Mercy CollegeNCLEX 1000NCLEX Review.BEST 2021

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Important Review: ABC’s ASSESS before intervening 1.ABC 2. Change in LOC 3. Change in VS 4. Unstable metabolic disorders (hypo/hyper glycemia, electrolyte shift) 5. Pain 6. Any treatments you ne... ed to perform 7. Family requesting you to come/Discharge teaching LPN’s CANNOT Teach, Plan, Assess, Initiate Careplan, Evaluate, handle blood (Central Lines) They CAN administer meds, gather data, make observations, attach leads, obtain EKG, monitor effects of meds, listen to lung sounds, wound care, set up equip for O2 and suction NA’s CAN Vital Signs, remind, monitor I&O, encourage, Pack/year = 20 cigs a day per year Na 135-145 K 3.5-5.5 Ca 8.5-10.5 Mg 1.5-2.0 Cl 98-108 Platelets 150,000-450,000 PTT 30-60 seconds therapeutic range is 1.5 to 2 times this WBC 5,000-11,000 RBC 4.5-6.0 million Reticulocyte = immature RBC’s Hct 37-48% or 45-54% Hgb 12-16 or 14 to 18 BUN 7-20 Creatinine 0.5-1.5 Quickening 16 weeks fetal heart tones 20 weeks fetal heart rate 120-160 Litium intial 1.0-1.5, therapeutic 0.6-1.2 Dilantin 10-20 Digoxin 0.8-2.0 Heparin look at ptt and antidote is Protamine Sulfate Coumadin look at INR and antidote is vitamin K Mag Sulfate antidote is Calcium Gluconate narcotic antidote is Narcan Tylenol antidote is Mucomist Insulin: Reg 30-60 min onset, 2-4 hr peak and 5-7 duration NPH 1-3 hr onset, 6-12 hr peak and 18-24 duration Lispro-fast acting and to eat right away pH 7.35-7.45 PaCO2 35-45 PaO2 90-100% HCO3 22-26 Rules of Nines: 9% is head and both arms, 18% is front torso, back torso and both legs and 1% is groin 5 P's with fractues: pain, pallor, pulselessness, paresthesia and paralysis Cranial nerves: Olfactory, Optic, Oculomotor, Trochlear, Trigeminal, Abducens, Facial, Acoustic, Glassopharnygeal, Vagus, Spinal Accessory and Hypoglossal Fetal Heart strips: VEAL CHOP (Variable is cord, early is head, accelerations is ok and late is placental insuffenciency) starve a gastric ulcer, feed a duo ulcer 200-300 ml blood loss with vaginal birth, 500 ml with c-section, over is hemorrhage Urine specific gravity: 1.010-1.030 Diabetes Insipidus: ADH,  UO (dehydration),  urine specific gravity,  serum Na SIADH:  ADH,  UO  urine specific gravity,  serum Na, HHNKS: glucose > 800, no ketones, acidosis Total cholesterol: optimal <200. borderline 200-230. high > 239. LDL: optimal <139. borderline 140-160. high >160. AST: 10-40 ALT: 5-35 Serum albumin: 3.5-5.5 Hemophilia a: no asa, nsaids Blood type O = universal donor. Blood type AB = universal recipient CVP: nl 3-12. >12: hypervolemia, <3: hypovolemia Isotonic: 0.9% NaCl, LR, D5W Hypotonic: 0.45% NaCal Hypertonic: D10-15W, 3% NaCl 60mg=1grain Carbamazepine: therapeutic 5-12 Antabuse: avoid otc cough/cold-contain alcohol 24-34wks: fundal height correlates with wks gestation No grapefruit juice: cyclosporine, carbamazepine, buspar, zocor, verapamil OD benzodiazepines – antidote: flumazenil (romazicon) 24 hour old jaundice is abnormal, normal is over 24 hrs old Parkland Formula: 4 ml(kg)(%BSA)=24 hour fluid replacement with ½ first 8 hrs and 2nd ½ second and third 8 hrs ie; 4ml(54.5 kg)(60%)=13080 with 6540 first 8hr and 3270 second and third 8hr PR Interval is 0.12-0.20 and QRS Complex is 0.04-0.12 Addison's (AD-Aldosterone Deficiency to remember) disease- ↓NA and ↑ K, HYPOGLYCEMIA, ↑Ca. Remember – if there is low/absent NA+ in the body, than nothing holds H2O in. Thus, ↑Urine output, Hypotension +, Hypovolumia, dehydration and ↓ CO. Major function of Aldosterone – is to keep NA+ in & K+ out of the body . Cushing’s (too much glucocorticoids) syndrome is opposite to Addison’s. Adrenal hypersecretion of glucocorticoids. ↑ NA ↓K and ↓Ca, HYPERGLYCEMIA. When assessing think of the cushion (moon face, buffalo hump, truncal obesity). Pheochromocytoma - HTN is a hallmark. @ 20 weeks of gestation - fundus is @ umbilicus. Neutrophil count - 1800 - 7800; indicate +/- of infection Albumin 3.5-5.0 g/100ml Aldolase 1.3-8.2 U/L Amylase 4-25 units/ml BUN 8-25mg/100ml Calcium 8.3-10.5 mg/100ml increased levels think - hyperparathyroidism, nonparathyroid PTH producing tumor, metastatic bone tumor, Paget's disease, prolonged immobilization, vitamin D intoxication, lymphoma, Addison's disease, acromegaly, hyperthyroid Decreased levels think: hypoparathyroidism, renal failure, hyperphosphatemia, Rickets, vitamin D deficiency, osteomalacia, pancreatitis, alkalosis Signs/symptoms are : tachycardia, hypotension, paresthesias, twitching, cramps, tetany, positive Chvotek's or Trousseau's sign, diarrhea, hyperactive bowel sounds, prolonged QT interval Calcium and Phosphate run opposite each other Pylonephritis – infection of the kidney and ureters (ducts that carry urine from kidney) Nephrotic Syndrome – increased glomerular permeability – massive loss of protein/albumin (↑Na & ↑H2O retention) PPE: On – 1.Gown; 2.Mask; 3.Goggles; 4.Gloves PPE: Off – 1.Gloves; 2.Goggles; 3.Gown; 4.Mask [Show More]

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