Mark Klimek NCLEX单词卡 | Quizlet

Hyperthyroidism is also called

Grave's disease or hypermetabolism

Tip to remember Grave's disease s/s's

"Run yourself into the Grave" - everything is up ... diarrhea, thin, hot, high BP, high HR, cold tolerance, hot intolerance

Treatment for Grave's disease

Radioactive Iodine, PTU (put thyroid under), surgically remove

Total thyroidectomy ... totals get

tetany, need lifelong hormone replacement

After thyroidectomy patients are at risk for

hypocalcemia, remember hypocalcemia is opposite of the prefix and anything to BP so tetany, parasthesia

parathesia

numbness and tingling, first sign of electrolyte imbalance

Subtotal thyroidectomy ... subs get

storm

S/S of thyroid storm

Extremely high vital signs, hyperpyrexia, psychotic delerium

How to treat thyroid storm

give o2, lower temp to spare brain

Risks post op for total thyroidectomy

airway, hemorrhage for 1st 12 hours then for 12-48 hours hypocalcemia leading to tetany

Risks post op for sub total thyroidectomy

airway, hemorrage for 1st 12 hours then for 12-48 hours thyroid storm

Hypothyroidism is also called

Myxedema or hypometabolism

S/S of mydexema

everything is down, constipation, heat tolerance, cold intolerance

Treatment for mydexema

give thyroid medications

Where to put the 5 ice packs to cool a thyroid storm patient

neck pits groin

If you cool a patient too fast what might happen?

Heart arrythmias

Never hold the hormone for what patient?

patient who is NPO with mydexema

Addison's disease easy way to remember

Add a Sone (sone = steroid)

Adrenal Cortex diseases easy way to remember

A in Adrenal stands for Addison's

C in Cortex stands for Cushing's

Addison's disease is

undersecretion of adrenal cortex, not enough hormone, BRONZE/tan, go into shock very easily. STRESS can trigger.

Addison's disease treatment

give a steroid, chronic steroid therapy

Cushing's syndrome

Over secretion of adrenal cortex, too much hormone, too much steroid.

S/S of Cushing's syndrome

same as steroid use ... moon face, think cushman "I'm mad I have an infection", high blood sugar, losing Potassium,

Treatment for Cushing's syndrome

Surgery, bi or uni lateral adrenalectomy (bilateral is worse)

Donning PPE's order

Gown, Mask, Goggles, Gloves

Removing PPE's order

alphabetically inside the room

For airborne precautions the mask is removed where?

outside of the room

Avoid answers with what words for children 9 mths and younger?

build, sort, stack, construct, make

Toddlers (1-3) work on

their gross motor skills (jump, hop, throw), NO fine motor, parallel play

Preschoolers (3-6) work on

fine motor, balance (tumbling, dance, tricycle), cooperative play, pretend

School age (7-11) work on

creative, collect, competitive

Best default order for click and drag order questions?

Hold ..... med

Assess ..... what med does

Prepare ...... the correction

Call ..... or notify

Rarely if ever answer ...

call Doctor, NCLEX wants you to think critically

Creatinine lab values

same as lithium 0.6-1.2 Not a huge worry, not a dangerous lab to worry about

INR lab values

2-3, critical value if off, potential for patient to bleed. Use default order for order ?'s (hold all coumadin, assess for bleeding, prepare Vit K (antidote for Coumadin), Call or notify

Potassium lab values

3.5-5.3 If low it is a critical lab to worry about assess the heart and then prepare to give K

if high, hold all K, assess heart (EKG), give D5W and reg insulin, call

if really high, hold, assess, prepare, call STAT Get someone else involved! Dangerous!!

pH lab values

7.35-7.45 if pH is in the 6;s VERY dangerous remember as the patient's pH goes so goes the patient

If bad vitals, call rapid response team

BUN lab values

8-30 check for dehydration if elevated not a big deal, just be concerned

If a deadly or dangerous lab value is discovered AND they have symptoms call the

rapid response team!

HgB lab values

12-18 check for bleeding if low or high, if low prepare for tranfussion

HCO3 lab values

22-26 if it is abnormal so what!

CO2 lab values

35-45 if in the 50's assess respiratory status and have patient do pursed lip breathing, if in 60's considered deadly and respiratory failure, need intubated

Hct lab values

36-54 thickness of blood if abnormal not too big of a deal, assess for dehydration

PO2 lab values

78-100 this is only obtained from an ABG if low give O2 but if really low it is respiratory failure give O2, prepare for intubation, call resp therapy and call Dr

O2 sat lab values

93-100 pulse ox, if under 93 assess resp status and give O2

BNP lab value

less than 100 is normal, good indicator of CHF, edema, if elevated assess s/s of CHF

NA lab values

135-145, if a change in LOC then evaluate for fall/safety risk

WBC lab values

5000-11000 if low assess for infection

CD4 count less than 200 equals

AIDS

Neutropenic precautions (low WBC)

strict handwashing, avoid crowds, private room, low bacteria diet (no raw or undercooked), no water that has been standing longer than 15 min, vital signs Q4H

Platelets lab value

150000-400000 if lower than 90000 bad if lower than 40000 REALLY bad, if they sneeze they could die. Called thrombocytopenia

Bleeding precautions

no venipuncture, injection or IV, if necessary use small guage, handle patient gently, use drawsheet, no razor, no toothbrush, blow nose gently, no aspriin, no rectal temp, no hard foods

RBC lab values

4-6 million abnormal doesn't really matter

Reason for laminectomy

treat nerve root compression

S/S of nerve root compression

Pain

Parasthesia (numbness & tingling)

Paresis (muscle weakness)

Cervical

Diaphram and Arms affected, breathing, respiratory pattern

Thoracic

Abd muscles and gut affected, ability to cough

Lumbar

Bladder and legs affected, when did they last void, are they distended

#1 post op answer for spinal problems is

log roll patient

Activity post op spinal issue

do not dangle

stand, walk, lie down w/o restricitons

limit sitting to 30 min at a time

Post op complications for cervical spinal surgery

pneumonia

Post op complications for thoracic spinal surgery

pneumonia (no cough), paralytic illeus (gut shuts down)

Post op complications for lumbar spinal surgery

urinary retention

How long does temporary restrictions usually mean?

6 weeks (driving, lifting, etc.)

Nagele's Rule

1st day of last period + 7 days - 3 months

Weight gain during pregnancy

28 lbs plus or minus 3 lbs

1st trimester weight gain

1 lb/month or 3 lbs for 1st trimester

2nd/3rd trimester weight gain

1 lb/week

Easy way to calculate appropriate weight gain during pregnancy

The week number minus 9 so if 12 weeks pregnant 12-9=3 lbs. not allowed to be off by more than 2 lbs.

Fundal Height

not palpable until 12 weeks, 2nd and 3rd trimesters week gestation 20-22 in cm so at the navel is 20 weeks

Positive signs of pregnancy

xray, ultrasound, auscultation of fetal HR on doppler 10 weeks, examiner (not the mother) palpates fetal movement

Probable signs of pregnancy

blood and urine tests, Chadwick's sign, Goodell's sign, Hegar's sign

Chadwick's sign

Cervical color changes to Cyanosis See all the CCCCCC's!

Goodell's sign

Cervical softening

Hegar's sign

Uterine softening

All changes in cervix and vagina occur in what order?

alphabetical order

Pattern of Office Visits for prenatal care

once a month until 28 weeks, once every 2 weeks until week 36, once a week until delivery or week 42 when induction is scheduled

Pregnancy hemoglobin

normal is 12-18, first trimester falls to 11 which is okay, second trimester falls to 10.5 which is okay and then third trimester falls to 10 also okay

Easy way to remember station

has it made it through the "tight squeeze" (ischial spine) no then its a negative, yes then its a positive, 0 station is when it's at the ischial spine

Presenting part is 99% of the time the

head

What is bad as far as Lie?

Transverse is bad, vertical is good, parallel is good

Stage 1 of L&D

Labor - thinning and opening, has 3 phases, Latent, Active, Transitional, nothing to do with the baby just the cervix, no baby at the end of labor

Stage 2 of L&D

Delivery - pushing the baby out

Stage 3 of L&D

Placenta delivery

Stage 4 of L&D

Recovery (1st 2 hrs after delivery of placenta), considered unstable patient, stop the bleeding in stage 4

Memorize 1st stage 2nd phase of L&D then you know the rest

Active phase

CM dilated 5-7 cm

CXN Freq 3-5 min

Duration 30-60 sec

Intensity moderate

Contractions should not be longer than ____ seconds or closer than every _____ minutes.

90, 2

Prolapsed cord

OB emergency, baby will die if you don't do something

What to do with prolapsed cord

Push then position! Push head off cord then position in knee/chest of trendelenburg (head down)

Lithotomy position

on back with knees drawn up

Easy to remember interventions for complications of L&D

LIONPit

L left side, I increase IV, O oxygenate, N notify Dr, Pitocin

If question says there is pitocin running and there are complications

stop pit first then LIONpit

Pain meds in labor

know your peaks for IV, IM, PO, Subling. If baby is likely to be born when the pain med is peaking don't give! Why? Respiratory depression in baby

Fetal monitor patterns

if it starts with L it's bad so do LIONPit, ex; low fetal heart rate, low baseline variability, late decels

V C

E H

A O

L P

Variable Decels Cord Compression (bad)

Early Decels Head (bad)

Acels Okay (good)

Late Decels Placenta (bad)

Best answer for what to check first in fetal monitoring is

fetal heart rate, it's the ace of spades!

During the 2nd stage (delivery of baby), order of actions.

Deliver the head then stop pushing, suction the mouth first then the nose, check for nuchal cord, deliver shoulders and body, ID band

If the baby has to leave the delivery area, the priority is

the ID band

Umbilical cord has what in it

AVA 2 arteries and a vein

4th stage of L&D recovery stage, what do do?

4 things you do 4 times an hour in 4th stage

Vitals (assess for s/s of shock)

Fundus (want midline and firm, if boggy, massage, if displaced void/cath)

Pads (check and replace)

Roll on side (check for bleeding under patient)