Comprehensive Nursing Exam Review Flashcards

Flashcards providing a high-yield summary of nursing concepts including acid-base balance, pharmacology, lab values, obstetric care, and prioritization based on lecture notes.

According to the 'Rule of the B's', what determines if an acid-base imbalance is metabolic?

If the $pH$ and the $HCO_3$ are both in the same direction, it is metabolic.

Identify the imbalance: $pH\text{ 7.30}$ and $HCO_3\text{ 20}$.

Metabolic Acidosis (both are down).

Identify the imbalance: $pH\text{ 7.22}$ and $HCO_3\text{ 30}$.

Respiratory Acidosis ($pH$ is down, but $HCO_3$ is up).

What is the only acid-base imbalance that causes Kussmaul respirations?

Metabolic Acidosis (MAC Kussmaul).

What is the general rule for symptoms as the $pH$ goes up or down?

As the $pH$ goes, so goes my patient, except for Potassium ($K^+$). When $pH$ is up (alkalosis), systems are hyperexcitable; when $pH$ is down (acidosis), systems shut down.

Identify the symptoms associated with Alkalosis ($\text{up}$).

Hypokalemia, HTN, Tachycardia, Tachypnea, Seizures, Irritability, Spastic, Diarrhea, Borborygmi, and Hyperreflexia.

What triggers a High Pressure alarm on a ventilator?

Increased resistance to air flow, caused by obstructions like kinking of the tube, water in the tube, or mucus in the airway.

What triggers a Low Pressure alarm on a ventilator?

Decreased resistance to air flow, caused by disconnections of the main tubing or oxygen sensor tube.

What are the 5 stages of grief?

Denial, Anger, Bargain, Depression, Acceptance.

How is Wernicke's (Korsakoff's) Syndrome defined?

Psychosis induced by Vitamin $B_1$ (thiamine) deficiency.

What must patients avoid when taking Antabuse/Revia (Aversion Therapy)?

All forms of alcohol (mouthwash, cologne, perfume, aftershave, elixirs, OTC liquid medicines, insect repellant, vanilla extract, vinaigrettes, hand sanitizer) to avoid nausea, vomiting, and death.

What are the primary differences between Alcohol Withdrawal Syndrome (AWS) and Delirium Tremens (DT)?

AWS is not life-threatening and the patient is not a danger to self/others. DT can be fatal, and the patient is dangerous to self/others.

What are the toxic effects of Aminoglycosides (Mean Old Mycins)?

Ototoxicity (hearing, balance, tinnitus) and Nephrotoxicity (monitor creatinine).

When should the Trough level always be drawn?

$30$ minutes before the next dose.

What are the Category A Biological Agents?

Small Pox, Tularemia, Anthrax, Plague, Hemorrhagic illness, and Botulism.

What does the 'SLUDGE' acronym for Sarin gas exposure stand for?

Salivating, Lacrimating, Urination, Diaphoresis/Diarrhea, G.I upset, and Emesis.

What are the indications for Calcium Channel Blockers?

Antihypertensives, Anti-Angina, and Anti-Atrial Arrhythmic (Atrial flutter and Atrial fibrillation).

What are the potential side effects of Calcium Channel Blockers?

Headache and Hypotension.

What are the two lethal arrhythmias?

Asystole and Ventricular Fibrillation.

What is the treatment for Asystole?

Epinephrine first, then Atropine.

What is the specific purpose of an 'Apical' chest tube vs. a 'Basilar' chest tube?

Apical (high) removes air; Basilar (low) removes blood.

How is a 'TRouBLe' congenital heart defect identified?

The defect starts with 'T', results in a Right-to-Left shunt (R-L), and the patient is Cyanotic (Blue).

What are the four defects present in Tetralogy of Fallot?

Ventricular Defect, Pulmonary Stenosis, Overriding Aorta, and Right Hypertrophy.

How do you determine the correct gait for a patient using crutches?

Use even-numbered gaits ($2$ point or $4$ point) when weakness is evenly distributed; use the odd-numbered gait ($3$ point) when only one leg is affected.

What is the difference between a Delusion and an Illusion?

A delusion is a false, fixed belief with no sensory component; an illusion is a misinterpretation of reality with a referent (something in reality they refer to).

What is the recommended treatment for Type I Diabetes Mellitus?

Insulin (primary), Diet, and Exercise.

What are the onset, peak, and duration for Regular (R) insulin?

Onset: $1\text{ hr}$, Peak: $2\text{ hr}$, Duration: $4\text{ hr}$.

What is the #1 cause of Diabetic Ketoacidosis (DKA)?

Acute viral upper respiratory infection within the last $10$ days.

What are the therapeutic and toxic levels for Lithium?

Therapeutic level: $0.6 - 1.2$; toxic level: $\text{≥ } 2$.

Contrast the treatment for Hiatal Hernia and Dumping Syndrome regarding Head of Bed (HOB).

For Hiatal Hernia, HOB should be High (to empty the stomach); for Dumping Syndrome, HOB should be Low (to keep the stomach full).

What is the rule for Calcemias and symptoms?

Calcemias do the opposite of the prefix. Hyper-calcemia causes systems to go down; Hypo-calcemia causes systems to go up.

What are the two specific signs of neuromuscular irritability associated with Hypocalcemia?

Chvostek's Sign (cheek tap leads to facial spasm) and Trousseau's Sign (BP cuff leads to carpal spasm).

What is the treatment for Thyroid Storm?

Oxygen and lowering body temperature.

What are the signs and symptoms of Cushing's Syndrome?

Moon face, hirsutism, water retention, gynecomastia, buffalo hump, central obesity, bone density loss, easy bruising, irritability, and immunosuppression.

What diseases require Airborne Precautions?

Measles, TB, Chicken Pox (Varicella), and SARS.

What is the proper order for donning Personal Protective Equipment (PPE)?

$1. \text{Gown}$, $2. \text{Mask}$, $3. \text{Goggles}$, $4. \text{Gloves}$.

What is the therapeutic range for INR and what is considered critical?

Therapeutic range: $2 - 3$. Critical: $\text{≥ } 4$.

Identify the 5 'D's' (Deadly Dangerous lab values).

$K^+ \text{ ≥ } 6$, $pH$ in the $6\text{'s}$, $CO_2$ in the $60\text{'s}$, $PO_2 \text{ ≤ } 60\text{'s}$, and Platelets $< 40,000$.

What is the priority assessment for a pre-op cervical laminectomy?

Function of Upper extremities and breathing.

According to Nagele's Rule, how do you calculate a due date?

First day of the last menstrual period (LMP) $+ 7\text{ days } - 3\text{ months}$.

What is the most valid sign that a woman is in labor?

Onset of regular contractions.

Define the LION pit acronym for maternal complications.

Left side/Lateral position, IV increase, Oxygen, Notify MD, and stop Pitocin if in crisis.

What is the color of lochia in the first few days postpartum?

Rubra.