Mega NCLEX study

restlessness, stupor, twitching, fever

What are 4 s/s of hypernatremia/chloremia?

seizure, nausea, decreased DTRs, spasms, confusion

what are 5 s/s of hyponatremia/chloremia?

hyperactive BS, paresthesia, peaked T waves, metabolic acidosis

what are 4 s/s of hyperkalemia?

flat T waves, u waves, decreased DTRs, flaccidity

what are 4 s/s of hypokalemia?

DVTs, sedation, decreased DTRs, bradycardia

what are 4 s/s of hypercalemia?

chvostek’s sign, trousseau’s sign, paresthesia, irritable

What are 4 s/s of hypocalcemia?

kg/m²

what is the formula for calculating BMI?

>500 mL

how much residual would cause and NGT feed to be held?

empty when 1/3-1/2 full, change every 3-7 days

what are 2 nursing considerations for ostomies?

opens airways, reduce reflux

What are 2 reasons we use semi-fowler’s, fowler’s, or high fowlers (improves this with each level)?

drain secretions, reduce vomiting, aspiration, expand hips

what are 4 reasons to use the prone position?

promote venous return, hypotension, prolapsed umbilical cord

what are 3 reasons we use Trendelenburg?

promotes blood flow, settles GI content

what are 2 reasons we use reverse Trendelenburg?

easier than prone, enema

what are 2 reasons for the sims position (L laying with R hip/ knee flexed, L leg extended)

RSV, diphtheria, polio

What 3 diseases are considered contact precautions?

C. diff, norovirus, rotavirus

what 3 disease are contact enteric precautions (can’t use hand sanitizer only soap and water)?

pertussis, mumps, rubella, bacterial meningitis, RSV

what 5 diseases require droplet precautions?

Measles, TB, varicella, SARS, smallpox

What 5 diseases require airborne precautions?

HCP in 24 hrs, RN assess q1-2h, order expires 24 hrs

what are the 3 rules for restraints on a nonviolent patient?

HCP in q1h, RN assess q15mins, 4 hrs, 2 hrs, 1 hr

what are 2 rules for restraints on a violent patient? When does the order expire for adults, 9-17 y.o, or <9 y.o?

rear facing until 2 y.o, retainer clip at armpit level, straps below shoulders

what are 3 rules for car seats and kids?

rescue, alarm, contain, extinguish

what does RACE stand for in relation to fires?

scissors at bedside

what is the 1 nursing consideration for a Blakemore tube (device used for esophageal varices)?

>100 ml/hr

at what level would you call the provider over chest tube drainage?

cover w/ sterile dressing, tape on 3 sides, stay with pt

what are 3 things you should do if the chest tube comes out of the pt?

5-15

what is normal ICP?

headache, vomiting, cushing’s triad, posture changes

what are 4 s/s of increased ICP?

level with tragus

where do you keep the drain for an external ventricular drain (used for increased ICP emergencies).

gingival hyperplasia, avoid antacids

what are 2 nursing considerations for a patient taking phenytoin (long term seizure control)?

Battle sign, raccoon eyes, CSF drainage, never insert NGT

what are 3 s/s of a basilar skull fracture? what is 1 important nursing consideration?

permissive HTN, tPA in 60 mins, surgery

what are 3 things we do to manage an ischemic stroke?

Nuchal rigidity, photophobia, Kernig’s sign, Brudzinski’s sign

what are 4 s/s of meningitis?

ataxia, nystagmus, hypotonia, spasticity, inability to preform rapid alternating movements

what are 5 s/s of MS?

ptosis, weak muscles, +tensilion test (edrophonium)

what are 3 s/s of myasthenia gravis?

terbutaline, rescue/maintenance

a rescue/relief and maintenance drug for wheezing, SOB, and coughing assess for HR, BP, EKG, and BG

budesonide/ fluticasone

this is an inhaled corticosteroid used for long term control of asthma take daily can caused oral candidiassis

montelukast, long term control

this is a leukotriene modifier used in asthma by reducing reactions to triggers

theophylline, long term control

this is a bronchodilator used for asthma to prevent wheezing, must be used regularly

L lateral Trendelenburg

what position should we place the pt in if they have an air embolism?

high folwers

what position should we place the pt in if they have a pulmonary embolism?

-pril, HTN, CHF, assess dry cough, BP, pregnancy

What do ACE inhibitors end in (causes vasodilation), 2 uses what are 3 nursing considerations?

-sartan, HTN, CHF, DM neuropathy, monitor BP, fluids, pregnancy

What do ARBs end in (restricts vasocontriction), 3 uses? 3 nursing considerations?

-dipine/-mil, HTN, angina, avoid grapefruit, no AV block, gingival hyperplasia

what does calcium channel blockers end in? what are 2 uses? 3 nursing considerations?

HTN, arrythmia, anxiety, do not d/c suddenly, can mask hypoglycemia, cause bronchospasms

3 uses for beta blockers (ENDS IN LOL), what are 3 nursing considerations?

SVT, stops heart, rapid push, caution w/ asthmatics

when is adenosine given? 3 nursing considerations?

arrythmias, can disturb thyroid, no pregnancy, may cause heart block

when is amiodarone given? 3 nursing considerations?

sinus bradycardia, heart block, monitor urinary retention, constipation, no glaucoma

when is atropine given? 3 nursing considerations?

N/V, vision changes, bradycardia, arrythmias, digitalis

what are 2 early s/s of digoxin toxicity? what are 2 late s/s? what is the antidote?

hypokalemia, hypomagnesemia, hypercalcemia, elderly

what are 4 risk factors for digoxin toxicity?

dopamine, dobutamine, milrinone

name 3 inotropes (increases heart contractility)

vasopressin, epinephrine, phenylephrine

name 3 vasopressors

brown skin, swelling, uneven wound edges, pulse present, elevate legs

what are 4 s/s of PVD? 1 tx?

pallor w/ dependent rubor, hairless, poor pulses, pain stops with rest, dangle legs, antiplt

what are 4 s/s of PAD? 2 tx?

abd/back pain, gnawing/sharp pain

what are 2 s/s of a abd aortic aneurysm (AAA)?

SOB, back pain, hoarseness, struggling to swallow

what are 4 s/s of a thoracic aortic aneurysm?

SOB, decreased CO, JVD, narrowed pulse pressure, pericardiocentesis

what are 4 s/s of cardiac tamponade (fluid in pericardial sac)? 1 tx?

PR interval >0.20

what is the defining characteristic of a first-degree heart block?

PR interval gets longer until it drops off QRS

what is the defining characteristic of second degree type 1 heart block?

random QRS drop offs, normal QRS

what are 2 defining characteristics of second degree type 2 heart blocks?

p waves and QRS don’t work together

What is the defining characteristic of a third degree heart block?

sawtooth p waves, regular rhythm

what are the 2 defining characteristics of atrial flutter?

weird p wave, irregular rhythm

what are 2 defining characteristics of atrial fibrilation?

-sone/-lone, monitor for Cushing’s, hyperglycemia, osteoporosis

what do all steroids end in? what are 3 nursing considerations?

Lugol’s, radioactive iodine, methimazole

what are 3 antithyroid medications?

calcium chloride, gluconate, lactate, calcitrol

what 4 medications help increase serum calcium (last one is vitamin D)?

alendronate, risedronate, calcitonin

what 3 medications decrease serum calcium?

no renal/hepatic impairment, take with food, hold 24-48 hrs before contrast

what are 3 nursing considerations for metformin?

fatigue, weight loss, hypoglycemia, hyperpigmentation

what are 4 s/s of Addison’s disease (insufficient adrenocorticosteroids)?

fluid retention, moon face, buffalo hump, trunk obesity, immunosupression

what are 5 s/s of cushing’s disease (excess steroids)?

hypotension, muscle cramps, large amounts of urine, dilute urine, concentrated blood

what are 5 s/s of DI (not enough ADH)

monitor neuro, fluids, vasopressin

what are 3 considerations/tx for DI?

weight gain, no edema, hyponatremia s/s, concentrated urine, dilute blood

what are 5 s/s of SIADH?

monitor Na, seizure precautions, hypertonic fluids

what are 3 nursing considerations for the tx of SIADH?

Kussmual’s respirations, fruity breath, dry/flushed skin, N/V, fast onset

what are 5 s/s of DKA?

BG >600, no ketones, vision loss, fever, slow onset

what are 5 s/s of HHNS?

bag change q24h, daily weights, electrolytes, q4-6h BG

what are 4 nursing considerations for TPN?

loperamide, bismuth subsalicylate

what are 2 antidiarrheals?

administer slowly, QT prolongation and VT

what is 1 consideration for administering ondansetron and why?

-tidine, can give w/ meals, monitor kidney

What do all H2 receptor blockers end in (blocks acid secretion)? What are 2 nursing considerations?

-prazole, administer 30-60 mins before meals

What do PPIs end in (decreased acid production)? What is the 1 nursing consideration?

Take 1 hr before meals or 2 hrs after meal, no antacids within 30 minutes, contains sucrose, separate any other drugs by 2 hrs

What are 4 nursing considerations for sucralfate (coats stomach to protect ulcers)?

pain 1-2 hrs after meal, pain aggravated by eating, hematemesis

what are the 3 s/s of a gastric ulcer?

pain 2-4 hrs after meals, food relieves pain, melena

what are 3 s/s of a duodenal ulcer?

colicky pain + N/V, hypogastric pain + abd distension

what are the 2 s/s of a small intestinal obstruction? 2 s/s of a large intestinal obstruction?

ascites, abd mass, cullen’s sign, gray turner’s sign, jaundice

what are 5 s/s of pancreatitis?

asterixis, hyperreflexia, ALOC, ammonia breath

what are 4 s/s of hepatic encephalopathy (fix w/ lactulose NO CNS DEPRESSANTS)?

fecal oral route, low

how is Hep A and Hep E spread? What is the risk for chronic infection? (Hep A has a vaccine)

body fluids, high

How is Hep B + C + D spread? what is the risk for chronic infection (Hep B has a vaccine)?

recent strep, HTN, edema, hematuria

what are 4 s/s of glomerulonephritis?

proteinuria, hypoalbuminemia, edema, HLD, predisone, statin, high protein diet, ACE

what are 4 s/s of nephrotic syndrome? what are 4 tx? (this is the only kidney disease w/ this specific diet)

methotrexate

this is a DMARD used for RA, psoriasis, used to reduce and slow disease progression

avoid high purines (alcohol, organ meat, cheese, seafood), monitor leukopenia, fever, rash

what are 4 nursing considerations for allopurinol (anti-gout)?

monitor CNS depression, do not abruptly d/c

what are 2 nursing considerations for baclofen/dantrolene (muscle relaxer)?

thickening of skin, scaly red pruritic plaques, light therapy, retinoids, infliximab

what are 2 s/s of psoriasis? 3 tx?

hyperkalemia, hyponatremia, LR, 4 mL x TBSA% x kg, ½ in 8 hrs ½ in 16 hrs

what are 2 electrolyte imbalances that come from burns? what is the fluid of choice for burns? what is the parkland formula and how do we give the fluid?

q1-2 years from 40-75 y.o

how often should a woman get a mammogram?

syphilis, gonorrhea, chlamydia, chancroid, HIV

which 5 STDs are reportable to public health?

mid-axillary line, 4th intercoastal space

Where should the transducer of an arterial line be located (also called phlebostatic axis)?

no metal, no pacemakers, old tattoos

what are 3 contraindications for an MRI?

increase fluids, monitor UOP, hold metformin 24 hrs before 48 hrs after

what are 3 nursing considerations when giving contrast?