Nclex 4

Nclex 4 How is NPH insulin administered a. sub-q b. iv push c. on the gums - subq Lispro is what type of insulin - rapid acting which insulin is the only one that can be administered IV push - regular insulin Why is glyburide on the beers criteria? - can cause hypoglycemia especially in elderly patients who cannot eliminate waste well. How does one do pursed lip breathing? - exhale for four seconds through pursed lips, inhale through the nose for two seconds with the mouth closed which finding would be the most concerning in a 72 hour client experiencing hyperbilirubinemia? temp of 99 newborn is only wearing a diaper and eye protection two black tarry stools since birth - two black tarry stools since birth bc persistent meconium can indicate dehydration which worsens hyperbilirubinemia in an acute asthma attack, what should the patient take first betamethasone inhalers or albuterol? - first albuterol In hemophilia what can tingling in the joints represent? - joint bleeding In hemophilia preventative clotting medications is need before major/minor procedures? - both how should injections be given to hemophelia patients - use small guage needles and ice after what is scleroderma? - Is disease where the body has too much collagen and it causes hardening of the skin and connective tissue How do renal crises effect scleroderma? - it's a complication of scleroderma that causes malignant hypertension because the blood vessels connected to the kidneys are narrowing - early recognition is key potential complications of scleroderma are - malignant hyper tension pulmonary fibrosis heartburn and dysphagia Raynaud phenomenon What is Raynaud's phenomenon? - common in scleroderma inducing vasospasms which cause color changes in the fingers and toes and is relieved by immersing the fingers and toes in hot water dialysis disease equilibrium syndrome - more solutes are removed from the blood than from the brain and CSF causing a dangerous concentration gradient which can lead to cerebral edema which is the priority in a patient on dialysis who is experincing nausea vomitting and chest pain a. checking eletrolytes b. giving bP meds c. assessing the BP g anti-emetics - c. assessing BP- the first sign is hypotension what can prevent dialysis disease equilibrium - slowing the rate of hemodialysis scarlet fever is cuased by which bacteria - strep what are signs of scarlet fever - fever + pharyngitis tonsillar erythema and exudatesstrawberry tongue tender cervical nodes sandpaper rash how do you dx scarlet fever - rapid strep test, throat culture How do you treat scarlet fever - penicillin what are some interventions for chest tube removal - analgesic 30-60 mins b4 instruct the client to breathe in, bear down when the tube is being removed sterile air-tight petroleum dressing provide the health care provider sterile suture equiptment when assessing a patient in traction where should the weights be? - weights must be suspended in the air to provide the force to align the bone. if they are improperly aligned the patient will be in severe pain any patient with a spinal cord injury t6 and lower are at risk for - autonomic dysreflexia what are priority interventions with patients in autonomic dysreflexia? - check BP check bladder (this is the most common cause) digital rectal exam- bowel impaction remove constrictive clothing to avoid skin stimulation in order to encourage safe play for children what should parents keep on hand - ice packs how should you position a pt experiencing autonomic dysreflexia? - semi fowlers HOB 45 degrees or higher what should the nurse teach a patients parents about scabies? - apply permethrin cream to all areas of the skin except eyes treat all people that have been in contact with the child wash the childs clothing and linen in hot water you do not need to throw out stuffed animals or fumigate the house with nonwashable belongings how should you prevent the spread of scabies - put them in a sealed plastic bag for three days how is scabies spread? - skin to skin why is transdermal fentanyl not advised for treating acute postop pain? - because it is released slowly which of the following findings post-cystoscopy requires immediate follow-up a. small clots in the urine b. input of 3000 ml and output of 2000 c. bladder spasms relieved with oxybutynin d. BP of 116/70 and HR of 68 - b. input of 3000 and output of 2000 what does tinea capitis look like - red, circular scaley lesions how do we treat tinea capitis? - admitting oral griseofulvin advise against sharing helmet inspect family pets what is sjogren's syndrome - an autoimmune disease that attacks the bodies moisture producing what is most affected by sjorgren's syndrome? - mouth and lacriminal glands and vaginal dryness complications with a VP shunt present with symptoms? - bradycardia and lethargy who adjusts the straps of a Pavlik cast? - doctor do you remove the pavlik casts during diaper change - no What is varenicline used for? - smoking cessation upper intestinal bleeding is commonly cause from - NSAIDs Meleana is a sign of upper/lower GI bleeding? - upper what is a lactovovegetarian? - they eat milk, eggs, but not meat who is more at risk for anemia? lactovovegetarian/vegan - vegan true or false: drinking alcohol with food is a good way to prevent ulcers - false what is polycythemia vera? - too much rbcs formation whats the most dangerous side effect of polycythemia vera? - blood clots What is the oculocephalic reflex? - also known as doll's eyes, is an expected finding in a brainstem infarction, where the eyes move in the opposit direction of the head when its turned (not done in spinal trauma) normal pupil diameter - 3-5 mm neck can't flex towards the chest is a sign of - meningitis known is nuchal rigidity Lanugo, a fine downy hair found on preterm newborns beginning at ____ weeks gestation in called - 36 weeks deep creases and peeling of newborns skin is expected at what point in gestations - 38 wks + a preterm baby born at 28 weeks breasts will look like - no breast bud, flat areola in adults with osteoporosis is it recommended to raise all guardrails at night? - No, the client will likely injure themselves trying to get around the rails which diseases require airborne precautions - rubella, varicella, herpes zoster, TB in disseminated HSV, the patient requires airborne precautions and what else - contact what are the components of airborne precautions? - N95 air room with negative pressure if contact with body fluids is expected: gown, gloves, goggles subfix of ace inhibitors - pril subfix of arbs - tan if a patient on an ace inhibitor begins to cough do you a) try a dif ace b) prescribe a cough medicine c) give a dif BP drugs - c. give a dif BP drug Patients on warfarin should avoid which foods? oranges bananas spinach kale - spinach and kale because they are rich in vitamin k: oranges + bananas are rich in k+ why should patients on carbamazepine report any cold or sore throat - it cause leukopenia which depresses the immune system what are common causes of pancreatitis? - cholelithiasis, alcohol use disorder, abdominal trauma, thiazides, hypertriglyceridemia and medical procedures which agitate the pancreas what is pediculosis capitis? - lice how do we educate parents of a patient diagnosed with lice? - fine tooth comb to remove nits vacuum mattresses carpets and furniture in the house wash child clothing and bedding in hot water lice shampoo additional treatment maybe needed 7-10 days later vancomycin can cause toxicity to which orgnas - ears and kidney A patient is experiencing anxiety and SOB before a procedure what should the nurse do 1st? reassure the patient give morphine iv push 2 mg place the client in semi-fowler/high fowler request an rx for albuterol - place the client in semi-fowler/high fowler what are precautions we can take against wound dehiscence? - giving stool softeners, zofran prn, blood sugar control and wound binder why should clients with unilateral weakness dress the affected side first - limits the amount of movement necessary on the affected side how can you aid patients with receptive aphasia? - visual aids and hand motions because they suffer from written and verbal language how can you help patient with left sided neglect to be safe in their environemnt? - remind them to turn their heads to scan the environemnt people with right sided strokes often suffer from - impulse control