increases the antiplatelet effectW 27!. Rattle snake +ite 2". !ar safety in chil,ren less than 7C l+s< 21. )AS1 S14NS $'A$ 1$ 1S R1N4 2 "%!R%AS% %R1'%RA) %"%*A5 22. $ 1$' 4)*%N)%'R1$1S 6R1N% R%S6)$ B)" 23. D-0/%-/ ,etoxifie, +y liver< 24. $he nurse cares for a client receivin& 1. anti+iotics every ? hours for the past > ,ays< $he anti+iotic is mixe, in "3< $he nurse ,etermines that a post-infusion phle+itis has occurre, if which of the followin& is o+serve,Q < re,,ene,5 warm area note, aroun, insertion site or on path of veinV ,iscontinue 1.5 apply warm5 moist compresses5 restart 1. at new site 25. 'ow lon& shoul, a client with tu+erculosis +e on me,icationQ -D *onths 26. hat are symptoms of hepatitisQ 1nflammation of )iver Gaun,ice Anorexia R6P pain !lay-colore, stools5 tea-colore, urine ruritis (+ile salts eliminate, throu&h skin %levate, A)$5 AS$ rolon&e, $ (liver involvement with clottin& factor 27. hat is the transmission of 'epatitis AQ Fecal/ral !onsume contaminate, foo, or water $ravelers to ,evelopin& countries at risk !lients with hepatitis A shoul, not prepare foo, for others 2. hat is the transmission of 'epatitis BQ arenteral/Sexual contact Bloo, or +o,y flui,s At risk in,ivi,uals are the one=s that a+use 1. ,ru&s5 ,ialysis5 healthcare workers .accine ,evelope, 2!. hat is the transmission of 'epatitis !Q Bloo, or +o,y flui,s !an +ecome chronic ,isease 2!". Seen in patients with hemophilia •
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(una+le to clot 2!1. hat is the transmission of "elta 'epatitisQ !o-infects with hepatitis B 2!2. here to put > y/o chil, in a car Booster seat 2!3. $o,,ler layin& si,e +y si,e w/o sharin& pf toys 2!4. )antus un,erstan,in& 1 will avoi, $! with chromium 2!5. hat nursin& care are recommen,e, for 'epatitisQ Rest (mainly for liver !ontact an, stan,ar, precautions )ow-fat5 'i&h-!alorie5 an, 'i&h rotein ,iet (nee,e, for or&an healin& No alcoholic +evera&es *e,ications (.itamin 5 AMua*ephyton for +lee,in& pro+lems5 Antiemetic # no compaine5 use $i&an or ("ramamine< !orticosteroi,s to ,ecrease inflammatory response5 an, antihistamines5 will use lotions or +aths than systemic ones< 2!6. 1ntermiettent clau,ication intervention )ower the le&s 2!7. Femoral fracture5 in,icate complication etechiae 2!. Sickle cell crisis 1ncrease, reticulocyte count 2!!. *ultiple Sclerosis Baclofen 3"". ost-arthroscopy5 notify m, ainful knee 3"1. steoporosis history takin& at risk $akin& wine or +eer 3"2. ilm=s $umor Flank pain 3"3. Fosamax LC minutes +efore meals 3"4. !otrimoxaole Tellow sclera 3"5. $e&retol ith meals 3"6. !olchicine ith meals 3"7. .alium *onitor liver function 3". Antivert 8 hour +efore travel 3"!. *annitol5 effectiveQ 1ncrease awareness 31". rinase LC minutes +efore meals 311. "ia+eta (4lipii,e LC minutes +efore meals 312. *etformin '!) $ake with foo, to ,ecrease 41 upset 313. 4antrisin "rink 7-L ) for the whole ,ay 314. Amaryl (4limiperi,e ith or w/o +reakfast 315. Start to assess ra,ial pulse 7 y/o 316. "ischar&e teachin& for postcholecystectomy client< Reportin& of complication (pale stool 0 ,ark urine •
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317. "ia&nostic test for Renal Failure *onitor B6N5 !reatinine5 electrolyte *onitor for aci,osis 31. !omplications of $6R Sterility may or may not occur Blee,in& is normal5 moniot for hemorrha&e Bla,,er spasms common postopt5 ant-spasmo,ics are prescri+e, 31!. "ru& therapy for Rheumatoi, Arthritis Salicylates 4ol, salts IV. DRUGS E%:0=;/-= A=-, #E,&=-/;are consi,ere, loop ,iuretics an, are potassium wastin&V encoura&e client to increase intake of potassium-rich foo,s< ran&e Guice/Bananas5 etc< A@-/':;-/& #T<':;-/&;is a xanthine +roncho,ilatorV maOor si,e effects: palpitations5 nervousness5 rapi, pulse5 ,ysrhythmias5 nausea5 an, vomitin&< $oxic effects: confusion5 hea,ache5 flushin&5 tachycar,ia5 an, seiure< M':-/& S<0%&;,ecreases +loo, return to the ri&ht si,e of the heart5 an, ,ecrease peripheral resistance< 1n other wor,s5 ,ecreases preloa, an, afterloa, pressures an, car,iac workloa,V causes vaso,ilation an, poolin& of flui, in extremitiesV provi,es relief from anxiety< Antihistamine an, chemotactic receptor I/%'-/ #D'0@-/&;vasoactive me,ication are &iven 1. to restore B in hypotensive statesV 1ncreases +loo, return to the ri&ht si,e of the heart5 an, increase peripheral resistanceV S/%: hea,ache5 severe hypertension5 ,ysrhythmiasV check B M7 minutes until sta+ilie,5 then M3 minutes TPN;han& no lon&er than 7> hoursV 1. tu+in& an, filters every 7> hoursV site of catheter chan&e, every > weeks< F<9&%-/& #P>0=;a selective serotonin reuptake inhi+itor (SSR1 use, to treat ,epression an, o+sessive compulsive ,isor,er< S/%: postural hypotension5 ,ry mouth5 rapi, heart+eat5 anorexia5 wei&ht loss5 severe hea,ache< 1f ,ose is misse,5 omit ,ose 0 instruct client to return to re&ular ,osin& sche,ule< P'0/ #-/,&0;a +eta-a,rener&ic +locker use, as antihypertensiveV S/%: +ronchospasm5 +ra,ycar,ia5 ,epression< $ake pulse +efore a,ministration 0 &ra,ually ,ecrease when ,iscontinuin&< "o not &ive to asthmatic pts G-'->-,& #G<=%;an oral hypo&lycemic that ,ecreases +loo, su&ar +y stimulatin& insulin release from the +eta cells of the pancreasV may cause aplastic anemia an, photosensitivity< P&,/-$/& #D&%0$/&;a corticosteroi,< Si,e effects: hyper&lycemia B&%:0/&=: #U&=:-/&;a choliner&ic or parasympathomimetic use, to treat functional urinary retentionV mimics action of acetylcholine< V&/%-=<0 T0=:;=0,-0;causes chest pain5 ,iiness5 an, faintin&< • •
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8 &rain 2 Cm& L&8%:;9-/& #S;/%:-, ;thyroi, preparation shoul, +e a,ministere, at +reakfast to prevent insomnia< C00@0>&'-/& #T&&%( ;interferes with action of hormonal contraceptives< Si,e effects: photosensitivity< A<@-/<@ H;,9-,& #A@':& ;an antaci,V neutralies hy,rochloric aci, an, re,uces pepsin activityV take one hour +efore an, hour of sleep< Antaci,s most effective after ,i&estion has starte,5 +ut prior to the emptyin& of the stomach< I$/-0>-, #INH(;S/%: peripheral neuropathy (a,minister pyri,oxine5 rash5 urticaria 0 swellin& of the face5 lips5 an, eyeli,s< P;-,9-/& #V-%0@-/ B6 B&&$-9 D9-/&;reMuire, for amino aci,5 car+ohy,rate 0 lipi, meta+olism< 6se, in the transport of amino aci,s5 formation of neurotransmitters 0 sythesis of heme< revention of neuropathy< C00@0>&'-/& #T&&%;prevention of seiures 0 relief of pain i n tri&eminal neural&ia< $ri&eminal neural&ia is an a&oniin& pain result in severe ,epression 0 suici,e< C/-,-/& #C0%0'&$TTS;is a centrally actin& alpha-a,rener&ic use, to treat 'N S/%: ,rowsiness5 se,ation5 orthostatic hypotension5 heart failure< 1f patch use, +e cautious aroun, microwaves results in +urns5 heat will increase me,ication a+sorption lea,in& to toxicity< P:&-%-$;ten,erness5 re,nessV remove iv5 apply warm soaks to ,ecrease inflammation5 swellin&5 an, ,iscomfort< A<%<$ ,;may &ive +loo, 3 weeks +efore sur&eryV can &ive 7 to > units of +loo,V may have to take iron pills C0-,'0)L&8,'0 #S-/&@&%;use, to treat symptoms of arkinson=s ,isease< $ake imme,iately +efore meals an, hi&hprotein meals may impair effectiveness of me,ication< Re,uces ri&i,ity an, +ra,ykinesis 0 facilitates client=s mo+ility< D9;=;=-/& #V-0@;=-/;a tetracycline that is taken at re&ular intervals +ut not within 8 hour of +e,time +ecause it may cause esopha&eal irritation< 6se another metho, of +irth control5 ,o not take antaci,s within 8-L hours of takin& me,ication5 an, may cause photosensitivity< A<%& #P8&/%-;a +roncho,ilator< Si,e effects: tremors5 hea,ache5 hyperactivity5 tachycar,ia< 6se first +efore steroi, me,ication so opens up +ronchioles for steroi, to &et in< ait one minute +etween puffs of the inhalers for +est effect< B&=@&%:0$/& #V0/=&-;a steroi, me,ication< S/%: fun&al infections5 ,ry mouth5 throat5infections< I/$<-/ ;N' nset: 8<3 hours eak: >-87 hours Re&ular nset: C<3 hours eak: 7<3-3 hours T'-0@0%& #T'0@09(is an anticonvulsant< Shoul, ,rink 7CCC-LCCCml of flui, ,aily to prevent ki,ney stones< Si,e effects: orthostatic hypotension5 ocular symptoms5 +lin,ness5 an, ,ecrease effects of hormonal contraceptives<
P'0/ #I/,&0;a +eta-+locker that takes up +eta-a,rener&ic receptor sites5 which prevents a,renaline from causin& symptoms an, &lyco&enolysis< 1n,eral may mask symptoms of 'ypo&lycemia5 removin& the +o,y=s early warnin& system< P:&/0>';-,-/& #P;-,-<@;acts on urinary tract mucosa to pro,uce anal&esic or local anesthetic effects< Si,e effects: +ri&ht oran&e urine5 yellowish ,iscoloration of skin or sclera in,icates ,ru& accumulation ,ue to renal impairment< T-@&%:'-@$<0@&%:90>& #B0=%-@(;most common si,e effect mil, to mo,erate rash (urticaria Amino&lycosi,es are ototoxic< B<%':0/ T0%0%& #S%0,;anal&esic use, for mo,erate to severe painV Si,e effects inclu,e chan&e in B5 +ra,ycar,ia5 respiratory ,epression< I/0/% /@0 &$%-/ :&0% 0%&: 87C-8>C Salt su+stitutes contain potassium hen ,irectin& a 6A5 the nurse must communicate clearly a+out each ,ele&ate, task with specific instructions on what must +e reporte,< Because the RN is responsi+le for all care-relate, ,ecisions5 only implementation tasks shoul, +e assi&ne, +ecause they ,o not reMuire in,epen,ent Ou,&ment< hen applyin& the nursin& process5 assessment is the first step in provi,in& care< $he 3 XsX of vascular impairment can +e use, as a &ui,e (pain5 pulse5 pallor5 paresthesia5 paralysis Rash an, +loo, ,yscrasias are si,e effects of anti-psychotic ,ru&s< A history of severe ,epression is a contrain,ication to the use of neuroleptics< $he nurse instructs the client takin& ,examethasone ("eca,ron to take it with foo, or milk +ecause "eca,ron increases the pro,uction of hy,rochloric aci,5 which may cause &astrointestinal ulcers< $he protest phase of separation anxiety is a normal response for a chil, this a&e (7 yearol, hospitalie, chil,< 1n to,,lers5 a&es 8 to L5 separation anxiety is at its peak S-/$ %0,-8& ,;$-/&$-0 inclu,e smackin& lips5 &rin,in& of teeth an, Xfly catchin&X ton&ue movements< V&0'0@- B&%;-<@ 0/, A@-,0/& increases serum ,i& levels5 possi+ly causin& "i&italis $oxicity S-/$)S;@'%@$ D--%0 T9-=-%;: f8st sx inclu,e a+,ominal pain5 anorexia5 nausea5 vomitin&5 visual ,istur+ances5 +ra,ycar,ia5 an, other arrhythmias< 1n infants an, small chil,ren5 the 8st sx of over,ose are usually car,iac arrhythmias< L&%S-,& CHF K "yspnea5 orthopnea K !ou&h K ulmonary e,ema K eakness/!han&es in mental status Ri&ht-Si,e !'F K "epen,ent e,ema K )iver enlar&ement K A+,ominal pain/Nausea/Bloatin& K !oolness of extremities CHF I@'&@&/%0%-/$ K A,minister ,i&oxin5 ,iuretics
K )ow-so,ium5 low-calorie5 low-resi,ue ,iet K xy&en therapy K "aily wei&ht K $each a+out me,ications an, ,iet 'er+s: $oxicities an, "ru& 1nteractions 8< C:0@@-& 6ses: !hamomile is often use, in the form of a tea as a se,ative< Reactions: Aller&ic reactions can occur5 particularly in persons aller&ic to ra&wee,< Reporte, reactions inclu,e a+,ominal cramps5 ton&ue thickness5 ti&htness in the throat5 swellin& of the lips5 throat an, eyes5 itchin& all over the +o,y5 hives5 an, +locka&e of the +reathin& passa&es< !lose monitorin& is recommen,e, for patients who are takin& me,ications to prevent +loo, clottin& (anticoa&ulants such as warfarin< 2. E=:-/0=&0 6ses: )ar&ely +ecause white +loo, cells in the la+oratory can +e stimulate, to eat particles5 %chinacea has +een toute, to +e a+le to +oost the +o,yEs a+ility to fi&ht off infection< S/% : unpleasant tastel5 liver toxicity< !/1: ketaconaole5 leflunomi,e (Arava5 methotrexate (Rheumatrex5 isoniai,e (Nioral< 3. S%. *:/$ % 6ses: ,epression5 anxiety5 an, sleep ,isor,ers< 1t is technically known as 'ypericum perforatum< S/%: sun sensitivity which causes +urnin& of the skin< )eave nerve chan&es in sun+urne, areas< !/1: tetracycline/Achromycin5 sulfa- containin& me,ications5 piroxicam (Fel,en,< S/%: hea,aches5 ,iiness5 sweatin&5 an, a&itation when use, in com+ination with serotonin reuptake inhi+itor me,ications such as fluoxetine (roac an, paroxetine (axil< >< G0-= 6ses: lower +loo, pressure an, cholesterol S/%: Aller&ic reactions5 skin inflammation5 an, stomach upset 5 Ba, +reath < ,ecrease normal +loo, clottin& an, shoul, +e use, with caution in patients takin& me,ications to prevent +loo, clottin& (anticoa&ulants such as warfarin /!ouma,in< 3< F&8&& 6ses: *ost commonly use, for mi&raine hea,aches< Reactions: Feverfew can cause aller&ic reactions5 especially in persons who are aller&ic to chamomile5 ra&wee,5 or yarrow< Nonsteroi,al antiinflammatory ,ru&s (NSA1"s such as i+uprofen (A,vil5 naproxen (Aleve or *otrin can re,uce the effect of feverfew<
A con,ition calle, Xpostfeverfew syn,romeX features symptoms inclu,in& hea,aches5 nervousness5 stiffness5 Ooint pain5 tire,ness5 an, nervousness< Feverfew can impair the action of the normal +loo, clottin& element (platelets< 1t shoul, +e avoi,e, in patients takin& me,ications to prevent +loo, clottin& (anticoa&ulants such as warfarin (!ouma,in< 4inko Bilo+a 6ses: $his her+ is very popular as a treatment for ,ementia (a pro&ressive +rain ,ysfunction an, to improve thinkin&< Reactions: *il, stomach upset an, hea,ache have +een reporte,< 4inko seems to have +loo, thinnin& properties< $herefore5 it is not recommen,e, to +e taken with aspirin5 nonsteroi,al antiinflammatory ,ru&s (A,vil5 naproxen (Aleve or *otrin5 or me,ications to prevent +loo, clottin& (anticoa&ulants such as warfarin (!ouma,in< 4inko shoul, +e avoi,e, in patients with epilepsy takin& seiure me,icines5 such as phenytoin ("ilantin5 car+amaepine ($e&retol5 an, pheno+ar+ital< 4insen& 6ses: 4insen& has +een use, to stimulate the a,renal &lan,5 an, there+y in crease ener&y< 1t also may have some +eneficial effect on re,ucin& +loo, su&ar
psychosis< 4in&er 6ses: 4in&er has +een use, as a treatment for nausea an, +owel spasms< Reactions: 4in&er may lea, to +loo, thinnin&< 1t is not recommen,e, to +e taken with me,ications that prevent +loo, clottin& (anticoa&ulants such as warfarin (!ouma,in< Saw almetto 6ses: Saw palmetto has +een most commonly use, for enlar&ement of the prostate &lan,< Saw palmetto has also +een toute, as a ,iuretic an, urinary antiseptic to prevent +la,,er infections< Reactions: $his her+ may affect the action of the sex hormone testosterone5 there+y re,ucin& sexual ,rive or performance< "r< *iller states that Xhile no ,ru&-her+ interactions have +een ,ocumente, to ,ate5 it woul, +e pru,ent to avoi, concomitant use with other hormonal therapies (e<&<5 estro&en replacement therapy an, oral contraceptives<<
