NCLEX-RN STUDY GUIDE

NCLEX-RN STUDY GUIDE

RBC - 4.2-6.2

WBC - 4,500-11,00

Platelets - 150,000-450,000

Hematocrit - 35-52%

Hemoglobin - 12-18

Normal Bleeding Time - 1.5-9.5 minutes

PTT - 20-39 seconds

PT - 9.5-12 seconds

INR - 1.0 normal 2-3 seconds for a.fib treatment 2.5-3.5 seconds for prosthetic heart valves

ESR - <30 mm/hr >50 years old <25 mm/hr if <50 years old (time that erythrocytes settle in well mixed venous blood)

Blood Sugar - 60-110

Cholesterol - 150-200

LDL - <160 (<100 if CAD)

HDL - 35-85

Triglycerides - 100-200

BUN - 10-20 g/dL (high=kidney failure)

Cr - 0.4-1.4 (high=kidney failure)

Urine Specific Gravity - 1.005-1.030

Alkaline Phosphatase - 50-120u/L (increased=liver damage)

Creatine Kinase - MM bands present= skeletal muscle damage MB bands present= cardiac muscle damage elevated= MI (>336 Males, >176 Females)

Albumin - 3.5-5.5

ALT and AST - 10-40 (high=liver damage/failure)

Bilirubin - <5 in newborns 0.3-1 in adults

Therapeutic Digoxin Level - 0.5-2

Sodium - 135-145

Potassium - 3.5-5

Calcium - 8.6-10.2

Magnesium - 1.3-2.3

Cranial Nerves - 1- Olfactory (smell) 2-Optic (vision) 3- Oculomotor (pupil constriction, raising eyelid) 4- Throclear (down and inward eye movement) 5- Trigminal (jaw movement; face/neck sensation) 6- Abducens (lateral eye movement) 7-Facial (movement/taste) 8- Acoustic (hearing/balance) 9-Glossopharyngeal (pharyngeal/movement, taste) 10-Vagus (swallow/speaking) 11- Spinal Accessory (flex/roatation of the head and shoulder shrugging) 12- Hypoglossal (tongue movement)

What do you do for a transfusion reaction? - Stop, Restart NS, Save blood/tubing and return to blood bank, Draw blood sample, Urine sample, Monitor for hematuria

Hemolytic Reaction - From incompatibility--> have N/V, chills, lower back pain, hypotension, increased HR

Isotonic Fluids - Same concentration as body fluids (NS,LR,D5W)

Hypotonic Fluids - Less concentration than body fluids- pulls water into the cell= cell bursts (1/2NS) given with dehydration

Hypertonic Fluids - More concentration than body fluids- pulls water out of the cell= cell shrivels (10-15% D, NaBicarb 5%) given for hyponatremia

IV Insertion - Using non dominant hand, place tourniquet 4-6" above, warm area/hand over bed/make a fist to dilate vein Clean with alcohol inside to outside then with iodine Insert at 10-30 degree angle and lessen, once you see blood lower 1/4" and remove tourniquet, remove needle and advance catheter Secure, tubing, infuse

Rapid Acting Insulin - O=10-30 min P=0.5-3 hr D= 3-6 hr Lispro, Aspart, Glusine

Short Acting Insulin - O=30-60 min P= 1-5 hr D= 6-10 hr Regular

Intermediate Insulin - O= 1-2 hr P= 6-12 hr D= 16 hr NPH

Long Acting Insulin - O= 3-4 hr P= cont D= 24hr

Meds to take at night - Stating H2Antagonists Antisecretory Tricyclic Alpha Adrenergic Blockers

Meds that interact with grapefruit - Can increase serum drug level- CCB, Statings, Caffeine, SSRIs, Dextromorphan, Sirolimus, Carbamazepine, Buspirone, Midazolam, Sildenafil, Praziquantel, Tacrolimus

Stoma Care - Will function 3-6 days post op~ want a low residue diet 6-8wks post op!Swelling normal in first few days post op pouch opening 1/8 inch larger than stoma, skin barrier under all tapes and to protect skin surrounding stoma, cleanse gently/pat dry, use stoma adhesive/hold pouch for 30 sec when setting and change if seal breaks or if 1/4 full

Bleeding Precautions - Electric Razor Soft Toothbrush Pressure post venipuncture

Metabolic Alkalosis Causes - Vomiting

Respiratory Alkalosis Causes - Hyperventilation/Mechanical Vent

Respiratory Acidosis Causes - Decreased rest stimuli (ex-anesthesia), COPD, Pneumonia, Atelectasis

Metabolic Acidosis Causes - DKA, Renal failure, Dehydration, Liver failure, Diarrhea, Fistulas

Normal pH - 7.35-7.45

PaCO2 normal levels - 35-45

HCO3 - 22-26

Trach Care - Q8H or PRN; hyper O2 prior, suction, remove old dressings, open sterile teach care kit/sterile glove, remove inner cannula (clean with hydrogen peroxide), reinsert, clean stoma with hydrogen peroxide and sterile water, change ties, new sterile dressing (DONT CUT GAUZE)

Nasal Cannula - 1-6L/min

Face Mask - 6-8L/min

Partial Rebreather - 8-11L/min

Nonrebreather - 12L/min

Venturi Mask - 4-8L/min

Trach Collar - 8-10L/min

Ear Drops for adult vs child - Up and back with adult; down and back for child! After lie on unaffected ear to facilitate absorption

NGT Insertion - Measure distance from tip of nose to earlobe to bottom of xiphoid process; mark the end with tape ~lubricate, insert through nose, offer sips of water/bend head forward (HOB 60-90 degrees) ~secure with hypoallergenic tape MONITOR FOR RESP DISTRESS! (sign that it is misplaced in the lungs)

NGT Verication - VERIFY WITH CHEST XRAY ~Aspirate gastric contents and check pH (should be <4 if gastric location)

NGT Care - Check residual before feedings and Q4H if continuous feeding (hold feeding if >100mL); 15-30mL water before and after each med and feed; admin fluids at room temperature; change bag Q24-72H; HOB 30 when feeding and 30 min post