Nclex Study From Mark Klimek

Hyperthyroidism is also called - correct answer Grave's disease or hypermetabolism Tip to remember Grave's disease s/s's - correct answer "Run yourself into the Grave" - everything is up ... diarrhea, thin, hot, high BP, high HR, cold tolerance, hot intolerance Treatment for Grave's disease - correct answer Radioactive Iodine, PTU (put thyroid under), surgically remove Total thyroidectomy ... totals get - correct answer tetany, need lifelong hormone replacement After thyroidectomy patients are at risk for - correct answer hypocalcemia, remember hypocalcemia is opposite of the prefix and anything to BP so tetany, parasthesia parathesia - correct answer numbness and tingling, first sign of electrolyte imbalance Subtotal thyroidectomy ... subs get - correct answer storm S/S of thyroid storm - correct answer Extremely high vital signs, hyperpyrexia, psychotic delerium How to treat thyroid storm - correct answer give o2, lower temp to spare brain Risks post op for total thyroidectomy - correct answer airway, hemorrhage for 1st 12 hours then for 12-48 hours hypocalcemia leading to tetany Risks post op for sub total thyroidectomy - correct answer airway, hemorrage for 1st 12 hours then for 12-48 hours thyroid storm Hypothyroidism is also called - correct answer Myxedema or hypometabolism S/S of mydexema - correct answer everything is down, constipation, heat tolerance, cold intolerance Treatment for mydexema - correct answer give thyroid medications Where to put the 5 ice packs to cool a thyroid storm patient - correct answer neck pits groin If you cool a patient too fast what might happen? - correct answer Heart arrythmias Never hold the hormone for what patient? - correct answer patient who is NPO with mydexema Addison's disease easy way to remember - correct answer Add a Sone (sone = steroid) Adrenal Cortex diseases easy way to remember - correct answer A in Adrenal stands for Addison's C in Cortex stands for Cushing's Addison's disease is - correct answer undersecretion of adrenal cortex, not enough hormone, BRONZE/tan, go into shock very easily. STRESS can trigger. Addison's disease treatment - correct answer give a steroid, chronic steroid therapy Cushing's syndrome - correct answer Over secretion of adrenal cortex, too much hormone, too much steroid. S/S of Cushing's syndrome - correct answer 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 - correct answer Surgery, bi or uni lateral adrenalectomy (bilateral is worse) Donning PPE's order - correct answer Gown, Mask, Goggles, Gloves Removing PPE's order - correct answer alphabetically inside the room For airborne precautions the mask is removed where? - correct answer outside of the room Avoid answers with what words for children 9 mths and younger? - correct answer build, sort, stack, construct, make Toddlers (1-3) work on - correct answer their gross motor skills (jump, hop, throw), NO fine motor, parallel play Preschoolers (3-6) work on - correct answer fine motor, balance (tumbling, dance, tricycle), cooperative play, pretend School age (7-11) work on - correct answer creative, collect, competitive Best default order for click and drag order questions? - correct answer Hold ..... med Assess ..... what med does Prepare ...... the correction Call ..... or notify Rarely if ever answer ... - correct answer call Doctor, NCLEX wants you to think critically Creatinine lab values - correct answer same as lithium 0.6-1.2 Not a huge worry, not a dangerous lab to worry about INR lab values - correct answer 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 - correct answer 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!! pH lab values - correct answer 7.35-7.45 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 - correct answer 8-30 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 - correct answer rapid response team! HgB lab values - correct answer 12-18 check for bleeding if low or high, if low prepare for tranfussion HCO3 lab values - correct answer 22-26 if it is abnormal so what! CO2 lab values - correct answer 35-45 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 - correct answer 36-54 thickness of blood if abnormal not too big of a deal, assess for dehydration PO2 lab values - correct answer 78-100 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 - correct answer 93-100 pulse ox, if under 93 assess resp status and give O2 BNP lab value - correct answer less than 100 is normal, good indicator of CHF, edema, if elevated assess s/s of CHF NA lab values - correct answer 135-145, if a change in LOC then evaluate for fall/safety risk WBC lab values - correct answer if low assess for infection CD4 count less than 200 equals - correct answer AIDS Neutropenic precautions (low WBC) - correct answer strict handwashing, avoid crowds, private room, low bacteria diet (no raw or undercooked), no water that has been standing longer than 15 min, vital signs Q4H Platelets lab value - correct answer if lower than 90000 bad if lower than 40000 REALLY bad, if they sneeze they could die. Called thrombocytopenia Bleeding precautions - correct answer no venipuncture, injection or IV, if necessary use small guage, handle patient gently, use drawsheet, no razor, no toothbrush, blow nose gently, no aspriin, no rectal temp, no hard foods RBC lab values - correct answer 4-6 million abnormal doesn't really matter Reason for laminectomy - correct answer treat nerve root compression S/S of nerve root compression - correct answer Pain Parasthesia (numbness & tingling) Paresis (muscle weakness) Cervical - correct answer Diaphram and Arms affected, breathing, respiratory pattern Thoracic - correct answer Abd muscles and gut affected, ability to cough Lumbar - correct answer Bladder and legs affected, when did they last void, are they distended #1 post op answer for spinal problems is - correct answer log roll patient Activity post op spinal issue - correct answer do not dangle stand, walk, lie down w/o restricitons limit sitting to 30 min at a time Post op complications for cervical spinal surgery - correct answer pneumonia Post op complications for thoracic spinal surgery - correct answer pneumonia (no cough), paralytic illeus (gut shuts down) Post op complications for lumbar spinal surgery - correct answer urinary retention How long does temporary restrictions usually mean? - correct answer 6 weeks (driving, lifting, etc.) Nagele's Rule - correct answer 1st day of last period + 7 days - 3 months Weight gain during pregnancy - correct answer 28 lbs plus or minus 3 lbs 1st trimester weight gain - correct answer 1 lb/month or 3 lbs for 1st trimester 2nd/3rd trimester weight gain - correct answer 1 lb/week Easy way to calculate appropriate weight gain during pregnancy - correct answer The week number minus 9 so if 12 weeks pregnant 12-9=3 lbs. not allowed to be off by more than 2 lbs. Fundal Height - correct answer not palpable until 12 weeks, 2nd and 3rd trimesters week gestation 20-22 in cm so at the navel is 20 weeks Positive signs of pregnancy - correct answer xray, ultrasound, auscultation of fetal HR on doppler 10 weeks, examiner (not the mother) palpates fetal movement Probable signs of pregnancy - correct answer blood and urine tests, Chadwick's sign, Goodell's sign, Hegar's sign Chadwick's sign - correct answer Cervical color changes to Cyanosis See all the CCCCCC's! Goodell's sign - correct answer Cervical softening Hegar's sign - correct answer Uterine softening All changes in cervix and vagina occur in what order? - correct answer alphabetical order Pattern of Office Visits for prenatal care - correct answer once a month until 28 weeks, once every 2 weeks until week 36, once a week until delivery or week 42 when induction is scheduled Pregnancy hemoglobin - correct answer normal is 12-18, first trimester falls to 11 which is okay, second trimester falls to 10.5 which is okay and then third trimester falls to 10 also okay Easy way to remember station - correct answer has it made it through the "tight squeeze" (ischial spine) no then its a negative, yes then its a positive, 0 station is when it's at the ischial spine Presenting part is 99% of the time the - correct answer head What is bad as far as Lie? - correct answer Transverse is bad, vertical is good, parallel is good Stage 1 of L&D - correct answer Labor - thinning and opening, has 3 phases, Latent, Active, Transitional, nothing to do with the baby just the cervix, no baby at the end of labor Stage 2 of L&D - correct answer Delivery - pushing the baby out Stage 3 of L&D - correct answer Placenta delivery Stage 4 of L&D - correct answer Recovery (1st 2 hrs after delivery of placenta), considered unstable patient, stop the bleeding in stage 4 Memorize 1st stage 2nd phase of L&D then you know the rest - correct answer Active phase CM dilated 5-7 cm CXN Freq 3-5 min Duration 30-60 sec Intensity moderate Contractions should not be longer than ____ seconds or closer than every _____ minutes. - correct answer 90, 2 Prolapsed cord - correct answer OB emergency, baby will die if you don't do something What to do with prolapsed cord - correct answer Push then position! Push head off cord then position in knee/chest of trendelenburg (head down) Lithotomy position - correct answer on back with knees drawn up