Nclex- Random Flashcards

heart rate
Terms Definitions
QRS complex
0.04-0.10
newborn pulse rate
120-160
Telangiectasias
Telangiectasias, or vascular "spiders," are tiny, star-shaped or branch-shaped, slightly raised and pulsating end-arterioles usually found on the neck, thorax, face, and arms. They occur as a result of elevated levels of circulating estrogen. The "spiders" usually disappear after birth.
AICD
automatic internal cardioverter defibrillator detects and delivers an electric shock to terminate life-threatening v. tach and v. fib. These devices are implanted in clients who are considered high risk, including those who have survived sudden cardiac death unrelated to myocardial infarction, those who are refractive to medication therapy, and those who have syncopal episodes related to ventricular tachycardia.
GGT
Gamma-glutamyl transferase. more specific than ALP (elevated in bone or liver disease). GGT is also raised in alcohol and hepatotoxic drugs and is useful to monitor drug tox and alcohol abuse
resonance
found with air-filled tissue
DDAVP
Desmopressin given to treat DI.
trousseau's sign
positive sign indicates hypocalcemia.
hypocalcemia
tingling, numbness, tetany, seizures, abdominal cramps, prolonged QT intervals, hypotension.
α-Glucosidase inhibitors
α-Glucosidase inhibitors inhibit carbohydrate digestion.
packed RBCs
complete transfusion within 4h
Hypercortisolism causes:
hypergylcemia, osteoporosis, buffalo hump, moon face, obesity.
newborn respiratory rate
30-60 per min
pt with HYPOTHYROIDISM should avoid
nARCOTICS
Hypertonic dystocia
Hypertonic dystocia usually occurs during the latent phase of labor and contractions would be painful, frequent, and usually uncoordinated.
salicylism
Salicylic acid is absorbed readily through the skin, and systemic toxicity (salicylism) can result. Symptoms include tinnitus, dizziness, hyperpnea, and psychological disturbances.
risperdal
s/s: wt gain, orthostatic hypotension, insomnia
PSA
prostrate specific antigen test should begin at age 50 in men. men with a strong fam history of prostrate cancer or black men should begin earlier.
digital exam prior to blood testing may lead to falsely elevated levels of PSA (glycoprotein that is found only in the cytoplasm of the epithelial cells of the prostrate)
tamoxifen
anti-estrogenic med used to treat cancer of the breast in both pre- and post-menopausal women. it has shown to delay recurrences
ginkgo bilobav
herb that enhances memory/cognition delaying alzheimers
reduces effectiveness of coumadin
IABP
Intra-aortic balloon pump therapy most often is used in the treatment of cardiogenic shock and is most effective if instituted early in the course of treatment. Use of the IABP is contraindicated in clients with aortic insufficiency and thoracic and abdominal aneurysms. This therapy is not used in the treatment of congestive heart failure or pulmonary edema.
preeclampsia
The three classic signs of preeclampsia are hypertension, generalized edema, and proteinuria
GTPAL
Pregnancy outcomes can be described with the acronym GTPAL. G is gravidity, the number of pregnancies. T is term births, the number born at term (longer than 37 weeks), P is preterm births, the number born before 37 weeks' gestation, A is abortions or miscarriages, the number of abortions or miscarriages (included in gravida if before 20 weeks' gestation; included in parity if past 20 weeks' gestation), and L is the number of current living children
First stage of labor
1-10 cm dilation
SE's of Dilaudid
hypOtension and respiratory depression
boutonneire deformity
inflammation of the finger tendons seen in RA which results in permanent deformity of the fingers
multiple myeloma
excessive growth and proliferation of abnormal plasma cells in the lymph nodes and bone marrow. characterized by an elevated number of al the different types of white cells in the blood. during multiple myeloma, the pt will have significant decrease in the WBC due to growth of the extra plasma cells interfering with the WBC production
albuterol (Proventil)
Montelukast is used to prevent difficulty breathing, chest tightness, wheezing and coughing caused by asthma. Montelukast is also used to prevent bronchospasm (breathing difficulties) during exercise. Montelukast is also used to treat the symptoms of seasonal (occurs only at certain times of the year), and perennial (occurs all year round) allergic rhinitis (a condition associated with sneezing and stuffy, runny or itchy nose). Montelukast is in a class of medications called leukotriene receptor antagonists (LTRAs). It works by blocking the action of substances in the body that cause the symptoms of asthma and allergic rhinitis.
take 2h b/f activities or once a day in the evening
s/s of hypoglycemia
fatigue, h/a, shakiness, nausea, drowsiness
precipitous delivery
pt delivers suddenly. uterine atony can result causing postpartum hemorrhaging. Palpate fundus q10-15m during 4th stage of labor
LAP level
left atrial pressure: 1-10 mm Hg
lamotrigine (Lamictal)
anticonvulsant. report rash - stevens johnson's syndrom and toxic epidermal necrolysis which typically occurs in first 2-8w
Lindane
Lindane (treats scabies) is applied in a thin layer to the body below the head. No more than 30 g (1 oz) should be used. The medication is removed by washing 8 to 12 hours later. In most cases, only one application is required.
Schultz presentation
Schultz presentation is the expulsion of the placenta with the fetal side presenting first and is not associated with uterine rupture.
apgar
One of the earliest indicators of successful adaptation of the newborn is the Apgar score. Scores range from 0 to 10. Five criteria are used to measure the infant's adaptation. Heart rate: absent = 0; less than 100 = 1; greater than 100 = 2. Respiratory effort: absent = 0; slow or irregular weak cry = 1; good, crying lustily = 2. Muscle tone: limp or hypotonic = 0; some extremity flexion = 1; active, moving, and well flexed = 2. Irritability or reflexes (measured by bulb suctioning): no response = 0; grimace = 1; cough, sneeze, or vigorous cry = 2. Color: cyanotic or pale = 0; acrocyanotic, cyanosis of extremities = 1; pink = 2.
One of the earliest indicators of successful adaptation of the newborn to extrauterine life is the Apgar score. Scoring ranges from 0 to 10. A score of 8 to 10 indicates that the newborn is adjusting well to extrauterine life. A score of 5 to 7 often indicates that the newborn requires some resuscitative interventions. Scores of less than 5 indicate that the newborn is having difficulty adjusting to extrauterine life and requires vigorous resuscitation.
Sunscreen efficacy
Sunscreens are most effective when applied about 30 to 60 minutes before exposure to the sun so that they can penetrate the skin. All sunscreens should be reapplied after swimming or sweating.
Short-term variability
Short-term variability refers to the beat-to-beat range in the fetal heart rate.
third stage of labor
delivery of the placenta
assessment of the abdomen
inspection, auscultation, percussion and palpation
When does the posterior fontanelle close?
2-3 months
What is used to diagnose interstitial cystitis?
cytoscopy
Crohn's disease
Crohn's disease is a form of inflammatory bowel disease (IBD). It usually affects the intestines, but may occur anywhere from the mouth to the end of the rectum (anus).
s/s: Crampy abdominal (belly area) pain, Fever, Fatigue, Loss of appetite, Pain with passing stool (tenesmus), Persistent, watery diarrhea, Unintentional weight loss
diet: avoid high fiber, fatty, gassy, drink lots of water
fetal Heart rate
First trimester: 160-170 and slows with fetal growth.
Near and at term: 120-160
saw palmetto
herb that promotes urinary health such as BPH
3rd stage
Delivery of neonate to delivery of placenta. Placental separation and expulsion.
schultze presentation: shiny fetal surface of placenta emerges first.
duncan presentation: dull maternal surface of placenta emerges first
Goodell's sign
(softening of the cervix that occurs at the beginning of the second month),
Meds that increase blood glucose
Corticosteroids, thiazide diuretics, and lithium may decrease the effect of glyburide, thus causing hyperglycemia.
Mammogram
should be done every yr after age 40
Butorphanol tartrate (Stadol)
Butorphanol tartrate is an opioid analgesic that provides systemic pain relief during labor.
ovarian cycle
The ovarian cycle consists of three phases, the follicular, ovulatory, and luteal phases
Silver sulfadiazine (Silvadene)
Silver sulfadiazine (Silvadene) is an antibacterial that has a broad spectrum of activity against gram-negative bacteria, gram-positive bacteria, and yeast. It is applied directly to the wound to assist in healing. It does not stain the skin. Used for treating burns
Cardiac Tamponade s/s
tachycardia, distant or muffled heart sounds, jugular vein distention, and a falling blood pressure accompanied by pulsus paradoxus (a drop in inspiratory BP greater than 10 mm Hg).
murmur
has a swishing or a whistling quality. they are caused by turbulent blood flow through the valves or ventricular outflow tracts. low and medium frequency sounds are more easily heard with the bell of the stethoscope applied lightly to the skin; high frequency sounds are more easily heard with a diaphragm. a murmur may be a sign of valvular disease
gentamycin (Garamycin)
Gentamicin may cause damage to the kidneys and/or nerves. Kidney function and drug levels in the blood may be monitored with blood tests during treatment. Tell your doctor if you experience hearing loss, dizziness, numbness, skin tingling, muscle twitching, or seizures which may be signs of nerve damage.
allopurinol (Zyloprim)
Allopurinol is used to treat gout, high levels of uric acid in the body caused by certain cancer medications, and kidney stones. Allopurinol is in a class of medications called xanthine oxidase inhibitors. It works by reducing the production of uric acid in the body. High levels of uric acid may cause gout attacks or kidney stones. Allopurinol is used to prevent gout attacks, not to treat them once they occur.
No Warfarin - can increase risk for bleeding
Terbutaline (Brethine)
oral, long term tx of chronic asthma
prazosin (Minipress)
Prazosin is used alone or in combination with other medications to treat high blood pressure. Prazosin is in a class of medications called alpha-blockers. It works by relaxing the blood vessels so that blood can flow more easily through the body. Prazosin comes as a capsule to take by mouth. common s/e: orthostatic hypotension
Unstable angina
Unstable angina occurs at lower and lower levels of activity or at rest, is less predictable, and is often a precursor of myocardial infarction.
Long term cortisone therapy can cause:
osteoporosis, weakness, muscle-wasting, depression, alopecia, buffalo hump, obesity, mood swings, slow wound healing
1gr = how many mg?
1gr=60mg therefore 10gr=600 mg
alprazolam (Xanax)
high risk of abuse. not for alcohol abusers
antidote for hypertensive crisis
The antidote for hypertensive crisis is phentolamine, and a dosage of 5 to 10 mg is administered by intravenous injection. Hypertensive crisis may be manifested by hypertension, occipital headache radiating frontally, neck stiffness and soreness, nausea, vomiting, sweating, fever and chills, clammy skin, dilated pupils, and palpitations. Tachycardia or bradycardia and constricting chest pain also may be present.
permethrin (Elimite, Nix, Acticin)
Used to treat pediculosis capitus (lice). The instructions for the use of permethrin include wash, rinse, and towel-dry hair, apply sufficient volume to saturate hair and scalp, allow to remain on hair 10 minutes, and then rinse with water
Alendronate sodium (Fosamax)
prevent dev of osteoporosis. may be given with full glass of water first thing in AM on empty stomach at lease 30 min prior to consuming food/beverage. after taking med, pt must remain seated upright for min of 30m to prevent esophageal irritation
sotalol hydrochloride (Betapace)
Sotalol is used to treat irregular heartbeats. Sotalol is in a class of medications called antiarrhythmics. It works by acting on the heart muscle to improve the heart's rhythm. Sotalol comes as a tablet to take by mouth. s/e: decreased heart rate
pericardial friction rub
has a scratching, grating or squeaking leathery quality. tends to be high in frequency and best heard with the diaphragm with pt leaning forward. it is a sign of pericardial inflammation and may be heard with infective carditis with MI, following cardiac sx or trauma, and with some autoimmune problems such as rheumatic fever
low-pressure alarm on ventilator
leak with ventilator circuitry or disconnection from vent tubing. almost all low-pressure alarms are from malfunction or displacement of connections
total (simple mastectomy)
removal of the entire breast with lymph nodes intact
how many mg/kg of iron per day is needed?
women-15
men-10
pregnant=30
In vitro fertilization
In vitro fertilization is a method of medically assisted reproduction for women with nonpatent, diseased, or missing fallopian tubes or with infertility of unknown etiology. Ova and sperm are obtained from the potential parent or donor, placed in a nutrient medium, and allowed to incubate, and then the fertilized ovum is transferred into the woman's uterus. The woman houses the pregnancy throughout gestation and gives birth
ammonia value
The normal ammonia value is 15 to 45 mcg/dL
fluoxetine (Prozac)
is an SSRI and is used to treat depression, obsessive-compulsive disorder (bothersome thoughts that won't go away and the need to perform certain actions over and over), some eating disorders, and panic attacks (sudden, unexpected attacks of extreme fear and worry about these attacks). Fluoxetine (Sarafem) is used to relieve the symptoms of premenstrual dysphoric disorder, including mood swings, irritability, bloating, and breast tenderness.
No Nsaids!
normal absolute neutrophil count
Filgrastim is used to promote the growth of neutrophils and enhance the function of mature neutrophils. Treatment is continued until the absolute neutrophil count reaches 10,000/mm3.
penrose drain
is a surgical device placed in a wound to drain fluid. It consists of a soft rubber tube placed in a wound area, to prevent the build up of fluid.
use montgomery strap adhesive strips to secure
Fetal Development: week 8
At gestational week 8, the eyelids begin to fuse.
Sodium hypochlorite (Dakin's solution)
Sodium hypochlorite is a solution used for irrigating and cleaning necrotic or purulent wounds. It cannot be used to pack purulent wounds because the solution is inactivated by copious pus. The solution should not come into contact with healing or normal tissue and should be rinsed off immediately following irrigation. The solution loses its potency during storage, so fresh solution should be prepared frequently.
Does a pt hypo or hypervetilate in respiratory alkalosis?
HYPERVENTILATION.....
CAUSES THINK OVERSTIMULATION OF THE RESP. SYSTEM..LIKE HYSTERIA, HYPERVENTILATION, ANXIETY,ECT..
pressure equalization tubes
stay in place for 1-2y until they fall out on their own
Fetal Development: week 28
At 28 weeks of gestation, the fetus weighs approximately 1200 g.
Position assumed by children with congenital heart disease; tetralogy of fallot to relieve hypoxia
squatting position with arms wrapped around the legs
what does a swan-ganz catheter measure
neasures the pulmonary artery wedge pressure which indirently measures the pressure in the ventricles
Before infusion of Dopamine the nurse should?
Assess patency of the IV
Which lab value is result of massive cell destruction from chemo?
Hyperuricemia (increased uric acid level) is especially common following treatment for leukemias and lymphomas because chemotherapy results in massive cell kill.
Fetal Development: week 5
The fetal heart begins to beat at week 5. By gestational week 5, double heart chambers are visible by ultrasound and the heart begins to beat. The fetal heart is only two parallel tubes at week 3. At week 5, the heart can be visualized only by ultrasound. To be heard by Doppler, the gestation must be 12 weeks; to be heard by fetoscope, the gestation must be at 20 weeks.
Which result indicates pregnancy?
hCG can be detected in the blood as early as 6 days after conception or 20 days after the last menstrual period.
MOST important intervention after pt has been placed in physical restraints?
check that the restraints have been applied correctly
Risk factor for colorectal cancer:
diet high in fat, high in protein, low on fiber
An important nursing consideration for a pt with Myasthenia Gravis
assess muscle groups toward the end of the day
normal heart rate for a newborn infant
The normal heart rate for a newborn infant ranges from approximately 110 to 160 beats/min.
What is the function of a Miller-Abbott Tube?
removes fluid and gas from the small intgestines..often used for tx of paralytic ileus
The reason a fluid challenge is given to a pt with possible acute renal failure is
to rule out dehydration as the cause of oliguria
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