Must-Know
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Notes for
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- Negligence: harm that results because a person didn’t act
NCLEX-RN NOTES reasonably.
- Malpractice: professional negligence.
TIPS: - Slander: character attacked and uttered in the presence of
- Deal with patients rather than with machines. others.
- AVOID: never, always, must, “why?”, “I understand”. - Assault: act in which there is a threat or attempt to do bodily
- If 2 opposites (e.g. hyper-/hypo-), one is correct. harm.
- Do not leave the patient alone. - Battery: unauthorized physical contact.
- Choose physical over psychological.
- IDK the answer: pick the one with the most information. CULTURAL CONSIDERATIONS
1. African Americans
ABC (except in emergencies, distress situations & CPR) - Higher incidence of high blood pressure and obesity;
Assessment vs. Implementation - High incidence of lactose intolerance.
Acute vs. Chronic 2. Arab Americans
Stable vs. Unstable - May remain silent about STIs, substance abuse, and mental
Expected vs. Unexpected illness;
Real vs. Potential - After death, the family may want to prepare the body and
Odd man out autopsy is discouraged unless required by law; - Use same-sex
family members as interpreters. 3. Asian Americans
DO NOT DELEGATE (PACET): - Believe in the yin/yang “hot-cold” theory of illness; - Sodium
- Planning; intake is generally high because of salted and dried foods;
- Assessment (initial); - Usually refuse organ donation;
- Collaboration; - Evaluation; - Teaching. - May nod without necessarily understanding.
4. Latino Americans
- Family members are typically involved in all aspects of decision
UAP’s cannot be delegated: “EAT”, medication & unstable
making such as terminal illness; - May see no reason to submit
patients.
to mammograms or vaccinations. 5. Native Americans
LPN’s cannot be delegated anything related with blood and - Diet may be deficient in vitamin D and calcium because many
are assigned the most stable patients. suffer from lactose intolerance or don’t drink milk; - Obesity
and diabetes are major health concerns.
1 tsp = 5 ml 1 pint = 2 cups (16 oz)
RELIGIOUS CONSIDERATIONS
1 tbsp = 3 tsp (15 ml) 1 quart = 2 pints (32 oz) - Jehovah’s Witness: no blood products should be used.
1 oz = 30 ml 1 gr (grain) = 60 mg - Hindu: no beef or items containing gelatin.
- Jewish: special dietary restrictions, use of kosher foods.
1 cup = 8 oz 1 kg = 2,2 lbs - Adventists: no pork nor alcohol and sometimes no meat. -
1 g = 1 ml (diapers) ºF = (ºC x 1,8) + 32 Muslims: no pork nor alcohol; people with chronic illnesses
and women that are pregnant, breast-feeding or menstruating
Temperature normal range: 98,6ºF ±1 (37ºC don’t fast during Ramadan.
±0,5)
MAP: (systolic + 2xdyastolic)/3 ORDER OF ASSESSMENT:
Normal: 70-105 mmHg (>60 mmHg) Inspection
Abdomen:
CVP: 2-8 mmHg ( CVP can indicate right
Palpation 1º Inspection
ventricular failure or fluid volume overload) 2º Auscultation
Percussion 3º Percussion
ETHICS & LEGAL ISSUES 4º Palpation
- Veracity is truth and is an essential component of a therapeutic Auscultation
relationship between a health care provider and his patient.
- Beneficence is the duty to do no harm and the duty to do ABO BLOOD TYPE COMPATIBILITY
good. There’s an obligation in patient care to do no harm and
an equal obligation to assist the patient.
- Nonmaleficence is the duty to do no harm. Blood Type Can receive from: Can donate to:
- Tort: litigation in which one person asserts that an injury
O O O, A, B, AB
(physical, emotional or financial) occurred as a consequence of
another’s actions or failure to act. A A, O A, AB
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B B, O B, AB BURNS
AB O, A, B, AB AB Parkland formula:
4ml/kg/%body burned
TRACTIONS
- Buck’s traction: knee immobility
- 1st 8h: ½ total volume
- Russell traction: femur or lower leg
- 2nd/ 8h: ¼ total volume
- Dunlap traction: skeletal or skin
- 3rd 8h: ¼ total volume
- Bryant’s traction: children <3y, <35 lbs with femur fracture.
INFANT’S DEVELOPMENT:
2-3 months: turns head side to side
4-5 months: grasps, switch & roll
6-7 months: sit at 6 and waves bye-bye
8-9 months: stands straight at eight
10-11 months: belly to butt (phrase has 10 letters)
12-13 months: twelve and up, drink from a cup
ERIKSON’S STAGES OF PSYCHOSOCIAL DEVELOPMENT
AGE STAGES CHARACTERISTICS CRANIAL NERVES (Sensory=S |Motor=M |Both=B)
Infancy (0- Trust vs. Development of trust Oh (Olfactory I) Some
18m) Mistrust based on caregivers Oh (Optic II) Say
Oh (Oculomotor III) Marry
Autonomy vs. Development of sense
Early childhood To (Trochlear IV) Money
Shame & of personal control
(18m-3yrs) Touch (Trigeminal V) But
doubt
And (Abducens VI) My
Development of sense Feel (Facial VII) Brother
Preschool Initiative vs.
of A (Auditory VIII) Says
(3-5yrs) Guilt
purpose and directive Girls (Glossopharyngeal IX) Big
School age Industry vs. Development of pride Vagina (Vagus X) Bras
(611yrs) Inferiority in accomplishments And (Accessory XI) Matter
Hymen (Hypoglossal XII) More
Exploration of
Adolescence Identity vs.
independence and
(12-18yrs) Role confusion
development of self
Cranial nerve What it controls
Early Development of
Intimacy vs. I Olfactory Smell test
adulthood personal relationships
Isolation
(1840yrs) and love II Optic Visual acuity and visual fields
Fulfilling goals and Pupil constriction and extraocular
Adulthood Generativity vs. III Oculomotor
building career and movements
(4065yrs) Stagnation
family
Extraocular movements: inferior
Older adult Integrity vs. Looking back on life IV Trochlear
adduction
(>65yrs) Despair with acceptance
V Trigeminal Clench teeth and light touch
Extraocular movements: lateral
VI Abducens
abduction
VII Facial Facial movement: close eyes, smile
VIII Auditory Hearing and Romberg test
IX Glossopharyngeal Gag reflex
Say “ah” – uvular and palate
X Vagus
movement
Turn head and lift shoulders to
XI Accessory
resistance
XII Hypoglossal Stick out tongue
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