NCLEX study from Mark Klimek
Hyperthyroidism is also called - ANSGrave's disease or hypermetabolism
Tip to remember Grave's disease s/s's - ANS"Run yourself into the Grave" - everything is up ...
diarrhea, thin, hot, high BP, high HR, cold tolerance, hot intolerance
Treatment for Grave's disease - ANSRadioactive Iodine, PTU (put thyroid under), surgically
remove
Total thyroidectomy ... totals get - ANStetany, need lifelong hormone replacement
After thyroidectomy patients are at risk for - ANShypocalcemia, remember hypocalcemia is
opposite of the prefix and anything to BP so tetany, parasthesia
parathesia - ANSnumbness and tingling, first sign of electrolyte imbalance
Subtotal thyroidectomy ... subs get - ANSstorm
S/S of thyroid storm - ANSExtremely high vital signs, hyperpyrexia, psychotic delerium
How to treat thyroid storm - ANSgive o2, lower temp to spare brain
Risks post op for total thyroidectomy - ANSairway, hemorrhage for 1st 12 hours then for 12-48
hours hypocalcemia leading to tetany
Risks post op for sub total thyroidectomy - ANSairway, hemorrage for 1st 12 hours then for
12-48 hours thyroid storm
Hypothyroidism is also called - ANSMyxedema or hypometabolism
S/S of mydexema - ANSeverything is down, constipation, heat tolerance, cold intolerance
Treatment for mydexema - ANSgive thyroid medications
Where to put the 5 ice packs to cool a thyroid storm patient - ANSneck pits groin
If you cool a patient too fast what might happen? - ANSHeart arrythmias
Never hold the hormone for what patient? - ANSpatient who is NPO with mydexema
Addison's disease easy way to remember - ANSAdd a Sone (sone = steroid)
,Adrenal Cortex diseases easy way to remember - ANSA in Adrenal stands for Addison's
C in Cortex stands for Cushing's
Addison's disease is - ANSundersecretion of adrenal cortex, not enough hormone,
BRONZE/tan, go into shock very easily. STRESS can trigger.
Addison's disease treatment - ANSgive a steroid, chronic steroid therapy
Cushing's syndrome - ANSOver secretion of adrenal cortex, too much hormone, too much
steroid.
S/S of Cushing's syndrome - ANSsame as steroid use ... moon face, think cushman "I'm mad I
have an infection", high blood sugar, losing Potassium,
Treatment for Cushing's syndrome - ANSSurgery, bi or uni lateral adrenalectomy (bilateral is
worse)
Donning PPE's order - ANSGown, Mask, Goggles, Gloves
Removing PPE's order - ANSalphabetically inside the room
For airborne precautions the mask is removed where? - ANSoutside of the room
Avoid answers with what words for children 9 mths and younger? - ANSbuild, sort, stack,
construct, make
Toddlers (1-3) work on - ANStheir gross motor skills (jump, hop, throw), NO fine motor, parallel
play
Preschoolers (3-6) work on - ANSfine motor, balance (tumbling, dance, tricycle), cooperative
play, pretend
School age (7-11) work on - ANScreative, collect, competitive
Best default order for click and drag order questions? - ANSHold ..... med
Assess ..... what med does
Prepare ...... the correction
Call ..... or notify
Rarely if ever answer ... - ANScall Doctor, NCLEX wants you to think critically
Creatinine lab values - ANSsame as lithium 0.6-1.2 Not a huge worry, not a dangerous lab to
worry about
, INR lab values - ANS2-3, 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 - ANS3.5-5.3 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!!
pH lab values - ANS7.35-7.45 if pH is in the 6;s VERY dangerous remember as the patient's pH
goes so goes the patient
If bad vitals, call rapid response team
BUN lab values - ANS8-30 check for dehydration if elevated not a big deal, just be concerned
If a deadly or dangerous lab value is discovered AND they have symptoms call the - ANSrapid
response team!
HgB lab values - ANS12-18 check for bleeding if low or high, if low prepare for tranfussion
HCO3 lab values - ANS22-26 if it is abnormal so what!
CO2 lab values - ANS35-45 if in the 50's assess respiratory status and have patient do pursed
lip breathing, if in 60's considered deadly and respiratory failure, need intubated
Hct lab values - ANS36-54 thickness of blood if abnormal not too big of a deal, assess for
dehydration
PO2 lab values - ANS78-100 this is only obtained from an ABG if low give O2 but if really low it
is respiratory failure give O2, prepare for intubation, call resp therapy and call Dr
O2 sat lab values - ANS93-100 pulse ox, if under 93 assess resp status and give O2
BNP lab value - ANSless than 100 is normal, good indicator of CHF, edema, if elevated assess
s/s of CHF
NA lab values - ANS135-145, if a change in LOC then evaluate for fall/safety risk
WBC lab values - ANS5000-11000 if low assess for infection
CD4 count less than 200 equals - ANSAIDS
Hyperthyroidism is also called - ANSGrave's disease or hypermetabolism
Tip to remember Grave's disease s/s's - ANS"Run yourself into the Grave" - everything is up ...
diarrhea, thin, hot, high BP, high HR, cold tolerance, hot intolerance
Treatment for Grave's disease - ANSRadioactive Iodine, PTU (put thyroid under), surgically
remove
Total thyroidectomy ... totals get - ANStetany, need lifelong hormone replacement
After thyroidectomy patients are at risk for - ANShypocalcemia, remember hypocalcemia is
opposite of the prefix and anything to BP so tetany, parasthesia
parathesia - ANSnumbness and tingling, first sign of electrolyte imbalance
Subtotal thyroidectomy ... subs get - ANSstorm
S/S of thyroid storm - ANSExtremely high vital signs, hyperpyrexia, psychotic delerium
How to treat thyroid storm - ANSgive o2, lower temp to spare brain
Risks post op for total thyroidectomy - ANSairway, hemorrhage for 1st 12 hours then for 12-48
hours hypocalcemia leading to tetany
Risks post op for sub total thyroidectomy - ANSairway, hemorrage for 1st 12 hours then for
12-48 hours thyroid storm
Hypothyroidism is also called - ANSMyxedema or hypometabolism
S/S of mydexema - ANSeverything is down, constipation, heat tolerance, cold intolerance
Treatment for mydexema - ANSgive thyroid medications
Where to put the 5 ice packs to cool a thyroid storm patient - ANSneck pits groin
If you cool a patient too fast what might happen? - ANSHeart arrythmias
Never hold the hormone for what patient? - ANSpatient who is NPO with mydexema
Addison's disease easy way to remember - ANSAdd a Sone (sone = steroid)
,Adrenal Cortex diseases easy way to remember - ANSA in Adrenal stands for Addison's
C in Cortex stands for Cushing's
Addison's disease is - ANSundersecretion of adrenal cortex, not enough hormone,
BRONZE/tan, go into shock very easily. STRESS can trigger.
Addison's disease treatment - ANSgive a steroid, chronic steroid therapy
Cushing's syndrome - ANSOver secretion of adrenal cortex, too much hormone, too much
steroid.
S/S of Cushing's syndrome - ANSsame as steroid use ... moon face, think cushman "I'm mad I
have an infection", high blood sugar, losing Potassium,
Treatment for Cushing's syndrome - ANSSurgery, bi or uni lateral adrenalectomy (bilateral is
worse)
Donning PPE's order - ANSGown, Mask, Goggles, Gloves
Removing PPE's order - ANSalphabetically inside the room
For airborne precautions the mask is removed where? - ANSoutside of the room
Avoid answers with what words for children 9 mths and younger? - ANSbuild, sort, stack,
construct, make
Toddlers (1-3) work on - ANStheir gross motor skills (jump, hop, throw), NO fine motor, parallel
play
Preschoolers (3-6) work on - ANSfine motor, balance (tumbling, dance, tricycle), cooperative
play, pretend
School age (7-11) work on - ANScreative, collect, competitive
Best default order for click and drag order questions? - ANSHold ..... med
Assess ..... what med does
Prepare ...... the correction
Call ..... or notify
Rarely if ever answer ... - ANScall Doctor, NCLEX wants you to think critically
Creatinine lab values - ANSsame as lithium 0.6-1.2 Not a huge worry, not a dangerous lab to
worry about
, INR lab values - ANS2-3, 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 - ANS3.5-5.3 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!!
pH lab values - ANS7.35-7.45 if pH is in the 6;s VERY dangerous remember as the patient's pH
goes so goes the patient
If bad vitals, call rapid response team
BUN lab values - ANS8-30 check for dehydration if elevated not a big deal, just be concerned
If a deadly or dangerous lab value is discovered AND they have symptoms call the - ANSrapid
response team!
HgB lab values - ANS12-18 check for bleeding if low or high, if low prepare for tranfussion
HCO3 lab values - ANS22-26 if it is abnormal so what!
CO2 lab values - ANS35-45 if in the 50's assess respiratory status and have patient do pursed
lip breathing, if in 60's considered deadly and respiratory failure, need intubated
Hct lab values - ANS36-54 thickness of blood if abnormal not too big of a deal, assess for
dehydration
PO2 lab values - ANS78-100 this is only obtained from an ABG if low give O2 but if really low it
is respiratory failure give O2, prepare for intubation, call resp therapy and call Dr
O2 sat lab values - ANS93-100 pulse ox, if under 93 assess resp status and give O2
BNP lab value - ANSless than 100 is normal, good indicator of CHF, edema, if elevated assess
s/s of CHF
NA lab values - ANS135-145, if a change in LOC then evaluate for fall/safety risk
WBC lab values - ANS5000-11000 if low assess for infection
CD4 count less than 200 equals - ANSAIDS
