Nclex Terms(50)

7/27/2019 Nclex Terms(50)

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Delegation Rule of Thumb? DO NOT delegate what you can EAT!E - evaluate

A - assessT - teach

Venous VV and Arterial AA? eleVate Veins; dAngle Arteries for better perfusio

Apgar Scoring? A= appearance (color all pink, pink and blue, blu[pale])P= pulse (>100, < 100, absent)G= grimace (cough, grimace, no response)

A= activity (flexed, flaccid, limp)R= respirations (strong cry, weak cry, absent)

Airborne Transmitted diseases acronym? My - MeaslesChicken - Chicken Pox/VaricellaHez - Herpez Zoster/ShinglesTB

Protocol for Airborne Transmission? Private Room - negative pressure with 6-12 airexchanges/hrMask, N95 for TB

Droplet transmitted diseases acronym? DROPLETthink of SPIDERMAN!S - sepsisS - scarlet feverS - streptococcal pharyngitisP - parvovirus B19P - pneumoniaP - pertussisI - influenzaD - diptheria (pharyngeal)E - epiglottitisR - rubellaM - mumpsM - meningitisM - mycoplasma or meningeal pneumonia

An - Adenovirus


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Protocol for Droplet Precautions? Private Room or cohort mask

Contact transmitted diseases acronym? CONTACT PRECAUTIONMRS.WEEM - multidrug resistant organismR - respiratory infectionS - skin infections *W - wound infxnE - enteric infxn - clostridium difficileE - eye infxn - conjunctivitis

What to do in the case of anAir/Pulmonary Embolism?

turn pt to left side and lower the head of the bed

What to do in the case of- A woman inlabor with Un-Reassuring FHR?

(late decels, decreased variability, fetalbradycardia, etc) --> turn on left side (and giveO2, stop Pitocin, increase IV fluids)

What to do in the case of tube feedingwith decreased LOC?

position pt on right side (promotes emptying of tstomach) with the HOB elevated (to preventaspiration)

Position during epidural puncture? Side lying

After lumbar puncture? e (and also oil-based Myelogram)--> pt lies in flasupine (to preventheadache and leaking of CSF)

How to position heat stroke patient? Lie flat with legs elevated

During CBI (continuous bladderirrigation)

catheter is taped to thigh so leg should bekept straight. No other positioning restrictions.

After Myringotomy? Position on the side of the AFFECTED EAR aftersurgery to allow drainage of secretions

After Cataract surgery? pt will sleep on unaffected side with a night shielfor 1-4weeks.


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After Thyroidectomy? low or semi-Fowler's, support head, neck andshoulders.

Infant with Spina Bifida? position prone (on abdomen) so that sac does norupture

Buck's Traction? (skin traction) --> elevate foot of bed for countertraction

After Total Hip Replacement? don't sleep on operated side, don't flex hip morethan 45-60 degrees, don't elevate HOB more than 45degrees. Maintain hip abduction by separating

thighs with pillows.

Pt position for Prolapsed Cord? knee-chest position or Trendelenburg

Infant with Cleft lip? position on back or in infant seat to preventtrauma to suture line.While feeding, hold in upright position.

To prevent dumping syndrome? (post-operative ulcer/stomach surgeries) --> eat reclining position, lie down after meals for 20-30

minutes (also restrict fluids during meals, lowCHO and fiber diet, small frequent meals)

Above the knee amputation? elevate for first 24 hours on pillow, position pronedaily toprovide for hip extension.

Below the knee amputation? foot of bed elevated for first 24 hours, positionprone daily to

provide for hip extension.

Detached Retina? area of detachment should be in the dependentposition-- dependent meaning supported bysomething

Enema positioning? position pt in left side-lying (Sim's) with knee


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flexed

After Supratentorial Surgery? (incision behind hairline) --> elevate HOB 30-45degrees

After Infratentorial Surgery? (incision at nape of neck)--> position pt flat andlateral oneither side.

During internal radiation? on bedrest while implant in place

Autonomic Dysreflexia/ Hyperreflexia? (S&S: pounding headache, profuse sweating, nascongestion, goose flesh, bradycardia,hypertension) --> place client in sitting position

(elevateHOB) first before any other implementation.

Shock? bedrest with extremities elevated 20 degrees,knees straight, head slightlyelevated (modified Trendelenburg)

Head Injury? elevate HOB 30 degrees to decrease intracranialpressure

Peritoneal Dialysis when outflow isinadequate?

turn pt from side to side BEFOREchecking for kinks in tubing (according to Kaplan

Lumbar Puncture? AFTER the procedure, the client should be placedin the supineposition for 4 to 12 hrs as prescribed. (Saunders3rd ed p. 229)

The difference between Myasthenia

Gravis, Myastenia Crisis, and CholinergicCrisis?

Myasthenia Gravis: worsens with exercise and

improves with rest.Myasthenia Crisis: a positive reaction to Tensilon-will improve symptomsCholinergic Crisis: caused by excessive medicatiostop med-giving Tensilon will make it worse

Prior to liver biopsy? Its important to be aware of the lab result for


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prothrombin time

From the ass? From the Mouth?Metobolic

From the a** (diarrhea)= metabolic acidosisFrom the mouth (vomitus)=metabolic alkalosis

Myxedema/ hypothroidism? slowed physical and mental function, sensitivity tcold, dry skinand hair

Graves disease/ Hyperthyroidism? accelerated physical and mental function;sensitivity toheat, fine/soft hair

Thyroid storm? increased temp, pulse and HTN

Post Thyroidectomy? semi-Fowler's, prevent ncekflexion/hyperextension, trach at bedside

Hypo-parathyroid? CATS - convulsions, arrhythmias, tetany, spasmsstridor (decreasedcalcium), high Ca, low phosphorus diet

Hyperparathyroid? fatigue, muscle weakness, renal calculi, back andjoint pain (increasedcalcium), low Ca, high phosphorus diet

Hypovolemia? incrased temp, rapid/weak pulse, increaserespiration, hypotension, anxiety,urine specific gravity >1.030

Hypervolemia? bounding pulse, SOB, dyspnea, rares/crackles,peripheral edema, HTN, urinespecific gravity


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HA; administer Declomycin, diuretics

HypoKalemia? muscle ewakness, dysrhythmias, increase K(raisins, bananas, apricots, oranges,beans, potatoes, carrots, celery)

HyperKalemia? MURDER - muscle weakness, urine(oliguria/anuria), respiratory depression,decreased cardiac contractility, ECG changes,reflexes

Hyponatremia? nausea, muscle cramps, increased ICP, musculartwitching, convulsion; osmoticdiuretics, fluids

Hypernatremia? increased temp, weakness,disorientation/delusions, hypotension, tachycardihypotonic solution

Hypocalemia? CATS - convulsions, arrhythmias, tetany, spasmsand stridor

Hypercalemia? muscle weakness, lack of coordination, abdominapain, confusion, absent

tendon reflexes, sedative effect on CNS

HypoMg? tremors, tetany, seizures, dyrshythmias,depression, confusion, dysphagia; dig toxicity

HyperMg? depresses the CNS, hypotension, facial flushing,muscle ewakness, absent deeptendon reflexes, shallow respirations, emergency

Addisons? hypoNa, hyperK, hypoglycemia, dark pigmentatiodecreased resistance to stress,fractures, alopecia, weight loss, GI distress

Cushings? hyperNa, hypoK, hyperglycemia, prone toinfection, muscle wasting, weakness,edema, HTN, hirsutism, moonface/buffalo hump


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Addisonian Crisis? n/v, confusion, abdominal pain, extremeweakness, hypoglycemia,dehydration, decreased BP

Pheochromocytoma? hypersecretion of epi/norepi, persistent HTN,increased HR,hyperglycemia, diaphoresis, tremor, pounding HAavoid stress, frequent bating and rest breaks,avoid cold and stimulating foods, surgery toremove tumor

NMS? -NMS is like S&M;-you get hot (hyperpyrexia)

-stiff (increased muscle tone)-sweaty (diaphoresis)-BP, pulse, and respirations go up &-you start to drool

Dangerous thing to get duringpregnancy?

I kept forgetting which was dangerous whenyou're pregnant; regular measles (rubeola), orGerman measles (rubella), so remember:-never get pregnant with a German (rubella)

Tetraology of Fallot? Think DROP(child drops to floor or squats) orPOSHDefect, septalRight Ventricular hypertrophyOverriding aortsPulmonary stenosis

Autonomic Dysreflexia? Autonomic dysreflexia: potentially life threateningemergency- elevate head of bed to 90 degree- loosen constrictive clothing- assess for bladder distention and bowelimpaction (triger)- Administer antihypertensive meds (may causestroke, MI, seisure )


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FHR patterns in ob? Think VEAL CHOPV CE H

A OL P

V = variable decels; C = cord compression causeE = early decels; H = head compression caused

A = accels; O = okay, not a problem!L = late decels = placental insufficiency, can't fill

For cord compression in OB? For cord compression, place the mother in theTRENDELENBERG position because this removespressure of the presenting part off the cord. (If hhead is down, the baby is no longer being

pulled out of hte body by gravity)If the cord is prolapsed, cover it with sterile salingauze to prevent drying of the cord and tominimize infection.

Late Decels? For late decels, turn the mother to her left side, tallow more blood flow to the placenta.

Before Epidural? Hydration is a big priority!

Major risks of epidural? Hypotension and bradypnea / bradycardia aremajor risks and emergencies.

OB secret?NEVER check the monitor or a machine as a firstaction. Always assess the patient first; forexmaple listen to the fetal heart tones with astethoscope in NCLEX land. Sometimes it's hard ttell who to check on first, the mother or the babyit's usually easy to tell the right answer if themother or baby involves a machine. If you're notsure who to check first, and one of the choicesinvolves the machine, that's the wrong answer.

Hearing the baby in OB?If the baby is a posterior presentation, the soundare heard at the sides.If the baby is anterior, the sounds are heard closto midline, between teh umbilicus and whereyou would listen to a posterior presentation.


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If the baby is breech, the sounds are high up inthe fundus near the umbilicus. If the baby isvertex, they are a little bit above the symphysispubis.

Ventilator Alarms? HOLDHigh alarm- Obstruction due to incr. secretions,kink, pt. coughs, gag or bitesLow press alarm- Disconnection or leak inventilatior or in pt. airway cuff, pt. stopsspontaneous breathing

To remember blood sugar? hot and dry-sugar high (hyperglycemia)cold and clammy-need some candy (hypoglycem

ICP and Shock have? ICP AND SHOCK HAVE OPPOSITE V/SICP-increased BP, decreased pulse, decreasedresp.shock- decreased BP, increased pulse, increasedresp.

Cor Pulmonae? right sided heart failure caused by left ventricularfailure (so pick edema, jvd, if it is a choice.

Heroin withdrawl in a neonate? Irritable, and poor sucking

Jews? No meat and milk together

Brachial Pulse? Pulse area cpr on infant

What to check children for at age 12months?

always check lead posioning levels

Sources of potassium? Bananas, potatoes, citrus fruits

What is obtained before starting any ivantibiotic?

Cultures

Why would a pt with leukemia haveepistaxis?

b/c of low platelets


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Best way to warm a newborn? skin to skin contact on mom with a blanket

When a pt comes in and she is in activelabor?

nurses FIRST action is to listen to fetal rate/tone

How to treat phobic disorders? systematic desensitization

Best way to tube feed or feed kids? small frequent is better than large

With lower amputations? place in prone position

LVN/LPN cant? Handle any blood

Cardinal signs of ARDS? hypoxemia (low oxygen level in tissues).

Best indicator of dehydration? weight

Besides sodium, water also follows? Glucose

Use of cold and hot? Use cold for acute pain (sprained ankle) and heatfor chronic pain (arthritis)

Guided imagery is great for? CHRONIC pain

When patient is in distress? Med administration is rarely a good choice

Pneumonia? fever and chills are usually present. For the elderconfusion is often present.

COPD and Pneumonia? COPD is chronic, pneumonia is acute. Emphysemand bronchitis are both COPD. in COPD patientsthe baroreceptors that detect the CO2 level are

destroyed. Therefore, O2 level must be lowbecause high O2 concentration blows the patientstimulus for breathing.

4 options for cancer? chemo, radiation, surgery, allow todie with dignity.


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Nuetropenic patients? no live vaccines, no fresh fruits, no flowers shoulbe used forneutropenic patients.

Where are chest tubes placed? chest tubes are placed in the pleural space.

Diff between angina and MI? angina (low oxygen to heart tissues) = no deadheart tissues. MI=dead heart tissue present.

Preload and Afterload? Preload affects amount of blood that goes to the ventricle.

Afterload is the resistance the blood has toovercome when leaving the heart.

CABG? the great saphenous vein is taken it is turnedinside out due to the valves that are inside.

Temp conversion? * To convert Centigrade to F. F= C+40, multiply9/5 and substract 40* To convert Fahrenheit to C. C= F+40, multiply5/9 and substract 40.

After Endoscopy? after endoscopy check gag reflex.

Low Residue diet? low residue diet means low fiber

Diverticulitis? inflammation of the diverticulum in the colon painis around LL quadrant.

Appendicitis pain is in RL quadrant with rebound tenderness.

Cause of Ascites? portal hypotension + albuminemia

Who produces insulin? beta cells of pancreas produce insulin

s3 heart sound is normal? not? Normal in CHF from the squishin'.. NOT normal inan MI patient

Signs observed in hypocalemia? Trousseau and Tchovoski signs observed in


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hypocalcemia

DKA? when body is breaking down fat instead of sugarfor energy. Fats leave ketones (acids) that causepH to decrease.71. DKA is rare in diabetes mellitus type II becauthere is enough insulin to prevent breakdown offats.

s/s of a fat embolism? petechiae. Treated with heparin.

Knee replacement? use continuous passive motion machine.

Glaucoma patients loose peripheral vision. Treated with meds

c02 builds up and causes? vasoconstriction.

Where are most spinal cord injuries? cervical or lumbar regions

autonomic dysreflexia life threatening inhibited sympathetic responseof nervous system to a noxious stimulus- patientswith spinal cord injuriesat T-7 or above is usually caused by a full bladde

Myasthenia gravis? decrease in receptor sites for acetylcholine. Sincesmallest concentration of ACTH receptors are incranial nerves, expect fatigue and weakness ineye, mastication, pharyngeal muscles.

Guillian Barre? ascending paralysis. Keep eye on respiratorysystem.

Parkisons? RAT: rigidity, akinesia (loss of muscle mvt),

tremors.Treat with levodopa.

TIA? TIA (transient ischemic attack) mini stroke with ndead brain tissue

CVA? CVA (cerebrovascular accident) is with dead brain


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tissue.

Hodgkins disease? Hodgkin's disease= cancer of lymph is very curabin early stage.

Rule of nines? Head and Neck= 9%Each upper ext= 9%Each lower ext= 18%Front trunk= 18%Back trunk= 18%Genitalia= 1%

Peds weight ? Birth weight doubles by 6 month and triple by 1year of age.

Dig rule for kids? if HR is


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Wilms tumor? encapsulated above the kidneys causing flankpain.

Facts about hemophilia? It is X-linked. Mother passes the disease to her s

What happens when phenylalanineincreases?

brain problems occur

Bucks traction = knee immobility

Russel Traction = femur or lower leg instability

Dunlap traction= Skeletal or skin

Bryant's traction= Children


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Diff between placenta previa andplacenta abrupto?

placenta previa = there is no pain, there isbleeding. Placentaabruption = pain, but no bleeding.

Bethamethasone? (celestone)=surfactant. Med for lung expansion.

Dystocia? baby cannot make it down to canal

Therapies? milieu therapy= taking care of patient/environmecognitive therapy= counselingcrisis intervention=short term.

Rule of thumb for

obsessions/distractions?

Obsession is to thought. Compulsion is to action.

Rule of thumb for assisting pyschpatients?

if patients have hallucinations redirect them. Indelusions distract them.

Alzheimers? chronic, progressive, degenerative cognitivedisorder that accounts for more than 60% of alldementias

Hyperthyroidism? think of MICHAEL JACKSON in THRILLER!SKINNY, NERVOUS, BULDGING EYES, Up all nighheart beating fast

Awesome remembering for cranialnerves?

Sensory=S Motor=M Both=BOh (Olfactory I) SomeOh (Optic II) SayOh (Oculomotor III) MarryTo (Trochlear IV) MoneyTouch (Trigeminal V) But

And (Abducens VI) MyFeel (Facial VII) BrotherA (Auditory VIII) SaysGirls (Glossopharyngeal IX) Big

Vagina (Vagus X) BrasAnd (Accessory XI) MatterHymen (Hypoglassal XII) More


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Hypernatremia? SALT? SALT!Skin flushed

AgitationLow grade feverThirst

Developmental milestones? Developmental2-3 months: turns head side to side4-5 months: grasps, switch & roll6-7 months: sit at 6 and waves bye-bye8-9 months: stands straight at eight10-11 months: belly to butt (phrase has 10 letter12-13 months: twelve and up, drink from a cup

Hepatitis? ends in a VOWEL, comes from the BOWEL (Hep AHepatitis B=Blood and Bodily fluidsHepatitis C is just like B

Apgar scores/scoring? Apgar measures HR,RR,Muscle tone, Reflexes,Skcoloreach 0-2 point. 8-10 OK. 0-3 RESUSCITATE.

Cute way to remember glascow coma?GLASGOW COMA SCALE. EYES, VERBAL,MOTOR!It is similar to measuring dating skills...max 15

points -one can do itif below 8 you are in Coma.So, to start dating you gotta open your EYES firstif you albe to dothat spontaneously and use them correctly to SEEwhom you dating you earn 4. But if she has toscream on you to make youopen them it is only 3....and 1 you dont care toopen even if she tries to hurt you.if you get good EYE contact (4 points) then moveto VERBAL.talk to her/ him! if you can do that You are reallyORIENTED insituation she/he uncontiously gives you 4 points!you like her try not to be CONFUSED (3), andof cause do not use


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INAPPROPRIATE WORDS (3), she will not like it))try not to RESPOND WITH INCOMPREHENSIBLESOUNDS (2), if you do not like herjustshow no VERBAL RESPONSE(1)Since you've got EYE and VERBAL contact you caMOVE now using your Motor Response Points.THis is VERY important since Good moves give yo6!

What to do for addisons/cushings? Addison's disease (need to "add" hormone)Cushing's syndrome (have extra "cushion" ofhormones)

Dumping syndrome? Dumping syndrome: increase fat and protein, sm

frequent meals, lie down after meal to decreaseperistalsis, wait 1 hr after meals to drink.

Blood typing? For blood types: "O" is the universal donor(remember "o" in donor) "AB" is the universalreceipient

Gross things to remember about nurseswith herpes!!!!

Disseminated Herpes Zoster is AIRBORNEPRECAUTIONS, as to Localized Herpes Zoster isCONTACT PRECAUTIONS. A nurse with a localize

herpes zoster CAN care for patients as long asthe patients are NOT immunosuppressed and thelesions must be covered!

Birth control- Diaphram? must stay in place 6 hours after intercourse. Theare also fitted so must be refittedif you lose or gain a significant amount of weight

Cushing ulcers and cushings triad? Cushings ulcers r/t BRAIN injury

*Cushings triad r/t ICP in BRAIN (htn, bradycard,irr. resp)

Thyroid storm and myxedema? Thyroid storm is HOT (hyperthermia)*Myxedema coma is COLD (hypothermia)

Nondairy sources of calcium? RUBARB, SARDINES, COLLARD GREENS


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Whats petaling? You can petal the rough edges of a plaster castwith tape to avoid skin irritation.

How do you teach someone to reduceback aches?

With low back aches, bend knees to relieveWilliam's position

Koplick's spots? red spots with blue center characteristic ofPRODROMALstage of Measles.Usually in mouth.

Pancreatitis pts? fetal position, NPO, gut rest, prepare antecubitalsite for PICCcuz they'll probably be getting TPN/Lipids

Trendelenberg's test? for varicose veins. If they fill proximally =varicosity.

What can't you give toimmunosupressed pts?

Yogurt - it has live cultures

How to itch under a cast? cool air via blow dryer, ice pack for 10- 15minutes. NEVER useqtip or anything to scratch area

Murphy's sign? pain with palpation of gall bladder area seen withcholecystitis

Cullens sign? ecchymosis in umbilical area, seen withpancreatitis

Turner's sign? flank grayish blue (turn around to see your flankspancreatitis

Mcburney's point? pain in RLQ indicative of appendicitis--RLQ -appendicitis, watch for peritonitis

Pain in the LLQ indicative of? diverticulitis , low residue, no seeds, nuts, peas

Guthrie test? Tests for PKU, baby should have eaten source ofprotein first


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tomatoes, peaches

ALS? Amyotrophic lateral sclerosis a condition in whichthere is a degeneration of motor neurons in boththe upper & lower motor neuron systems.

TEF? Transesophageal Fistula- esophagus doesn't fullydevelop (this is a surgical emergency)The 3 C's of TEF in the newborn:1) Choking2) Coughing3) Cyanosis

MMR SHot? given SQ not IM.

Color codes?Red--unstable, ie, occluded airway, activelybleeding, see first

Yellow---stable, can wait up to an hour fortreatment, ie burns, see secondGreen---stable, can wait even longer to be seen,"walking wounded"Black--unstable clients that will probably not makit, need comfort measuresDOA---dead on arrival

Greeks? they put an amulet or any other use of protectivecharms around their baby'sneck to avoid "evil eye" or envy of others

4 year olds? can not interpret TIME. Need to explain time inrelationship to a known COMMON EVENT (eg:"Mom will be back after supper").

Hep B vaccine always ask? Anaphylactic reaction to baker's yeast is

contraindication for Hep B vaccine.

Flu shot always ask? allergic to eggs??? (Tristan D. ) !

Before giving MMR>? ** Ask for anaphylactic rxn to eggs or neomycinbefore


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If kid has a cold? can still give immunizations

SARS precautions? severe acute resp syndrome - airborne + contact(just like varicella)

Disease precautions? ** Hepatitis A is contact precautions** Tetanus, Hepatitis B, HIV are STANDARDprecautions

Willam's position? Semi Fowlers with knees flexed (inc. knee gatch)to relieve lower backpain.

Signs of a hip fracture? EXTERNAL ROTATION, SHORTENING, ADDUCTIO

S/S of a fat embolism? Blood tinged sputum (r/t inflammation), inc ESR,respiratory alkalosis (not acidosis r/t tachypnea),hypocalcemia,increased serum lipids, "snow stormeffect on CXR.

Complications of mechanical ventilation? Pneumothorax, Ulcers

Paget's disease? tinnitus, bone pain, enlargement of bone, thickbones.

IVP requires? bowel prep so they can visualize the bladder bett

ACID ash diet? cheese, corn, cranberries, plums, prunes, meat,poultry, pastry, bread

Alkaline Ash diet? milk, veggies, rhubarb, salmon

Orange tag in pysch non emergent Psych

Greenstick fracture? usually seen in kids bone breaks on one side andbends on the other

Side effects of thyroid hormones? Insomnia. Saunders confirms it. Makes sensethough!Increased met. rate, your body is "too buto sleep" as opposed to the folks with


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hypothyroidismwho may report somnolence (dec. met rate, bodyis slow and sleepy).

Botox? for strabismus. Patch the GOOD eye so that theweaker eye can get stronger. Found a cool linkabout its use in peds pt with strabismus. I had tolook it up cuz I heard it was importantah hem ah hem

Tidal volume? 7 - 10ml / kg

COPD patients? REMEMBER: 2LNC or less (hypoxic NOThypercapnic drive), Pa02 of 60ish and

Sa02 90% is normal for them b/c they are chroniCO2 retainers. ...

Stranger Danger>?!? anxiety is greatest 7 - 9 months, Separationanxiety peaks in toddlerhood

Lymes mostly found in mostly in Conneticuts

Asthma and arthritis best excercise? swimming

What is a bad sign in asthma? intercostal retractions

ABG drawin? you need to put the blood in a heparinized tube,make sure there are nobubbles, put on iceimmediately after drawing, with a lable indicatingthe pt was on room air orhow many liters of O2.Remember to preform the Allen's Test prior todoing an ABG to check for sufficient blood flow

Before a pft? a pt's bronchodilators will be with-held and theyare not allowed to smoke for 4 hrs prior

For a lung biopsy? position pt lying on side of bed or with arms raiseup on pillows over bedsidetable, have pt hold breath in midexpiration, chest


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x-ray done immediately afterwards to check forcomplication of pneumothorax, sterile dressingapplied

For a lumbar puncture? pt is positioned in lateral recumbent fetal positionkeep pt flat for 2-3 hrsafterwards, sterile dressing, frequent neuroassessments

For an EEG test? hold meds for 24-48 hrs prior, no caffine orcigarettes for 24 hrs prior, pt can eat, pt muststay awake night before exam, pt may be asked hyperventilate and watch a bright flashinglight, after EEG, assess pt for seizures, pt's will be

at increased risk

Munchhausen Syndrome?is a psychiatric disorder that causes an individualto self-inflict injuryor illness or to fabricate symptoms of physical ormental illness, in order to receive medical careor hospitalization. In a variation of the disorder,Munchausen by proxy (MSBP), an individual,typically a mother, intentionally causes orfabricates illness in a child or other person underher

care.

MS? a chronic, progressive disease with demyelinatinglesions in the CNS whichaffect the white matter of the brain and spinalcord.Motor S/S: limb weakness, paralysis, slow speechSensory S/S: numbness, tingling, tinnitusCerebral S/S: nystagmus, ataxia, dysphagia,dysarthria

Huntington's Chorea? 50% genetic, autosomal dominant disorderS/S: chorea --> writhing, twisting, movements offace, limbs and body-gait deteriorates to no ambulation-no cure, just palliative care


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Shift to the left means? WBC shift to the left in a patient withpyelonephritis (neutrophils kick in to fightinfection)

How to Dx a AAA? Definitive diagnosis for abd. aortic aneurysm (AA--> CT scan

Uremic Fetor? smell urine on the breath

Hirschsprungs? bile is lower obstruction, no bile is upperobstruction; ribbon like stools.

No Cantalope? Thank you, I finally realize why a person shouldn

have cantaloupe before a occult stool test,because cantaloupe is high in vit c and vit c causa false + for occult blood. Now I just need tofigure out why they can't have fish.

Penis Problems? Hypospadias: abnormality in which urethral meatis located on the ventral (back) surface ofthe penis anywhere from the corona to theperineum (remember hypo, low (for lower side ounder side)

Epispadias: opening of the urethra on the dorsal(front) surface of the penisPriapism: painful erection lasting longer than 6 h

When you see coffee brown emesisthink?>

Peptic ulcer

For PVD remember? remember DAVE (Legs are Dependent forArterialfor Venous Elevated)

Traction rule? Never release traction unless you have an orderfrom an MD to do so

Halo? Remember safety first, havea screwdriver nearby.


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Compartment syndrome? an emergency situation. Paresthesias andincreased painare classic symptoms. Neuromuscular damage isirreversible 4-6 hours after onset.

Behavior/Developmental-PedsBehavior motivated by need to avoid anxiety andsatisfy needs1. Infancy 0-18 months others will satisy needs2. childhood >6yrs learn to delay need gratificatio3. juvenile 6-9 years learn to relate to peers4. preadolescence 9-12 yrs learns to relate tofriends of of opposite sex5. early adolescence12-14yrs:learn independenceand how to relate to opposite sex6. late adolecence 14-21yrs: develop intimate

relationship with person of opposite sexis this not about communication?....

Fetal alcohol sydrome? -upturned nose-flat nasal bridge-thin upper lip-SGA

Immunizations rules? vastus lateralis is IM administration site for 6moninfants

For toddlers above 18 months ventrogluteal

sites for children

Eyes? OU- both eyesOS- left eyeOD- right eye ( dominent Right eye- just a tip toremember)

Cane walking? 1. COALC - caneO - opposite

A - affectedL - leg

In depth- Color codes??Red- Immediate: Injuries are life threatening butsurvivable with minimal intervention. Ex:


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hemothrax, tension pneumothorax, unstable chesand abdominal wounds, INCOMPLETEamputations, OPEN fx's of long bones, and 2nd/3degree burn with 15%-40% of total bodysurface, etc.

Yellow- Delayed: Injuries are significant andrequire medical care, but can wait hrs withoutthreatto life or limb. Ex: Stable abd wounds withoutevidence of hemorrhage, fx requiring openreduction, debridement, external fixation, most eand CNS injuries, etc.Green- Minimal: Injuries are minor and tx can bedelayed to hrs or days . Individuals in this group

should be moved away from the main triage areaEx: upper extremity fx, minor burns, sprains,sm. lacerations, behavior disorders.Black- Expectant: Injuries are extensive andchances of survival are unlikely. Seperate but donabandoned, comfort measures if possible. Ex:Unresponsive, spinal cord injuries, woulds withanatomical organs, 2nd/3rd degree burn with 60%of body surface area , seizures, profoundshock with multipe injuries, no pulse, b.p, pupils

fixed or dilated.

Thoracentesis? Take v.s., shave area around needle insertion,position patient with armson pillow on over bed table or lying on side, nomore than 1000cc at a one time. Post- listenfor bilateral breath sounds, v.s., check leakage,sterile dressing.

Cath lab? npo 8-12hr, empty bladder, pulses, tell pt may fe

heat palpitations or desire to cough with dyeinjection. Post- Vital signs keep leg straight bedre6-8hr.

MRI? claustrophobia, no metal, assess pacemaker


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Cerebral angio prep? well hydrated, lie flat, sire shaved, pulses markedpost- keep flat 12-14hr, check site, pulses,forcefluids.

More info on lumbar puncture? fetal postion. post- nuero assess q15-30 untilstable, flat2-3hr, encouragefluids, oral anlgesics for headache, observedressing

More info on EEG? no sleep the night before, meals not withheld, nostimulants for 24hr before,tranquilizer/stimulant meds held 24-48hr before,may be asked to hyperventilate 3-4min andwatch a bright flashing light.

Myelogram? Npo 4-6hr, allergy hx, phenothiazines, cnsdepressants, and stimulants withheld 48hrprior, table will be moved to various postionsduring test. Post- neuro q2-4, water soluble HOBup, oil soluble HOB down, oral analgesics for h/aencourage po fluids, assess for distendedbladder, inspect site.

Liver biopsy? Adm vit k , npo morning of exam 6hr, give

sedative, Teach pt that he will beasked to hold breath for 5-10sec, supine postion,lateral with upper arms elevated.Post- postion on right side, frequent v.s., reportsevere ab pain stat, no heavy lifting 1wk.

Paracentesis? semi fowlers or upright on edge of bed, emptybladder.Post- v.s., report elevated temp, observe for signof hypovolemia.

Laparoscopy? CO2 used to enhances visual, general anesthesiafoley. Post- walk patient todecrease CO2 build up used for procedure.

Sengstaken blakemore tube ? used for tx of esophageal varices, keep scissors a


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bedside.

Hemovac? used after mastectomy, empty when full or q8hr,remove plug, empty contents, placeon flat surface, cleanse opening and plug withalcohol sponge, compress evacuator completelyto remove air, release plug, check system foroperation.

Common S/S of PTB? low-grade afternoon fever.

Common S/S of pneumonia? Rusty sputum

Common S/S of asthma Wheezing on EXPIRATION

Common S/S of emphysema? Barrel chest

Common S/S of Kawasaki syndrome? Strawberry tongue

Common S/S of pernicious anemia red beefy tongue

Common S/S of down syndrome protruding tongue

Common S/S of Cholera? Rice watery stool

Common S/S of Malaria? Stepladder like fever with chills

Common S/S of Thypohiod Rose spots on abdomen

Common S/S of Diptheria? Psuedo membrane formation

Common S/S of measles? Kopliks spots

Common S/S of SLE? Butterfly rashes

Common S/S of Liver cirrhoisis? Spider like varices- Varices can be in stomach,esophagus or the skin! They are justspider/varicose veins! Ithcy on the skin

Common S/S of leprosy? Lioning face


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Common S/S of Bulimia? chipmunk face

Common S/S of appendicitis rebound tenderness

Common S/S of Dengue petechiae or + Herman's sign

Common S/S of Meningitis? Kernigs Sign (leg flex then leg pain on extension)Brudinzski sign (neck flex= lower leg flex)

Common S/S of Tetany? Risus Sardonicus

Common S/S of pancreatitis? Cullens sign ( ecchymosis of umbilicus) (+) GreyTurner spots

Common S/S of pyloric stenosis? olive like mass

Common s/s of PDA Machine like murmur

Common S/S of addisions? bronze like skin pigmentation

Common S/S of Cushings syndrome? Moon face appearance and buffalo hump

Common S/S of Intusseption? Sausage shaped mass , Dance sign (empty portioof RLQ)

Common S/S of MS>? Charcot's Triad (IAN)

Common S/S of MG? Descending muscle weakness

Common S/S of guillian Barre Syndrome Ascending muscle paralysis.. dont confuse with M

Common S/S of chicken pox? Vesicular rash (central to distal) dew drop on ros

petal

Common S/S of LTB? inspiratory stridor.. LTB = croup!!!!

Common S/S of TEF? 4 C'S- Coughing, Choking, Cyanosis andcontinuous droolings


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Common S/S of epiglottitis? 3 D'S --Drooling, Dysphonia, Dysphagia

Common S/S of HodgkinsDisease/Lymphoma?

Painless, progressive englargement of spleen andlymph tissues, and Reedstenberg cells!

Common S/S of InfectiousMononucleosis?

Hallmark= Sore throat, cervical lymph adenopathfever

Common S/S of parkinsons? Pilling rolling tremors

Cmmon S/S Fibrin Hyalin? Expiratory grunt-- Causes Infant respiratorydistress!

Common S/S of cystic fibrosis? Salty skin

Common S/S of DKA Kussmauls breathing (deep rapid RR)

Common S/S of Bladder Cancer? painless hematuria...

Common S/S of BPH? reduced size and force of urine

Common S/S of Pemphigus Vulgaris? Nilosky's sign (seperation of epidermis caused byrubbibng of the skin)

Common S/S of retinal detachment? Visual floaters, flashes of light, curtain vision

Common S/S of glaucoma? Painful vision loss, tunnel/gun barrel/ halo vision(peripheral vision loss)

Common S/S of Cataract? PainLESS vision loss, opacity of lens, blurring ofthe vision

Common S.S of Retino Blastoma? Cat's eye reflex (grayish discoloration of the pupi

Common S/S Acromegaly? Coarse facial features

Common S/S Duchennes MuscularDystrophy?

Gower's sign (use of the hands to push ones selffrom the floor_) Looks EXACTLY like the PilatesDownward dog!!!!!!!


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Common S/S of GERD? Barrets Esophagus (erosion of the lower portion othe esophageal mucosa)

Common S/S Hepatic Encephalopathy ? Flapping tremors

Common S/S of Hydrocephalosis? Bossing Sign (prominent forehead)

Common S/S of Increased ICP? HYPERTENSION, BRADYpnea, BRADYcardia(cushings triad)!

Common S/S of Shock? HYPERtension TACHYpnea and TACHYcardia

Common S/S Meniere's Disease? Vertigo, Tinnitus

Common S/S of Cystitis? Burning on urination

Common S/S of hypocalcemia? Chvostek and Trosseaus sign! Also hypomag!

Common S/S of Ulcerative Colitis? Recurrent bloody diarrhea

Common S/S of Lyme's disease Bull's eye rash

Common S/S of Basilar Fracture? Ottorhea

Common S/S of orbital fracture? Battles Sign and Racoon's eyes

Osteomyeltitis? an infectious bone dz. Give blood cultures andantibiotics, then if necessary surgery to drainabscess.

Nephrotic syndrome? s/s edema + hypotension. Turn and reposition(risk for impaired skinintegrity)

Renal impairment labs? Renal impairment: serum creatinine elevated andurine clearance decreased

Normal Hemoglobin? Neonates 18-273 mos 10.6-16.53 yrs 9.4-15.5


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10 yrs 10.7-15.5

Glomerulonephritis? take vs q 4 hrs + daily weights

Age 4=5 year shots? needs DPT/MMR/OPV

Cystic fibrosis? give diet low fat, high sodium, fat soluble vitaminADEK. Aerosal bronchodilators,mucolytics and pancreatic enzymes.

More info on droplet precautions? sepsis, scarlet fever, streptococcal pharyngitis,parovirus B19, pnuemonia,pertusis, influenza, diptheria, epiglottis, rubella,mumps, meningitis, mycoplasma and adenovirus

Door open, 3 ft distance, private room or cohort,mask

Meningeal irriatation>? S/s nuchal rigidity, positive Brudzinski + Kernigsigns and PHOTOPHOBIA too!

Babinski sign? toes curl= GREAT Toes fan = BAD

GTT for preggos? result of 140 or higher needs further evaluation.

Cranial nerves for Assessing extraoculareye movements?

3,4,6

Stomas? dusky means poor blood supply, protruding meanprolapsed, sharp pain + rigidity meansperitonitis, mucus in ileal conduit is expected.

Tension Pneumothorax? Trachea shifts to the opposite side

Change in color is ? a LATE sign! Always~!

Incentive Spirometry steps? 1) Sit upright 2) Exhale 3) Insert mouthpiece 4)Inhale for 3seconds, and then HOLD for 10 seconds

MRSA and VRSA precautions? *MRSA - Contact precaution ONLY


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*VRSA - Contact AND airborne precaution (Privatroom, door closed, negative pressure)

Thrombocyopenia- bleeding precautions 1)Soft bristled toothbrush2)No insertion of anything! (c/i suppositories,douche)

Burn Degrees? 1st Degree - Red and Painful2nd Degree - Blisters3rd Degree - No Pain because of blocked andburned nerves

Menieres's disease? Admin diuretics to decrease endolymph in thecochlea, restrict Na, lay on affected ear when in

bed. Triad:1)Vertigo2)Tinnitus3)N/V

Gastric ulcer pain occurs 30 minutes to 90 minutes after eating, noat night, and doesn't goaway with food

Med that can't be infused Intra

osseously?

isoproterenol, a beta agonist.

Sickle cell crisis? two interventions to prioritize: fluids and painrelief.

Glomerulonephritis considerations you should consider blood pressure to be yourmost importantassessment parameter. Dietary restrictions you cexpect include fluids, protein, sodium, and

potassium.

Labs for congenital heart disease? result in hypoxia whichthe body attempts to compensate for (influx ofimmature rbc's)? Labs supporting this would showincreased hematocrit, hemoglobin, and rbc count


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Kidneys and ears? Did you know there is an association between lowset ears and renal anomalies? Now youknow what to look for if down's isn't there tochoose. (just to expand on it a little, the kidneysandears develop around the same time in utero.Hence, they're shaped similarly. Which is whywhendoing an assessment of a neonate, if the nursenotices low set or asymmetrical ears, there isgood reason to investigate renal functioning.Knowing that the kidneys and ears are similarshapes helped me remember this).

School aged kids and five year olds? old enough, and should have an explanation ofwhat will happen a week before surgery such astonsillectomy.

What if a toddler says no to medication? leave the room and come back in five minutes,because to a toddler it is another episode. Nexttime, don't ask.

First sign of pyloric stenosis in a baby? mild vomiting that progresses to projectilevomiting. Later you may be able to palpate a

mass, the baby will seem hungry often, and mayspit up after feedings.

Kawasaki disease causes? a heart problem, but what specifically? Coronaryarteryaneurysms d/t the inflammation of blood vessels.

A child with a ventriculoperitoneal shuntwill have a small upper-abdominal incision. This iwhere the shunt is guided into the abdominalcavity, and tunneled under the skin up to theventricles. You should watch for abdominaldistention, since fluid from the ventricles will beredirectedto the peritoneum. You should also watch for sigof increasing intracranial pressure,such as irritability, bulging fontanels, and high-pitched cry in an infant. In a toddler watch lack o


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appetite and headache. Careful on a bed positionquestion! Bed-position after shunt placementis flat, so fluid doesn't reduce too rapidly. If yousee s/s of increasing icp, then raise the hob to15-30 degrees.

What could cause bronchopulmonarydysplasia?

Dysplasia means abnormality or alteration.Mechanical ventilation can cause it. Prematurenewborns with immature lungs are ventilatedand over time it damages the lungs. Other causecould be infection, pneumonia, or otherconditions that cause inflammation or scarring.

How do children less than one breathe? It is essential to maintain nasal patency with

children < 1 yr. because they are obligatorynasal breathers.

Milk for kids?Watch out for questions suggesting a child drinksmore than 3-4 cups of milk each day. (Milksgood, right?) Too much milk reduces intake ofother essential nutrients, especially iron. Watch fanemia with milk-aholics. And don't let that mothput anything but water in that kid's bottleduring naps/over-night. Juice or milk will rott thakids teeth right out of his head.

Traction in kids?What traction is used in a school-age kid with afemur or tibial fracture with extensive skindamage? Ninety, ninety. Huh? I never heard of iteither. The name refers to the angles of the

joints. A pin is placed in the distal part of thebroken bone, and the lower extremity is in a boocast. The rest is the normal pulleys and ropesyou're used to visualizing with balancedsuspension. While we're talking about traction, akid's hinder should clear the bed when inBryant's traction (also used for femurs andcongenial hip for young kids).

Yeast infection in a babys mouth? If you can remove the white patches from themouth of a baby it is just formula. If you can't, itcandidiasis.


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MMR and Varicella? Just know the MMR and Varicella immunizationscome later (15 months).

Cryptoorchidism? Undescended testis is a known risk factor fortesticular cancer later in life.Start teaching boys testicular self exam around 1because most cases occur duringadolescence.

Maslow for a guy who lost his house in afire?

- A guy loses his house in a fire. Priority is usingcommunityresources to find shelter, before assisting withfeelings about the tremendous loss. (Maslow).

Kids pain relief in NCLEX land? No aspirin with kids b/c it is associated with ReyeSyndrome, and also no nsaids such asibuprofen. Give Tylenol.

How will CSF look in meningitis? will have high protein, and low glucose.

Suctioning is good--except No nasotracheal suctioning with head injury orskull fracture.

Peds positioning for GERD? Position prone w hob elevated with gerd. In almoevery other case, though, you better lay thatkid on his back (Back To Sleep - SIDS).

When instilling eardrops? Pull pinna down and back for kids < 3 yrs. wheninstilling eardrops.

Kids with RSV?> no contact lenses or pregnant nurses in roomswhere ribavirin is being

administered by hoot, tent, etc.

Positioning with pneaumonia? lay on the affected side to splint and reduce painBut if you aretrying to reduce congestion the sick lung goes up(Ever had a stuffy nose, and you lay with thestuff side up and it clears?)


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TB test confirmation? A positive ppd confirms infection, not justexposure. A sputum test will confirm activedisease.

Asthmas and wheezers? Coughing w/o other s/s is suggestive of asthma.Speaking of asthma, watch out if yourwheezer stops wheezing. It could mean he isworsening.

What treats tet spells? treated with morphine.

Group-A strep? precedes rheumatic fever. Chorea is part of thissickness (grimacing, sudden

body movements, etc.) and it embarrasses kids.They have joint pain. Watch for elevatedantistreptolysin O to be elevated. Penicillin!

Tylenol poisioining ? liver failure possible for about 4 days. Closeobservation required duringthis time-frame, as well as tx with Mucomyst.

Radioactive iodine? The key word here is flush. Flush substance out obody w/3-4 liters/day

for 2 days, and flush the toilet twice after using f2 days. Limit contact w/patient to 30minutes/day. No pregnant visitors/nurses, and nokids.

Main hypersensitivity for antiplateletdrugs?

broncospasm (anaphylaxis)

Common sites for metastatsis? liver, brain, lung, bone, and lymph

Orthostatis is verfied by? a drop in presssure with increasing heart rate...Orthostatis= orthostatic hypotension

Bence Jones protein in urine? confirms multiple myeloma

How do you treat a small bowel Don't fall for 'reestablishing a normal bowel


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obstruction? pattern' as a priority with small bowel obstructionBecause the patient can't take in oral fluids'maintaining fluid balance' comes first.

G tube and J tubes are usually? Other than initially to test tolerance, given ascontinuous feedings.

Side rail rules? Four up can be considered a form of restraint.Even in LTC facility when a client is afall risk, keep lower rails down, and one side ofbed against the wall, lowest position, wheelslocked.

Post spleenectomy? Pneumovax 23 gets administered post splenectom

to prevent pneumococcal sepsis.

Potassium lab importance?Let's say every answer in front of you is anabnormal value. If potassium is there you can beitis a problem they want you to identify, becausevalues outside of normal can be lifethreatening. Normal potassium is 3.5-5.0. Even abun of 50 doesn't override a potassium of 3.0in a renal patient in priority.

Every new admission needs? if he has an advance directive, and if not you wilexplain it,and he will have the option to sign or not.

Potassium and acid base balance? A little trick regarding potassium:ALKALOSIS: K is LOWAcidosis is just the opposite: K is HighThe vital sign you should check first with highpotassium is pulse (due to dysrhythmias).

What is bleeding considered in ADPIE? Bleeding is part of the 'circulation' assessment ofthe ABCD's in an emergent situation.Therefore, if airway and breathing are accountedfor, a compound fracture requires assessmentbefore Glasgow coma scale and a neuro check(D=disability, or neuro check)


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What to do in a sucking stab wound? dress the wound and tape it onthree sides which allows air to escape. Do not usan occlusive dressing, which could convert thewound from open pneumo to closed one, and atension pneumothorax is worse situation. Afterthat get your chest tube tray, labs, iv.

What to do if your patients chest tubeaccidently getes removed?

An occulsive dressing is used

Labs in DKA>?Serum acetone and serum ketones rise. As youtreat the acidosis and dehydrationexpect the potassium to drop rapidly, so be readywith potassium replacement.

Fluids are the most important intervention, so gefluids going first.With HHNS there is no ketosis, and no acidosis.Potassium is low in HHNS (d/t diuresis).

Decorticate and Decerebrate? Decorticate positioning in response to pain= Cortex involvement. Decerebrate inresponse topain = Cerebellar, brain stem involvement

Other S/S of MS? Hyperactive deep tendon reflexes, vision changesfatigue and spasticity

After removal of the pituitary gland whatshould you watch for?

hypocortisolism and temporarydiabetes insipidus.

After appendectomy? position on the RIGHT side with legs flexed

Hirschsprungs is dx how? diagnosed with rectal biopsy looking for absence

ganglionic cells. Cardinalsign in infants is failure to pass meconium, andlater the classic ribbon-like and foul smellingstools.

More info on intussception? common in kids with CF. Obstruction may causefecal emesis, currant jellylike


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stools (blood and mucus). A barium enema may used to hydrostatically reduce thetelescoping. Resolution is obvious, with onset ofbowel movements.

Omphalocele? herniation of abdominal contents- dress with loossalinedressing covered with plastic wrap, and keep eyeon temp. Kid can lose heat quickly.

Hydrocele? provide ice bags and scrotal support.

PKU ? No phenylalanine with a kid positive for PKU (nomeat no dairy no aspartme

When to test urine for ketones andglucose?

Second voided urine most accurate

Nepphrotic syndrome? characterized by massive proteinuria (looks darkand frothy) caused byglomerular damage. Corticosteroids are themainstay. Generalized edema common.

Western blot test? A positive Western blot in a child


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The first s/s of ards? increased respirations. Later comes dyspnea,retractions, air hunger,cyanosis.

PCWP pulm capillary wedge pressure is 8-13. Readings 18-20 are consideredhigh.

First sign of pe? sudden chest pain, followed by dyspnea andtachypnea.

Carbon dioxide narcosis? High potassium is expected (hydrogen floods thecell forcing

potassium out). Causes increased intracranialpressure.

Pulmonary sarcoidosis? leads to right sided heart failure..Sarcidosis isbasically scar tissue build up

NG tube rules? can be irrigated with cola, and should be taught tfamily when a client is going home with an NGtube.

If your patient starts seeing bugs? If your normally lucid patient starts seeing bugsyou better check his respiratory status first.The first sign of hypoxia is restlessness, followedby agitation, and things go downhill from thereall the way to delirium, hallucinations, and coma.So check the o2 stat, and get abg's if possible.

Cold stress in a newborn? The biggest concern is respiratory distress.

A preggo in a minus station? If your laboring mom's water breaks and she isany minus station you better know there is arisk of prolapsed cord.

CPR in a five year old? In a five-year old breathe once for every 5compressions doing cpr.


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After Gtube placement? the stomach contents are drained by gravity for 2hours before it can be used for feedings.

Cephalhematoma (caput succinidanium)? resolves on its own in a few days. This is the typofedema that crosses the suture lines.

Hep A precautions? acute stage gown and gloves are required. In theconvalescent stage it isno longer contagious.

More labs suggestive of renal failure? Low magnesium and high creatinine signal

Hightest priority for RA? Pain is usually the highest priority

TB health risk? If a TB patient is unable/unwilling to comply withtx they may need supervision (directobservation). TB is a public health risk.

Highest priortiy in status elipticus? Level of consciousness is the most importantassessment parameter

Crackles most likely are? suggest pneumonia, which is likely to beaccompanied by hypoxia, which wouldmanifest itself as mental confusion, etc.

Anorexia sucks because? Absence of menstruation leads to osteoporosis inthe anorexic.

Low crit/hemoglobin? should be evaluated for signs ofbleeding, such as dark stools.

More IVP info? A laxative is given the night before in order to

better visualize the organs.

Pt with edema and walking? A patient with liver cirrhosis and edema mayambulate, then sit with legs elevated to try tomobilize the edema.

High priority in Addisons? Managing stress in a patient is paramount,


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because ifthe adrenal glands are stressed further it couldresult in Addisonian crisis. While we're on

Addison's, remember blood pressure is the mostimportant assessment parameter, as it causessevere hypotension.

Pancreatitis prioritys? After pain relief, cough and deep breathe isimportant because of fluid pushing up in thediaphragm.

Likely cause of cardiac arrest in child? Prolonged hypoxemia is a likely cause of cardiacarrest in a child.

What can also cause an s3 heart sound? Fluid volume overload caused by IVC fluidsinfusing too quickly (or whatever reason) and CH

coarctation of the aaorta causes? causes increased blood flow and bounding pulsesin the arms

If you THINK a patient has new HTN? should have BP assessed in both arms

Depression manifests itself? in somatic ways, such as psychomotor retardatiogi

complaints, and pain.

Chief concern in CF Respiratory problems!

More info on TB testing a positive result? PPD is positive if area of induration is:>5 mm in an immunocompromised patient>10 mm in a normal patient>15 mm in a patient who lives in an area whereTB is very rare.

Hba1c? test to assess how well blood sugars have beencontrolled over the past 90-120 days. 4-6 corresponds to a blood sugar of 70-110; 7 isideal for a diabetic and corresponds to a bloodsugar of 130.


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Most accurate way to test kids formedication accuracy?

BSA is considered the most accurate method formedication dosing with kids. (I though it wasweight, but apparently not)

Placement of a wheelchair? parallel to the bed on the side of weakness

If you see a nurse make a mistake?Chain of command?

speak to her before going to management. If thesituation persists, then take it higher.

Besides meds and congenital problems ..what can lead to decreased preload ?

Sepsis and anaphylaxis (along with the obvioushemorrhaging) reduce circulating volume byway of increased capillary permeability, whichleads to reduced preload (volume in the leftventricle at the end of diastole). This is a

toughie...think about it.

Nitrazine paper? Amniotic fluid is alkaline, and turns paper blue.Urine and normal vaginal dischargeare acidic, and turn it pink.

STD= gonnorrhea? a reportable disease

MORE info on DKA? ugh! While treating DKA, bringing the glucose down tofar and too fast can result in increased

intracranial pressure d/t water being pulled intothe CSF.Polyuria is common with the hypercalcemia causeby hyperparathyroidism.

Nonfat milk? Nonfat milk reduces reflux by increasing loweresophageal sphincter pressure

Gerd again? lay on their left side with the HOB elevated 30

degrees.

To prevent dumping syndrome? Unusual positional tip - Low-fowlers recommendeduring meals to prevent dumpingsyndrome. Limit fluids while eating.

Emphysema? the stimulus to breathe is low PO2, not increased


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PCO2 like the rest of us, sodon't slam them with oxygen. Encourage pursed-lip breathing which promotes CO2elimination, encourage up to 3000mL/day fluids,high-fowlers and leaning forward.

Kernigs sign? One of the physically demonstrable symptoms ofmeningitis Severe stiffness of the hamstringscauses an inability to straighten the leg when thehip is flexed to 90 degrees.

Brudzinski's sign? One of the physically demonstrable symptoms ofmeningitis. Severe neck stiffness causes a patienhips and knees to flex when the neck is flexed (

The kid knees will fly up and he lift his bum off thtable cause it hurts his neck)

Phenalalanine? It is an amino acid that is BAD for people withPKU. It is found in food only and is also found inaspartame

Vertical C section? Used in plus sized women or risky or emergency sections. less chance of harm for the baby

Dystocia? Just means a difficult or abnormal delivery orbirth... example.. shoulder dystocia

Peritoneal dialysis?does not require that the patient's blood bepumped outside of his body. Instead, the blood icleaned while still inside the body. The organs inthe abdomen are surrounded by the peritoneum,which is a membrane that allows waste products pass through it. Peritoneal dialysis uses aTenckhoff catheter to run the dialysis fluid, a sug

solution with some salts, into the abdominal, orperitoneal, cavity. This allows the patient's blood be filtered without pumping it through a dialysismachine. A Tenkhoff catheter is usually used inperitoneal dialysis

Why would somone who is allergic toCROSS REACTION! may be allergic to some foodas well. When this happens, your body responds


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latex be allergic to food too? with the same allergic symptoms that you wouldhave if you were exposed to latex. Cross reactiondiffer from one person to another. Someone mayhave a reaction to all the foods noted to causecross reaction while another may have no reactioat all. Likewise, if you are allergic to any of thesefoods, you may also be allergic to latex:apples, bananas, kiwi, peaches, plums, figs,grapes, melons, papaya, passion fruit, cherries,nectarines, pears, pineapple and strawberries;carrots, celery, raw potatoes, avocados andtomatoes;chestnuts and hazelnuts;wheat and rye.

Acid/ ASH diet? a diet intended for health and may be prescribedby your physician to control illness or disease.Once your liver has metabolized the food youingest, it leaves a mineral deposit, known as ash,which can be acidic or alkaline depending on itseffect on the pH of your urine. Eating foods thatcreate an acid ash may help to balance yoursystem or create a hostile environment to inhibitbacterial growth..... Acid/ ash diet is used to BALANCE the

acid/alkaline ash in the body... Ash wiill affect theurinary system and even the nervous system.Imbalance will be diet modified

PTB means? Pumonary tuberculosis

Psuedomembrane in DIptheria? Diptheria is an upper respiratory tract infection. Iis characterized by sore throat, low fever and thepsuedomembrane! Which is just a capsule aroundthe tonsils that you can see with your penlight...

just looks like a whiteish yellow capsule around ttonisils

SLE? Systemic Lupus Ethramoutus.... (Lupus)

Dengue hemorrhagic fever? Hermans sign= flushes and redness of skin with


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lighter color at the center of the rash.... It is adisease that comes from tropical and subtropicalareas that are spread by misquotos

Risus Sardonicus? a highly characteristic, abnormal, sustained spasmof the facial muscles that appears to producegrinning--- From Tetany! Sad and scary looking!

Grey Turners sign? Purple bruises around the belly button...Pancreatitis!

PDA? patent ductuous arteriousus in infants! Valvedoesn't close!

Dance Sign? RUQ mass (intussusception) with RLQ empty spa(movement of cecum out of normal position).

Charcots sign? triad for multiple sclerosis

1. Nystagmus2. Intention tremor3. Scanning or staccato speech

MG and Guillian Barre? Opposites!

Chvostek and Trosseaus sign Chvostek= Tapping on the face above the cheekbone will cause spams! Trosseaus= using a BP cuand inflating it, and it will cause spasms of thewrist

VRSA? Staph infection that is resistant to Vancomycintreatement! Worse than MRSA

Tet spells?

results from a transient increase in resistance to

blood flow to the lungs with increased preferentiaflow of desaturated blood to the body. Tet spellsare characterized by a sudden, marked increase cyanosis followed by syncope, and may result inhypoxic brain injury and death. Older children wiloften squat during a tet spell, which increasessystemic vascular resistance and allows for a


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temporary reversal of the shunt.

HHNS Vs DKA Diabetic ketoacidosis (DKA) is a condition ofDKA=insulin deficiency resulting in acidemia due altered metabolism.

Hyperosmolar hyperglycemic nonketoticsyndrome (HHNS) is primarily a disorder ofdehydration due to hyperglycemia

S/s of Air/Pulmonary Embolism chest pain, difficulty breathing, tachycardia,pale/cyanotic,sense of impending doom

Nclex Terms(50)

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