Mumps

Mumps

-paramyxo virus; common during winter and spring

-uni or bilateral

-downward, forward formation of swelling

Fatal complications: orchitis

Kawasaki disease

Kawasaki disease – from korea

Strawberry tongue; 5 days = white tongue

Reye's Syndrome

Reye’s Syndrome

-accumulation of fats in liver; aspirin toxicity

-below 10 years old

-use Tylenol instead (widely used analgesic)

2 posture associated with neuro disorder

1.       Decorticate- cortex (basal ganglia)

2.       Decerebrate – pons (rate, depth of respiration)

Manifestations: lethargic, tinnitus, neuro disorder

Tumor

Tumor

-space occupying lesions

2 types of tumor in brain: 1. Glioblastoma – adult

                                                    2. medullablastoma – children

Mgt: Surgery

a.       Craniotomy – opening of skull

b.      Craniectomy – part of skull removed

Nsg priority: SAFETY (wear helmet)

Drug: steroid ( decrease edema), NSAIDS

Note: prolonged use of steroids causes osteoporosis; if asthmatic weight gain

HERBAL MEDS

Chamomile

Uses: Chamomile is often used in the form of a tea as a sedative.

Reactions: Allergic reactions can occur, particularly in persons allergic to ragweed. Reported reactions include abdominal cramps, tongue thickness, tightness in the throat, swelling of the lips, throat and eyes, itching all over the body, hives, and blockage of the breathing passages. Close monitoring is recommended for patients who are taking medications to prevent blood clotting (anticoagulants) such as warfarin.

Echinacea

Uses: Largely because white blood cells in the laboratory can be stimulated to eat particles, Echinacea has been touted to be able to boost the body's ability to fight off infection.
Reactions: The most common side effect is an unpleasant taste. Echinacea can cause liver toxicity. It should be avoided in combination with other medications that can affect the liver (such as ketaconazole, leflunomide (Arava), methotrexate (Rheumatrex), isoniazide (Nizoral).

St. John's Wort

Uses: St. John's Wort is popularly used as an herbal treatment for depression, anxiety, and sleep disorders. It is technically known as Hypericum perforatum. C

Benign Prostatic Hyperplasia

( As the age of man progresses, the prostate gland enlarges (Age 50=%50% - Age 75=75% will developed BPH)

S/S: FRIENDS
F requency of urination
R esidual urine volume >50mL
I rritability
E valuation thru urodynamic flow is decrease
N octuria
D iscomfort and hesitancy
S mall urinary stream

Highly Active Antiretroviral Therapy

HAART is the name given to aggressive treatment regimens used to suppress HIV viral replication and the progression of HIV disease. The regimen combines t 3 or more different drugs such as 2 nucleoside reverse transcriptase inhibitors (NRTIs) & a protease inhibitor (PI), two NRTIs and a non-nucleoside reverse transcriptase inhibitor (NNRTI)

SIDE EFFECTS: HAART
H eadache
A bdominal pain
A nemia
R ash
T even's Johnson Syndrome

OLANZIPINE

OLANZAPINE - is a medication that is used to treat schizophrenia and acute manic episodes associated with bipolar I disorder. Side effects seen with olanzapine include akathisia (an inability to sit still), constipation, dizziness, drowsiness, insomnia, dry mouth, orthostatic hypotension ♥ ♥ ♥

Nclex-RN notes

NCLEX-RN NOTES

AORTIC DISSECTION

AORTIC DISSECTION
Aortic dissection is a potentially life-threatening condition in which there is bleeding into and along the wall of the aorta, the major artery leaving the heart.

HFQ CONCEPTS
A - frican American
A - therosclerosis
A - n increase of BP
A - rteritis and syphillis
A - ortic repair and
A - ntihypertensive are the management
A - rroyo is a risk person

CRETINISM

CRETINISM-CONGENITAL HYPOTHYROIDISM
C - onstipation
R - est and sleeps a lot
E - dematous face
T - ongue and belly enlargement
I - nfertility
N - o or stunted growth
I - ncreasing jaundice
S - hort stature
M - ental retardation (DOC:SYNTHROID)

FOSCARNET

FOSCARNET (foscaVIR IV ) - Foscarnet is used to treat the symptoms of cytomegalovirus (CMV) infection of the eyes in patients with AIDS. Foscarnet will not cure this eye infection, but it may help to control worsening of the symptoms. It is also used to treat herpes simplex virus (HSV) infections of the skin and mucous membranes ♥ ♥ ♥

NITROPRUSSIDE

NITROPRUSSIDE (HFQ)

1. Indicated for patients with hypertensive crisis
2. Also for patients with CHF
3. Dilution: 50 mg of NITROPRESS must be further diluted in 250-1000 mL of sterile 5% dextrose injection.
4 . The diluted solution should be protected from light, using the supplied opaque sleeve, aluminum foil, or other opaque material ♥ ♥ ♥

SINUSITIS

SINUSITIS
Sinusitis is a condition consisting of inflammation of the paranasal sinuses, which may or may not be as a result of infection, from bacterial, fungal, viral, allergic or autoimmune

HFQ: DIET FOR SINUSITIS
Patients should take a balanced diet. Most persons with sinus trouble also suffer from acidity. Their diet should, therefore; veer to the alkaline side. The intake of salt should be reduced to the minimum as salt leads to accumulation of water in the tissues and expels calcium from the body.

In the acute stage of the disease, when fever is pre¬sent, the patient should abstain from all solid foods and only drink fresh fruit and vegetable juices diluted with water in the proportion of 50:50. After the fever subsides, he may adopt a low-calorie raw fruit and vegetable diet with plenty of raw juices.

After the acute symptoms are over, the patient may gradually embark upon a well-balanced diet of three basic food groups, namely seeds, nuts and grains; vegetables and fruits. In persistent chronic conditions, repeated short juice fasts may be undertaken for a week or so at intervals of two months.

MI AND ANESTHESIA

THE most common complication of client with MI is cardiac Arrhythmia-PVC. The drug of choice is lidocaine. It is neurotoxic - monitor for signs of toxicity such as confusion, tremors and ataxia :)

Remember ice chips after anesthesia if the patient is nauseated. Extremes will not stimulate the vomiting center. (CHildren cold soda-adults hot or cold ginger ale)

PERSANTIN STRESS TEST

PERSANTIN STRESS TEST
is a test where pictures are taken of your heart muscle.

This test helps to diagnose a CAD. This test helps caregivers see areas of the heart muscle that do not get enough blood supply. The test can also show areas that have been damaged after a heart attack (PERSANTIN)

P regnancy is a contraindication to this procedure
E ating is restricted 6H PTP
R efrain from caffein
S smoking must be avoided
A ssess allergy to persantin
N o to sports drinks
T hallium is a a radioisotope that will also be injected
I V line must be patent
N uclear medicine department - location of the procedure

IMPETIGO

IMPETIGO (SATA)

I mpetigo contagiosa (highly contagious)
M outh and face - most common site
P ustules & vesicles - appearance of lesion progressing to an
E xudative and crusting stage
T reatment - ABT - antibiotic therapy
I solation precaution is CONTACT (GGG)
G ABHS or staph auresus - agent
O ral ABT, ointment and PHISOHEX are included in the Tx

NCLEX sample q's 104

1. A new mother has some questions about (PKU). Which of the following statements made by a nurse is not correct regarding PKU?

A: A Guthrie test can check the necessary lab values.

B: The urine has a high concentration of phenylpyruvic acid

C: Mental deficits are often present with PKU.

D: The effects of PKU are reversible.

2. A patient has taken an overdose of aspirin. Which of the following should a nurse most closely monitor for during acute management of this patient?

A: Onset of pulmonary edema

B: Metabolic alkalosis

C: Respiratory alkalosis

D: Parkinson’s disease type symptoms

3. A fifty-year-old blind and deaf patient has been admitted to your floor. As the charge nurse your primary responsibility for this patient is?

A: Let others know about the patient’s deficits.

B: Communicate with your supervisor your patient safety concerns.

C: Continuously update the patient on the social environment.

D: Provide a secure environment for the patient.

4. A patient is getting discharged from a SNF facility. The patient has a history of severe COPD and PVD. The patient is primarily concerned about their ability to breath easily. Which of the following would be the best instruction for this patient?

A: Deep breathing techniques to increase O2 levels.

B: Cough regularly and deeply to clear airway passages.

C: Cough following bronchodilator utilization

D: Decrease CO2 levels by increase oxygen take output during meals.

5. A nurse is caring for an infant that has recently been diagnosed with a congenital heart defect. Which of the following clinical signs would most likely be present?

A: Slow pulse rate

B: Weight gain

C: Decreased systolic pressure

D: Irregular WBC lab values

6. A mother has recently been informed that her child has Down’s syndrome. You will be assigned to care for the child at shift change. Which of the following characteristics is not associated with Down’s syndrome?

A: Simian crease

B: Brachycephaly

C: Oily skin

D: Hypotonicity

7. A patient has recently experienced a (MI) within the last 4 hours. Which of the following medications would most like be administered?

A: Streptokinase

B: Atropine

C: Acetaminophen

D: Coumadin

8. A patient asks a nurse, “My doctor recommended I increase my intake of folic acid. What type of foods contain the highest concentration of folic acids?”

A: Green vegetables and liver

B: Yellow vegetables and red meat

C: Carrots

D: Milk

9. A nurse is putting together a presentation on meningitis. Which of the following microorganisms has noted been linked to meningitis in humans?

A: S. pneumonia

B: H. influenza

C: N. meningitis

D: Cl. difficile

10. A nurse is administering blood to a patient who has a low hemoglobin count. The patient asks how long to RBC’s last in my body? The correct response is.

A: The life span of RBC is 45 days.

B: The life span of RBC is 60 days.

C: The life span of RBC is 90 days.

D: The life span of RBC is 120 days.

Answer Key

1. (D) The effects of PKU stay with the infant throughout their life.

2. (D) Aspirin overdose can lead to metabolic acidosis and cause pulmonary edema development.

3. (D) This patient’s safety is your primary concern.

4. (C) The bronchodilator will allow a more productive cough.

5. (B) Weight gain is associated with CHF and congenital heart deficits.

6. (C) The skin would be dry and not oily.

7. (A) Streptokinase is a clot busting drug and the best choice in this situation.

8. (A) Green vegetables and liver are a great source of folic acid.

9. (D) Cl. difficile has not been linked to meningitis.

10. (D) RBC’s last for 120 days in the body.

NCLEX Practice Test 101

1. A 43-year-old African American male is admitted with sickle cell anemia. The nurse plans to assess circulation in the lower extremities every 2 hours. Which of the following outcome criteria would the nurse use?

1. Body temperature of 99°F or less

2. Toes moved in active range of motion

3. Sensation reported when soles of feet are touched

4. Capillary refill of <>

2. A 30-year-old male from Haiti is brought to the emergency department in sickle cell crisis. What is the best position for this client?

1. Side-lying with knees flexed

2. Knee-chest

3. High Fowler's with knees flexed

4. Semi-Fowler's with legs extended on the bed

3. A 25-year-old male is admitted in sickle cell crisis. Which of the following interventions would be of highest priority for this client?

1. Taking hourly blood pressures with mechanical cuff

2. Encouraging fluid intake of at least 200mL per hour

3. Position in high Fowler's with knee gatch raised

4. Administering Tylenol as ordered

4. Which of the following foods would the nurse encourage the client in sickle cell crisis to eat?

1. Peaches

2. Cottage cheese

3. Popsicle

4. Lima beans

5. A newly admitted client has sickle cell crisis. The nurse is planning care based on assessment of the client. The client is complaining of severe pain in his feet and hands. The pulse oximetry is 92. Which of the following interventions would be implemented first? Assume that there are orders for each intervention.

1. Adjust the room temperature

2. Give a bolus of IV fluids

3. Start O₂

4. Administer meperidine (Demerol) 75mg IV push

6. The nurse is instructing a client with iron-deficiency anemia. Which of the following meal plans would the nurse expect the client to select?

1. Roast beef, gelatin salad, green beans, and peach pie

2. Chicken salad sandwich, coleslaw, French fries, ice cream

3. Egg salad on wheat bread, carrot sticks, lettuce salad, raisin pie

4. Pork chop, creamed potatoes, corn, and coconut cake

7. Clients with sickle cell anemia are taught to avoid activities that cause hypoxia and hypoxemia. Which of the following activities would the nurse recommend?

1. A family vacation in the Rocky Mountains

2. Chaperoning the local boys club on a snow-skiing trip

3. Traveling by airplane for business trips

4. A bus trip to the Museum of Natural History

8. The nurse is conducting an admission assessment of a client with vitamin B12 deficiency. Which of the following would the nurse include in the physical assessment?

1. Palpate the spleen

2. Take the blood pressure

3. Examine the feet for petechiae

4. Examine the tongue

9. An African American female comes to the outpatient clinic. The physician suspects vitamin B12 deficiency anemia. Because jaundice is often a clinical manifestation of this type of anemia, what body part would be the best indicator?

1. Conjunctiva of the eye

2. Soles of the feet

3. Roof of the mouth

4. Shins

10. The nurse is conducting a physical assessment on a client with anemia. Which of the following clinical manifestations would be most indicative of the anemia?

1. BP 146/88

2. Respirations 28 shallow

3. Weight gain of 10 pounds in 6 months

4. Pink complexion

11. The nurse is teaching the client with polycythemia vera about prevention of complications of the disease. Which of the following statements by the client indicates a need for further teaching?

1. "I will drink 500mL of fluid or less each day."

2. "I will wear support hose when I am up."

3. "I will use an electric razor for shaving."

4. "I will eat foods low in iron."

12. A 33-year-old male is being evaluated for possible acute leukemia. Which of the following would the nurse inquire about as a part of the assessment?

1. The client collects stamps as a hobby.

2. The client recently lost his job as a postal worker.

3. The client had radiation for treatment of Hodgkin's disease as a teenager.

4. The client's brother had leukemia as a child.

13. An African American client is admitted with acute leukemia. The nurse is assessing for signs and symptoms of bleeding. Where is the best site for examining for the presence of petechiae?

1. The abdomen

2. The thorax

3. The earlobes

4. The soles of the feet

14. A client with acute leukemia is admitted to the oncology unit. Which of the following would be most important for the nurse to inquire?

1. "Have you noticed a change in sleeping habits recently?"

2. "Have you had a respiratory infection in the last 6 months?"

3. "Have you lost weight recently?"

4. "Have you noticed changes in your alertness?"

15. Which of the following would be the priority nursing diagnosis for the adult client with acute leukemia?

1. Oral mucous membrane, altered related to chemotherapy

2. Risk for injury related to thrombocytopenia

3. Fatigue related to the disease process

4. Interrupted family processes related to life-threatening illness of a family member

16. A 21-year-old male with Hodgkin's lymphoma is a senior at the local university. He is engaged to be married and is to begin a new job upon graduation. Which of the following diagnoses would be a priority for this client?

1. Sexual dysfunction related to radiation therapy

2. Anticipatory grieving related to terminal illness

3. Tissue integrity related to prolonged bed rest

4. Fatigue related to chemotherapy

17. A client has autoimmune thrombocytopenic purpura. To determine the client's response to treatment, the nurse would monitor:

1. Platelet count

2. White blood cell count

3. Potassium levels

4. Partial prothrombin time (PTT)

18. The home health nurse is visiting a client with autoimmune thrombocytopenic purpura (ATP). The client's platelet count currently is 80, It will be most important to teach the client and family about:

1. Bleeding precautions

2. Prevention of falls

3. Oxygen therapy

4. Conservation of energy

19. A client with a pituitary tumor has had a transphenoidal hyposphectomy. Which of the following interventions would be appropriate for this client?

1. Place the client in Trendelenburg position for postural drainage

2. Encourage coughing and deep breathing every 2 hours

3. Elevate the head of the bed 30°

4. Encourage the Valsalva maneuver for bowel movements

20. The client with a history of diabetes insipidus is admitted with polyuria, polydipsia, and mental confusion. The priority intervention for this client is:

1. Measure the urinary output

2. Check the vital signs

3. Encourage increased fluid intake

4. Weigh the client

21. A client with hemophilia has a nosebleed. Which nursing action is most appropriate to control the bleeding?

1. Place the client in a sitting position with the head hyperextended

2. Pack the nares tightly with gauze to apply pressure to the source of bleeding

3. Pinch the soft lower part of the nose for a minimum of 5 minutes

4. Apply ice packs to the forehead and back of the neck

22. A client has had a unilateral adrenalectomy to remove a tumor. To prevent complications, the most important measurement in the immediate post-operative period for the nurse to take is:

1. Blood pressure

2. Temperature

3. Output

4. Specific gravity

23. A client with Addison's disease has been admitted with a history of nausea and vomiting for the past 3 days. The client is receiving IV glucocorticoids (Solu-Medrol). Which of the following interventions would the nurse implement?

1. Glucometer readings as ordered

2. Intake/output measurements

3. Sodium and potassium levels monitored

4. Daily weights

24. A client had a total thyroidectomy yesterday. The client is complaining of tingling around the mouth and in the fingers and toes. What would the nurses' next action be?

1. Obtain a crash cart

2. Check the calcium level

3. Assess the dressing for drainage

4. Assess the blood pressure for hypertension

25. A 32-year-old mother of three is brought to the clinic. Her pulse is 52, there is a weight gain of 30 pounds in 4 months, and the client is wearing two sweaters. The client is diagnosed with hypothyroidism. Which of the following nursing diagnoses is of highest priority?

1. Impaired physical mobility related to decreased endurance

2. Hypothermia r/t decreased metabolic rate

3. Disturbed thought processes r/t interstitial edema

4. Decreased cardiac output r/t bradycardia

Mnemonics 01

MI management: MONA
Morphine
O2
Nitroglycerine
Aspirin

HYPOGLYCEMIA: TIRED
T Tired
I Irritability
R Restless
E Excessive hunger
D Diaphoresis-Depression

HEART MURMURS: SPASM
S Stenosis
P Partial obstruction
A Aneurysms
S Septal defect
M Mitral regurgitation

Hyperthyroidism (s/s)
THYROIDISM
Tremor
Heart rate up
Yawning (fatigueability)
Restlessness
Oligomenorrhea & amenorrhea
Intolerance to heat
Diarrhea
Irritability
Sweating
Muscle wasting & weight loss

Miotic: Little word=Little pupil
Mydriatic: Big word=Big pupil

Anticholingergics Side Effects:
Can't see
Can't pee
Can't spit
Can't sh*t

5W's of common causes of post-op fever

Wind (think pneumonia, splinting, incentive spirometer exercises not done, DB+ coughing not done)
Water (dehydration...)
Wound (infection, dehiscence...)
Walking (PE...)
Wonder drug (approriate antibiotic...)

Cranial Nerves

Oh Olfactory Some
Oh Optic Say
Oh Oculomotor Marry
To Trochlear Money
Touch Trigeminal But
And Abducens My
Feel Facial Brother
Virgin Vestibulocochlear Says
Girl's Glossopharangeal Big
Violins Vagus Breasts
Ah Accessory Mean
Heaven Hypoglossal More

For the third column, S stands for sensory, M for motor, and B is both. Also, you have one nose, so Olfactory is CNI, two eyes, so optic is CNII. To remember which order the As come in, ABducens comes before ACcessory alphabetically.

Acute Pancreatitis: I GET SMASHED

I - idiopathic
G - gallstone
E - EtOH
T - trauma
S - steroids
M - mumps (paramyxovirus) and other viruses (EBV, CMV)
A - autoimmune
S - scorpion sting / snake bite
H - hypercalcemia, hyperlipidemia and hypothermia
E - ERCP
D - drugs, duodenal ulcers

To apply a telemetry monitor:
White over right (top right shoulder)
Black beside the white (Over lt shoulder)
Checkers (red below the black)
Christmas (Green beside the red)
Then ofcourse, the brown will be in the middle!

The HYPERKALEMIA "Machine" - Causes of Increased Serum K+
M - Medications - ACE inhibitors, NSAIDS
A - Acidosis - Metabolic and respiratory
C - Cellular destruction - Burns, traumatic injury
H - Hypoaldosteronism, hemolysis
I - Intake - Excesssive
N - Nephrons, renal failure
E - Excretion - Impaired


Signs and Symptoms of Increased Serum K+: MURDER
M - Muscle weakness
U - Urine, oliguria, anuria
R- Respiratory distress
D - Decreased cardiac contractility
E - ECG changes
R - Reflexes, hyperreflexia, or areflexia (flaccid)

HYPERNATREMIA
"You Are Fried"

F - Fever (low grade), flushed skin
R - Restless (irritable)
I - Increased fluid retention and increased BP
E - Edema (peripheral and pitting)
D - Decreased urinary output, dry mouth


"CATS" of "HYPOCALCEMIA"

C - Convulsions
A- Arrhythmias
T - Tetany
S - Spasms and stridor