-
Don't delegate what you can EAT.
-
Addisons and Cushings? Na...???
Na, BP, Vol, K, Gly
- Addisons: down, down, down, up, down
- Cush: up, up, up, down, up
-
No P, No K.
No giving potassium without enough pee
-
How to remember better perfusion?
EleVate Veins; dAngle Arteries
-
APGAR scale?
- Appearance: all pink; pink/blue; blue
- Pulse: >100, <100, absent
- Grimace: cough, grimace, no response
- Activity: flexed, flaccid, limp
- Respirations: strong cry; weak cry; absent
-
MTV = airborne
- Measles
- TB
- Varicella - chickenpox - herpes/zoster - shingles
*remember - private room, N95 TB
-
Droplet; think SPIDERMAN
What kind of room and mask do you need?
- Sepsis
- Scarlet fever
- Strep. pharyn
- Parovirus B19
- Pneumonia
- Pertussis
- Influenza
- Diptheria (pharyngeal)
- Epiglottis
- Rubella
- Mumps
- Mennigitis
- Myocoplasma or meningeal pneumonia
- AdeNovirus
private room; cohort mask
-
How do you remember contact precautions?
MRS. WEE.
- M - multi.drug resistant
- R - resp. infxn
- S - skin infxn
- W - wound infxn
- E - enteric infxn
- E - eye infxn
-
Air/pulm emboli.
S/S and what do you do?
chest pain, diff. breathing, tachy, pale, impending doom.
lower HOB; left side
-
Woman in labor with unreassuring FHR.
what does it look like and what do you do?
late decels, decreased variability, fetal brady.
left side; stop pitocin;increase IV fluids.
-
What position for after a lumbar puncture?
supine. prevent HA and leaking CSF
-
Position for heat stroke?
flat w/ legs elevated
-
Position for continuous bladder irrigation?
catheter taped to leg so leg is straight. No other position restrictions.
-
Position after myringotomy?
on affected side. (drains secretions)
-
Position after cataract surgery?
unaffected side - night shield - 1-4 weeks.
-
Position after thyroidectomy?
semi-fowlers, support head and neck.
-
Position for Spina Bifida?
Prone. (so don't rupture sac)
-
Position for Total hip replacement.
No elevate HOB more than 45, no bend more than 60, pillow for ABduction.
-
Position for prolapsed cord?
Knee-chest or Trendelenburg
-
Position for infant with cleft lip?
upright or car seat to prevent damage to suture line
-
How to prevent dumping syndrome? (post-op ulcer and stomach surguries)
eat in reclining, lie down after meals 20-30 mins, restrict fluids, low CHO and fiber, small frequent
-
Position for AKA?
elevate for first 24 hours, then prone for hip extension
-
Position for BKA?
foot of bed elevated for 24 hours, then prone.
-
Position for detached retina?
area of detachment should be dependent
-
Position for enema?
left side lying (sims)
-
Position after incision behind hairline?
HOB 30-45 degrees.
-
Position after infratenorial surgury (incision at nape of neck)
flat, lateral on either side
-
Position while pt is on internal radiation?
bedrest while implant in place.
-
Autonomic dysreflexia/hyperreflexia. What to do before any implementation?
sitting position (elevate HOB)
-
Position after shock?
bedrest, extremities elevated 20, knees straight, head slightly elevated (modified trendelenburg)
-
Position for head injury?
elevated HOB to decrease ICP
-
Position for dialysis if outflow is inadequate?
turn pt side to side BEFORE checking for kinks in tubing
-
Position for lumber puncture?
AFTER procedure, client should be placed in supine position for 4-12 hours as prescribed.
-
We don't use morphine sulfate for pancreatitis, we use _______.
Demorol
-
Myasthenia Gravis worsens with ______ and improves with ______.
worsens with exercise and improves with rest
-
During a cholinergic crisis in a MG pt...caused by _____ so we do what?
excessive medication, stop med, tensilon makes it worse.
-
What is a go-to head injury med? What do you have to remember to use with it?
Mannitol (osmotic diuretic). crystalizes at room temp - FILTER NEEDLE.
-
What do you need to be aware of before your patient goes for a liver biopsy?
PTT
-
From the ass (diarrhea = metabolic _____
acidosis
-
From the mouth (vomit) = metabolic ______
alkalosis
-
Myxedema/hypothyroidism is?
slowed physical and mental fxn, sensitivity to cold, dry skin and hair.
-
Graves disease/hyperthyroidism is what?
accelerated physical and mental fxn, sensitivity to heat, fine/soft hair.
-
Thyroid storm is what?
increased temp, pulse and HTN
-
Pt is post-thyroidectomy. What position do you put him at?
semi-fow, prevent neck flexion/hyperextension, trach at bedside.
-
To help remember hypo-parathyroid - CATS
convulsions, arrythmias, tetany, spasms, stridor.
need high Ca, low Phos diet.
-
Hyper-parathyroids looks like weak calcium monsters.
fatigue, muscle weakness, renal calculi, back and joint pain (increased ca).
need low ca, high phos diet.
-
Hypovolemia looks like what?
Think everything increased except BP
increased temp, rapid/weak pulse, sweating, anxiety, specific gravity <1.030
hypotension
-
Hypervolemia looks like?
Bounding pulse, SOB, dypnea, rales/crackles, periph edema, HTN, urine gravity >1.010, Semi-Fowlers
-
Diabetes Insipidus (increased ADH) looks like?
What do you give?
Lots of urine, thirsty, dehydration, weakness, administer Pitressin
-
SIADH (increased ADH) looks like what, what do you give?
change in LOC, decreased deep tendon reflexes, tachy, n/v/a, HA; administer Declomycin, diuretics
-
Hypokalemia. What are some tell-tale, what can you do?
muscle weakness and dysrhythmias. Increase K (raisins, bananas, apricots, oranges, beans, ptotatos, carrots, celery)
-
Hyperkalemia - remember MURDER
Muscle weakness, Urine (oliguria/anuria), Resp. depression, Decreased cardiac contractility, ECG changes, Reflexes.
-
Hyponatremia. What is common and what do you give?
nausea, muscle cramps, increased ICP, musclar twitching, convulsion.
diuretics; fluids.
-
hypernatremia. What is common and what do you give?
increased temp, weakness, disorientation/delusions, hypotension, tachy.
hypotonic solution.
-
Hypocalcemia - remember CATS
convulsions, arrhythmias, tetany, spasms, stridor
-
Hypercalcemia. If too little Ca gives tetany and spasms...
Too much will give muscle weakness, lack of coordination, so you're confused, tendon reflexes are gone, sedative effect on CNS.
-
HypoMg.
tremors, tentany, seizures, dysrhythmias, depression, confusion, dysphagia; dig toxcity.
-
Hyper Mg
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.
k
-
What has dark pigmentation, decreased resistance to stress fractures, alopecia, wt loss, GI distress?
Addison's or Cushings?
Addison's
-
Which has prone to infection, muscle wasting, weakness, edema, HTN, hirsutism, moonface/buffalo hump?
Addison's or Cushings?
Cushing's
-
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
- Defect, spetal
- Right Ventricular Hypertrophy
- Overriding aorts
- Pulmonary stenosis
-
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
-
Amphojel?
tx of GERD. watch for consti.
-
Vistaril?
tx of anxiety and itching, watch for dry mouth. given preop commonly.
-
Versed
given for conscious sedation. Watch for resp. depression and hyoptension
-
PTU and Tapazole
prevention of thyroid storm
-
Sinemet
tx pf parkinsons. Sweat, saliva, urine may turn reddish brown. Drowsiness.
-
Artane
Tx of parkinson. may be sedative.
-
Cogentin
Tx of parkinson and extrapyramidal effects of other drugs.
-
Tigan
Tx of postop n/v and v associated with gastroenteritis.
-
-
Bactrim
abx. don't take if allergic to sulfa. diarrhea common. drink plenty fluids.
-
Gout meds.
probenecid, Colchicine, Allopurinol
-
Hydralazine
tx HTN or CHF. report flu-like sx. rise slowly. take with meals.
-
bentyl
tx of IBS. assess for anticholinergic
-
Calan (verapamil)
CCB. HTN, angina, assess for consti.
-
Carafate
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.
-
Mucomyst
anitidote to tylenol. Orally.
-
Diamox
tx of glaucoma, high altitude sickness. Don't take if allergic to sulfa drugs.
-
Indocin
NSAID. tx of arthritis, bursitis, tendonitis.
-
Synthroid
tx of hypothyroidism. may take several weeks to take effect. Notify of have chest pain, take AM on empty sotmach, could cause hyperthyroidism.
-
Librium
tx of alchy w/d. What happens if you take this with a drink? Bad n/v.
-
Oncovin
Tx of leukemia. IV ONLY.
-
Kwell
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.
-
Premarin
Tx after menopause estrogen replacement
-
Dilantin. Thera drug level?
tx of seizures. thera drug level: 10-20.
-
Navane
tx of schizo. Assess for EPS.
-
Ritalin
tx of ADHD. assess for heart related SE, report immediately. child may need drug hiliday d/t stunt growth.
-
Dopamine (Inotropine)
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?
hydration
-
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?
on sides
-
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.
-
Cor pulmonae
right sided HF caused by left. (so pick jvd, edema if it's a choice).
-
Herion w/d neonate?
poor sucking
-
Jews food?
no milk and meat together.
-
pulse area for CPR on infant?
brachial
-
what age you test child for lead poisoning?
12 months.
-
pt with leukemia may have epitaxis why?
low platelets.
-
What is first action for mother in active labor?
fetal heart tones.
-
for phobic d/o, use _______
systematic desensitisation.
-
When getting down to two answers, choose assessment over intervention except in an emergency is distress situation.
k
-
Choose answers that deal with person's body, NOT with machine.
k
-
Remember to discard the absolutes (never, always, must).
k
-
Lower amputations, pt is placed in _____ position
prone
-
small, freq meals are better than larger ones.
k
-
LPN cannot handle _____
blood
-
Amynoglycosides (vanco) causes _____
nephroand ototoxicity.
-
IV push should go over __ minutes
2
-
If patient is not a child, the answer with family option can be ruled out.
k
-
ARDS (fluid in alveoli) and DIC are always secondary to something else.
k
-
cardinal sign of ARDS is ______
hypoxemia
-
____ is the best indicator of dehydration
weight.
-
Where ever there is sugar, water follows
k
-
Don't give aspirin to children, why?
Reyes syndrome (encephalopathy)
-
Cold for acute pain (sprain), heart for chronic (rheumatoid arth)
k
-
What is great for chronic pain other than heat?
guided imagery
-
When pt is in distress, ______ is rarely a good choice
meds administration
-
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.
k
-
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.
k
-
Exacerbation is acute, distress.
k
-
Epi is given in a _____ syringe.
TB
-
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 ____
pleural space.
-
Angina vs MI?
angina has low O2, no dead tissue yet.
-
Mecavor must be given with evening meal is it's QD
k
-
do no give nitro is BP is below?
90
-
CCB affects the ___load
after
-
nitro does not relieve unstable angina
k
-
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 heparin?
promatine sulfate
-
-
reverse ammonia?
lactulose
-
reverse acetaminophen?
n-Acetylcysteine
-
reverse Iron?
deferoxamine
-
-
reverse alchy w/d?
librium
-
detoxify/tx pain in narcotic addicts?
methadone
-
PT/INR tells you what?
coumadin levels
-
aPTT tells you what?
Heparin levels.
-
Med of choice for Vtach is ____
lidocaine
-
Med o choice for SVT is ____
adenosine or adenocard
-
Med o choice for asystole is _____
atropine
-
Med o choice for CHF is ______
ace inhibitor
-
Med o choice for anaphylactic shock is _____
epi
-
Med o choice for Staticus Epiepticus is ____
Valium
-
Med o CHoice for bipolar is _____
lithium
-
Amiodarone (antiarythmic) is good for both ventricular and atrial complications
k
-
S3 is normal in CHF, not in MI
k
-
Give carafate (GI med) before meals to coat stomach
-
-
After endoscopy, you want to check their ____
gag reflex
-
TPN is given through the?
subclavian line
-
low residue diet means?
low fiber
-
portal hypotension + albuminemia = _____
acites
-
what cells produce insulin?
beta cells of pancreas
-
Don't give ____ in pancreatitis, give ____ instead.
morphine; demorol
-
Trousseau and Tchovosko signs are seen in _____
hypocalcemia
-
In DKA, body break down fat instead of sugar for energy. Fats leave ketones (acids) that cause pH to decrease.
k
-
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?
lens removal
-
Autonomic dysreflexia is usually caused by?
full bladder
-
What do you have to worry about that comes right after a SCI?
spinal shock.
-
What can you give to check to see if MG is the culprit here?
tensilon test.
-
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.
k
-
cyanotic 3Ts
Tof, Truncys ateriosus, Transposition of great vessels.
All won't give blood to heart.
-
With R side cardiac cath, look for _____ problems
valve
-
L side cardiac cath, look for ____ problems.
coronary
-
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?
Kernig's/Brudzinski's sign
-
Wilm's tumor is usually encapsulated above the kidneys causing _____
flank pain
-
Bucks tractions involves?
knee
-
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.
k
-
patient with vertical c-section will most likely get another one.
k
-
perform amniocentesis before __ weeks to check for cardiac and pulmonary abnormalities
20
-
Who receives rhogam?
Rh- mothers to protect next baby
-
Anterior fontanelle closes by __ months. Posterior by __ weeks.
18 months.
posterior 6-8 weeks
-
caput succedaneum
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.
-
Dystocia is?
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?
counseling
-
SSRIs take about _ weeks to work.
3
-
Obscession is to _____. Compulsion is to ____.
thought; action
-
If pts have hallucinations, _____.
if they have delusions, _____.
hallucinations; redirect them.
delusions?; distract them.
-
Thorazine and Haldol can lead to what SE?
Extrapyramidal SE
-
Hypertyroidism - think m.jackson's thriller!
skinny, nervous, bulging eyes, up all night, heart beating fast!
-
Atropine used for?
decrease secretions
-
Phenergan used for?
antiemetic. nausea.
-
Diazepam commonly used for?
reduce anxiety
-
No not give _____ to those with sickle cell
demerol
-
What method you use to give iron injection?
z-track.
-
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.
- Olfactory
- Optic
- Occulomotor
- Trochclear
- Trigeminal
- Abducens
- Facial
- Auditory
- Glossopharyngeal
- Vagus
- Accessory
- Hypoglassal
-
Hypernatremia - think SALT
- Skin flushed
- Agitation
- Low grade fever
- Thirst
-
Developmental:
2-3 months:
4-5 months:
6-7 months:
8-9 months:
10-11 months:
12-13 months:
- 2-3 months: head side-to-side
- 4-5 months: grasps, switch & roll
- 6-7 months: sit at 6, waves bye bye
- 8-9 months: stands straight at 8
- 10-11 months: belly to butt (phrase has 10 letters)
- 12-13 months: 12 and up, drink from a cup
-
How to remember Hep?
- ends in a vowel; comes from the bowel
- Hep B - blood and body fluids
- Hep C - C is just like B
-
Apgar scale measures? Think of MRS. heart and lungs.
HR, RR, muscle, reflex, skin tone
-
Glascow coma scale - how to remember? DATING.
EYES. VERBAL. MOTOR.
First, you have to open your eyes. If you can, 4. If she gotta scream to make you open, 3. If she too ugly you won't wanna? 1.
Talk to your date. She makes sense? 4 points. Shes confused, words you can't understand? 3. She making sounds? 2. No verbal? 1
Good motor response? 6
-
avoid salt substitutes with people with dig and K+ supplements.
They're potassium based
-
Dumping syndrome, what do I eat?
more fat and protein. Lie down after you eat to decrease peristalsis. Wait 1 hr after meals to drink.
-
Blood type _ is the universal donor.
Type _ is the universal recipient.
O - think donor
AB - universal receipient
-
Disseminated Herpes Zoster is AIRBORNE. Localised herpes is contact. Can a nurse with localised herpes take care of a pt?
Yes. just as long as they're not immunocompromised and lesions must be covered.
-
Fat-soluable vitamins are?
ADEK.
-
Give which classes of drugs with food?
NSAIDS, corticos, bipolar, cephalosporins, sulfas
-
what is the go to med for status ep?
ativan
-
Give the bronchodilator first.
k
-
Theyphylline increases the risk for ___ toxicity and decreases the effects of ___ and ____.
dig; lithium and dilantin.
-
INtal does what?
inhaler; tx allergy induced asthma
-
Isoniazid treats what, and you have to look out for what?
treats TB, look out for peripheral neuritis. Give with Vit B6 to prevent. Also hepatotoxic.
-
You have a peptic ulcer. What do you get to treat it?
Flagyl, Prilosec or Biaxin.
This kills bacteria and stops acid, but does not heal ulcer.
-
What do you have to remember about weighted intestinal tubes?
Must float from stomach to intestine, so leave it next to bedside. Don't tape it right away.
-
How long does the diaphragm have to stay in place after sex?
6 hours.
-
I lost weight since I got the diaphragm fitted, is there going to be a problem?
Yes, they are fitted. They must be refitted.
-
Best time to take growth hormone? AM or PM?
PM.
-
Best time to take steroids? AM or PM?
AM.
-
Best time to take diuretics? AM or PM?
AM.
-
Best time to take Aricept? AM or PM?
AM.
-
Administration tips for Carafate? (tx of ulcers). Is there a SE to look out for?
before meals. Consti.
-
Administration tips for Tagamet?
(tx ulcers, GERD, etc)
with food.
-
What to look out for when using Amphojel long term? (antacids)
weak bones
-
Cushing's triad is?
3 signs that point to increased ICP:
HTN, brady, irregular respirations.
-
Tyroid storm is HOT
(hyperthermia - hyperthyroidism)
-
Myxedema coma is COLD
COLD. (Hypothyroidism)
-
If glaucoma intraocular pressure is high, give ____, NO ATROPINE.
miotics.
-
Non dairy sources of Ca?
rhubarb, sardines, collard greens
-
Low back aches, _____ to relieve. (non-pharm)
bend knees.
-
Push fluids with allopurinol, flush that uric acid out.
k
-
Koplick's spots are?
red spots with blue center. characteristic of PRODROMAL stage of Measles. usually in mouth.
-
Rifampin will turn your fluids what color?
Red Orange.
-
Ethambutol messes with your ____
Eyes
-
Pancreatitis pts, put in what position? Diet? prepare them for what?
Put them in fetal position, NPO, gut rest, prepare antecubital site. They gonna get a PICC.
-
Remember yogurt has live cultures, so you don't want to give them to _____
Immunosuppressed.
-
Murphy's sign is?
pain with palpation of gallbladder area seen with cholecysitis.
-
Cullen's sign is?
ecchymosis in umbilical area, seen with pancreatitis.
-
Turner's sign is?
grayish blue sides. pancreatitis.
-
Mcburney's point is?
Pain in the RLQ indicative of appendicitis.
-
Pain in the LLQ usually means?
Diverticulitis.
This means low residue diet. (no nuts, seeds, peas)
-
RLQ pain usually means?
appendicitis. Watch for peritonitis.
-
Guthrie test is?
Tests for PKU. baby should have eaten entire source of protein first.
-
Shilling test is?
Pernicious anemia. How well one absorbs VitB12.
-
Allen's test.
Occlude both ulnar and radial artery until hands blanch, then let go. If the hands pink up, the ulnar artery is good and you can go ahead with the ABG/radial stick.
-
Cloudy outflow from dialysis is NEVER NORMAL
k
-
Amniotic fluid with yellow particles are what?
meconium stained.
-
What does it mean if the indirect Comb's test was positive?
Means that the mother has the antibody so you don't need to give Rhogam.
-
The three Cs of TEF (transesophogeal fistula)
-
MMR vaccine is given what kind of shot?
SQ
-
Greeks believe in putting charms on baby to protect them from "evil eye" or envy of others.
k
-
4yo CANNOT TELL TIME. You need to tell them in relation to events that they know.
"Mom will come back after supper".
-
Anaphalactic rx to baker's yeast is a contraindication to what?
Hep B vaccine
-
Ask for allergy to ____ before flu shot.
eggs
-
When on nitroprusside, monitor thiocynate (cyanide). Normal is 1, less than that is tox territory.
-
-
SARS is ___ precaution
airborne and contact.
-
Hep A is ____ precautions.
contact.
-
Tentanus, Hep B, HIV are _____ precautions.
standard.
-
WIlliam's position is?
semi fowlers with knees flexed
-
Paget's disease looks like?
tinnitus, bone pain, thick bones.
-
Acid ash diet
cheese, corn, cranberries, plums, prunes, meat, poultry, pastry, bread
-
Alk ash diet
milk, veggies, rhubarb, salmon
-
Orange tag in triage means?
non-emergent psych
-
Insomnia a SE from thyroid hormones.
Body is "too busy" to sleep.
-
BOTOX for strabismus (crossed eyes).
You patch the good eye so the weaker one can get stronger.
-
Tidal vol is _____
7-10 ml/kg
-
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!
k
-
Pancuronium (muscle relaxant before surgeries). Reverse use what?
atropine (think about it, atropine brings back a "relaxed" heart!)
-
Ampho B (tx fungus) can cause _____
hypokalemia
-
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.
k
-
Kidney glucose threshold is ____
180
-
Stranger anxiety is strong in what ages? What about separation anxiety?
7-9 months.
toddler years.
-
MMR is what kind of shot?
SQ
-
Lymes disease and ticks and shit are mostly found where?
Connecticut
-
WHen drawing ABG, you need to put in heparanized tube, on ICE, what kind of air the patient was on.
k
-
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 ______
hypokalemia
-
Dexedrine, used for ADHD, may alter _____. avoid taking with MAOIs. take in morning is possible (insomnia effect).
insulin needs.
-
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)
vitB6
-
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.
6mg
-
Levodopa is contraindicated in pts with glaucoma.
avoid Vitb6
-
Sinemet (parkinsons) is contra with _____
MAOIs
-
Hydroxyurea, report any signs of ____. may be signs of tox.
GI sx.
-
Zocor (hyperlipid), take with _____ stomach.
empty.
-
Decorticate (CORD) is rigid with hands toward body, decerebrate is other way. (hands on side)
k
-
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?
CT
-
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.
WITH.
-
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.
-
Anticholinergic effects:
can't spit
can't pee
can't shit
can't see
- dry mouth
- urine retension
- constipated
- blurred vision
-
you see coffee ground emesis, you think?
peptic ulcer
-
anytime you see fluid retention, think?
heart problem
-
an answer that delays tx or care is always wrong!
k
-
Remember compartment syndrome is an EMERGENCY bc neuromuscular damage is irreversible 4-6 hours after onset.
k
-
always select a "patient focused" answer
k
-
an answer that states "reassess in 15 min" is probably wrong.
k
-
What does fetal alchy syndrome look like?
- upturned nose
- flat nasal bridge
- thin upper lip
- SGA (small for gestational age)
-
You give IM injections to infants to 6mo where?
vastus lateralis
-
You give IM inj to toddlers above 18 mo where?
ventrogluteal
-
latin names for the eyes:
OU
OS
OD
- 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?
Red.
-
-
Triage eye and CNS injuries
yellow
-
Thoracentesis prep
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.
Post: listen for bilateral breath sounds; v/s; check leakage; sterile dresssing.
-
How long is the bedrest for cardiac cath pts?
6-8hrs.
-
How long pt has to be supine after lumbar puncture?
2-3 hrs.
-
What is the process for EEG?
no sleep night before, no stimulants. Can eat. may be asked to hyperventilate and watch a bright flashing light.
-
Prep for a myelogram
NPO 4-6 hrs; allergy hx; meds withheld 48 hrs prior; table will move verious positions within test.
Post: neuro q2-4 hrs; water soluble HOB up, oil soluble HOB down; check for distended bladder.
-
Prep for a liver biopsy
Adm vitK; npo morning of exam 6 hrs; sedative; pt hold breath 5-10 sec, supine, lateral with upper arms elevated.
Post: position on right side; freq v/s; report severe abd pain stat.
-
Prep for paracentesis
semi-fow; upright on edge of bed. Empty bladder.
-
Sengstajen blakemore tube used for tx of esophageal varices
keep scissors at bedside.
-
Common sx of PTB (pulmonary TB)?
low-grade afternoon fever.
-
What you thinking when you see rusty sputum?
pneumonia
-
What you think when you see barrel chest?
Emphysema
-
What you thinking when you see a strawberry tongue?
Kawasaki
-
What you thinking when you see a red, beefy tongue?
Pernicious anemia
-
What you thinking when you see a protruding tongue?
Down syndrome
-
What you thinking when you see rice, watery stool?
Cholera
-
What you thinking when you the fever rise up like a stepladder with chills?
Malaria
-
What you thinking when you see rose spots in the abd?
Typhoid
-
What you thinking when you see pseudo membrane formation?
Diptheria
-
What you thinking when you see Koplick's spots?
Measles
-
What you thinking when you see butterfly rashes?
Lupus lol
-
What you thinking when you see spider like varices?
Liver cirrhosis
-
What you thinking when you see tetany?
low Ca.
-
What you thinking when you see Cullen's sign (ecchymosis of umbilicus)?
Pancreatitis
-
What you thinking when you see bronze skin pigmentation?
Addison's
-
What you thinking when you see a Buffalo hump and a moon face?
Cushing's
-
Sign of Transesophageal fistula? Think 4 C's.
- Coughing
- Choking
- Cyanosis
- Continuous Drooling
-
Epiglotitis signs - think 3 D's
- Drooling
- Dysphagia
- Dysphonia
-
Classic sign of Fibrin Hyalin?
expiratory grunt
-
What you thinking of when you taste salty skin?
cystic fibrosis
-
What is a classic sign of DKA?
Kussmaul's breathing
-
What does painless hematuria tell you
Bladder CA
-
What does a reduced size and force of urine stream tell you?
benign prostate hyperplasia
-
What does a seperation of dermis caused by rubbing tell you?
Pemphigus Vulgaris
-
You have flashes of light and curtain vision. What might have happened?
Retinal detached.
-
You have cat's eye reflex. Grayish discoloration of pupils. What might you have?
Retino Bastoma
-
What is common with hepatic encephalopathy?
Flapping tremors. (you move your hands up and they start to tremor)
-
You see hypotension, but breathing fast and fast heart rate?
shock
-
Cystitis feels like what?
burns when you pee
-
Chvostek and Trosseau's sign is indicative of what?
hypocalcemia
-
You see a "bull's eye" rash. What are you thinking?
Lyme.
-
Classic sign of basilar fx is?
ottorhea (ear pain)
-
Atropine OD - think Hot as a Hare (temp), Mad as a hatter (LOC), Red as a beet (flushed face), dry as a bone (thirsty).
k
-
Ag 4-5 yrs child needs what vaccines?
DPT/MMR/OPV
-
Cystic fibrosis what kind of diet?
low fat, high sodium, at soluble ADEK.
bronchodilators, mucolytics, pancreatic enzymes.
-
Measles is what precaution?
air
-
chicken pox is what precaution
air
-
TB is what precaution?
air
-
Common SE for Zoloft?
agitation, sleep disturb, dry mouth
-
Common SE for Clozapine?
agranulocytosis, tachy and seizures
-
An ill child _____ in behaviors
regresses
-
What is the threshold for further eval in the glucose tolerance test in preggos?
140
-
What cranial nerves involve eye movements?
3,4,6
-
Concerning stomas: should we be expecting mucus in the ileal conduit?
Yes.
-
Remember, change in color is always a ____ sign!
late
-
How do you use a incentive spirometry?
- Sit up
- Exhale
- Inhale for 3 sec
- Hold for 10 sec
-
Aminoglycoside (__mycin; except erythromycin) SE are bean shaped.
nephrotoxic and ototoxic
-
MRSA is ____ precaution
contact
-
VRSA is _____ precaution
contact and airborne (private room, negative pressure)
-
Remember the Mnemonic LITHIUM
- L - level of effect 0.5-1.5
- I - indicate mania
- T - toxic 2-3; n/v, diarrhea, tremors
- H - hydrate 2-3L/day
- I - increased UO and dry mouth
- U - uh oh; give mannitol and diamox
- M - maintain Ns intake 2-3g/day
-
Menierie's Disease. Remember....
diuretics to decrease endolymph in the cochlea, restrict Na, lay on affected ear in bed.
-
How do you know it's gastric ulcer pain?
occurs 30-90 mins after eating, not at night, doesn't go away with food.
-
What is the one med that can't be put through a intraosseous infusion (needle dug into the bon so meds can be administered)?
isoproterenol.
-
What are the priorities in a sickle cell crisis?
fluids and pain
-
Remember that the kidneys and ears are the same shape.
They develop in utero at the same time. So if you see the ears low-set (and you don't see down's as an answer), think kidney function.
-
What age are children old enough to receive an explanation about the procedure and how long of a notice do you give them?
5 years and older can be explained a week in advance.
-
What is the first sign of Pyloric stenosis in a baby?
mild vomiting turning into projectile.
-
What heart problems does Kawasaki cause?
coronary artery aneurysms d/t inflammation of blood vessels
-
With a child with a ventriculoperitoneal shunt (tx to relieve CSF), you should watch out for _______ and _______. The bed position should be _______.
abd. distention and increased ICP (in children, look out for not eating and HA).
Bed should be flat. Don't want fluids to reduce too rapidly.
-
It is essential to maintain nasal patency in children ___ because they are obligatory nasal breathers.
<1
-
What is bad about too much milk?
milk reduces the intake of nutrients. There could be anemia. No milk overnight, it will rot out the teeth.
-
What traction is used in school-aged child with femus or tibial fracture with extensive skin damage?
90-90.
-
White patches on the baby's tongue, how can you tell if it's formula or candidiasis?
If you can remove it - formula. If not? Candidiasis.
-
Just know MMR and Varicella vaccines come when?
15 months.
-
Teach boys to do self-testicular exams at age ____. Why?
12. Undescended testes is a risk factor for testicular cancer.
-
CSF in meningitis has ____ protein and ____ glucose.
high protein and low glucose
-
It is always a correct answer to report suspected cases of child abuse.
k
-
You feed _____ to avoid ottis media.
upright.
-
Position ____ with HOB up with GERD.
prone.
-
Pinna up and back for adults. It's ___ and ____ for kids under 3.
down; back
-
For kids with RSV, no contact lenses or preggo nurses where ribavirin is being administered.
k
-
With pneumonia, you want to splint and reduce pain? Lay on the ____ side.
You want to clear it up? Bring the affected lung____.
affected; up.
-
A positive ppd will confirm infection, not just exposure. A ____ will confirm active disease.
Sputum.
-
Coughing with out other s/s is suggestive of ____.
asthma
-
Watch out if your wheezer stops wheezing. Why?
It could mean it's getting worse.
-
Tet spells are treated with ______.
morphine.
-
Group-A strep _____ rheumatic fever.
precedes.
-
Chorea embarrasses kids. They have joint pain. Give them _____(med).
Penicillin.
-
Don't pick cough over tachycardia for signs of chf in children.
k
-
No MILK in neutropenic pts.
k
-
Tyelenol poisoning possible for about _ days.
4
-
Radioactive Iodine. Key word: flush.
Flush the body 3-4L/day. Flush toilet twice for 2 days. Limit 30 mins/day. No preggos people, no kids.
-
The main hypersensitivity in antiplatelet drugs is ______.
bronchospasm.
-
Common sites for metastasis include the ____, _____, ____, _____, _____.
liver, brain, lung, bone, lymph.
-
Orthostasis is a drop in BP with ____ heart rate.
increased.
-
_____ _____ protein confirms multiple myeloma.
Bence Jones.
-
Dont fall for "reestablishing a normal bowel pattern" in small bowl obstruction. They can't take in fluids yet, so pick ________
Maintaining fluid balance.
-
You see pallor, tachy and a sore, red tongue. you thinking?
pernicious anemia
-
With Tambocor (antiarrythmic), limit ____ and ____.
fluids and sodium. Don't want water to stick around (with the Na) and cause HF.
-
_____ releases histamine during an allergic response.
Basophils.
-
_____ is the med o choice for paroximal atrial tachy.
Adenosine.
-
Iatragenic means?
it was caused by tx, procedure or med.
-
G and J tube feedings are run at ____ feedings.
continuous.
-
Priority in radiation tx patients is ____, not skin irritation.
Leukopenia.
-
A pt that is on Tamoxifen should report changes in _____, since it's irreversible.
visual acuity.
-
________ gets administered post splenectomy to prevent pneumococcal sepsis.
Pneumovax 23.
-
Lets say every value in the answers are all abnormal. If potassium is there, pick it. Even a BUN of 50 doesn't override a potassium of 3.0 in a renal patient. it's life threatening.
k
-
Trick in figuring out potassium in alk and acid.
AlKalosis - K is low.
Acid os opposite - K is high.
k
-
Vital sign to check with potassium is ____.
pulse. (dysrhythmias)
-
Give ____ to MG pts 45 mins before to help with chewing and swallowing.
Neostigmine.
-
_____ is used a short term muscular blocking agent for procedures like intubation and ECT. ____ is for intermediate or long term.
Anectine; Norcuron.
-
The parathyroid gland requires ____ to work.
VitD
-
_____ increases the effects of oral anticoags.
Glucagon.
-
Remember, bleeding is part of the ABCs. So if breathing and and airway is in check, a broken bone is next before neuro checks.
k
-
An ____ dressing is used if a chest tube is pulled out.
Occlusive
-
When O2 deprived, the body will hyperventilate. Paper bag? NO. Look at their PaO2. Less than 80? They need O2.
If you see PE, think O2.
-
Typical adverse rxn to oral hypoglycemics is ____.
rash.
-
In DKA, when you treat the acidosis and dehydration, be prepared for the ___ to drop rapidly.
potassium.
-
____ is most important with HHNS and DKA.
Fluids.
-
Decorticate positioning in repsonse to pain = ____ involvement.
Decerebrate positioning in response to pain = _____ involvement.
cortex involvement
cerebellar - brain stem involvement.
-
Dantrium (spasticity) may take a ___ to kick in.
week.
-
Decreased ______ is related to senile dementia.
acetylcholine.
-
After removal of the pituitary gland, you must look out for ____ and temporary _____ _____.
hypocortisolism and diabetes insipidus
-
Position on ____ side with legs flexed after appendectomy.
right.
-
Ribbon like stools and failure to pass meconium is what?
Hirschsprung
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