Mark Klimek­ Yellow Book
Return to deck
1.
Rule of the ': If the ____ and the _____ are ______ in the ame direction then
it i meta_____
pH, icar, oth, olic
2.
pH 7.30_______ HCO3 20_______
↓= acidoi; ↓= metaolic
3.
pH 7.58_______ HCO3 32_______
↑= alkaloi; ↑= metaolic
4.
pH 7.22_______ HCO3 30_______
↓= acidoi; ↑= repirator
5.
You are providing care to a client with the following lood ga reult: pH
7.32, CO2 49, HCO3 29, PO2 80, and SaO2 90%. aed on thee reult, the
client i experiencing:
↓= acidoi; ↑= repirator
6.
MacKumaul
The onl acid ae to caue Kumaul repiration i Metaolic
ACidoi
7.
A the _______ goe, o goe _______ except for _______
pH, m patient, Potaium
8.
Up
hokalemia, alkaloi, HTN, Tachcardia, Tachpnea, Seizure,
Irritailit, Spatic, Diarrhea, ororgme, hperreflexia, etc
9.
Down
hperkalemia, acidoi, htn, radcardia, contipation, aent owel
ound, flacid, radpnea
10.
Caue of acid­ae imalance: Firt ak ourelf, "I it _______?" If e, then
it' _______. Then ak ourelf: "Are the _______ or _______. If _______, pick
_______. If _______, pick _______
lung, repirator, overventilating, underventilating, overventilating,
alkaloi, underventilating, acidoi
11.
Caue of acid­ae imalance: If it' not lung, then it' _______. If the patient
ha _______ _______ vomiting or uction, pick _______. For everthing ele
that in't lung, pick _______ _______. When ou don't know what to pick,
chooe _______
metaolic, prolonged gatric, alkaloi, metaolic acidoi, metaolic
acidoi
12.
High preure alarm are triggered  _______ reitance to air flow.
increaed
13.
High preure alarm are triggered  increaed reitance to airflow and can
e caued  otruction of three tpe: _______ action, _______ action,
_______ action
(kinked tue) unkink, (water in tue) empt, (mucu in airwa) cough
and deep reathe
14.
Low preure alarm are triggered  _______ reitance to airflow.
decreaed
15.
Low preure alarm are triggered  decreaed reitance to airflow and can
e caued  diconnection of the _______ or _______
tuing (reconnect it), oxgen enor tue (reconnect it UNLSS tue i
on the floor­ ag them and call RT if thi happen)
16.
Repirator alkaloi mean ventilator etting ma e too _______
high
17.
Repirator acidoi mean ventilator etting ma e too _______
low
18.
What doe "wean" mean?
graduall decreae with the goal of getting off altogether
19.
What i Malow' highet priorit to lowet priorit?
1. Phiological
2. Safet
3. Comfort
4. Pchological (prolem within the peron)
5. Social (prolem with other people)
6. Spiritual
20.
Arrange from highet to lowet priorit uing Malow':
Denial
Spiritual Ditre
Pain in low
Fall Rik
Pathological Famil Dnamic
lectrolte Imalance
lectrolte Imalance (Phiological)
Fall Rik (Safet)
Pain in low (Comfort)
Denial (Pchological)
Pathological Famil Dnamic (Social)
Spiritual Ditre (Spiritual)
21.
What are the 5 tage of grief?
Denial
Anger
argain
Depreion
Acceptance
22.
The #1 prolem in aue i _______
denial
23.
Denial i the _______ to accept the _______ of their prolem
refual, realit
24.
Treating denial: _______ it  pointing out to the peron the difference
etween what the _______ and what the _______. In contrat, _______ the
denial of lo and grief
confront, a, do, upport
25.
Dependenc: When the _______ get the Significant Other to do thing for
them or make deciion for them
auer
26.
Codependenc: When the _______ _______ derive poitive _______ from doing
thing for or making deciion for the _______
Significant Other, elf­eteem, auer
27.
When treating dependenc/codependenc: Set _______ and _______ them.
Agree in advance on what requet are allowed, then enforce the agreement
limit, enforce
28.
When treating dependenc/codependenc: Work on the _______ of the
codependent peron
elf­eteem
29.
Manipulation: when the _______ get the _______ _______ to do thing for
him/her that are not in the _______ _______ of the _______ _______. The nature
of the act i _______ or _______ to the _______ _______
auer, ignificant other, interet, ignificant other, harmful, dangerou,
ignificant other
30.
Treating manipulation: et _______ and _______
limit, enforce
31.
Wernicke' (Korakoff') Sndrome: _______ induced  Vitamin
_______(thiamine) deficienc
Pchoi, 1
32.
Primar mptom of Wernicke' (Korakoff') Sndrome: _______ with
_______
amneia (memor lo), confaulation (make up tuff)
33.
Characteritic of Wernicke' (Korakoff') Sndrome:
1. _______
2. _______
3. _______
preventale (take vitamin)
arretale (take vitamin)
irreverile (kill rain cell)
34.
Antaue/Revia i aka _______ Therap
Averion
35.
Onet and duration of effectivene of Antaue/Revia: _______
2 week
36.
Patient teaching with Antaue/Revia: Avoid _______ form of _______ to
avoid _______, _______, _______
all, alcohol, nauea, vomiting, death
37.
What are example of product that contain alcohol?
mouth wah, cologne, perfume, afterhave, elixir, mot OTC liquid
medicine, inect repellant, vanilla extract, vinagerette, hand anitizer
38.
ver alcoholic goe through _______. Onl a minorit get _______
Alcohol Withdrawal Sndrome, Delirium Tremen
39.
_______ i not life­threatening. _______ can kill ou
Alcohol Withdrawal Sndrome, Delirium Tremen
40.
Patient with _______ are not a danger to themelve or other. Patient with
________ are dangerou to elf and other
Alcohol Withdrawal Sndrome, Delirium Tremen
41.
AWS or DT: emiprivate room, an location
AWS
42.
AWS or DT: private room near the nure' tation
DT
43.
AWS or DT: Regular diet
AWS
44.
AWS or DT: Clear liquid or NPO diet (rik for apiration)
DT
45.
AWS or DT: Up at liert
AWS
46.
AWS or DT: Retricted to edret with no athroom privilege
DT
47.
AWS or DT: No retraint
AWS
48.
AWS or DT: Uuall retrained with either vet or 2 point (1 arm and 1 leg)
DT
49.
AWS or DT: Give anti­HTN medication
oth
50.
AWS or DT: Give tranquilizer
oth
51.
AWS or DT: Give multivitamin to prevent Wernicke'
oth
52.
For Aminoglcoide, think " __ ____ ___ _____"
a mean old mcin
53.
When are antiiotic/aminoglcoide ued?
to treat eriou, life­threatening, reitant infection
54.
All aminoglcoide end in _______, ut not all drug that end in _______ are
aminoglcoide.
mcin, mcin
55.
What are ome example of wannae mcin?
Azithromcin, Clarithromcin, rthromcin
56.
What are ome example of aminoglcoide?
Streptomcin, Cleomcin, Toramcin, Toramcin, Gentamcin,
Vancomcin, Clindamcin
57.
When rememering toxic effect of mcin' think _______
mice= ear
58.
What i the toxic effect of aminoglcoide and what mut ou monitor?
ototoxicit; monitor hearing, alance, and tinitu
59.
The human ear i haped like a _______ o another toxic effect of
aminoglcoide i _______ o monitor _______
kidne, nephrotoxicit, creatinine
60.
The numer "___" drawn inide the ear remind ou of cranial nerve ___ and
frequenc of adminitration ___
8, 8, Q8H
61.
Do not give aminoglcoide PO expect in thee 2 cae:
1. _______ _______ (due to high _______ level)
2. Pre­op _______ urger
hepatic encephalopath (liver coma, ammonia­induce
encephalopath), ammonia, owel
62.
Who can terilize m owel?
Neo­ Kan
63.
What i the reaon for drawing Trough and Peak level?
Narrow therapeutic level
64.
When do ou ALWAYS draw the Trough?
30 minute efore next doe
65.
When do ou draw the Peak level of Sulingual medication?
5­10 minute after drug diolve
66.
When do ou draw the Peak level of IV medication?
15­30 minute after medication i finihed
67.
When do ou draw the Peak level of IM medication?
30­60 minute after injecting it
68.
When do ou draw the Peak level of SQ medication?
Depend on tpe of inulin
69.
When do ou draw the Peak level of PO medication?
Not necear
70.
What are iological Agent in Categor A?
STAPH 
Small Pox
Tularemia
Anthrax
Plague
Hemorrhagic illne
otulim
71.
What are iological Agent in Categor ?
All other
72.
What are iological Agent in Categor C?
Nipeh Viru
Hanta Viru
73.
When it come to iological Agent: Categor __ i _______, Then Categor __,
Then Categor __
A, the wort, , C
74.
Small Pox
Inhaled tranmiion/ on airorne precaution
die from epticemia­ no treatment
rah tart around mouth firt
Categor A
75.
Tularemia
chet mptom
die from repirator failure
treat with treptomcin
Categor A
76.
Anthrax
pread  inhalation
look like the flu
die from repirator failure
treat with upro, PCN, and treptomcin
Categor A
77.
Plague
pread  inhalation
ha the 3 H': Hemopti (coughing up lood), Hematemei (vomiting
up lood), Hematochezia (lood in tool)
dei from repirator failure and DIC (leed to death)
treat with Doxccline and Mcin
no longer communicale after 48 hour of treatment
Categor A
78.
Hemorrhagic illnee
primar mptom are petechiae (pinpoint pot) and ecchmoe
(ruiing)
high % fatal
Categor A
79.
otulim
it i ingeted
ha 3 major mptom: decending parali, fever, ut i alert
die from repirator arret
Categor A
80.
What are ome example of chemical agent that caue ioterrorim?
Mutard ga
Canide
Phogine chlorine
Sarin
81.
What i the primar mptom of Mutard Ga?
liter (veicant)
82.
What i the primar mptom of Canide and how do ou treat it?
Repirator arret. Treat with Sodium Thioulfate IV
83.
What i the primar mptom of Phogine Chlorine?
Choking
84.
What are the mptom of Sarin (hint it' a nerve agent)?
 SLUDG­ jut rememer ever ecretion in our od i eing
excreted exceivel
ronchopam
ronchorrhea
Salivating
Lacrimating (tear)
Urination
Diaphorei/ Diarrhea
G.I upet
mei
85.
What do ou ue when cleaning patient expoed to chemical agent?
All chemical agent require onl oap and water cleaning except
Sarin, which require leach.
86.
Which agent do ou iolate the patient for?
iological Agent
87.
Which agent do ou decontaminate for?
Chemical Agent
88.
How doe decontamination work?
Gather expoed people
Take to decontamination center where people remove clothing, hower,
dre in non­contaminated clothe, then releae to other ervice
Put contaminated clothing in pecial ag and throw awa (e ure not
to touch it)
89.
Calcium Channel locker: the are like ________ for our heart. What doe
that mean?
Valium. It relaxe the heart
90.
Calcium Channel locker: _______ inotropoic, chronotropic, dromotropic
Negative
91.
Inotropic
trength of heart
92.
Poitive Inotropic
trong hearteat
93.
Negative Inotropic
weak hearteat
94.
Chronotropic
rate of hearteat
95.
Poitive Chronotropic
fat hearteat
96.
Negative Chronotropic
low hearteat
97.
Dromotropic
conductivit of heart
98.
Poitive Dromotropic
excitale heart
99.
Negative Dromotropic
lock/low conduction
100.
Poitive Inotropic, Chronotropic, and Dromotropic i een with which
medication?
atropine, epinephrine, and norepinephrine
101.
Negative Inotropic, Chronotropic, and Dromotropic i een with which
medication?
Calcium Channel locker and eta locker
102.
What do Calcium Channel locker treat? (indication)
Antihpertenive (decreae P)
Anti Angina (imalance etween O2 uppl and demand)
Anti Atrial Arrhthmic (Atrial flutter and Atrial firillation)
103.
What are ome of the ide effect of Calcium Channel locker?
Headache
Hpotenion
104.
Name of Calcium Channel locker can e rememered  aing....
I op zem dipine in the Calcium Channel ("zem", "dipine",
"verapamil/ioptin")
105.
"QRS depolarization" alwa refer to __________
Ventricular (not atrial, junctional or nodal).
106.
"P wave" refer to _________
Atrial
107.
Atole
a lack of QRS depolarization (flat line)
108.
Atrial Flutter
rapid P­wave depolarization in a aw­tooth pattern (flutter)
109.
Atrial Firillation
chaotic P­wave depolarization
110.
Ventricular Tachcardia
wide izarre QRS'
111.
Premature Ventricular Contraction (PVC)
Periodic wide, izarre QRS'
112.
e concerned aout PVC' if:
More than 6 per minute
6 in a row
PVC fall on T­wave of previou eat
113.
What are the lethal arrhthmia?
atole and ventricular firillation
114.
What i the potentiall life­threatening arrhthmia?
1. v­tach, 2. a­fi, 3. a­flutter
115.
When dealing with an IV puh drug if ou don't know go ____ except
________!
low, adenocard
116.
What i the treatment for PVC'?
lidocaine and amiodarone
117.
What i the treatment for V Tach?
lidocaine and amiodarone
118.
What are the treatment for upraventricular arrhthmia?
ACD
Adenocard/adenoine
etalocker (end in lol)
Calcium Channel locker
Digitali/Digoxin (lanoxin)
119.
What i the treatment for V­fi?
ou defi
120.
What i the treatment for Atol?
Give pi firt then Atropine
121.
atole
122.
atrial firillation
123.
atrial flutter
124.
Normal Sinu Rhthm
125.
Supraventricular tachcardia
126.
ventricular firillation
127.
The purpoe for chet tue i to re­etalih _______ preure in the pleural
pace
negative
128.
In the pneumothorax, the chet tue remove ___
air
129.
In the hemothorax, the chet tue remove _____
lood
130.
In the pneumohemothorax, the chet tue remove ___ and _____
air and lood
131.
when the chet tue i ______ (____) for ___. aka ____
Apical (high), air, apex
132.
When the chet tue i ______ (___) for _____ aka ____
ailar (low), lood, ae (ottom of lung)
133.
How man chet tue and where for unilateral pneumohemothorax?
2; apical and ailar on ide of pneumo
134.
How man chet tue and where for ilateral pneumothorax?
2; apical for oth
135.
How man chet tue and where for pot­op chet urger/chet trauma?
aume unilateral pneumohemothorax­ 2; apical and ailar on ide of
pneumo
136.
In routine _____ clamp chet tue. In emergenc _____ the chet tue
NVR; CLAMP
137.
What do ou do if ou kick over the collection ottle?
Set it ack up (not an emergenc)
138.
What do ou do if the water eal reak?
Firt­ clamp it, cut tue awa from device
et­ umerge the tue under water, then unclamp
139.
What do ou do if the chet tue come out?
Firt­ cover with a gloved hand
et­ cover the hole with vaeline gauze, put a dr terile dreing on
top, tape on 3 ide
140.
If there' uling in the water eal intermittentl it i...
good
141.
If there' uling in the water eal and it' continuou it i...
ad
142.
If there' uling in the uction control chamer intermittentl it i...
ad
143.
If there' uling in the uction control chamer continuoul it i...
good
144.
Rule for clamping the tue:
never clamp longer than __________ without Dr' order
ue _____________________________
15 econd, ruer tipped doule clamp
145.
ver congenital heart defect i either ___________ or ____ ___________
TRouLe, No TRouLe
146.
R­L
Right to Left hunt
147.

lue
148.
T
tart with the letter "T"
149.
What are ome example of "TRouLe" congenital heart defect?
Trunku arterioi, Tran. poition of great veel, Tetrolog of Fallot,
Tricupid tenoi, TAPZ, Left ventricular hperplamic ndrome
150.
What are ome example of "No TRouLe" congenital heart defect?
Patent fore. ov., ventricular eptal defect, pulmonar tenoi
151.
Akk CHD kid will have 2 thing, whether TRouLe or No TRouLe...
1. Murmur
2. chocardiogram
152.
Four defect preent in Tetralog of Fallot are...
VarieD
PictureS
Of A
RancH
Ventricular Defect
Pulmonar Stenoi
Overriding Aorta
Right Hpertroph
153.
How do ou meaure crutche for a peron?
2­3 fingerwidth elow anterior axillar fold to a point lateral and
lightl in front of foot
154.
When the handgrip i properl placed, the angle of elow flexion will e ____
degree
30
155.
2 point gait
tep one­­ move one crutch and oppoite foot together
tep two­­ move other crutch and other foot together
(rememer 2 point together for a 2 point gait)
Ued for minor weakne on oth leg
156.
3 point gait
tep one­­ move two crutche and ad leg together
tep two­­ move good foot
(Rememer 3 point i called 3 point ecaue 3 point touch down at
once)
157.
4 point gait
tep one­­ one crutch
tep two­­ oppoite foot
tep three­­ other crutch
tep four­­ other foot
nothing move together and everthing i reall weak
158.
Swing through
for two raced extremitie
(Amputee)
159.
Ue the _____ numered gait when weakne i _______ ditriuted. ___
point for mild prolem and ___ point for evere
even, evenl, 2, 4
160.
Ue the ___ numered gait when one leg i ______
odd, effected
161.
Stair: which foot lead when going up and down tair on crutche? ______
with the _______ and _______ with the _____. The crutche alwa move with
the ____ leg
up, good, down, ad, ad
162.
Cane: Hold cane on the __________ _______ ide. Advance cane with the
_________ ide for a wide ae of upport
uneffected ide, oppoite
163.
What i the correct wa to ue a walker?
pick it up, et it down, and walk to it
164.
What i a ig NO when it come to walker?
Do not tie elonging to the front of the walker
165.
What i the correct wa to get up from a chair uing a walker?
Hold on to chair, tand up, then gra walker
166.
What i the difference etween a non­pchotic peron and a pchotic
peron?
a non­pchotic peron ha inight (know the're ick and that it'
meing them up) and i realit aed (the ee realit the ame wa
a ou) and a pchotic peron ha no inight and i not realit­aed.
167.
Deluion
a fale, fixed elief or idea or thought. There i no enor component
168.
What are the 3 tpe of deluion?
Paranoid/Perecutor, Grandioe, & Somatic
169.
Paranoid or Perecutor Deluion
fale, fixed elief that people are out to harm ou
170.
Grandioe deluion
Fale, fixed elief that ou are uperior
171.
Somatic deluion
Fale, fixed elief aout a od part
172.
Hallucination
a fale, fixed enor exerience
173.
What are the 5 tpe of hallucination?
auditor (hearing), tactile (feeling), viual (eeing), gutator (tating),
and olofactor (melling)
174.
Illuion
a miinterpretation of realit. It i a enor experience
175.
What i the difference etween illuion and hallucination?
With illuion there i a referent in realit (omething to which the
can refer to)
176.
When dealing with a patient experiencing deluion, hallucination or
illuion, firt ak ourelf, "What i their prolem?" (what are the different
prolem that could e going on?)
functional pchoi, pchoi of dementia, and pchotic delirium
177.
What are the different tpe of functional pchoi?
chziophrenia, chzioaffected (mood diorder thought proce), major
depreion, and mania
178.
With a functional pchoi the patient ha the potential to learn realit.
How can ou teach realit to a functional pchotic?
1. acknowledge feeling
2. preent realit
a. poitive­ what i realit
. negative­ what i not realit
3. et a limit
4. enforce the limit
179.
Pchoi of dementia
People with Alzheimer', Wernicke', Organic rain Sndrome, and
dementia. Thi patient ha a rain detruction prolem and cannot
learn realit
180.
How do ou deal with a peron with Pchoi of Dementia?
1. Acknowledge feeling
2. Redirect­ get them to expre the fixation that the are expreing
inappropriatel to appropriatel
181.
Pchotic Delirium
Temporar epiodic econdar dramatic udden onet of lo of realit
due to chemical imalance (UTI, throid imalance, electrolte
imalance)
182.
How do ou deal with a patient with Pchotic Delirium?
1. Acknowledge feeling
2. Reaure them of afet and temporarne
183.
What are the different tpe of looening of aociation?
Flight of idea, word alad, neologim
184.
Flight of idea
Stringing phrae together (looel aociated phrae; tangentialit)
185.
Word alad
Throw word together
186.
Neologim
Making up new word
187.
Narrowed elf­concept
When a PSYCHOTIC refue to change their clothe or leave the room.
*don't make a pchotic do omething the don't want to do
188.
Idea of reference
You think everone i taking aout ou
189.
Dementia hallmark
Memor lo, inailit to learn.
*Functional can teach, dementia cannot
190.
Alwa acknowledge ______________
Feeling
191.
What are the 3 "Re'"?
Reaure
Redirect
Realit
192.
Diaete mellitu
An error of glucoe metaolim
193.
Diaete inipidu
Dehdration, polurethane, poldipia
194.
Tpe I Diaete Mellitu
Inulin dependent (not producing inukin)
Juvenile onet
Ketoi prone
195.
Tpe II Diaete Mellitu
Non inulin dependent (od reiting inulin)
Adult onet
Non ketoi prone
196.
Sign and mptom of diaete mellitu
Poluria (pee a lot)
Poldipia (drink a lot)
Polphagia (eat/wallow a lot)
197.
Treatment for Tpe I Diaete Mellitu
3. Diet (calorie from car)
1. Inulin
2. xercie
198.
Treatment for Tpe II Diaete Mellitu
1. Diet
3. Oral hpoglcemic
2. Activit
199.
Diet of Diaetic
Calorie (car) retriction
Need to eat 6x per da­­> maller more frequent meal
200.
Inulin act to _____________ lood ugar
Lower
201.
Inulin Tpe: R
R= Regular, Rapid, Run (IV)
Onet: 1hr
Peak: 2hr
Duration: 4hr
202.
Inulin Tpe: N
N= NPH, Not in the ag, Not o fat, Not clear (cloud)
Onet: 6hr
Peak: 8­10hr
Duration: 12 hr
203.
Inulin Tpe: Humalog
Inulin Lipro
Fatet
Onet: 15min
Peak: 30min
Duration: 3hr
204.
Inulin Tpe: Lantu
Long acting
Slow aorption
No peak
Duration: 12­24hr
205.
With inulin rememer:
Check expiration date
Refrigerate ut once open no refrigeration
206.
xercie ________ inulin: if more exercie, need _________ inulin. If le
exercie, need __________ inulin
Potentiate, le, more
207.
Sick da rule for inulin
Take inulin
Take ip of water
Sta active a poile
208.
Low lood ugar in Tpe I Diaete Mellitu (inulin hock) i caued :
Not enough food
Too much inulin
Too much exercie
209.
Wh i low lood ugar in Tpe I Diaete Mellitu (inulin hock)
dangerou?
Permanent rain damage
210.
Sign and mptom of low lood ugar in Tpe I Diaete Mellitu (inulin
hock):
Cereral impairment, vaomotor collape, cold, clamm, low reaction
time, "drink hock"
211.
Treatment for low lood ugar in Tpe I Diaete Mellitu (inulin hock):
Adminiter rapidl metaolizale carohdrate (cand, hone)
Ideal comination: ugar and protein
If unconciou IV D50 IM glucagon
212.
High lood Sugar in Tpe I Diaete Mellitu/ DKA/ Diaetic Coma i caued
:
Too much food
Not enough inulin
Not enough exercie
#1 caue i acute viral upper repirator infection within the lat 10
da
213.
Sign and mptom of High lood Sugar in Tpe I Diaete Mellitu/ DKA/
Diaetic Coma
Dehdration
Ketone, Kumaul reathing, high K+
Acidoi, Acetone reath, Anorexia
214.
Treatment for High lood Sugar in Tpe I Diaete Mellitu/ DKA/ Diaetic
Coma
Inulin IV (R)
IV rate flow 200mg/hr
215.
Treatment for low lood ugar in Tpe II Diaete Mellitu:
Adminiter rapidl metaolizale carohdrate (cand, hone)
Ideal comination: ugar and protein
If unconciou IV D50 IM glucagon
216.
High lood Sugar in Tpe II Diaete Mellitu
Called HHNK or HHNC­ Hperomolar, Hperglcemic, Non­Ketotic
Coma
Thi i evere dehdration
217.
Sign and mptom of High lood Sugar in Tpe II Diaete Mellitu
Hit, dr, increaed HR, decreaed kin turgor
218.
Treatment for High lood Sugar in Tpe II Diaete Mellitu
Rehdration
219.
Long term complication of HHNC are related to
Poor tiue perfuion
Peripheral neuropath
220.
Which la tet i the et indicator of long­term lood glucoe control
(compliance/effectivene/adherence)?
Ha1c (average lood ugar over lat 90 da)
221.
Cold and clamm­ _____________________________
Hot and dr­ ____________________________
Get ome cand
Sugar' high
222.
What i the therapeutic and toxic level for Lithium?
therapeutic level: 0.6­1.2
toxic level: ≥ 2
223.
What i the therapeutic and toxic level for Lanoxin (Digoxin)?
therapeutic level: 1­2
toxic level: >2
224.
What i the therapeutic and toxic level for Aminophlline?
therapeutic level: 10­20
toxic level: ≥ 20
225.
What i the therapeutic and toxic level for iliruin?
therapeutic level (elevated level): 10­20
toxic level: >20
226.
Kernicteru
iliruin in the CSF
227.
Opithotono
poition of light extenion in neck een in patient' with Kernicteru.
(ad ign)
228.
Dumping Sndrome
Pot­Op gatric urger complication in which gatric content dump
too quickl into the duodenum
229.
Hiatal Hernia
Regurgitation of acid into eophagu, ecaue upper tomach herniate
upward through the diaphragm
230.
Hiatal Hernia or Dumping Sndrome: Gatric content move in the right
direction at the wrong rate
Dumping Sndrome
231.
Hiatal Hernia or Dumping Sndrome: Gatric content move in the wrong
direction at the right rate
Hiatal Hernia
232.
Hiatal Hernia or Dumping Sndrome: GRD like mptom when upine and
after eating
Hiatal Hernia
233.
ADS S&S
Acute Dumping Sndrome
Adominal ditre (cramping, N/V, hperactive S(ororgmi))
Drunk­ cereral impairment
Shock (vaomotor collape, rapid thread HR)
234.
Treatment for Hiatal Hernia
HO during & 1hr after meal­ high
Amount of fluid with meal­ high
Carohdrate content of meal­ high
goal: get an empt tomach
235.
Treatment for Dumping Sndrome
HO during & 1hr after meal­ low
Amount of fluid with meal­ low
Carohdrate content of meal­ low
goal: get a full tomach
236.
Kalemia do the ______ a the prefix except for ___________ and __________
Hperkalemia=
Hpokalemia=
ame; heart rate; urine output
Hper= ↑; HR ↓, Urine Output ↓
Hpo= ↓; HR ↑, Urine Output ↑
237.
Calcemia do the _______ of the prefix. No exception.
Hpercalcemia=
Hpocalcemia=
oppoite
Hper=↓
Hpo= ↑
238.
Two ign of neuromucular irritailit aociated with _____________:
1.
2..
hpocalcemia
1. Chvotek' Sign= cheek tap→ facial pam
2. Troueau' Sign= P cuff→ carpal pam
239.
Magneemia do the ____________ of the prefix.
Hpermagneemia=
Hpomagneemia=
oppoite
Hper= ↓
Hpo= ↑
240.
If mptom involve nerve or keletal mucle, pick ________. For an other
mptom, pick __________ ( generall anthing effecting ____________)
Calcium, Potaium, lood preure
241.
Hprnatermia
dhdration (dr kin, thread pule, rapid HR)
242.
hpOnatremia=
Overload (crackle, ditended neck vein)
243.
The earliet ign of an electrolte diorder i _________ & __________
numne, tingling (paretheia)
244.
The univeral ign­mptom of electrolte imalance i ________________
mucle weakne (parei)
245.
Never puh ____________ IV
Potaium
246.
Not more than ______ of K+ per liter of IV fluid
40mq
247.
Give _____ & ______ to decreae K+
D5W, inulin (not permanent)
248.
Kaexalate:
K+­ exit­ late (not a quick, more of a permanent olution)
249.
In a patient with hpercalcemia, which monitor pattern would e the mot
likel threat?
A. Paroxmal atrial tachcardia with decreaed ST egment
. radcardia with 2nd degree Moitz Tpe II lock & elevated ST egment
C. Frequent PAC' with multifocal coupling of PVC' and tall T­wave
D. Firt degree heart lock with decreaed ST egment and inverted T­wave
D. Firt degree heart lock with decreaed ST egment and inverted T­
wave
250.
Hperthroidim=
Hper­ metaolim (high metaolic rate)
251.
Sign and Smptom of Hperthroidim
weight lo, diarrhea, ↑HR, hot, heat intolerance, HTN, exopthalmo
(ulging ee­ Don Knopp)
252.
Hperthroidim i alo known a ____________________. So rememer _____
ourelf into the ______
Grave' Dieae; Run; Grave
253.
The prolem i hperthroidim. Treatment option:
Radioactive iodine, proplthroid utiil, urgical removal
254.
What i the ig rik with radioactive iodine?
radiation rik in urine­ doule fluh, need private athroom
255.
What doe PTU do?
proplthroid utinil knock out WC
256.
What i the mot common treatment for hperthroidim?
urgical removal
257.
Total throidectom­ need lifelong ________ replacement.
at rik for ___________
hormone; hpocalcemia (difficult to pare parathroid)
258.
What are ou at rik for with a utotal throidectom?
throid torm
259.
What are ign and mptom of throid torm?
extremel high vital ign, extremel high fever, pchoticall
deliriou. Thi i a medical emergenc
260.
What i the treatment for throid torm?
oxgen and lower od temperature
261.
Total= T_____
Sutotal= S______
Tetan
Storm
262.
Pot operation rik for total and utotal throidectom in firt 12 hr
airwa/reathing, leeding
263.
Pot operation rik for total throidectom in 12­48 hr
tetan (r/t ↓Ca)
264.
Pot operation rik for u­total throidectom in 12­48 hr
throid torm
265.
Hpothroidim = hpo­_________
metaolim
266.
ign and mptom of hpothroidim
weight gain, htn, contipation, letharg, coldintolerance, "low"
267.
Hpothroidim i alo known a _______________
mxedema
268.
What are the 3 reaon for accucheck?
diaete, TPN, teroid
269.
Treatment for hpothroidim
throid replacement (/e: hperthroidim)
270.
Caution: with hpothroidim treatment DO NOT ________
edate (the are alread edated)
271.
Surgical implication for the hpothroid patient
Anetheia i ver high rik and do not hold throid pill when NPO
272.
Adrenal Cortex Dieae tart with letter ___ or ____
A, C
273.
Addion' Dieae i _______________ of the adrenal cortex
underecretion
274.
Sign and Smptom of Addion' Dieae
hperpigmented (darker), doen't repond to tre well (JFK)
275.
Treatment for Addion' Dieae
teroid (need to wear a med alert racelet)
276.
Addion'=
add­a­one
277.
Cuhing' Sndrome i ___________ of the adrenal cortex
overecretion (cuh= more)
278.
Sign and Smptom of Cuhing' Sndrome (ame a teroid)
moon face, hirutim (↑ od hair), water retention, gnecomatia (man
oo), uffalo hump, central oeit (mall kinn lim),↓ one
denit, ea ruiing, irritailit, immunouppreion
279.
Treatment for Cuhing' Sndrome
adrenalectom→ replacement therap→ teroid)
280.
What i CONTACT precaution ued for?
Herpe, nteric (Rotaviru, Shigellou), Staph (MRSA), RSV
(tranmitted via droplet ut contact ecaue kid put mouth on
everthing)
281.
CONTACT PRCAUTIONS: Select all that appl:
___ Private Room
___ e/Face Shield
___ Mak
___ Dipoale Supplie
___ Glove
___ Negative Air Flow
___ Special Filter Repirator Mak
___ Handwahing
___ Gown
___ Pt wear mak when leaving room
Private Room (mot important)
Glove
Gown
Handwahing
Dipoale upplie (P cuff)
Stethocope can e taken from room to room a long a terilized after
ue
282.
What i droplet precaution ued for?
influenza (H1N1), meningiti, diphtheria, pertui, mump
283.
DROPLT PRCAUTIONS: Select all that appl:
___ Private Room
___ e/Face Shield
___ Mak
___ Dipoale Supplie
___ Glove
___ Negative Air Flow
___ Special Filter Repirator Mak
___ Handwahing
___ Gown
___ Pt wear mak when leaving room
Private Room
Mak (mot important)
Glove
Handwahing
Pt wear mak when leaving room
Dipoale upplie
284.
What i airorne precaution ued for?
Meale, T (pread via droplet), Chicken POx (Varicella), SARS
285.
AIRORN PRCAUTIONS: Select all that appl:
___ Private Room
___ e/Face Shield
___ Mak
___ Dipoale Supplie
___ Glove
___ Negative Air Flow
___ Special Filter Repirator Mak
___ Handwahing
___ Gown
___ Pt wear mak when leaving room
Private room (door cloed
Mak
Glove
Gown
Handwahing
Special FIlter Repirator Mak (for T onl­ and not uppoed to leave
room unle the have to)
Pt wear mak when leaving room
Dipoale upplie
Negative air flow (mot important)
verone that enter the room mut wear a mak
286.
Unle otherwie pecified, aume that PP include:
glove, gown, goggle, and mak
287.
The proper place for donning PP i ________ the room and doffing PP i
_________ the room
outide, inide
288.
The proper order for donning PP i
1. ___________
2. ___________
3. ___________
4. ___________
1. Gown
2. Mak
3. Goggle
4. Glove
(tart low and go high)
289.
The proper order for removing PP i:
1. ________
2. ________
3. ________
4. ________
1. Glove
2. Goggle (from ehind)
3. Gown (from ehind)
4. Mak (from ehind­ outide room)
(alphaetical order)
290.
In airorne and droplet precaution onl, the mak i removed _______ the
room and the patient remove mak ________ the room.
outide, inide
291.
Hand­wahing or Scruing: poition hand elow elow
hand­wahing
292.
Hand­wahing or Scruing: poition elow elow hand
cruing
293.
Hand­wahing or Scruing: length econd
hand­wahing
294.
Hand­wahing or Scruing: length minute
cruing
295.
Hand­wahing or Scruing: can touch handle
hand­wahing
296.
Hand­wahing or Scruing: not allowed to touch handle
cruing
297.
Hand­wahing or Scruing: ue when entering/leaving room, efore/after
glove ue, whenever hand get oiled
hand­wahing
298.
Hand­wahing or Scruing: ue when patient i immunouppreed
(eginning of tuff)
cruing
299.
Hand­wahing or Scruing: oap and water
hand­wahing
300.
Hand­wahing or Scruing: ue "chlor­­­"
cruing
301.
When can ou ue an Alcohol­aed olution?
Onl utitute for handwahing, enter/leave room, efore/after glove,
NVR utitute after oiling hand
302.
Can ou ue an alcohol­aed olution after uing the retroom?
No! (oiling hand)
303.
Dr hand from ________ to _________. Turn water off with _____ paper towel
cleanet, dirtiet, new
304.
Sterile Gloving:
glove ________ hand firt
grap ________ of cuff
touch onl the _______ of glove urface
do not _______ cuff
finger _______ econd glove cuff
keep thum _______
onl touch _______ urface of glove
dominant
outide
inide
roll
inide
aducted
outide
305.
SkIN touche _______ of glove
INide
306.
OUTide of glove onl touche _______ of glove
OUTide
307.
Remove ______ to _______; _______ to _______
glove, glove, kin, kin
308.
What patient do NOT need interdiciplinar care?
People who have multiple prolem in the ame diviion of care
x: COPD, arthriti, cancer of owel (all medical prolem)
309.
What i the major criteria for interdiciplinar care?
1. Patient with multidimenional need (phical, intellectual,
emotional, ocial, piritual)­ x COPD, homelene, & chizophrenia
(need medical, SW, and pchiatrit)
2. Patient who need rehailitation (PT, SW, OT, Speech will e effected)
310.
What i the minor criteria for interdiciplinar care?
a patient whoe current treatment i ineffective
a patient who i preparing for dicharge
311.
What are the 3 principle to conider when chooing appropriate to for
kid?
1. i it afe
2. i it age­appropriate
3. i it feaile (can ou actuall do it?­ pecific to child' ituation)
312.
What are ome afet conideration when it come to kid to?
1. ize of to (no mall to for children under 4)
2. no metal to if oxgen i in ue (park thing)
3. eware of fomite (non living oject that haror microorganim)­
wort: pluh to/ tuffed animal; leat­ platic to that can e
diinfected
313.
What i the ST to for 0­6 month old (enorimotor)?
mucial moile
314.
What i the 2nd ST to for 0­6 month old (enorimotor)?
large and oft
315.
What i the ST to for 6­9 month old (oject permanence)?
cover/uncover to (jack in the ox)
316.
What i the 2nd ST to for 6­9 month old (oject permanence)?
firm ut large (wood/ hard platic allowed)
317.
What i the ST to for 9­12 month old?
veral to (tickle me elmo)
318.
Rememer with 9­12 month old ___________ activit with _________
purpoeful, oject
319.
Avoid anwer with the following word in them for children 9 month and
ounger:
uild, ort, tack, make, & contruct
320.
What i the et to for toddler (1­3 ear)?
puh/pull to (wagon)
321.
What kill i eing worked on when toddler pla?
gro motor kill
322.
What tpe of pla do toddler do?
parallel pla (pla alongide ut not with)
323.
What tpe of to hould e avoided with toddler?
to that require good finger control/dexterit
324.
Prechooler need to that work on:
fine motor kill (finger) and alance (dance, ice kating and tumling)
325.
Prechooler pla i characterized 
cooperative pla (pla with each other)
326.
Prechooler like to pla ________.
pretend
327.
School age (7­11 ear) aka _________ are characterized  the 3 C':
1.
2.
3.
Concrete
1. created/creative (give lank paper; get them involved)
2. competitive (winner and loer)
3. collective (aeall card and arie)
328.
Adolecent (12­18 ear)­ their "pla" i _______ _______ _____________. Allow
adolecent to e in each other' room unle one of them i :
1.
2.
3.
peer group aociation (hang out in group)
1. freh pot­op (le than 12 hour)
2. immunouppreed
3. contagiou
329.
When given a variet of age to chooe from alwa go __________ ecaue
children ________ when ick and ou want to give them
__________________________________
ounger, regre, a much time to grow
330.
Creatinine
et indicator of kidne function
331.
Creatinine la value
0.6­1.2
If elevated it' anormal ut not too worriome (jut mean kidne are
failing)
332.
INR (International Normalized ratio)
Monitor Coumadin (Warfarin) therap (Coumadin and War Fare make
ou leed)
333.
What i the therapeutic range for INR?
2­3
↑INR= leed rik
≥4 i critical
334.
What do ou do when INR i ≥ 4?
Hold all Coumadin
Ae leeding
Prepare to give Vitamin K
Call the Dr
335.
What i the therapeutic range for Potaium (K+)?
3.5­5.0
336.
What do ou do if Potaium i low?
Critical
Ae heart
Prepare to give Potaium
Call the Dr
337.
What do ou do if Potaium i 5.4­5.9?
Critical (high ut till in the 5')
Hold all Potaium
Ae heart
Prepare Kaexalate/D5W
Call the Dr
338.
What do ou do if Potaium i ≥6?
Deadl Dangerou
Do all of the following at once: Hold Potaium, ae heart, prepare
Kaexalate/D5W, Call Dr (will need a team to addre thi)
339.
What i the therapeutic range of pH?
7.35­7.45
340.
What do ou do if pH i in the 6'?
Deadl Dangerou
get vital and call Dr
(mot important when aked in quetion)
341.
What i the therapeutic range for UN (lood urea nitrogen)?
8­30 (8 un in a pack)
342.
What do ou do when a patient ha an elevated UN?
e concerned
Check for dehdration
343.
What i the therapeutic range for Hg (hemogloin)?
12­18 (teenage ear)
344.
What do ou do when a patient ha a 8­11 hg?
e concerned
monitor the patient
345.
What do ou do if a patient ha a hg of <8?
Critical
Ae leeding, prepare for tranfuion, call Dr
346.
What i the therapeutic range for HCO3?
22­26
If out of range it i anormal ut not worriome
347.
What i the therapeutic range for CO2?
35­45
348.
What do ou do if CO2 i in the 50'?
Critical (ign of repirator inufficienc)
Ae repiration
Do pured lip reathing (low out candle and exhale for longer period)
Don't give O2 (it will increae CO2)
Thi doe not appl to COPD (thi i their "normal")
349.
What do ou do if CO2 i in the 60'?
Deadl Dangerou
ign of repirator failure
Ae repiration
Do pured lip reathing (to ↓ anxiet)
Prepare to intuate and ventilate
Call repirator therap
Call Dr
350.
What i the therapeutic range for Hct?
36­54
(if anormal e concerned)
351.
What i the therapeutic range for PO2?
78­100
352.
What do ou do if PO2 i 70­77?
Critical
Sign of repirator inufficienc
Ae repiration
Give Oxgen
353.
What do ou do when PO2 i ≤60'?
Deadl Dangerou
Sign of repirator failure
Ae Repiration
Give Oxgen
Prepare intuate and ventilate
Call repirator therap
Call Dr
354.
What i the therapeutic range for O2 aturation?
93­100
355.
What do ou do if O2 aturation i le than 93?
Ae repiration and give oxgen
356.
NP
Good indicator of CHF
357.
What i the therapeutic range for NP?
<100
358.
What do ou do if NP i elevated?
e concerned and continue to monitor patient
359.
What i the therapeutic range for Sodium?
135­145
360.
What do ou do if Sodium i anormal in a patient?
e concerned until there' a change in the LOC (then it ecome critical)
361.
What i the therapeutic range for WC'?
5,000­11,000
362.
What i the therapeutic range for ANC?
500 (want aove 200)
363.
What i the therapeutic range for CD4 count?
<200= AIDS
364.
What i another name for high WC count?
Leukoctoi
365.
What are ome other name for low WC count?
Leukopenia
Neutropenia
Agranuloctoi
Immunouppreion
one Marrow Supreion
366.
What do ou do when WC i <5,000
Critical­ immunouppreed
Neutropenic precaution
367.
What do ou do if ANC i < 500?
Critical­immunouppreed
Neutropenic precaution
368.
What do ou do if CD4 <200?
Critical­ immunouppreed
Neutropenic precaution
369.
What i neutropenic precaution?
aka Revere/Protective Iolation
Strict hand wahing
Shower ID with antimicroial oap
Avoid crowd
Private Room
Limit numer of taff entering room
Limit viitor to health adult
No freh flower or potted plant
Low acteria diet: no raw fruit, veggie, alad or undercooked meat
Do not drink water that ha een tanding for longer than 15 minute
Vital ign (temp) ever 4 hour
Check WC (ANC) dail
Avoid ue of indwelling catheter
Do not re­ue cup... mut wah etween ue
Ue dipoale plate, cup, traw, utenil
Dedicated item in room: tethocope, P cuff, Thermometer, glove
370.
What i the therapeutic range for platelet?
150,000­400,000
371.
What do ou do if platelet are <90,000?
Critical
Ae for leeding
leeding Precaution
372.
What do ou do if platelet are <40,000?
Deadl Dangerou (can pontaneoul leed to death)
Ae for leeding
leeding Precaution
373.
What i leeding precaution?
No unnecear venipuncture­ injection or IV. Ue mall gauge
Handle patient gentl (ue drawheet)
Ue electric razor
No toothruhing or floing
No hard food
Well­fitting denture
low noe gentl
No rectal temp, enema, or uppoitor
No apirin
No contact port
No walking in are feet
No tight clothing or hoe
Ue tool oftener. No training
Notif MD of lood in urine, tool
374.
What i the therapeutic range for RC'?
4­6
(if anormal e concerned)
375.
What are the 5 D'?
(rememer the 6')
1. K+≥6
2. pH in the 6'
3. CO2 in the 60'
4. pO2 ≤60'
5. Platelet < 40,000
376.
When hould ou call a Rapid Repone Team?
When la value are Critical or Deadl Dangerou or if ad mptom
during aement
377.
Laminectom
"ctom"= removal of
"lamina"= verteral pinu procee
378.
What i the reaon for a laminectom?
to treat nerve root compreion
379.
What are the 3 ign and mptom of nerve root compreion?
Pain
Paretheia (numne & tingling)
Parei (mucle weakne)
380.
What are the different location for a laminectom?
cervical (neck)
thoracic (upper ack)
lumar (lower ack)
381.
What i the mot important aement in a pre­op cervical laminectom>
function of Upper extremitie and reathing
382.
What i the mot important aement in a pre­op thoracic laminectom?
cough (tet adominal mucle) and owel ound
383.
What i the mot important aement in a pre­op lumar laminectom?
urine output and leg
384.
What i the #1 pot­op anwer on NCLX?
alwa log roll our patient
385.
What i the pecific "activit"/moilization trateg pot­op?
1. do not dangle/it on ide of ed
2. allowed to walk, it, tand and lie down
3. limit itting 20­30 min at a time
386.
Pot­op complication for cervical laminectom
watch for pneumonia
387.
Pot­op complication for thoracic laminectom
watch for pneumonia and paraltic illeu
388.
Pot­op complication for lumar laminectom
watch for urinar retention
389.
Laminectom with fuion involve taking a _____ ______ from the ______
______. Of the two inciion, which ite ha the mot:
Pain?
leeding/Drainage?
Rik for infection?
Rik for rejection?
one graft, illiac cret (hip)
hip
hip
hip/pine
pine
390.
Surgeon are uing cadaver one from one ank. Wh?
ecaue it get rid of 2nd inciion and cut recover time in half
391.
What are ome temporar retriction (6 wk) with dicharge teaching?
1. Don't it for longer than 30 min
2. Lie flat and log roll for 6 wk
3. Lifting retriction: do not lift more than 5l
392.
what are ome permanent retriction for laminectom patient?
1. Laminectom patient will never e allowed to lift  ending at the
wait (ue their need)
2. Cervical laminectom patient will never e allowed to lift oject
aove their head
3. No horeack riding, off­trail iking, jerk amuement park ride, etc.
393.
Nagele' Rule (calculating due date)
Take the firt da of the lat mentrual period (LMP)
Add 7 da
Sutract 3 month
394.
Total weight gain during pregnanc
25­31 l
395.
1t trimeter weight gain
1 l per month (3 l total for firt trimeter)
396.
2nd/3rd trimeter weight gain
1 l per week
397.
Fundu (top of uteru) in not palpale until week ____
12
398.
Fundu tpicall reache the umilical (navel) level at week ______
20­22
399.
What are 4 poitive ign of pregnanc?
1. fetal keleton on an x­ra
2. fetal preence on ultraound
3. aucultation of the fetal heart (doppler)
4. examiner palpate fetal movement/outline
400.
What are ome proal/preumptive ign of pregnanc?
1. all urine and lood pregnanc tet
2. Chadwick' ign (color change of the cervix to canoi)
3. Goodell' ign (cervical oftening)
4. Hegar' ign (uterine oftening)
401.
Morning ickne: Which trimeter and what treatment?
1t trimeter
eat dr car, cracker efore out of ed, and avoid empt tomach
402.
Urinar incontinence: Which trimeter and what treatment?
1t/3rd
void Q2H
403.
Dpnea: Which trimeter and what treatment?
tripod poition (lean forward with hand on knee)
404.
ack pain: Which trimeter and what treatment?
2nd/3rd
pelvic tilt exercie
(put foot on tool then ack again)
405.
What i the truet, mot valid ign of laor?
onet of regular contraction
406.
Dilation
opening of cervix (0­10 cm)
407.
ffacement
thinning of cervix (thick­100%)
408.
Station
relationhip of fetal preenting part to mom' ichial pine (tightet
queeze for a head)
negative= aove pine
poitive= elow pine
409.
ngagement
tation "0" at ichial pine
410.
Lie
Relationhip etween pine of a and pine of mom
411.
Preentation
part of a that enter irth canal firt
412.
What i tage 1 of laor and deliver?
laor­ dilate and phae cervix (3 phae of laor­­ latent, active,
tranitional)
413.
What i tage 2 of laor and deliver?
deliver of a
414.
What i tage 3 of laor and deliver?
deliver of placenta
415.
What i tage 4 of laor and deliver?
recover­ firt 2 hour to top leeding
416.
tranvere lie and tation that won't go poitive=
c­ection
417.
Latent:
CM dilated
CXN freq
Duration
Intenit
0­4cm
5­30 min
15­30 ec
mild
418.
Active:
CM dilated
CXN freq
Duration
Intenit
5­7 cm
3­5 min
30­60 ec
Moderate
419.
Tranition:
CM dilated
CXN freq
Duration
Intenit
8­10 cm
2­3 min
60­90 ec
Strong
420.
Contraction hould not e longer than ____ econd or cloer than ever ___
minute
90
2
421.
Aement of contraction: Frequenc
eginning of one contraction to the eginning of the next contraction
422.
Aement of contraction: Duration
eginning to end of one contraction
423.
Aement of contraction: Intenit
trength of contraction. Palpate with finger of one hand over the
fundu
424.
What complication of laor i indicated if the mom i having painful ack
pain?
a turned around ackward.
Low priorit
Poition knee­chet then put on her ack
425.
What hould ou do with a prolaped cord?
Puh head ack in off cord and poition in knee­chet or trendelenurg
(hip up, houlder down). Prep for c­ection
426.
Intervention for all other complication of laor and irth
Left ide/ Lateral
IV increae
Oxgen
Notif
top Pit if in crii
427.
Do not adminiter a SYSTMIC pain medication to a woman in laor IF the
a i likel to e ______ when the _______ i _________
orn, pain, peaking (repirator depreion)
428.
What do ou do with a low fetal heart rate?
ad
LION pit
429.
What do ou do with FHR Acceleration?
no crii
430.
What do ou do with low aeline variailit?
ad
LION pit
431.
What do ou do with high aeline variailit?
record it
432.
What do ou do with late deceleration?
ad
LION pit
433.
What do ou do with earl deceleration?
HR ↓
434.
What do ou do with variale deceleration?
can e ver ad
prolaped cord
435.
Second tage of laor and deliver­ what do ou do?
1. deliver the head (top puhing)
2. uction mouth and noe
3. check for nuchal cord (cord around neck)
4. deliver houlder and od
5. make ure a ha ID and
436.
What do ou check for with the deliver of the placenta?
3 veel (2 arterie and 1 vein) "AVA"
437.
During the ___ tage (recover tage) (firt 2 hour after deliver) what __
thing do ou do ___ time an hour
4th, 4, 4
1. vital ign (ae for ign and mptom hock
2. check fundu (if ogg, maage. if diplaced, void/cath)
3. check pad (exceive lochia= pad at in 15 min)
4. roll on to ide (check for leeding under patient)
438.
What i the tone, height and location of the uteru potpartum?
tone: firm not ogg
height: right after deliver it i  pui  24 hour it i at navel. 2 cm
for ever PP da
location: midline (if diplaced from R/L if mean catheterize)
439.
What i the color of lochia in the firt da?
rura
440.
What i the color of lochia after a week or o of potpartum?
eroa
441.
What i a moderate amount of lochia?
4­6 in on pad in one hour
442.
What i an exceive amount of lochia?
aturate pad in 15 min
443.
What do ou ae for in the potpartum aement?
uteru, lochia, exteremitie (pule, edema, S7S thromophleiti)
444.
ditended eaceou gland which appear a tin white pot on a'
face
milia
445.
mall, white epithelial ct on a' gum
eptein' pearl
446.
luih­lack macule appearing over the uttox and/or thigh of darker­
kinned neonate
mongolian pot
447.
red papular rah on a' toro which i enign and diappear after a
few da
erthema toxicum neonatorum
448.
enign tumor of capillarie
hemangioma
449.
welling caued  leeding etween the otium and perioteum of the
kull. Thi welling doe not cro uture line
Cephalohematoma
450.
edematou welling on calp caued  preure during irth. Thi
welling ma cro uture line. It uuall diappear in a few da
caput uccedaneum
451.
normal, phiologic jaundice appear after 24 hour of age and diappear
at aout one week of age
Hperiliruinemia
452.
whitih, cheee­like utance which appear intermittentl over the firt
7­10 da
vernix caeoa (caeu= cheee)
453.
normal canoi of a' hand and feet which appear intermittentl
over the firt 7­10 da
acrocanoi
454.
generic term for irthmark
1. nonlanchale port wine tain
2. lanchale pink "tork ite"
nevu/nevi
1. nevu flammeu
2. telangiectatic nevi
455.
Tocoltic (top contraction)
Terutaline (rethine)
S/­ tachcardia (don't give with cardiac dieae)
Nifedipine
S/­ headache/hpotenion (can give with cardiac dieae)
456.
Oxtocic­ timulate laor
Pitocin (Oxtocin)
S/­ uterine hpertimulation
Cervidil (Protaglandin)­ dilate cervix
S/­ uterine hpertimulation
457.
Fetal/ Neonatal Lung Med
etamethaone (teroid)­ give to mother IM; give efore a after
viailit. can repeat
S/­ ↑S
Survanta­ give to a after a i orn (trantracheal)
458.
Step of drawing up inulin
1. draw up the total doe in air
2. preurize the "N" vial (put air in)
3. preurize the "R" vial
4. draw up "R" doe
5. draw up "N" doe
(Nichole Richie, RN)
459.
IM­ length and guage
1 in oth the guage and length (I look like 1)
460.
SQ­ length and guage
5 in oth part (S look like a 5)
461.
Heparin
­work immediatel
­can onl take for 21 da
­antidote: ­Protamin ulfate (heParin)
­la: PTT and all clotting and leeding time
­http­­> PttHeparin
­can ue in pregnanc
­pregnanc cla C
462.
Coumadin
­take da
­can take for
­entire life
­PO onl
­antidote: vitamin K
­la: PT, INR
­can't ue if pregnant
­cla x pregnanc
463.
aclofen (Lioreal)
mucle relaxant
1. caue fatigue
2. caue parei (mucle weak)
3. do not drink alcohol
4. do not drive a car
5. do not watch kid under age 12
When ou are on aclofen ou are on our ack "loafin"
464.
Senorimotor
Age: 0­2/o
Characteritic: totall preent­oriented. Onl think aout what the
are ene of are doing right now
Teaching Guideline­
When: a it happen
What: ou are doing now
How: tell them what ou're doing a ou're doing it
465.
Pre­Operational
Age: 3­6/o (prechooler)
Characteritic: Fanta oriented. illogical. no rule. (can teach ahead of
time ut not too far)
Teaching Guideline­
When: lightl ahead of time (morning of...)
What: ou will do
How: pla, to, torie
466.
Concrete Operation
Age: 7­11/o
Characteritic: Rule­oriented. Live and die  the rule! Cannot
atract
Teaching Guideline­
When: da ahead of time
What: ou're gonna do and kill
How: age appropriate reading and A/V material, role pla i ok
467.
Formal Operation
Age: 12­14 /o
Characteritic: ale to think atractl. Undertand caue­effect.
Thinking like adult emotionall ut phicall not there ut the can
think like one
Teaching Guideline­
When: like an adult
What: like an adult
How: like an adult
468.
kin till intact, non lanching, erthema (redne)
tage 1 preure ore
469.
ulcerated, uperficial,pink dermi
tage 2
470.
ellow ucutaneou (fat)
Stage 3
471.
red­white (mucle and one)
tage 4
472.
_______ eat _______
acute, chronic
473.
_______ __________ eat _______ or _______ _________
freh pot op, medical, other urgical
474.
______ eat _______
tale, untale
475.
What make a patient tale?
1. ue of the word tale
2. chronic illne
3. pot op> 12 hr
4. local or regional anetheia
5. unchanged aement
6. phrae: "To e dicharged"
7. la value A/
Stale patient are experiencing the expected tpical ign and
mptom of the dieae with which the have een diagnoed and for
which the are receiving treatment
476.
What make a patient untale?
1. Ue of the word untale
2. acute illne
3. pot op <12 hour
4. general anetheia
5. changing aement
6. phrae: "newl admitted" or "newl diagnoed"
7. la value C/D
Untale patient are experiencing unexpected atpical ign and
mptom, complication
477.
What 4 patient are alwa untale?
1. hemorrhage
2. hpoglcemia
3. fever ≥104
4. pulelene or reathlene
478.
The more _____ the ______, the higher the priorit
vital, organ
Mot vital→ rain → lung → heart → liver → kidne → pancrea
479.
What reponiilitie would ou not delegate to an LPN?
­Starting an IV
­Hanging or mixing IV med
­valuating an IV ite
­Giving an IV puh/P med
­Giving a lood tranfuion
­Performing aement that require inference/judgment (can gather
data)­ can make oervation aout tale people ut cannot make
aumption
­Plan of care
­Developing or performing teaching (can reinforce and review)
­Taking veral order from MD or trancriing order
480.
What would ou not delegate to a UAP?
­cannot chart ut ma document what the did
­aement­ except for VS and accucheck
­med and IV­ ma appl otc topical lotion and cream
­treatment­ except for SS. Not fleet
You ma delegate ath, ed, and ADL
481.
Do not delegate to ___________: _______ reponiilitie. The can onl do
what ou _______ them to do
famil, afet, teach
482.
how do ou intervene with inappropriate ehavior of taff? (4 option)
1. tell the upervior
2. intervene immediatel
3. counel them later on
4. ignore it. Jut let it go (never the right anwer)
483.
What 4 quetion hould ou ak when dealing with inappropriate ehavior
from taff?
1. i what the're doing illegal? (if e tell the upervior)
2. i the patient or taff memer in immediate danger of phical or
pchological harm? (if e intervene immediatel)
3. i thi ehavior legal, not harmful, ut impl inappropriate? (if e
counel them later on)
484.
Pre­interaction phae
purpoe: for the nure to explore hi/her feeling. to prevent
judgmental, intolerant reaction
length: egin when ou learn ou are going to e caring for omeone
and end when ou meet them
correct anwer: "the nure will explore hi/her feeling aout..."
485.
Introductor phae (orientation phae)
purpoe: to etalih and explore/ae
length: egin when ou firt meet the patient and end when a
mutuall agree­upon care plan i in place
correct anwer: Should e ver tolerant, accepting, explorative, proing,
"no". e warm and fuzz
486.
Working phae (therapeutic phae)
purpoe: to implement the plan of care
length: from the finihed care plan until dicharge
correct anwer: hould e focued, directive, "tough". in ome wa
thee anwer will eem tern and lightl unfriendl. et limit.
enforce proper communication
487.
When doe the termination phae egin?
on admiion
488.
Pch Treatment Protocol for depreion
Whenever a patient dipla an notion of uicide or harm ou MUST
inquire aout it
Mut get a afet contract
*activitie with other people that doen't require interaction
489.
Pch Treatment Protocol for chizophrenia
If pacing Pch→ reduce timulation (clear the room), make oervation,
offer preence
*need realit aed activitie ut not competitive; hould e with other
people
490.
Pch Treatment Protocol for ipolar
Mania' can't go to work or maintain famil order wherea a hpo
manic can
­finger food are et; epeciall ↑ calorie
­8hr of leep. ncourage nap
*exercie the gro motor that i non competitive
491.
Pch Treatment Protocol for Anxiet Diorder
Phoia­ irrational fear that limit dail life
→tx: deenitization: graduall expoe
1. Talk aout it
2. Show pic
3. e around
4. Interact
When ou move to next tep, make ure not anxiou
492.
Retraint protocol
In pch: need to e evaluated within 1 hr. Mut e contantl oerved
Not pch: oerve ever 15 min. No evaluation. Need Dr order Q24h
493.
Pch Treatment Protocol for Violent Client
It take 5 people to control a violent client. One for each lim and head.
Onl one peron talk. The peron i given a few econd to deecalate
494.
All pch drug caue....
Hpotenion, weight change, and primar weight gain
495.
Phenothiazine
All end in "zine"
x: Thorazine, compazine
Action: large doe­ antipchotic, mall doe­ antiemetic, major­
tranquilizer
496.
Side ffect of Phenothiazine
Rememer ACDFG...
A= anticholinergic (dr mouth)
= lurred viion and ladder retention
C= contipation
D= drowine
= PS (tremor, parkinonian)
F= "f"otoenitivit (kin urn)
G= aGranuloctoi (low WC count­ immunoupreed)
Teach patient to report ore throat and ign and mptom of infection
to doctor
Never top the zine
Never top the zine
497.
Nuring care for Phenothiazine
Treat ide effect. Numer one diagnoi i afet
498.
Deconate or "D"
Long acting IM form of Phenothiazine given to non compliant patient
499.
Tricclic Antidepreant
"Mood elevator" to treat depreion
x­ lavil, Trofranil, Aventl, Derel
500.
Side effect of Tricclic Antidepreant
(lavil tart with "" o thi group goe to "")
A= anticholinergic (dr mouth)
= lurred viion
C= contipation
D= drowine
= euphoria (happ)
Mut take med for 2­4 week efore eneficial effect
501.
enzodiazepine
Antianxiet med (conidered minor tranquilizer)
Alwa have "Pam"/"lam" in name
Prototpe: Valium
Indication: induction of anethetic, mucle relaxant, alcohol
withdrawal, eizure (epeciall tatu epilepticu), facilitate
mechanical ventilation
Tranquilizer work quickl. MUST NOT take for more than 6 week­ 3
month. Keep on Valium until lavil kick in
Numer one nuring diagnoi i afet
502.
Side effect of enzoDiazepine
A= anticholinergic
= lurred viion
C= contipation
D= drowine
503.
Monoamine Oxidae (MAO) Inhiitor
Antidepreant
Depreion i thought to e caued  deficienc of norepinephrine,
dopamine, and erotonin in the rain. Monoamine oxidae i the
enzme reponile for reaking down norepinephrine, dopamine, and
erotonin. MAO Inhiitor prevent the reakdown of thee
neurotranmitter a and thu retore more normal level and decreae
depreion
Drug name: MARplan, NARdil, PARnate
504.
Side effect of MAO inhiitor
A= anticholinergic
= lurred viion
C= contipation
D= drowine
505.
Interaction/ patient teaching for MAO Inhiitor
To prevent ever, acute, ometime fatal hpertenive crii, the
patient MUST avoid all food containing tramine
Food containing tramine:
Fruit and veggie­ rememer alad "AR"→ avoid anana, Avacado,
Raiin (an dried fruit);
Grain: ll oka except thing made from active eat
Meat: no organ meat­ liver, kidne, tripe, heart, etc. no preerved
meat­ moked, dried, cured, pickled, hot dog
Dair: no cheee except mozzarella and cottage cheee (no aged cheee)
Other: no alcohol, elixir, tincture (iodine/etadine), caffeine, chocolate,
licorice, o auce
506.
Lithium
An electrolte (notice "ium" ending a in potaium etc)
Ued for treating ipolar diorder (manic­depreion)→ it decreae the
mania
507.
Side effect of Lithium
The three "P'":
Peeing (poluria)
Pooping (diarrhea)
Paretheia (tingling/numne)
Medicall inducing a lithium/electrolte imalance
Toxic: tremor, metallic tate, evere diarrhea, and an other neuro ign
→numer one intervention: good fluid hdration. If weating give
odium (or other electrolte) a well a fluid. Don't give water. Drink
Gatorade or other electrolte olution. Monitor odium level
508.
Prozac
SSRI ( Selective Serotonin Reuptake Inhiitor)
Similar to lavil
Antidepreant­ mood elevator
509.
Side effect of Prozac
A= anticholinergic
= lurred viion
C= contipation
D= drowine
Caue inomnia, o give efore 12 noon. If ID, give at 6am and 12 noon
When changing the doe of Prozac for an adolecent or oung adult,
watch for uicide
510.
Haldol (Haloperidol)
Tranquilizer
Alo ha a deconate form
Long acting IM form given to non compliant patient
511.
Side effect of Haldol
A= anticholinergic
= lurred viion
C= contipation
D= drowine
= PS
F= fotoenitvit
G= aGranuloctoi
lderl patient ma develop NMS from overdoe. NMS i Neuroleptic
Malignant Sndrome­ a potentiall fatal hperplaia (fever) with temp
of 104.0. Doe for elderl patient hould e half of uual adult doe.
Safet concern r/t ide effect
512.
Clozaril (clozapine)
Atpical antipchotic
Ued to treat evere chizophrenia
Advantage: it doe not have ide effect A­F
Do not confue with Klonopin (clonazepam)
513.
Side effect of Clozaril
Agranuloctoi (wore than cancer drug)
Can ink precrie for 7 da then get WC drawn for 4 week, then
once a month for 6 month then ever 6 month
514.
Zoloft (Sertraline)
Another SSRI like Prozac
Antidepreant
Alo caue inomnia ut can e given in evening
Watch for interaction with St John' Wort (erotonin ndrome), and
warfarin (watch for leeding)
515.
Side effect of Zoloft
SAD Head
Sweating
Apprehenive
Dizz
Headache