NCLEX study from Mark Klimek with 100% correct answers

called Grave's disease or hypermetabolism Tip to remember Grave's disease s/s's "Run yourself into the Grave" - everything is up ... diarrhea, thin, hot, high BP, high HR, cold tolerance, hot intolerance 00:01 01:17 Treatment for Grave's disease Radioactive Iodine, PTU (put thyroid under), surgically remove Total thyroidectomy ... totals get tetany, need lifelong hormone replacement After thyroidectomy patients are at risk for hypocalcemia, remember hypocalcemia is opposite of the prefix and anything to BP so tetany, parasthesia parathesia numbness and tingling, first sign of electrolyte imbalance Subtotal thyroidectomy ... subs get storm S/S of thyroid storm Extremely high vital signs, hyperpyrexia, psychotic delerium How to treat thyroid storm give o2, lower temp to spare brain Risks post op for total thyroidectomy airway, hemorrhage for 1st 12 hours then for 12-48 hours hypocalcemia leading to tetany Risks post op for sub total thyroidectomy airway, hemorrage for 1st 12 hours then for 12-48 hours thyroid storm Hypothyroidism is also called Myxedema or hypometabolism S/S of mydexema everything is down, constipation, heat tolerance, cold intolerance Treatment for mydexema give thyroid medications Where to put the 5 ice packs to cool a thyroid storm patient neck pits groin If you cool a patient too fast what might happen? Heart arrythmias Never hold the hormone for what patient? patient who is NPO with mydexema Addison's disease easy way to remember Add a Sone (sone = steroid) Adrenal Cortex diseases easy way to remember A in Adrenal stands for Addison's C in Cortex stands for Cushing's Addison's disease is undersecretion of adrenal cortex, not enough hormone, BRONZE/tan, go into shock very easily. STRESS can trigger. Addison's disease treatment give a steroid, chronic steroid therapy Cushing's syndrome Over secretion of adrenal cortex, too much hormone, too much steroid. S/S of Cushing's syndrome same as steroid use ... moon face, think cushman "I'm mad I have an infection", high blood sugar, losing Potassium, Treatment for Cushing's syndrome Surgery, bi or uni lateral adrenalectomy (bilateral is worse) Donning PPE's order Gown, Mask, Goggles, Gloves Removing PPE's order alphabetically inside the room For airborne precautions the mask is removed where? outside of the room Avoid answers with what words for children 9 mths and younger? build, sort, stack, construct, make Toddlers (1-3) work on their gross motor skills (jump, hop, throw), NO fine motor, parallel play Preschoolers (3-6) work on fine motor, balance (tumbling, dance, tricycle), cooperative play, pretend School age (7-11) work on creative, collect, competitive Best default order for click and drag order questions? Hold ..... med Assess ..... what med does Prepare ...... the correction Call ..... or notify Rarely if ever answer ... call Doctor, NCLEX wants you to think critically Creatinine lab values same as lithium 0.6-1.2 Not a huge worry, not a dangerous lab to worry about INR lab values 2-3, critical value if off, potential for patient to bleed. Use default order for order ?'s (hold all coumadin, assess for bleeding, prepare Vit K (antidote for Coumadin), Call or notify Potassium lab values 3.5-5.3 If low it is a critical lab to worry about assess the heart and then prepare to give K if high, hold all K, assess heart (EKG), give D5W and reg insulin, call if really high, hold, assess, prepare, call STAT Get someone else involved! Dangerous!!