Lecture Note
Mark Klimek Yellow Book
-
University:
College -
Course:
Licensed Vocational Nurse Academic year:
2025
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Views:
231
Pages:
96
Author:
customer-8397346
Mark Klimek Yellow Book
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1.
Rule of the : If the ____ and the _____ are ______ in the ame direction then
it i meta_____
pH, icar, oth, olic
2.
pH 7.30_______ HCO3 20_______
↓= acidoi; = metaolic
3.
pH 7.58_______ HCO3 32_______
↑= alkaloi; ↑= metaolic
4.
pH 7.22_______ HCO3 30_______
↓= acidoi; ↑= repirator
5.
You are providing care to a client with the following lood ga reult: pH
7.32, CO2 49, HCO3 29, PO2 80, and SaO2 90%. aed on thee reult, the
client i experiencing:
↓= acidoi; ↑= repirator
6.
MacKumaul
The onl acid ae to caue Kumaul repiration i Metaolic
ACidoi 7.
A the _______ goe, o goe _______ except for _______
pH, m patient, Potaium
8.
Up
hokalemia, alkaloi, HTN, Tachcardia, Tachpnea, Seizure,
Irritailit, Spatic, Diarrhea, ororgme, hperreflexia, etc
9.
Down
hperkalemia, acidoi, htn, radcardia, contipation, aent owel
ound, flacid, radpnea
10.
Caue of acidae imalance: Firt ak ourelf, "I it _______?" If e, then
it' _______. Then ak ourelf: "Are the _______ or _______. If _______, pick
_______. If _______, pick _______
lung, repirator, overventilating, underventilating, overventilating,
alkaloi, underventilating, acidoi
11.
Caue of acidae imalance: If it' not lung, then it' _______. If the patient
ha _______ _______ vomiting or uction, pick _______. For everthing ele
that in't lung, pick _______ _______. When ou don't know what to pick,
chooe _______
metaolic, prolonged gatric, alkaloi, metaolic acidoi, metaolic
acidoi
12.
High preure alarm are triggered _______ reitance to air flow. increaed
13.
High preure alarm are triggered increaed reitance to airflow and can
e caued otruction of three tpe: _______ action, _______ action,
_______ action
(kinked tue) unkink, (water in tue) empt, (mucu in airwa) cough
and deep reathe
14.
Low preure alarm are triggered _______ reitance to airflow.
decreaed
15.
Low preure alarm are triggered decreaed reitance to airflow and can
e caued diconnection of the _______ or _______
tuing (reconnect it), oxgen enor tue (reconnect it UNLSS tue i
on the floor ag them and call RT if thi happen)
16.
Repirator alkaloi mean ventilator etting ma e too _______
high
17.
Repirator acidoi mean ventilator etting ma e too _______
low
18.
What doe "wean" mean?
graduall decreae with the goal of getting off altogether 19.
What i Malow' highet priorit to lowet priorit?
1. Phiological
2. Safet
3. Comfort
4. Pchological (prolem within the peron)
5. Social (prolem with other people)
6. Spiritual
20.
Arrange from highet to lowet priorit uing Malow':
Denial
Spiritual Ditre
Pain in low
Fall Rik
Pathological Famil Dnamic
lectrolte Imalance
lectrolte Imalance (Phiological)
Fall Rik (Safet)
Pain in low (Comfort)
Denial (Pchological)
Pathological Famil Dnamic (Social)
Spiritual Ditre (Spiritual)
21.
What are the 5 tage of grief?
Denial
Anger
argain
Depreion
Acceptance
22.
The #1 prolem in aue i _______
denial
23. Denial i the _______ to accept the _______ of their prolem
refual, realit
24.
Treating denial: _______ it pointing out to the peron the difference
etween what the _______ and what the _______. In contrat, _______ the
denial of lo and grief
confront, a, do, upport
25.
Dependenc: When the _______ get the Significant Other to do thing for
them or make deciion for them
auer
26.
Codependenc: When the _______ _______ derive poitive _______ from doing
thing for or making deciion for the _______
Significant Other, elfeteem, auer
27.
When treating dependenc/codependenc: Set _______ and _______ them.
Agree in advance on what requet are allowed, then enforce the agreement
limit, enforce
28.
When treating dependenc/codependenc: Work on the _______ of the
codependent peron
elfeteem
29.
Manipulation: when the _______ get the _______ _______ to do thing for
him/her that are not in the _______ _______ of the _______ _______. The nature of the act i _______ or _______ to the _______ _______
auer, ignificant other, interet, ignificant other, harmful, dangerou,
ignificant other
30.
Treating manipulation: et _______ and _______
limit, enforce
31.
Wernicke' (Korakoff') Sndrome: _______ induced Vitamin
_______(thiamine) deficienc
Pchoi, 1
32.
Primar mptom of Wernicke' (Korakoff') Sndrome: _______ with
_______
amneia (memor lo), confaulation (make up tuff)
33.
Characteritic of Wernicke' (Korakoff') Sndrome:
1. _______
2. _______
3. _______
preventale (take vitamin)
arretale (take vitamin)
irreverile (kill rain cell)
34.
Antaue/Revia i aka _______ Therap
Averion
35. Onet and duration of effectivene of Antaue/Revia: _______
2 week
36.
Patient teaching with Antaue/Revia: Avoid _______ form of _______ to
avoid _______, _______, _______
all, alcohol, nauea, vomiting, death
37.
What are example of product that contain alcohol?
mouth wah, cologne, perfume, afterhave, elixir, mot OTC liquid
medicine, inect repellant, vanilla extract, vinagerette, hand anitizer
38.
ver alcoholic goe through _______. Onl a minorit get _______
Alcohol Withdrawal Sndrome, Delirium Tremen
39.
_______ i not lifethreatening. _______ can kill ou
Alcohol Withdrawal Sndrome, Delirium Tremen
40.
Patient with _______ are not a danger to themelve or other. Patient with
________ are dangerou to elf and other
Alcohol Withdrawal Sndrome, Delirium Tremen
41.
AWS or DT: emiprivate room, an location
AWS 42.
AWS or DT: private room near the nure' tation
DT
43.
AWS or DT: Regular diet
AWS
44.
AWS or DT: Clear liquid or NPO diet (rik for apiration)
DT
45.
AWS or DT: Up at liert
AWS
46.
AWS or DT: Retricted to edret with no athroom privilege
DT
47.
AWS or DT: No retraint
AWS
48.
AWS or DT: Uuall retrained with either vet or 2 point (1 arm and 1 leg) DT
49.
AWS or DT: Give antiHTN medication
oth
50.
AWS or DT: Give tranquilizer
oth
51.
AWS or DT: Give multivitamin to prevent Wernicke'
oth
52.
For Aminoglcoide, think " __ ____ ___ _____"
a mean old mcin
53.
When are antiiotic/aminoglcoide ued?
to treat eriou, lifethreatening, reitant infection
54.
All aminoglcoide end in _______, ut not all drug that end in _______ are
aminoglcoide. mcin, mcin
55.
What are ome example of wannae mcin?
Azithromcin, Clarithromcin, rthromcin
56.
What are ome example of aminoglcoide?
Streptomcin, Cleomcin, Toramcin, Toramcin, Gentamcin,
Vancomcin, Clindamcin
57.
When rememering toxic effect of mcin' think _______
mice= ear
58.
What i the toxic effect of aminoglcoide and what mut ou monitor?
ototoxicit; monitor hearing, alance, and tinitu
59.
The human ear i haped like a _______ o another toxic effect of
aminoglcoide i _______ o monitor _______
kidne, nephrotoxicit, creatinine
60.
The numer "___" drawn inide the ear remind ou of cranial nerve ___ and
frequenc of adminitration ___ 8, 8, Q8H
61.
Do not give aminoglcoide PO expect in thee 2 cae:
1. _______ _______ (due to high _______ level)
2. Preop _______ urger
hepatic encephalopath (liver coma, ammoniainduce
encephalopath), ammonia, owel
62.
Who can terilize m owel?
Neo Kan
63.
What i the reaon for drawing Trough and Peak level?
Narrow therapeutic level
64.
When do ou ALWAYS draw the Trough?
30 minute efore next doe
65.
When do ou draw the Peak level of Sulingual medication?
510 minute after drug diolve
66.
When do ou draw the Peak level of IV medication? 1530 minute after medication i finihed
67.
When do ou draw the Peak level of IM medication?
3060 minute after injecting it
68.
When do ou draw the Peak level of SQ medication?
Depend on tpe of inulin
69.
When do ou draw the Peak level of PO medication?
Not necear
70.
What are iological Agent in Categor A?
STAPH
Small Pox
Tularemia
Anthrax
Plague
Hemorrhagic illne
otulim
71.
What are iological Agent in Categor ?
All other 72.
What are iological Agent in Categor C?
Nipeh Viru
Hanta Viru
73.
When it come to iological Agent: Categor __ i _______, Then Categor __,
Then Categor __
A, the wort, , C
74.
Small Pox
Inhaled tranmiion/ on airorne precaution
die from epticemia no treatment
rah tart around mouth firt
Categor A
75.
Tularemia
chet mptom
die from repirator failure
treat with treptomcin
Categor A
76.
Anthrax
pread inhalation
look like the flu
die from repirator failure
treat with upro, PCN, and treptomcin
Categor A 77.
Plague
pread inhalation
ha the 3 H': Hemopti (coughing up lood), Hematemei (vomiting
up lood), Hematochezia (lood in tool)
dei from repirator failure and DIC (leed to death)
treat with Doxccline and Mcin
no longer communicale after 48 hour of treatment
Categor A
78.
Hemorrhagic illnee
primar mptom are petechiae (pinpoint pot) and ecchmoe
(ruiing)
high % fatal
Categor A
79.
otulim
it i ingeted
ha 3 major mptom: decending parali, fever, ut i alert
die from repirator arret
Categor A
80.
What are ome example of chemical agent that caue ioterrorim?
Mutard ga
Canide
Phogine chlorine
Sarin
81. What i the primar mptom of Mutard Ga?
liter (veicant)
82.
What i the primar mptom of Canide and how do ou treat it?
Repirator arret. Treat with Sodium Thioulfate IV
83.
What i the primar mptom of Phogine Chlorine?
Choking
84.
What are the mptom of Sarin (hint it' a nerve agent)?
SLUDG jut rememer ever ecretion in our od i eing
excreted exceivel
ronchopam
ronchorrhea
Salivating
Lacrimating (tear)
Urination
Diaphorei/ Diarrhea
G.I upet
mei
85.
What do ou ue when cleaning patient expoed to chemical agent?
All chemical agent require onl oap and water cleaning except
Sarin, which require leach.
86. Which agent do ou iolate the patient for?
iological Agent
87.
Which agent do ou decontaminate for?
Chemical Agent
88.
How doe decontamination work?
Gather expoed people
Take to decontamination center where people remove clothing, hower,
dre in noncontaminated clothe, then releae to other ervice
Put contaminated clothing in pecial ag and throw awa (e ure not
to touch it)
89.
Calcium Channel locker: the are like ________ for our heart. What doe
that mean?
Valium. It relaxe the heart
90.
Calcium Channel locker: _______ inotropoic, chronotropic, dromotropic
Negative
91.
Inotropic
trength of heart 92.
Poitive Inotropic
trong hearteat
93.
Negative Inotropic
weak hearteat
94.
Chronotropic
rate of hearteat
95.
Poitive Chronotropic
fat hearteat
96.
Negative Chronotropic
low hearteat
97.
Dromotropic
conductivit of heart 98.
Poitive Dromotropic
excitale heart
99.
Negative Dromotropic
lock/low conduction
100.
Poitive Inotropic, Chronotropic, and Dromotropic i een with which
medication?
atropine, epinephrine, and norepinephrine
101.
Negative Inotropic, Chronotropic, and Dromotropic i een with which
medication?
Calcium Channel locker and eta locker
102.
What do Calcium Channel locker treat? (indication)
Antihpertenive (decreae P)
Anti Angina (imalance etween O2 uppl and demand)
Anti Atrial Arrhthmic (Atrial flutter and Atrial firillation)
103.
What are ome of the ide effect of Calcium Channel locker?
Headache Hpotenion
104.
Name of Calcium Channel locker can e rememered aing....
I op zem dipine in the Calcium Channel ("zem", "dipine",
"verapamil/ioptin")
105.
"QRS depolarization" alwa refer to __________
Ventricular (not atrial, junctional or nodal).
106.
"P wave" refer to _________
Atrial
107.
Atole
a lack of QRS depolarization (flat line)
108.
Atrial Flutter
rapid Pwave depolarization in a awtooth pattern (flutter)
109.
Atrial Firillation
chaotic Pwave depolarization 110.
Ventricular Tachcardia
wide izarre QRS'
111.
Premature Ventricular Contraction (PVC)
Periodic wide, izarre QRS'
112.
e concerned aout PVC' if:
More than 6 per minute
6 in a row
PVC fall on Twave of previou eat
113.
What are the lethal arrhthmia?
atole and ventricular firillation
114.
What i the potentiall lifethreatening arrhthmia?
1. vtach, 2. afi, 3. aflutter
115.
When dealing with an IV puh drug if ou don't know go ____ except
________! low, adenocard
116.
What i the treatment for PVC'?
lidocaine and amiodarone
117.
What i the treatment for V Tach?
lidocaine and amiodarone
118.
What are the treatment for upraventricular arrhthmia?
ACD
Adenocard/adenoine
etalocker (end in lol)
Calcium Channel locker
Digitali/Digoxin (lanoxin)
119.
What i the treatment for Vfi?
ou defi
120.
What i the treatment for Atol?
Give pi firt then Atropine
121. atole
122.
atrial firillation
123.
atrial flutter
124.
Normal Sinu Rhthm 125.
Supraventricular tachcardia
126.
ventricular firillation
127.
The purpoe for chet tue i to reetalih _______ preure in the pleural
pace
negative
128.
In the pneumothorax, the chet tue remove ___
air
129.
In the hemothorax, the chet tue remove _____
lood
130. In the pneumohemothorax, the chet tue remove ___ and _____
air and lood
131.
when the chet tue i ______ (____) for ___. aka ____
Apical (high), air, apex
132.
When the chet tue i ______ (___) for _____ aka ____
ailar (low), lood, ae (ottom of lung)
133.
How man chet tue and where for unilateral pneumohemothorax?
2; apical and ailar on ide of pneumo
134.
How man chet tue and where for ilateral pneumothorax?
2; apical for oth
135.
How man chet tue and where for potop chet urger/chet trauma?
aume unilateral pneumohemothorax 2; apical and ailar on ide of
pneumo
136.
In routine _____ clamp chet tue. In emergenc _____ the chet tue
NVR; CLAMP
137. What do ou do if ou kick over the collection ottle?
Set it ack up (not an emergenc)
138.
What do ou do if the water eal reak?
Firt clamp it, cut tue awa from device
et umerge the tue under water, then unclamp
139.
What do ou do if the chet tue come out?
Firt cover with a gloved hand
et cover the hole with vaeline gauze, put a dr terile dreing on
top, tape on 3 ide
140.
If there' uling in the water eal intermittentl it i...
good
141.
If there' uling in the water eal and it' continuou it i...
ad
142.
If there' uling in the uction control chamer intermittentl it i...
ad
143.
If there' uling in the uction control chamer continuoul it i...
good 144.
Rule for clamping the tue:
never clamp longer than __________ without Dr' order
ue _____________________________
15 econd, ruer tipped doule clamp
145.
ver congenital heart defect i either ___________ or ____ ___________
TRouLe, No TRouLe
146.
RL
Right to Left hunt
147.
lue
148.
T
tart with the letter "T"
149.
What are ome example of "TRouLe" congenital heart defect?
Trunku arterioi, Tran. poition of great veel, Tetrolog of Fallot,
Tricupid tenoi, TAPZ, Left ventricular hperplamic ndrome
150.
What are ome example of "No TRouLe" congenital heart defect? Patent fore. ov., ventricular eptal defect, pulmonar tenoi
151.
Akk CHD kid will have 2 thing, whether TRouLe or No TRouLe...
1. Murmur
2. chocardiogram
152.
Four defect preent in Tetralog of Fallot are...
VarieD
PictureS
Of A
RancH
Ventricular Defect
Pulmonar Stenoi
Overriding Aorta
Right Hpertroph
153.
How do ou meaure crutche for a peron?
23 fingerwidth elow anterior axillar fold to a point lateral and
lightl in front of foot
154.
When the handgrip i properl placed, the angle of elow flexion will e ____
degree
30
155.
2 point gait
tep one move one crutch and oppoite foot together
tep two move other crutch and other foot together
(rememer 2 point together for a 2 point gait)
Ued for minor weakne on oth leg 156.
3 point gait
tep one move two crutche and ad leg together
tep two move good foot
(Rememer 3 point i called 3 point ecaue 3 point touch down at
once)
157.
4 point gait
tep one one crutch
tep two oppoite foot
tep three other crutch
tep four other foot
nothing move together and everthing i reall weak
158.
Swing through
for two raced extremitie
(Amputee)
159.
Ue the _____ numered gait when weakne i _______ ditriuted. ___
point for mild prolem and ___ point for evere
even, evenl, 2, 4
160.
Ue the ___ numered gait when one leg i ______
odd, effected
161.
Stair: which foot lead when going up and down tair on crutche? ______
with the _______ and _______ with the _____. The crutche alwa move with
the ____ leg up, good, down, ad, ad
162.
Cane: Hold cane on the __________ _______ ide. Advance cane with the
_________ ide for a wide ae of upport
uneffected ide, oppoite
163.
What i the correct wa to ue a walker?
pick it up, et it down, and walk to it
164.
What i a ig NO when it come to walker?
Do not tie elonging to the front of the walker
165.
What i the correct wa to get up from a chair uing a walker?
Hold on to chair, tand up, then gra walker
166.
What i the difference etween a nonpchotic peron and a pchotic
peron?
a nonpchotic peron ha inight (know the're ick and that it'
meing them up) and i realit aed (the ee realit the ame wa
a ou) and a pchotic peron ha no inight and i not realitaed.
167.
Deluion
a fale, fixed elief or idea or thought. There i no enor component 168.
What are the 3 tpe of deluion?
Paranoid/Perecutor, Grandioe, & Somatic
169.
Paranoid or Perecutor Deluion
fale, fixed elief that people are out to harm ou
170.
Grandioe deluion
Fale, fixed elief that ou are uperior
171.
Somatic deluion
Fale, fixed elief aout a od part
172.
Hallucination
a fale, fixed enor exerience
173.
What are the 5 tpe of hallucination?
auditor (hearing), tactile (feeling), viual (eeing), gutator (tating),
and olofactor (melling)
174.
Illuion
a miinterpretation of realit. It i a enor experience 175.
What i the difference etween illuion and hallucination?
With illuion there i a referent in realit (omething to which the
can refer to)
176.
When dealing with a patient experiencing deluion, hallucination or
illuion, firt ak ourelf, "What i their prolem?" (what are the different
prolem that could e going on?)
functional pchoi, pchoi of dementia, and pchotic delirium
177.
What are the different tpe of functional pchoi?
chziophrenia, chzioaffected (mood diorder thought proce), major
depreion, and mania
178.
With a functional pchoi the patient ha the potential to learn realit.
How can ou teach realit to a functional pchotic?
1. acknowledge feeling
2. preent realit
a. poitive what i realit
. negative what i not realit
3. et a limit
4. enforce the limit
179.
Pchoi of dementia
People with Alzheimer', Wernicke', Organic rain Sndrome, and
dementia. Thi patient ha a rain detruction prolem and cannot
learn realit
180. How do ou deal with a peron with Pchoi of Dementia?
1. Acknowledge feeling
2. Redirect get them to expre the fixation that the are expreing
inappropriatel to appropriatel
181.
Pchotic Delirium
Temporar epiodic econdar dramatic udden onet of lo of realit
due to chemical imalance (UTI, throid imalance, electrolte
imalance)
182.
How do ou deal with a patient with Pchotic Delirium?
1. Acknowledge feeling
2. Reaure them of afet and temporarne
183.
What are the different tpe of looening of aociation?
Flight of idea, word alad, neologim
184.
Flight of idea
Stringing phrae together (looel aociated phrae; tangentialit)
185.
Word alad
Throw word together
186.
Neologim Making up new word
187.
Narrowed elfconcept
When a PSYCHOTIC refue to change their clothe or leave the room.
*don't make a pchotic do omething the don't want to do
188.
Idea of reference
You think everone i taking aout ou
189.
Dementia hallmark
Memor lo, inailit to learn.
*Functional can teach, dementia cannot
190.
Alwa acknowledge ______________
Feeling
191.
What are the 3 "Re'"?
Reaure
Redirect
Realit
192.
Diaete mellitu
An error of glucoe metaolim 193.
Diaete inipidu
Dehdration, polurethane, poldipia
194.
Tpe I Diaete Mellitu
Inulin dependent (not producing inukin)
Juvenile onet
Ketoi prone
195.
Tpe II Diaete Mellitu
Non inulin dependent (od reiting inulin)
Adult onet
Non ketoi prone
196.
Sign and mptom of diaete mellitu
Poluria (pee a lot)
Poldipia (drink a lot)
Polphagia (eat/wallow a lot)
197.
Treatment for Tpe I Diaete Mellitu
3. Diet (calorie from car)
1. Inulin
2. xercie
198.
Treatment for Tpe II Diaete Mellitu
1. Diet
3. Oral hpoglcemic
2. Activit 199.
Diet of Diaetic
Calorie (car) retriction
Need to eat 6x per da> maller more frequent meal
200.
Inulin act to _____________ lood ugar
Lower
201.
Inulin Tpe: R
R= Regular, Rapid, Run (IV)
Onet: 1hr
Peak: 2hr
Duration: 4hr
202.
Inulin Tpe: N
N= NPH, Not in the ag, Not o fat, Not clear (cloud)
Onet: 6hr
Peak: 810hr
Duration: 12 hr
203.
Inulin Tpe: Humalog
Inulin Lipro
Fatet
Onet: 15min
Peak: 30min
Duration: 3hr
204. Inulin Tpe: Lantu
Long acting
Slow aorption
No peak
Duration: 1224hr
205.
With inulin rememer:
Check expiration date
Refrigerate ut once open no refrigeration
206.
xercie ________ inulin: if more exercie, need _________ inulin. If le
exercie, need __________ inulin
Potentiate, le, more
207.
Sick da rule for inulin
Take inulin
Take ip of water
Sta active a poile
208.
Low lood ugar in Tpe I Diaete Mellitu (inulin hock) i caued :
Not enough food
Too much inulin
Too much exercie
209.
Wh i low lood ugar in Tpe I Diaete Mellitu (inulin hock)
dangerou?
Permanent rain damage 210.
Sign and mptom of low lood ugar in Tpe I Diaete Mellitu (inulin
hock):
Cereral impairment, vaomotor collape, cold, clamm, low reaction
time, "drink hock"
211.
Treatment for low lood ugar in Tpe I Diaete Mellitu (inulin hock):
Adminiter rapidl metaolizale carohdrate (cand, hone)
Ideal comination: ugar and protein
If unconciou IV D50 IM glucagon
212.
High lood Sugar in Tpe I Diaete Mellitu/ DKA/ Diaetic Coma i caued
:
Too much food
Not enough inulin
Not enough exercie
#1 caue i acute viral upper repirator infection within the lat 10
da
213.
Sign and mptom of High lood Sugar in Tpe I Diaete Mellitu/ DKA/
Diaetic Coma
Dehdration
Ketone, Kumaul reathing, high K+
Acidoi, Acetone reath, Anorexia
214.
Treatment for High lood Sugar in Tpe I Diaete Mellitu/ DKA/ Diaetic
Coma
Inulin IV (R)
IV rate flow 200mg/hr
215. Treatment for low lood ugar in Tpe II Diaete Mellitu:
Adminiter rapidl metaolizale carohdrate (cand, hone)
Ideal comination: ugar and protein
If unconciou IV D50 IM glucagon
216.
High lood Sugar in Tpe II Diaete Mellitu
Called HHNK or HHNC Hperomolar, Hperglcemic, NonKetotic
Coma
Thi i evere dehdration
217.
Sign and mptom of High lood Sugar in Tpe II Diaete Mellitu
Hit, dr, increaed HR, decreaed kin turgor
218.
Treatment for High lood Sugar in Tpe II Diaete Mellitu
Rehdration
219.
Long term complication of HHNC are related to
Poor tiue perfuion
Peripheral neuropath
220.
Which la tet i the et indicator of longterm lood glucoe control
(compliance/effectivene/adherence)?
Ha1c (average lood ugar over lat 90 da)
221.
Cold and clamm _____________________________ Hot and dr ____________________________
Get ome cand
Sugar' high
222.
What i the therapeutic and toxic level for Lithium?
therapeutic level: 0.61.2
toxic level: ≥ 2
223.
What i the therapeutic and toxic level for Lanoxin (Digoxin)?
therapeutic level: 12
toxic level: >2
224.
What i the therapeutic and toxic level for Aminophlline?
therapeutic level: 1020
toxic level: ≥ 20
225.
What i the therapeutic and toxic level for iliruin?
therapeutic level (elevated level): 1020
toxic level: >20
226.
Kernicteru
iliruin in the CSF
227.
Opithotono poition of light extenion in neck een in patient' with Kernicteru.
(ad ign)
228.
Dumping Sndrome
PotOp gatric urger complication in which gatric content dump
too quickl into the duodenum
229.
Hiatal Hernia
Regurgitation of acid into eophagu, ecaue upper tomach herniate
upward through the diaphragm
230.
Hiatal Hernia or Dumping Sndrome: Gatric content move in the right
direction at the wrong rate
Dumping Sndrome
231.
Hiatal Hernia or Dumping Sndrome: Gatric content move in the wrong
direction at the right rate
Hiatal Hernia
232.
Hiatal Hernia or Dumping Sndrome: GRD like mptom when upine and
after eating
Hiatal Hernia
233.
ADS S&S
Acute Dumping Sndrome Adominal ditre (cramping, N/V, hperactive S(ororgmi))
Drunk cereral impairment
Shock (vaomotor collape, rapid thread HR)
234.
Treatment for Hiatal Hernia
HO during & 1hr after meal high
Amount of fluid with meal high
Carohdrate content of meal high
goal: get an empt tomach
235.
Treatment for Dumping Sndrome
HO during & 1hr after meal low
Amount of fluid with meal low
Carohdrate content of meal low
goal: get a full tomach
236.
Kalemia do the ______ a the prefix except for ___________ and __________
Hperkalemia=
Hpokalemia=
ame; heart rate; urine output
Hper= ↑; HR ↓, Urine Output ↓
Hpo= ↓; HR ↑, Urine Output ↑
237.
Calcemia do the _______ of the prefix. No exception.
Hpercalcemia=
Hpocalcemia=
oppoite
Hper=↓
Hpo= ↑ 238.
Two ign of neuromucular irritailit aociated with _____________:
1.
2..
hpocalcemia
1. Chvotek' Sign= cheek tap→ facial pam
2. Troueau' Sign= P cuff→ carpal pam
239.
Magneemia do the ____________ of the prefix.
Hpermagneemia=
Hpomagneemia=
oppoite
Hper= ↓
Hpo= ↑
240.
If mptom involve nerve or keletal mucle, pick ________. For an other
mptom, pick __________ ( generall anthing effecting ____________)
Calcium, Potaium, lood preure
241.
Hprnatermia
dhdration (dr kin, thread pule, rapid HR)
242.
hpOnatremia=
Overload (crackle, ditended neck vein)
243.
The earliet ign of an electrolte diorder i _________ & __________
numne, tingling (paretheia) 244.
The univeral ignmptom of electrolte imalance i ________________
mucle weakne (parei)
245.
Never puh ____________ IV
Potaium
246.
Not more than ______ of K+ per liter of IV fluid
40mq
247.
Give _____ & ______ to decreae K+
D5W, inulin (not permanent)
248.
Kaexalate:
K+ exit late (not a quick, more of a permanent olution)
249.
In a patient with hpercalcemia, which monitor pattern would e the mot
likel threat?
A. Paroxmal atrial tachcardia with decreaed ST egment
. radcardia with 2nd degree Moitz Tpe II lock & elevated ST egment
C. Frequent PAC' with multifocal coupling of PVC' and tall Twave
D. Firt degree heart lock with decreaed ST egment and inverted Twave
D. Firt degree heart lock with decreaed ST egment and inverted T
wave 250.
Hperthroidim=
Hper metaolim (high metaolic rate)
251.
Sign and Smptom of Hperthroidim
weight lo, diarrhea, ↑HR, hot, heat intolerance, HTN, exopthalmo
(ulging ee Don Knopp)
252.
Hperthroidim i alo known a ____________________. So rememer _____
ourelf into the ______
Grave' Dieae; Run; Grave
253.
The prolem i hperthroidim. Treatment option:
Radioactive iodine, proplthroid utiil, urgical removal
254.
What i the ig rik with radioactive iodine?
radiation rik in urine doule fluh, need private athroom
255.
What doe PTU do?
proplthroid utinil knock out WC
256.
What i the mot common treatment for hperthroidim? urgical removal
257.
Total throidectom need lifelong ________ replacement.
at rik for ___________
hormone; hpocalcemia (difficult to pare parathroid)
258.
What are ou at rik for with a utotal throidectom?
throid torm
259.
What are ign and mptom of throid torm?
extremel high vital ign, extremel high fever, pchoticall
deliriou. Thi i a medical emergenc
260.
What i the treatment for throid torm?
oxgen and lower od temperature
261.
Total= T_____
Sutotal= S______
Tetan
Storm
262.
Pot operation rik for total and utotal throidectom in firt 12 hr
airwa/reathing, leeding 263.
Pot operation rik for total throidectom in 1248 hr
tetan (r/t ↓Ca)
264.
Pot operation rik for utotal throidectom in 1248 hr
throid torm
265.
Hpothroidim = hpo_________
metaolim
266.
ign and mptom of hpothroidim
weight gain, htn, contipation, letharg, coldintolerance, "low"
267.
Hpothroidim i alo known a _______________
mxedema
268.
What are the 3 reaon for accucheck?
diaete, TPN, teroid
269.
Treatment for hpothroidim
throid replacement (/e: hperthroidim) 270.
Caution: with hpothroidim treatment DO NOT ________
edate (the are alread edated)
271.
Surgical implication for the hpothroid patient
Anetheia i ver high rik and do not hold throid pill when NPO
272.
Adrenal Cortex Dieae tart with letter ___ or ____
A, C
273.
Addion' Dieae i _______________ of the adrenal cortex
underecretion
274.
Sign and Smptom of Addion' Dieae
hperpigmented (darker), doen't repond to tre well (JFK)
275.
Treatment for Addion' Dieae
teroid (need to wear a med alert racelet)
276.
Addion'=
addaone 277.
Cuhing' Sndrome i ___________ of the adrenal cortex
overecretion (cuh= more)
278.
Sign and Smptom of Cuhing' Sndrome (ame a teroid)
moon face, hirutim (↑ od hair), water retention, gnecomatia (man
oo), uffalo hump, central oeit (mall kinn lim),↓ one
denit, ea ruiing, irritailit, immunouppreion
279.
Treatment for Cuhing' Sndrome
adrenalectom→ replacement therap→ teroid)
280.
What i CONTACT precaution ued for?
Herpe, nteric (Rotaviru, Shigellou), Staph (MRSA), RSV
(tranmitted via droplet ut contact ecaue kid put mouth on
everthing)
281.
CONTACT PRCAUTIONS: Select all that appl:
___ Private Room
___ e/Face Shield
___ Mak
___ Dipoale Supplie
___ Glove
___ Negative Air Flow
___ Special Filter Repirator Mak
___ Handwahing
___ Gown
___ Pt wear mak when leaving room Private Room (mot important)
Glove
Gown
Handwahing
Dipoale upplie (P cuff)
Stethocope can e taken from room to room a long a terilized after
ue
282.
What i droplet precaution ued for?
influenza (H1N1), meningiti, diphtheria, pertui, mump
283.
DROPLT PRCAUTIONS: Select all that appl:
___ Private Room
___ e/Face Shield
___ Mak
___ Dipoale Supplie
___ Glove
___ Negative Air Flow
___ Special Filter Repirator Mak
___ Handwahing
___ Gown
___ Pt wear mak when leaving room
Private Room
Mak (mot important)
Glove
Handwahing Pt wear mak when leaving room
Dipoale upplie
284.
What i airorne precaution ued for?
Meale, T (pread via droplet), Chicken POx (Varicella), SARS
285.
AIRORN PRCAUTIONS: Select all that appl:
___ Private Room
___ e/Face Shield
___ Mak
___ Dipoale Supplie
___ Glove
___ Negative Air Flow
___ Special Filter Repirator Mak
___ Handwahing
___ Gown
___ Pt wear mak when leaving room
Private room (door cloed
Mak
Glove
Gown
Handwahing
Special FIlter Repirator Mak (for T onl and not uppoed to leave
room unle the have to)
Pt wear mak when leaving room
Dipoale upplie
Negative air flow (mot important)
verone that enter the room mut wear a mak
286.
Unle otherwie pecified, aume that PP include:
glove, gown, goggle, and mak 287.
The proper place for donning PP i ________ the room and doffing PP i
_________ the room
outide, inide
288.
The proper order for donning PP i
1. ___________
2. ___________
3. ___________
4. ___________
1. Gown
2. Mak
3. Goggle
4. Glove
(tart low and go high)
289.
The proper order for removing PP i:
1. ________
2. ________
3. ________
4. ________
1. Glove
2. Goggle (from ehind)
3. Gown (from ehind)
4. Mak (from ehind outide room)
(alphaetical order)
290.
In airorne and droplet precaution onl, the mak i removed _______ the
room and the patient remove mak ________ the room.
outide, inide
291.
Handwahing or Scruing: poition hand elow elow handwahing
292.
Handwahing or Scruing: poition elow elow hand
cruing
293.
Handwahing or Scruing: length econd
handwahing
294.
Handwahing or Scruing: length minute
cruing
295.
Handwahing or Scruing: can touch handle
handwahing
296.
Handwahing or Scruing: not allowed to touch handle
cruing
297.
Handwahing or Scruing: ue when entering/leaving room, efore/after
glove ue, whenever hand get oiled
handwahing
298.
Handwahing or Scruing: ue when patient i immunouppreed (eginning of tuff)
cruing
299.
Handwahing or Scruing: oap and water
handwahing
300.
Handwahing or Scruing: ue "chlor"
cruing
301.
When can ou ue an Alcoholaed olution?
Onl utitute for handwahing, enter/leave room, efore/after glove,
NVR utitute after oiling hand
302.
Can ou ue an alcoholaed olution after uing the retroom?
No! (oiling hand)
303.
Dr hand from ________ to _________. Turn water off with _____ paper towel
cleanet, dirtiet, new
304.
Sterile Gloving:
glove ________ hand firt
grap ________ of cuff
touch onl the _______ of glove urface
do not _______ cuff
finger _______ econd glove cuff
keep thum _______ onl touch _______ urface of glove
dominant
outide
inide
roll
inide
aducted
outide
305.
SkIN touche _______ of glove
INide
306.
OUTide of glove onl touche _______ of glove
OUTide
307.
Remove ______ to _______; _______ to _______
glove, glove, kin, kin
308.
What patient do NOT need interdiciplinar care?
People who have multiple prolem in the ame diviion of care
x: COPD, arthriti, cancer of owel (all medical prolem)
309.
What i the major criteria for interdiciplinar care?
1. Patient with multidimenional need (phical, intellectual,
emotional, ocial, piritual) x COPD, homelene, & chizophrenia
(need medical, SW, and pchiatrit)
2. Patient who need rehailitation (PT, SW, OT, Speech will e effected) 310.
What i the minor criteria for interdiciplinar care?
a patient whoe current treatment i ineffective
a patient who i preparing for dicharge
311.
What are the 3 principle to conider when chooing appropriate to for
kid?
1. i it afe
2. i it ageappropriate
3. i it feaile (can ou actuall do it? pecific to child' ituation)
312.
What are ome afet conideration when it come to kid to?
1. ize of to (no mall to for children under 4)
2. no metal to if oxgen i in ue (park thing)
3. eware of fomite (non living oject that haror microorganim)
wort: pluh to/ tuffed animal; leat platic to that can e
diinfected
313.
What i the ST to for 06 month old (enorimotor)?
mucial moile
314.
What i the 2nd ST to for 06 month old (enorimotor)?
large and oft
315.
What i the ST to for 69 month old (oject permanence)?
cover/uncover to (jack in the ox) 316.
What i the 2nd ST to for 69 month old (oject permanence)?
firm ut large (wood/ hard platic allowed)
317.
What i the ST to for 912 month old?
veral to (tickle me elmo)
318.
Rememer with 912 month old ___________ activit with _________
purpoeful, oject
319.
Avoid anwer with the following word in them for children 9 month and
ounger:
uild, ort, tack, make, & contruct
320.
What i the et to for toddler (13 ear)?
puh/pull to (wagon)
321.
What kill i eing worked on when toddler pla?
gro motor kill
322.
What tpe of pla do toddler do?
parallel pla (pla alongide ut not with) 323.
What tpe of to hould e avoided with toddler?
to that require good finger control/dexterit
324.
Prechooler need to that work on:
fine motor kill (finger) and alance (dance, ice kating and tumling)
325.
Prechooler pla i characterized
cooperative pla (pla with each other)
326.
Prechooler like to pla ________.
pretend
327.
School age (711 ear) aka _________ are characterized the 3 C':
1.
2.
3.
Concrete
1. created/creative (give lank paper; get them involved)
2. competitive (winner and loer)
3. collective (aeall card and arie)
328.
Adolecent (1218 ear) their "pla" i _______ _______ _____________. Allow
adolecent to e in each other' room unle one of them i :
1.
2.
3. peer group aociation (hang out in group)
1. freh potop (le than 12 hour)
2. immunouppreed
3. contagiou
329.
When given a variet of age to chooe from alwa go __________ ecaue
children ________ when ick and ou want to give them
__________________________________
ounger, regre, a much time to grow
330.
Creatinine
et indicator of kidne function
331.
Creatinine la value
0.61.2
If elevated it' anormal ut not too worriome (jut mean kidne are
failing)
332.
INR (International Normalized ratio)
Monitor Coumadin (Warfarin) therap (Coumadin and War Fare make
ou leed)
333.
What i the therapeutic range for INR?
23
↑INR= leed rik
≥4 i critical
334. What do ou do when INR i ≥ 4?
Hold all Coumadin
Ae leeding
Prepare to give Vitamin K
Call the Dr
335.
What i the therapeutic range for Potaium (K+)?
3.55.0
336.
What do ou do if Potaium i low?
Critical
Ae heart
Prepare to give Potaium
Call the Dr
337.
What do ou do if Potaium i 5.45.9?
Critical (high ut till in the 5')
Hold all Potaium
Ae heart
Prepare Kaexalate/D5W
Call the Dr
338.
What do ou do if Potaium i ≥6?
Deadl Dangerou
Do all of the following at once: Hold Potaium, ae heart, prepare
Kaexalate/D5W, Call Dr (will need a team to addre thi)
339.
What i the therapeutic range of pH?
7.357.45 340.
What do ou do if pH i in the 6'?
Deadl Dangerou
get vital and call Dr
(mot important when aked in quetion)
341.
What i the therapeutic range for UN (lood urea nitrogen)?
830 (8 un in a pack)
342.
What do ou do when a patient ha an elevated UN?
e concerned
Check for dehdration
343.
What i the therapeutic range for Hg (hemogloin)?
1218 (teenage ear)
344.
What do ou do when a patient ha a 811 hg?
e concerned
monitor the patient
345.
What do ou do if a patient ha a hg of <8?
Critical
Ae leeding, prepare for tranfuion, call Dr 346.
What i the therapeutic range for HCO3?
2226
If out of range it i anormal ut not worriome
347.
What i the therapeutic range for CO2?
3545
348.
What do ou do if CO2 i in the 50'?
Critical (ign of repirator inufficienc)
Ae repiration
Do pured lip reathing (low out candle and exhale for longer period)
Don't give O2 (it will increae CO2)
Thi doe not appl to COPD (thi i their "normal")
349.
What do ou do if CO2 i in the 60'?
Deadl Dangerou
ign of repirator failure
Ae repiration
Do pured lip reathing (to ↓ anxiet)
Prepare to intuate and ventilate
Call repirator therap
Call Dr
350.
What i the therapeutic range for Hct?
3654
(if anormal e concerned)
351. What i the therapeutic range for PO2?
78100
352.
What do ou do if PO2 i 7077?
Critical
Sign of repirator inufficienc
Ae repiration
Give Oxgen
353.
What do ou do when PO2 i ≤60'?
Deadl Dangerou
Sign of repirator failure
Ae Repiration
Give Oxgen
Prepare intuate and ventilate
Call repirator therap
Call Dr
354.
What i the therapeutic range for O2 aturation?
93100
355.
What do ou do if O2 aturation i le than 93?
Ae repiration and give oxgen
356.
NP
Good indicator of CHF 357.
What i the therapeutic range for NP?
<100
358.
What do ou do if NP i elevated?
e concerned and continue to monitor patient
359.
What i the therapeutic range for Sodium?
135145
360.
What do ou do if Sodium i anormal in a patient?
e concerned until there' a change in the LOC (then it ecome critical)
361.
What i the therapeutic range for WC'?
5,00011,000
362.
What i the therapeutic range for ANC?
500 (want aove 200)
363.
What i the therapeutic range for CD4 count?
<200= AIDS 364.
What i another name for high WC count?
Leukoctoi
365.
What are ome other name for low WC count?
Leukopenia
Neutropenia
Agranuloctoi
Immunouppreion
one Marrow Supreion
366.
What do ou do when WC i <5,000
Critical immunouppreed
Neutropenic precaution
367.
What do ou do if ANC i < 500?
Criticalimmunouppreed
Neutropenic precaution
368.
What do ou do if CD4 <200?
Critical immunouppreed
Neutropenic precaution
369.
What i neutropenic precaution?
aka Revere/Protective Iolation
Strict hand wahing
Shower ID with antimicroial oap
Avoid crowd Private Room
Limit numer of taff entering room
Limit viitor to health adult
No freh flower or potted plant
Low acteria diet: no raw fruit, veggie, alad or undercooked meat
Do not drink water that ha een tanding for longer than 15 minute
Vital ign (temp) ever 4 hour
Check WC (ANC) dail
Avoid ue of indwelling catheter
Do not reue cup... mut wah etween ue
Ue dipoale plate, cup, traw, utenil
Dedicated item in room: tethocope, P cuff, Thermometer, glove
370.
What i the therapeutic range for platelet?
150,000400,000
371.
What do ou do if platelet are <90,000?
Critical
Ae for leeding
leeding Precaution
372.
What do ou do if platelet are <40,000?
Deadl Dangerou (can pontaneoul leed to death)
Ae for leeding
leeding Precaution
373.
What i leeding precaution?
No unnecear venipuncture injection or IV. Ue mall gauge
Handle patient gentl (ue drawheet)
Ue electric razor
No toothruhing or floing
No hard food
Wellfitting denture
low noe gentl
No rectal temp, enema, or uppoitor No apirin
No contact port
No walking in are feet
No tight clothing or hoe
Ue tool oftener. No training
Notif MD of lood in urine, tool
374.
What i the therapeutic range for RC'?
46
(if anormal e concerned)
375.
What are the 5 D'?
(rememer the 6')
1. K+≥6
2. pH in the 6'
3. CO2 in the 60'
4. pO2 ≤60'
5. Platelet < 40,000
376.
When hould ou call a Rapid Repone Team?
When la value are Critical or Deadl Dangerou or if ad mptom
during aement
377.
Laminectom
"ctom"= removal of
"lamina"= verteral pinu procee
378.
What i the reaon for a laminectom?
to treat nerve root compreion 379.
What are the 3 ign and mptom of nerve root compreion?
Pain
Paretheia (numne & tingling)
Parei (mucle weakne)
380.
What are the different location for a laminectom?
cervical (neck)
thoracic (upper ack)
lumar (lower ack)
381.
What i the mot important aement in a preop cervical laminectom>
function of Upper extremitie and reathing
382.
What i the mot important aement in a preop thoracic laminectom?
cough (tet adominal mucle) and owel ound
383.
What i the mot important aement in a preop lumar laminectom?
urine output and leg
384.
What i the #1 potop anwer on NCLX?
alwa log roll our patient
385.
What i the pecific "activit"/moilization trateg potop? 1. do not dangle/it on ide of ed
2. allowed to walk, it, tand and lie down
3. limit itting 2030 min at a time
386.
Potop complication for cervical laminectom
watch for pneumonia
387.
Potop complication for thoracic laminectom
watch for pneumonia and paraltic illeu
388.
Potop complication for lumar laminectom
watch for urinar retention
389.
Laminectom with fuion involve taking a _____ ______ from the ______
______. Of the two inciion, which ite ha the mot:
Pain?
leeding/Drainage?
Rik for infection?
Rik for rejection?
one graft, illiac cret (hip)
hip
hip
hip/pine
pine
390.
Surgeon are uing cadaver one from one ank. Wh?
ecaue it get rid of 2nd inciion and cut recover time in half 391.
What are ome temporar retriction (6 wk) with dicharge teaching?
1. Don't it for longer than 30 min
2. Lie flat and log roll for 6 wk
3. Lifting retriction: do not lift more than 5l
392.
what are ome permanent retriction for laminectom patient?
1. Laminectom patient will never e allowed to lift ending at the
wait (ue their need)
2. Cervical laminectom patient will never e allowed to lift oject
aove their head
3. No horeack riding, offtrail iking, jerk amuement park ride, etc.
393.
Nagele' Rule (calculating due date)
Take the firt da of the lat mentrual period (LMP)
Add 7 da
Sutract 3 month
394.
Total weight gain during pregnanc
2531 l
395.
1t trimeter weight gain
1 l per month (3 l total for firt trimeter)
396.
2nd/3rd trimeter weight gain
1 l per week 397.
Fundu (top of uteru) in not palpale until week ____
12
398.
Fundu tpicall reache the umilical (navel) level at week ______
2022
399.
What are 4 poitive ign of pregnanc?
1. fetal keleton on an xra
2. fetal preence on ultraound
3. aucultation of the fetal heart (doppler)
4. examiner palpate fetal movement/outline
400.
What are ome proal/preumptive ign of pregnanc?
1. all urine and lood pregnanc tet
2. Chadwick' ign (color change of the cervix to canoi)
3. Goodell' ign (cervical oftening)
4. Hegar' ign (uterine oftening)
401.
Morning ickne: Which trimeter and what treatment?
1t trimeter
eat dr car, cracker efore out of ed, and avoid empt tomach
402.
Urinar incontinence: Which trimeter and what treatment?
1t/3rd
void Q2H 403.
Dpnea: Which trimeter and what treatment?
tripod poition (lean forward with hand on knee)
404.
ack pain: Which trimeter and what treatment?
2nd/3rd
pelvic tilt exercie
(put foot on tool then ack again)
405.
What i the truet, mot valid ign of laor?
onet of regular contraction
406.
Dilation
opening of cervix (010 cm)
407.
ffacement
thinning of cervix (thick100%)
408.
Station
relationhip of fetal preenting part to mom' ichial pine (tightet
queeze for a head)
negative= aove pine
poitive= elow pine
409. ngagement
tation "0" at ichial pine
410.
Lie
Relationhip etween pine of a and pine of mom
411.
Preentation
part of a that enter irth canal firt
412.
What i tage 1 of laor and deliver?
laor dilate and phae cervix (3 phae of laor latent, active,
tranitional)
413.
What i tage 2 of laor and deliver?
deliver of a
414.
What i tage 3 of laor and deliver?
deliver of placenta
415.
What i tage 4 of laor and deliver?
recover firt 2 hour to top leeding
416. tranvere lie and tation that won't go poitive=
cection
417.
Latent:
CM dilated
CXN freq
Duration
Intenit
04cm
530 min
1530 ec
mild
418.
Active:
CM dilated
CXN freq
Duration
Intenit
57 cm
35 min
3060 ec
Moderate
419.
Tranition:
CM dilated
CXN freq
Duration
Intenit
810 cm
23 min
6090 ec
Strong
420.
Contraction hould not e longer than ____ econd or cloer than ever ___ minute
90
2
421.
Aement of contraction: Frequenc
eginning of one contraction to the eginning of the next contraction
422.
Aement of contraction: Duration
eginning to end of one contraction
423.
Aement of contraction: Intenit
trength of contraction. Palpate with finger of one hand over the
fundu
424.
What complication of laor i indicated if the mom i having painful ack
pain?
a turned around ackward.
Low priorit
Poition kneechet then put on her ack
425.
What hould ou do with a prolaped cord?
Puh head ack in off cord and poition in kneechet or trendelenurg
(hip up, houlder down). Prep for cection
426.
Intervention for all other complication of laor and irth Left ide/ Lateral
IV increae
Oxgen
Notif
top Pit if in crii
427.
Do not adminiter a SYSTMIC pain medication to a woman in laor IF the
a i likel to e ______ when the _______ i _________
orn, pain, peaking (repirator depreion)
428.
What do ou do with a low fetal heart rate?
ad
LION pit
429.
What do ou do with FHR Acceleration?
no crii
430.
What do ou do with low aeline variailit?
ad
LION pit
431.
What do ou do with high aeline variailit?
record it
432.
What do ou do with late deceleration?
ad LION pit
433.
What do ou do with earl deceleration?
HR ↓
434.
What do ou do with variale deceleration?
can e ver ad
prolaped cord
435.
Second tage of laor and deliver what do ou do?
1. deliver the head (top puhing)
2. uction mouth and noe
3. check for nuchal cord (cord around neck)
4. deliver houlder and od
5. make ure a ha ID and
436.
What do ou check for with the deliver of the placenta?
3 veel (2 arterie and 1 vein) "AVA"
437.
During the ___ tage (recover tage) (firt 2 hour after deliver) what __
thing do ou do ___ time an hour
4th, 4, 4
1. vital ign (ae for ign and mptom hock
2. check fundu (if ogg, maage. if diplaced, void/cath)
3. check pad (exceive lochia= pad at in 15 min)
4. roll on to ide (check for leeding under patient) 438.
What i the tone, height and location of the uteru potpartum?
tone: firm not ogg
height: right after deliver it i pui 24 hour it i at navel. 2 cm
for ever PP da
location: midline (if diplaced from R/L if mean catheterize)
439.
What i the color of lochia in the firt da?
rura
440.
What i the color of lochia after a week or o of potpartum?
eroa
441.
What i a moderate amount of lochia?
46 in on pad in one hour
442.
What i an exceive amount of lochia?
aturate pad in 15 min
443.
What do ou ae for in the potpartum aement?
uteru, lochia, exteremitie (pule, edema, S7S thromophleiti)
444. ditended eaceou gland which appear a tin white pot on a'
face
milia
445.
mall, white epithelial ct on a' gum
eptein' pearl
446.
luihlack macule appearing over the uttox and/or thigh of darker
kinned neonate
mongolian pot
447. red papular rah on a' toro which i enign and diappear after a
few da
erthema toxicum neonatorum
448.
enign tumor of capillarie
hemangioma
449.
welling caued leeding etween the otium and perioteum of the
kull. Thi welling doe not cro uture line
Cephalohematoma
450. edematou welling on calp caued preure during irth. Thi
welling ma cro uture line. It uuall diappear in a few da
caput uccedaneum
451.
normal, phiologic jaundice appear after 24 hour of age and diappear
at aout one week of age
Hperiliruinemia
452.
whitih, cheeelike utance which appear intermittentl over the firt
710 da
vernix caeoa (caeu= cheee) 453.
normal canoi of a' hand and feet which appear intermittentl
over the firt 710 da
acrocanoi
454.
generic term for irthmark
1. nonlanchale port wine tain
2. lanchale pink "tork ite"
nevu/nevi
1. nevu flammeu
2. telangiectatic nevi
455.
Tocoltic (top contraction)
Terutaline (rethine)
S/ tachcardia (don't give with cardiac dieae)
Nifedipine
S/ headache/hpotenion (can give with cardiac dieae)
456.
Oxtocic timulate laor
Pitocin (Oxtocin)
S/ uterine hpertimulation Cervidil (Protaglandin) dilate cervix
S/ uterine hpertimulation
457.
Fetal/ Neonatal Lung Med
etamethaone (teroid) give to mother IM; give efore a after
viailit. can repeat
S/ ↑S
Survanta give to a after a i orn (trantracheal)
458.
Step of drawing up inulin
1. draw up the total doe in air
2. preurize the "N" vial (put air in)
3. preurize the "R" vial
4. draw up "R" doe
5. draw up "N" doe
(Nichole Richie, RN)
459.
IM length and guage
1 in oth the guage and length (I look like 1)
460.
SQ length and guage
5 in oth part (S look like a 5)
461.
Heparin work immediatel
can onl take for 21 da
antidote: Protamin ulfate (heParin)
la: PTT and all clotting and leeding time
http> PttHeparin
can ue in pregnanc
pregnanc cla C
462.
Coumadin
take da
can take for
entire life
PO onl
antidote: vitamin K
la: PT, INR
can't ue if pregnant
cla x pregnanc
463.
aclofen (Lioreal)
mucle relaxant
1. caue fatigue
2. caue parei (mucle weak)
3. do not drink alcohol 4. do not drive a car
5. do not watch kid under age 12
When ou are on aclofen ou are on our ack "loafin"
464.
Senorimotor
Age: 02/o
Characteritic: totall preentoriented. Onl think aout what the
are ene of are doing right now
Teaching Guideline
When: a it happen
What: ou are doing now
How: tell them what ou're doing a ou're doing it
465.
PreOperational
Age: 36/o (prechooler)
Characteritic: Fanta oriented. illogical. no rule. (can teach ahead of
time ut not too far)
Teaching Guideline
When: lightl ahead of time (morning of...)
What: ou will do
How: pla, to, torie
466.
Concrete Operation
Age: 711/o
Characteritic: Ruleoriented. Live and die the rule! Cannot
atract
Teaching Guideline When: da ahead of time
What: ou're gonna do and kill
How: age appropriate reading and A/V material, role pla i ok
467.
Formal Operation
Age: 1214 /o
Characteritic: ale to think atractl. Undertand caueeffect.
Thinking like adult emotionall ut phicall not there ut the can
think like one
Teaching Guideline
When: like an adult
What: like an adult
How: like an adult
468.
kin till intact, non lanching, erthema (redne)
tage 1 preure ore
469. ulcerated, uperficial,pink dermi
tage 2
470.
ellow ucutaneou (fat)
Stage 3
471.
redwhite (mucle and one)
tage 4
472.
_______ eat _______
acute, chronic 473.
_______ __________ eat _______ or _______ _________
freh pot op, medical, other urgical
474.
______ eat _______
tale, untale
475.
What make a patient tale?
1. ue of the word tale
2. chronic illne
3. pot op> 12 hr
4. local or regional anetheia
5. unchanged aement
6. phrae: "To e dicharged"
7. la value A/
Stale patient are experiencing the expected tpical ign and
mptom of the dieae with which the have een diagnoed and for
which the are receiving treatment
476.
What make a patient untale?
1. Ue of the word untale
2. acute illne
3. pot op <12 hour
4. general anetheia
5. changing aement
6. phrae: "newl admitted" or "newl diagnoed"
7. la value C/D
Untale patient are experiencing unexpected atpical ign and
mptom, complication
477.
What 4 patient are alwa untale? 1. hemorrhage
2. hpoglcemia
3. fever ≥104
4. pulelene or reathlene
478.
The more _____ the ______, the higher the priorit
vital, organ
Mot vital→ rain → lung → heart → liver → kidne → pancrea
479.
What reponiilitie would ou not delegate to an LPN?
Starting an IV
Hanging or mixing IV med
valuating an IV ite
Giving an IV puh/P med
Giving a lood tranfuion
Performing aement that require inference/judgment (can gather
data) can make oervation aout tale people ut cannot make
aumption
Plan of care
Developing or performing teaching (can reinforce and review)
Taking veral order from MD or trancriing order
480.
What would ou not delegate to a UAP?
cannot chart ut ma document what the did
aement except for VS and accucheck
med and IV ma appl otc topical lotion and cream
treatment except for SS. Not fleet
You ma delegate ath, ed, and ADL
481.
Do not delegate to ___________: _______ reponiilitie. The can onl do
what ou _______ them to do
famil, afet, teach 482.
how do ou intervene with inappropriate ehavior of taff? (4 option)
1. tell the upervior
2. intervene immediatel
3. counel them later on
4. ignore it. Jut let it go (never the right anwer)
483.
What 4 quetion hould ou ak when dealing with inappropriate ehavior
from taff?
1. i what the're doing illegal? (if e tell the upervior)
2. i the patient or taff memer in immediate danger of phical or
pchological harm? (if e intervene immediatel)
3. i thi ehavior legal, not harmful, ut impl inappropriate? (if e
counel them later on)
484.
Preinteraction phae
purpoe: for the nure to explore hi/her feeling. to prevent
judgmental, intolerant reaction
length: egin when ou learn ou are going to e caring for omeone
and end when ou meet them
correct anwer: "the nure will explore hi/her feeling aout..."
485.
Introductor phae (orientation phae)
purpoe: to etalih and explore/ae
length: egin when ou firt meet the patient and end when a
mutuall agreeupon care plan i in place
correct anwer: Should e ver tolerant, accepting, explorative, proing,
"no". e warm and fuzz
486. Working phae (therapeutic phae)
purpoe: to implement the plan of care
length: from the finihed care plan until dicharge
correct anwer: hould e focued, directive, "tough". in ome wa
thee anwer will eem tern and lightl unfriendl. et limit.
enforce proper communication
487.
When doe the termination phae egin?
on admiion
488.
Pch Treatment Protocol for depreion
Whenever a patient dipla an notion of uicide or harm ou MUST
inquire aout it
Mut get a afet contract
*activitie with other people that doen't require interaction
489.
Pch Treatment Protocol for chizophrenia
If pacing Pch→ reduce timulation (clear the room), make oervation,
offer preence
*need realit aed activitie ut not competitive; hould e with other
people
490.
Pch Treatment Protocol for ipolar
Mania' can't go to work or maintain famil order wherea a hpo
manic can
finger food are et; epeciall ↑ calorie
8hr of leep. ncourage nap *exercie the gro motor that i non competitive
491.
Pch Treatment Protocol for Anxiet Diorder
Phoia irrational fear that limit dail life
→tx: deenitization: graduall expoe
1. Talk aout it
2. Show pic
3. e around
4. Interact
When ou move to next tep, make ure not anxiou
492.
Retraint protocol
In pch: need to e evaluated within 1 hr. Mut e contantl oerved
Not pch: oerve ever 15 min. No evaluation. Need Dr order Q24h
493.
Pch Treatment Protocol for Violent Client
It take 5 people to control a violent client. One for each lim and head.
Onl one peron talk. The peron i given a few econd to deecalate
494.
All pch drug caue....
Hpotenion, weight change, and primar weight gain
495.
Phenothiazine
All end in "zine"
x: Thorazine, compazine
Action: large doe antipchotic, mall doe antiemetic, major
tranquilizer 496.
Side ffect of Phenothiazine
Rememer ACDFG...
A= anticholinergic (dr mouth)
= lurred viion and ladder retention
C= contipation
D= drowine
= PS (tremor, parkinonian)
F= "f"otoenitivit (kin urn)
G= aGranuloctoi (low WC count immunoupreed)
Teach patient to report ore throat and ign and mptom of infection
to doctor
Never top the zine
Never top the zine
497.
Nuring care for Phenothiazine
Treat ide effect. Numer one diagnoi i afet
498.
Deconate or "D"
Long acting IM form of Phenothiazine given to non compliant patient
499.
Tricclic Antidepreant
"Mood elevator" to treat depreion
x lavil, Trofranil, Aventl, Derel
500.
Side effect of Tricclic Antidepreant
(lavil tart with "" o thi group goe to "")
A= anticholinergic (dr mouth)
= lurred viion C= contipation
D= drowine
= euphoria (happ)
Mut take med for 24 week efore eneficial effect
501.
enzodiazepine
Antianxiet med (conidered minor tranquilizer)
Alwa have "Pam"/"lam" in name
Prototpe: Valium
Indication: induction of anethetic, mucle relaxant, alcohol
withdrawal, eizure (epeciall tatu epilepticu), facilitate
mechanical ventilation
Tranquilizer work quickl. MUST NOT take for more than 6 week 3
month. Keep on Valium until lavil kick in
Numer one nuring diagnoi i afet
502.
Side effect of enzoDiazepine
A= anticholinergic
= lurred viion
C= contipation
D= drowine
503.
Monoamine Oxidae (MAO) Inhiitor
Antidepreant
Depreion i thought to e caued deficienc of norepinephrine,
dopamine, and erotonin in the rain. Monoamine oxidae i the
enzme reponile for reaking down norepinephrine, dopamine, and
erotonin. MAO Inhiitor prevent the reakdown of thee
neurotranmitter a and thu retore more normal level and decreae
depreion
Drug name: MARplan, NARdil, PARnate
504.
Side effect of MAO inhiitor A= anticholinergic
= lurred viion
C= contipation
D= drowine
505.
Interaction/ patient teaching for MAO Inhiitor
To prevent ever, acute, ometime fatal hpertenive crii, the
patient MUST avoid all food containing tramine
Food containing tramine:
Fruit and veggie rememer alad "AR"→ avoid anana, Avacado,
Raiin (an dried fruit);
Grain: ll oka except thing made from active eat
Meat: no organ meat liver, kidne, tripe, heart, etc. no preerved
meat moked, dried, cured, pickled, hot dog
Dair: no cheee except mozzarella and cottage cheee (no aged cheee)
Other: no alcohol, elixir, tincture (iodine/etadine), caffeine, chocolate,
licorice, o auce
506.
Lithium
An electrolte (notice "ium" ending a in potaium etc)
Ued for treating ipolar diorder (manicdepreion)→ it decreae the
mania
507.
Side effect of Lithium
The three "P'":
Peeing (poluria)
Pooping (diarrhea)
Paretheia (tingling/numne)
Medicall inducing a lithium/electrolte imalance
Toxic: tremor, metallic tate, evere diarrhea, and an other neuro ign
→numer one intervention: good fluid hdration. If weating give
odium (or other electrolte) a well a fluid. Don't give water. Drink
Gatorade or other electrolte olution. Monitor odium level
508. Prozac
SSRI ( Selective Serotonin Reuptake Inhiitor)
Similar to lavil
Antidepreant mood elevator
509.
Side effect of Prozac
A= anticholinergic
= lurred viion
C= contipation
D= drowine
Caue inomnia, o give efore 12 noon. If ID, give at 6am and 12 noon
When changing the doe of Prozac for an adolecent or oung adult,
watch for uicide
510.
Haldol (Haloperidol)
Tranquilizer
Alo ha a deconate form
Long acting IM form given to non compliant patient
511.
Side effect of Haldol
A= anticholinergic
= lurred viion
C= contipation
D= drowine
= PS
F= fotoenitvit
G= aGranuloctoi
lderl patient ma develop NMS from overdoe. NMS i Neuroleptic
Malignant Sndrome a potentiall fatal hperplaia (fever) with temp
of 104.0. Doe for elderl patient hould e half of uual adult doe.
Safet concern r/t ide effect
512. Clozaril (clozapine)
Atpical antipchotic
Ued to treat evere chizophrenia
Advantage: it doe not have ide effect AF
Do not confue with Klonopin (clonazepam)
513.
Side effect of Clozaril
Agranuloctoi (wore than cancer drug)
Can ink precrie for 7 da then get WC drawn for 4 week, then
once a month for 6 month then ever 6 month
514.
Zoloft (Sertraline)
Another SSRI like Prozac
Antidepreant
Alo caue inomnia ut can e given in evening
Watch for interaction with St John' Wort (erotonin ndrome), and
warfarin (watch for leeding)
515.
Side effect of Zoloft
SAD Head
Sweating
Apprehenive
Dizz
Headache
Mark Klimek Yellow Book
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