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Mark Klimek NCLEX Review- Lecture/Yellow Book

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1. Rule of the B's: If the ____ and the _____ pH, Bicarb, Both, 12. High pressure alarms are increased
are ______ in the same direction then it is Bolic triggered by _______ resistance to
meta_____ air flow.
2. pH 7.30_______ HCO3 20_______ ↓= acidosis; ↓= 13. High pressure alarms are (kinked tube) unkink,
metabolic triggered by increased resistance (water in tube) empty,
to airflow and can be caused by (mucus in airway) cough
3. pH 7.58_______ HCO3 32_______ ↑= alkalosis; ↑=
obstructions of three types: and deep breathe
metabolic
_______ action, _______ action,
4. pH 7.22_______ HCO3 30_______ ↓= acidosis; ↑= _______ action
respiratory
14. Low pressure alarms are decreased
5. You are providing care to a client with ↓= acidosis; ↑= triggered by _______ resistance to
the following blood gas results: pH 7.32, respiratory airflow.
CO2 49, HCO3 29, PO2 80, and SaO2
15. Low pressure alarms are tubing (reconnect it),
90%. Based on these results, the client
triggered by decreased oxygen sensor tube
is experiencing:
resistance to airflow and can be (reconnect it UNLESS
6. MacKussmaul The only acid base caused by disconnections of the tube is on the floor- bag
to cause Kussmaul _______ or _______ them and call RT if this
respirations is happens)
Metabolic
16. Respiratory alkalosis means high
ACidosis
ventilator settings may be too
7. As the _______ goes, so goes _______ pH, my patient, _______
except for _______ Potassium
17. Respiratory acidosis means low
8. Up hyokalemia, ventilator settings may be too
alkalosis, HTN, _______
Tachycardia,
18. What does "wean" mean? gradually decrease with
Tachypnea,
the goal of getting off
Seizures,
altogether
Irritability, Spastic,
Diarrhea, 19. What is Maslow's highest priority 1. Physiological
Borborygme, to lowest priority? 2. Safety
hyperreflexia, etc 3. Comfort
4. Psychological
9. Down hyperkalemia,
(problems within the
acidosis, htn,
person)
bradycardia,
5. Social (problems with
constipation,
other people)
absent bowel
6. Spiritual
sounds, flacid,
bradypnea 20. Arrange from highest to lowest Electrolyte Imbalance
priority using Maslow's: (Physiological)
10. Causes of acid-base imbalances: First lung, respiratory,
Denial Fall Risk (Safety)
ask yourself, "Is it _______?" If yes, then overventilating,
Spiritual Distress Pain in Elbow (Comfort)
it's _______. Then ask yourself: "Are they underventilating,
Pain in Elbow Denial (Psychological)
_______ or _______. If _______, pick _______. overventilating,
Fall Risk Pathological Family
If _______, pick _______ alkalosis,
Pathological Family Dynamics Dynamics (Social)
underventilating,
Electrolyte Imbalance Spiritual Distress
acidosis
(Spiritual)
11. Causes of acid-base imbalances: If it's metabolic,
21. What are the 5 stages of grief? Denial
not lung, then it's _______. If the patient prolonged gastric,
Anger
has _______ _______ vomiting or suction, alkalosis,
Bargain
pick _______. For everything else that metabolic
Depression
isn't lung, pick _______ _______. When you acidosis,
Acceptance
don't know what to pick, choose _______ metabolic acidosis
_______ 22. The #1 problem in abuse is _______ denial
23. Denial is the _______ to accept the _______ refusal, reality 37. What are examples of mouth wash, cologne,
of their problem products that contain perfume, aftershave, elixir,
alcohol? most OTC liquid medicines,
24. Treating denial: _______ it by pointing out confront, say, do,
insect repellant, vanilla
to the person the difference between support
extract, vinagerettes, hand
what they _______ and what they _______. In
sanitizer
contrast, _______ the denial of loss and
grief 38. Every alcoholic goes Alcohol Withdrawal
through _______. Only a Syndrome, Delirium Tremens
25. Dependency: When the _______ gets the abuser
minority get _______
Significant Other to do things for them
or make decisions for them 39. _______ is not life- Alcohol Withdrawal
threatening. _______ an kill Syndrome, Delirium Tremens
26. Codependency: When the _______ _______ Significant Other,
you
derives positive _______ from doing things self-esteem,
for or making decisions for the _______ abuser 40. Patients with _______ are not Alcohol Withdrawal
a danger to themselves or Syndrome, Delirium Tremens
27. When treating limits, enforce
others. Patients with ________
dependency/codependency: Set _______
are dangerous to self and
and _______ them. Agree in advance on
others
what requests are allowed, then enforce
the agreement 41. AWS or DT: semiprivate AWS
room, any location
28. When treating self-esteem
dependency/codependency: Work on 42. AWS or DT: private room DT
the _______ of the codependent person near the nurse's station
29. Manipulation: when the _______ gets the abuser, 43. AWS or DT: Regular diet AWS
_______ _______ to do things for him/her significant other,
44. AWS or DT: Clear liquid or DT
that are not in the _______ _______ of the interest,
NPO diet (risk for
_______ _______. The nature of the act is significant other,
aspiration)
_______ or _______ to the _______ _______ harmful,
dangerous, 45. AWS or DT: Up at liberty AWS
significant other 46. AWS or DT: Restricted to DT
30. Treating manipulation: set _______ and limits, enforce bedrest with no bathroom
_______ privileges

31. Wernicke's (Korsakoff's) Syndrome: Psychosis, B1 47. AWS or DT: No restraints AWS
_______ induced by Vitamin 48. AWS or DT: Usually DT
_______(thiamine) deficiency restrained with either vest
32. Primary symptoms of Wernicke's amnesia or 2 point (1 arm and 1 leg)
(Korsakoff's) Syndrome: _______ with (memory loss), 49. AWS or DT: Give anti-HTN Both
_______ confabulation medication
(make up stuff)
50. AWS or DT: Give Both
33. Characteristics of Wernicke's preventable tranquilizer
(Korsakoff's) Syndrome: (take vitamin)
51. AWS or DT: Give Both
1. _______ arrestable (take
multivitamin to prevent
2. _______ vitamin)
Wernicke's
3. _______ irreversible (kills
brain cells) 52. For Aminoglycosides, think a mean old mycin
" __ ____ ___ _____"
34. Antabuse/Revia is aka _______ Therapy Aversion
53. When are to treat serious, life-
35. Onset and duration of effectiveness of 2 weeks
antibiotics/aminoglycosides threatening, resistant
Antabuse/Revia: _______
used? infections
36. Patient teaching with Antabuse/Revia: all, alcohol,
54. All aminoglycosides end in mycin, mycin
Avoid _______ forms of _______ to avoid nausea,
_______, but not all drugs
_______, _______, _______ vomiting, death
that end in _______ are
aminoglycosides.
55. What are some examples of Azithromycin, 72. What are Biological Nipeh Virus
wannabe mycins? Clarithromycin, Agents in Category C? Hanta Virus
Erythromycin
73. When it comes to A, the worst, B, C
56. What are some examples of Streptomycin, Cleomycin, Biological Agents:
aminoglycosides? Tobramycin, Tobramycin, Category __ is _______, Then
Gentamycin, Vancomycin, Category __, Then
Clindamycin Category __
57. When remembering toxic mice= ears 74. Small Pox Inhaled transmission/ on
effects of mycin's think _______ airborne precautions
dies from epticemia- no
58. What is the toxic effect of ototoxicity; monitor
treatment
aminoglycosides and what must hearing, balance, and
rash starts around mouth first
you monitor? tinitus
Category A
59. The human ear is shaped like a kidney, nephrotoxicity,
75. Tularemia chest symptoms
_______ so another toxic effect of creatinine
dies from respiratory failure
aminoglycosides is _______ so
treat with streptomycin
monitor _______
Category A
60. The number "___" drawn inside 8, 8, Q8H
76. Anthrax spread by inhalation
the ear reminds you of cranial
looks like the flu
nerve ___ and frequency of
dies from respiratory failure
administration ___
treat with supro, PCN, and
61. Do not give aminoglycosides PO hepatic encephalopathy streptomycin
expect in these 2 cases: (liver coma, ammonia- Category A
1. _______ _______ (due to high induces encephalopathy),
77. Plague spread by inhalation
_______ level) ammonia, bowel
has the 3 H's: Hemoptysis
2. Pre-op _______ surgery
(coughing up blood),
62. Who can sterilize my bowel? Neo- Kan Hematemesis (vomiting up
63. What is the reason for drawing Narrow therapeutic level blood), Hematochezia (blood
Trough and Peak levels? in stool)
deis from respiratory failure
64. When do you ALWAYS draw the 30 minutes before next
and DIC (bleed to death)
Trough? dose
treat with Doxycycline and
65. When do you draw the Peak 5-10 minutes after drug Mycins
level of Sublingual medications? dissolves no longer communicable after
66. When do you draw the Peak 15-30 minutes after 48 hours of treatment
level of IV medications? medication is finished Category A

67. When do you draw the Peak 30-60 minutes after 78. Hemorrhagic illnesses primary symptoms are
level of IM medications? injecting it petechiae (pinpoint spots) and
ecchymoses (bruising)
68. When do you draw the Peak Depends on type of high % fatal
level of SQ medications? insulin Category A
69. When do you draw the Peak Not necessary 79. Botulism it is ingested
level of PO medications? has 3 major symptoms:
70. What are Biological Agents in STAPH B descending paralysis, fever, but
Category A? Small Pox is alert
Tularemia dies from respiratory arrest
Anthrax Category A
Plague 80. What are some examples Mustard gas
Hemorrhagic illness of chemical agents that Cyanide
Botulism cause bioterrorism? Phosgine chlorine
71. What are Biological Agents in All others Sarin
Category B? 81. What is the primary Blisters (vesicant)
symptom of Mustard Gas?
82. What is the primary Respiratory arrest. Treat with 96. Negative Chronotropic slow heartbeat
symptom of Cyanide Sodium Thiosulfate IV
97. Dromotropic conductivity of heart
and how do you treat
it? 98. Positive Dromotropic excitable heart

83. What is the primary Choking 99. Negative Dromotropic blocks/slows conduction
symptom of Phosgine 100. Positive Inotropic, atropine, epinephrine, and
Chlorine? Chronotropic, and norepinephrine
84. What are the BB SLUDGE- just remember every Dromotropic is seen with
symptoms of Sarin secretion in your body is being which medications?
(hint it's a nerve excreted excessively 101. Negative Inotropic, Calcium Channel Blockers
agent)? Chronotropic, and and Beta Blockers
Bronchospasm Dromotropic is seen with
Bronchorrhea which medications?
Salivating
102. What do Calcium Channel Antihypertensives
Lacrimating (tears)
Blockers treat? (indications) (decrease BP)
Urination
Anti Angina (imbalance
Diaphoresis/ Diarrhea
between O2 supply and
G.I upset
demand)
Emesis
Anti Atrial Arrhythmic
85. What do you use when All chemical agents require only (Atrial flutter and Atrial
cleansing patients soap and water cleansing except fibrillation)
exposed to chemical Sarin, which requires bleach.
103. What are some of the side Headache
agents?
effects of Calcium Channel Hypotension
86. Which agents do you Biological Agents Blockers?
isolate the patient for?
104. Names of Calcium Channel I sop zem dipine in the
87. Which agents do you Chemical Agents Blockers can be remembered Calcium Channel ("zem",
decontaminate for? by saying.... "dipine",
88. How does Gather exposed people "verapamil/isoptin")
decontamination Take to decontamination center 105. "QRS depolarization" always Ventricular (not atrial,
work? where people remove clothing, refers to __________ junctional or nodal).
shower, dress in non-contaminated
106. "P wave" refers to _________ Atrial
clothes, then release to other
services 107. Asystole a lack of QRS
Put contaminated clothing in depolarizations (flat line)
special bag and throw away (be 108. Atrial Flutter rapid P-wave
sure not to touch it) depolarizations in a saw-
89. Calcium Channel Valium. It relaxes the heart tooth pattern (flutter)
Blockers: they are like 109. Atrial Fibrillation chaotic P-wave
________ for your heart. depolarizations
What does that mean?
110. Ventricular Tachycardia wide bizarre QRS's
90. Calcium Channel Negative
Blockers: _______ 111. Premature Ventricular Periodic wide, bizarre
inotropoic, Contractions (PVC) QRS's
chronotropic, 112. Be concerned about PVC's if: More than 6 per minute
dromotropic 6 in a row
91. Inotropic strength of heart PVC falls on T-wave of
previous beat
92. Positive Inotropic strong heartbeat
113. What are the lethal asystole and ventricular
93. Negative Inotropic weak heartbeat arrhythmias? fibrillation
94. Chronotropic rate of heartbeat 114. What is the potentially life- 1. v-tach, 2. a-fib, 3. a-
95. Positive Chronotropic fast heartbeat threatening arrhythmias? flutter
115. When dealing with an IV push drug if you don't know go ____ except ________! slow, adenocard
116. What is the treatment for PVC's? lidocaine and amiodarone
117. What is the treatment for V Tach? lidocaine and amiodarone
118. What are the treatments for supraventricular arrhythmias? ABCD
Adenocard/adenosine
Betablocker (end in lol)
Calcium Channel Blocker
Digitalis/Digoxin (lanoxin)
119. What is the treatment for V-fib? you defib
120. What is the treatment for AsystolE? Give Epi first then Atropine