Exam (elaborations)
HESI Hints and NCLEX Gems Answering NCLEX questions
- Course
- Institution
HESI Hints and NCLEX Gems Answering NCLEX questions
[Show more]
Seller
Follow
ACTUALSTUDY
Reviews received
Content preview
1HESI Hints and NCLEX Gems
Answering NCLEX questions
o Maslow’s Hierarchy of Needs
Physiologic
Safety
Love and Belonging
Esteem
Self-Actualization
o Nursing Process
Assessment
Diagnosis
Planning
Implementation
Evaluation
o ABCs
Airway
Breathing
Circulation
Normal Values
o Hgb
Males 14 – 18
Females 12 – 16
o Hct
Males 42 – 52
Females 37 – 47
o RBCs
Males: 4.7 – 6.1million
Females: 4.2 – 5.4 million
o WBCs
4.5 – 11K
o Platelets
150 – 400K
o PT (Coumadin/Warfarin)
11 – 12.5 sec
INR and PT TR = 1.5-2 times normal)
o aPTT (Heparin)
60 – 70 sec
o BUN: 10 – 20
o Creatinine: 0.5 – 1.2
o Glucose: 70 – 110
o Cholesterol: <200
o Bilirubin newborn: 1 – 12
o Phenylalanine
Newborn: <2
Adult: <6
o Na: 135 – 145
o K: 3.5 – 5.0
Hypokalemia: Prominent U waves, Depresses ST segment, Flat T waves
Hyperkalemia: Tented T waves, prolonged PR interval, wide QRS
, 2
o Calcium: 9 – 10.5
Hypocalcemia: muscle spasms, convulsions, cramping, tetany, pos Trousseau’s, pos Chvostek’s,
prolonged ST interval, prolonged QT segments
o Mg: 1.5 – 2.5
o Cl: 96 – 106
o Phos: 3 – 4.5
o Albumin: 3.5 – 5
o Specific Gravity: 1.005 – 1.030
o HgbA1C:
Ideal = 4-6%
Ok (120 days) <7%
o Dilantin TR: 10 – 20
o Lithium TR: 0.5 – 1.5
o Arterial Blood Gas
pH = 7.35 – 7.45
CO2 = 35 – 45
HCO3 = 22 – 28
O2 = 80 – 100
O2 Sat = 95 – 100%
Antidotes
o Digoxin – Digiband
o Coumadin – Vit K
o Benzos – Flumzaemil (Tomazicon)
o Heparin – Protamine Sulfate (Keep aPTT and PTT at 1.5-2 times normal)
o Tylenol – Mucomyst (loading dose + 17 doses)
o Opiates (narcotics analgesics, heroin, morphine) – Narcan (naloxone)
o Cholinergic meds (myesthenic bradycardia) – Atropine
o Methotrexate – Leucovorin
Delegation
o RN only
Blood products (2 RNs must check)
Clotting factors
Sterile dressing changes and procedures
Assessments that require clinical judgment
Ultimately responsible for all delegated duties
o Unlicensed Assistive Personnel
Non-sterile procedures
Precautions and Room Assignments
o Universal (Standard) Precautions – HIV initiated
Wash hands
Wear gloves
Gowns for splashes
Masks and Eye protection for splashes and droplets
Don’t recap needles
Mouthpiece of Ambu-bag for resuscitation
Refrain from giving care if you have skin lesions
o Droplet (Respiratory) Precautions – wear mask
Sepsis, scarlet fever, strep, fifth disease (Parvo B19), pertusis, pneumonia, influenza, diphtheria,
epiglottitis, rubella, rubeola, meningitis, mycoplasma, adenovirus, rhinovirus
, 3
RSV (needs contact precautions too)
TB (Respiratory isolation)
o Contact Precautions = universal + goggles, mask, and gown
o No infectious patients with immunosuppressed patients
Clean with clean
Dirty with dirty
Misc.
o Rifampin (for TB) – rust/orange/red urine and body fluids
o Pyridium (for bladder infection) … Orange/red/pink urine
o Glasgow Coma Scale … < 8 = coma
o Myasthenia Gravis
Myasthenic Crisis = Weakness with change in vitals (give more meds)
Cholinergic Crisis = Weakness with no change in vitals (reduce meds)
o Diabetic Coma vs. Insulin Shock … Give glucose first – If no help, give insulin
o Fruity Breath = Diabetic Ketoacidosis
o Acid-Base Balance
If it comes out of your ass, it’s Acidosis.
Vomiting = Alkalosis
o Skin Tastes Salty = Cystic Fibrosis
o Lipitor (statins) in PMs only – No grapefruit juice
o Stroke
Tongue points toward side of lesion (paralysis)
Uvula deviates away from the side of lesion (paralysis)
o Hold Digoxin if HR < 60
o Stay in bed for 3 hours after first ACE Inhibitor dose
o Avoid Grapefruit juice with CCBs
o Anthrax = Multi-vector biohazard
o Pulmonary air embolism prevention = Trendelenberg (HOB down) + on left side (to trap air in right side of heart)
o Head Trauma and Seizures – maintain airway = primary concern
o Peptic Ulcers
Feed a Duodenal Ulcer (pain relieved by food)
Starve a gastric ulcer
o Acute Pancreatitis
Fetal position, Bluish discoloration of flanks (Turner’s Sign), Bluish discoloration of pericumbelical
region (Cullen’s Sign), Board like abdomen with guarding
Self digestion of pancreas by trypsin.
o Hold tube feeding if residual > 100mL
o In case of Fire – RACE and PASS
o Check Restraints every 30 minutes – 2 fingers room underneath
o Gullian-Barre Syndrome
Weakness progresses from legs upward – leads to Resp arrest
o Trough draw = ~30 min before scheduled administration
o Peak Draw = 30-60 min after drug administration.
Mental Health and Psychiatry
o Most suicides occur after beginning of improvement with increase in energy levels
o MAOIs
Hypertensive Crisis with Tyramine foods
Nardil, Marplan, Parnate
Need 2 wk gap from SSRIs and TCAs to admin MAOIs
The benefits of buying summaries with Stuvia:
Guaranteed quality through customer reviews
Stuvia customers have reviewed more than 700,000 summaries. This how you know that you are buying the best documents.
Quick and easy check-out
You can quickly pay through credit card or Stuvia-credit for the summaries. There is no membership needed.
Focus on what matters
Your fellow students write the study notes themselves, which is why the documents are always reliable and up-to-date. This ensures you quickly get to the core!
Frequently asked questions
What do I get when I buy this document?
You get a PDF, available immediately after your purchase. The purchased document is accessible anytime, anywhere and indefinitely through your profile.
Satisfaction guarantee: how does it work?
Our satisfaction guarantee ensures that you always find a study document that suits you well. You fill out a form, and our customer service team takes care of the rest.
Who am I buying these notes from?
Stuvia is a marketplace, so you are not buying this document from us, but from seller ACTUALSTUDY. Stuvia facilitates payment to the seller.
Will I be stuck with a subscription?
No, you only buy these notes for $7.99. You're not tied to anything after your purchase.
Can Stuvia be trusted?
4.6 stars on Google & Trustpilot (+1000 reviews)
75632 documents were sold in the last 30 days
Founded in 2010, the go-to place to buy study notes for 14 years now
Recently viewed by you
