1 MarkKlimeknotes Howtoguess 1.Useknowledge 2.Commonsense 3.Guessingstrategy Psych 1Nursewillexamineownfeelingaboutsomething-sodonotcountertransfer 1Establishtrustrelationship Nutrition 1Pickchickennotfriedchicken 1Fishbutnotshellfish 1Neverpickcasserolesforkids 1Nevermixmedsinfood 1Toddlers-fingerfoods 1Preschool-onemealadayisOK.Leavethemalone 3expectationstohave 1Donotexpect75questions-think265 1Donotexpecttoknoweverything 1Donotexpecteverythingwillgoright Pharm 1Mosttestedareaissideeffects 1Donotworryaboutrouteordose 1Ifknowwhatdrugdoesbutdonotknowsideeffect-pickasideeffectinsamebodysystemthedrugis working 1Noideawhatthedrugis-looktoseeifitisPO-pickGIsideeffect 1Nevertellkidsthatmediscandy OB-checkfetalHR MedSurg 11 st thingassess-LOC 11 st thingdo-establishairway Peds 1Allbasedonprinciple-givechildmoretimetogrowanddevelop 1Whenindoubt-callitnormal 1Whenindoubt-picktheolderage 1Whenindoubt-picktheeasiertask-moretimetodotheharderone
2 General 1Ruleoutabsolutes 1If2answerssaysamething-neitheriscorrect 1If2answersareopposite-oneisprobablyright 1Umbrellastrategy 1Ifquestionshas4rightanswersandaskforpriorityofneedsofapatient-worseconsequencesgame-worst outcome 1Whenstuckbetweentwoanswers-readthequestion Sesamestreetrule-useonlyaslastoption 1Rightanswertendstobedifferentthantherest 1Wronganswersareusuallyallsimilar 1Rightanswerismostuniqueordifferent Answerbasedonwhatyouknow,notwhatyoudon’tknow 1Ifyoudontknowsomethinginaquestion-pullitoutoftheequation-usecommonsense 1Nclexalsotestingoncommonsense-donotoveranalyze-donotthinklikeanurse 1Gowithgutanswer-onlyifotheranswerissuperior
3 Prioritization 1Decidewhoissickestorhealthiest--->basedonquestion 1ABCdoesnoworkwithprioritizationquestions 1Answerswillhave4parts .Age .Gender .Diagnosis .Modifyingphrase 12areirrelevant---->ageandgender 1InPedspayattentiontoagebutinprioritizationageisnotimportant 1Modifyingphrasemostimportant
1Ex:pthasanginapectorisvsMI---->MIishighpriority
1PthasanginapectorisandunstableBPvsMIwithstableVS---->anginawithunstableBPisnowthe priority 4rulestoprioritization 1.Acutebeats(higherprioritythan)chronic
Example:COPDversusappendicitis--->appendicitisisthepriority
2.Freshpostop(<12hrs)beatsmedicalorothersurgical
Example:2hrpostopversusappendicitis--->2hrpostopisthepriority
3.Unstablebeatsstable StablewordsUnstablewords 1Stable 1Chronicillness 1Postop>12hrs 1Localorregionalanesthesia 1LababnormalitiesAorBlevel 1Unchangedassessments 1Tobedischarged 1Readyfordischarge 1Admittedlongerthan24hrsago 1ExperiencingthetypicalexpectedS/Sof diseasewithwhichtheywerediagnoses 1Unstable 1Acuteillness 1Postop<12hrs 1Generalanesthesia(1 st 12hrs) 1LababnormalitiesCorClevel 1Changed/changingassessment 1Notreadyfordischarge 1Newlydiagnosed 1Newlyadmitted 1ExperiencingunexpectedS/S
Example:
116yow/meningococcalmeningitiswhohashadtempof103.8Fsinceadmission3daysago.161yomalew/IBSwhospikedtempof103Fthisafternoon.1Whoishigherpriorityandwhy?--->2ndoptionispriority-->havemorehighprioritiesthan1 st Alwaysunstablenomatterwhat-evenifexpected
4 1Hemorrhaging(notbleeding) 1Highfeverover105F--->patientcanhaveseizure 1Hypoglycemia 1Pulselessness(vfiborasystole)orbreathlessness
Note:atsceneofaccident(unwitnessed)-theyaredeath-lowpriority
3thingsthatcausesblacktag @sceneofaccident 1Pulselessness 1Breathlessness 1Fixedanddilatedpupils(evenifstillbreathing) 4.Tiebreaker--->themorevitaltheorgan,thehigherthepriority.1Organinwhichthemodifyingphraseisreferringto 1Mostvitalorgans 1.Brain 2.Lungs 3.Heart 4.Liver 5.Kidneys 6.Pancreas
12hrs>