NCLEX STUDY FROM MARK KLIMEK

NCLEX STUDY FROM MARK KLIMEK

GUIDE SOLUTION ALREADY PASSED

Hyperthyroidism is also called Answer -Grave's disease or hypermetabolism

Tip to remember Grave's disease s/s's Answer -"Run yourself into the Grave" - everything is up ... diarrhea, thin, hot, high BP, high HR, cold tolerance, hot intolerance

Treatment for Grave's disease Answer -Radioactive Iodine, PTU (put thyroid under), surgically remove

Total thyroidectomy ... totals get Answer -tetany, need lifelong hormone replacement

After thyroidectomy patients are at risk for Answer -hypocalcemia, remember hypocalcemia is opposite of the prefix and anything to BP so tetany, parasthesia

parathesia Answer -numbness and tingling, first sign of electrolyte imbalance

Subtotal thyroidectomy ... subs get Answer -storm

S/S of thyroid storm Answer -Extremely high vital signs, hyperpyrexia, psychotic delerium

How to treat thyroid storm Answer -give o2, lower temp to spare brain

Risks post op for total thyroidectomy Answer -airway, hemorrhage for 1st 12 hours then for 12-48 hours hypocalcemia leading to tetany

Risks post op for sub total thyroidectomy Answer -airway, hemorrage for 1st 12 hours then for 12-48 hours thyroid storm

Hypothyroidism is also called Answer -Myxedema or hypometabolism

S/S of mydexema Answer -everything is down, constipation, heat tolerance, cold intolerance

Treatment for mydexema Answer -give thyroid medications

Where to put the 5 ice packs to cool a thyroid storm patient Answer -neck pits groin

If you cool a patient too fast what might happen? Answer -Heart arrythmias

Never hold the hormone for what patient? Answer -patient who is NPO with mydexema

Addison's disease easy way to remember Answer -Add a Sone (sone = steroid)

Adrenal Cortex diseases easy way to remember Answer -A in Adrenal stands for Addison's C in Cortex stands for Cushing's

Addison's disease is Answer -undersecretion of adrenal cortex, not enough hormone, BRONZE/tan, go into shock very easily. STRESS can trigger.

Addison's disease treatment Answer -give a steroid, chronic steroid therapy

Cushing's syndrome Answer -Over secretion of adrenal cortex, too much hormone, too much steroid.

S/S of Cushing's syndrome Answer -same as steroid use ... moon face, think cushman "I'm mad I have an infection", high blood sugar, losing Potassium,

Treatment for Cushing's syndrome Answer -Surgery, bi or uni lateral adrenalectomy (bilateral is worse)

Donning PPE's order Answer -Gown, Mask, Goggles, Gloves

Removing PPE's order Answer -alphabetically inside the room

For airborne precautions the mask is removed where? Answer -outside of the room

Avoid answers with what words for children 9 mths and younger? Answer -build, sort, stack, construct, make

Toddlers (1-3) work on Answer -their gross motor skills (jump, hop, throw), NO fine motor, parallel play

Preschoolers (3-6) work on Answer -fine motor, balance (tumbling, dance, tricycle), cooperative play, pretend

School age (7-11) work on Answer -creative, collect, competitive

Best default order for click and drag order questions? Answer -Hold ..... med Assess ..... what med does Prepare ...... the correction Call ..... or notify

Rarely if ever answer ... Answer -call Doctor, NCLEX wants you to think critically

Creatinine lab values Answer -same as lithium 0.6-1.2 Not a huge worry, not a dangerous lab to worry about

INR lab values Answer -2-3, critical value if off, potential for patient to bleed. Use default order for order ?'s (hold all coumadin, assess for bleeding, prepare Vit K (antidote for Coumadin), Call or notify

Potassium lab values Answer -3.5-5.3 If low it is a critical lab to worry about assess the heart and then prepare to give K if high, hold all K, assess heart (EKG), give D5W and reg insulin, call if really high, hold, assess, prepare, call STAT Get someone else involved! Dangerous!!

pH lab values Answer -7.35-7.45 if pH is in the 6;s VERY dangerous remember as the patient's pH goes so goes the patient If bad vitals, call rapid response team

BUN lab values Answer -8-30 check for dehydration if elevated not a big deal, just be concerned

If a deadly or dangerous lab value is discovered AND they have symptoms call the Answer -rapid response team!

HgB lab values Answer -12-18 check for bleeding if low or high, if low prepare for tranfussion

HCO3 lab values Answer -22-26 if it is abnormal so what!

CO2 lab values Answer -35-45 if in the 50's assess respiratory status and have patient do pursed lip breathing, if in 60's considered deadly and respiratory failure, need intubated

Hct lab values Answer -36-54 thickness of blood if abnormal not too big of a deal, assess for dehydration

PO2 lab values Answer -78-100 this is only obtained from an ABG if low give O2 but if really low it is respiratory failure give O2, prepare for intubation, call resp therapy and call Dr

O2 sat lab values Answer -93-100 pulse ox, if under 93 assess resp status and give O2

BNP lab value Answer -less than 100 is normal, good indicator of CHF, edema, if elevated assess s/s of CHF

NA lab values Answer -135-145, if a change in LOC then evaluate for fall/safety risk

WBC lab values Answer -5000-11000 if low assess for infection

CD4 count less than 200 equals Answer -AIDS

Neutropenic precautions (low WBC) Answer -strict handwashing, avoid crowds, private room, low bacteria diet (no raw or undercooked), no water that has been standing longer than 15 min, vital signs Q4H

Platelets lab value Answer -150000-400000 if lower than 90000 bad if lower than 40000 REALLY bad, if they sneeze they could die. Called thrombocytopenia

Bleeding precautions Answer -no venipuncture, injection or IV, if necessary use small guage, handle patient gently, use drawsheet, no razor, no toothbrush, blow nose gently, no aspriin, no rectal temp, no hard foods

RBC lab values Answer -4-6 million abnormal doesn't really matter

Reason for laminectomy Answer -treat nerve root compression

S/S of nerve root compression Answer -Pain Parasthesia (numbness & tingling) Paresis (muscle weakness)

Cervical Answer -Diaphram and Arms affected, breathing, respiratory pattern

Thoracic Answer -Abd muscles and gut affected, ability to cough

Lumbar Answer -Bladder and legs affected, when did they last void, are they distended

#1 post op answer for spinal problems is Answer -log roll patient

Activity post op spinal issue Answer -do not dangle stand, walk, lie down w/o restricitons limit sitting to 30 min at a time

Post op complications for cervical spinal surgery Answer -pneumonia

Post op complications for thoracic spinal surgery Answer -pneumonia (no cough), paralytic illeus (gut shuts down)

Post op complications for lumbar spinal surgery Answer -urinary retention

How long does temporary restrictions usually mean? Answer -6 weeks (driving, lifting, etc.)