NCLEX

I. SATA
1. CERVICAL CA
Risk Factors:
African- American/ Native
women
Behavior (Sexual promiscuity)
Chronic instrumentation of cervix
Disease STD
Early age of Sex
High Parity
Poor Hygiene
Low economic status
Multiple sexual partners
Partner with Prostate CA
Sx:
Post-coital bleeding
Painful sex
Menstrual irregularities
2. OVARIAN CA
Risk factors:
Ovarian dysfunction
Vaginal use of talcum powder
Alcohol
Race - White women & family
history
Infertility
Age - Peak=5th decade of life
Nulliparity
Genetic predisposition
3. DM FOOT CARE
Meticulous care to feet
Wash feet with warm water not hot &
dry
Can use lotion but No lotion in
between toes
Wear socks to keep feet warm
Avoid thermal baths, heating pads
Do not soak feet
Inspect feet daily
Do not treat corns, blisters
Wear loose socks and no barefoot
Change into clean cotton socks daily
Break in new shoes gradually
Use emery board
Do not smoke
Do not wear same pair of shoes 2
days in a row
Check shoes for cracks before using
leather instead of plastic
4. BLOOD TRANSFUSION
REACTION
Transfusion Reactions
Hemolytic Reaction
Allergic Reaction
Circulatory Overload
Septicemia
Iron Overload
Hypocalcemia
Disease Transmission
Hyperkalemia
Citrate Intoxication
5. HYPERTHYROIDISM
Soft smooth skin & hair
Mood swings
HPN
Diaphoresis
Intolerance to heat
PTU drug to block thyroid synthesis
6. LUNG CA
Bronchogenic Carcinoma
1st leading cause of death
From asbestos, bacterial invasion,

cigarette
Sx: Nagging cough, hoarseness of
voice, dyspnea, diminished breath
sounds
7. SX OF PARKINSONS
Tremors, akinesia, rigidity
Weakness, motorized propulsive
gait
Slurred speech, dysphagia, drooling
Monotonous speech
Mask like expression
Teach ambulation modification:
goose stepping walk (marching),
ROM exercises
MedsArtane, Cogentin, L-Dopa,
Parlodel, Sinemet, Symmetrel
Activities should be scheduled for
late morning when energy level is
highest
Encourage finger exercises.
Promote family understanding of
disease intellect/sight/ hearing not
impaired,
8. ACUTE PANCREATITIS
Abdominal Pain severe acute sx
pain radiating to the back
Complication : Shock,Hypovolemia
Limited fat & protein intake
9. CAST CARE
Dont rest on hard surface
Dont cover until dry 48+ hours
Handle with palms of hands not with
fingers
Keep above level of heart
Check for CSM
10. HYDROCEPHALUS
Anterior fontanel bulges & nonpulsating
Bones of head separated (cracked
pot sound) Macewen sound
Check for sun-setting eyes
D Increase ICP
Evidence of Frontal Bossing
Failure to thrive
Irritability
High-pitched cry
11. ESRD DIET
Restricted protein intake
Increase CHO
Low K, P
Restrict Na
12. NORMAL IN 8 MONTH OLD
CHILD
- can sit with out support
- can roll from front to back
- can hold a bottle
- closure of ant. fontanel
- can say mama and dada
- 2 teeth present 8-6=2)
- stranger anxiety peak
13. SUPERIOR VENA CAVA OCCLUSION
Sx occur in the morning
Edema of face, eyes & tightness of
shirt/ (Stokes sign)
Late sx: edema of arms, hands,
dyspnea, erythema, epistaxis
14. ULCERATIVE COLITIS
Sx:
Severe diarrhea with blood & mucus
Abdominal tenderness & cramping
Anorexia
Wt. Loss
Vit. K deficiency
Anemia

Dehydration
Electrolyte imbalance
Low residue & high protein diet
15. DILANTIN
do not floss throughout the day
do not use hard bristled
toothbrush
Gingivitis S/E
purple glove syndrome
16. ANAPHYLACTIC REACTION
(steps)
Stop medication
Maintain airway
Notify MD
Maintain IV access of 0.9 NSS
Place in supine position with legs
elevated
Monitor VS
Administer prescribed
emergency drugs
17. BLADDER CA
Risk Factors:
Hx of smoking
Exposure to radiation
Working in industrial Factory
18. S/S OF DKA
Fruity breath Odor (fetor hepaticus)
Oliguria
Kusmaull's (deep & nonlabored)
19. SITE FOR IM INJECTION ADULT
Deltoid
Ventrogluteal
Vastus Lateralis
Gluteus Maximus
20. S/S OF BACTERIAL MENINGITIS
N&V
Seizures
Stiff Neck
Photophobia
Positive Brudzinski sign
decrease glucose in csf
21. TB
Waking up sweating at night
Low grade fever
Dull aching chest pain
Cough streaked with blood
Weight loss
Anorexia
Fatigue
22. LIVER CIRRHOSIS
N&V
Edema
Ascites
23. PULMONARY EMBOLISM
Sx:
Blood-tinged sputum
Distended neck vein
Chest Pain / Hypotension /
Cyanosis
Cough / Shallow respirations
Rales on auscultation
Tachypnea / Tachycardia
24. COLON CA
Risk Factors:
Family HX
Age above 50
Jewish
Male
25. DIGOXIN THERAPY
Do not administer in infants if <
100bpm
Do not give to older children if
<70 bpm
Sx of toxicity to a child N &V

26. S/S OF CAD

Chest Pain
Palpitations
Dyspnea / Syncope
Hemoptysis
Excessive Fatigue
27. COPD
Rhythmic, diaphragmatic
breathing
If restless, perform purse-lip
breathing not more than 1
minute
Perform deep breathing with
mouth held together during
expiration
28. SEEN IN 15 MONTH OLD CHILD
Speaks 6 words
Sits w/o support
Builds a tower of 5 blocks
Strong palmar grasp
29. CUSHINGS SYNDROME
Osteoporosis
Muscle wasting
Hypertension
Purple skin striations
Moon face
Truncal obesity
Decreased resistance to infection
Low Carbohydrate, Low Calorie,
High Protein, High K, Low sodium
Monitor glucose level
Check for color of stool, cortisol
increase secretion of gastric acid
Peptic ulcer & GI bleeding
C/I to Aspirin, increased bleeding
30. ADDISONS DISEASE
Fatigue
Weakness
Dehydration
Eternal tan
Decreased resistance to stress
Low Sodium
Low Blood Sugar
High Potassium
High protein, carbohydrate, Sodium,
Low potassium diet
Teach life-long hormone replacement
Glucocorticoids (sugar) - SoluMedrol (succinate) to prevent
addisonian crisis
Mineralocorticoids (salt)
Florinef
6 A's of Addison's disease
1.) Avoid Stress
2.) Avoid Strenuous
3.) Avoid Individuals with Infection
4.) Avoid OTC meds
5.) A lifelong Glucocorticoids Therapy
6.) Always wear medic alert bracelet
Addisonian Crisis
Hypotension
Extreme weakness
Nausea vomiting
Abdominal pain /
Severe hypoglycemia
Dehydration
Administer NaCl IV, vasopressors,
hydrocortisone
Monitor VS /Absolute bedrest
31. PLACENTA PREVIA
Check Hematocrit level
External fetal monitor not internal
No vaginal examination
Assess for bleeding

Improperly implanted placenta at

lower uterine
Painless bright red, vaginal
bleeding
Soft, relaxed, nontender uterus
Fundal height greater than
expected
32. ABRUPTIO PLACENTA
Premature separation of
placenta from uterine wall
Painful dark red bleeding
Uterine rigidity
Severe abdominal pain
Maternal shock
Fetal distress
33. HEMODIALYSIS
Palpate for a bruit or thrill
Weigh client daily, before, during
& after
Hold antihypertensive drugs b4
dialysis
Check for thrill and bruit q 8 hours
Dont use extremity for BP, finger
stick
Monitor vital signs, weight, breath
sounds
Monitor for hemorrhage
34. PERITONEAL DIALYSIS
Weight before and after treatment
Monitor BP
Monitor breath sounds
Use sterile technique
If problem w/ outflow, reposition
client
Side effects: constipation
35. TYPE 1 IDDM
Test blood glucose every 4 hrs if
no feeling well
Eat fruit or cheese sandwich
before exercise
Do not exercise if blood glucose
is >250mg/dl & urinary ketones
present
Administer regular insulin 30
minutes before meals
36. COMPARTMENT SYNDROME
Increased pain & swelling
Pain with passive motion
Loss of sensation
Inability to move joints
Pulselessness
most characteristic pain unrelieved by
mdication
37. CARDIAC CATHETERIZATION
NPO 6-8 hrs. & no liquid for 4
hrs. prior to prevent vomiting &
aspiration
Feel a flush, warm, fluttery
feeling, desire to cough,
palpitations in introduction of dye
Shave & Clean insertion site with
antiseptic solution
38. PERNICIOUS ANEMIA
Severe pallor
Smooth, beefy red tongue
Slight jaundice
Paresthisias of hands & feet
Disturbances with gait & balance
39. DUMPING SYNDROME
Occurs 30 minutes after eating
Abdominal fullness & cramping
Diarrhea
Tachycardia
Perspiration

Weakness / dizziness
Borborygmi sound
40. TPN COMPLICATIONS
Air Embolism
Fluid Overload
Hyperglycemia
Hypoglycemia
Infection
Pneumothorax
41. DIC
Bruising, purpura
Presence of occult blood
Low fibrinogen level, hct, platelet
Increased PT, PTT
Complication: RENAL FAILURE
42. PERIPHERAL ARTERIAL DISEASE
Dry scaly skin on lower
extremities
Rest Pain, at night
Intermittent claudication/
Thickened toenails
Cold & gray-blue color of skin
Decreased or absent peripheral
pulses
Instruct pt. to walk to point of
claudication, stop & rest & walk
a little farther
43. THROMBOPHLEBITIS
Avoid pressure behind legs
Avoid prolonged sitting
Avoid constrictive clothing
Avoid crossing the legs
Avoid massaging the legs
44. SYPHILIS
Painless chancre
fades after 6 weeks
Low grade fever
Copper-colored rash on palms and
soles of feet
Spread by contact of mucous
membranes
Treat with Penicillin G IM
If patient has penicillin allergy, will
use erythromycin for 10-15 days.
After treatment, patient must be
retested to make sure disease is gone
45. POLYCYTHEMIA VERA
Increased RBC
Leukocytosis / Thrombocytosis
Angina
Intermittent claudication
Dyspnea /HPN
Lethargy / Syncope / Paresthesia
46. PRIMARY HPN
Risk Factors:
Aging
Black race
Chronic stress
Family Hx
Obesity
Smoking
Men
47. CHOLECYSTITIS
Sx:
N&V
Belching
Indigestion
Flatulence
Epigastric pain that radiates to the
scapula 2 hrs. after eating fatty food
Pain localized in RLQ
Guarding, rigidity & rebound
tenderness
Cannot take a deep breath when

fingers are pressed below hepatic

margin (Murphys Sign)
II. COMPUTATION
1. Dopamine
2. Dobutamine drip: Order is
2.5mcg/kg/min, patient weights 176 lbs.
Stock is 500mg in 500ml of NSS,
Compute for ml/hr?
Formula: Stock (mg) x 1000 mcg/mg
Quantity (ml)
Flow rate: Dose (mcg/kg/min) x wt (kg) x
60 min/hr
Concentration
(mcg/ml)
Answer: 12ml/hr
3. Md with IV order for patient 3,000ml in
24 hrs., get the rate at ml per hour.
Solution: 3000/24 = 125 ml/hr
4. Tablets : Dose of 20 mg per dose in
stock dose of 5 mg per tablet, how many
tablets?
Solution: 20/5 x 1 = 4 tablets
III. TOPICS
1. SAFETY INFECTION CONTROL
AIRBORNE : Hepa Filter Mask / N95
Particulate MASK
PTB
Measles / Rubella
Chicken Pox/
Varicella
SARS
Anthrax
CONTACT : GGG
(gown,gloves,goggles)
Conjunctivitis
Open wounds /drainage
Lesions
MRSA / VRSA /
CDAD
RSV/ VRE
DROPLET : Surgical Mask
Scarlett Fever
Diphtheria
Meningitis
Strep. Pharyngitis
Pneumonia
ENTERIC: Gown , Gloves
Diarrhea
Hep. A
Salmonella
Acute Gastroenteritis
Peptic H. Pylori
Shigella / Rotavirus Giardiasis /
Cryptosporidium Muris
FROTECTIVE:
Blood dyscrasias
Aplastic anemia
Leukemia
Major burns (50%)
Organ transplant
Aids
Multiple Myeloma
Prolong Steroid Therapy
Concepts:
1. Infection control:
a. clean with clean for
example patients with
CVA, DM, Cardio disease
2. Same precaution
techniques:
a. Universal precaution:
Hep B,D, AIDS
2. PRIORITIZATION
Remember the rule of stable vs.
unstable. Although you consider the

client unstable but if it expected in him,

this is stable. Example. Asthma with
wheezing- you consider this unstable.
ABC, unstable , first think EXPECTED
in asthma so this will be considered
stable.
3. DELEGATION
RN - Newly admitted, needs
assessment, pre op teaching and post
op, nsg. Judgment & discharge
planning ,IV meds, BT.
LPN-Can give meds except IV, sterile
techniques like wound dressing,
catheterization, insertion of NG tube,
remove sutures.Stable expected
outcome.
NA/ UAP/CN/ Senior nursing student
- All -ing ex bathing, reading v/s in
long term pt. Testing occult blood, BS,
monitoring, soap sud enema, testing
occult blood,
-Isolation precautions, basic hygiene
ADL, Input & Output, Finger stick with
gestational diabetes, urinalysis, TSB,
turning unconscious patient, change
perineal pad, assist in ambulation,
discharge tomorrow,
-Stable v/s, pulse oximetry, reading,
terminally ill because of comfort only
needed.
- Routinary Procedure
4. Patient Hx C/I for MRI :
Mitral Valve Replacement
5. Glaucoma :
Halos around light
6. U waves :
Hypokalemia
7. Patient with arterial insufficiency
Elevate the affected leg
8. Patient with Dumping Syndrome:
Avoid cheese
9. Adverse Effect of Anti-metabolite 5FU
Stomatitis
10. Obtaining sputum specimen from pt.
with tracheostomy:
Instruct pt. to cough prior to
obtaining sputum
11. Post-hypophysectomy pt. Report if:
Specific Gravity of 1.005
12. Diet for Hypothyroidism
Low sodium, High K
13. Patient with CHF cor pulmonale S & S
Jugular vein distention &
peripheral edema
14. Circumcision of a new infant:
Diaper fasted loosely
15. Acute Pancreatitis
Increase lipase/amylase
16. Short-term goal for anti-social patient
Follow unit rules
17. Use of walker
Partial weight bearing
Stand in front, walk unto walker
18. Borderline patient
Splitting
19. Neonates in nursery developed diarrhea
Meconium stool study w/in 24
hrs.
20. Nsg. Action in pt. post cardiac
catherization
Check pulse in lower
extremities
21. Diet for Diverticulitis
Avoid high-fiber foods when

inflammation occurs, only low

residue
Introduce soft high-fiber foods
when inflammation has
resolved
22. Low iron.WBC & albumin, what type?
Nutritional deficit
(malnutrition)
23. What will you ask on pt for cardiac
stress test (Thallium stress test)?
Is he on beta-blocker?
(if with radionuclide already,
Persantine, then invasive & shld.
avoid caffeine, calcium channel
blockers, b-blockers, theophylline)
24. Highest risk of accident
9 month infant eating grapes
& apricot
25. Pancrease in Cystic Fibrosis
Give with meals, dilute in
applesauce
26. Client post-CVA, diet teaching
Low salt, low fat
27. Client passing stones with calcium, diet
teaching:
Should be acid-ash diet &
avoid oxalate rich & Ca rich
food such as tea, almonds,
rhubarbs beans, spinach,
cocoa, vegetables, fruits
Give cranberries, prunes,
plums, tomatoes, cereals,
corn, legumes
I
28. Pagets Disease
Bowing of bones
29. Side Effect of Ansef (Cefazolin)
Antibiotic (RTI,URTI)
Diarrhea, Nausea
Oral candidiasis
Pancythopenia
30. Peptic ulcer disease
Avoid stressful situation to
prevent exacerbation
31. Schillings Test
For pernicious anemia
32. Prior To MUGA SCAN:
Informed consent
Allergy not a concern
33. Action of Aquamephyton
Prevention of
hypoprothrobinemia
34. Action of Lipitor
Anti-lipimec
35. Positioning of Hip Spica Cast in children
Maintain flexion, abduction &
external rotation
36. Fear of 3 y/o child
Injury (abandonment,
castration)
37. To prevent ureteral stones
Increase
38. MDI
Hold breath
39. Frostbite
Soak in warm water
40. Normal respiratory changes in elderly
Decreased cough reflex
41. Patient w/ DM & HPN, question if
Given beta-blocker (causes
bronchospasm )
42. Maximum injection on 10 month old
infant
1 ml

43. Pt. with endometriosis takes Danocrine,

action of the drug?
Suppress menstruation/
ovulation
44. Post NSD with epidural anesthesia with
bladder distension
Offer bedpan
45. Apmhotericin B, side effect?
Headache
Hypokalemia
Hypotension
46. PT. with angina unrelieved by 3
nitroglycerin
Administer O2
47. Patient on Halo Vest
Tape the wrench to the vest
(Torque screw)
48. Pre-menopausal syndrome
experiencing hot flashes
Black Cohosh for menoposh
49. Abdominal Assessment
Inspection
Auscultation
Percussion
Palpation
50. Sclerotherapy
Application of pressure dressing
for 12-48 hrs.
51. RSV
Droplet precaution
52. SIADH
Sodium 128 only (Normal:
135-145)
53. Dementia of Alzheimer Type
Check what the pt. is taking
54. PEG
55. What medicine if given shld be
monitored for bleeding
Indomethacin (NSAID)
56. GBS, priority nursing diagnosis
Aspiration
57. Discharge teaching for Bells Palsy
Provide eye care at bedtime
58. Sign of Scoliosis
Asymmetry of the iliac crest
59. Normal for a 3 day old infant
Describe normal tonic neck
reflex
60. Manifestation of Paranoid Schizophrenia
Inappropriate anxiety with
delusion
61. Sign of Alcohol withdrawal
Feeling of euphoria in 1st 24 hrs.
62. Activity for Alzheimer disease
Reading magazine
63. Type 1 IDDM post renal test 48 hrs ago,
watch out for:
Hematuria
64. Correct understanding of antidepressant
Anti-depressant takes effect
after 1 week
65. DUROGESIC PATCH / FENTANYL
For chronic pain lasts 3 days
Maybe worn while bathing,
showering, swimming
Apply to flat, nonirritated,
nonirradiated area like chest,
flank, upper arm, back
Overdose : difficulty in breathing
66. Signs of increase ICP in pt. with close
head injury
Increase systolic pressure &
weak bounding pulse
67. Positive outcome for Calcium Channel

blockers
Decrease chest pain
68. Obsessive Compulsive Behavior
To alleviate anxiety
69. Patient with back pain, proper body
mechanics
Sit with knees higher than hips
70. What to check prior administration of
EPOETEN
BP
S/E : HPN, Seizures
71.
72. Patient with pancreatitis if developing
ascites would manifest:
Cullens Sign (bluish
discoloration of abdomen or
peri-umbilical hematoma)
Turners Sign (gray-blue
discoloration of flank)
Shallow, rapid breathing
Abdominal pain
Dyspnea & difficulty eating
Orthopnea
73. Digitalis + Lasix = Weight Loss
74. Side effect of Garamycin
Ototoxicity
Nephrotoxic
Hypomagnesimea
Muscular paralysis
Hypersensitivity
75. Side Effect of Theophylline
Tremors & tachycardia
Insomnia
76. Nsg. Management for cleft palate infant
Enlarged nipple for feeding
Stimulate sucking
Swallow
Rest
Burp frequently
77. Patient with expressive aphasia, best
communication:
Use picture language
78. Diet for patient with colostomy
DAT
Low residue food 1-2 days postopt
Avoid gas-forming foods
79. Patient allergic to Pseudoephedrine,
What is contraindicated?
Patient taking Ma Huang
80. Patient with testicular cancer, correct
understanding?
Testicular CA is painless
81. 1st intervention in prolapsed cord
Positioning knee
chest/trendelenberg
82. 2nd Stage of labor
Cervical dilatation to delivery of
baby
83. Thiazide diuretic, what to watch out for?
Potassium
84. Manic pt. taking lithium
Watch out for sodium serum
85. Diet for patient with ileostomy
Post opt 4 wks -- LOW FIBER
non-irritant diet to decrease fast
movement of liquid stool, after
can tolerate high fiber diet
already
Foods that thicken stool like
boiled rice, low fat cheese
should be given
Low fat diet
Normal stool is liquid
86. G & D of a 2 y/o

Combines 2 words
Kicks a ball
50 word vocabulary
87. ALS
Decreased sensation of touch
Muscle weakness
Excess glutamate
88. S/S of Kawasaki
Desquamation of skin
Joint pain
Mucocutaneous lymph node
syndrome
89. Watch out for in lumbar puncture
Increased ICP
Brain Herniation
90. S/S of DVT
Edema
Calf or groin tenderness
Pain with or w/o swelling
+ Homans Sign
Warm skin
91. Developmental Milestone of 10 month
old
Pincer grasp
92. Risk for breast CA
38 y/o female on oral
contraceptive
93. Need to consider anti-coagulant therapy
If taking Gingko Biloba
94. Check 1st before tonsillectomy
Bleeding time
95. Complication of CAST
Compartment syndrome
Fat embolism
Shock
Avascular necrosis
96. What should the nurse question?
St. Johns Wort to a kidney
transplant
(C/I to anti-neoplastic drugs, lessen
effect)
97. Physician orders beta-blockers, for w/c
pt. should the nurse question the order:
Patient on insulin
(B-blockers may mask signs of
hypoglycemia)
98. Patient hypersensitivity
Give macrolides like
erythromycin,azithromycin
(Penicillin & Cephalosporins the same)
99. Patient with autonomic dysreflexia
Pounding headache ,
piloerection
100. Pt. with carafate & antacids order,
select the schedule.
Carafate 1 hr. before meals &
antacids after meals
101. Increasing pulse pressure
Widening pulse pressure (late
sign)
Decreased LOC, restlessness
(Early)
102. Pt. with Hemophilia & Leukemia
Can lead to DIC
103. Effective teaching to DM patient
Peak of NPH insulin 8 hrs.
104. Mg SO4 given to PIH pt. Nurse
should watch out for?
Epigastric pain & headache
105. Pt. with calcium oxalate stones
Diet with fig & wheat germs
106. Cancer & Sepsis can lead to DIC
low platelet count
107. Pt. in labor with crusted popular

eruption, priority?
Eye prophylaxis of the newborn
108. Heroin addicted mother in labor,
nursing action?
Avoid withdrawal in active stage
109. Signs of Heroin intoxication?
Euphoria
Decrease response to pain
Respiratory depression
Apathy
110. Venorofaxen
111. Scarlett Fever isolation precaution
Respiratory precaution
droplet until 24 hrs. start of
treatment
112. Laryngectomy
Avoid swimming, showering,
using aerosol sprays
Teach client clean suction
technique
113. External irradiation therapy
Time & distance shielding
114. Pt. with anorexia nervosa, signs
Tachycardia
115. Brain injury
Decorticate rigidity
116. Signs of renal failure
Urine output less than 100ml/hr
117. Post-thyroidectomy patient, WOF
Tingling sensation in the cheek
(complication)
118. Ventricular Fibrillation
Do chest compression
119. Pt. in crutches, nurse should check
Check armpits to see if there is
pressure secondary to crutch
(Pressure shld be on the hands not on
the axilla)
120. Influenza Vaccine indicated for:
Anyone 50 y/o & above
annually
Age 6 months & up with risk like
asthma
Immunocompromised patients
Pts with cardiac & pulmonary
disease
121. Herpes Simplex I & II
2 strains of herpes virus family
HSV I cold blisters / fever
blisters
HSV II in STD /Genital
Herpes/Shingles & varicella
zoster infection same with
chicken pox
122. Above the knee amputation, patient
shld
Prevent internal or external
rotation of the limb
Place sandbag or rolled towel
along side of thigh to prevent
rotation
123. HIV suspect patient
Hairy tongue and leukoplakia
(Leukoplakia, pre-malignant lesion)
124. DVT on Heparin therapeutic goal
Ambulate ASAP
( Prevent thrombus formation)
125. Esophageal varices, refer pt if
Cold clammy skin ( sx of shock)
126. Pregnant 39 weeks, knows true
labor if
Contractions from back going to
abdomen
127. Bipolar manic patients, what to do?

Limit group activities

128. Multiple Myeloma, care
Force fluid from 3 - 4 L/day to
offset hypercalcemia,
hyperurecemia
Encourage ambulation to
prevent renal stones
129. Post pace maker transplant, correct
understanding
Patient CAN USE electric
blankets, cell phones <3 watts,
microwave ovens, metal
detectors
130. Patient taking garlic supplements
should take precaution when on aspirin
therapy
131. DKA patient, what to administer 1st?
Start IV line 0.9 NaCl
132. Hearing aid, correct teaching:
Turn off & remove battery when
not in use
Avoid excessive wetting of
hearing aid, keep dry
Ear mold is the only part that
may be washed w/ soap &
water
Cannula is cleaned with small
pipe cleaner device or toothpick
133. PEEP
134. 18 day old infant, how to assess
trunk curvature
Place in prone position & stroke
spinal colum, see if infants body
move towards the stimulated
area
135. Postural drainage, correct
understanding:
Positionlung segment to be
drained is uppermost
Drink a glass of water before PD
to loosen secretions
136. Sign of Abdominal Aortic Aneurysm
Pulsation between umbilicus &
pubis
137. Echinacea
To boost immune system
Use only up to 8 weeks
138. Action of PILOCARPINE
Increase outflow of aqueous
humor
For OPEN ANGLE GLAUCOMA
139. Signs of acute angle glaucoma
Eye pain / headache
140. Phenytoin for seizure. Watch out for:
Gum Bleeding
141. Coumadin Therapy. Correct
understanding?
Ask MD before taking OTC
drugs
142. Diet for hepatic encephalopathy
Adequate caloric intake in form
of glucose
143. Side effect of TCA
Urinary retention
144. HELLP
Nausea
Epigastric Pain
Tx: FFP / Platelets
145. Drugs that can produced
Hyperglycemia
Prednisone
146. Side effect of Haldol
EPS, NMS
147. CA (Internal & External Radiation)

External Radiotherapy
Leave markings on skin
Avoid use of creams, lotions
Only vitamin A&D =ointment)
Check for redness, cracking
Wear cotton clothing
Administer antiemetics
Do not pose any hazard to
anyone
Internal radiation
sealed source
Lead container and longhandled
forceps in room
Save all dressings, bed linen
until source removed
Urine and feces not
radioactive
Dont stand close or in line
with source
Patient on bed rest Cancer
Implementation:
Internal Radiation
Time and distance important
Private room sign on door
Nurse wears dosimeter at all
times
Limit visitors and time spent in
room
Rotate staff
Self-care when can do
Internal radiation
unsealed source
All body fluids contaminated
Greatest danger first 24-96
hours
148. LTB (Croup). Correct
understanding.
Mother can be in the tent with
the child
149. Liver cirrhosis. What to assess
before nasotracheal suctioning?
Platelet (risk for bleeding)
150. Adverse effect of 5FU (Fluoronacil)
Antagonistic to iron Anemia
151. Transition phase of labor
Do short, shallow (PANT)
breathing
152. Mother (-), baby (+), Direct Coombs
test (-)
Give Rhogram
153. Legionnaires disease
Type of pneumonia
Droplet precaution
Sx: Fever, chills, cough, ataxia,
muscle aches, Diarrhea
Middle age & older persons
Treated with antibiotics ,
macrolides
154. Hepatitis C, Signs & sx
Same with Hep B.
Transmitted parenterally
Common to drug users
Major cause of post-transfusion
hepatitis
Universal Precaution same with
Hep. B
155. Sx of Furosemide
Decreased edema, abdominal
girth, BP & calcium
Increased urinary output
156. Colchicines Toxicity
Anti-gout drug
Nausea & Diarrhea
Vomiting

 Sore gums
Metallic taste
157. TENS, how to explain procedure
Use for chronic nerve pain
Uses only electrodes
Painless
Non-invasive, passive modality
158. PROBENECID
Treat gout /hyperurecemia
Increase uric acid removal in
the urine
159. Meaning of death to a 5 y/o
Magical thinking
Death as temporary
160. Meaning of death to a 7 y/o
Death as punishment
161. Meaning of death to 9 y/o
Death as irreversible
162. Death to an adolescent
Universal
163. Infant sounds
1 3 months = Cooing
4 -6 months = Babbling
6 -8 months interest in sounds
9 -12 months = use of gestures
164. CEFTRIAXONE/ROCIPHEN
Monitor tongue & oral cavity
165. EMG
Stop all CNS meds 240 prior
procedure
Skin prep on site
To be stimulated with needles
166. Pt with uncomplicated cholelithiasis,
expect elevated?
Alkaline Phosphotase
167. CANE
COAL (cane opposite affected
leg)
168. Hep A, predisposing factor?
From day care centers
169. Patient with Testicular CA
Undescended testes
170. Diet teaching for Celiac Disease
(SPrue)
Gluten free diet
C/I wheat/rye/oats/barley)
Give corn, rice, soybeans &
potatoes
171. Aspirin
172. Isoniazid (INH)
S/E: peripheral neuropathy
(administer pyridoxine)
Rash, urticaria
Swelling of the face, lips, and
eyelids.
173. Rifampicin
Hepatotoxic
174. Triage (External) Treat first the stable before the
unstable.
Emergent first before urgent. But
kung E.R. unstable muna
before stable. ABC
175. Spinal Cord Injury
176. Reflexes
177. LABORATORY VALUES
178. DIET
Clear liquid
No milk
No juice with pulp Full liquid
No jam
No fruit
No nuts
Low Fat /Cholesterol

Can eat lean meat

No avocado, milk, bacon, egg
yolks butter Sodium restricted
No cheese High roughage, high
fiber
No white bread without fiber
Low Residue Diet
Minimize intestinal activity
Buttered rice white processed food
No whole wheat corn bran
High Protein diet
Reestablish anabolism to raise
albumin levels
Egg, roast beef sandwich,
No junk food Renal
Keeps protein, potassium and
sodium low
No beans, no cereals, no citrus
fruits
Low Phenylalanine diet
Prevents brain damage from
imbalance of amino acids
Fats, fruits, jams allowed
No meats eggs bread
179. Lumbar puncture
180. Laminectomy
181. Myasthenia gravis
Ptosis
182. Multiple sclerosis
Fatigue / Ataxia /Vertigo
183. PCA
184. Influenza Vaccine, C/I?
Allergy to eggs
185. Nephrotic syndrome
PROTEINURIA frothy urine
186. HERBAL MEDS
187. AUTONOMIC DYSREFLEXIA
C6 injury
188. Primary, team, functional Nsg.
189. Consent and Advance Directives
190. Glasgow coma scale
191. Glomerulonephritis
HEMATURIA
cola/tea urine
Glomerulonephritis Assessment
Fever, Chills
Hematuria
Proteinuria
Edema
Hypertension
Abdominal or flank pain
Occurs 10 days after beta
hemolytic streptococcal throat
infection
Implementation
Antibiotics, corticosteroids
Antihypertensives,
immunosuppressive agents
Restrict sodium and water intake
Bedrest
I&O
Daily weight
High Calorie, Low protein
192. PEAK FLOW METER vs. METERED
DOE INHALER vs. INCENTIVE
SPIROMETER
193. Rheumatoid vs. Osteoporosis vs Gouty
194. Burn
Assessments
Superficial partial thicknesspink to red,
painful
Deep partial thicknessred to white,
blisters, painful
Full thicknesscharred, waxy, white,

painless
Wound Care for Burns
Never break blisters
Isotonic fluids (Lactated Ringers)
Closed method (Silvadene) covered
with dressings
Open method (Sulfamylon) that are not
covered with dressings
IV pain medication initially: not PO
takes too long, not IM circulation impaired
Medicate patient before wound care
Silver nitrate (warn patient skin will
turn black)
High calorie, High carbohydrate, High
protein diet
Vitamin B,C, and Iron
TPN maybe
Prevent contractures
195. Chest Tubes
1. Air-leak if bubbling in water-seal
chamber
(middle chamber)
2. Obstruction: milk tube in direction
of drainage
3. Removal of chest tube:
Pt. does valsalva maneuver
Clamp chest tube,
Remove quickly
Apply occlusive dressing
4. Dislodged
Apply tented dressing
Tube becomes disconnected
from drainage system, cut off
contaminated tip, insert
sterile connector
and reinsert
Tube becomes disconnected
from drainage
system, immerse in 2cm of
water
Jackson-Pratt:
Notify physician if drainage
increases or becomes bright
red
Penrose: Expect drainage on
dressing
196. Cataract
Assessments
Distorted, blurred vision
Milky white pupil Cataracts
Postop: check for
hemorrhage
Check pupilconstricted
with lens implanted,
dilated without lens
Eye drops / Night shield
Sleep on unaffected side
197. Glaucoma
Abnormal increase in intraocular
pressure that leads to blindness
Blurred vision
Lights with halos
Decreased peripheral vision
Pain
Headache Glaucoma
Administer miotics (constrict
pupil) Carbonic
anhydrase inhibitors
Surgery
Avoid heavy lifting, straining of
stool
Mydriatics C/I with glaucoma.
198. Detached Retina
Flashes of light

Loss of vision
Particles moving in line of
vision confusion a Implementations
Bedrest, affected eye in dependent
position
Eye patched (one or both)
Surgery
Sedatives and tranquilizers
Avoid stooping, straining at stool,
strenuous activity
199. FLORINEF (fludrocortisones
acetate)
For Addisons Disease
Given AM with meals, causes
PUD
Causes Cushing-like syndrome
200. Traction
Bucks Traction
Use to relieve muscle spasm of
leg and back
If used for muscles spasms only,
they can turn to either side.
If used for fracture treatment,
only can turn to unaffected side.
Use 8-20 lbs of weight, if used for
scoliosis will use 40 lbs of weight.
Elevate head of bed for counter
traction or foot bed
Place pillow below leg not under
heel or behind knee.
Russells Traction
Sling is used
Check for popliteal pulse
Place pillow below lower leg and
heel off the bed
Dont turn from waist down
Lift patient, not the leg
Cervical Tongs
Never lift the weights
No pillow under head during
feedings
Balanced Suspension Traction
For femur realignment
Maintain weights hanging
free and not on floor
Maintain continuous pull
Halo Jacket
Maintain pin cleansing
201. Fractured Hip
Assessments
Leg shortened
Adducted
Externally rotated
Care after a total hip replacement
Abduction pillows
Crutch walking with 3-point gait
Dont sleep on operated side
Dont flex hip more than 45-60
degrees
Dont elevate head of the bed more
than 45 degrees
202. IV SIDE EFFECTS
Change tubing Q72 hours
Change bottle Q24 hours
Infiltration
Assessment: cool skin, swelling,
pain, decrease in flow rate
Implementation: discontinue IV,
warm compresses, elevate arm,
start new site proximal to
infiltrated site
IV Phlebitis, Thrombophlebitis
Assessmentredness, warm,
tender, swelling, leukocytosis
Implementationdiscontinue IV,

warm moist compresses, start IV in

opposite extremity
Hematoma
Assessmentecchymosis,
swelling, leakage of blood
Implementationdiscontinue IV,
apply pressure, ice bag 24 hours,
restart IV in opposite extremity
IV Clotting
Assessmentdecreased flow rate,
back flow of blood into tubing
Implementationdiscontinue, do
not irrigate, do not milk, do not
increase rate of flow or hang
solution higher, do not aspirate
cannula, inject Urokinase, D/C and
start on other site.
203. Lung Sounds
204. Shock
205. NORMAL AGING PROCESS
206. Levin vs. Salem vs.
Sengstaken tube
Nasogastric Tubes:
Levin-singlesingle-lumen, used for
decompression or tube feeding
Salem sumpdouble-lumen, used for
decompression or tube feeding
Sengstaken-Blakemoretriple-lumen,
used for bleeding esophageal varices
Linton-Nachlas4-lumen, used for
bleeding esophageal varices
Keofeed/Dobhoffsoft silicone, used
for long-term feedings
Cantorsingle lumen with mercuryfilled
balloon and suction port
Miller-Abbottdouble-lumen with
mercury-filled balloon and suction port
Harrissingle lumen with mercuryfilled
balloon and suction port
NG tube placement:
BEST WAY to check is to aspirate for
gastric
contents and check for pH of aspirate
<4
Implementation of feeding:
Check residual before intermittent
feeding, reinstall residual
Check residual Q4 hours with
continuous feeding, reinstall residual
Hold feeding if >50% residual from
previous hour (adults) or >25%
(children)
Flush tube with water before and after
feeding
Use pump to control rate of tube
feeding
Administer fluid at room temperature
Change bag Q8 hours for continuous
feeding
Elevate head of bed while feeding is
running
Check patency Q4 hours
Good mouth care
NG Irrigation Tubing:
Verify placement of tube
Insert 30-50 cc of normal saline into
tube
If feel resistance, change patient
position, check for kinks
Withdraw solution or record amount as
input
NG removal:
Clamp tube
Remove tape
Instruct patient to exhale

Remove tube with smooth, continuous

pull
Intestinal Tubes (Cantor, Mill-Abbott,
Harris)
o After tube is in stomach, have patient
lie on right side, then back in Fowlers
position, then left side
o Gravity helps to position tube
o Coil excess tube loosely on bed, do
not tape
o Position of tube verified by x-ray
o Measure drainage QShift
Removal
o Clamp tube
o Remove tape
o Deflate balloon or aspirate contents of
intestinal tube balloon
o Instruct patient to exhale
o Remove 6 every 10 min. until reaches
the stomach, then remove completely
with smooth, continuous pull
T-Tube: 500-1000 cc/day, bloody first 2
hours
Penrose: expect drainage on dressing
207. Immunizations
208. PHEOCHROMOCYTOMA
Persistent hypertension
Hyperglycemia
Pounding headache
Palpitations
Visual disturbances
Histamine Test, Regitine Test, 24hour urine VMA test
Avoid emotional and physical stress
Encourage rest
Avoid coffee and stimulating foods
Postop care after adrenalectomy
209. Chrons Disease
Fever, cramp-like colicky pain
after meals
Abdominal distention
Diarrhea (semi-solid)
Anorexia, N & V
210. PIH, APGAR
211. EVISTA
212. SAW PALMETTO
213. CIALIS
214. SANDIMMUNE,
215. CELESTONE
216. PNST, CST, COLONOSCOPY,
ARTERIOGRAPHY,
217. CPR, CARDIOVERSION
Defibrillation
Start CPR first
1st attempt 200 joules
2nd attempt 200 to 300 joules
3rd attempt 360 joules
Check monitor between shocks for
rhythm
Cardioversion
Elective procedure, Informed Consent
Valium IV
Synchronizer on
25-360 joules
Check monitor between rhythm
CPR
Shake, shout, summon help, open airway,
look, listen, feel for signs of breathing, pinch
nose, give 2 full breaths (if no rise,
reposition)
Adults 12/min check carotid, chest
compressions
80-100/min 1.5 inches
Infants 20/min check brachial pulse, chest
compression

100/min - 1 inch
15:2 Adult 4 cycles
Infant 20 cycles
Reassess pulse and breathing
Continue CPR until:
Victim responds
Someone else takes over
Victim is transferred
Rescuer is unable to continue
218. POSITIONING
Therapeutic Positions
Supineavoids hip flexion
Dorsal recumbentsupine with knees
flexed
Proneextension of hip
joint(after amputation)
Side lateraldrainage of oral secretions
Knee-chestvisualization of rectal area
Simsdecreases abdominal tension (side
lying with legs bent)
Fowlersincreases venous return,
lung expansion
High Fowlers60-90
Fowlers45-60
Semi-Fowlers30-45
Low Fowlers15-30
Modified Trendelenburgused for shock;
Feet elevated 20 degrees, knees straight,
trunk flat, head slightly elevated
Elevation of extremityincreases blood
to extremity and venous return
Lithotomyused for vaginal exam
219. Cushing what will you expect?
a. Na of 142 b. ph 7.41 c. K of 3.1
220. ff statements is correct for
malpractice?
a. a nurse giving Celebrex to an RA pt
who has an allergy to aspirin
b. a nurse telling the pt not to take
zafirlukast during an asthma attack ( C/I
DURING ASTHMA ATTACK USE AS
PROPHYLAXIS FOR & TX FOR CHRONIC
BRONCHIAL ASTHMA)
221. Diet for Addisons?
a. high calcium
222. A pt with pneumonia will go to
radiology for x-ray?
pt will wear a surgical mask while
traveling in the hallway.
223. a pt with pneumonia safety
precaution?
wear mask while bathing the pt.
224. sealed radiation what will be the
safety to the nurse?
a. limit exposure for 30mins close
contact to pt during shift
b. giving the radiation bandage/band to
the nurse for the next shift
225. Lipitor what will be the concern?
a. muscle
weakness/pain
b. adverse effect:
myalgia &
rhabdomyositis
226. Break confidentiality?
nurses talking in the hallway
227. Gastrochisis?
put soaked gauze with nss to
abdomen
228. Clostridium deficille? private rm
229. suctioning pt needs further
teaching?
my wife have shortness of breath
during my suctioning.
230. sickle cell crisis what is your

concern?
i still have joint pain even though
im taking analgesic daily
231. dysphagia pt how to feed?
put head of bed to 60degrees
before feeding
232. total knee replacement immdtly post
op what is the correct statement?
ill put an abduction pillow
233. Tapazole?
with meals
234. a 28yrs old pt 35wks pregnant is
having internal bleeding was rushed to
ED, what does the nurse do first?
fhr external monitoring
235. a pt taking captopril what will check
or concern?
im having cough at night
236. Jewish orthodox dead?
dont leave body alone, should be
with relatives
237. Reglan?
take 30mins before meals
238. Maoi- C/I?
chicken bullion and cheese
239. what food to give to a child?
Crackers
240. food rich in Ca?
broccoli
241. fracture of arm what position?
place pillow under arm
242. pt is constipated what health
teaching?
increase intake of fruits and
veggies
243. Arcabose is given to px health tx?
helps pancreas to release insulin
244. px with myasthenia gravis what will
you monitor?
k
245. 3 month old baby. parents plan to
buy/purchase an electronic door that
sings open when there is weight. what is
the health tx?
delay purchase of electronic
device
246. pt taking nardil has stopped taking
the drug for 5 days and began taking
chocolate and cheeseburger. he
suddenly feels severe headache and
goes to er.
pt is reacting to the food recently
taking
247. sickle cell crisis advice to give to
teenager?
lessen physical activity
Sickle Cell Anemia
Pain /Swelling/Fever
Sclera jaundiced
Cardiac murmurs / Tachycardia
Check for signs of infection (prevent
crisis)
Check joint areas for pain and
swelling
Encourage fluids
Provide analgesics with PCA pump c
crisis
248. how are you going to irrigate
ileostomy?
with nss
249. px taking iron supplement, what
statement by px shld you be cautioned?
will crush the tablet before i drink
it

250. Position after liver biopsy?

sidelying on rt side with pillow
under right side of ribs
251. LYMES DISEASE
Multi-system infection caused by
a tick bite. There are three stages.
Stage 1
Erythematous papule develops
into lesion with clear center
(Bulls-eye)
Regional lymphadenopathy
Flu-like symptoms (fever,
headache, conjunctivitis)
Can develop over 1 to several
months
Stage 2
Develop after 1 to 6 months if
disease untreated.
Cardiac conduction defects
Neurologic disorders (Bells
palsy, temporary paralysis)
Stage 3
Develops after 1 to several months,
if reached at this stage may
persist for several years.
Arthralgias
Enlarged, inflamed joints
Teaching
Cover exposed areas when
in wooded areas
Check exposed areas for
presence of ticks
Antibiotics 3-4 weeks
Stage 1 use Doxicillin
IV penicillin with later
stages
252. Huntington's dse
253. Osteoporosis
254. NST
255. Early deceleration
256. Vanillylmandelic acid
1. used to diagnose
pheochromocytoma which is a
tumor in the adrenal gland.
24-hour urine collection. Save all the
urine in 24 hours..
257. Which is the wrong statement in
Addisons disease?
Administer potassium.
258. Stress management-- Instruct the
patient to imagine that he is in the
beach-- this is correct. this is guided
imagery wherein the patient imagines or
fantasizes to reduce stress. pls.
259. Multiple sclerosis-- low bed position-- think safety
260. Herpes zoster/shingles
will the pt experience acute pain?
YES
261. What is the purpose of swimming in
arthritis?
262. Mycoplasma pneumonia-- what
precaution? DROPLET
263. How many ml is 1/2 banana?
264. Tamoxifen- inhibit estrogen
production
265. Total thyroidectomy d/c teaching?
Monitor pulse rate and temp
266. 3rd degree burn
267. Digoxin +Quinidine?
268. IDDM advice lifestyle change?
a. Avoid strenuous ex
b. Increase insulin dose if involved to
sports
269. which among the ff psych meds is

incorrect statement?
White wine is not ok with maoi, red
wine is ok
270. Earliest sign of magnesium sulfate
toxicity
271. Receptive aphasia? Picture board
272. SEROQUEL?
273. Internal disaster drill?
274. external disaster drill
275. what is normal for a 2 days old
baby?
276. enhance effect of Coumadin
277. Schizo pt- lalabas? Wear long
sleeves
278. Do not take garlic if you are
receiving aspirin. It increases the
antiplatelet effect!
279. Rattle snake bite
280. Car safety in children less than 20
lbs.
281. LASIX SIGNS THAT IT IS
WORKING = DECREASE
PERIPHERAL EDEMA,
282. PT WITH GLOMENOLEPHRITIS
URINE RESULT
BLOOD
283. Dilantin detoxified by liver.
284. The nurse cares for a client
receiving IV antibiotics every 8 hours for
the past 4 days. The antibiotic is
mixed in D5W. The nurse determines
that a post-infusion phlebitis has
occurred if which of the
following is observed? .
reddened, warm area noted around
insertion site or on path of vein;
discontinue IV, apply warm, moist
compresses, restart IV at new
site
285. How long should a client with
tuberculosis be on medication?
6-9 Months
286. What are symptoms of hepatitis?
Inflammation of Liver
Jaundice
Anorexia
RUQ pain
Clay-colored stools, tea-colored urine
Pruritis (bile salts eliminated through
skin)
Elevated ALT, AST
Prolonged PT (liver involvement with
clotting factor)
287. What is the transmission of
Hepatitis A?
Fecal/Oral
Consume contaminated food or water
Travelers to developing countries at
risk
Clients with hepatitis A should not
prepare food for
others
288. What is the transmission of
Hepatitis B?
Parenteral/Sexual contact
Blood or body fluids
At risk individuals are the ones that
abuse IV drugs,
dialysis, healthcare workers
Vaccine developed
289. What is the transmission of
Hepatitis C?
Blood or body fluids
Can become chronic disease
290. Seen in patients with hemophilia

(unable to clot)
291. What is the transmission of Delta
Hepatitis?
Co-infects with hepatitis B
292. Where to put 4 y/o child in a car
Booster seat
293. Toddler
Playing side by side w/o sharing pf
toys
294. Lantus understanding
I will avoid OTC with chromium
295. What nursing care are
recommended for Hepatitis?
Rest (mainly for liver)
Contact and standard precautions
Low-fat, High-Calorie, and High
Protein diet (needed for organ
healing)
No alcoholic beverages
Medications (Vitamin K, AquaMephyton for bleeding problems, Antiemetic
no compazine, use Tigan or
(Dramamine).
Corticosteroids to decrease
inflammatory response, and antihistamines,
will use lotions or
baths than systemic ones.
296. Intermiettent claudication
intervention
Lower the legs
297. Femoral fracture, indicate
complication
Petechiae
298. Sickle cell crisis
Increased reticulocyte count
299. Multiple Sclerosis
Baclofen
300. Post-arthroscopy, notify md
Painful knee
301. Osteoporosis history taking at risk
Taking wine or beer
302. Wilms Tumor
Flank pain
303. Fosamax
30 minutes before meals
304. Cotrimoxazole
Yellow sclera
305. Tegretol
With meals
306. Colchicine
With meals
307. Valium
Monitor liver function
308. Antivert
1 hour before travel
309. Mannitol, effective?
Increase awareness
310. Orinase
30 minutes before meals
311. Diabeta (Glipizide)
30 minutes before meals
312. Metformin HCL
Take with food to decrease GI upset
313. Gantrisin
Drink 2-3 L for the whole day
314. Amaryl (Glimiperide)
With or w/o breakfast
315. Start to assess radial pulse
2 y/o
316. Discharge teaching for
postcholecystectomy
client.
Reporting of complication (pale
stool & dark urine)

317. Diagnostic test for Renal Failure

Monitor BUN, Creatinine, electrolyte
Monitor for acidosis
318. Complications of TURP
Sterility may or may not occur
Bleeding is normal, moniot for
hemorrhage
Bladder spasms common postopt,
ant-spasmodics are
prescribed
319. Drug therapy for Rheumatoid
Arthritis
Salicylates
Gold salts
IV. DRUGS
Ethacrynic Acid (Edecrin)are considered
loop diuretics and are potassium wasting;
encourage client to increase intake of
potassium-rich foods. Orange
Juice/Bananas, etc.
Aminophylline (Truphylline)is a
xanthine bronchodilator; major side effects:
palpitations, nervousness, rapid pulse,
dysrhythmias, nausea, and vomiting.
Toxic effects: confusion, headache,
flushing, tachycardia, and seizure.
Morphine Sulfatedecreases blood return
to the right side of the heart, and decrease
peripheral resistance. In other words,
decreases preload and afterload
pressures and cardiac workload; causes
vasodilation and pooling of fluid in
extremities; provides relief from anxiety.
Antihistamine and chemotactic receptor
Inotropin (Dopamine)vasoactive
medication are given IV to restore BP in
hypotensive states; Increases blood return
to the right side of the heart, and increase
peripheral resistance;
S/E: headache, severe hypertension,
dysrhythmias; check BP q2 minutes until
stabilized, then q5 minutes
TPNhang no longer than 24 hours; IV
tubing and
filters every 24 hours; site of catheter
changed every 4 weeks.
Fluoxetine (Prozac)a selective serotonin
reuptake inhibitor (SSRI) used to treat
depression and obsessive compulsive
disorder.
S/E: postural hypotension, dry mouth, rapid
heartbeat, anorexia, weight loss, severe
headache. If dose is missed, omit dose &
instruct client to return to regular dosing
schedule.
Propanolol (inderal)a beta-adrenergic
blocker used as antihypertensive;
S/E: bronchospasm, bradycardia,
depression. Take pulse before
administration & gradually decrease when
discontinuing. Do not give to asthmatic pts
Glipizide (Glucotrol)an oral
hypoglycemic that decreases blood sugar by
stimulating insulin release from the beta
cells of the pancreas; may cause aplastic
anemia and photosensitivity.
Prednisone (Deltasone)a corticosteroid.
Side effects: hyperglycemia
Bethanechol (Urecholine)a cholinergic
or parasympathomimetic used to treat
functional urinary retention; mimics action of
acetylcholine.
Ventricular Tachycardiacauses chest
pain, dizziness, and fainting.

1 grain = 60mg
Levothyroxine (Synthroid)
thyroid preparation should be
administered at breakfast to prevent
insomnia.
Carbamazepine (Tegretol)
interferes with action of hormonal
contraceptives. Side effects:
photosensitivity.
Aluminum Hydroxide (Amphojel)
an antacid; neutralizes hydrochloric acid
and reduces pepsin activity; take one hour
before and hour of sleep. Antacids most
effective after digestion has started, but prior
to the emptying of the stomach.
Isoniazid (INH)S/E: peripheral
neuropathy (administer pyridoxine), rash,
urticaria & swelling of the face, lips, and
eyelids.
Pyridoxine (Vitamin B6, Beesix,
Doxine)required for amino acid,
carbohydrate & lipid metabolism. Used in
the transport of amino acids, formation of
neurotransmitters & sythesis of heme.
Prevention of neuropathy.
Carbamazepine (Tegretol)prevention of
seizures & relief of pain in trigeminal
neuralgia. Trigeminal neuralgia is an
agonizing pain result in severe depression &
suicide.
Clonidine (Catapres-TTS)is a centrally
acting alpha-adrenergic used to treat HPN
S/E: drowsiness, sedation, orthostatic
hypotension, heart failure. If patch used be
cautious around microwaves results in
burns, heat will increase medication
absorption leading to toxicity.
Phlebitistenderness, redness; remove iv,
apply warm soaks to decrease inflammation,
swelling, and discomfort.
Autologous bloodmay give blood 5
weeks before surgery; can give 2 to 4 units
of blood; may have to take iron pills
Carbidopa/Levodopa (Sinemet)used to
treat symptoms of Parkinsons disease.
Take immediately before meals and
highprotein
meals may impair effectiveness of
medication. Reduces rigidity and
bradykinesis & facilitates clients mobility.
Doxycycline (Vibramycin)a tetracycline
that is taken at regular intervals but not
within 1 hour of bedtime because it may
cause esophageal irritation. Use another
method of birth control, do not take antacids
within 1-3 hours of taking medication, and
may cause photosensitivity.
Albuterol (Proventil)a bronchodilator.
Side effects: tremors, headache,
hyperactivity, tachycardia. Use first before
steroid medication so opens up bronchioles
for steroid to get in. Wait one minute
between puffs of the inhalers for best effect.
Beclomethasone (Vanceril)a steroid
medication. S/E: fungal infections, dry
mouth, throat,infections.
Insulin
NPH Onset: 1.5 hours Peak: 4-12 hours
Regular Onset: 0.5 hours Peak: 2.5-5 hours
Topiramate (Topamax)is an
anticonvulsant. Should drink 2000-3000ml of
fluid daily to prevent kidney stones.
Side effects: orthostatic hypotension, ocular
symptoms, blindness, and decrease effects
of hormonal contraceptives.

Propranolol (Inderal)a beta-blocker that

takes up beta-adrenergic receptor sites,
which prevents adrenaline from causing
symptoms and glycogenolysis.
Inderal may mask symptoms of
Hypoglycemia, removing the bodys early
warning system.
Phenazopyridine (Pyridium)acts on
urinary tract mucosa to produce analgesic or
local anesthetic effects.
Side effects: bright orange urine,
yellowish discoloration of skin or sclera
indicates drug accumulation due to renal
impairment.
Trimethoprim-sulfamethoxazole
(Bactrim)most common
side effect mild to moderate rash (urticaria)
Aminoglycosides are ototoxic.
Butorphanol Tartrate (Stadol)analgesic
used for moderate to severe pain; Side
effects include change in BP, bradycardia,
respiratory depression.
Infant normal resting heart rate:
120-140
Salt substitutes contain potassium
When directing a UAP, the nurse must
communicate clearly about each delegated
task with specific instructions on what must
be reported. Because the RN is responsible
for all care-related decisions, only
implementation tasks should be assigned
because they do not require independent
judgment.
When applying the nursing process,
assessment is the first step in providing
care. The 5 "Ps" of vascular impairment can
be used as a guide (pain, pulse, pallor,
paresthesia, paralysis)
Rash and blood dyscrasias are side effects
of anti-psychotic drugs. A history of severe
depression is a contraindication to the use of
neuroleptics.
The nurse instructs the client taking
dexamethasone (Decadron) to take it with
food or milk because Decadron increases
the production of hydrochloric acid, which
may cause gastrointestinal ulcers.
The protest phase of separation anxiety is a
normal response for a child this age (2 yearold
hospitalized child). In toddlers, ages 1 to
3, separation anxiety is at its peak
Signs of tardive dyskinesia include
smacking lips, grinding of teeth and "fly
catching" tongue movements.
Verapamil, Bretylium, and Amiodarone
increases serum dig levels, possibly causing
Digitalis Toxicity
Signs/Symptoms of Digital Toxicity: f1st
sx include abdominal pain, anorexia,
nausea, vomiting, visual disturbances,
bradycardia, and other arrhythmias. In
infants and small children, the 1st sx of
overdose are usually cardiac arrhythmias.
Left-Side CHF
Dyspnea, orthopnea
Cough
Pulmonary edema
Weakness/Changes in mental status
Right-Side CHF
Dependent edema
Liver enlargement
Abdominal pain/Nausea/Bloating
Coolness of extremities
CHF Implementations
Administer digoxin, diuretics

Low-sodium, low-calorie, low-residue diet

Oxygen therapy
Daily weight
Teach about medications and diet
Herbs: Toxicities and Drug Interactions
1. 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.
2. 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.
S/E : unpleasant tastel, liver toxicity.
C/I: ketaconazole, leflunomide (Arava),
methotrexate
(Rheumatrex), isoniazide (Nizoral).
3. St. John's Wort
Uses: depression, anxiety, and sleep
disorders. It is technically known as
Hypericum
perforatum.
S/E: sun sensitivity which causes burning of
the skin.
Leave nerve changes in sunburned areas.
C/I: tetracycline/Achromycin, sulfa- containing
medications, piroxicam (Feldend).
S/E: headaches, dizziness, sweating, and
agitation when used in combination with
serotonin
reuptake inhibitor medications such as
fluoxetine
(Prozac) and paroxetine (Paxil).
4. Garlic
Uses: lower blood pressure and
cholesterol
S/E: Allergic reactions, skin inflammation, and
stomach upset , Bad breath . decrease normal
blood
clotting and should be used with caution in
patients
taking medications to prevent blood clotting
(anticoagulants) such as warfarin /Coumadin.
5. Feverfew
Uses: Most commonly used for migraine
headaches.
Reactions: Feverfew can cause allergic
reactions,
especially in persons who are allergic to
chamomile,
ragweed, or yarrow. Nonsteroidal antiinflammatory
drugs (NSAIDs such as ibuprofen (Advil),
naproxen
(Aleve) or Motrin) can reduce the effect of
feverfew.

A condition called "postfeverfew syndrome"

features
symptoms including headaches, nervousness,
stiffness,
joint pain, tiredness, and nervousness.
Feverfew can
impair the action of the normal blood clotting
element
(platelets). It should be avoided in patients
taking
medications to prevent blood clotting
(anticoagulants)
such as warfarin (Coumadin).
Ginko Biloba
Uses: This herb is very popular as a treatment
for
dementia (a progressive brain dysfunction)
and to
improve thinking.
Reactions: Mild stomach upset and headache
have been
reported. Ginko seems to have blood thinning
properties. Therefore, it is not recommended
to be
taken with aspirin, nonsteroidal antiinflammatory
drugs (Advil), naproxen (Aleve) or Motrin), or
medications to prevent blood clotting
(anticoagulants)
such as warfarin (Coumadin). Ginko should be
avoided
in patients with epilepsy taking seizure
medicines,
such as phenytoin (Dilantin), carbamazepine
(Tegretol), and phenobarbital.
Ginseng
Uses: Ginseng has been used to stimulate the
adrenal
gland, and thereby increase energy. It also
may have
some beneficial effect on reducing blood sugar
.in
patients with diabetes mellitus. (Dr. Miller
emphasized that there is substantial variation
in the
chemical components of substances branded
as
"Ginseng.")
Reactions: Ginseng can cause elevation in
blood
pressure, headache, vomiting, insomnia, and
nose
bleeding. Ginseng can also cause falsely
abnormal
blood tests for digoxin level. It is unclear
whether
ginseng may affect female hormones. Its use
in
pregnancy is not recommended. Ginseng may
affect the
action of the normal blood clotting element
(platelets). It should be avoided in patients
taking
aspirin, nonsteroidal antiinflammatory drugs
(such as
ibuprofen (Advil), naproxen (Aleve) or Motrin),
or
medications to prevent blood clotting
(anticoagulants)
such as warfarin (Coumadin). Ginseng may
also cause
headaches, tremors, nervousness, and
sleeplessness. It
should be avoided in persons with manic
disorder and

psychosis.
Ginger
Uses: Ginger has been used as a treatment
for nausea
and bowel spasms.
Reactions: Ginger may lead to blood thinning.
It is
not recommended to be taken with
medications that
prevent blood clotting (anticoagulants) such as
warfarin (Coumadin).
Saw Palmetto
Uses: Saw palmetto has been most commonly
used for
enlargement of the prostate gland. Saw
palmetto has
also been touted as a diuretic and urinary
antiseptic to
prevent bladder
infections.
Reactions: This herb may affect the action of
the sex
hormone testosterone, thereby reducing
sexual drive or
performance. Dr. Miller states that "While no
drug-herb interactions have been documented
to date,
it would be prudent to avoid concomitant use
with
other hormonal therapies (e.g., estrogen
replacement
therapy and oral contraceptives...")
Black Cohosh
Claims, Benefits: A natural way to treat
menopausal
symptoms.
Bottom Line: Little is known about its benefits
and its risks.
A child with celiac disease mustnt consume
foods containing gluten and therefore should
avoid prepared puddings, commercially
prepared ice cream, malted milk, and all food
and beverages containing wheat, rye, oats, or
barley.
The infant of a diabetic mother may be slightly
hyperglycemic immediately after birth because
of the high glucose levels that cross the
placenta from mother to fetus. During
pregnancy, the fetal pancreas secretes
increased levels of insulin in response to this
increases glucose amount that crosses the
placenta from the mother.