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Monday, May 26, 2008

Nclex Review Materials: Resource Bullet 3

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Glycosylated Hgb gives an indication of what the patient ate over the past 3 months by reporting the average blood sugar over a period of time.

MgSO4 causes vasodilatation and lowers BP. The patient could become hypotensive.

Cryptorchidism is the absence of one or both testes from the scrotum. Cryptorchidism may cause permanent damage to the testicle and interfere with either sperm production or transport of sperm.

Adoption studies of twins indicates that predisposition for schizophrenia may be inherited. Research indicates that there is a genetic vulnerability as well as other factors that contribute to the development of schizophrenia.

Low serum albumin can indicate poor nutritional status or liver failure, making patient poor candidate for surgery.

Gowns, masks and goggles or face shields are required if there is a possibility of splattering.

Stomatitis is an inflammation of the mucous lining of any of the structures in the mouth, which may involve the cheeks, gums, tongue, lips, throat, and roof or floor of the mouth.

People who drink alcohol are more susceptible to cancer of mouth, liver, pancreas, stomach.

SIADH causes water retention, which leads to edema, and weight gain. Urine output is low, Serum Na is low and urine specific gravity is high > 1.020.

Haloperidol is used in the treatment of schizophrenia and, more acutely, in the treatment of acute psychotic states and delirium.

It is preferred that cyclophosphamide (cytoxan) be given in the morning, this will permit to force fluids during the day and increase the number of times the child voids, which will help prevent hemorrhagic cystitis.

Tingling in the mouth and fingers is a sign of hyperventilation commonly occurring during the transitional phase of labor due to increased breathing patterns in response to pain. Slowing of breathing pattern will help to increase CO2 content.

Leukemia or leukaemia is a cancer of the blood or bone marrow and is characterized by an abnormal proliferation (production by multiplication) of blood cells, usually white blood cells (leukocytes). It is part of the broad group of diseases called hematological neoplasms.

In severe depression activities of daily living are ignored as self-esteem and self worth are severely impaired. The patient is showing an interest in self-care, which is a sign of improvement.

PTT normal is 35-45 seconds

Humulin R is a regular (short acting) insulin the only type that can be given IV.

Monthly self-breast exam should be done on the 7th day after the beginning of the menstrual flow.

Because the release of oxytocin during breastfeeding stimulates uterine contractions. During the first few days of involution this may feel like strong cramping. A mild analgesic will relieve the pain and will not interfere with establishing breastfeeding milk supply.

Hirschsprung's disease, or congenital aganglionic megacolon, involves an enlargement of the colon, caused by bowel obstruction resulting from an aganglionic section of bowel (the normal enteric nerves are absent) that starts at the anus and progresses upwards.

Hirschprung's disease usually includes a temporary colostomy until the dilated portion of the bowel returns to normal function.

Interfering with the completion of the ritual increases anxiety. Providing hand cream offers some protection to the skin until the rituals reduce as the patient improves.

Chicken liver is high in Tyramine.

Patient with rheumatic fever will not develop bronchitis, oliguria or nausea. He will develop polyarthritis.

Prudent nursing practice is turning bed-bound patient every 2 hours. Turning every 4 hours fails to meet nursing standards.

Green leafy vegetables are full of Vitamin K which interferes with Coumadin therapy. They may be eaten but intake should be consistent so therapy can be adequately adjusted. None of the others are contraindicated.

Patient has cirrhosis, you should be concern with itching which could indicate pruritus and liver failure.

Babies with hydrocephalus may have difficulty lifting and turning their heads due to the increased size. To prevent skin breakdown of the bony prominences it is important to turn and position the child frequently.

Hypertension with Acute Glomerulonephritis occurs during the acute phase of the disease. Normal BP range would indicate that the condition was resolving.

In the court case Rogers vs. Okin in the Federal District Court of Massachusetts, it was ruled that involuntary mental patients are competent and have the right to make treatment decisions. Forcible administration of medication is justified in an emergency if needed to prevent violence and if other alternatives have been ruled out.

Guillain-Barre Syndrome (Polyradiculitis) is a clinical syndrome which affects both cranial and peripheral nerves. Its' origin is not known, however it has been found to be preceded by either a recent Upper Respiratory Infection, Gastrointestinal Infection, or immunization against the flu (ie: Swine Flu). It is NOT hereditary.

During the acute phase of Bacterial Endocarditis the patient is usually on bed rest and the nurse must assist patient, to conserve energy and reduce cardiac workload. At the same time the nurse should be able to provide, as tolerated, activities to reduce feelings of boredom and helplessness.

Ecchymoses - The passage of blood from ruptured blood vessels into subcutaneous tissue, marked by a purple discoloration of the skin.

Patients receiving Carafate should not be given antacids for at least a half hour following the administration of this drug for the drug to exert its' maximum efficacy.

The BEST indicator of efficacy of Lasix in a patient with CHF, is the patient's CVP. The change in CVP is an indication of adequacy of venous blood volume. Along with the patient's clinical picture the improvement in breathing, weight loss, increased urine output, and reduction in edema indicate a therapeutic response to the action of this medication.

Patients on TPN must be monitored closely, and the rate of the infusion must be maintained as ordered. If the rate is too fast hyperosmolar diuresis occurs, and the patient may c/o headache, nausea, chills, and may have a fever. In this situation the nurse should suspect Hyperglycemia, and check glucose (finger stick), and urine output (Diuresis is likely) and notify M.D. Also be prepared to add Insulin to infusion.

HIB vaccine is against H influenza virus. People who have allergies to eggs often have allergic reaction to HIB vaccine.

Toxoplasmosis is a protozoa infection caused by Toxoplasma gondii, found in raw or undercooked foods and cat feces.

Celestone is corticosteroid and is used to accelerate fetal lung maturity. It has a better effect if it is given at least 24 hours prior to delivery.

Children with Tetralogy of Fallot do not have enough energy to practice gross motor skills therefore become developmentally delayed. They also may have frequent hospitalizations, which limit their activity.

Abrupt cessation of alcohol when addicted can result in seizures including status epilepticus.

Depending on the area of the brain affected, and the degree of involvement, the patients with cerebral aneurysms may exhibit one or more of the following signs/symptoms/behaviors, ie: unilateral neglect of paralyzed side, astereognosis, aphasia, emotional lability, etc. The nurse should be aware of these and be able to intervene effectively, ie. In this case use of good communication skills, and provide reassurance.

Asterixis is a tremor of the wrist when the wrist is extended (dorsiflexion), sometimes said to resemble a bird flapping its wings. Also called "liver flap", it can be a sign of hepatic encephalopathy, damage to brain cells due to the inability of the liver to metabolize ammonia to urea. The cause is thought to be related to abnormal ammonia metabolism.

Lactulose (Cephulac) is prescribed to patients with impending or actual Hepatic Coma. The drug's primary action is to reduce serum ammonia. It does this by retaining ammonia in the colon and expelling it in the stool through an osmotic laxative effect. The BEST indicator that the drug is exerting its physiological effect would be the patient having two to three soft stools per day.

Often after removal of foley, patient will have frequent sensation to void accompanied by burning sensation on first void.

The mood stabilizing effect of Lithium takes around one to two weeks based on how fast a therapeutic level can be reached and maintained.

Crutchfield tongs are cervical tongs applied for immobilization of cervical injuries. Post-procedure nursing care includes assessing the client for any changes in neurologic status. The insertion site is monitored for signs of infection.

National stroke association says 2/3 of all strokes occur in people over 65, M>F, Blacks>Whites. HTN is the No.1 risk factor.

Soft or pureed foods are easier to swallow and be controlled with a lazy tongue. Liquids increase risk of aspiration.

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