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Wednesday, June 11, 2008

NLE / CGFNS / Nclex Review Materials 2

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11. ESRD DIET
• Restricted protein intake
• Increase CHO
• Low K, P
• Restrict Na

12. NORMAL IN 8 MONTH OLD CHILD
- can sit with out support
- can roll from front to back
- can hold a bottle
- closure of ant. fontanel
- can say mama and dada
- 2 teeth present

13. SUPERIOR VENA CAVA OCCLUSION
• Sx occur in the morning
• Edema of face, eyes & tightness of shirt/ (Stoke’s sign)
• Late sx: edema of arms, hands,
dyspnea, erythema, epistaxis

14. ULCERATIVE COLITIS
Sx:
• Severe diarrhea with blood & mucus
• Abdominal tenderness & cramping
• Anorexia
• Wt. Loss
• Vit. K deficiency
• Anemia
• Dehydration
• Electrolyte imbalance
• Low residue & high protein diet

15. DILANTIN
• do not floss throughout the day
• do not use hard bristled toothbrush
• Gingivitis S/E

16. ANAPHYLACTIC REACTION
(steps)
• Stop medication
• Maintain airway
• Notify MD
• Maintain IV access of 0.9 NSS
• Place in supine position with legs elevated
• Monitor VS
• Administer prescribed emergency drugs

17. BLADDER CA
Risk Factors:
• Hx of smoking
• Exposure to radiation
• Working in industrial Factory

18. S/S OF DKA
• Fruity breath Odor
• Oliguria
• Kusmaull'’s (deep & nonlabored)

19. SITE FOR IM INJECTION ADULT
• Deltoid
• Ventrogluteal
• Vastus Lateralis
• Gluteus Maximus

20. S/S OF BACTERIAL MENINGITIS
• N & V
• Seizures
• Stiff Neck
• Photophobia

21. TB
• Waking up sweating at night
• Low grade fever
• Dull aching chest pain
• Cough streaked with blood
• Weight loss
• Anorexia
• Fatigue

22. LIVER CIRRHOSIS
• N & V
• Edema
• Ascites

23. PULMONARY EMBOLISM
Sx:
• Blood-tinged sputum
• Distended neck vein
• Chest Pain / Hypotension / Cyanosis
• Cough / Shallow respirations
• Rales on auscultation
• Tachypnea / Tachycardia

24. COLON CA
Risk Factors:
• Family HX
• Age above 50
• Jewish
• Male

25. DIGOXIN THERAPY
• Do not administer in infants if S/S OF CAD
• Chest Pain
• Palpitations
• Dyspnea / Syncope
• Hemoptysis
• Excessive Fatigue

27. COPD
• Rhythmic, diaphragmatic breathing
• If restless, perform purse-lip breathing not more than 1 minute
• Perform deep breathing with mouth held together during expiration

28. SEEN IN 15 MONTH OLD CHILD
• Speaks 6 words
• Sits w/o support
• Builds a tower of 5 blocks
• Strong palmar grasp

29. CUSHING’S SYNDROME
• Osteoporosis
• Muscle wasting
• Hypertension
• Purple skin striations
• Moon face
• Truncal obesity
• Decreased resistance to infection
• Low Carbohydrate, Low Calorie, High Protein, High K, Low sodium
• Monitor glucose level
• Check for color of stool, cortisol increase secretion of gastric acid – Peptic ulcer & GI bleeding
• C/I to Aspirin, increased bleeding

30. ADDISONS DISEASE
Fatigue
Weakness
Dehydration
Eternal tan
Decreased resistance to stress
Low Sodium
Low Blood Sugar
High Potassium

High protein, carbohydrate, Sodium, Low potassium diet

Teach life-long hormone replacement
• Glucocorticoids (sugar) - Solu- Medrol (succinate) to prevent addisonian crisis
• Mineralocorticoids (salt) – Florinef

6 A's of Addison's disease
1.) Avoid Stress
2.) Avoid Strenuous
3.) Avoid Individuals with Infection
4.) Avoid OTC meds
5.) A lifelong Glucocorticoids Therapy
6.) Always wear medic alert bracelet

Addisonian Crisis
• Hypotension
• Extreme weakness
• Nausea vomiting
• Abdominal pain /
• Severe hypoglycemia
• Dehydration
• Administer NaCl IV, vasopressors, hydrocortisone
• Monitor VS /Absolute bedrest

31. PLACENTA PREVIA
• Check Hematocrit level
• External fetal monitor not internal
• No vaginal examination
• Assess for bleeding
• Improperly implanted placenta at
lower uterine
• Painless bright red, vaginal
bleeding
• Soft, relaxed, nontender uterus
• Fundal height greater than
expected

32. ABRUPTIO PLACENTA
• Premature separation of placenta from uterine wall
• Painful dark red bleeding
• Uterine rigidity
• Severe abdominal pain
• Maternal shock
• Fetal distress

33. HEMODIALYSIS
• Palpate for a bruit or thrill
• Weigh client daily, before, during & after
• Hold antihypertensive drugs b4 dialysis
• Check for thrill and bruit q 8 hours
• Don’t use extremity for BP, finger stick
• Monitor vital signs, weight, breath sounds
• Monitor for hemorrhage

34. PERITONEAL DIALYSIS
• Weight before and after treatment
• Monitor BP
• Monitor breath sounds
• Use sterile technique
• If problem w/ outflow, reposition client
• Side effects: constipation

35. TYPE 1 IDDM
• Test blood glucose every 4 hrs if no feeling well
• Eat fruit or cheese sandwich before exercise
• Do not exercise if blood glucose is >250mg/dl & urinary ketones present
• Administer regular insulin 30 minutes before meals

36. COMPARTMENT SYNDROME
• Increased pain & swelling
• Pain with passive motion
• Loss of sensation
• Inability to move joints
• Pulselessness

37. CARDIAC CATHETERIZATION
• NPO 6-8 hrs. & no liquid for 4 hrs. prior to prevent vomiting & aspiration
• Feel a flush, warm, fluttery feeling, desire to cough, palpitations in introduction of dye
• Shave & Clean insertion site with antiseptic solution

38. PERNICIOUS ANEMIA
• Severe pallor
• Smooth, beefy red tongue
• Slight jaundice
• Paresthisias of hands & feet
• Disturbances with gait & balance

39. DUMPING SYNDROME
Occurs 30 minutes after eating
• Abdominal fullness & cramping
• Diarrhea
• Tachycardia
• Perspiration
• Weakness / dizziness
Borborygmi sound

40. TPN COMPLICATIONS
• Air Embolism
• Fluid Overload
• Hyperglycemia
• Hypoglycemia
• Infection
• Pneumothorax




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