nclex bootcamp

Risk factors for STIs include:

• Alcohol/drug abuse that impairs judgment

• Unvaccinated against HPV

• Unprotected intercourse

• History of STIs

• Multiple partners

Koplik spots

Bluish gray spots on the buccal mucosa that are key features of measles

Signs of increased agitation (pacing, shouting) in a schizophrenic client should be

Assessed for suicidal ideation

Hallucinations

False sensory experiences: visual, hearing, olfactory, or tactile

Dysfunctional grief

Prolonged and impairs daily functioning. Watch for persistent hopelessness, avoidance, or refusal to accept the loss

Clients with bulimia often have a normal weight, but display indicators of

Self induced vomiting, such as dental erosion, swollen parotid glands, and calluses or scarring on the hands

Anorexic/bulimic clients should gain weight (2 lbs per week) gradually to prevent

Refeeding syndrome which is a fatal complication caused by hypophosphatemia

Dementia medications

Cholinesterase inhibitors (donepezil, rivastigmine) slows progression of the disease but does not cure it

Generalized anxiety disorder

Excessive persistent worry about everyday life (work, health, relationships, finances) that disproportionate to the situation

Pediculosis cavities

Lice

Lice and scabies is treated with

Permethrin hair cream (pediculicide) ( scabicide)

Classic symptom of Duchenne muscular dystrophy

When the client walks hands up the legs to rise from the floor to a standing position . This Gower sign

Pavlik harness

Involves keeping the client legs flexed and thighs abducted. Caregivers should avoid applying lotions and powders under the straps and dress the infant in clothing and a single diaper to prevent skin irritation.

what cluster is :

Paranoid

Schizoid

Schizotypal

Cluster A : odd, eccentric

what cluster is :

Antisocial

Borderline

Histrionic

Narcissistic

Cluster B : dramatic, erratic

what cluster is :

Avoidant

Dependent

Obsessive-compulsive

Cluster C : anxious, fearful

Antisocial

Lies, manipulates

Lacks guilt or remorse

Narcissistic

Needs praise and admiration

Lacks empathy

Borderline

High risk for self injury and suicide

Fears abandonment

Impulsive

H influenza causes

Epiglottis

Left-sided stroke:

think “LEFT = LANGUAGE & LOGIC”

Left Loses Language and Logic, but walks cautiously.”

Right-sided stroke:

think “RIGHT = RECKLESS & ‘REAR-VIEW’ (vision/spatial)”

Use this phrase: “Right is Reckless and can’t see the Right side of space right.”

Following a endovascular repair of abdominal aortic aneurysm the nurse should prioritize

Monitoring lower extremity perfusion since the aorta supplies blood to the lower half of the body. Diminished or absent pedal pulses could indicate impaired blood flow.

Pericarditis manifeststations include

Widespread ST elevations

Fever and leukocytosid

Relief when sitting up and leaning forward

Pericarditis friction rub

Interventions for acute pancreatitis

NPO status

Fetal position

Gastric suction (NG tube)

Monitor for symptoms of hypocalcemia

Administer PPI and opioids

Methimazole

Blocks thyroid hormone production

Hypothyroidism

High TSH, low T4

Secondary hypothyroidism

Low TSH and T4

Flank pain radiating to the groin

Nephrolithiasis

To prevent and identify mastitis

Mastitis causes breast redness and flu like symptoms

Continue to empty the breast (feeding, pumping) every 2-3 hrs

Ensure a proper latch to avoid cracked nipples

TORCH infections to avoid in pregnancy

Toxoplasmosis

Other infections

Rubella

Cytomegalovirus

Herpes simplex

Litter boxes

Undercooked meats

Live vaccines (rubella)

Lightening

Fetus descends into the pelvis

False labor

Braxton Hicks (irregular contractions that stop with rest)

No effacement or dilation

True labor

Regular, intensified contractions and activity does not subside with rest.

Progressive dilation (opening) and effacement (thinning)

Ig E

Allergic reactions

Ig G

Long term immunity in bacterial and viral infections

What is the presentation?

Cephalic (head first)

Signs of ectopic pregnancy

Missed period, spotting, unilateral abdominal pain, positive pregnancy test with no intrauterine pregnancy visualized on the the ultrasound.

If confirmed, administer methotrexate or prepare for surgery

Molar pregnancy

If the client has dark brown vaginal bleeding with grape like clusters and fundal height higher than expected. Prepare client for evacuation of the uterus.

Mastitis findings

Localized breast pain with fever and chills

Expected lochia postpartum

Scant to moderate amount, amount lowers each day

Gush of blood when first standing after laying or sitting for prolonged period

Unexpected lochia postpartum

Saturated perineal pad in <15 min

Blood trickling, oozing, gushing or pooling under client’s butt

Large clots

Foul smelling discharge = endometritis ( infection)

Episiotomy

Incisions made to widen the vaginal opening during delivery

Postpartum Deep severe pain unrelieved by analgesia indicates

Hematoma

Premature rupture of membranes

vaginal fluid leakage (underwear wet) , occurs before labor begins. Confirm ROM with nitrazine test

Ig A

Mucosal immunity

What is the presentation?

Breech (buttocks first)

What is the presentation?

Shoulder

Leopold maneuver

Assesses fetal position

When the amniotic sac ruptures assess TACO:

Time, Amount, Color, and Odor

Immediately report amniotic fluid that is green (meconium) or cloudy and foul odored (infection)

Signs of hemorrhage

Tachycardia and low BP, excessive bleeding

Give ______ with epidural anesthesia to prevent hypotension cause by vasodilation from anesthesia

500-1000 mL IV fluids

Amniotomy

Artificial rupture of membranes to induce or augment labor

Prostaglandins

Dioprostone, misoprostol : used to promote cervical ripening (softening)

Uterine tachysytole

Contractions more than 5 in 10 minutes

Before an amnitomy, confirm that the fetal head is ____, and asssess the amniotic fluid.

Engaged ( 0 station)

Teach client to _______ with contractions to maximize efforts

Push

Avoid administering opioids if delivery is expected within ____ hours.

4

Ig M

Initial response to infections

Teaching point about lithium for bipolar disorder

Take lithium with food to minimize stomach upset and enhance adherence to

Maintain adequate hydration to prevent dehydration and lithium toxicity

Avoid strenuous exercise in hot weather to reduce the risk of lithium toxicity

Normal hemoglobin level for sickle cell anemia?

7-11

Vaginal suppositories administration

Have the client void before insertion

Position the client supine with knees bent (dorsal recumbent)

Use a water based lubricant before inserting the suppository as far possible into the vagina (3-4 in)

Extended release tablets

Are made with enteric coating, and absorbed over a prolonged period to maintain drug levels over an extended period

Sublingual medications:

Are absorbed rapidly into the bloodstream

Are placed under the tongue until hey completely dissolve

Should not be crushed, chewed, or swallowed

Rectal suppositories

Place client in left lateral or left sims position with the upper leg flexed for easy insertion.

Suppositories are contraindicated in clients with cardiac arrhythmias, recent rectal surgery, or rectal bleeding.

Insert suppository 4 inches (10 cm) deep along the rectal wall

Client should remain lying down for 5 minutes

Serious side effects of oral contraceptives

Memory trick: ACHES

Abdominal pain

Chest pain

Headaches

Eye problems

Severe leg pain

Menopause

Cessation of the menstrual cycle for one year caused by age-related changes or due to surgical removal of the ovaries.

Estrogen loss can cause

Vaginal dryness, discomfort, itchiness, and dyspareunia. Estradiol is prescribed for hormone replacement due to estrogen loss.

Dinoprostone

A uterine stimulant and cervical ripened for labor induction

Polycystic ovarian syndrome

Occurs from androgen excess (too much testosterone) and insulin resistance. This hormonal imbalance interferes with ovulation, causing ovarian cysts, irregular menstrual cycle, weight gain, infertility and hirsutism

Metformin

Oral anti diabetic that also treats pcos by increasing insulin sensitivity why lowers androgen levels improving pcos symptoms

Transdermal contraceptive patch teaching

Apply to clean, dry, intact skin, avoid breasts

Apply patch weekly for 3 weeks, no patch on week 4 to allow for menstruation

Use backup contraception if off for more than 24 hrs.

Use of patch increases risk for blood clots

Clomiphene citrate

Oral medication used to treat infertility in clients who are not ovulating (anovulation). Increases the chance of twins.

Once pregnancy is confirmed the medication should be stopped (can cause birth defects)

Doxycycline is the first line treatment for

Chlamydia

Eye drops administration

- into conjunctival sac (NOT cornea)

- press nasolacrimal duct

- wait 5 min between different eye drops

Before giving atropine eye drops, what key assessment question should the nurse ask?

Ask about any history of glaucoma or “tunnel vision.”

Oxybutynin is used for

Overactive bladder, neurogenic bladder (too many bladder spasms, peeing too often)

Basically a bladder relaxer that helps hold urine

Phenazopyridine

A urinary analgesic that alleviates dysuria (painful urination) caused by UTIs, it does NOT treat the infection.

Causes urine to turn a harmless orange or reddish orange color.

Should be discontinued once dysuria resolves

Priapism

A prolonged and painful erection lasting more than 4 hours. It is a medical emergency. (If taking a ED med)

Transformational leadership

Inspires team members and fosters personal growth

Transactional leadership

Focuses on the transaction between leaders and followers.

Ex: if you meet goals, you will be rewarded

Authoritarian leadership

The leader makes decisions and team members follow

Democratic leadership

Encourages collaboration of team members in decision making

Laissesz-faire leadership

Promotes independence in team members with minimal guidance

Critical pathways

A valuable tool to ensure clients receive standardized, evidence-based care based on their diagnosis or treatment.

Ex: Performing chart audits to determine whether all clients were given aspirin after a stroke

Dark colored urine following a traumatic injury is an early indicator of an

Acute kidney injury

FLANK PAIN + ↓ URINE =

KIDNEY PROBLEM

ORGAN FAILURE

Central cyanosis

Blue tinged lips and mucous membranes

Pediatric post cardiac surgery: when is chest tube drainage a red flag?

Concerning for hemorrhage:

Chest tube drainage > 3 mL/kg/hour for more than 3 consecutive hours

OR

5-10 mL/kg in 1 hour

DKA + HEADACHE =

CEREBRAL EDEMA

NEURO CHANGE = EMERGENCY

Proper hand hygiene

Wash hands for 20 seconds in warm, soapy water or use hand sanitizer if hands are not visibly soiled

Variance

Work not done in the correct way

Sterile surgical aseptic

Keep sterile field above their waist, sterile gauze into placed sterile field , holds hands above their elbows during handwashing

MENINGITIS + PURPLE RASH =

Emergency! Think MENINGOCOCCAL SEPSIS

Post op + dyspnea =

Pulmonary embolism

True or false.

Mania is a psychiatric emergency requiring priority intervention, as inpatient hospitalization may be needed for safety and stabilization

True

Peripheral Arterial Disease

Memory tricks:

A = AWAY from the heart —> blood can’t get down to the feet

Venous disease/Chronic Venous insufficiency

Memory trick:

V = VOYAGE back—> blood can’t get back up to the heart

In PAD (arteries) skin is __________ and pulses are _________

Skin: Pale, cool, thin shiny, hairless

Pulses: Poor or absent