Mark Klimek Yellow Book (KV) last 400 Questions with Correct Answers

INR monitors? - Coumadin/Warafin therapy INR therapeutic level? - 2-3 If the INR is over 4 you? - Hold all Coumadin/Warafin Assess bleeding Prepare to give K+ Call doctor Potassium norm? - 3.5-5.3 If the potassium is below 3.5 you? - Assess the heart Prepare to give potassium Call the doctor If the potassium is high (5.4-5.9 high but still within the 5's) you? - Hold potassium if in the IV Assess the heart Prepare to give D5W with insulin Call the doctor If the potassium is over 6 you? - Stop what you're doing and assess If negative effects present you call rapid response. If no negative effects you do the same as "high but within the 5's) pH norm? - 7.35-7.45 If the pH is under 6 you? - Assess vital signs Call the doctor ASAP BUN norm? - 8-30 If the BUN is elevated check for? - Dehydration How should you prioritize labs? - Which level will do the most harm to the body and NOT the disease it's associated with. If you have a lab thats high and you don't know why pick? - Dehydration Hgb norm? - 12-18 Hgb under 8 you? - Assess bleeding Prepare blood Call doctor Elevated Hemoglobin? - Dehydration Bicarb (HCO3) norm? - 22-26 CO2 norm? - 35-45 CO2 is the 50's you? - Assess respiratory status Do pursed lip breathing ^ exhale time DON't give O2 if the above isn't working call the doctor! Severe Acidosis means what? - Hyperkalemia! Biggest priority CO2 in the 60's (respiratory failure) you? - Assess respiratory status Do pursed lip breathing Prepare for intubation Call respiratory therapy Call the doctor Hct norm? - 36-54 PO2 norm? - 78-100 PO2 70-77 you? - Assess respiratory status Give O2 PO2 below 60 you? - Assess respiratory status Give O2 Prepare for intubation Call respiratory therapy Call the doctor O2 sat norm? - 93-100 O2 sat below 93 you? - Assess respiratory status Give O2 BNP norm? - <100 BNP is a good indicator of what? - CHF What is the best indicator of CHF? - ANF ANF and BNP= - CHF Sodium norm? - 135-145 Sodium is ok if abnormal unless what occurs? - Change in LOC WBC norm? - 5,000-11,000 Absolute neutrophil count (ANC) norm? - 500 CD4 norm? - >200 (below that=aids) If the WBC count is high this is called? - Leukocytosis If the WBC is low it is called? - Leukopenia Neutropenia Agranulocytosis Immunosupression Bone marrow supression If the WBC is low you should? - Follow strict handwashing Shower BID with antimicrobial soap Avoid crowds Private room No fresh flowers or potted plants Low bacteria diet- no raw fruits/veggies, no undercooked meat. No water drinking if its been sitting for longer then 15 minutes. Vitals Q4H Check WBC daily Avoid reusable plates/silverware etc, Platelets norm? - 150,000-400,000 If platelets are below 90,000 you? - Check for bleeding Place on bleeding precautions (thrombolytic precautions) If platelets are below 40,000 you? - Prepare platelet transfusion Call the doctor RBC norm? - 4-6 What is a lamina? Reason for laminectomy? - Vertebral spins process (bumpy bones at back of neck) To treat nerve root compression. 3 P's of nerve root compression (S/S) ? - Pain Paresis= muscle weakness Parasthesia Knowing the location of a laminectomy is key to getting the ? right. - ... Cervical = - Neck Thoracic = - Upper back Lumbar = - Lower back Pre-op cervical laminectomy's most important assessment is? - 1st breathing (rate and rhythm) 2nd arm and motor sensory Pre-op thoracic laminectomy's most important assessment is? - 1st cough (uses abdominal muscles) 2nd bowel sounds (If you can't contract these muscles, you can't cough) Pre-op lumbar laminectomy's most important assessment is? - 1st voiding ( when was last time, can they) 2nd leg motor and sensory. The rule of ABC"s doesnt work in what area of health? - Neuro What is the #1 post-op answer for the NCLEX? - Log roll the patient Activity requirements/restrictions Q8H after laminectomy surgery? - Do NOT dangle (AKA sit on the side of bed) May stand, walk and lay without restrictions Don't sit longer than 30 minutes What post-op complication do you watch for with a cervical laminectomy? - Pneumonia/Atelectesis (breathing issues) What post-op complication do you watch for with a thoracic laminectomy? - Decreased cough= Aspiration > pneumonia Decreased GI= ilius What post-op complication do you watch for with a lumbar laminectomy? - Urinary retention For a laminectomy what incision site is more painful? - Hip site