Mark Klimek NCLEX Review- Lecture/Yellow Book

Mark Klimek NCLEX Review- Lecture/Yellow Book

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NCLEX EXAM PREVIEW

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Rule of the B's: If the ____ and the _____ are ______ in the same

direction then it is meta_____ pH, Bicarb, Both, Bolic pH 7.30_______ HCO3 20_______↓= acidosis; ↓= metabolic pH 7.58_______ HCO3 32_______↑= alkalosis; ↑= metabolic pH 7.22_______ HCO3 30_______↓= acidosis; ↑= respiratory You are providing care to a client with the following

blood gas results: pH 7.32, CO2 49, HCO3 29, PO2 80,

and SaO2 90%. Based on these results, the client is

experiencing:

↓= acidosis; ↑= respiratory MacKussmaulThe only acid base to cause Kussmaul respirations is Metabolic ACidosis As the _______ goes, so goes _______ except for _______ pH, my patient, Potassium Uphyokalemia, alkalosis, HTN, Tachycardia, Tachypnea, Seizures, Irritability, Spastic, Diarrhea, Borborygme, hyperreflexia, etc Downhyperkalemia, acidosis, htn, bradycardia, constipation, absent bowel sounds, flacid, bradypnea

Causes of acid-base imbalances: First ask yourself, "Is it

_______?" If yes, then it's _______. Then ask yourself: "Are they

_______ or _______. If _______, pick _______. If _______, pick _______ lung, respiratory, overventilating, underventilating, overventilating, alkalosis, underventilating, acidosis

Causes of acid-base imbalances: If it's not lung, then it's

_______. If the patient has _______ _______ vomiting or suction, pick _______. For everything else that isn't lung, pick _______ _______. When you don't know what to pick, choose _______

_______

metabolic, prolonged gastric, alkalosis, metabolic acidosis, metabolic acidosis High pressure alarms are triggered by _______ resistance to air flow.increased High pressure alarms are triggered by increased resistance to airflow and can be caused by obstructions

of three types: _______ action, _______ action, _______ action

(kinked tube) unkink, (water in tube) empty, (mucus in airway) cough and deep breathe Low pressure alarms are triggered by _______ resistance to airflow.decreased Low pressure alarms are triggered by decreased resistance to airflow and can be caused by disconnections of the _______ or _______ tubing (reconnect it), oxygen sensor tube (reconnect it UNLESS tube is on the floor- bag them and call RT if this happens) Respiratory alkalosis means ventilator settings may be too

_______

high Respiratory acidosis means ventilator settings may be too

_______

low What does "wean" mean?gradually decrease with the goal of getting off altogether What is Maslow's highest priority to lowest priority? 1. Physiological

• Safety
• Comfort
• Psychological (problems within the person)
• Social (problems with other people)
• Spiritual

Arrange from highest to lowest priority using Maslow's:

Denial Spiritual Distress Pain in Elbow Fall Risk Pathological Family Dynamics Electrolyte Imbalance Electrolyte Imbalance (Physiological) Fall Risk (Safety) Pain in Elbow (Comfort) Denial (Psychological) Pathological Family Dynamics (Social) Spiritual Distress (Spiritual) What are the 5 stages of grief?Denial Anger Bargain Depression Acceptance The #1 problem in abuse is _______denial

Denial is the _______ to accept the _______ of their problem refusal, reality

Treating denial: _______ it by pointing out to the person the

difference between what they _______ and what they _______.In contrast, _______ the denial of loss and grief confront, say, do, support

Dependency: When the _______ gets the Significant Other

to do things for them or make decisions for them abuser

Codependency: When the _______ _______ derives positive

_______ from doing things for or making decisions for the

_______

Significant Other, self-esteem, abuser

When treating dependency/codependency: Set _______ and

_______ them. Agree in advance on what requests are allowed, then enforce the agreement limits, enforce

When treating dependency/codependency: Work on the

_______ of the codependent person self-esteem

Manipulation: when the _______ gets the _______ _______ to do

things for him/her that are not in the _______ _______ of the _______ _______. The nature of the act is _______ or _______ to the

_______ _______

abuser, significant other, interest, significant other, harmful, dangerous, significant other

Treating manipulation: set _______ and _______limits, enforce

Wernicke's (Korsakoff's) Syndrome: _______ induced by

Vitamin _______(thiamine) deficiency Psychosis, B1

Primary symptoms of Wernicke's (Korsakoff's) Syndrome:

_______ with _______ amnesia (memory loss), confabulation (make up stuff)

Characteristics of Wernicke's (Korsakoff's) Syndrome:

1. _______

2. _______

3. _______

preventable (take vitamin) arrestable (take vitamin) irreversible (kills brain cells) Antabuse/Revia is aka _______ TherapyAversion

Onset and duration of effectiveness of Antabuse/Revia:

_______

• weeks

Patient teaching with Antabuse/Revia: Avoid _______ forms

of _______ to avoid _______, _______, _______ all, alcohol, nausea, vomiting, death What are examples of products that contain alcohol? mouth wash, cologne, perfume, aftershave, elixir, most OTC liquid medicines, insect repellant, vanilla extract, vinagerettes, hand sanitizer

Every alcoholic goes through _______. Only a minority get

_______

Alcohol Withdrawal Syndrome, Delirium Tremens _______ is not life-threatening. _______ an kill youAlcohol Withdrawal Syndrome, Delirium Tremens Patients with _______ are not a danger to themselves or others. Patients with ________ are dangerous to self and others Alcohol Withdrawal Syndrome, Delirium Tremens

AWS or DT: semiprivate room, any locationAWS

AWS or DT: private room near the nurse's station DT

AWS or DT: Regular dietAWS

AWS or DT: Clear liquid or NPO diet (risk for aspiration) DT

AWS or DT: Up at libertyAWS

AWS or DT: Restricted to bedrest with no bathroom

privileges DT

AWS or DT: No restraintsAWS

AWS or DT: Usually restrained with either vest or 2 point

(1 arm and 1 leg) DT

AWS or DT: Give anti-HTN medicationBoth

AWS or DT: Give tranquilizerBoth

AWS or DT: Give multivitamin to prevent Wernicke's Both

For Aminoglycosides, think " __ ____ ___ _____" a mean old mycin When are antibiotics/aminoglycosides used?to treat serious, life-threatening, resistant infections All aminoglycosides end in _______, but not all drugs that end in _______ are aminoglycosides.mycin, mycin What are some examples of wannabe mycins? Azithromycin, Clarithromycin, Erythromycin What are some examples of aminoglycosides?Streptomycin, Cleomycin, Tobramycin, Tobramycin, Gentamycin, Vancomycin, Clindamycin When remembering toxic effects of mycin's think _______ mice= ears What is the toxic effect of aminoglycosides and what must you monitor?ototoxicity; monitor hearing, balance, and tinitus