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NCLEX: Mark Klimek - Lecture 12 (Pr...
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3.5-5.0
Low or high is C unless it reaches 6+ then it's a D Assess Heart, give K+, call doc Obtundedlethargy dynamic ileusdecrease or loss of bowel motility Choose an answer 1Potassium2Obtunded 3Potassium4Calcemias Don't know?
KalcemiasDo the same as the prefix except for heart rate and urine output clonusmuscle spasm or twitching Calcemiasdo the opposite of prefix. Muscles and nerves Chvostek's signCheek, facial spasm when Cheek is tapped associates with hypocalcemia Trousseau's signBP cuff; hand/finger spasms due to hypocalcemia MagnesemiasDo the opposite of the prefix hypErnatremiadehydration hypOnatremiaFluid Overload ParesthesiaNumbness and tingling; earliest sign of electrolyte imbalance ParesisMuscle Weakness; all electrolyte imbalances will cause this PotassiumNever give more than 40 of K+ per L of IV fluid Lower PotassiumGive D5W w/ Insulin; this will drive K+ into the cell and out of the blood.KayexalateFull of sodium, given via enema or orally. Trades Na+ for K+ then you shit it out.K+ Exits Late Assess pt abdomen and normal bowel function to avoid risk of intestinal necrosis LaminectomyRemoval of vertebral spinal processes; relieves nerve root compression
S/s: pain, paresthesia, paresis
Location: cervical - airway and arm function
thoracic - cough & bowel mechanisms lumbar - bladder (last void?) Leg function Spinal Cord Injuries post-opLog Roll Can't sit longer than 30 mins May walk, stand, lay down w/o restrictions Creatinine0.6-1.2
INR2-3
Anything 4+ is C
Potassium3.5-5.0 Low or high is C unless it reaches 6+ then it's a D Assess Heart, give K+, call doc
PH7.35-7.45
Anything in the 6's is a D
BUN10-20
Assess for dehydration Hgb12-18 8-11 it's a B Assess for Anemia/bleeding/ malnutrition Below 8 it's a C Assess for bleeding, prepare to give blood, call doc CO246-59 (C) assess respiration, Pursed lip breathing 60+ (D) assess respiration, prepare fir intubation, ventilation, call respiratory therapy the doc Phenothiazines 1st Gen/ Typical Antipsychotics "ZINES" Major tranquilizers Zzz.. zines (sedatives)
S/E:
Anticholinergic (dry mouth) Blurred Vision Constipation Drowsiness EPS Fotosensitivity aGranulocytosis Tricyclic Antidepressants (NSSRI)
V C E H A O L P M I N E L I O N Variable Decels Cord Compression (bad) Early Decels Head (bad) Acels Okay (good) Late Decels Placenta (bad) Move pt to the left Identify labor progress No action needed Execute Left side Increase IV O2 Notify Stage 4 of Labor4 things you do 4 times (q 15 min) an hour in the 4th stage Vital Signs Fundus Check - if boggy = massage, if displaced = avoid cath Pads - 98% sat is ok Roll her over - check for bleeding underneath TocolyticsStop preterm labor Terbutaline - causes maternal heart rate Magnesium Sulfate - causes hypermagnesemia making uterine contractions, HR, BP, reflexes, RR, and LOC all go down - IF RR is > 12 its okay and if its undertitrate down
- Reflexes +1 is BAD
Oxytoxicsstimulate & strengthen labor Pitocin - may cause uterine hyper stimulation; contractions longer than 90 secs closer then q2mins - STOP PIT Methergine - Causes high BP Fetal Lung Maturing MedBetamethasone (steroid) - Mom gets it, given IM, given before the baby is born Servanta (Surfactant) - given to neonate, given trans-tracheal (blown into trachea), given when baby is born IM Injection - what size?always pick the ANSR that has a 1 (for IM) on both sides.
Ex: 21 gauge/1inch
Subcutaneous - what size?pick the ANSR that as a 5 (5 looks like an S) on both sides.
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