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NCLEX Kaplan Review (51 Pages)

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SOME OF THE CONTENT IN BRIEF: Normal Lab Values Hgb (hemoglobin): males=14-18 females=12-16; w/ <6.8= NC of 2L o <12= iron deficiency anemia…… >15= dehydration, HF, or COPD  Hct (hematocrit... ): males=42-52 females=37-47; ↑ of >4 points in 2 weeks= ↑ risk for seizures  RBC’s: males=4.7-6.1 million females=4.2-5.4 million Arterial Blood Gases o pH: 7.35-7.45 o CO2 (respiratory driver): 35-45- Acidodic o HCO3 (metabolic driver): 21-28- Alkalosis Fluid & Electrolytes  Fluid Volume Deficit Fluid Volume Excess ↑hematocrit ↓ hematocrit ↓ BP ↑BP ↑ Urine specificity >1.030 ↓ urine specificity ↑ CVP (normal 4-11) ↑ BUN Antidotes  Digoxin→ Digiband  Coumadin→ Vitamin K  Benzodiazepines→ Flumazenil (Tomazicon)  Mg Sulfate→ Calcium Gluconate Pediatrics  The preferred injection site for vitamin K in the newborn is the lateral aspect of the middle third of the vastus lateralis muscle in the newborn's thigh.  Newborn S&S of hiatal hernia: vomiting, coughing, wheezing, short periods of apnea, and failure to thrive. Myelomeningocele= cover w/ moist sterile water dressing, prone positioning- prevents meningitis  NO MMR on kids w/ an egg/ neomycin Physiologic jaundice is normal @ 2-3 days caused by a rupture of large amounts of blood cells within a short period. Leopold’s Maneuvers Gerontology o Most reliable sign of infection >65= tachypnea o Renal threshold Medical-Surgical  Respiratory o Assess cough reflex & ability to swallow before giving fluids= ↑ ICP & risk for aspiration. o Rifampin for TB= turns urine rusty/red/orange * NO eye contacts. o Isoniazid (INH) for TB= ↑ Dilantin levels Cardiac ♥ Hold digoxin <60 ♥ Stay in bed after 1st ACE inhibitor dose. ♥ Pts w/ hypertension should avoid weight lifting & hot baths/sauna- can lead to hypotension. Endocrine  Hypophysectomy- removal of pituitary gland  Check output- they might not be producing ADH which will lead to copious amounts of urine. Cushing’s syndrome is a metabolic disorder characterized by abnormally increased secretion (endogenous) of cortisol, caused by increased amounts of adrenocorticotropic hormone (ACTH) Gastrointestinal  Lipitor (statin) given in PM only! No grapefruit juice.  Peptic ulcer disease should avoid: ASA, Alcohol, & caffeine.  Duodenal ulcer (feed) pain is relieved by food. Genitourinary  PET scan= teaching: empty bladder before test  Clomidene- increases ovulation… S/E= multiple births Musculoskeletal  Following a myelogram encourage fluids to get rid the oil based dye.  Never pull yourself up using a walker= safety Psychiatry  Pts admitted against their will still retain their right to refuse tx.  Phobias involve projection & displacement Psychiatry  Pts admitted against their will still retain their right to refuse tx.  Phobias involve projection & displacement Positioning  NG tube placement: high fowler’s  G-tube= liquid med (sorbitol) is of great concern since it can cause diarrhea  THR- (only abducted) NO! adduction past midline or hip flexion past 90 Pre/post-operative care:  Breathing is taught before sx  Incentive spirometry= inhale slowly & completely hold for 5 seconds. Done 10 x’s a day.  ↑ corticosteroids & insulin’s too if needed Diseases/Illnesses  Reynaud’s disease: o Warm up car before starting to drive/ avoid cold weather: wear wool gloves & stay home. o Go to yoga class after clinic (↓ stress) Herbs  Chamomile interferes w/ anticoagulants  St. John’s wort: Contraindicated in pregnancy & lactation. Do not take if experiencing major depression, or while on: MAOI’s, SSRI’s, or levodopa. AVOID: tyramine foods & excessive sunlight Nutrition  K+= bananas, dried fruits, citrus, potatoes, legumes, tea, peanut butter, raisins, cantaloupe, & strawberries. Diets  Full liquid: plain ice, cream, sherbet, custards, milk, pudding, soups, breakfast drinks.  Clear liquids: water, bouillon, broth, coffee, gelatin, lemonade, tea, hard candy, carbonated beverages Feedings  When preparing to D/C PN the nurse should first slow down the infusion rate.  Nurse must get infusion pump before hanging infusion Pharmacology  Anticonvulsants **CNS depressants** o Phenytoin (Dilantin)→10-20 therapeutic level Ginko, gensin, garlic= antiplatelet properties o Trough draw: 30 min. before administration. o Peak draw: 30 min. after administration. o Watch for hyperK+ w/ aldactone (spironolactone) & ACE inhibitors. o Fibronolytics= streptokinase o Persantine combined with warfarin sodium (Coumadin) is prescribed to protect the client's artificial heart valves. o w/ Rimfampin check levels of SGPT (liver) o Neupogen ↑ levels of uric acid. (When using the IV line should be flushed before & after w/ 5% dextrose) o Pentazopine hydrochloride (Talwin) - for stenosis of the spine. Assess of respirations & lethargy. o Amoxifen citrate (Nolvadex) causes soft tissue disease & subsides rapidly. o Carbidopa (Sinemet) - makes levodopa more readily available for transport. o Risperdal-S/E includes hyperglycemia, weight loss, & blurred vision.  Monitor glucose o Cyclophosphamide (Cytoxan)- S/E are leukopenia; check WBC o Phentolamin mesylate- should be infiltrated when extravasation of dopamine occurs. o Sodium thiomate- S/E are a ↓ in platelets- check for bruising & bleeding. o Clozapine (clorazil)-schizophrenia=adverse effect- agranulocytosis-leukemia; monitor WBC’s. o Gentamicin sulfate- avoid sunlight exposure (photosensitivity). o Zoloft- watch out for nausea, vomiting, abdominal cramps, & diarrhea= hyponatremia. o Plasma cholesterol screening: only sips of water for 12 hours before the test. [Show More]

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