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Wednesday, May 28, 2008

Nclex Review Materials: Resource Bullet 4

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Unlocking Halo vest traction - An open-ended wrench is taped to the client's vest. This wrench provides immediate release of the bolts to remove the vest in the event the client, requires external cardiac compression. The posterior portion of vest remains in place to provide stability for the spine during CPR.

Indomethacin is NSAIDS. Bleeding may occur.

Verapamil is a calcium channel blocker, antihypertensive and antianginal.

K-Lor is a potassium supplement.

Clozaril requires weekly blood tests.

Risperdal [risperidone] - It targets both negative and positive symptoms of schizophrenia; It has fewer neurological side effects than the phenothiazines; It is unlikely to cause tardive dyskinesia.

The heparin drip has a protocol that needs to be followed, including regular PTT levels, and adjustment of the heparin drip ---- Assign to RN

Any threat to inflict harm is assault.

Shock phase (24-48 hrs after) the patient is dehydrated decrease B/P, increased P, decreased U/O.

Variable deceleration is the result of compression of umbilical cord. Nurse should change maternal position, if no improvement seen, administer oxygen, discontinue oxycitocin if infusing.

Influenza virus vaccine and the pneumococcal vaccine can be administered concomitantly; Deltoid or lateral mid-thigh is the preferred injection site; The vaccines should be administered in the dominant arm.

Check for fecal impaction on client with spinal cord injury has autonomic dysreflexia.

Family and friends around the bed, chanting and singing depicts Hindu death rituals. What the nurse should expect is that while Hindus normally bring their ill home to die, on occasion the hospital is the site of death. When death is imminent, the person is placed with his head facing east. A lamp is lit near his head and he is encouraged to concentrate on his mantra. Family members keep vigil until death comes, singing hymns, praying and reading scriptures.

Nurse should instruct the client to rinse her mouth with a normal saline and baking soda solution on a patient with painful and bleeding ulcerations in her mouth.

Good Samaritan laws shield you from liability for negligence but not gross negligence.

A health care proxy is a document appointing someone else to make medical decision.

Celiac disease - gluten free diet.

PKU patient needs to avoid protein.

Sternum and forehead are reliable sites for evaluating dehydration in elderly.

Magnesium sulfate is an anti-convulsant which can cause cardiac arrhythmias. Nurse should check for clients pulse and respiration

Tricyclic anti-depressants have anti-cholinergic s/effects (urinary retention)

Genital herpes is transmitted when lesions are present and 10 days after lesions have healed.

Counter transference reaction: The tendency of the nurse/counselor to displace feelings that are a response to people in the counselor's past onto the client.

Barbiturates decrease anti-coagulant activity. Should not be medicated along with warfarin sodum (coumadin) or other anti-coagulant meds.

S/S of adrenal insufficiency are anorexia, nausea and hypotension

Spinal shock occurs 30-60 minutes after a spinal cord injury due to disruption of nerve pathways. S/s are pulse and respirations are increasing and blood pressure is decreasing

Position of choice when caring for a client with increased intracranial pressure (IICP)? This position allows proper drainage of cerebral edema and helps decrease ICP. Anything less than 30ยบ increases pressure (blood flow) to the brain.

Client with Bulimia has a deficit in the sense of responsibility. They feel unable to take charge of their own life.

Spinal cord patients are prone to autonomic dysreflexia which is triggered by some form of stimulus-most common is full bowel, or full bladder.

Two groups are especially susceptible - men whose testicles descended into the scrotum after age 6 and those, whose testicles never descended. Males with either of these risks are up to 17 times more likely to develop testicular cancer.

VIT D preparations are given 3 times per week during dialysis. Iron is given to treat anemia.

Aspirin prolongs bleeding time 4-7 days.

You cannot treat a minor without the permission of her parents unless she is emancipated. If she has a sexually transmitted disease, you must tell health department. Minor cannot sign for her own treatment.

Normal PT is 9.5-12 seconds.

The bronchodilator first opens the airways then the steroid can be inhaled deeply enough to reduce inflammation.

Patient with intussusception, Vomiting is an expected finding and can lead to dehydration.

MMR immunization, nurse should check the child for allergy to neomycin for prior to administering the vaccine

Coumadin takes 2-3 days to start working

A patient is on a Heparin drip and is started on Coumadin. Why she is on both not just one. The only time it is appropriate to see both anti-coagulants given is when a patient is to be sent home on Coumadin. Then they must wean the heparin and start the Coumadin in order to give it time to work.

Give simple, slow directions to patient which receptive aphasia.

disseminated intravascular coagulation (DIC) is characterized by dropping platelet count and prolonged coagulation studies.

Atenolol needs to be withheld to avoid aggravating the hypotensive effect of dialysis.

Remember that folic acid is needed to maturation of RBC .... Spinach, eggs, peanuts

Giardia is transmitted by drinking contaminated water or food. People who travel to undeveloped nations are susceptible as are those who do not travel out of the US but who drink water from mountain streams.

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