NCLEX-PN

DO NOT delegate what you can EAT!

E-evaluate

A-assess

T-teach

Addisons

down, down, down, up, down

Cushings

up, up, up, down, up

Addisons

hyponatremia, hypotension, decreased blood vol, hyperkalemia, hypoglycemia

Cushings

hypernatremia, hypertension, increased blood vol, hypokalemia, hyperglycemia

No Pee

No K

do not give POTASSIUM without adequate urine output

APGAR

A=appearance (color all pinks, pink and blue, blue (pale)

P= pulse (>100,

AIRBORNE

MY-Measles

Chicken-Chicken Pox/Varicella

Hez=Herpez Zoster/Shingles

TB

or remember . . .

MTV=Airborne

Measles

TB

Varicella-Chicken Pox/Herpes Zoster-Shingles

*Private Room-negative pressure with 6-12 air exchanges/hr mask, N95 for TB

DROPLET

think of SPIDERMAN

S-sepsis

S-scarlet fever

S-streptococcal pharyngitis

P-parvovirus B19

P=pneumonia

P-pertussis

I-influenza

D-diptheria (pharyngeal)

E=epiglottitis

R-rubella

M-mumps

M-meningitis

M-mycoplasma

An-adenovirus

*Private Room or cohort*

*Mask*

CONTACT PRECAUTION

Mrs. Wee

M-multidrug resistant organism

R-respiratory infection

S-skin infections

W-wound infxn

E-enteric infxn - clostridum difficile

E- eye infxn - conjunctivitis

SKIN INFECTIONS

VCHIPS

V-varicella zoster

C-cutaneous diptheria

H-herpez simplex

I-impetigo

P-pediculosis

S-scabies

Air/Pulmonary Embolism

S&S;chest pain, difficulty breathing, tachycardia, pale/cyanotic, sense of impending doom

turn patient to left side and lower the head of the bed

Woman in Labor w/un-reassuring FHR

late decels, decreased variability, fetal bradycardia, etc.

turn patient to the left side (and give O2, stop pitocin, increase IV fluids

Tube feeding w/decreased LOC

position patient on the right side (promote emptying of the stomach) with HOB elevated (to prevent aspiration)

During Epidural Puncture

side lying

After Lumbar Puncture

and also oil myelogram . . .patient lies flat supine (to prevent headache and leaking of CSF)

patient with heat stroke

lie flat w/legs elevated

during continuous bladder irrigation (CBI)

catheter is taped to thigh so leg should be straight. no other position restrictions

after myringotomy

position on side of affected ear after surgery (allow for drainage of secretions)

after cataract surgery

patient will sleep on unaffected side with night shield for 1-4 weeks

after thyroidectomy

low or semi fowlers, support head, neck and shoulders

infant with spina bifida

position prone (on abdomen) so that sac doesn't rupture

bucks traction (skin traction)

elevate foot of bed for counter-traction

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 seperating thighs with pillows

prolapsed cord

knee chest position or trendelenburg

infant with cleft lip

position on back or in infant seat to prevent trauma to suture line. while feeding, hold in upright position.

to prevent dumping syndrome

post operative ulcer/stomach surgeries . . . eat reclining position, lie down after meals for 20-30 minutes (also restrict fluids during meals, low CHO and fiber diet, small frequent meals

above knee amputation

elevate for first 24 hours on pillow, position prone daily to provide for hip extension

below knee amputation

foot of bed elevated for first 24 hours, position prone daily to provide for hip extension

detached retina

area of detachment should be in the dependent position

administration of enema

position patient in left side lying (sim's) with knew flexed

after supratentorial surgery (incision behind hairline)

elevate HOB 30-45 degrees

after infatentorial surgery (incision at nape of neck)

position pt flat and lateral on eithe rside

during internal radiation

on bed rest while implant in place

autonomic dysrelexia/hyperreflexia

S&S; pounding headache, profuse sweating, nasal congestion, goose flesh, bradycardia, hypertension . . . place pt. in sitting position (elevate HOB first before any other implentation)

shock

bedrest with extremities elevated 20 degrees, knees straight, head slightly elevated (modified trendelenburg)

head injury

elevate HOB 30 degrees to decrease intacranial pressure

peritoneal dialysis when outflow is inadequate

turn pt. from side to side BEFORE checking the tubing for kinks

lumbar puncture

after the procedure, the client should be placed in the supine position for 4-12 hours as prescribed

demorol for pancreatitis

DO NOT GIVE MORPHINE SULFATE

myasthenia gravis

worsens with excercise and improves with rest

myasthenia crisis

a positive reaction to tensilon . . .will improve symptoms

cholinergic crisis

caused by excessive medication . . stop med giving tension will make it worse

head injury medication

mannitol (osmotic diuretic) crystallizes at room temp so ALWAYS usse filter needle

prior to liver biopsy

important to be aware of lab result for prothrombin time

from the a** (diarrhea)

metabolic acidosis

from the mouth (vomiting)

metabolic alkalosis

myxedema/hypothyroidism

slowed physical and mental function, sensitivity to cold, dry skin and hair

kept forgetting which was dangerous when you're pregnant; reg. measles or German measles

so remember . . . NEVER GET PREGNAT WITH A GERMAN (rubella)

when drawing up REGULAR INSULIN & NPH together, remember

RN . . . regular comes before NPH

MAOI's that are used as antidepressants: weird way to remember . . .

Pirates say arrr, so think; pirates take MAOI's when they're depressed. explanation: MAOI's used from depressants all have an "arrrr" in the middle (parnate, marplan, nardil)

autonomic dysreflexia; potentially life threatening emergency

elevate head of bed to 90 degrees

loosen constrictive clothing

assess for bladder distention and bowel impaction (triger)

adminster antihypertensive meds (may cause stroke, MI, seizure)

easy way to remember MAOI's

thinks PANAMA

PA-parnate

NA-nardil

MA-marplan

metallic bitter taste

digoxin

check pulse, less than 60 hold, check dig levels and potassium levels

antacid

tx of GERD and kidney stones . . . watch out for constipation

vistaril

tx of anxiety and also itching . . . watch for dry mouth, commonly give preop

Midazolam, is a benzodiazepine

given for conscious sedation . . watch for resp. depression and hypotension

PTU and tapazole

prevention and thyroid storm

carbidopa and levodopa

tx of parkinsons . . . sweat, saliva, urine may turn reddish brown and occassionally causes drowsines

antispasmodic medication (trihexyphenidyl

tx of parkinson . . . sedative effect also

cogentin

tx of parkinson and extrapyramidal effects of other drugs

trimethobenzamide,

tx of post op n/v and for nausea associated gastroentertitis

timolol (timoptic)

tx of glaucoma

bactrim

antibiotic . . . don't take if allergic to sulfa drugs . . . diarrhea common side effect . . . drink plenty of fluids

gout meds

probenecid (benemid), cohchicine, allopurinol (zyloprim)

apresoline (hydralazine)

tx of HTN or CHF, report flu like symptoms, rise slowly from sittin/lying position; take with meals

bentyl

tx of irritable bowel . . . assess for anticholingergic side effects

calan (verapamil)

calcium channel blocker: tx of HTN angina . . . assess for constipation

carafate

tx of duodenal ulcers . . .coats the ulcer . . so take before meals

theophylline

tx of asthma or COPD . . therap drug level 10-20

mucomyst

is the antedote to tylenol and is adminstered orally

acetazolamide

tx of glaucoma, high altitudes sickness . . . don't take if allergic to sulfa drugs

indocin (NSAID)

tx of arthitis (osteo, rheumatoid, gouty) bursitis and tendonitis

synthroid

tx of hypthyroidism . . . may take several weeks to take effect . . . notify doctor of chest pain . . . take in AM on empty stomach . . . could cause hyperthyroidism

chlordiazepoxide, benzodiazepine

tx of alcohol w/d . . don't take alcohol with this . . very bad vomiting can occur

oncovin (vincristine)

tx of leukemia . . . given IV only

kwell

tx of scabies and lice . . . scabies apply lotion once and leave on for 8-12 hours . . . lice use the shampoo and leave on for 4 minutes with hair uncovered than rinse with warm water and comb with a fine tooth comb

premarin

after menopause estrogen replacement

dilantin

tx of seizures. thera drug level 10-20

thiothixene

tx of schizophrenia . . . assess for EPS

methylphenidate and amphetamines

tx of ADHD . . . assess for heart related side effects reports immediately . . . child may need drug holiday b/c it stunts growth

dopamine (intropine)

tx of hypotension, shock, low cardiac output, poor perfusion to vital organs . . . montitor EKG for arrhythmias, monitor BP

have trouble remembering FHR patterns in OB? think VEAL CHOP

V-variable decels; C-cord compression caused

E-early decels; H- head compression caused

A- accels; O-okay, not a problem!

L- late decels; P-placental insufficiency, can't fill

for cord compression

place mother in TRENDELENBERG position because this removes pressure of the presenting part off the cord. If her head is down, the baby is no longer being pulled out of the body by gravity.

If the cord is prolapsed, cover it with sterile saline gauze to prevent drying of the cord and to minimize infection.

for late decels

turn the mother to her left side, to allow for more blood flow to the placenta.

for any kind of bad fetal heart rate pattern

you give O2, often by mask

when doing an epidural anesthesia

hydration before hand is a priority

hypotension and bradyapnea/bradycardia

are major risks and emergencies

if the baby is a posterior presentation

the sounds are heard on the sides

if the baby is anterior

the sounds are heard closer to midline, between the umbillicus and where you would listen to posterior presentation

if baby is breech

the sounds are high up in the fundus near the umbilicus

if the baby is vertex

the sounds are little bit above the symphsis pubis

to remember blood sugar

hyperglycemia

hot and dry-sugar high

hypoglycemia

cold and clammy-need some candy

cor pulmonae

right sided heart failure caused by left ventricular failure (so pick edema, jvd, if it is a choice)

heroin withdrawal neonate

irritable, poor sucking

jews

no meat and milk together

brachial pulse

pulse area CPR on an infant

test child for lead poisoning around

12 months

good sources of potassium

bananas, potatoes, citrus fruits