depresses the CNS; hypotension, facial flushing, muscle weakness, absent deep tendon reflexes, shallow repirations, emergency!
How to easily tell addisons and cushings hyper/hypo? Put the electrolytes in order (calcemia, glycemia, kalemia, natremia). Alpha, Addison's comes first, so does hyper-, then switch between. Hyper, hypo, hyper, hypo.
Cushings is opposite. Hypo, hyper, hypo, hyper.
What has dark pigmentation, decreased resistance to stress fractures, alopecia, wt loss, GI distress?
Addison's or Cushings?
Which has prone to infection, muscle wasting, weakness, edema, HTN, hirsutism, moonface/buffalo hump?
Addison's or Cushings?
What does NMS look like?
Hot, sweaty, STIFF, drool, everything is going UP (BP, pulse, resp.)
Which is more dangerous? regular measles (rubeola), or German measles (rubella).
Never get pregnant with a German (rubella)
When drawing up regular insulin and NPH, remember - you're an "RN".
Regular before NPH.
How to remember tet of fallot? when you hear you child have it, your heart DROPS
Right Ventricular Hypertrophy
How do you remember MAOIs that are used in depression? Think that pirates (arrrr) take MAOIs when they're feeling down...
So the MAOIs that are used for depression have arrrr in their name (Parnate, Marplan, Nardil)
You have a patient with autonomic dysreflexia, GO!
HOB 90 (get that pressure down)
loosen restrictive clothing
assess bladder distension or bowel impaction
admin antihypertensive meds!
Easy way to remember MAOIs? this PANAMA
Digoxin, remember what?
less than 60; hold. check potassium
tx of GERD. watch for consti.
tx of anxiety and itching, watch for dry mouth. given preop commonly.
given for conscious sedation. Watch for resp. depression and hyoptension
Tx of parkinson and extrapyramidal effects of other drugs.
Tx of postop n/v and v associated with gastroenteritis.
Tx of glaucoma.
abx. don't take if allergic to sulfa. diarrhea common. drink plenty fluids.
probenecid, Colchicine, Allopurinol
tx HTN or CHF. report flu-like sx. rise slowly. take with meals.
tx of IBS. assess for anticholinergic
CCB. HTN, angina, assess for consti.
tx of duodenal ulcers. coats the ulcer. take before meals.
Theophylline. What is therapeutic drug level?
Tx of asthma of COPD. therap. drul level 10-20.
anitidote to tylenol. Orally.
tx of glaucoma, high altitude sickness. Don't take if allergic to sulfa drugs.
NSAID. tx of arthritis, bursitis, tendonitis.
tx of hypothyroidism. may take several weeks to take effect. Notify of have chest pain, take AM on empty sotmach, could cause hyperthyroidism.
tx of alchy w/d. What happens if you take this with a drink? Bad n/v.
Tx of leukemia. IV ONLY.
tx of scabies (apply lotion once, leave 8-12 hrs) and lice (use shampoo and leave on 4 mins, hair uncovered, rinse warm water, comb.
Tx after menopause estrogen replacement
Dilantin. Thera drug level?
tx of seizures. thera drug level: 10-20.
tx of schizo. Assess for EPS.
tx of ADHD. assess for heart related SE, report immediately. child may need drug hiliday d/t stunt growth.
tx of hypotension, shock, low cardio output, poor perfusion to vital organs.
monitor arrythmias and BP.
FHR patterns? think VEAL CHOP.
Variable - Cord compression
Early - Head compression
Accels - OK, not a problem!
Late - Placental insufficiency; can't fill.
Please, this baby's cord is being compressed, what position do I put her?
Tren. puts pressure off presenting part of cord!
The cord is showing! What do I do!
put sterile saline gauze to prevent it from drying.
I'm having late decels, what can I do?
turn on left side, gives more blood to placenta
What is priority before giving epidural?
You have to check on mother or baby. Which do you check first?
check the one that doesn't involve a machine. Remember, check the pt, not the machine. You listen to baby's FH tones with steth. You are presented with both? It's the one that is not associated with a machine.
If baby is posterior presentaion, heart sounds are heard?
Baby is anterior, heart sounds are?
closer to midline.
How to remember blood sugar?
Hot and dry
Cool and clammy
hot and dry - sugar high
cool and clammy - need some candy
ICP and shock have opposite v/s.
ICP - increased BP, decreased pulse, decreased resp.
shock - opposite.
right sided HF caused by left. (so pick jvd, edema if it's a choice).
Herion w/d neonate?
no milk and meat together.
pulse area for CPR on infant?
what age you test child for lead poisoning?
pt with leukemia may have epitaxis why?
What is first action for mother in active labor?
fetal heart tones.
for phobic d/o, use _______
When getting down to two answers, choose assessment over intervention except in an emergency is distress situation.
Choose answers that deal with person's body, NOT with machine.
Remember to discard the absolutes (never, always, must).
Lower amputations, pt is placed in _____ position
small, freq meals are better than larger ones.
LPN cannot handle _____
Amynoglycosides (vanco) causes _____
IV push should go over __ minutes
If patient is not a child, the answer with family option can be ruled out.
ARDS (fluid in alveoli) and DIC are always secondary to something else.
cardinal sign of ARDS is ______
____ is the best indicator of dehydration
Where ever there is sugar, water follows
Don't give aspirin to children, why?
Reyes syndrome (encephalopathy)
Cold for acute pain (sprain), heart for chronic (rheumatoid arth)
What is great for chronic pain other than heat?
When pt is in distress, ______ is rarely a good choice
With pneumonia, _____ and _____ is always present. Old people, _____ is often present.
fever and chills. Confusion. Old people get confused when their body is under attack,
Always check for _____ before giving abx. Make sure you have _____ before giving first dose.
Allergies! and cultures before the first dose. You want to know how well it's going to work, don't you?
Cor pulmonale is essentially fluid overload. So caused by right-sided HF.
COPD is chronic, pneumonia is acute.
Empysema and bronchitis are COPD
COPD pts, the baroreceptors that detect CO2 leves are destroyed. Thats why the O2 have to be low. Or else you blow the stimulus to breathe.
Exacerbation is acute, distress.
Epi is given in a _____ syringe.
Prednisone toxicity = cushing's syndrome
buffalo hump, moon face, high glucose, hypertention
Neutropenic pts get NO _____
fruits, flowers, live vaccines
Chest tubes are placed in ____
Angina vs MI?
angina has low O2, no dead tissue yet.
Mecavor must be given with evening meal is it's QD
do no give nitro is BP is below?
CCB affects the ___load
nitro does not relieve unstable angina
Centigrade to F:
F to Centi:
Write it out: C comes before F
C to F: add 40, multiply 9/5, subtract 40.
F to C: add 40, multiply 5/9, subtract 40
reverse alchy w/d?
detoxify/tx pain in narcotic addicts?
PT/INR tells you what?
aPTT tells you what?
Med of choice for Vtach is ____
Med o choice for SVT is ____
adenosine or adenocard
Med o choice for asystole is _____
Med o choice for CHF is ______
Med o choice for anaphylactic shock is _____
Med o choice for Staticus Epiepticus is ____
Med o CHoice for bipolar is _____
Amiodarone (antiarythmic) is good for both ventricular and atrial complications
S3 is normal in CHF, not in MI
Give carafate (GI med) before meals to coat stomach
After endoscopy, you want to check their ____
TPN is given through the?
low residue diet means?
portal hypotension + albuminemia = _____
what cells produce insulin?
beta cells of pancreas
Don't give ____ in pancreatitis, give ____ instead.
Trousseau and Tchovosko signs are seen in _____
In DKA, body break down fat instead of sugar for energy. Fats leave ketones (acids) that cause pH to decrease.
DKA is rare in Type II because?
there is enough insulin to prevent breakdown of fats
Classic sign of fat embolism is ____. You treat it with?
petechiae. tx with hep.
For knee replacement, use what machine?
continuous passive motion machine
How to tx cataract?
Autonomic dysreflexia is usually caused by?
What do you have to worry about that comes right after a SCI?
What can you give to check to see if MG is the culprit here?
What is the neuro-degenerative disease that progresses from the bottom-up?
Guillain-Barre. Watch for when it reaches the lungs.
Parkinson's. Think RAT
rigid, akinesia, tremors. Tx with levodopa.
TIA vs CVA?
TIA is a mini stroke with no dead brain tissue. CVA is dead braine tissue.
What is hodgkin's?
cancer of lymph. curable in early stages.
birth wt doubles by _ and triples by _
doubles by 6; triples by 1
first sign of cystic fibrosis in baby is meconium ileus at birth. baby is inconsoluable, won't eat, not passing meconium.
Tof, Truncys ateriosus, Transposition of great vessels.
All won't give blood to heart.
With R side cardiac cath, look for _____ problems
L side cardiac cath, look for ____ problems.
Rheumatic fever can lead to _____
cardiac valve malfxn
What is cerebral palsy?
poor muscle control d/t birth injuries and/or decrease oxygen to brain tissues
What signs help you determine meningitis?
Wilm's tumor is usually encapsulated above the kidneys causing _____
Bucks tractions involves?
Russels tractions involves?
femur or lower leg
Dunlap traction involves
skeletal or skin
Bryant's traction involves
children less than 3.
eclampsia is a seizure.
patient with vertical c-section will most likely get another one.
perform amniocentesis before __ weeks to check for cardiac and pulmonary abnormalities
Who receives rhogam?
Rh- mothers to protect next baby
Anterior fontanelle closes by __ months. Posterior by __ weeks.
posterior 6-8 weeks
diffuse edema of the fetal scalp that crosses the suture lines. Swelling reabsorbs 1-3 days.
Pathological jaundice vs physiological
occurs bfore 24 hrs and last 7 days.
psysiological occurs after 24 hours
placenta previa vs abruption
previa: bleeding, no pain
abruption: pain, no bleeding
bethamethasone is used for?
surfactant. Used for lung expansion.
baby can't make it down to canal
mag sulfate is used for what? contraindicated in what?
halt preterm labor. if no more DTR
what is milieu therapy?
taking care of pt/environment.
cognitive therapy is?
SSRIs take about _ weeks to work.
Obscession is to _____. Compulsion is to ____.
If pts have hallucinations, _____.
if they have delusions, _____.
hallucinations; redirect them.
delusions?; distract them.
Thorazine and Haldol can lead to what SE?
Hypertyroidism - think m.jackson's thriller!
skinny, nervous, bulging eyes, up all night, heart beating fast!
Atropine used for?
Phenergan used for?
Diazepam commonly used for?
No not give _____ to those with sickle cell
What method you use to give iron injection?
Cranial nerves. Oh, Oh, Oh, To Touch And Feel A Girl's Vagina And Hymen.
Some Say Marry Money But My Brother Says Big Bras Matter More.
You patch the good eye so the weaker one can get stronger.
Tidal vol is _____
COPD, remember 2LNC (don't want to stop the reflex to breathe!) Also remember that the are running low on the Pa02 (60ish) and Sa02 (90ish) because of their condition. So don't worry about that in the question!
Pancuronium (muscle relaxant before surgeries). Reverse use what?
atropine (think about it, atropine brings back a "relaxed" heart!)
Ampho B (tx fungus) can cause _____
What do you have to remember to do before giving asperginase (leukemia drug)?
test for hypersensitivity
Take Vermox (worm infections) with a high fat diet.
Kidney glucose threshold is ____
Stranger anxiety is strong in what ages? What about separation anxiety?
MMR is what kind of shot?
Lymes disease and ticks and shit are mostly found where?
WHen drawing ABG, you need to put in heparanized tube, on ICE, what kind of air the patient was on.
What test do you do before you take a ABG?
allen's test (occlude the arteries and let go after to check to see if it's patent, bloodflow, all that good stuff).
Diamox, used for glaucoma, can cause ______
Dexedrine, used for ADHD, may alter _____. avoid taking with MAOIs. take in morning is possible (insomnia effect).
Cytovene, used for retinitis caused by cytomegalovirus, pt will need regular eye exams, report ____, _____, _____ immediately.
dizziness, confusion, seizures.
Remember to give _____ with INH (TB med)
Antipsychotics can't be mixed in what liquid?
caffeine or apple juice
Risperdal (first line AP med in children), doses over ___ can lead to tardive diskinesia.
Levodopa is contraindicated in pts with glaucoma.
Sinemet (parkinsons) is contra with _____
Hydroxyurea, report any signs of ____. may be signs of tox.
Zocor (hyperlipid), take with _____ stomach.
Decorticate (CORD) is rigid with hands toward body, decerebrate is other way. (hands on side)
munchausen syndrome is?
they do self-harm or lie about being hurt to get medical care.
munchausen by proxy is?
when someone harms or pretends to harm someone under their care so they can get health care.
Huntington's Chorea is?
50% genetic, autosomal dominant d/o.
writhing, twisting movements of face, limbs and body. gait deteriorates until can't walk.
no cure. just comfort care.
How can you forreal tell a abd. aortic aneurysm?
Uremic fetor is?
smell of pee on breath
Hirschsprung's is what?
bile is lower obstruction, no bile in upper obstruction;ribbon like stools
Pancreatic enzymes are taken ____ meals.
Why can't patients have canteloupe before occult blood test?
the vit c will create a false positive.
Hypospadias is what?
The pee hole is under where it should be. - think hypo-, under.
Epispadias is what?
The pee hole is on the front surface of where it should be.
Priapism is what?
painful bonor lasting more then 6 hours.
you see coffee ground emesis, you think?
anytime you see fluid retention, think?
an answer that delays tx or care is always wrong!
Remember compartment syndrome is an EMERGENCY bc neuromuscular damage is irreversible 4-6 hours after onset.
always select a "patient focused" answer
an answer that states "reassess in 15 min" is probably wrong.
What does fetal alchy syndrome look like?
flat nasal bridge
thin upper lip
SGA (small for gestational age)
You give IM injections to infants to 6mo where?
You give IM inj to toddlers above 18 mo where?
latin names for the eyes:
B) OU - both
OS - left
OD - right (think, dominant right eye)
Think of COAL when using a cane to help walk.
How would you triage an open fx of a long bone?
Triage a hemothorax
Triage eye and CNS injuries
v/s; shave area around needle insertion; position pt with arms on pillow on over bed table or lying on side; no more than 1000cc at at ime.