Endometiral infection usually occurs
with a prolonged rupture of membranes, not vacuum-assisted births.
Intenstinal gas is a common side effect of
clients following a cesarean birth
Cervical lacerations are common complications from
vacuum-assisted birth are rare but can include perineal, vaginal, or cervical lacerations
When a client is experiencing a wound evisceration...
the nurse should initially stay with the client and call for help. Next, the nurse should place saline-soaked gauze on the exposed bowels to keep the internal organs moist. The nurse should then place the client in a supine position with his hips and knee
Valproic acid can cause
hepatic toxicity
continuous passive motion (CPM) machine
Turn of the CPM machine during meals to promote comfort and dietary intake.
-The affected extremity should maintain neutral alignment.
Heparin
is an anticoagulant that inhibits the conversation of prothrombin to thrombin. Patients on an anticoagulant drug such as heparin are at an increased risk of bleeding.
-Signs of bleeding: ecchymoses, tarry stools, mucosal bleeding, and pink/ red-tinged uri
Correct method for walking upstairs with crutches
1. Hold to rail with one hand and crutches with the other hand.
2. Push down on the stair rail and the crutches and step up with the "unaffected" leg.
3. If not allowed to place weight on the "affected" leg, hop up with the "unaffected" leg.
4. Bring the
Droplet precautions
DROPLET: "SPIDERMAn"
-Sepsis
-Scarlet Fever
-Strep
-Pertussis
-Pneumonia
-Parvovirus
-Influenza
-Diphtheria
-Epiglottitis
-Rubella
-Mumps
-Adenovirus
Management: Private room/mask
-A private room a rom with other clients with the same infectious disease.
Airborne precautions:
AIRBORNE: "My Chicken Hez TB"
-Measles
-Chicken pox
-Herpes zoster
-TB
Management: neg. pressure room, private room, mask, n-95 for TB.
-A private room
-Masks or respiratory protection devices for caregivers and visitors.
-An N95 or high-efficiency partic
Contact precautions
CONTACT: "MRS WEE"
-MRSA
-RSV
-Skin infections (herpes zoster, cutaneous diphtheria, impetigo, pediculosis, scabies, and staph)
-Wound infections
-Enteric infections (C-Diff)
-Eye infections (conjunctivitis)
Management: gown, gloves, goggles, private room
Stage I pressure ulcer
Intact skin with an area of persistent, nonblanchable redness, typically over a bony prominence, that may feel warmer or cooler than the adjacent tissue. The tissue is swollen and has congestion, with possible discomfort at the site. With darker skin tone
Stage II pressure ulcer
Partial-thickness skin loss involving the epidermis and the dermis. The ulcer is visible and superficial and may appear as an abrasion, blister, or shallow crater. Edema persists, and the ulcer may become infected, possibly with pain and scant drainage.
Stage III pressure ulcer
Full-thickness tissue loss with damage to or necrosis of subcutaneous tissue. The ulcer may extend down to, but not through, underlying fascia. The ulcer appears as a deep crater with or without undermining of adjacent tissue and without exposed muscle or
Stage IV pressure ulcer
Full-thickness tissue loss with destruction, tissue necrosis, or damage to muscle, bone, or supporting structures. There may be sinus tracts, deep pockets of infection, tunneling, undermining, eschar (black scab-like material), or slough (tan, yellow, or
Glasgow Coma Score
is calculated by using appropriate stimuli (a painful stimulus may be necessary) and then assessing the clients response in three areas.
Eye opening (E) - The best eye response, with responses ranging from 4 to 1
4 = Eye opening occurs spontaneously.
3 =
When verifying NG tube placement, the pH of aspirated gastric fluid should
A good indication of appropriate placement is obtaining gastric contents with a pH between 0 and 4.
Sodium
136-145
Potassium
3.5-5
Total Calcium
9.0-10.5
Magnesium
1.3-2.1
Phosphorus
3.0-4.5
BUN
10-20
Creatinine males
0.6-1.2
Creatinine females
0.5-1.1
Glucose
70-105
HcbA1c
<6.5%
WBC
5,000-10000
RBC men
4.7-6.1 million/mm3
RBC women
4.2-5.4 millin/mm3
Hemoglobin men
14-18
Hemoglobin women
12-16
Hematocrit men
42-52
Hematocrit women
37-47
Platelet
150,000-400,000
pH
7.35-7.45
pC02
35-45
p02
80-100
HC03
21-26
Normal PT=
11-12.5 seconds
Normal INR=
0.7-1.8 (Therapeutic INR 2-3)
Normal PTT=
30-40 seconds (Therapeutic PTT 1.5-2 x normal or control values)
Digoxin
0.5-2.0
Lithium
0.8-1.4
Dilantin
10-20
Theophylline
10-20
Latex Allergies
Note that clients allergic to bananas, apricots, cherries, grapes, kiwis, passion fruit, avocados, chestnuts, tomatoes, and/or peaches may experience latex allergies as well.
Order of Assessment
I-inspection
P-palpation
P-percussion
A-auscultation
Except with abdomen it is IAPP-inspect, auscultate, percuss and palpate.
Cane Walking
C-cane
O-opposite
A-affected
L-leg
Crutch walking
Remember the phase "step up" when picturing a person going up stairs with crutches. The good leg goes up first followed by the crutches and the bad leg. The opposite happens going down the stairs....OR "up to heaven...down to hell
Delegation
RNs DO NOT delegate what they can EAT--evaluate, assess, teach
Angina Precipitating Factors: 4 E's
Exertion: physical activity and exercise
Eating
Emotional distress
Extreme temperatures: hot or cold weather
Arterial occlusion: 4 P's
Pain
Pulselessness or absent pulse
Pallor
Paresthesia
Congestive Heart Failure Treatment: MADD DOG
Morphine
Aminophylline
Digoxin
Dopamine
Diuretics
Oxygen
Gasses: Monitor arterial blood gasses
Heart Murmur Causes: SPASM
Stenosis of a valve
Partial obstruction
Aneurysms
Septal defect
Mitral regurgitation
Heart Sounds: All People Enjoy the Movies
Aortic: 2nd right intercostal space
Pulmonic: 2nd left intercostal space
Erb's Point: 3rd left intercostal space
Tricuspid: 4th left intercostal space
Mitral or Apex: 5th left intercostal space
Hypertension Care: DIURETIC
Daily weight
Intake and Output
Urine output
Response of blood pressure
Electrolytes
Take pulse
Ischemic episodes or TIAs
Complications: CVA, CAD, CHR, CRF
Shortness of Breath (SOB) Causes: 4 As+4Ps
Airway obstruction
Angina
Anxiety
Asthma
Pneumonia
Pneumothorax
Pulmonary Edema
Pulmonary Embolus
Stroke Signs: FAST
Face
Arms
Speech
Time
Compartment Syndrome Signs and Symptoms: 5 P's
Pain
Pallor
Pulse declined or absent
Pressure increased
Paresthesia
Shock Signs and Symptoms: CHORD ITEM
Cold, clammy skin
Hypotension
Oliguria
Rapid, shallow breathing
Drowsiness, confusion
Irritability
Tachycardia
Elevated or reduced central venous pressure
Multi-organ damage
Hypoglycemia Signs: TIRED
Tachycardia
Irritability
Restlessness
Excessive hunger
Depression and diaphoresis
Hypocalcaemia Signs and Symptoms: CATS
Convulsions
Arrhythmias
Tetany
Stridor and spasms
Hypokalemia Signs and Symptoms: 6 L's
Lethargy
Leg cramps
Limp muscles
Low, shallow respirations
Lethal cardiac dysrhythmias
Lots of urine (polyuria)
Hypertension Complications: The 4 C's
Coronary artery disease (CAD)
Congestive heart failure (CHF)
Chronic renal failure (CRF)
Cardiovascular accident (CVA): Brain attack or stroke
Traction Patient Care: TRACTION
Temperature of extremity is assessed for signs of infection
Ropes hang freely
Alignment of body and injured area
Circulation check (5 P's)
Type and location of fracture
Increase fluid intake
Overhead trapeze
No weights on bed or floor
Cancer Early Warning Signs: CAUTION UP
Change in bowel or bladder
A lesion that does not heal
Unusual bleeding or discharge
Thickening or lump in breast or elsewhere
Indigestion or difficulty swallowing
Obvious changes in wart or mole
Nagging cough or persistent hoarseness
Unexplained weight l
Leukemia Signs and Symptoms: ANT
Anemia and decreased hemoglobin
Neutropenia and increased risk of infection
Thrombocytopenia and increased risk of bleeding
Clients Who Require Dialysis: AEIOU (The Vowels)
Acid base imbalance
Electrolyte imbalances
Intoxication
Overload of fluids
Uremic symptoms
Asthma Management: ASTHMA
Adrenergics: Albuterol and other bronchodilators
Steroids
Theophylline
Hydration: intravenous fluids
Mask: oxygen therapy
Antibiotics (for associated respiratory infections)
Hypoxia: RAT (signs of early) BED (signs of late)
Restlessness
Anxiety
Tachycardia and tachypnea
Bradycardia
Extreme restlessness
Dyspnea
Pneumothorax Signs: P-THORAX
Pleuretic pain
Trachea deviation
Hyperresonance
Onset sudden
Reduced breath sounds (& dyspnea)
Absent fremitus
X-ray shows collapsed lung
Transient incontinence Causes: DIAPERS
Delirium
Infection
Atrophic urethra
Pharmaceuticals and psychological
Excess urine output
Restricted mobility
Stool impaction
Dealing with Constipation
Constipation is difficult or infrequent passage of stools, which may be hard and dry.
Causes include: irregular bowel habits, psychogenic factors, inactivity, chronic laxative use or abuse, obstruction, medications, and inadequate consumption of fiber and
Dealing with Dysphagia:
Dysphagia is an alteration in the client's ability to swallow.
Causes include:
Obstruction
Inflammation
Edema
Certain neurological disorders
Modifying the texture of foods and the consistency of liquids may enable the client to achieve proper nutrition.
C
Dumping Syndrome
Dumping Syndrome occurs as a complication of gastric surgeries that inhibit the ability of the pyloric sphincter to control the movement of food into the small intestine.
This "dumping" results in nausea, distention, cramping pains, and diarrhea within 15
Gastroesophageal Reflux Disease (GERD)
GERD leads to indigestion and heartburn from the backflow of acidic gastric juices onto the mucosa of the lower esophagus.
Encourage weight loss for overweight clients.
Avoid large meals and bedtime snacks.
Avoid trigger foods such as citrus fruits and ju
Peptic Ulcer Disease (PUD)
PUD is characterized by an erosion of the mucosal layer of the stomach or duodenum.
This may be caused by a bacterial infection with Helicobacter pylori or the chronic use of non-steroidal anti-inflammatory drugs (NSAIDs), such as aspirin and ibuprofen.
A
Lactose intolerance
Lactose intolerance results from an inadequate supply of lactase, the enzyme that digests lactose.
Symptoms include distention, cramps, flatus, and diarrhea.
Clients should be encouraged to avoid or limit their intake of foods high in lactose such as: mil
Diverticulosis and Diverticulitis:
A high-fiber diet may prevent diverticulosis and diverticulitis by producing stools that are easily passed and thus decreasing pressure within the colon.
During acute diverticulitis, a low-fiber diet is prescribed in order to reduce bowel stimulation.
Avo
Cholecystitis
Cholecystitis is characterized by inflammation of the gallbladder. The gallbladder stores and releases bile that aids in the digestion of fats.
Fat intake should be limited to reduce stimulation of the gallbladder.
Other foods that may cause problems incl
Acute Renal Failure (ARF):
ARF is an abrupt, rapid decline in renal function. It is usually caused by trauma, sepsis, poor perfusion, or medications. ARF can cause hyponatremia, hyperkalemia, hypocalcemia, and hyperphosphatemia. Diet therapy for ARF is dependent upon the phase of A
Pre-End Stage Renal Disease (pre-ESRD):
Pre-ESRD, or diminished renal reserve/renal insufficiency, is a predialysis condition characterized by an increase in serum creatinine.
Goals of nutritional therapy for pre-ESRD are to:
Help preserve remaining renal function by limiting the intake of prot
End Stage Renal Disease (ESRD):
End Stage Renal Disease (ESRD):
ESRD, or chronic renal failure, occurs when the glomerular filtration rate (GFR) is less than 25 mL/min, the serum creatinine level steadily rises, or dialysis or transplantation is required.
The goal of nutritional therapy
Nephrotic Syndrome
Nephrotic syndrome results in serum proteins leaking into the urine.
The goals of nutritional therapy are to minimize edema, replace lost nutrients, and minimize permanent renal damage.
Dietary recommendations indicate sufficient protein and low-sodium in
Nephrolithiasis (Kidney Stones)
Increasing fluid consumption is the primary intervention for the treatment and prevention of the formation of renal calculi. Excessive intake of protein, sodium, calcium, and oxalates (rhubarb, spinach, beets) may increase the risk of stone formation.
Prioritization
Prioritization includes clinical care coordination such as clinical decision making, priority setting, organizational skills, use of resources, time management, and evaluation of care.
Clinical decisions are made by completing a thorough assessment which
Variant angina (Prinzmetal's angina)
Due to a coronary artery spasm, oftening occurring during periods of rest.
Unstable angina
Occurs with exercise or emotional stress, but it increases in occurrence, severity, and duration over time.
Stable angina
Occurs with exercise or emotional stress and is relieved by rest or nitroglycerin (Nitrostat).
electrolyte imbalance manifestations:
hypocakelmia--> flat T waves on ECG
hypercalcemia--> decreased deep tendon reflexes (DTRs)
hypocalcemia--> tetany
hyperkalemia--> tall peaked T waves on ECG
Addison's disease
Decreased aldosterone and renin
Hypothyroidism
Decreased triiodothyronine (T3) and thyroxine
Cushing's disease
Elevated cortisol
Diabetes Insipidus (DI)
Decreased urine specific gravity
Diabetes melitus
Elevated glycosylated hemoglobin (HbA1c)
Syndrome of Inappropriate Secretion of Antidiuretic Hormone
Increased urine osmolality
Cataract
Progressive and painless loss of vision
Angle-closure glaucoma
Rapid onset of elevated IOP
macular degeneration
Central loss of vision
Open-angle galucoma
Loss of peripheral vision
Retinal detachment
Sudden loss of vision without pain
Common disease's manifestations
Cholecystitis--> Murphy's sign
Pancreatitis--> Turner's sign
Peptic Ulcer Disease--> Upper epigastric pain 1-2 hours after meals
Appendicits--> Pain at McBurney's point
Decorticate
Decerebrate
Hepatitis disease transmissions
Hepatitis A--> Ingestions o contaminated food/water
Hepatitis B--> Unprotected sexual contact
Nonviral Hepatits--> Drug toxicity
Heart Failure
Symptoms: Shortness of breath, fatigue, jugular vein distention, and an S3 are signs/symptoms of heart failure resulting from the decreased pumping ability of the heart and increased fluid volume.
Hypovolemic shock
position: Supine with legs elevated (shock position)
Below-the-knee amputation
Position: The client should be placed in the prone position several times a day to prevent hip flexion contractions.
Chest tube
-Continuous bubling in the water seal champers indicates an air leak. If this is observed, the nurse should attempt to located the source of the air leak and intervene accordingly (tighten the connections, replace drainage system)
Compartment syndrome
Symptoms: Pulselessness (late sign), Increased pain unrelieved with elevation or by pain medication
Left homonymous hemianopsia
has lost the left visual field of both eyes. They are unable to visualize anything to the left of midline of the body.
dialysis fistula
client teaching: avoid lifting heavy objects with access-site arm, avoid carrying objects that compress the extremity, avoid sleeping on top of the extremity with the access device, perform hand exercises that promote fistula maturation, check the access
Chronic renal failure
Diet: low-protein, low-potassium, and high-carbohydrate, as well as low-sodium and low-phosphate
Synchronized cardioversion
is the electrical management of choice for atrial fibrillation, supra ventricular tachycardia (SVT) and ventricular tachycardia with a pulse.
Myoglobin
is the earliest marker of injury to cardiac or skeletal muscle and levels no longer evident after 24 hr.
Troponin I
A positive Troponin I indicates damage to cardiac tissues and level are no longer evident in the blood after 7 days.
Hyperglycemia
-Test urines for ketones and report if outside the expected reference range
atropine
blocks the cardiac muscarinic receptors and inhibits the parasympathetic nervous system. The blockage of parasympathetic activity results in an increased heart rate. When the heart rate increases, cardiac output will also increase.
Constant bubbling in a water seal chamber (of a chest tube) is an indication of
an air leak
Cleft lip: nursing care plan (postoperative)�"CLEFT LIP
Crying, minimize
Logan bow
Elbow restraints
Feed with Brecht feeder
Teach feeding techniques; two months of age (average age at repair)
Liquid (sterile water), rinse after feeding
Impaired feeding (no sucking)
Position�never on abdomen
Complication of severe preeclampsia�"HELLP" syndrome
Hemolysis
Elevated Liver enzymes
Low Platelet count
Dystocia: general aspects (maternal)�"4P's
Powers
Passageway
Passenger
Psych
Infections during pregnancy�"TORCH
Toxoplasmosis
Other (hepatitis B, syphilis, group B beta strep)
Rubella
Cytomegalovirus
Herpes simplex virus
IUD: potential problems with use�"PAINS
Period (menstrual: late, spotting, bleeding)
Abdominal pain, dyspareunia
Infection (abnormal vaginal discharge)
Not feeling well, fever or chills
String missing
Newborn assessment components�"APGAR
Appearance
Pulse
Grimace
Activity
Respiratory effort
Obstetric (maternity) history�"GTPAL
Gravida
Term
Preterm
Abortions (SAB, TAB)
Living children
Oral contraceptives: Signs of potential problems�"ACHES
Abdominal pain (possible liver or gallbladder problem)
Chest pain or shortness of breath (possible pulmonary embolus)
Headache (possible hypertension, brain attack)
Eye problems (possible hypertension or vascular accident)
Severe leg pain (possible thromb
Preterm infant: Anticipated problems�"TRIES
Temperature regulation (poor)
Resistance to infections (poor)
Immature liver
Elimination problems (necrotizing enterocolitis [NEC])
Sensory-perceptual functions (retinopathy of prematurity [ROP])
VEAL CHOP-which relates to fetal heart rate.
Variable decels => Cord compression (usually a change in mother's position helps)
Early decels => Head compression (decels mirror the contractions; this is not a sign of fetal problems)
Accelerations => O2 (baby is well oxygenated-this is good)
Late decel
Nine-point Postpartum Assessment...BUBBLEHER
B- Breasts
U- Uterus
B- Bladder
B- Bowel function
L- Lochia
E- Episiotomy
H- Hemorrhoids
E- Emotional Status
R- Respiratory System
Considerations for the pregnant client
Admittance of a pregnant client to a medical-surgical unit:
You may have a pregnant client admitted with a diagnosis unrelated to her pregnancy and, therefore, she may be admitted to a general medical-surgical floor. A mnemonic to assist you in performing
Admittance of a postpartum client to a medical-surgical unit
There are times when a woman may be hospitalized during the postpartum period for a medical condition. When this occurs, she'll most likely be placed on a general medical-surgical unit. Her admission will cause you to ask: "What's normal during the weeks
Placenta Previa (PP) versus Abruptio Placenta (AP)
Problem:
PP--> Low implantation of the placenta
AP--> Premature separation of the placenta
Incidence:
PP--> It occurs in approximately 5 in every 1000 pregnancies
AP--> It occurs in about 10% of pregnancies and is the most common cause of perinatal death
Common Thyroid Medications
Levo thyro xine (Syn thro id,Levo thro id)
Lio thyro nien (Cytomel)
Liotrix ( Thyro lar)
Thyroid ( Thryoid USP)
Antithyroid Medications (hyperthyroidism)
Antithyroid medications are used to block (anti) the thyroid hormones. Antithyroid medications block (anti) the conversion of T4 into T3. Used to treat clients with Graves Disease, thyro toxicosis. Antithryoid medications are prescribed for clients who ha
Thyroid-Radioactive Iodine (hyperthyroidism)
At high doses, thyroid radioactive iodine destroys thyroid cells. This drug is used for clients who have thyroid cancer and an over active thyroid (hyperthyroidism).
Thyroid-NonRadioactive Iodine (hyperthyroidism)
This medication creates a high level of iodine that will reduce iodine uptake by the thyroid gland. It inhibits the thyroid hormone production and blocks the release of thyroid hormones into the bloodstream.
This medication tastes nasty; has a metallic ta
Oral Hypoglycemic Agents
These medications promote insulin release from the pancreas. Clients who are prescribed oral hypoglycemic agents do not produce enough insulin to lower their blood glucose (blood sugar) levels. Prescribed for clients with type 2 Diabetes Mellitus.
Common
For Insuline Overdose
Common medication for insulin overdose: Gluc agon (see the form of glucose in the drug name?) Glucagon (or glucose) is needed to increase blood glucose or blood sugar.
Anterior Pituitary Hormons/Growth Hormones
These medications stimulate growth. Are used to treat growth hormone deficiencies.
Use cautiously in clients who have Diabetes Mellitus since these medications cause hyperglycemia because of the decreased use of glucose.
Common Anterior Pituitary Hormones
Posterior Pituitary Hormones/Antidiuretic Hormone
This medication promotes the reabsorption of water within the kidneys; causes vaso constriction due to the contraction of vascular smooth muscle.
Common Posterior Pituitary Hormones/Antidiruetic Hormones:
desmopressin (DDAVP, stimate)
vaso pressin (Pitres
Anticonvulsants
The anticonvulsants are medications used for the treatment of epileptic seizures. These meds suppress the rapid and firing of neurons in the brain that start a seizure.
Drugs for all types of seizures, except petit mal:
CaPhe like cafe in French
CA rbamaz
Antiparkinsonian
An antiparkinson, or antiparkinsonian medications are used for clients diagnosed with Parkinson's Disease.
These medications increase dopamine activity or reduce acetylcholine activity in the brain. They do not halt the progression of the disease. These m
Opthalmic
Ophthalmic medications are drugs used for the eye. These medications are typically prescribed for clients who have Glaucoma, Macular Degeneration. Other ophthalmic medications are used to treat allergic conjunctivitis, inflammatory disorders, dyes to visu
Gestational diabetes mellitus
Impaired tolerance to glucose with the first onset or recognition during pregnancy
Hyperemesis Gravidarum
Severe morning sickness with unrelenting, excessive nausea or vomiting that prevents adequate intake of food and fluids
HELLP syndrome
A variant of gestational hypertension where hematologic conditions coexist with severe preeclampsia and hepatic dysfunction.
Gestational hypertension
Hypertension beginning after the 20th week of pregnancy with no proteinuria.
Mild preeclampsia
Hypertension beginning after the 20th week of pregnancy with 1 to 2+ proteinuria and a weight gain of more than 2 kg per week in the second and third trimesters.
Eclampsia
Severe preeclampsia symptoms with seizure activity or coma
Taking in phase
24-48 hours after birth: dependent, passive; focuses on own needs; excited, talkative
Taking hold phase
focuses on maternal role and care of the newborn; eager to learn; may develop blues
Letting go phase
Focuses on family and individual roles
Cephalopelvic disproportion
When the fetus has a head size, shape or position that does not allow for passage through the pelvis.
Presentation
Includes cephalic, breech and shoulder.
Longitudinal lie
The fetal long axis is parallel to the mother's long axis. The fetus is either in a breech or vertex presentation
Duration
The amount of time elapsed from the beginning of one contraction to the end of the same contraction.
Intensity
The strength of the uterine contraction.
Transverse lie
The long axis of the fetus is at a right angle to the mother's long axis. This is incompatible with a vaginal delivery if the fetus remains in this position
Frequency
The amount of time from the beginning of one contraction to the beginning of the next contraction
Regularity
The amount of consistency in the frequency and intensity of contractions.
Station
The relationship of the presenting part to the maternal ischial spines that measures the degree of descent of the fetus.
missing birth control pills...
In the event of a client missing a dose the nurse should instruct the client that if one pill is missed to take as soon as possible. If two or three pills are missed the client should follow the manufacturer's instructions and use an alternative form of c
pediatric acetaminophen levels
>200 mcg/ml
pediatric carbon dioxide
cord--> 14-22
premature 1 week --> 14-27
newborn --> 13-22
infant, child --> 20-28
pediatric chloride level
Cord --> 96-104
Newborn --> 97-110
Child --> 98-106
Conjugated direct Bilirubin level
0.0-0.2 mg/dl
pediatric creatinine level
cord --> 0.6-1.2
newborn --> 0.3-1.0
infant 0.2-0.4
child --> 0.3-0.7
adolescent --> 0.5-1.0
pediatric Digoxin toxic concentration
> 2.5 ng/ml
pediatric Glucose (Serum)
Newborn, 1 day --> 40 to 60
Newborn, > 1 day --> 50 to 90
Child --> 60 to 100
pediatric Hematocrit levels
1 day --> 48-69%
2 day --> 48-75%
3 day --> 44-72 %
2 month --> 28-42 %
6- 12 year --> 37-49%
12- 18 year Male --> 37-49%
12-18 year Female --> 36-46%
Antigout Medications - What is gout?
Gout is a type of arthritis. In healthy people the body breaks down dietary purines and produces uric acid. The uric acid dissolves and is excreted via the kidneys. In individuals affected with gout the body either produces too much uric acid or is unable
Anti-reabsorptives
What is anati-reabsorptive?
Bone is a living organ which is continually being removed (resorbed) and rebuilt. Osteoporosis develops when there is more resorption than rebuilding. Antiresorptive medications are designed to slow bone removal and or improve
Antirheumatics
What is rheumatoid arthritis?
Rheumatoid arthritis (RA) is a chronic disease that results in inflammation of the joints and surrounding tissues. RA affects the lining of the joints and the painful swelling can result in bone erosion and joint deformities.
Antineoplastics
Antineoplastics are used combat cancerous cells.
There are many kinds of anti-cancer drugs with a variety of actions. But in simple terms this category of drugs attack cells that multiply and divide. This very action which can kill cancer cells can also d
Oral hypoglycemics
What is diabetes?
Diabetes is a disorder that affects glucose metabolism.
Type 1 diabetes: The client either makes no insulin or not enough insulin.
Type 2 diabetes: The client makes enough insulin at least early in the disease but is unable to transport
Mental Status Exam
All clients should have a Mental Status Exam, which includes:
Level of consciousness
Physical appearance
Behavior
Cognitive and intellectual abilities
The nurse conducts the MSE as part of his or her routine and ongoing assessment of the client. Changes i
Use the following communication tips when answering questions on NCLEX:
* If the client is anxious or depressed - use open-ended, supportive statements
* If the client is suicidal - use direct, yes or no questions to assess suicide risk
* If the client is panicked - use gentle guidance and direction
* If the client is confuse
ECT
The most common type of brain stimulation therapy is electronconvulsive therapy or ECT. ECT is generally performed for major depressive disorders, schizophrenia or acute manic disorders. Most clients receive therapy three times a week for two to three wee
Anxiety disorders
Anxiety disorders are common mental health disorders. Generalized Anxiety Disorder, Panic Disorder, Phobias, Obsessive Compulsive Disorder, and Posttraumatic stress disorder (PTSD) are all considered types of anxiety disorders. Assess the client for risk
Depressive disorders
A classic symptom of depression is change in sleep patterns, indecisiveness, decreased concentration, or change in body weight. Any client who shows these signs or symptoms should be asked if they have suicidal ideation. Teach clients to never discontinue
Bipolar disorders
Bipolar disorders are mood disorders with periods of depression and mania. Clients have a high risk for injury during the manic phase related to decreased sleep, feelings of grandiosity and impulsivity. Hospitalization is often required and nurses should
abuse
There are several different types of abuse, including physical, sexual, or emotional. Abuse tends to be cyclic, following a pattern on tension building, battering and honeymoon phase. When test questions appear related to abuse, look for the phase to dete
violent clients
For the aggressive or violent client, setting boundaries and limits on behavior are important. The nurse should maintain a calm approach and use short, simple sentences.
SSRI's
SSRIs: Selective Serotonin Reuptake Inhibitors. These medications include Citalopram (Celexa), Fluoxetine (Prozac), or Sertraline (Zoloft). The client should avoid using St. John's Wort with these medications, and should eat a healthy diet while on these
TCAs
TCAs: Tricyclic Antidepressants. Amitriptyline (Elavil) is an example. Anticholinergic effects and orthostatic hypotension may occur.
MAOIs
MAOIs: Monoamine Oxidase Inhibitors. Phenelzine (Nardil) is an example. Hypertensive crisis may occur with tyramine food ingestion, so care must be taken to avoid these substances. Educate the client to avoid all medications until discussed with provider.
Atypical antidepressants
Atypical antidepressants. Bupropion (Wellbutrin) is the most common example. Appetite suppression is a common side-effect. Headache and dry mouth may be severe and client should notify the provider if this occurs. Atypical antidepressants should not be us
SNRI's
Serotonin Norepinephrine Reuptake Inhibitors. Common SNRIs include Venlafaxine (Effexor) and Duloxetine (Cymbalta). Adverse effects may include nausea, weight gain, and sexual dysfunction.
Antagonists
In order to understand how antagonist drugs work, you need to understand how agonist drugs produce therapeutic effects. Agonists are simply drugs that allow the body's neurotransmitters, hormones, and other regulators to perform the jobs they are supposed
Antidotes
Antidotes are agents given to counteract the effects of poisoning related to toxicity of certain drugs or substances. Antidotes are extremely valuable, however most drugs do not have a specific antidote.
Atropine--> is the antidote for muscarinic agnostic
Bronchodilators
Bronchodilators are used to treat the symptoms of asthma that result from inflammation of the bronchial passages, but they do not treat the inflammation. Therefore, most clients with asthma take an inhaled glucocorticoid concurrently to provide the best o
ACE inhibitors
ACE inhibitors block the production ofangiotensin II which results in vasodilation, sodium and water excretion, and potassium retention. Drugs in this class are used for treating heart failure, hypertension, myocardial infarction, and diabetic or nondiabe
Vasodilators
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