General NCLEX-RN Review

General NCLEX-RN Review

IM meds - quickly absorbed, 90 degree angle, 19-23 G needle, 1-2" length, average adult:11/2, 22G, mandatory to aspirate, purpose is to deposit meds into deep muscle for quick absorption

deltoid muscle - only used for 1-2 ml of med b/c is smaller muscle

quickest absorption - #1 is abdomen, #2 is arm, #3 is buttock

Insulin - done sub-q into fatty tissue, measured in Units, draw up air prior and insert into vial

Regular insulin - onset:15-30 mins, clear, peak:30-11/2 hr., duration:3-4 hrs., can mix with intermed.& short

Humulog - onset:15-30mins., clear, peak: 30-11/2, duration: 3-4 hrs., mix with intermed., reg, short

NPH - onset:1-4hr., cloudy, peak:6-10hrs., duration:10-16, up to 24 hrs., cannot mix!!

Lantus - onset:1-2hr., clear, no peak, duration:24 hrs., cannot be combined

Regular insulin - only insulin that can be given IV

rotate injection sites - to slow formation of scar tissue

most insulins - given right befor meals to control blood sugar

when mixing insulins - put air into cloudy first, then clear

NPH - has regular insulin in it already

sliding scale - always given with short acting insulin such as reg/ humulog

sub-q injections - 45-90 degree angle, 25G needle, 1/2-1" length, below dermis/above muscle

heparin/lovanox - bruising will occur aroun inj. sites, apply pressure for at least 30 seconds, check for bleeding gums, stools, sheck V/S for internal bleeding with anticoagulants

Intradermal injections - 10 degree angle, 25-27G needle, 5/8-1/2" needle, barely cover bevel under skin, do not do near a vein, do to the side, used for PPD&allergy testing

TB testing - read 48-72 hrs later, inject 0.1 ml, assess for induration(hard bump), measure in mm, greater than 5 mm is queestionable, 5-10 need CXR, redness indicates localized reaction not a concern, problem is induration

bacteriacidal - able to kill bacteria

bacteriostatic - retards bacteria growth

broad spectrum - atbs that are effective against many organisms

catecholamine - neurotransmitters that play important role in body's stress response

cathartic - meds used to treat constipation

depressant - slows down mental/physical processes

narrow spectrum - atbs that are effective agaist a few mo's

nephrotoxicity - toxicity due to blood and protien in the urine

opiate - pain relievers r/t opium

ototoxicity - toxic effect r/t damage to 8th cranial nerve resulting in dizziness, tinnitus, gradual hearing loss

septicemia - generalized infection throughout body

vasoconstrictor - constrict blood vessels

tetracycline - atb

lanolin - dermatologic

valium - sedative/hypnotic, a tranquilizer (trade name Valium) used to relieve anxiety and relax muscles

morphine - narcotic

dexamethasone - a corticosteroid drug (trade names Decadron or Dexamethasone Intensol or Dexone or Hexadrol or Oradexon) used to treat allergies or inflammation

captopril - a drug (trade name Capoten) that blocks the formation of angiotensin in the kidneys resulting in vasodilation

sudafed - vasoconstrictor (trade names Privine and Sudafed) used in nasal sprays to treat symptoms of nasal congestion and in eyedrops to treat eye irritation

dramamine - antihistamine and antiemetic, used to treat motion sickness

prilosec - antacid (trade name Prilosec) that suppresses acid secretion in the stomach

tamoxifen - an antagonist for estrogen that is used in the treatment of breast cancer

digitalis - cardiotonic

lasix - commonly used diuretic (trade name Lasix) used to treat hypertension and edema

before surgery the pt. should stop using - aspirin

meds used for antipyretic, inflamm, and analgesia - salicylates, NSAIDs

when on steriods watch for - infection

morphine - decreases RR

• ml - 1cc

• L - 1000 ml

• kg - 1000 g

1000mg - 1 g

• teacup - 6 oz.

• T - 3 tsp

• tsp - 60 gtt

• lb - 16 oz.

• ft - 12 in.

• qt - 2 pt

• pt - 16 oz

larger to smaller - right

smaller to larger - left

2.2lbs. - 1 kg

• lb - 0.45 kg

120 gtts of water - 1 tsp

• pinch - 1/8 tsp

first sign of narcotic OD - resp. depression

what are NSAIDs mainly given for - inflammation and pain

side effects of barbituates - drowsiness, mood change, depression

infiltration r/t IV - most common problem: when fluid or med leaks out of vein into tissue, edema occurs, feels cool, fluid in tissue will reabsorb eithin 24 hrs.

phlebitis r/t IV - inflamm of the vessel: caused by irritaition of vessel by needle, cannula, meds. S/S are warnth, swelling, tenderness. IV must be dc'd, warm compress to decrease discomfort

septicemia - bloodstream infection: if becomes very bas pt may have a red line along arm

catheter embolus - piece obstructing blood flow may have decreased bp, pain along vein, loss of conscoiusness

air embolus - may occur when changing bags, opening line

monitor elsrely pt with IV's more frequently to make sure of no fluid overload - check lung sounds q shift for crackles

metered dose inhaler - shake med, have pt breathe out, when starts to inhale press down, have the pt hold breath for 10 seconds, wait 1 min befroe next dose

MDI - administer bronchodilators before other meds

ear meds/ 3 and under - down and back

ear meds/3 and over - straight back

ear meds/adult - up and back

with ear meds if there are 2 differant meds - wait 5-10 mins inbetween meds