NCLEX NEXT GEN 2.0

What condition is commonly associated with PICA?
Anemia is common with PICA

T/F
NSAIDS can worsen asthma symptoms
TRUE

Fexofenadine
antihistamine

Hodgkin’s lymphoma

What are typical signs and symptoms of this disease?
chronic malignant disease of the lymph nodes
affects the lympathic system

S/S include:
Sweats
Painless Enlarged lymph nodes
Fever
Fatigue

How should a nurse provide care for a patient with schizophrenia and persecutory delusions?
Focus on reality and verbally reinforce it

Focus on the clients feeling secondary to the delusions (this is an example of empathy, and therapeutic communication)

What are interventions to help reduce viscosity of mucus?
-Increase fluids
-Cool mist humidifier
-Guaifensein (expectorant)
-Huff coughing – abdominal breathing with a huff, and expiratory cough technique

What GI condition is associated with olive shaped mass?
Pyloric stenosis

What is botulinum toxin type A

What should you closely monitor while using this drug?
Botox – a neuromuscular transmission used by inhibiting acetylcholine(excite) release from nerve endings. RELAXATION of skeletal and smooth muscles.

Used to treating wrinkles, blepharospasm (eye twitching), and cervical dystonia

What are some examples of SSRIs?

What are they and what is a common adverse effect of there use?

How long does it take for this medication to take effect?
Sertraline, Escitalopram
(-etine, -opram)

Selective Serotonin Re-uptake Inhibitors

Used to treat Depression and Anxiety

Side effect:
Sexual dysfunction which is usually under reported
WEIGHT GAIN (eat a health diet and regular exercise)

It will take about 4-6 weeks to take effect

Allopurinol (Zyloprim)

What does this medication treat?

What symptom of the medication can lead to higher complication? What is the complication?
Gout, Anti-gout medication

Used to decrease/prevent levels of Uric Acid

Takes with full glass of water to prevents complications with kidneys and nausea.

COMPLICATION:
Rash – which can indicate a hypersensitivity and develop to Stevens Johnsons Syndrome

Dabigatran (Pradaxa)

What condition is this used for? Why?

Where should you keep these pills?
Anticoagulant, Direct Thrombin Inhibitor

Commonly used for patients with A-Fib and Flutter

Do not crush or open pills.

KEEP THIS MEDICATION IN ITS ORIGINAL CONTAINER/BOX.

What is Trazadone?

What is this used for?

What are the common adverse effects of this medication?
A serotonin modulator

Used to treat Major depressive Disorders

Also blocks alpha and H1 receptors leading to ORTHOSTATIC HYPOTENSION, and SEDATION

What is priapism?

Is it painful?
A prolonged and painful erection

What is tissue plasminogen activator (tPA)

When should it be administered within? (hours)

What is it contraindicated with
Dissolve clots and restore perfusion

ADMINISTER within 3 to 4 hours

Contraindicated in patients with recent surgeries (2 weeks)

How are thyroid medications best absorbed?

What time of the day should they be taken?

Are they safe to take during pregnancy?
On an empty stomach

Best taken in the morning because they increase metabolism and energy

Safe during pregnancy

Steven Johnson Syndrome (SJS)

How does it appear on the skin?
Severe blistering of the skin, with mucous membrane involvement and fever

Can be FATAL

Begins with flu like symptoms, painful and purple/red rash.
Resembles 3rd degree burns.

Cyclosporine

What is it used for to prevent?
Immunosuppressant

Suppresses the immune system to prevent WBC from getting rid of a organ transplant

Tetracycline/Doxycycline // Sulfa Drugs

What are common complications with these type of drugs
Sulfa Drugs:
Tetracyclines

Antibiotics

Complication:
Sun Burn

What insulin is the ONLY insulin administered IV Push?
Regular Insulin

What is the correct administration route for NPH insulin?
Subcutaneous

Digoxin (Lanoxin)

What should be monitored while on this medication?

What the symptoms of Digoxin toxicity
cardiac glycoside

Be sure to monitor patients HR

Toxicity:
Visual symptoms
Gastrointestinal (N/V)
Neurologic manifestions

Positive Inotropic Effects (increase Cardiac Output)
and
Negative Chronotropic Effects (Decrease Heart Rate)

What can colorless nasal drainage indicate?
CSF
A complication

T/F
Any drug order-dose takes priority
TRUE

What can a new painful skin rash indicate?
Steven Johnsons Syndrome
Can be FATAL

What is the action of Sucralfate?

how should it be taken?
An oral medication that forms a protective layer in the gastrointestinal mucosa that provides a physical barrier against stomach acids and enzymes

TAKE ON A EMPTY STOMACH w water

Other meds should be taken 1 or 2 hours before or after this med!

Glyburide

What is this medication used for?

What common symptom is associated with his medication?
Diabeta

Used to treat diabetes mellitus.

Can cause severe hypoglycemia especially in children

How should patients be roomed together?
Patients with the same organism should be roomed together

Life before limb
prioritize interventions for a client in shock over interventions for a client who has a localized limb injury

Pulsatile Mass
Strong pulse of midline abdomen, possible aortic aneurysm

Phenytoin

What is this med used for?

What is the therapeutic range for this medication?

What are symptoms of toxicity?
Dilantin/Anticonvulsant

Used to treat tonic-clonic seizures

Range: 10 -20

Toxicity:
Horizontal Nystagmus
Gait unsteadiness

Hyperosmolar Hyperglycemic Syndrome (HHS)
a serious complication usually associated with type 2 diabetes

What does green amniotic fluid indicate?
fetus has passed meconium in utero

characteristic of DKA
Type 1 diabetes
Younger age

More rapid onset o hyperglycemia
Hyperventilation
Abdominal pain

Glucose 250-500
Bicarb <18
Elevated anion gap
KETONES
serum osm <320

characteristic of hyperosmolar hyperglycemia
Type 2 diabetes
Older age

Altered mental status
Gradual onset of hyperglycemia
Hyperventilation

glucose >600

BECAUSE people with type 2 can develop some insulin, the symptoms occur gradually

Metronidazole (Flagyl)

What condition is this medication usually used for?
antibiotic

Used for C.diff

What are nonselective beta blockers?

What can these medications effect?
Propranolol
Nadolol
Timolol

This medication has beta 2 blocking effect that results in bronchial smooth muscle constriction

After how many hours can a nurse consider a patient stabilized enough to eat after having a stroke?
48 hours

Addison’s disease – what does this effect

What are the treatments for this disease?
occurs when the adrenal glands do not produce enough of the hormones cortisol or aldosterone

Treatment includes:

Life long hormone replacement
Increase salt intake
Monitoring ortho BP

What is a sentinel event?
What is a near miss event?
Sentinel
Unanticipated, preventable errors that cause significant harm or death

Near-miss
Medical errors that are identified before reaching the clients and does not cause harm

What are 4 interventions that are important to monitor with HELLP?
Preparing the client for birth
Magnesium sulfate
Deep tendon reflexes
Monitoring clotting factors

What is DIC?

How would this be treated?
disseminated intravascular coagulation

A BLOOD CLOTTING disease that can turn into uncontrolled bleeding

this results from abnormal activation of clotting cascade followed by consumption of clotting factors and platlets

Treatment:
replacement of clotting factors
blood
platlets

Parovirus B19, what is another name for this condition

What kind of precautions are needed for this disease

Is this disease fatal to pregnant women?
fifth disease; erythema infectious
TORCH

Transmitted from person to person contact, RESPIRATORY secretions
Droplet precautions

Parovirus is infectious to the fetus, can cause abnormalities

What is postpartum psychosis?

How long after birth, can this condition occur?
syndrome occurring after childbirth characterized by severe depression, manic episodes, hallucinations, and/or delusions

Begins usually after 2 weeks of birth

Who/what role is legally appointment to be the primary decision maker for a patient?

What is the role of a __?
Health care proxy

the role is to make decisions for a client who is unable to do so.
They should have good understanding of the the clients wishes and be emotionally capable of fulfilling the role

What task are delegated to an RA?
Clinical assessment
Initial client education
Discharge education
Clinical judgment
Initiating blood transfusion

What task are delegated to an LPN?
Monitoring RN findings
Reinforcing education
Routine procedures
Most medication admin
Ostomy care
Tube patency and enteral feedng
Specific assessments

What task are delegated to a UAP?
Activities of daily living
Hygiene
Linene changes
Routine, stable vital signs
Documenting I&O
Positioning

ROM
Apply protective ointment

Occupational therapy

v.

Physical therapy
Above the waist

v

Below the waist

T/F – Food decreases the absorption of iron supplements
TRUE

gullian-barre syndrome
ascending symmetric muscle paralysis and areflexia (no reflexes), watch for respiratory problems.

Usually occurs after a respiratory or GI infections that triggers this immune response

testicular torsion

How is this condition usually treated?
twisting of the spermatic cord
AND
testicular ischemia and necrosis from inadequate blood supply

Treatment:
Surgery
Removal of the testes

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