(Mensy) P 1 of 8 Hints from Exam Cram NCLEX-PN
Question
Answer
Sodium:
135-145 mEq/L
Potassium:
3.5-5.5 mEq/L
Calcium:
8.5-10.9 mg/L
Chloride:
95-105 mEq/L
Magnesium:
1.5-2.5 mEq/L
Phosphorus:
2.5-4.5 mg/dL
RBC:
4.5-5.0 million
WBC:
5,000-10,000
Platelet.:
200,000-400,000
Hgb:
12-16 gms women; 14-18 gms men
HC03:
24-26 mEq/L
C02:
35-45 mEq/L
Pa02:
80%-100%
Sa02:
> 95%
Glucose:
70-110 mg/dL
Specific gravity:
1.010-1.030
BUN:
7-22 mg/dL
Serum creatinine:
0.6-1.35 mg/dL (< 2 in older adults)
LDH:
100-190 U/L
CPK:
21-232 U/L
Uric acid:
3.5-7.5 mg/dL
(Mensy) P 2 of 8 Triglyceride:
40-50 mg/dL
Total cholesterol:
130-200 mg/dL
Bilirubin:
< 1.0 mg/dL
Protein:
6.2-8.1 g/dL
Albumin:
3.4-5.0 g/dL
Digoxin:
0.5-2.0 ng/ml
Lithium:
0.8-1.5 mEq/L
Dilantin:
10-20 mcg/dL
Theophylline:
10-20 mcg/dL
Heart rate:
80-100
Respiratory rate:
12-20
Blood pressure:
110-120 (systolic); 60-90 (diastolic)
Temperature:
98.6°
FHR:
120-160 BPM
FHR Variability:
6-10 BPM.
Contractions: normal frequency
2-5 minutes apart
Contractions normal duration
< 90 sec.
Contractions intensity
< 100 mm/hg.
Amniotic fluid:
500-1200 ml (nitrozine urine-litmus paper green/amniotic fluidlitmus paper blue).
APGAR meaning
A = appearanceP = pulses, G = grimace, A = activity, R = reflexes
APGAR scoring done at
1 and 5 minutes
APGAR scoring:
0 for absent, 1 for decreased, and 2 for strongly positive
AVA:
The umbilical cord has two arteries and one vein (Arteries carry
(Mensy) P 3 of 8
deoxygenated blood. The vein carries oxygenated blood.) B stands for brain (decreases the incidence of neural tube FAB 9Folic acid = B9
defects); the client should begin taking B9 three months prior to becoming pregnant.
Decelerations are _______________findings on the fetal monitoring strip. Decelerations are classified as
abnormal
Earky, Variable and Late Begin prior to the peak of the contraction and end by the end of
Early decelerations
the contraction. They are caused by head compression. There is no need for intervention if the variability is within normal range (that is, there is a rapid return to the baseline fetal hear Are noted as V-shaped on the monitoring strip. Variable decelerations can occur anytime during monitoring of the fetus.
Variable decelerations
They are caused by
cord compression. The intervention is to
change the mother's position; if pitocin is infusing, stop the infusion; ap Occur after the peak of the contraction and mirror the contraction in length and intensity. These are caused by Late decelerations
uteroplacentalinsuffiency. The intervention is to change the mother's position; if pitocin is infusing, stop the infusion; apply oxygen;, and A combination of diseases including toxoplasmosis, rubella
TORCHS
syndrome in the neonate
(German measles), cytomegalovirus, herpes, and syphyllia. Pregnant nurses should not be assigned to care for the client with toxoplasmosis or cytomegalovirus.
STOP-This
is the treatment for maternal
1. Stop pitocin if infusing. 2. Turn the client on the left side. 3.
hypotension after an epidural anesthesia:
Administer oxygen. 4. If hypovolemia is present, push IV fluids.
Coumadin (sodium warfarin) PT:
10-12 sec. (control).
The
vitamin K.
antidote for Coumadin is
Heparin/Lovenox/Dalteparin PTT:
30-45 sec. (control).
The
protamine sulfate.
antidote for Heparin is
Therapeutic
level: It is important to maintain a
bleeding time that is slightly prolonged so that
1 1/2-2 times the control.
(Mensy) P 4 of 8
clotting will not occur; therefore, the bleeding time with mediication should be: The control (for anticoagulants) is
Rule of nines for calculating TBSA for burns
the premedication bleeding time. Head = 9% ; Arms = 18% (9% each) ; Back = 18% ; Legs = 36% (18% each) ; Genitalia = 1% Females avoid eye contact with males; touch is accepted if done by same-sex healthcare providers; most decisions are made by
Arab American cultural attributes
males; Muslims (Sunni) refuse organ donation; most Arabs do not eat pork; they avoid icy drinks when sick or hot/cold drinks toget They
Asian American cultural attributes
avoid direct eye contact; feet are considered dirty (the feet
should be touched last during assessment); males make most of the decisions; they usually refuse organ donation; they generally do not prefer cold drinks, believe in the "hot-cold" theory They sustain eye contact; blood and organ donation is generally
Native American cultural attributes
refused; they might refuse circumcision; may prefer care f rom the tribal shaman rather than using western medicine. They might avoid direct eye contact
Mexican American cultural attributes
with authorities; they might
refuse organ donation; most are very emotional during bereavement; believe in the "hot-cold" theory of illness.
Jehovah's Witness
No blood products should be used
Hindu
No beef or items containing gelatin
Jewish
Special dietary restrictions, use of kosher foods
Renal diet
Gout diet
Heart healthy diet
High calorie, high carbohydrate, low protein, low potassium, low sodium, and fluid restricted to intake = output + 500 ml Low purine; omit poultry ("cold chicken") medication for acute episodes: Colchicine; maintenance medication: Zyloprim Low fat (less than 30% of calories should be from fat) in respiratory acid/base disorders the pH is opposite to the other
ROME (respiratory opposite/metabolic equal) is a quick way of remembering that:
components. For example, in respiratory acidosis, the pH is below normal and the C02 is elevated, as is the HC03 (respiratory opposite). In metabolic disorders, the components
(Mensy) P 5 of 8
of the lab pH down, C02 up, and HC03 up:
respiratory acidosis
pH down, C02 down, and HC03 down:
metabolic acidosis
pH up, C02 down, and HC03 down:
respiratory alkalosis
pH up, C02 up, and HC03 up :
metabolic alkalosis
Addison's and Cushing's are diseases of the __________________ system involving either overproduction or inadequate production of
endocrine
cortisol.
Treatment
for the client with Addison's:
Treatment for the client
with Cushing's:
increase sodium intake; medications include cortisone preparations. restrict sodium; observe for signs of infection.
Treatment for spider bites/bleeding
RICE (rest, ice, compression, and elevate extremity)
Treatment for sickle cell crises
HHOP (heat, hydration, oxygen, pain medications)
Five Ps of fractures and compartment syndrome These are symptoms of fractures and
compartment Pain, Pallor, Pulselessness, Paresthesia, Polar (cold)
syndrome: Hip fractures commonly:
hemorrhage
Femur fractures are at risk for:
fat emboli
Profile of gallbladder disease
Delegate sterile skills such as dressing changes to the: Where nonskilled care is required, you can delegate the stable client to the:
Fair, fat, forty, five pregnancies, flatulent (actually gallbladder disease can occur in all ages and both sexes)
RN or LPN.
nursing assistant.
Choose the most critical client to assign to the______such as the client who has recently returned from chest surgery.
RN
(Mensy) P 6 of 8
Clients who are being discharged should have final assessments done by the:
The
PN, like the RN, can monitor clients with
For room assignments, do not coassign the p ostoperative client with clients who have:
RN
IV therapy, insert urinary catheters and feeding tubes, apply restraints, discontinue IVs, drains, and sutures.
vomiting, diarrhea, open wounds, or chest tube drainage.
Remember the ___________________ when answering questions choices that ask who would
A, B, Cs (airway, breathing, circulation)
you see first. For hospital triage, care for the client with a ________________ or__________________ first. For disaster triage, choose to triage first those clients who can: The ___ and
the __________ institute seclusion
protection. The ____ or the
_________ nurse can pronounces
client dead.
life-threatening illness or injury
be saved with the least use of resources.
RN, Physician
MD, hospice
Benazepril (Lotensin), lisinopril (Zestril), captopril (Capoten), Angiotensin-converting enzyme inhibiting agents:
enalapril (Vasotec), fosinopril (Monopril), moexipril (Univas), quinapril (Acupril), ramipril (Altace) Acebutolol (Monitan, Rhotral, Sectral), atenolol (Tenormin, Apo-
Beta adrenergic blockers:
Atenol, Nova-Atenol), esmolol (Brevibloc), metaprolol (Alupent, Metaproterenol), propanolol (Inderal) Gentamicin (Garamycin, Alcomicin, Genoptic), kanamycin
Anti-infective drugs:
(Kantrex), neomycin (Mycifradin), streptomycin (Streptomycin), tobramycin (Tobrex, Nebcin), amikacin (Amikin)
Benzodiazepine drugs:
Clonazepam (Klonopin), diazepam (Valium), chlordiazepox-ide (Librium), lorazepam (Ativan), flurazepam (Dalmane) Chlopromazine (Thorazine), prochlorperazine (Compazine),
Phenothiazine drugs:
trifluoperazine (Stelazine), promethazine (Phenergan), hydroxyzine (Vistaril), fluphenazine (Prolixin)
Glucocorticoid drugs:
Prednisolone (Delta-Cortef, Prednisol, Prednisolone), prednisone (Apo-Prednisone, Deltasone, Meticorten, Orasone, Panasol-S),
(Mensy) P 7 of 8
betametha-sone (Celestone, Selestoject, Betnesol), dexamethasone (Decadron, Deronil, Dexon, Mymethasone, Dalalone), cortisone (Co Acyclovir (Zovirax), ritonavir (Norvir), saquinavir (Invirase, Antivirals:
Fortovase), indinavir (Crixivan), abacavir (Ziagen), cidofovir (Vistide), ganciclovir (Cytovene, Vitrasert) Atorvastatin (Lipitor), fluvastatin (Lescol), lovastatin (Mevacor),
Cholesterol-lowering drugs:
pravastatin (Pravachol), simvas-tatin (Zocar), rosuvastatin (Crestor)
Angiotensin receptor blocker drugs:
Cox 2 enzyme blocker drugs:
Histamine 2 antagonist drugs:
Proton pump inhibitors:
Anticoagulant drugs:
Valsartan (Diovan), candesartan (Altacand), losartan (Cozaar), telmisartan (Micardis) Celecoxib (Celebrex), valdecoxib (Bextra) Cimetidine (Tagamet), famotidine (Pepcid), nizatidine (Axid), rantidine (Zantac) Esomeprazole (Nexium), lansoprazole (Prevacid), pantopra-zole (Protonix), rabeprazole (AciPhex) Heparin sodium (Hepalean), enoxaparin sodium (Lovenox), dalteparin sodium (Fragmin)
Schedule I drugs
Research use only (example LSD)
Schedule II drugs
Requires a written prescription (example Ritalin)
Schedule III drugs
Schedule IV drugs
Schedule
V drugs
Requires a new prescription after six months or five refills (example codeine) Requires a new prescription after six months (example Darvon) Dispensed as any other prescription or without prescription if state law allows (example antitussives)
Antacids
Reduce hydrochloric acid in the stomach
Antianemics
Increase red blood cell production
Anticholenergics
Decrease oral secretions
Anticoagulants
Prevent clot formation
(Mensy) P 8 of 8
Anticonvulsants
Used for management of seizures/bipolar disorder
Antidiarrheals
Decrease gastric motility and reduce water in bowel
Antihistamines
Block the release of histamine
Antihypertensives
Lower blood pressure and increase blood flow
Anti-infectives
Used for the treatment of infections
Bronchodilators
Dilate large air passages in asthma/lung disease
Diuretics
Decrease water/sodium from the Loop of Henle
Laxatives
Promote the passage of stool
Miotics
Constrict the pupils
Mydriatics
Dilate the pupils
Narcotics/analgesics
Relieve moderate to severe pain litigation in which one person asserts that an injury, which may
tort
be physical, emotional, or financial, occurred as a consequence of another's actions or failure to act.
negligence
harm that results because a person did not act reasonably
malpractice
prefessional negligence
slander
character attacked and uttered in the presence of others
assault
act in which there is a threat or attempt to do bodily harm
battery
unauthorized physical contact
