TABLE OF CONTENTS
Fluids and Electrolytes.....................................................................3
Acid-Base Balance...........................................................................13
Burns...........................................................................................16
Oncology......................................................................................22
Endoncrine.....................................................................................38
Cardiac.........................................................................................52
Psychiatric Nursing........................................................................71
Gastrointestinal.............................................................................92
Neuro..........................................................................................104
Maternity Nursing.........................................................................114
Respiratory...................................................................................139
Orthopedics...................................................................................144
Renal...........................................................................................150
Questions......................................................................................158
Final Thoughts..............................................................................178
Evaluations....................................................................................186
Table of Contents for CD...................................................................188
Pediatric........................................................................................189
Hurst Review Services 1
,Hurst Review does not condone the discussion of the NCLEX-RN exam post-
test. Thank you.
NOTICE TO FACULTY
All materials used during any Hurst Review Services seminar are
copyrighted and are not for use without the sole permission of Marlene Hurst
in any form or fashion.
This material is not intended for lecture use by any School of Nursing without
permission.
NOTICE TO STUDENTS
Please understand that this book is written to accompany the live or video
lectures presented in the class itself or my Internet Tutorials.
This book is only an outline of what is needed to pass NCLEX.
I hope you will join me in a live or video class or on the Internet to reap the
full benefits of my materials.
General Class Information
- Please turn off ALL cell phones and pagers.
-This class MAY NOT be recorded in any manner. (This included tape
recording or videoing.)
-Class Time: 8AM-4PM * Please note that each class is presented in a
particular sequence if your instructor completes the material for that day,
you may get out prior to 4 PM.
Hurst Review Services 2
,FLUID VOLUME EXCESS: HYPERVOLEMIA
Define: too much volume in the vascular space. Fluid is first build up in vascular space (any
vessel in the body include vein, capillaries, arteries, chambers of heart). When vascular space
can’t hold any more fluids then leak occurs leading to interstitial tissue -> edema.
l. Causes: 1. Heart failure
2. Renal Failure
3. Three thing with lots of sodium (Effervescent soluble medication, canned/processed food,
IVF with Na)
a. CHF: heart is weak, CO decrease, decreased kidney perfusion, UO decrease
*the volume stays in the vascular space.
b. RF (Renal Failure): Kidneys aren't working
c. Three thing that go together: they have lots of Sodium. Sodium retain water. Water retain
in the vascular space.
- Alkaseltzer
- Fleets enemas All 3 have a lot of sodium
- IVF with Na
d. Aldosterone (steroid, mineralocorticoid) ->Hormonal regulation fluid volume.
Where does aldosterone live? In the adrenal gland (right above the kidney)
-Normal action: when blood volume gets low (vomiting, blood loss, etc.) →aldosterone
secretion increases→ retain Na/water→ blood volume increase. This causes the BP to increase
On NCLEX when questions ask about Aldosterone: sodium and water
** Diseases with too much aldosterone:
-also seen with liver disease and heart disease
1. Cushing syndrome (when you have too much of all of steroids. Not just aldosterone)
2. Hyperaldosteronism (Conn’s syndrome)
**Disease with too little aldosterone: Lose sodium and water lead to fluid deficiency
1. Addison Disease
Hurst Review Services 3
, e. ADH (anti-diuretic hormone) Water only!
Normally makes you retain or diurese? Retain water!
Retain? Water.
2 ADH problems
Too Much Not enough
Retain Lose (diuese)
Fluid Volume in the vascualar space Fluid Volume excess
SIADH DI Syndrome of Inappropriate ADH Secretion Diabetes
Insipidus
Urine Urine concentrated (High Na)
Blood Blood Diluted (low Na)
*Concentrated makes #’s go up specific gravity, Na *Dilute makes #’s go down
ADH lives in pituitary; key words to make you think potential ADH problem: craniotomy, head
injury, sinus surgery, transphenoidal hypophysectomy
*Another name for anti-diuretic hormone (ADH) is Vasopressin. The drug Vasopressin
(Pitressin or DDAVP (Desmopressin acetate) may be utilized as an ADH replacement in
Diabetes Insipidus.
What happens when there is not enough Anti diuretic hormone (ADH)”
- Lose/diureses water causing FLUID VOLUME
DEFICIT What does to little diuretic hormone (ADH) cause?
- Diabetes insipidus (remember the D at the beginning which D stands for diuresis)
During Dibetes insipidus what is happening to the urine and blood?
- Urine is diluted
- Blood is concentrated (not holding on to the little volume you have)
Hurst Review Services 4
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