NCLEX

What is hyphema?

bleeding in the front chamber of the eye

What position should a client with hyphema remain in?

semi fowlers to reduce blood accumulation away from the optic center of the cornea

What is potassium iodine used for?

to reduce the size and vascularity of the thyroid

What does taking potassium iodine for 10 days prior to a thyroidectomy help do?

migrated the risk of significant blood loss

Propofol causes _____.

sedation

What is baclofen?

a muscle relaxer commonly used for MS and chronic back pain

What is phenytoin?

a antiepiletic used for prevention of seizures

What is haloperidol?

an typical antipsychotic indicated for treatment of schizophrenia and delirium

Schizophrenia has _____ and _____ symptoms.

positve and negative

What is lamotrigine?

a mood stabilizer and antiepileptic used for bipolar and epilepsy

What is the side effect of lamotrigine?

Steven johnson syndrome

What is Graves disease?

autoimmune disease that is an overactive thyroid gland; most common cause of hyperthyroidism

Hallmark finding of graves disease:

heat intolerance

Manifestations of graves disease:

-heat intolerance

-exophthalmos

-weight loss

-irritability

-thinning of scalp hair

Treatment of graves disease:

antithyroid medications or surgery

Hyperthyroid signs and symptoms:

THYROIDISM

-Tremor

-Heart rate dip

-Yawning/fatigue

-Restlessness

-Oligomenorrhea/amenorrhea

-Intolerance to heat

-Diarrhea

-Irritability

-Sweating

-Muscle wasting

What is aripiprazole?

an atypical antipsychotic used for schizophrenia and bipolar; also used in adjunctively for major depressive disorder

What is modafinil?

a psychostimulant used for narcolepsy and ADHD; promotes wakefulness; take once or twice a day

What is ropinirole?

dopaminergic medication used for Parkinson’s disease or restless leg syndrome

What is Quetiapine?

an atypical antipsychotic used for schizophrenia and bipolar

Naproxen should not be administered with _____.

corticosteroids

Corticosteroid side effects:

-Cataracts

-Up all night

-Suppressed immune system

-Hypertension

-Infections

-Necrosis

-Gain weight

-Striae

-Bone loss

-Acne

-Diabetes

-Myopathy

-Depression/mood changes

What is tizanidine?

muscle relaxant used for MS

Thyroid storm is a _____.

medical emergency

Thyroid storm manifestations:

tachycardia, hypertesnion, restlessness, fever

Treatment for thyroid storm:

-IV antithyroid meds

-IV corticosteroids to decrease conversion of T3 to T4

-IV propranolol to treat the adrenergic symptoms

What is the nursing management for thyroid storm?

-maintain airway

-cooling blankets

-cardiac monitoring

Avoid _____ if the patients have glaucoma.

anticholinergics (increase IOP and worsen glaucoma)

Acute cholecystits clinical features:

epigastric to RUQ pain that may radiate to R shoulder, n/v, malaise, elevated WBC, elevated serum liver enzymes and bilirubin

VEAL CHOP MINE

variable- cord compression- move client

early- head compression- identify stage of labor

accelerations- okay- no intervention needed

late- placental insufficiency- emergent intervention needed

Contact precautions:

hand hygiene, gown, gloves, dedicated disposable equipment

Contact precautions required for:

MRSA, conjunctivitis, RSV, HSV, lice, scabies, staph

Contact plus precautions:

hand hygiene with soap and water

Contact plus precautions required for:

C diff, norovirus, rotavirus

Droplet precautions:

Hand hygiene, mask

Droplet precautions required for:

RSV, influenza, pertussis, mumps, rhinovirus, rubella, epiglottitis, bacterial meningitis

Airborne precautions:

Hand hygiene, N95, private/negative pressure room with door closed, gown, gloves

Airborne precautions required for:

TB, measels, chickenpox

_____ is contraindicated in the treatment of bulimia because of its negative weight effects

bupropion

What is acyclovir?

antiviral used for management and prevention of outbreaks associated with HSV

What is amphotericin b?

treats serious, systemic fungal infections

What is theophylline?

bronchidilator and promotes exhalation of CO2

Average weight gain of a pregnany individual with a normal BMI is:

25 to 35

Gold standard for treating bipolar disorders is _____.

mood stabilizers (valproic acid is efficacious in treating mania because it has a fast onset)

Which do you treat first: acute or chronic?

acute

Which do you treat first: stable or unstable?

unstable

What is Bell’s palsy?

lower motor neuron facial nerve palsy that can result in the weakness of facial muscles and the muscles responsible for eye closure

What are the signs/symptoms of Bell’s palsy?

BELLS P

-blink reflex abnormal

-earache/eye rolls up

-lower corner of mouth and eyelid

-loss of taste and brow movements

-sudden onset

-paralysis unilateral (facial nerve: VII)

What electrolyte abnormality may cause U-waves?

hypokalemia

What are the 6 L’s of hypokalemia?

-lethargy

-low/shallow respirations

-limp muscles

-lethal dysrhythmias

-leg cramps

-lots of urine output

What are manifestations of hypernatremia?

muscle weakness, restlessness, lethargy, coma

What are manifestations of hyponatremia?

disorientation, apathy, depression, depressed DTR, agitation

_____ lines are associated with a higher risk of infection.

central

Should torniquets be used for snake bites?

no

What are the clinical manifestations of compartment syndrome?

-pain in the affected extremity

-swelling to the affected area

What are the clinical manifestations of cellulitis?

-pain in the affected extremity

-swelling to the affected area

-intact sensation

-warmth and erythema to the extremity

What are the clinical manifestations of venous thromboembolism?

-pain in the affected extremity

-swelling to the affected area

-intact sensation

-warmth and erythema to the extremity

What is tamsulosin?

an alpha antagonist that causes vasodilation

Can tamsulosin increase or decrease BP?

decrease because of its vasodilation effects

What are manifestations of acute pancreatitis?

persistent n/v, epigastric abdominal pain, worsening pain with palpation, hyperglycemia, leukocytosis, dehydration, and bruising around the umbilicus

What vitals indicate hypovolemic shock?

hypotension and tachycardia

What is the focus of hospice?

making the client comfortable

What is the focus of palliative care?

symptom management

What is catatonia?

-psychomotor disorder that affects the way a person moves

-may co-occur with bipolar or schizophrenia

What is the treatment for catatonia?

benzos

What are the functions of beta blockers in the cardiovascular system?

-block catecholamines from binding to the beta receptors

-reduce myocardial oxygen demand

What is conductive hearing loss?

something causing hearing loss that is reversible

What are examples of conductive hearing loss?

cerumen, foreign body, tumor, edema, and acute infection

What is sensorineural hearing loss?

hearing loss that is irreversible

What are examples of sensorineural hearing loss?

presbycisos, prolonged exposure to noise, and ototoxic substances

ACE-I may cause what electrolyte imbalance?

hyperkalemia

Can ACE-I cause a reduced taste sensation?

yes

What are signs and symptoms of Lyme’s disease?

-bullseye rash

-lymph node enlargement

-arthralgias

-malaise

-fatigue

-encephalopathy

What is the treatment for Bell’s palsy?

-antivirals b/c of the link to herpes

-corticosteroids to decrease facial nerve inflammation

What are signs and symptoms of hyperglycemia?

increased UO, tachycardia, orthostatic hypotension, blurred vision

WATER

-weakness

-abdominal pain

-tired

-extra thirsty

-really hot

What are common causes of hypomagnesemia?

-alcoholism

-anorexia

-diarrhea

-diuretics

What are common causes of hypermagnesemia?

-renal failure

-antacids

-excessive intake

-lithium therapy

-adrenal insufficiency

-hypothyroidism

What are manifestations of pyloric stenosis?

-projectile vomiting (hallmark sign)

-hunger after vomiting

-weight loss

-gastric peristalsis

-olive shaped mass in epigastrium

What is the treatment for generalized anxiety disorder?

SSRIs (citalopram) and/or short term use of benzos (alprazolam)

What is methylphenidate?

a psychostimulant indicated in managing ADHD

What is zolpidem?

a non-benzo hypnotic indicated in the treatment of insomnia

What are signs and symptoms of generalized anxiety disorder?

-excessive worry

-fatigue

-irritability

-muscle aches/soreness

-restlessness

-impaired concentration

-difficulty sleeping

Vaccine for diptheria is available starting at how old?

2 months old

What isolation precaution is diptheria?

droplet

What medications should be used to treat allergic reactions resulting from a blood tranfusion ot any other allergen?

-diphenhydramine

-epinephrine

-corticosteroids

What is the treatment for thyroid storm?

-corticosteroids (dexamethasone)

-BB (to reduce HR and BP)

-antithyroid medication (propylthiouracil)

_____ is contraindicated for children after a tonsillectomy.

codeine

Should ice be applied to a snake bite injury?

no b/c it can increase localized tissue damage

What position should a client be in after a liver biopsy?

right lateral for 2 hours post procedure b/c it allows the liver to rest against the lateral abdominal wall and put pressure on the biopsy site to reduce risk of post biopsy bleeding

Ketorolac should be _____ for those with cardiovascular issues.

avoided (potential to trigger cardiovascular events such as HF or MI)

What are the priorities for managing postpartum hemorrhage?

-volume expansion

-uterine contraction

Normal pediatric VS (chart)

What is cullen’s sign?

bluish periumbilical discoloration/ecchymosis, commonly indicates acute pancreatitis

What is Homan’s sign?

used to indicate pain in the calf with foot dorsiflexion, was previously associated with deep vein thrombosis (DVT) assessment

What is Kernig’s sign?

resistance and pain with knee extension when the hip is flexed, is associated with conditions like subarachnoid hemorrhage or meningitis

What is the common lab testing for syphilis infections?

RPR

What ABG may result from untreated ARDS?

respiratory alkalosis

What is risperidone?

an atypical antipsychotic indicated in treating schizophrenia, autism with behavioral disturbances, delusional disorder, and bipolar disorder

What can risperidone increase levels of?

prolactin levels resulting in gynecomastia and/or galactorrhea

What are early manifestations of lithium toxicity?

nausea and vomiting