Nle - Cgfns - Nclex Review Materials 3

NLE / CGFNS / Nclex Review Materials 3 41. DIC • Bruising, purpura • Presence of occult blood • Low fibrinogen level, hct, platelet • Increased PT, PTT • Complication: RENAL FAILURE 42. PERIPHERAL ARTERIAL DISEASE • Dry scaly skin on lower extremities • Rest Pain, at night • Intermittent claudication/ • Thickened toenails • Cold & gray-blue color of skin • Decreased or absent peripheral pulses • Instruct pt. to walk to point of claudication, stop & rest & walk a little farther 43. THROMBOPHLEBITIS • Avoid pressure behind legs • Avoid prolonged sitting • Avoid constrictive clothing • Avoid crossing the legs • Avoid massaging the legs 44. SYPHILIS Painless chancre fades after 6 weeks Low grade fever Copper-colored rash on palms and soles of feet Spread by contact of mucous membranes Treat with Penicillin G IM If patient has penicillin allergy, will use erythromycin for 10-15 days. After treatment, patient must be retested to make sure disease is gone 45. POLYCYTHEMIA VERA • Increased RBC • Leukocytosis / Thrombocytosis • Angina • Intermittent claudication • Dyspnea /HPN • Lethargy / Syncope / Paresthesia 46. PRIMARY HPN Risk Factors: • Aging • Black race • Chronic stress • Family Hx • Obesity • Smoking • Men 47. CHOLECYSTITIS Sx: •N&V • Belching • Indigestion

• Flatulence • Epigastric pain that radiates to the scapula 2 hrs. after eating fatty food • Pain localized in RLQ • Guarding, rigidity & rebound tenderness • Cannot take a deep breath when fingers are pressed below hepatic margin (Murphy’s Sign) II. COMPUTATION 1. Dopamine 2. Dobutamine drip: Order is 2.5mcg/kg/min, patient weights 176 lbs. Stock is 500mg in 500ml of NSS, Compute for ml/hr? Formula: Stock (mg) x 1000 mcg/mg Quantity (ml) Flow rate: Dose (mcg/kg/min) x wt (kg) x 60 min/hr Concentration (mcg/ml) Answer: 12ml/hr 3. Md with IV order for patient 3,000ml in 24 hrs., get the rate at ml per hour. Solution: 3000/24 = 125 ml/hr 4. Tablets : Dose of 20 mg per dose in stock dose of 5 mg per tablet, how many tablets? Solution: 20/5 x 1 = 4 tablets III. TOPICS 1. SAFETY INFECTION CONTROL AIRBORNE : Hepa Filter Mask / N95 Particulate MASK PTB Measles / Rubella Chicken Pox/ Varicella SARS Anthrax CONTACT : GGG (gown,gloves,goggles) Conjunctivitis Open wounds /drainage Lesions MRSA / VRSA / CDAD RSV/ VRE DROPLET : Surgical Mask Scarlett Fever Diphtheria Meningitis Strep. Pharyngitis

Pneumonia ENTERIC: Gown , Gloves Diarrhea Hep. A Salmonella Acute Gastroenteritis Peptic H. Pylori Shigella / Rotavirus Giardiasis / Cryptosporidium Muris FROTECTIVE: Blood dyscrasias Aplastic anemia Leukemia Major burns (50%) Organ transplant Aids Multiple Myeloma Prolong Steroid Therapy Concepts: 1. Infection control: a. clean with clean for example patients with CVA, DM, Cardio disease 2. Same precaution techniques: a. Universal precaution: Hep B,D, AIDS 2. PRIORITIZATION Remember the rule of stable vs. unstable. Although you consider the client unstable but if it expected in him, this is stable. Example. Asthma with wheezingyou consider this unstable. ABC, unstable , first think EXPECTED in asthma so this will be considered stable. 3. DELEGATION RN - Newly admitted, needs assessment, pre op teaching and post op, nsg. Judgment & discharge planning ,IV meds, BT. LPN-Can give meds except IV, sterile techniques like wound dressing, catheterization, insertion of NG tube, remove sutures. Stable expected outcome. NA/ UAP/CN/ Senior nursing student - All “-ing” ex bathing, reading v/s in long term pt. Testing occult blood, BS, monitoring, soap sud enema, testing occult blood, -Isolation precautions, basic hygiene ADL, Input & Output, Finger stick with gestational diabetes, urinalysis, TSB, turning unconscious patient, change perineal pad, assist in ambulation, discharge tomorrow, -Stable v/s, pulse oximetry, reading, terminally ill because of comfort only needed. - Routinary Procedure 4. Patient Hx C/I for MRI : • Mitral Valve Replacement

5. Glaucoma : • Halos around light 6. U waves : • Hypokalemia 7. Patient with arterial insufficiency • Elevate the affected leg 8. Patient with Dumping Syndrome: • Avoid cheese 9. Adverse Effect of Anti-metabolite 5FU • Stomatitis 10. Obtaining sputum specimen from pt. with tracheostomy: • Instruct pt. to cough prior to obtaining sputum 11. Post-hypophysectomy pt. Report if: • Specific Gravity of 1.005 12. Diet for Hypothyroidism • Low sodium, High K 13. Patient with CHF cor pulmonale S & S • Jugular vein distention & peripheral edema 14. Circumcision of a new infant: • Diaper fasted loosely 15. Acute Pancreatitis • Increase lipase/amylase 16. Short-term goal for anti-social patient • Follow unit rules 17. Use of walker • Partial weight bearing • Stand in front, walk unto walker 18. Borderline patient • Splitting 19. Neonates in nursery developed diarrhea • Meconium stool study w/in 24 hrs. 20. Nsg. Action in pt. post cardiac catherization • Check pulse in lower extremities 21. Diet for Diverticulitis • Avoid high-fiber foods when inflammation occurs, only low residue • Introduce soft high-fiber foods when inflammation has resolved 22. Low iron.WBC & albumin, what type? • Nutritional deficit (malnutrition) 23. What will you ask on pt for cardiac stress test (Thallium stress test)?

• Is he on beta-blocker? (if with radionuclide already, Persantine, then invasive & shld. avoid caffeine, calcium channel blockers, b-blockers, theophylline) 24. Highest risk of accident • 9 month infant eating grapes & apricot 25. Pancrease in Cystic Fibrosis • Give with meals, dilute in applesauce 26. Client post-CVA, diet teaching • Low salt, low fat 27. Client passing stones with calcium, diet teaching: • Should be acid-ash diet & avoid oxalate rich & Ca rich food such as tea, almonds, rhubarbs beans, spinach, cocoa, vegetables, fruits • Give cranberries, prunes, plums, tomatoes, cereals, corn, legumes I 28. Paget’s Disease • Bowing of bones 29. Side Effect of Ansef (Cefazolin) • Antibiotic (RTI,URTI) • Diarrhea, Nausea • Oral candidiasis • Pancythopenia 30. Peptic ulcer disease • Avoid stressful situation to prevent exacerbation 31. Schilling’s Test • For pernicious anemia 32. Prior To MUGA SCAN: • Informed consent • Allergy not a concern 33. Action of Aquamephyton • Prevention of hypoprothrobinemia 34. Action of Lipitor • Anti-lipimec 35. Positioning of Hip Spica Cast in children • Maintain flexion, abduction & external rotation 36. Fear of 3 y/o child • Injury (abandonment, castration) 37. To prevent ureteral stones • Increase fluids 38. MDI • Hold breath 39. Frostbite • Soak in warm water

40. Normal respiratory changes in elderly • Decreased cough reflex 41. Patient w/ DM & HPN, question if • Given beta-blocker (causes bronchospasm ) 42. Maximum injection on 10 month old infant • 1 ml 43. Pt. with endometriosis takes Danocrine, action of the drug? • Suppress menstruation/ ovulation 44. Post NSD with epidural anesthesia with bladder distension • Offer bedpan 45. Apmhotericin B, side effect? • Headache • Hypokalemia • Hypotension 46. PT. with angina unrelieved by 3 nitroglycerin • Administer O2 47. Patient on Halo Vest • Tape the wrench to the vest (Torque screw) 48. Pre-menopausal syndrome experiencing hot flashes • Black Cohosh for menoposh 49. Abdominal Assessment • Inspection • Auscultation • Percussion • Palpation 50. Sclerotherapy • Application of pressure dressing for 12-48 hrs.