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Common Board Topics
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Transcript of Common Board Topics
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COMMON BOARD TOPICS
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COMMON BOARD TOPICS
Dilantin (Phenytoin)
Detoxified by the liver
Teach about side effects
May cause bone marrow
depressionTaken with food
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COMMON BOARD TOPICS
PHLEBITIS
Heat
Redness
Tenderness
(-) swelling or edema
INFILTRATION
Pain
Edema
Cold
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COMMON BOARD TOPICS
Aminophylline (Truphylline;Theophylline
Major side effects: palpitations,nervousness, rapid pulse,dysrhythmias, nausea, and
vomiting.Check pulse!
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COMMON BOARD TOPICS
Morphine Sulfate
Decreases preload and after
load
Decreases anxiety
Not given to abdominal painCNS depressant
Constipating
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COMMON BOARD TOPICS
Total Parenteral Nutrition (TPN)
Hang no longer than 24 hours
Site of catheter changed every
4 weeks.
Monitor for complications
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COMMON BOARD TOPICS
Fluoxetine (Prozac)
(SSRI) for depression and OCD
S/E: Postural hypotension, dry mouth,rapid heartbeat, insomnia
If dose is missed, omit dose and
instruct client to return to regular
dosing schedule.
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COMMON BOARD TOPICS
Propanolol (Inderal)
Beta-adrenergic blocker
Antihypertensive Masks hypoglycemia
S/E: Bronchospasm, bradycardia,
depression. Take pulse beforeadministration
Do not give to asthmatic patients.
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COMMON BOARD TOPICS
Glipizide (Glucotrol)
Oral hyoglycemic agent
S/E: Aplastic anemia and photosensitivity
Hypoglycemia
Metformin (Glucophage)
Lactic acidosis
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COMMON BOARD TOPICS
Prednisone (Deltasone)
Corticosteroid causes hyperglycemia
Bethanechol (Urecholine) Cholinergic drug for functional urinary
retention
Prevents urinary retention
Oxybutynin Cl (Ditropan)
Increases bladder capacity
Not forglaucoma, Genitourinary
obstruction
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COMMON BOARD TOPICS
1 grain=60mg
1 glass=240 cc
1 ounce=30 cc
1 kg=2.2 lbs
1 kg=1 liter
1 inch=2.54 cm
1 feet=12 inches
1 meter=36 inches
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COMMON BOARD TOPICS
Levothyroxine (Synthroid)
Given in the morning on EMPTY
STOMACH
Report adverse reactions
(hyperthyroidism)
Carbamazepine (Tegretol) Interferes with action of hormonal
contraceptives.
S/E: photosensitivity.
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COMMON BOARD TOPICS
Treatment of tuberculosis
Rifampicin
Isoniazid (INH)Pyrazinamide (PZA)
Ethambutol
Streptomycin
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COMMON BOARD TOPICS
Carbidopa/Levodopa (Sinemet)
Drug for PD
Taken before meals avoid B6 and high-protein
food Decreases the rigidity and bradykinesia
. Albuterol (Proventil)
Bronchodilator
S/E: Tremors, headache, hyperactivity,tachycardia.
Use bronchodilator first before steroid medication
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COMMON BOARD TOPICS
Insulin PEAK effect:
Rapid-acting insulin: 1 hour
Regular-acting insulin: 2-4 hours
Intermediate/NPH insulin: 6-12
hours
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COMMON BOARD TOPICS
Phenazopyridine (Pyridium)
Trimethoprim-sulfamethoxazole(Bactrim)
Most common side effect mild to moderaterash (urticaria)
Aminoglycosides are ototoxic.
Butorphanol Tartrate (Stadol)Analgesic
S/E: Change in BP, bradycardia, respiratory
depression.
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COMMON BOARD TOPICS
Infant normal resting heart rate: 120-
140
Fetal heart rate is 120-160 Herbs and spices are good to improve
the taste of food
Salt substitutes contain potassium
Milk and dairy products are high in
calcium and PHOSPHORUS
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COMMON BOARD TOPICS
Children with CELIAC DISEASE
Should eat a gluten free diet. (No B-
R-O-W)Most concern is DEHYDRATION
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COMMON BOARD TOPICS
INFANT
Stranger anxiety
TODDLER
Separation anxiety
PRE-SCHOOLER
Castration fear/body mutilation, fear ofthe dark
SCHOOLER
Fear of replacement/displacement in
school, loss of privacy, fear of death
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COMMON BOARD TOPICS
Signs ofTD include smacking
lips, grinding of teeth and "fly
catching" tongue movements.
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COMMON BOARD TOPICS
Restlessness, confusion, irritabilityand disorientation may be the firstsigns offat embolism syndrome
Restraint: frame of bed, quick releaseties, document need for restraint Q4hours
IPPA for Physical Assessment
IAPerPal
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COMMON BOARD TOPICS
Never ask WHY questions in the
care of patients with psychiatric
problem Gag Reflex: dont assess gag reflex to
a client that has an absent swallow
reflex
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Bone marrow Aspiration
Site: iliac crest; painful
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Myelogram
Water-soluble dye: Elevate head
of bed 30 degrees Oil based dye: Flat in bed
(removed)
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COMMON BOARD TOPICS
Fractured Hip Assessments
Leg shortened
Adducted Externally rotated Implementation
Abduction pillows
Crutch walking with 3-point gait Dont sleep on operated side Dont flex hip more than 45-60 degrees Dont elevate head of the bed more than 45
degrees
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COMMON BOARD TOPICS
AMPUTATIONS Residual limb covered with dressing andelastic bandage (figure eight)
Figure-8 doesnt restrict blood flow, shapedto reduce edema
Elevated 24 hours (AKA-pillow, BKA-foot ofbed elevated)
Position prone daily Phantom Pain: acknowledge feelings, that
pain is real for them.
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COMMON BOARD TOPICS
Proper positioning on NGT/enteral
feeding
Enteral feeding held if: >150 ccsaspirated or 50% given in the
hour is aspirated
If cramping, vomiting occurs
decrease rate of enteral feeding
or keep it warm.
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COMMON BOARD TOPICS
Specific gravity of urine: 1.010-1.030
pH: 4.5-8(Slightly acidic)
UO: 1,000-1,500cc/day Credes Maneuver: Push urine out
Displaced uterus in a postpartum
mother: Check for distention Throbbing headache after SCI: Check
bladder or fecal impaction
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COMMON BOARD TOPICS
Normal urine output (1200-1500
ccday or 50-63 cc/hr)
Normal voiding pattern 5-6times/day.`
Infants: 6-8 times Green leafy vegetables contain
vitamin K.
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COMMON BOARD TOPICS
Glucose
Na
K Cl
Bicarbonate
BUN Creatinine clearance
Serum Creatinine
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COMMON BOARD TOPICS
Oculogyric crisis: uncontrollable
rolling back of eyes: side effect of
Phenothiazines Lithium helps control impulsive
behaviors.
Fluphenazine (Prolixin):antipsychotic medication
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COMMON BOARD TOPICS
Thiamine sources: organ meats,
liver, whole grain, nuts, legume, egg,
and milk. Dont document abuse. Report
suspected abuse to nursing
supervisor. Tonometry: measures intraocular
pressure; to rule out glaucoma
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COMMON BOARD TOPICS
Blind client:
address by name
Introduce self
Keep furniture arrangement consistent, open
or close doors
Walk step ahead
Instilling ear drops lie patient on unaffected earto absorb drops.
Position patient on affected ear to promote
drainage.
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COMMON BOARD TOPICS
Sick day rules: take insulin as ordered,
check blood glucose q3-4 hours, soft
foods, liquids
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COMMON BOARD TOPICS
Hepatobiliary disease
Decrease in ability of bile to absorb fat
Cystic fibrosis:
Absence of pancreatic enzymes;malabsorption of fat
Lung disease
Pancreatic enzyme replacement High-protein, high-calorie diet,
respiratory care/suction
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COMMON BOARD TOPICS
Position right side to promote gastric
emptying.
Dumping syndrome prevention:Teaching on prevention of signs and
symptoms
Sengstaken-Blakemore Tube
Treat patient with bleeding
esophageal varices.
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COMMON BOARD TOPICS
Obese person choking: use Chest
Thrusts.
Care for patient first, equipmentsecond
Signs for hypoxia: restlessness,
tachycardia
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COMMON BOARD TOPICS
Defibrillation
Start CPR first
1st attempt 200 joules
2nd attempt 200 to 300 joules
3rd attempt 360 joules Check monitor between shocks
for rhythm
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COMMON BOARD TOPICS
Cardioversion
Elective procedure, Informed Consent
Valium IV Synchronizer on
25-360 joules
Check monitor between rhythm
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COMMON BOARD TOPICS
Hypovolemic: Decreased in
intravascular volume
Cardiogenic: Decreased cardiacoutput
Septic shock
Anaphylactic shock
Neurogenic shock
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COMMON BOARD TOPICS
Shock Signs
and Symptoms
of SHOCK Cool, clammy
skin
Cyanosis Decreased
alertness
Tachycardia
Hypotension
Shallow, rapidrespirations
Oliguria
Decreased CVP
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COMMON BOARD TOPICS
Increased ICP
Assessments
Altered LOC(Earliest Sign)
Restlessness
Glasgow comascale
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COMMON BOARD TOPICS
Implementations for IICP
Elevate head 30-45 degrees
Avoid neck flexion and head rotationReduce environmental stimuli
Prevent Valsalva maneuver
Restrict fluids to 1200-1500 cc/dayMedications: Osmotic diuretics,
corticosteroids
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COMMON BOARD TOPICS
Seizures:Do not restrain!
Do not insert anything in mouth!No oral thermometerProtect airway during and after
seizureOrient the client
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COMMON BOARD TOPICS
ELECTROLYTES
Potassium :3.5-5.0 mEq/L
Sodium :135-145 mEq/L
Calcium :4.5-5.5 mEq/L or 9-11
Chloride :96-106 mEq/L
Magnesium :1.5-2.5 mEq/L Phosphorus :1.2-3 mEq/L
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COMMON BOARD TOPICS
HYPOKALEMIA
Assessments
K+ < 3.5 mEq/LMuscle weakness
Paresthesias
DysrhythmiasIncreased sensitivity to digitalis
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COMMON BOARD TOPICS
HYPOKALEMIA
Implementations
Potassium Supplements
Dont give > 40 mEq/L into peripheral IVor without cardiac monitor
Check URINE OUTPUT
For infants not more than 1 cc! Increase dietary intake of K
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COMMON BOARD TOPICS
Hyperkalemia
Assessments
K+ >5.0 mEq/LECG changes
Paralysis
Diarrhea
Nausea
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COMMON BOARD TOPICS
Hyperkalemia Implementations
K-I-D
Restrict intake of K
Calcium Gluconate and Na HCO3
Diuretics
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COMMON BOARD TOPICS
Hyponatremia
Assessments
Na+ < 135 mEq/L
Nausea
Muscle crampsConfusion
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COMMON BOARD TOPICS
Hyponatremia
Implementations
I & ODaily weight
Increase oral intake of sodium rich
foods
Water restriction
IV Lactated Ringers or 0.9% NaCL
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COMMON BOARD TOPICS
Hypernatremia Assessments
Na+ >145 mEq/L
Disorientation, delusion, hallucinations
Thirsty, dry, swollen tongue
Sticky mucous membranes
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COMMON BOARD TOPICS
Hypernatremia
Assessments
I & ODaily Weight
Give hypotonic solutions: 0.45%
NaCl or 5% Dextrose in water IV
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COMMON BOARD TOPICS
Hypercalcemia
Assessments
Ca+> 5.5 mEq/LMuscle weakness, lack of
coordination
Constipation, abdominal pain
Depressed deep tendon reflexes
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COMMON BOARD TOPICS
Hypercalcemia
Implementations
0.4% NaCl or 0.9% NaCl IV
Encourage fluids (acidic drinks:
cranberry juice)
Diuretics Calcitonin
Mobilize patient
Surgery for hyperparathyroidism
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COMMON BOARD TOPICS
Hypocalcemia
Assessments
Ca+ < 4.5mEq/L
Tetany
Positive
Trousseaus
sign
Positive
Chvosteks
sign
Seizures
Confusion
Irritability,paresthesias
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COMMON BOARD TOPICS
Hypocalcemia
Implementations
Oral calcium supplementsCalcium gluconate IV
Seizure precautions
Meet safety needs
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COMMON BOARD TOPICS
Wound Care for Burns
Pain, hyperkalemia, and shock are
problems
Isotonic fluids (Lactated Ringers)
Closed method (Silvadene)
Open method (Sulfamylon) IV painmedication initially: not PO takes too
long, not IM circulation impaired
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COMMON BOARD TOPICS
Medicate patient before wound care
Silver nitrate (warn patient skin will
turn black)High calorie, High carbohydrate,
High protein diet
Vitamin B,C, and Iron
TPN maybe used
Prevent contractures
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COMMON BOARD TOPICS
Pheochromocytoma
Assessment
Increase in catecholaminesHypertension
Collect urine for VMA
Avoid abdominal palpationPrepare to give P medications
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COMMON BOARD TOPICS
COPD Assessments
Blue Bloaters
Pink Puffers
Assume ORTHOPNEIC POSITION
Barrel-chest
Dyspnea
CoughAdventitious breath sounds
Clubbing
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COMMON BOARD TOPICS
COPD Implementations
Assess airway clearance
Listen to breath sounds
Administer low-flow oxygen (1-2 LPM)
Encourage fluids
Small frequent feedings
Humidify oxygen
Use metered dose inhalers (MDI)