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NLE / CGFNS / Nclex Review Materials 3

41. DIC
• Bruising, purpura
• Presence of occult blood
• Low fibrinogen level, hct, platelet
• Increased PT, PTT
• Complication: RENAL FAILURE

42. PERIPHERAL ARTERIAL DISEASE


• Dry scaly skin on lower extremities
• Rest Pain, at night
• Intermittent claudication/
• Thickened toenails
• Cold & gray-blue color of skin
• Decreased or absent peripheral pulses
• Instruct pt. to walk to point of claudication, stop & rest & walk a little farther

43. THROMBOPHLEBITIS
• Avoid pressure behind legs
• Avoid prolonged sitting
• Avoid constrictive clothing
• Avoid crossing the legs
• Avoid massaging the legs

44. SYPHILIS
Painless chancre fades after 6 weeks
Low grade fever
Copper-colored rash on palms and soles of feet
Spread by contact of mucous membranes
Treat with Penicillin G IM
If patient has penicillin allergy, will use erythromycin for 10-15 days.
After treatment, patient must be retested to make sure disease is gone

45. POLYCYTHEMIA VERA


• Increased RBC
• Leukocytosis / Thrombocytosis
• Angina
• Intermittent claudication
• Dyspnea /HPN
• Lethargy / Syncope / Paresthesia

46. PRIMARY HPN


Risk Factors:
• Aging
• Black race
• Chronic stress
• Family Hx
• Obesity
• Smoking
• Men

47. CHOLECYSTITIS
Sx:
•N&V
• Belching
• Indigestion
• Flatulence
• Epigastric pain that radiates to the scapula 2 hrs. after eating fatty food
• Pain localized in RLQ
• Guarding, rigidity & rebound tenderness
• Cannot take a deep breath when fingers are pressed below hepatic margin
(Murphy’s Sign)

II. COMPUTATION
1. Dopamine
2. Dobutamine drip: Order is 2.5mcg/kg/min, patient weights 176 lbs.
Stock is 500mg in 500ml of NSS,
Compute for ml/hr?

Formula: Stock (mg) x 1000 mcg/mg


Quantity (ml)
Flow rate: Dose (mcg/kg/min) x wt (kg) x
60 min/hr
Concentration
(mcg/ml)

Answer: 12ml/hr

3. Md with IV order for patient 3,000ml in 24 hrs., get the rate at ml per hour.
Solution: 3000/24 = 125 ml/hr

4. Tablets : Dose of 20 mg per dose in stock dose of 5 mg per tablet, how many
tablets?
Solution: 20/5 x 1 = 4 tablets

III. TOPICS
1. SAFETY INFECTION CONTROL

AIRBORNE : Hepa Filter Mask / N95

Particulate MASK
PTB
Measles / Rubella
Chicken Pox/
Varicella
SARS
Anthrax

CONTACT : GGG
(gown,gloves,goggles)
Conjunctivitis
Open wounds /drainage
Lesions
MRSA / VRSA /
CDAD
RSV/ VRE

DROPLET : Surgical Mask


Scarlett Fever
Diphtheria
Meningitis
Strep. Pharyngitis
Pneumonia

ENTERIC: Gown , Gloves


Diarrhea
Hep. A
Salmonella
Acute Gastroenteritis
Peptic H. Pylori
Shigella / Rotavirus Giardiasis /
Cryptosporidium Muris

FROTECTIVE:
Blood dyscrasias
Aplastic anemia
Leukemia
Major burns (50%)
Organ transplant
Aids
Multiple Myeloma
Prolong Steroid Therapy

Concepts:
1. Infection control:
a. clean with clean for example patients with CVA, DM, Cardio disease

2. Same precaution techniques:


a. Universal precaution: Hep B,D, AIDS

2. PRIORITIZATION
Remember the rule of stable vs. unstable. Although you consider the client
unstable but if it expected in him, this is stable. Example. Asthma with wheezing-
you consider this unstable.
ABC, unstable , first think EXPECTED in asthma so this will be considered stable.

3. DELEGATION
RN - Newly admitted, needs assessment, pre op teaching and post op, nsg.
Judgment & discharge planning ,IV meds, BT.

LPN-Can give meds except IV, sterile techniques like wound dressing,
catheterization, insertion of NG tube, remove sutures. Stable expected outcome.

NA/ UAP/CN/ Senior nursing student - All “-ing” ex bathing, reading v/s in
long term pt. Testing occult blood, BS, monitoring, soap sud enema, testing
occult blood,
-Isolation precautions, basic hygiene ADL, Input & Output, Finger stick with
gestational diabetes, urinalysis, TSB, turning unconscious patient, change
perineal pad, assist in ambulation,
discharge tomorrow,
-Stable v/s, pulse oximetry, reading,
terminally ill because of comfort only
needed.
- Routinary Procedure

4. Patient Hx C/I for MRI :


• Mitral Valve Replacement
5. Glaucoma :
• Halos around light

6. U waves :
• Hypokalemia

7. Patient with arterial insufficiency


• Elevate the affected leg

8. Patient with Dumping Syndrome:


• Avoid cheese

9. Adverse Effect of Anti-metabolite 5FU


• Stomatitis

10. Obtaining sputum specimen from pt. with tracheostomy:


• Instruct pt. to cough prior to obtaining sputum

11. Post-hypophysectomy pt. Report if:


• Specific Gravity of 1.005

12. Diet for Hypothyroidism


• Low sodium, High K

13. Patient with CHF cor pulmonale S & S


• Jugular vein distention & peripheral edema

14. Circumcision of a new infant:


• Diaper fasted loosely

15. Acute Pancreatitis


• Increase lipase/amylase

16. Short-term goal for anti-social patient


• Follow unit rules

17. Use of walker


• Partial weight bearing
• Stand in front, walk unto walker

18. Borderline patient


• Splitting

19. Neonates in nursery developed diarrhea


• Meconium stool study w/in 24 hrs.

20. Nsg. Action in pt. post cardiac catherization


• Check pulse in lower extremities

21. Diet for Diverticulitis


• Avoid high-fiber foods when inflammation occurs, only low residue
• Introduce soft high-fiber foods when inflammation has resolved

22. Low iron.WBC & albumin, what type?


• Nutritional deficit (malnutrition)

23. What will you ask on pt for cardiac stress test (Thallium stress test)?
• Is he on beta-blocker? (if with radionuclide already, Persantine, then invasive &
shld.
avoid caffeine, calcium channel blockers, b-blockers, theophylline)

24. Highest risk of accident


• 9 month infant eating grapes & apricot

25. Pancrease in Cystic Fibrosis


• Give with meals, dilute in applesauce

26. Client post-CVA, diet teaching


• Low salt, low fat

27. Client passing stones with calcium, diet teaching:


• Should be acid-ash diet & avoid oxalate rich & Ca rich food such as tea,
almonds, rhubarbs beans, spinach, cocoa, vegetables, fruits
• Give cranberries, prunes, plums, tomatoes, cereals, corn, legumes I

28. Paget’s Disease


• Bowing of bones

29. Side Effect of Ansef (Cefazolin)


• Antibiotic (RTI,URTI)
• Diarrhea, Nausea
• Oral candidiasis
• Pancythopenia

30. Peptic ulcer disease


• Avoid stressful situation to prevent exacerbation

31. Schilling’s Test


• For pernicious anemia

32. Prior To MUGA SCAN:


• Informed consent
• Allergy not a concern

33. Action of Aquamephyton


• Prevention of hypoprothrobinemia

34. Action of Lipitor


• Anti-lipimec

35. Positioning of Hip Spica Cast in children


• Maintain flexion, abduction & external rotation

36. Fear of 3 y/o child


• Injury (abandonment, castration)

37. To prevent ureteral stones


• Increase fluids

38. MDI
• Hold breath

39. Frostbite
• Soak in warm water
40. Normal respiratory changes in elderly
• Decreased cough reflex

41. Patient w/ DM & HPN, question if


• Given beta-blocker (causes bronchospasm )

42. Maximum injection on 10 month old infant


• 1 ml

43. Pt. with endometriosis takes Danocrine, action of the drug?


• Suppress menstruation/ ovulation

44. Post NSD with epidural anesthesia with bladder distension


• Offer bedpan

45. Apmhotericin B, side effect?


• Headache
• Hypokalemia
• Hypotension

46. PT. with angina unrelieved by 3 nitroglycerin


• Administer O2

47. Patient on Halo Vest


• Tape the wrench to the vest (Torque screw)

48. Pre-menopausal syndrome experiencing hot flashes


• Black Cohosh for menoposh

49. Abdominal Assessment


• Inspection
• Auscultation
• Percussion
• Palpation

50. Sclerotherapy
• Application of pressure dressing for 12-48 hrs.