(Nursing 4530) Mark Klimek Notes – Lecture Notes 1

(Nursing 4530) Mark Klimek Notes – Lecture Notes 1. How to guess 1. Use knowledge 2. Common sense 3. Guessing strategy Psych  Nurse will examine own feeling about something-so do not counter transfer  Establish trust relationship Nutrition  Pick chicken not fried chicken  Fish but not shellfish  Never pick casseroles for kids  Never mix meds in food  Toddlers-finger foods  Preschool-one meal a day is OK. Leave them alone 3 expectations to have  Do not expect 75 questions-think 265  Do not expect to know everything  Do not expect everything will go right Pharm  Most tested area is side effects  Do not worry about route or dose  If know what drug does but do not know side effect-pick a side effect in same body system the drug is working  No idea what the drug is-look to see if it is PO-pick GI side effect  Never tell kids that med is candy OB-check fetal HR Med Surg  1 st thing assess-LOC  1 st thing do-establish airway Peds  All based on principle-give child more time to grow and develop  When in doubt-call it normal  When in doubt-pick the older age  When in doubt-pick the easier task-more time to do the harder one 2 General  Rule out absolutes  If 2 answers say same thing-neither is correct  If 2 answers are opposite-one is probably right  Umbrella strategy  If questions has 4 right answers and ask for priority of needs of a patient-worse consequences game-worst outcome  When stuck between two answers-read the question Sesame street rule-use only as last option  Right answer tends to be different than the rest  Wrong answers are usually all similar  Right answer is most unique or different Answer based on what you know, not what you don’t know  If you dont know something in a question-pull it out of the equation-use common sense  Nclex also testing on common sense-do not overanalyze-do not think like a nurse  Go with gut answer-only if other answer is superior 3 Prioritization  Decide who is sickest or healthiest---based on question  ABC does no work with prioritization questions  Answers will have 4 parts  Age  Gender  Diagnosis  Modifying phrase  2 are irrelevant ----age and gender  In Peds pay attention to age but in prioritization age is not important  Modifying phrase most important  Ex: pt has angina pectoris vs MI ---- MI is high priority  Pt has angina pectoris and unstable BP vs MI with stable VS ----angina with unstable BP is now the priority 4 rules to prioritization 1. Acute beats (higher priority than) chronic Example: COPD versus appendicitis---appendicitis is the priority 2. Fresh postop (12 hrs) beats medical or other surgical Example: 2 hr post op versus appendicitis---2 hr post op is the priority 3. Unstable beats stable Stable words Unstable words  Stable  Chronic illness  Post op 12 hrs  Local or regional anesthesia  Lab abnormalities A or B level  Unchanged assessments  To be discharged  Ready for discharge  Admitted longer than 24 hrs ago  Experiencing the typical expected S/S of disease with which they were diagnoses  Unstable  Acute illness  Post op 12 hrs  General anesthesia (1st 12 hrs)  Lab abnormalities C or C level  Changed/changing assessment  Not ready for discharge  Newly diagnosed  Newly admitted  Experiencing unexpected S/S. We offer online tutoring, help with assignments and essay writing for all Majors with a guaranteed pass. For assistance Contact Tutor Lucas: