Nle - Cgfns - Nclex Review Materials 2

NLE / CGFNS / Nclex Review Materials 2 11. ESRD DIET • Restricted protein intake • Increase CHO • Low K, P • Restrict Na 12. NORMAL IN 8 MONTH OLD CHILD - can sit with out support - can roll from front to back - can hold a bottle - closure of ant. fontanel - can say mama and dada - 2 teeth present 13. SUPERIOR VENA CAVA OCCLUSION • Sx occur in the morning • Edema of face, eyes & tightness of shirt/ (Stoke’s sign) • Late sx: edema of arms, hands, dyspnea, erythema, epistaxis 14. ULCERATIVE COLITIS Sx: • Severe diarrhea with blood & mucus • Abdominal tenderness & cramping • Anorexia • Wt. Loss • Vit. K deficiency • Anemia • Dehydration • Electrolyte imbalance • Low residue & high protein diet 15. DILANTIN • do not floss throughout the day • do not use hard bristled toothbrush • Gingivitis S/E 16. ANAPHYLACTIC REACTION (steps) • Stop medication • Maintain airway • Notify MD • Maintain IV access of 0.9 NSS • Place in supine position with legs elevated • Monitor VS • Administer prescribed emergency drugs 17. BLADDER CA Risk Factors: • Hx of smoking • Exposure to radiation • Working in industrial Factory 18. S/S OF DKA • Fruity breath Odor

• Oliguria • Kusmaull'’s (deep & nonlabored) 19. SITE FOR IM INJECTION ADULT • Deltoid • Ventrogluteal • Vastus Lateralis • Gluteus Maximus 20. S/S OF BACTERIAL MENINGITIS •N&V • Seizures • Stiff Neck • Photophobia 21. TB • Waking up sweating at night • Low grade fever • Dull aching chest pain • Cough streaked with blood • Weight loss • Anorexia • Fatigue 22. LIVER CIRRHOSIS •N&V • Edema • Ascites 23. PULMONARY EMBOLISM Sx: • Blood-tinged sputum • Distended neck vein • Chest Pain / Hypotension / Cyanosis • Cough / Shallow respirations • Rales on auscultation • Tachypnea / Tachycardia 24. COLON CA Risk Factors: • Family HX • Age above 50 • Jewish • Male 25. DIGOXIN THERAPY • Do not administer in infants if S/S OF CAD • Chest Pain • Palpitations • Dyspnea / Syncope • Hemoptysis • Excessive Fatigue 27. COPD • Rhythmic, diaphragmatic breathing • If restless, perform purse-lip breathing not more than 1 minute • Perform deep breathing with mouth held together during expiration

28. SEEN IN 15 MONTH OLD CHILD • Speaks 6 words • Sits w/o support • Builds a tower of 5 blocks • Strong palmar grasp 29. CUSHING’S SYNDROME • Osteoporosis • Muscle wasting • Hypertension • Purple skin striations • Moon face • Truncal obesity • Decreased resistance to infection • Low Carbohydrate, Low Calorie, High Protein, High K, Low sodium • Monitor glucose level • Check for color of stool, cortisol increase secretion of gastric acid – Peptic ulcer & GI bleeding • C/I to Aspirin, increased bleeding 30. ADDISONS DISEASE Fatigue Weakness Dehydration Eternal tan Decreased resistance to stress Low Sodium Low Blood Sugar High Potassium High protein, carbohydrate, Sodium, Low potassium diet Teach life-long hormone replacement • Glucocorticoids (sugar) - Solu- Medrol (succinate) to prevent addisonian crisis • Mineralocorticoids (salt) – Florinef 6 A's of Addison's disease 1.) Avoid Stress 2.) Avoid Strenuous 3.) Avoid Individuals with Infection 4.) Avoid OTC meds 5.) A lifelong Glucocorticoids Therapy 6.) Always wear medic alert bracelet Addisonian Crisis • Hypotension • Extreme weakness • Nausea vomiting • Abdominal pain / • Severe hypoglycemia • Dehydration • Administer NaCl IV, vasopressors, hydrocortisone • Monitor VS /Absolute bedrest 31. PLACENTA PREVIA • Check Hematocrit level

• External fetal monitor not internal • No vaginal examination • Assess for bleeding • Improperly implanted placenta at lower uterine • Painless bright red, vaginal bleeding • Soft, relaxed, nontender uterus • Fundal height greater than expected 32. ABRUPTIO PLACENTA • Premature separation of placenta from uterine wall • Painful dark red bleeding • Uterine rigidity • Severe abdominal pain • Maternal shock • Fetal distress 33. HEMODIALYSIS • Palpate for a bruit or thrill • Weigh client daily, before, during & after • Hold antihypertensive drugs b4 dialysis • Check for thrill and bruit q 8 hours • Don’t use extremity for BP, finger stick • Monitor vital signs, weight, breath sounds • Monitor for hemorrhage 34. PERITONEAL DIALYSIS • Weight before and after treatment • Monitor BP • Monitor breath sounds • Use sterile technique • If problem w/ outflow, reposition client • Side effects: constipation 35. TYPE 1 IDDM • Test blood glucose every 4 hrs if no feeling well • Eat fruit or cheese sandwich before exercise • Do not exercise if blood glucose is >250mg/dl & urinary ketones present • Administer regular insulin 30 minutes before meals 36. COMPARTMENT SYNDROME • Increased pain & swelling • Pain with passive motion • Loss of sensation • Inability to move joints • Pulselessness 37. CARDIAC CATHETERIZATION • NPO 6-8 hrs. & no liquid for 4 hrs. prior to prevent vomiting & aspiration • Feel a flush, warm, fluttery feeling, desire to cough, palpitations in introduction of dye • Shave & Clean insertion site with antiseptic solution 38. PERNICIOUS ANEMIA • Severe pallor

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Smooth, beefy red tongue Slight jaundice Paresthisias of hands & feet Disturbances with gait & balance

39. DUMPING SYNDROME • Occurs 30 minutes after eating • Abdominal fullness & cramping • Diarrhea • Tachycardia • Perspiration • Weakness / dizziness • Borborygmi sound 40. TPN COMPLICATIONS • Air Embolism • Fluid Overload • Hyperglycemia • Hypoglycemia • Infection • Pneumothorax