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NCLEX-RN Review Book Instructor’s Guide Sample and Quick Facts Regina Hughes RN, BSN Copyright 2010 NCLEX Express Table of Contents Instructor’s Guide Best Bet for kids………………………………………………………………………………………….. 4 Blow Them Away……………………………………………………………………………….......... 5 Blockers………………………………………………………………………………………………………..6 Blood Gas Interpretation……………………………………………………………………………… 7 Chest Tubes………………………………………………………………………………………………… 9 CHF……………………………………………………………………………………………………………… 12 Diabetes………………………………………………………………………………………………………. 13 Diagnostic Procedures…………………………………………………………………………………. 19 Diets……………………………………………………………………………………………………….…… 20 Delegation…………………………………………………………………………………………………... 21 Electrolytes………………………………………………………………………………………………….. 22 Endocrine……………………………….…………………………………………………………………….23 Expected Changes in Aging………………………………………………………………………….. 26 Heart Rhythms…………………………………………………………………………………………….. 27 Infant Heart Defects…………………………………………………………………………………….. 29 Isolation Precautions…………………………………………………………………………………... 31 Lab Values…………………………………………………………………………………………………….32 Legal Eagle…………………………………………………………………………………………………… 33 Make it a Priority…………………………………………………………………………………………. 34 Math……………………………………………………………………………………………………………. 35 Natural Alternative………………………………………………………………………………………..36 Normal & High Risk Newborn………………………………………………………………………. 37 Orthopedics………………………………………………………………………………………………… 39 Pregnancy…………………………………………………………………………………………………… 41 Psych…………………………………………………………………………………………………………… 46 Save A Life……………………………………………………………………………………………………..52 Substance Abuse…………………………………………………………………………………………. 53 Therapeutic Communication……………………………………………………………………….. 54 Therapeutic Drug Range………………………………………………………………………………. 56 T.V. drugs…………………………………………………………………………………………………….. 57 Tips for Alternate Format Questions……………………………………………………………. 58 Words of Wisdom……………………………………………………………………………………….. 59 Congestive Heart Failure Regina Hughes A.) CHF happens when the heart can’t pump enough blood to meet the body’s needs. Left Side Signs L think L_______ Right Side Signs R think R____________ Most clients have failure on both sides. B.) Tests to Do: 1. ABG- will see patient is hypoxic 2. Chest-xray- will see pulmonary congestion, enlarged heart 3. BNP- greater than 100 C.) Medications 1. Morphine 2. O2 Morphine for pain, O2 will help client with 3. Diuretics breathing, Diuretics will help get rid of extra fluid. 4. Digoxin Make sure to do daily weights and monitor Intake and Output when a client is on diuretics. Digoxin D.) Nursing Interventions will increase cardiac output. Bedrest Monitor digoxin toxicity Monitor oxygen toxicity in COPD clients Diet- low sodium, low fat Legal Eagle Regina Hughes A.) Advanced Directives- legal documents that allow client to make decisions in advance. Durable Power of Attorney Living Will ***Know client’s DNR status!!! B) Informed Consent- make sure client is able to understand what is going on. ___________________________________________________________________ Need written consent to do Can do without written consent New NCLEX topic! ________________ ________________ _________________ _________________ _________________ __________________ Who gets it? The MD doing the procedure, RN can only witness. Stay out of jail tips: Good documentation (write down everything you did) Provide the best care for everyone (do not neglect the difficult ones) Do not give drugs that you don’t know As the RN you are responsible for treatments whether they get done or not Table of Contents Quick Facts Acid Reflux………………………….…….2 A.I.D.S………………………………….……2 Acute Renal Failure……………….…..4 Allergies………………………………….…4 Amputation…………………………..…..5 Aneurysm……………………………….…6 Anorexia Nervosa…………………..….6 Appendicitis……………………………...7 Arterial blood gas……………………….7 Asthma……………………………………...8 Autonomic Dyreflexia…………………8 Bell’s Palsy………………………………...9 Benign Prostatic Hyperplasia………9 Blood Administration……………....11 Blood Pressure Medication……….12 Breast Feeding…………………….……13 Buerger’s Disease………………….….13 Bulimia Nervosa…………………….…13 Burns……………………………………….14 Cancer……………………………………..16 Car Seats……………………………....…17 Cataracts………………………….………17 Celiac’s Disease…………………….....18 Cerebrovascular Accident………...18 C.O.P.D…………………………………….20 Chronic Renal Failure……………..…21 Compazine……………………………….21 Corticosteriods………………………...22 Cranial Nerves…………………….…...23 Crohn’s Disease…………………….….23 Cystic Fibrosis………………………..…24 Diabetic Teaching………………….....25 Digoxin…………………………………….26 Diuretics………………………………..…26 Donning Sterile Gloves………………27 Epiglottitis………………………………..27 Genital Herpes……………………….…28 Glaucoma…………………………….…..29 Immunizations………………………....30 Inflammatory Bowel Disease…….31 Incentive Spirometry…………….....31 Increased Intracranial Pressure…31 Instillation of Ear Medications…..32 Instillation of Eye Medications….33 Intravenous Therapy………………...33 Laminectomy…………………………….34 Lead Posioning………………………….34 Legal Issues……………………………….35 Lung Sounds……………………………..35 Lyme Disease……………………..…….36 Maslow’s Heirarchy of Needs……37 Masectomy……………………………….37 Medication Administration……….37 Meniere’s Syndrome…………………38 Menigitis……………………………….…39 Mongolian Spots……………………….39 Myasthenia Gravis…………………….40 Myocardial Infarction………………..41 Neomycin Sulfate……………………..41 Neuroleptic Malignant Synd……..42 NG Tube…………………………………..42 Nitroglycerin…………………………….43 NSAIDs………………………………………43 Nursing Abbreviations……………....44 Orthostatic Hypotension………..….45 Osteoarthritis………………………….…46 Otitis Media………………………………47 Oxygen Delivery System…………….47 Pacemakers……………………………….48 Paracentesis……………………………...49 Parkinson’s………………………………..50 Peptic Ulcer Disease…………………..51 Peripheral Artery Disease……….….52 Pheochromocytoma…………………...52 Phlebitis…………………………………....53 Piaget’s Theory of Cog Dev………...53 Pleural Effusion………………………….53 PTSD………………………………………....54 Pregnancy Stuff………………………….55 Presbycusis…………………………………55 Pressure Ulcers…………………………..55 Radiation Therapy……………………...56 Raynaud’s Disease……………………..57 Rheumatoid Arthritis………………….57 Sickle Cell Anemia………………………58 Starting an IV……………………………..59 Tardive Dyskinesia……………………..60 T.P.N………………………………………….60 Trimethoprim-Sulfamethoxazole..60 Tuberculosis……………………………….61 Vitamins……………………………………..62 Appendicitis Commonly seen in what age range? 10 to 30 What is the classic sign of appendicitis? Acute right lower abdominal pain What are some other signs/symptoms? Loss of appetite, nausea, vomiting, low grade temperature Localized tenderness is found where? McBurney’s point What are the tests for appendicitis? Complete history and physical exam with WBC count (will be elevated) What is the treatment for appendicitis? Immediate surgery to remove appendix, IV antibiotics, semi-fowlers position. NPO to rest gut General treatment for any acute abdominal pain? NPO status, no heat on abdomen, assess abdominal distention, IV fluid therapy Arterial blood gas Where are most samples drawn from? Radial artery in wrist How long should pressure be applied to the site after collecting a sample? 5 minutes Which test should be performed before collecting ABG? Allen’s Test Aspergers Syndrome This syndrome is a form of ______? Autism Peptic Ulcer Disease What bacteria is responsible for most peptic ulcers? H. pylori Where are most peptic ulcers found? Gastric and duodenal When a client has ulcers what will the vomit look like? “Coffee ground” When a client has ulcers what will the stool look like? “Black tarry” What medications should be avoided? NSAIDs Is Tylenol (acetaminophen) a NSAID? No Ulcers Where are the ulcers? Does stomach acid increase? Where does the pain occur? When does pain occur? Gastric Stomach Normal production Mid-epigastric region With meals or after eating “starve a gastric ulcer” Duodenal Duodenum Increased production Mid-epigastric region On an empty stomach “feed a duodenal ulcer” What type of medication will be given to decrease gastric acid production in duodenal ulcers? H2 blockers and Proton pump inhibitors What are medication examples of H2 blockers? Zantac (ranitidine) Tagamet (cimetidine) What are medication examples of proton pump inhibitors? Generic ending in “zole” Nexium (esomeprazole) Protonix (pantoprazole) Prilosec (omeprazole) _______ are prescribed to neutralize gastric acid? Antacids What should you teach clients with ulcers to avoid? Smoking and alcohol