Garlic - antihypertensive (avoid aspirin) Ginseng - Anti stress (C/I in coumadin) Green tea - antioxidant (check if risk for
Licorice - cough and cold
Ginger root - antinausea (C/I in Coumadin)
Ginkgo - improves circulation (C/I in anticoagulant,
V - vomiting
D - diarrhea
A - abdominal pain
Drugs which can cause URINE DISCOLORATION
Rifabutin--------- Red orange
Rifampicin------- Red orange
Bactrim---------- Red orange
Robaxin--------- Brown, Black or Greenish
Azulfidine------ Orange yellow
Dilantin---------- Pink tinged
Anti Psychotic-- Pinkish to Red brown
Early signs of hypoxia:
Late signs of hypoxia:
Kussmaul- fruity acetone breath odor
Cheyne-stokes- near death breathing pattern
Seasonal Affective Disorder (SAD) may affect over 10 million
The typical symptoms of SAD include depression, lack of energy,
increased need for sleep, a craving for sweets and weight gain.
Symptoms begin in the fall, peak in the winter and usually resolve in
the spring. Some individuals experience great bursts of energy and
creativity in the spring or early summer.
Susceptible individuals who work in buildings without windows may
experience SAD-type symptoms at any time of year. Some people with
SAD have mild or occasionally severe periods of mania during the
spring or summer. If the symptoms are mild, no treatment may be
necessary. If they are problematic, then a mood stabilizer such as
Lithium might be considered. There is a smaller group of individuals
who suffer from summer depression.
SAD is recognized in the DSM-IV (The American Psychiatric
Association's diagnostic manual) as a subtype of major depressive
Some individuals who work long hours inside office buildings with few
windows may experience symptoms all year round. Some very
sensitive individuals may note changes in mood during long stretches
of cloudy weather.
A sign of improvement from dehydration would be a decreased urine
specific gravity and a decreased/decreasing hematocrit. So the SG of
1.015 and a Hct of 46% would be the answer. It is the best answer of
the two you had in you question.
The normal urine SG is 1.003-1.035 (Usually between 1.010-1.025
with normal hydration and volume) (different texts give a slightly
SG 1.025-1.030+ (concentrated urine)
SG 1.001-1.010 (dilute urine)
SG 1.001-1.018 in infants under 2 years of age
Specific gravity is a measurement of the kidney's ability to concentrate
urine. The range of urine's SG depends on the state of hydration and
varies with urine volume and the load of solids to be excreted under
standardized conditions; when fluid intake is restricted or increased, SG
measures the concentrating and diluting functions of the kidney. Loss
of these functions is an indication of renal dysfunction.
SG values usually vary inversely with amounts of urine excreated
(decrease in urine volume = increase in specific gravity). However in
some conditions this is not the case.
OU- both eyes
OR- right eye
OS- left eye
C = Check VS, particularly BP
U = Urinary output & weight monitoring
S = Stress Management
H = High CHON diet
I = Infection precaution
N = Na+ restriction
G = Glucose & Electrolytes Monitoring
S = Spousal support
Hirschsprung\u2019s diagnosed with rectal biopsy looking for absence of
ganglionic cells. Cardinal sign in infants is failure to pass meconium,
and later the classic ribbon-like and foul smelling stools.
Intussusception common in kids with CF. Obstruction may cause fecal
emesis, currant jelly-like stools (blood and mucus). A barium enema
may be used to hydrostatically reduce the telescoping. Resolution is
obvious, with onset of bowel movements.
With omphalocele and gastroschisis (herniation of abdominal contents)
dress with loose saline dressing covered with plastic wrap, and keep
eye on temp. Kid can lose heat quickly.
Nephrotic syndrome is characterized by massive proteinuria (looks
dark and frothy) caused by glomerular damage. Corticosteroids are the
mainstay. Generalized edema common.
A positive Western blot in a child <18 months (presence of HIV
antibodies) indicates only that the mother is infected. Two or more
positive p24 antigen tests will confirm HIV in kids <18 months. The
p24 can be used at any age.
For HIV kids avoid OPV and Varicella vaccinations (live), but give
Pneumococcal and influenza. MMR is avoided only if the kid is
severely immunocompromised. Parents should wear gloves for care,
not kiss kids on the mouth, and not share eating utensils.
An antacid should be given to a mechanically ventilated patient w/ an ng tube if the ph of the aspirate is <5.0. Aspirate should be checked at least every 12 hrs.
retractions, air hunger, cyanosis.
Normal PCWP is 8-13. Readings of 18-20 are considered high.
First sign of PE (pulmonary embolism) is sudden chest pain, followed
High potassium is expected with carbon dioxide narcosis (hydrogen
floods the cell forcing potassium out). Carbon dioxide narcosis causes
increased intracranial pressure.
Sample Test Item:
1. Which of the following clients should the nurse deal with FIRST?
o 1 A client who needs his daily vitamin
o 2 A client who needs to be suctioned
o 3 A client who needs diaper to be changed
o 4 A client who is being prepared for discharge
Correct Answer: 2. A client who needs to be suctioned
Obstruction in the airway \u2013 secretions
Need to be suctioned
2. Delegation, RN, LVN, UAP, CNA
Which of the following clients should the LPN be assigned to?
o 1 A newly diagnosed patient with MYASTHENIC CRISIS
o 2 An immediate post-op client in PACU
o 3 A client awaiting medication for vitamins
o 4 A new admission for KIDNEY Transplant Patient
Correct Answer: 3-stable, A client awaiting medication for vitamins
Myasthenic Crisis \u2013 Unstable, Acute Respiratory Failure
Immediate Post \u2013 op \u2013 Unstable, Risk for Complications,
Kidney Transplant \u2013 Unstable, needs assessment for rejection
DELEGATION: Remember the 5R's, Right Task, Right Person, Right
Circumstance, Right Communication & Right Feedback)
RN Least stable, unstable, central catheters (hickman, broviac),
admission, discharge, health teachings, patient for transfer, blood
LPN Technical Doer, Stable, medications, wound dressing
CNA Routine Care, Urine Dip Stix, Reporting to RN, Routine VS
UAP turning q2H, conducting group activities, ambulation
For future USRNs
This is for you... from the purkinje fibers of my heart....
Room Assignment(Who to Share Room with)
C hain of infection/circumstance
E nviroment (dim light, darkened, red nightlapm)
Sample Test Item:
The best roommate for patient with LEUKEMIA is
O 1 A 9-year-old with ruptured appendix
O 2 A 12-year-old with chicken pox
O 3 A 2-year-old with fever of unknown origin
O 4 A 5-year-old with nephrotic syndrome
Correct Answer: 4. A 5-year-old with nephrotic syndrome.
1,2 & 3, manifest symptoms of infection. A client with leukemia is
immunosuppressed and Patients with infection shouldn't be placed in
this room. Since patient with nephrotic syndrome receives diuretics and
steroids, this child will also need immunocompromised host precaution.
Sample Test Item:
3. Which of the following methods should the RN utilize in patient with
O 1 Airborne Precautions
O 2 Droplet Precautions
O 3 Neutropenic Precautions
O 4 Enteric Precautions
The correct answer: 4.
Salmonella mode of transmission is fecal oral (enteric)
Gloves must be used in handling bedpan and diapers
Gown - if soiling is likely to happen.
Source of infection:
Contaminated food and water.
Remember - Transmission Based precautions:
B orne, small particles are dispersed in the air like MTB, varicella
C ontact, drug-resistant microorganisms
D roplet, large particles are dispersed into air, resp.infections except
E nteric, fecal-oral like hepaA & salmonella
(HOPPING WITH ONE LEG)
Sample test Item:
4. Which of the following is NOT a characteristic of a preschooler?
O 1 predominantly "parallel play" period
O 2 balances on 1 foot with eyes closed
O 3 skips on alternate feet
O 4 jumps rope
The correct answer is: 1. Parallel play is more common in
Preschooler (3-6 years)
Gross motor development
HOPS ON ONE (1) FOOT BY 4 YEARS
SKIPS & HOPS ON ALTERNATE FEET BY 5 YEARS
SUPERHEROES (Remember the movie: Jingle All The way!)
FEAR: Intrusive procedures, venipunctures, IM injections, body
Toxoplasmosis, where else you can contract this (thinking of cat litter
but it aint there)
Sample test Item:
5. To which of the following pregnant clients will be risk for
Select all that apply:
O 1 A pregnant client who eat raw meat.
O 2 A pregnant client handling cat litter of infected cats.
O 3 A pregnant client gardening and cultivating soil exposed to cat
O 4 A pregnant client with low rubella titer
O 5 A pregnant client who have undergone external radiation.
O 6 A pregnant client with draining, painful vesicles in the external
The correct answers: 1, 2 & 3.
How do people get toxoplasmosis?
A Toxoplasma infection occurs by:
Accidentally swallowing cat feces from a Toxoplasma-infected cat that
is shedding the organism in its feces.
This might happen if you were to accidentally touch your hands to your
mouth after gardening,
cleaning a cat's litter box, or
touching anything that has come into contact with cat feces.
Eating contaminated raw or partly cooked meat, especially pork, lamb,
by touching your hands to your mouth after handling undercooked
Contaminating food with knives, utensils, cutting boards and other
foods that have had contact with raw meat.
Drinking water contaminated with Toxoplasma.
Receiving an infected organ transplant or blood transfusion, though this
(From the internet-Division of Parasitic Disease)
Which of these statements by the nurse is incorrect if the nurse has the
goal to reinforce information about cancers to a group of young adults?
1. \u201cYou can reduce your risk of this serious type of stomach cancer by
eating lots of fruits and vegetables, limiting all meat, and avoiding
2. \u201cProstate cancer is the most common cancer in American men with
results to threaten sexuality and life.\u201d
3. \u201cColorectal cancer is the second-leading cause of cancer-related
deaths in the United States.\u201d
4. \u201cLung cancer is the leading cause of cancer deaths in the United
States. Yet it's the most preventable of all cancers.
Tonometry: normal (10-21 mm Hg)
PR Interval: normal (0.12-0.20 seconds)
Serum Amylase: normal (25-151 units/dL)
Serum Ammonia: normal (35 to 65 mcg/dL)
Calcium: adult (8.6-10 mg/dL)
(Female: 9.5-11.3 seconds)
Platelet Count: normal (150,000-400,000 cells/uL)
Albumin level: normal (3.4 to 5 g/dL)
Serum Osmolality: normal (285 to 295 mOsm/kg)
high value indicates dehydration
Safe Suction Range: normal [Infant] 50-95 mm Hg
[Child] 95-115 mm Hg
[Adult]100-120 mm Hg)
Serum Lithium: normal (1 to 1.5 mEq/L)
acute mania (0.6 to 1.4 mEq/L) maintenance treatment
Phenytoin (Dilantin): normal serum (10 to 20 mcg/mL)
Digoxin: therapeutic blood level (0.8 to 2.0 ng/ml)
WBC\u2019s In Pregnancy: normal (11,000 to 15,000 cells/mm3, up to
18,000 cells/mm3). Immediate postpartum period, (maybe as high as
25,000 to 30,000 cells/mm3)
Newborn infant (10 to 20 mL)
1-week-old (30 to 60 mL)
2-3-week-old infant (75 to 100 mL)
1-month-old infant (90 to 150 mL)
(Regular, Humulin R)
Type: Fast acting
Onset: \u00bd -1 hr
Peak: 2-4 hr
Duration: 6-8 hr Insulin
(NPH, Humulin N)
Type: Intermediate acting
Duration 18-26hr Insulin
(Ultralente, Humulin U)
Type: Slow acting
Duration: 24-36hr Insulin
Onset: \u00bd hr
Potassium: 3.5-5.0 mEq/L
Sodium: 135-145 mEq/L
Calcium: 4.5-5.2 mEq/L or 8.6-10 mg/dL
Magnesium: 1.5-2.5 mEq/L
Chloride: 96-107 mEq/L
Phosphorus: 2.7 to 4.5 mg/dL
PR measurements: normal (0.12 to 0.20 second)
QRS measurements: normal (0.04 to 0.10 second)
Ammonia: 35 to 65 ug/dL
Cholesterol: 140 to 199 mg/dL
LDL: <130 mg/dL
HDL: 30 to 70 mg/dL
Triglycerides: <200 mg/dL
\u2022 Direct: 0 to 0.3 mg/dL
\u2022 Indirect: 0.1 to 1.0 mg/dL
\u2022 Total: <1.5 mg/dL
Female 2.5 to 6.3 mg/dL
Glycosylated Hemoglobin HbA1c: good control 7.5% or less
Serum creatinine: 0.6 to 1.3 mg/dL
BUN: 9-25 mg/dL
Normal CK is 26-174 U/L
Troponin I value: normal (<0.6 ng/mL)
Troponin T >0.1 to 0.2 ng/mL = MI Erythrocyte studies: 0-30 mm/hour Serum iron: Male 65-175 ug/dL
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