Nursing Fundamentals Quiz

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Questions and Answers

In the RACE acronym, the first step is to ______ patients at risk.

rescue

The first degree burn is characterized by red and ______.

painful

Before drawing an ABG, perform the ______ Test to check for sufficient blood flow.

Allen's

Patients with Rh negative blood should NOT receive Rh ______ blood.

<p>positive</p> Signup and view all the answers

The Glasgow Coma Scale is used to assess a patient's level of ______.

<p>consciousness</p> Signup and view all the answers

In treating burns, the Parkland Formula is used for calculating total fluid ______ after a burn.

<p>requirement</p> Signup and view all the answers

A sucking stab wound should be dressed and taped on ______ sides to allow air to escape.

<p>3</p> Signup and view all the answers

The 5 P's of compartment syndrome include pain, paresthesia, paralysis, pallor, and ______.

<p>pulselessness</p> Signup and view all the answers

For burn management, airway patency is the ______ priority.

<p>number one</p> Signup and view all the answers

After a blood transfusion reaction occurs, the first step is to ______ the transfusion.

<p>STOP</p> Signup and view all the answers

The earliest sign of diabetic neuropathy is ______.

<p>microalbuminuria</p> Signup and view all the answers

In diabetes insipidus, there is excessive thirst and ______.

<p>urination</p> Signup and view all the answers

In SIADH, the body retains water, which can lead to dilutional ______.

<p>hyponatremia</p> Signup and view all the answers

To prevent otitis media, it is recommended to feed infants in an ______ position.

<p>upright</p> Signup and view all the answers

Impetigo is characterized by red sores around the ______ and mouth.

<p>nose</p> Signup and view all the answers

Acute Kidney Injury can lead to a high level of ______ in the blood.

<p>creatinine</p> Signup and view all the answers

In Chronic Renal Failure, patients are at risk for ______ and fluid overload.

<p>hyperkalemia</p> Signup and view all the answers

Drug therapy for tuberculosis typically lasts 6 months or longer and one of the medications used is ______.

<p>Rifapentine</p> Signup and view all the answers

A Glomerular Filtration Rate (GFR) of 60-89 indicates ______ stage of Chronic Kidney Disease.

<p>mild</p> Signup and view all the answers

A ______ occurs when air enters the pleural space, causing lung collapse.

<p>pneumothorax</p> Signup and view all the answers

A nasopharyngeal airway is a tube-like device used to maintain upper airway ______.

<p>patency</p> Signup and view all the answers

Severe dehydration in a patient with very high glucose levels necessitates starting an IV infusion of ______.

<p>normal saline</p> Signup and view all the answers

The Somogyi Effect occurs when a patient takes insulin before bed and experiences ______ around 2-3am.

<p>hypoglycemia</p> Signup and view all the answers

The normal blood flow through the heart can be remembered with the phrase ______ to describe the sequence.

<p>Toilet Paper My Ass</p> Signup and view all the answers

Type II Diabetes Mellitus is characterized by insulin resistance or lack of ______.

<p>insulin</p> Signup and view all the answers

In acute coronary syndromes, unstable angina is typically relieved by ______.

<p>medications</p> Signup and view all the answers

A HbA1C level of 7 is considered ideal for a ______.

<p>diabetic</p> Signup and view all the answers

A ______ occurs when there is a full occlusion leading to infarction or death of heart muscle.

<p>STEMI</p> Signup and view all the answers

Fluids are the most important intervention in both DKA and ______.

<p>HHNS</p> Signup and view all the answers

Myocardial infarction management includes administering the acronym ______ for immediate treatment.

<p>MONA</p> Signup and view all the answers

In heart failure, blood may back up into the lungs, which is known as ______.

<p>left sided HF</p> Signup and view all the answers

Cardiac tamponade is a medical emergency characterized by fluid buildup in the ______.

<p>pericardium</p> Signup and view all the answers

In pericarditis, a key indicator is the presence of a ______ rub.

<p>friction</p> Signup and view all the answers

Pleuritic chest pain is a symptom associated with ______ injuries.

<p>myocarditis</p> Signup and view all the answers

Increased ______ is a sign of pressure build-up in the skull.

<p>intracranial pressure (ICP)</p> Signup and view all the answers

The classic symptoms of endocarditis include shortness of breath, fever, and ______.

<p>palpitations</p> Signup and view all the answers

Peripheral Arterial Disease (PAD) is caused by the buildup of plaque in the ______.

<p>arteries</p> Signup and view all the answers

In seizures, the ______ phase occurs after a seizure and ends when the patient is back to baseline.

<p>postictal</p> Signup and view all the answers

In cases of Myasthenia Gravis, muscle weakness and fatigue often ______ with rest.

<p>improves</p> Signup and view all the answers

An acute medical emergency seen in patients with spinal cord injuries at T6 or higher is ______.

<p>autonomic dysreflexia</p> Signup and view all the answers

Myocarditis can present with symptoms such as fever, fatigue, chest pain, and ______.

<p>shortness of breath (SOB)</p> Signup and view all the answers

A bulge in a blood vessel that can lead to a hemorrhagic stroke is called an ______.

<p>aneurysm</p> Signup and view all the answers

Increased levels of ______ in the blood can indicate heart failure.

<p>BNP</p> Signup and view all the answers

Fat embolism commonly occurs after fractures of long bones, particularly the ______.

<p>femur</p> Signup and view all the answers

Cholinergic Crisis is marked by excessive ______ at the neuromuscular junction.

<p>acetylcholine (ACh)</p> Signup and view all the answers

In stroke management, administering TPA is a treatment option for ______ strokes.

<p>ischemic</p> Signup and view all the answers

Patients with PKU cannot break down ______.

<p>phenylalanine</p> Signup and view all the answers

Normal urine output for infants and children is ______ mL/kg/hr.

<p>1-2</p> Signup and view all the answers

The usage of ______ for poison removal is no longer recommended.

<p>ipecac</p> Signup and view all the answers

______ is the term for a woman who has never been pregnant.

<p>Nulligravida</p> Signup and view all the answers

The first trimester of pregnancy lasts from the first day of the last menstrual period to ______ weeks.

<p>13</p> Signup and view all the answers

The Nagele Rule is used for estimating the date of ______.

<p>birth</p> Signup and view all the answers

Fundal height is a measurement of the uterus used to determine ______ age of the fetus.

<p>gestational</p> Signup and view all the answers

Fetal heart rate can be heard via ______ at 10-12 weeks gestation.

<p>Doppler</p> Signup and view all the answers

Prenatal visits for low-risk pregnant women should occur every ______ weeks until 28 weeks.

<p>4</p> Signup and view all the answers

Some states require screening for neural tube defects using maternal alpha-______ levels.

<p>fetoprotein</p> Signup and view all the answers

Cleft lip repair is typically performed at ______ months.

<p>3-6</p> Signup and view all the answers

Patients with esophageal atresia may experience the ______ of excess salivation.

<p>sign</p> Signup and view all the answers

Pyloric stenosis occurs due to swelling of the ______ muscle.

<p>pylori</p> Signup and view all the answers

The '3 C's' of tracheoesophageal fistula include coughing, choking, and ______.

<p>cyanosis</p> Signup and view all the answers

The nursing intervention for children with sores recommends keeping them open to ______.

<p>air</p> Signup and view all the answers

Fluid moves from interstitial to ______ compartment.

<p>intravascular</p> Signup and view all the answers

To correct metabolic acidosis caused by diarrhea, you must monitor ______ levels.

<p>potassium</p> Signup and view all the answers

The antidote for potassium overdose is ______.

<p>insulin</p> Signup and view all the answers

After surgery, the first 24 hours are critical for monitoring ______.

<p>bleeding</p> Signup and view all the answers

In anaphylaxis, it is essential to administer ordered ______.

<p>epinephrine</p> Signup and view all the answers

In cases of dysphagia, there is a risk for ______ pneumonia.

<p>aspiration</p> Signup and view all the answers

Beta 1 receptors are primarily found in the ______.

<p>heart</p> Signup and view all the answers

Hyperventilation can lead to ______ alkalosis due to increased carbon dioxide.

<p>respiratory</p> Signup and view all the answers

An older patient with acute onset confusion is often a sign of a ______.

<p>UTI</p> Signup and view all the answers

In the presence of angina, the patient typically experiences ______ pain.

<p>sharp chest</p> Signup and view all the answers

Cushing’s syndrome is associated with symptoms like moonface and ______ hump.

<p>buffalo</p> Signup and view all the answers

After a lumbar puncture, the patient should remain ______ to prevent headache and leaking of CSF.

<p>supine</p> Signup and view all the answers

During a pulmonary embolism, the patient should be turned to the left side and have the ______ lowered.

<p>head of the bed</p> Signup and view all the answers

In cases of hyperthyroidism, patients may present with ______ eyes.

<p>bulging</p> Signup and view all the answers

In a woman in labor with unreassuring FHR, it is recommended to turn her on her ______.

<p>left side</p> Signup and view all the answers

The procedure known as ______ is used to examine diseases of the pancreas, liver, gallbladder, and bile ducts.

<p>Endoscopic Retrograde Cholangio Pancreatography (ERCP)</p> Signup and view all the answers

A hallmark sign of appendicitis is ______ tenderness.

<p>rebound</p> Signup and view all the answers

After thyroidectomy, the patient should be positioned in low ______.

<p>semi-Fowlers</p> Signup and view all the answers

Cullen's Sign indicates internal hemorrhage causing ecchymosis around the ______ region.

<p>umbilical</p> Signup and view all the answers

The presence of Beck's Triad suggests a diagnosis of ______ tamponade.

<p>cardiac</p> Signup and view all the answers

In managing a patient with heat stroke, they should lie flat with legs ______.

<p>elevated</p> Signup and view all the answers

A symptom of Meningitis includes positive ______ signs.

<p>Brudzinski and Kernig's</p> Signup and view all the answers

A positive Babinski Sign indicates ______ system issues in children over 2 years and adults.

<p>nervous</p> Signup and view all the answers

A healthcare provider should be alert for ______ pain when assessing for appendicitis.

<p>RLQ</p> Signup and view all the answers

Murphy’s Sign tests for pain with palpation of the ______ area, indicative of cholecystitis.

<p>gallbladder</p> Signup and view all the answers

The Guthrie Test is a neonatal heel prick that tests for ______.

<p>PKU (phenylketonuria)</p> Signup and view all the answers

Amniocentesis must be performed with a full bladder if done ______ in pregnancy.

<p>early</p> Signup and view all the answers

Too much milk reduces the amount of ______ they intake.

<p>iron</p> Signup and view all the answers

Placenta previa is characterized by painless, bright red ______ bleeding.

<p>vaginal</p> Signup and view all the answers

A nonreactive result in a Nonstress Test may indicate that further testing is ______.

<p>needed</p> Signup and view all the answers

Patients with PKU cannot break down ______.

<p>phenylalanine</p> Signup and view all the answers

Magnesium sulfate is commonly used in managing ______.

<p>preeclampsia</p> Signup and view all the answers

A woman who has had 1 birth after 20 weeks gestation is known as a ______.

<p>Primipara</p> Signup and view all the answers

The therapeutic range for magnesium sulfate is ______-8 mg/dL.

<p>4</p> Signup and view all the answers

The length of a full-term pregnancy is approximately ______ days.

<p>280</p> Signup and view all the answers

Hydration is important before administering an ______.

<p>epidural</p> Signup and view all the answers

Normal urine output for infants and children is ______ mL/kg/hr.

<p>1-2</p> Signup and view all the answers

The Nagele Rule helps estimate the ______ of birth.

<p>date</p> Signup and view all the answers

Folic acid is recommended to be taken before and throughout ______.

<p>pregnancy</p> Signup and view all the answers

During a Stress Test, a positive result means the fetal heart rate ______ during contractions.

<p>slows</p> Signup and view all the answers

A woman who has never had a birth greater than 20 weeks gestation is called a ______.

<p>Nullipara</p> Signup and view all the answers

The measurement of the uterus to determine gestational age is known as ______ height.

<p>fundal</p> Signup and view all the answers

Defect screenings often include testing maternal ______ levels.

<p>alpha-fetoprotein</p> Signup and view all the answers

In low-risk pregnancies, visits to the doctor are scheduled every ______ weeks until 28 weeks.

<p>4</p> Signup and view all the answers

If not treated, HIV can lead to ______.

<p>AIDS</p> Signup and view all the answers

A patient with HIV has low levels of ______ cells, particularly when the CD4+ count falls below 200 cells/mcl.

<p>T</p> Signup and view all the answers

Common triggers for Systemic Lupus Erythematosus (SLE) include sunlight, stress, and ______.

<p>pregnancy</p> Signup and view all the answers

Breast cancer screening includes checking for lumps or hard knots in the shower and examining any changes in the _______, preferably monthly.

<p>breast</p> Signup and view all the answers

Patients with low white blood cell counts due to chemotherapy should be monitored for ______.

<p>infection</p> Signup and view all the answers

The key for passing NCLEX is taking as many test questions as you can to build your ______.

<p>knowledge</p> Signup and view all the answers

A minimum of ______ questions is required for the NCLEX exam.

<p>60</p> Signup and view all the answers

The INR level is used to determine the amount of ______ given to patients.

<p>warfarin</p> Signup and view all the answers

In pharmacology, it is important to review topics that you don't feel ______ in.

<p>confident</p> Signup and view all the answers

PTT is a lab test used to assess if blood-thinning therapy with ______ is working.

<p>heparin</p> Signup and view all the answers

The vital signs include measurements such as temperature, pulse, ______, and respiratory rate.

<p>blood pressure</p> Signup and view all the answers

The ______ format used in Nurse Achieve closely mirrors the NCLEX testing structure.

<p>CAT</p> Signup and view all the answers

High levels of PT can be caused by vitamin K deficiency, cancer, or ______ disease.

<p>liver</p> Signup and view all the answers

To ensure thorough preparation, it is advised to take several CAT exams ______ weeks before the NCLEX date.

<p>one to two</p> Signup and view all the answers

NCLEX critical care information is essential for nursing roles in ______ care environments.

<p>intensive</p> Signup and view all the answers

Rifapentine may cause _____ colored body secretions.

<p>orange</p> Signup and view all the answers

In a tension pneumothorax, air cannot leave the pleural space and _____ the lungs.

<p>compresses</p> Signup and view all the answers

A nasopharyngeal airway is NOT to be inserted in a patient who may have had a head _____.

<p>trauma</p> Signup and view all the answers

The normal blood flow through the heart is represented by the phrase _____.

<p>Toilet Paper My Ass</p> Signup and view all the answers

Pulmonary edema is a symptom of _____ sided heart failure.

<p>left</p> Signup and view all the answers

Cardiac tamponade is characterized by fluid buildup in the _____, creating pressure on the heart.

<p>pericardium</p> Signup and view all the answers

Beck’s Triad consists of hypotension, JVD, and _____ heart sounds.

<p>muffled</p> Signup and view all the answers

Myocardial infarction is indicated by ST _____ on an ECG.

<p>elevation</p> Signup and view all the answers

When a woman in labor has an unreassuring FHR, she should be turned to her ______ side.

<p>left</p> Signup and view all the answers

Angina occurs due to reduced blood flow to the _____.

<p>heart</p> Signup and view all the answers

In Prinzmental’s angina, chest pain typically occurs at _____ or early morning.

<p>rest</p> Signup and view all the answers

Cullen's Sign indicates internal hemorrhage with ecchymosis around the ______ region.

<p>umbilical</p> Signup and view all the answers

McBurney's Point pain is indicative of ______.

<p>appendicitis</p> Signup and view all the answers

Beck's Triad consists of hypotension, JVD, and ______ heart sounds.

<p>muffled</p> Signup and view all the answers

The Guthrie Test is performed with a neonatal heel prick to test for ______.

<p>PKU</p> Signup and view all the answers

To assess for nervous system issues, the Babinski Sign is checked; a positive test shows toes ______.

<p>fan</p> Signup and view all the answers

The procedure known as ERCP is used to examine diseases of the pancreas, liver, gallbladder, and ______ ducts.

<p>bile</p> Signup and view all the answers

An infant with only a cleft palate may require intervention on their ______ or abdomen.

<p>side</p> Signup and view all the answers

Amniocentesis must be performed with a full _____ if done early in pregnancy.

<p>bladder</p> Signup and view all the answers

The presence of bright red vaginal bleeding with a soft abdomen may indicate _____ previa.

<p>placenta</p> Signup and view all the answers

Magnesium sulfate is used in cases of _____ for its therapeutic effects.

<p>preeclampsia</p> Signup and view all the answers

In the nonstress test, a reactive result indicates the fetal heart rate _____ with movement.

<p>increased</p> Signup and view all the answers

A _____ result in a stress test indicates that the fetus is not properly responding to stress during contractions.

<p>positive</p> Signup and view all the answers

Folic acid should be taken before and throughout _____.

<p>pregnancy</p> Signup and view all the answers

If amniotic fluid appears yellow with particles, it indicates that it is _____ stained.

<p>meconium</p> Signup and view all the answers

Patients taking NSAIDs should avoid them in the _____ trimester due to the risk of complications.

<p>3rd</p> Signup and view all the answers

Intussusception may cause ______ due to obstruction.

<p>vomiting</p> Signup and view all the answers

Hirschsprung's Disease occurs due to the absence of ______ cells in the colon.

<p>ganglion</p> Signup and view all the answers

Reye Syndrome is associated with the use of ______ in recovering patients.

<p>aspirin</p> Signup and view all the answers

Sickle Cell Anemia's main interventions involve ______ and pain relief.

<p>fluids</p> Signup and view all the answers

In Hemophilia, patients have an inability to form ______.

<p>clots</p> Signup and view all the answers

Epiglottitis can cause airway ______ due to the swelling of the epiglottis.

<p>obstruction</p> Signup and view all the answers

Cystic Fibrosis causes secretions to be ______ and stickier.

<p>thicker</p> Signup and view all the answers

Children with Cyanotic Heart Disease have ______ blood entering systemic circulation.

<p>unoxygenated</p> Signup and view all the answers

In Congestive Heart Failure, patients may experience ______ due to fluid overload.

<p>edema</p> Signup and view all the answers

In Bronchiolitis, children typically present with ______ due to a respiratory virus.

<p>wheezing</p> Signup and view all the answers

The normal systolic blood pressure is typically around ____ mmHg.

<p>120</p> Signup and view all the answers

A normal heart rate typically ranges from ____ to 100 bpm.

<p>60</p> Signup and view all the answers

The typical respiratory rate for an adult is ____ to 20 breaths per minute.

<p>12</p> Signup and view all the answers

A normal body temperature typically ranges from ____ to 99°F.

<p>97.8</p> Signup and view all the answers

For intradermal injections, the angle of administration is typically between ____ and 15°.

<p>10</p> Signup and view all the answers

The common sites for subcutaneous injections include the abdomen and ____ upper arm.

<p>posterior</p> Signup and view all the answers

For intramuscular injections, the commonly used sites are the deltoid, vastus lateralis, and ____.

<p>ventrogluteal</p> Signup and view all the answers

The normal oxygen saturation level is typically between ____ and 100%.

<p>95</p> Signup and view all the answers

When patients know you are taking their respirations, they may breathe differently, making it ______.

<p>easier</p> Signup and view all the answers

The normal value for sodium (Na+) is ______.

<p>145</p> Signup and view all the answers

Hypernatremia can be addressed by using ______ saline.

<p>0.225</p> Signup and view all the answers

The basic metabolic panel (BMP) includes measurements like Na, Cl, BUN, and ______.

<p>K</p> Signup and view all the answers

A patient with a calcium level of 11 may experience symptoms such as ______ pain and kidney stones.

<p>bone</p> Signup and view all the answers

An arterial blood gas (ABG) pH level below 7.35 indicates ______.

<p>acidosis</p> Signup and view all the answers

In renal failure, patients may be at risk for ______ due to electrolyte imbalances.

<p>dehydration</p> Signup and view all the answers

5% dextrose in 0.9% saline is classified as a ______ solution.

<p>hypertonic</p> Signup and view all the answers

A complete blood count (CBC) includes hemoglobin (Hgb) and ______.

<p>WBC</p> Signup and view all the answers

Normal urine output for infants is approximately ______ mL/kg/hr.

<p>1-2</p> Signup and view all the answers

In cases of metabolic alkalosis, you might see symptoms such as ______, muscle cramps, and respiratory distress.

<p>tetany</p> Signup and view all the answers

For a potassium level of 2.5, a patient may exhibit decreased ______ signs.

<p>reflex</p> Signup and view all the answers

The conversion for 1 gram is equal to ______ milligrams.

<p>1000</p> Signup and view all the answers

Fetal heart rate ______ can be an indicator of fetal well-being during pregnancy.

<p>decelerations</p> Signup and view all the answers

Early ______ can result from head compression during labor.

<p>decelerations</p> Signup and view all the answers

The presence of ______ indicates normal fetal oxygenation during labor.

<p>accelerations</p> Signup and view all the answers

______ can occur due to pressure on the umbilical cord during contractions.

<p>Compression</p> Signup and view all the answers

Monitoring ______ during labor is crucial for assessing fetal health.

<p>contractions</p> Signup and view all the answers

The first stage of labor involves regular contractions and complete dilation to ______ cm.

<p>10</p> Signup and view all the answers

Newborns are primarily ______ breathers.

<p>abdominal</p> Signup and view all the answers

Signs of respiratory distress may include retractions, nasal ______, and grunting.

<p>flaring</p> Signup and view all the answers

The third stage of labor involves the delivery of the ______.

<p>placenta</p> Signup and view all the answers

Fetal monitoring helps assess the baby's condition using tools to interpret ______ strips.

<p>fetal</p> Signup and view all the answers

Late decelerations are a sign of ______ distress during labor.

<p>fetal</p> Signup and view all the answers

The second stage of labor is defined as the phase when the baby is ______.

<p>delivered</p> Signup and view all the answers

During recovery, the mother is typically monitored for up to ______ hours postpartum.

<p>4</p> Signup and view all the answers

Mom's normal blood pressure (bp) systolic is around ______ mmHg.

<p>120</p> Signup and view all the answers

A baby's heart rate (hr) can range from ______ to 160 bpm.

<p>110</p> Signup and view all the answers

A normal respiratory rate (rr) for adults is between 12 and ______ breaths/min.

<p>20</p> Signup and view all the answers

The normal temperature (t) range for a baby is ______ to 99.5°F (36.5 - 37.5°C).

<p>97.7</p> Signup and view all the answers

The oxygen (o2) saturation level for a healthy individual typically falls between ______ and 100%.

<p>95</p> Signup and view all the answers

A baby's normal respiratory rate (rr) is approximately ______ to 60 breaths/min.

<p>30</p> Signup and view all the answers

To assess a patient's respiratory rate accurately, you should take the heart rate and keep your finger on their ______.

<p>pulse</p> Signup and view all the answers

The MAP is equal to the number of weeks ______ or higher in pregnancy.

<p>gestation</p> Signup and view all the answers

Eclampsia is when a woman with preeclampsia has ______.

<p>seizures</p> Signup and view all the answers

Postpartum hemorrhage is defined as massive blood loss greater than ______ mL for vaginal birth.

<p>500</p> Signup and view all the answers

One treatment option for postpartum hemorrhage is surgical ______.

<p>ligation</p> Signup and view all the answers

Magnesium sulfate (MgSO4) is used for ______ control in eclampsia.

<p>blood pressure</p> Signup and view all the answers

The removal of leftover ______ may be necessary to treat postpartum hemorrhage.

<p>placenta</p> Signup and view all the answers

In evaluating postpartum hemorrhage, ______ is used to assess maternal circulation.

<p>pulse</p> Signup and view all the answers

Immediate delivery of the baby may be necessary in cases of severe ______.

<p>preeclampsia</p> Signup and view all the answers

Preeclampsia and eclampsia are pregnancy-related ______ conditions.

<p>hypertensive</p> Signup and view all the answers

Hemabate and Misoprostol are effective for uterine ______.

<p>contractions</p> Signup and view all the answers

A ______ occurs when the wall of the uterus breaks open.

<p>rupture</p> Signup and view all the answers

After a uterine rupture, possible interventions include blood transfusions and a ______.

<p>hysterectomy</p> Signup and view all the answers

Oxytocin, also known as Pitocin, is commonly used to stimulate ______ contractions.

<p>uterine</p> Signup and view all the answers

Misoprostol serves as a cervical ______ agent.

<p>ripening</p> Signup and view all the answers

Terbutaline is a medication that halts uterine ______.

<p>contractions</p> Signup and view all the answers

Nifedipine is another agent that can be used to ______ uterine contractions.

<p>halt</p> Signup and view all the answers

Magnesium sulfate is used for preventing and controlling ______ in pregnant patients.

<p>seizures</p> Signup and view all the answers

The Apgar score assesses the ______ of a newborn at 1 and 5 minutes.

<p>appearance</p> Signup and view all the answers

Babies with a score of 7-10 typically need ______ interventions.

<p>minimal</p> Signup and view all the answers

A score of 0-3 on the Apgar scale indicates the baby needs ______ resuscitation.

<p>full</p> Signup and view all the answers

Breathing slow and irregular, along with a weak cry, indicates a poor ______ in a newborn.

<p>respiration</p> Signup and view all the answers

A floppy response to stimulation may indicate a baby's low ______.

<p>tone</p> Signup and view all the answers

Acrocyanosis is the term for ______ extremities in newborns.

<p>blue</p> Signup and view all the answers

A pink body color in a newborn is a sign of ______ well-being.

<p>physical</p> Signup and view all the answers

The woman in labor with unreassuring FHR should be turned on her ______ side.

<p>left</p> Signup and view all the answers

In the case of a prolapsed cord, the patient should be placed in a ______ position.

<p>knee to chest</p> Signup and view all the answers

Cullen’s Sign is indicative of internal hemorrhage causing ecchymosis around the ______ region.

<p>umbilical</p> Signup and view all the answers

Health professionals assess arterial blood supply in the hand using the ______ test.

<p>Allen’s</p> Signup and view all the answers

Murphy’s Sign indicates pain with palpation in the ______ area.

<p>gallbladder</p> Signup and view all the answers

Beck's Triad includes hypotension, JVD, and ______ heart sounds.

<p>muffled</p> Signup and view all the answers

The Guthrie Test is a neonatal heel prick that screens for ______.

<p>PKU</p> Signup and view all the answers

The Halo Sign indicates the presence of cerebrospinal fluid and a positive test shows concentric ______.

<p>rings</p> Signup and view all the answers

___ means a multidrug resistant organism that poses a risk to patient care.

<p>M</p> Signup and view all the answers

The first sign of cerebral hypoxia is often ___ and irritability.

<p>restlessness</p> Signup and view all the answers

In asthma, patients often present with symptoms like SOB, wheezing, coughing, and ___ .

<p>hypoxemia</p> Signup and view all the answers

For patients with COPD, the normal SpO2 level should remain between ___ and 92%.

<p>88</p> Signup and view all the answers

Empyema is the presence of ___ in the pleural cavity, often associated with pneumonia.

<p>pus</p> Signup and view all the answers

The acronym MTV refers to infections that can be transmitted through ___ precautions.

<p>airborne</p> Signup and view all the answers

In severe asthma cases, it is crucial to avoid administering ___ as it can lead to exacerbation.

<p>morphine</p> Signup and view all the answers

In ARDS, fluid fills the ___ in the lungs, severely inhibiting oxygen exchange.

<p>alveoli</p> Signup and view all the answers

During post mastectomy care, patients should avoid heavy activity and lifting to prevent ______.

<p>lymphedema</p> Signup and view all the answers

Iron deficiency anemia can be treated by giving iron ______ with vitamin C or on an empty stomach.

<p>PO</p> Signup and view all the answers

Patients with pernicious anemia need to take Vitamin B12 for ______ due to lack of intrinsic factor.

<p>LIFE</p> Signup and view all the answers

Thrombocytopenia patients should be placed on bleeding ______ to minimize risk of injury.

<p>precautions</p> Signup and view all the answers

Radioactive iodine treatment requires patients to flush with at least ______ liters of fluids per day for 2 days.

<p>3-4</p> Signup and view all the answers

In the nursing process, the first step is ______ information.

<p>assessing</p> Signup and view all the answers

The formula used to calculate fluid requirements after a burn is called the ______ Formula.

<p>Parkland</p> Signup and view all the answers

In cases of compartment syndrome, the 5 P's include pain, paresthesia, paralysis, pallor, and ______.

<p>pulselessness</p> Signup and view all the answers

When a chest tube is disconnected, place the end of the tube in a container of sterile ______.

<p>saline</p> Signup and view all the answers

Patients who are Rh positive can receive blood from ______ donors.

<p>AB</p> Signup and view all the answers

Burns are classified into three degrees, and a second-degree burn features ______ and edema.

<p>blisters</p> Signup and view all the answers

To ensure patient safety, always keep the bed in the lowest ______.

<p>position</p> Signup and view all the answers

It is crucial to notify the MD if there are signs of ______ syndrome such as increasing pain and paresthesia.

<p>compartment</p> Signup and view all the answers

When managing a sucking stab wound, the dressing should be taped on ______ sides.

<p>three</p> Signup and view all the answers

The ______ Test is performed to check for sufficient blood flow before drawing an arterial blood gas.

<p>Allen’s</p> Signup and view all the answers

Myocarditis is typically caused by a _____ infection.

<p>viral</p> Signup and view all the answers

The main symptom of endocarditis includes _____ pain.

<p>chest</p> Signup and view all the answers

Peripheral Arterial Disease (PAD) can lead to tissue _____ if left unmanaged.

<p>necrosis</p> Signup and view all the answers

Patients with Autonomic Dysreflexia may experience severe _____ and bradycardia.

<p>hypertension</p> Signup and view all the answers

Increased _____ from the heart can indicate heart failure.

<p>BNP</p> Signup and view all the answers

Cholinergic Crisis occurs due to excessive _____ at the neuromuscular junction.

<p>acetylcholine</p> Signup and view all the answers

A _____ stroke occurs when there is a blockage of blood flow to the brain.

<p>Ischemic</p> Signup and view all the answers

In meningitis, a patient may experience nuchal _____, also known as a stiff neck.

<p>rigidity</p> Signup and view all the answers

The risk factors for strokes include hypertension, diabetes, and _____ habits.

<p>smoking</p> Signup and view all the answers

Increased intracranial pressure can lead to Cushing's _____.

<p>Triad</p> Signup and view all the answers

A key symptom of Fat Embolism includes sudden _____ as well as tachycardia.

<p>confusion</p> Signup and view all the answers

In cases of multiple sclerosis, the immune system attacks the _____ sheath.

<p>myelin</p> Signup and view all the answers

Patients with Myasthenia Gravis may present with ptosis or eyelid _____.

<p>drooping</p> Signup and view all the answers

The classic symptom of anaphylaxis is _____ response involving nausea and rash.

<p>allergic</p> Signup and view all the answers

Intussusception results in a partial or complete ______ of the intestine.

<p>obstruction</p> Signup and view all the answers

In Hirschsprung’s Disease, the absence of ganglion cells in the colon and rectum leads to ______ and obstruction.

<p>peristalsis</p> Signup and view all the answers

Reye Syndrome is triggered by the use of ______ in children recovering from a viral infection.

<p>aspirin</p> Signup and view all the answers

Cystic Fibrosis is characterized by thick and sticky ______ that obstructs various systems.

<p>secretions</p> Signup and view all the answers

Signs of Congestive Heart Failure (CHF) include shortness of breath, tachypnea, and ______.

<p>cyanosis</p> Signup and view all the answers

In children born to HIV positive mothers, antiretroviral treatment is essential to prevent ______.

<p>transmission</p> Signup and view all the answers

Symptoms of Hemophilia include increased bleeding, bruising, and ______ in urine.

<p>blood</p> Signup and view all the answers

The medical emergency of Epiglotitis can cause severe airway ______.

<p>obstruction</p> Signup and view all the answers

Bronchiolitis is typically caused by ______ and is characterized by thick secretions.

<p>RSV</p> Signup and view all the answers

Von Willebrand disease is a genetic disorder that inhibits coagulation due to low levels of ______ factor.

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Flashcards

Acute Kidney Injury

Kidneys lose ability to filter blood; potentially reversible.

Chronic Renal Failure

Irreversible kidney damage leading to uremia (waste build-up).

Glomerular Filtration Rate (GFR)

Rate at which kidneys filter blood.

GFR >90

Normal kidney function.

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GFR 60-89

Mild Chronic Kidney Disease (CKD) - Stage 2.

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DKA (Diabetic Ketoacidosis)

Very high blood sugar with ketones and acidosis.

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HHNS (Hyperglycemic Hyperosmolar Non-ketotic Syndrome)

Very high blood sugar, dehydration, no ketones.

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HbA1c

Blood test showing average blood sugar over 90-120 days.

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Insulin Drawing

Procedure of mixing NPH and Regular insulin.

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Dawn Phenomenon

Increased blood sugar in the early morning.

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Somogyi Effect

Blood sugar swings from low to high overnight.

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Type 2 DM

Body does not properly use insulin.

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RACE

A fire safety procedure: Rescue, Alarm, Contain, Extinguish.

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Primary Prevention

Preventing diseases or injuries before they occur.

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Secondary Prevention

Treating injuries or diseases after they've happened.

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Tertiary Prevention

Follow-up care of a patient for recovery.

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Nursing Process (Steps)

Assessing, Diagnosing, Outcome/Planning, Implementing, Evaluating.

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Pulse Strength 0

Absent pulse.

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Pulse Strength 1+

Weak pulse.

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Pulse Strength 2+

Normal pulse.

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Pulse Strength 3+

Bounding pulse.

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Allen's Test

A test to check for sufficient blood flow before ABG.

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Burn - Airway

Maintain a patent airway, which is the first priority.

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Rule of 9s

A method to estimate burn surface area.

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Parkland Formula

Calculates a burn patient's total fluid requirement for 24 hours

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1st Degree Burn

Red and painful burn

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2nd Degree Burn

Blisters and edema present

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3rd Degree Burn

No pain due to nerve damage.

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Blood Type O-

Universal blood donor

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Blood Type AB+

Universal recipient

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Compartment Syndrome

Increased pressure restricting blood flow to an extremity.

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Sucking Stab Wound

Open chest wound allowing air to enter.

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Chest Tube

Drains fluid and air from the pleural space.

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Pressure Ulcer Stages

Different levels of skin breakdown

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Blood Transfusion Precautions

Monitor patient closely for the first 15 minutes and for signs of a reaction.

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Don and Doff

Order to put on (don) and take off (doff) protective clothing

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Pneumothorax

Lung collapse due to air in the pleural space (between lungs and chest wall).

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Open Pneumothorax

Air circulates freely into the pleural space.

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Closed Pneumothorax

Air in the pleural space doesn't increase.

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Tension Pneumothorax

Air can't leave the pleural space, compressing the lung and shifting the mediastinum.

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Nasopharyngeal Airway

Tube used to keep the upper airway open in alert or semiconscious patients.

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Blood Flow (Heart)

Tricuspid → Pulmonic → Mitral → Aortic (Toilet Paper My Ass).

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Heart Sound Pathway

APE To Man (Aortic valve, pulmonary valve, Erb's point, tricuspid valve, mitral valve).

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Unstable Angina

Minor blockage, chest pain, typically relieved by medicine.

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NSTEMI

Partial blockage, ischemia, damages heart muscle; elevated biomarkers.

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STEMI

Full blockage, infarction, elevated biomarkers, ST elevation on EKG.

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Angina

Chest pain from reduced blood flow to heart.

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Prinzmetal's Angina

Rest-occurring chest pain, often at night, triggered by factors like stress.

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Myocardial Infarction

Blocked blood flow to heart, ECG shows ST elevation.

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MONA

Treatment acronym for MI (Morphine, Oxygen, Nitroglycerin, Aspirin).

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Heart Failure

Heart cannot pump enough blood, blood backs up in body or lungs.

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Right-sided Heart Failure (Cor Pulmonale)

Caused by left-sided failure, causing peripheral edema, JVD, and weight gain.

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Left-sided Heart Failure

Backup in the lungs, causing pulmonary edema, dyspnea, and crackles.

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Cardiac Tamponade

Fluid buildup around the heart, impeding pumping.

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Pericarditis

Inflammation of the outer heart layer; friction rub.

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Diabetic Neuropathy Earliest Sign

Microalbuminuria is the earliest sign of diabetic neuropathy.

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Diabetes Insipidus

A disorder of salt and water metabolism, leading to excessive thirst and urination, dehydration, and weakness.

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Diabetes Insipidus cause

Decreased ADH (antidiuretic hormone) production.

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Diabetes Insipidus Nursing Interventions

Monitor electrolytes and I&O; administer fluids; and monitor urine specific gravity and serum osmolality.

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SIADH

A condition characterized by water retention causing dilutional hyponatremia (low sodium).

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SIADH Nursing Interventions

Daily weights, diuretics, and assessments of reflexes and neurologic changes (if Na+ is very low).

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Pediatric Ear Drop Administration

Pull pinna down and back for children under 3 years old.

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Otitis Media

Middle ear infection.

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Otitis Media Prevention

Feeding upright, breastfeeding for first 6 months, and immunizations.

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Otitis Media Symptoms

Fever, ear pulling, enlarged lymph nodes, and potential ear discharge.

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Impetigo

Bacterial skin infection causing sores around the nose and mouth.

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Head Lice Symptoms

Itchy scalp, irritability, and red bumps.

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Head Lice Management

Use PPE (personal protective equipment), Wood's lamp examination, pediculicide shampoo, nit-comb treatment, daily linen/cloth changes.

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Pleuritic Chest Pain

Sharp, stabbing chest pain worsened by breathing.

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ST Elevation and T-wave Inversion

ECG findings suggestive of myocardial ischemia or injury.

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Myocarditis

Inflammation of the heart muscle, often viral.

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Endocarditis

Inflammation of the heart's inner lining.

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Peripheral Arterial Disease (PAD)

Narrowing of arteries, often in the legs, from plaque.

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Coronary Artery Disease (CAD)

Narrowing of coronary arteries, reducing blood flow to the heart.

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Scleroderma

Disease causing abnormal blood flow, often triggered by cold.

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Fat Embolism

Fat released into bloodstream, often after fractures.

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Deep Vein Thrombosis (DVT)

Blood clot in a deep vein, often in the legs.

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Decorticate Positioning

Abnormal posture; arms flexed, legs extended.

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Decerebrate Positioning

Abnormal posture; arms and legs extended.

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Seizures

Sudden, uncontrolled electrical activity in the brain.

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Status Epilepticus

Continuous or repeated seizures without regaining consciousness.

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Stroke

Interruption of blood supply to the brain.

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Ischemic Stroke

Stroke caused by a blocked blood vessel.

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Hemorrhagic Stroke

Stroke caused by a ruptured blood vessel.

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Aneurysm

Bulge in a blood vessel that can burst.

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Parkinson’s Disease

Central nervous system disorder causing motor problems.

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Increased ICP

Pressure buildup inside the skull.

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Meningitis

Inflammation of the brain and spinal cord membranes.

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Guillain-Barré Syndrome

Immune system attacks nerves, causing paralysis.

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Multiple Sclerosis

Chronic disease affecting brain/spinal cord, attacking the myelin sheath.

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Myasthenia Gravis

Weakness of muscles, caused by altered acetylcholine.

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Myasthenia Crisis

Medical emergency marked by worsening muscle weakness.

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Cholinergic Crisis

Excessive acetylcholine, often from medication.

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Amyotrophic Lateral Sclerosis (ALS)

Progressive nerve cell degeneration affecting voluntary movement.

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Autonomic Dysreflexia

Severe hypertension in patients with spinal cord injuries.

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Basilar Skull Fracture

Fracture of bones at the base of the skull.

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Wernicke's Encephalopathy

Neurological disorder caused by thiamine deficiency.

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Spinal Cord Injury

Damage to the spinal cord, causing paralysis.

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Immunoglobulins

Antibodies that provide immunity.

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Sepsis

Severe, uncontrolled immune response to infection.

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Anaphylaxis

Severe allergic reaction, needing immediate treatment.

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HIV

Virus affecting the immune system.

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Botulism Risk

Infants and young children are vulnerable to botulism, a potentially serious illness.

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Milk Intake (Infants)

Excessive milk intake (over 3-4 cups/day) can reduce iron absorption and potentially cause anemia.

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PKU

A genetic condition where the body cannot break down phenylalanine.

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PKU Diet

Avoid high-protein foods (meat, dairy, nuts, legumes) and artificial sweeteners containing aspartame due to PKU.

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Normal Infant/Child Urine Output

Normal urine output for infants and children is 1-2 mL/kg/hr.

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Ipecac Use (Pediatrics)

Ipecac is no longer recommended for inducing vomiting to treat poisoning in children, as it may be harmful.

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Seizure Care

Do not use a tongue blade during a seizure to avoid potential damage to the oral cavity.

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Gestation

The time from fertilization to birth.

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Nulligravida

A woman who has never been pregnant.

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Primigravida

A woman pregnant for the first time.

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Multigravida

A woman pregnant for the second or more time.

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Gravidity

The number of pregnancies a woman has experienced.

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Parity

The number of births after 20 weeks gestation.

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GTPAL

An acronym used to track a woman's pregnancies (Gravidity, Term births, Preterm births, Abortions/Miscarriages, Living children).

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Nullipara

A woman who has not had a birth beyond 20 weeks gestation.

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Primipara

A woman who has had one birth after 20 weeks gestation.

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Pregnancy Length

Pregnancy typically lasts 280 days (40 weeks) from the first day of the last menstrual period (LMP).

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Pregnancy Hypercoagulable State

Pregnancy creates a natural hypercoagulable state, a thickened blood state that protects against postpartum hemorrhage but can lead to possible blood clots.

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Nagele's Rule

A method used to estimate the due date based on the first day of the last menstrual period (LMP).

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Fundal Height

Measurement of the uterus to determine the gestational age of the fetus.

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Fetal Heart Rate

Fetal heart rate can be detected using a Doppler device around 10-12 weeks of gestation.

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Prenatal Visits (Low Risk)

Low-risk pregnancies usually require prenatal visits every 4 weeks until 28 weeks, every 2 weeks from 28-36 weeks, and weekly from 36-40 weeks.

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Defect Screenings (Prenatal)

Some states require screening for neural tube defects during pregnancy, often using maternal alpha-fetoprotein (AFP) levels.

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Skin Sores (Possible Cause)

A skin condition characterized by rupture, oozing, and discoloration to yellow-brown, primarily affecting children aged 2-5 in warm, humid environments and with close contact

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Cleft Lip/Palate

A birth defect where the lip and/or roof of the mouth fails to fully fuse, requiring surgery at specific age ranges.

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Esophageal Atresia with TEF

A congenital condition where the esophagus doesn't fully develop, resulting in a connection (fistula) with the trachea, presenting with symptoms like coughing, choking, and cyanosis, requiring immediate surgical intervention

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Pyloric Stenosis

A narrowing of the pyloric sphincter (muscle between stomach and intestines), typically presenting in infants between birth and 6 months, causing vomiting and the need for surgical correction

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Edema Assessment

Evaluating the presence and degree of swelling in tissues.

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0.45% NS

A hypotonic intravenous solution.

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0.33% NS

Another hypotonic intravenous solution.

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Hypertonic Solutions

Solutions with higher solute concentration than blood.

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3% and 5% NS

Examples of hypertonic intravenous solutions.

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D5W with ½ NS

A solution that contains dextrose and a diluted salt.

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D10W

A hypertonic solution of dextrose in water.

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D5LR

A solution with dextrose, lactated ringers.

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Colloid Solutions

Solutions containing large proteins that increase intravascular volume.

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Albumin

A colloid commonly used to increase intravascular volume.

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Dextran

Another colloid solution used to expand intravascular volume.

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Beta 1 receptors

Found primarily in the heart; responsible for heart function.

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Beta 2 receptors

Found primarily in the lungs; responsible for lung function.

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Metabolic Acidosis

Acid-base imbalance often resulting from diarrhea.

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Metabolic Alkalosis

Acid-base imbalance often resulting from vomiting.

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Potassium (K+) levels and Acidosis

Potassium levels are generally high in acidosis and low during alkalosis.

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Hyperventilation

Increased rate and depth of breathing.

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Heparin antidote

Protamine sulfate.

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Warfarin antidote

Vitamin K.

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NPO

Nothing by mouth.

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Neurological patient positioning

Keep head of bed at 30-45 degrees.

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Post-op monitoring

Observe for bleeding within 24 hours and infection within 48 hours.

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Fluid problem patient monitoring

Daily weight checks in patients with fluid imbalances.

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Electrolyte imbalance monitoring

Keep a close watch on electrolytes in patients with vomiting and diarrhea.

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Anaphylaxis treatment

Administer epinephrine as ordered.

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Antibiotic administration

Obtain cultures before administering antibiotics.

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Dysphagia risk

Increased risk of aspiration pneumonia in patients with difficulty swallowing.

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Cleft Palate (Infant)

Birth defect affecting the roof of the mouth.

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Unreassuring FHR (Labor)

Abnormal fetal heart rate, indicating possible distress.

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Prolapsed Cord

Fetus' umbilical cord coming out before the baby.

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Allen's Test

Assessment of hand artery circulation.

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Cullen's Sign

Umbilical bruising from internal bleeding, often in pancreatitis.

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Turner's Sign

Grayish blue discoloration on the flanks (sides) indicating internal bleeding,often in pancreatitis.

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Murphy's Sign

Pain with gallbladder area palpation, suggesting cholecystitis (gallbladder inflammation).

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McBurney's Point

RLQ (right lower quadrant) pain, indicative of appendicitis

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Guthrie Test

Heel prick test for PKU (phenylketonuria).

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Babinski Sign

Reflex test on the bottom of the foot, assessing nervous system function.

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Beck's Triad

Hypotension, muffled heart sounds, and JVD (jugular venous distension), suggestive of cardiac tamponade.

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Halo Sign

Concentric rings (blood and fluid), indicating head injury with CSF.

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ERCP

Endoscopic procedure examining pancreas, liver, gallbladder, and bile ducts.

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ABC's (Nursing Priority)

Airway, breathing, and circulation; most critical aspects of patient assessment, when in distress, do not assess

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Maslow's Hierarchy

Prioritizing patient needs in hierarchy (ABCs, Safety, Comfort, Psychological, Social, Spiritual)

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Infant Botulism Risk Factors

Infants are susceptible to botulism, a serious illness caused by bacteria producing toxins.

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Milk Consumption Impact

Excessive milk intake in infants can reduce iron absorption, potentially causing anemia.

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PKU Diet Considerations

Individuals with Phenylketonuria (PKU) cannot process phenylalanine, requiring dietary restrictions to prevent metabolic problems.

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PKU Food Restrictions

High protein foods like meat, dairy, nuts, and legumes should be avoided by those with PKU.

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Aspartame in PKU

Aspartame is strictly prohibited in the diet of individuals with PKU.

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Normal Infant/Child Urine Output

Normal urine output for infants and children is 1-2 mL/kg/hour.

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Ipecac for Poison Removal

The use of ipecac syrup to induce vomiting in poisoning cases is no longer recommended by the American Academy of Pediatrics.

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Gestation

The time from fertilization until birth.

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Nulligravida

A woman who has never been pregnant.

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Primigravida

A woman who is pregnant for the first time.

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Multigravida

A woman who is pregnant for at least the second time.

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Parity

The number of births past 20 weeks gestation (live or stillborn).

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Nullipara

A woman who has not had a birth past 20 weeks gestation.

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Primipara

A woman who has had one birth after 20 weeks gestation.

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GTPAL

A system for recording pregnancy history (Gravidity, Term, Preterm, Abortions, Living Children).

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Pregnancy Length

Pregnancy lasts approximately 280 days, 40 weeks, or 9 months.

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First/Second/Third Trimester

The divisions of pregnancy (weeks 1-13, 14-26, 27-40).

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Nagele's Rule

A method for estimating the due date using the first day of the last menstrual period.

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Fundal Height

Measurement of the uterus to determine gestational age.

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Fetal Heart Rate Detection

Fetal heart rate is detectable via Doppler around 10-12 weeks of gestation.

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Low-Risk Prenatal Visits

Low-risk pregnancies typically require prenatal visits every 4 weeks until 28 weeks, every 2 weeks from 28-36 weeks, then weekly from 36 to 40 weeks.

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Defect Screenings in Prenatal Care

Some states require screenings for neural tube defects, often using maternal alpha-fetoprotein (AFP) levels.

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Amniocentesis Timing (Early)

Performed early in pregnancy, requiring a full bladder.

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Amniocentesis Timing (Late)

Performed late in pregnancy, requiring an empty bladder.

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Epidural Hydration

Hydration is essential before an epidural.

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C-Section DVT Risk

C-sections increase the risk of deep vein thrombosis (DVT).

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Placenta Abruption Symptoms

Rigid abdomen, dark red vaginal bleeding, and severe pain.

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Placenta Previa Bleeding

Painless, bright red vaginal bleeding.

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Amniotic Fluid Acidity

Amniotic fluid is alkaline (turns nitrazine paper blue), while urine/discharge is acidic (pink).

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Meconium-Stained Fluid

Yellow amniotic fluid with particles indicates meconium staining.

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Folic Acid Before Pregnancy

Consume folic acid before and during pregnancy.

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Folic Acid Usage

Used for anemia prevention during pregnancy.

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Folic Acid Sources

Leafy vegetables, eggs, and citrus foods are good sources.

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NSAID Use in Pregnancy

Use in first and second trimesters only if risks are outweighed by benefits.

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NSAID Use in Third Trimester

Avoid in the third trimester due to potential fetal ductus arteriosus closure risks.

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Acetaminophen in Pregnancy

A common pain reliever and fever reducer used during pregnancy.

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Acetaminophen Daily Limit

Limit daily intake to 4g to avoid harm.

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Magnesium Sulfate Use

Used in preeclampsia to prevent seizures.

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Magnesium Sulfate Therapeutic Range

Therapeutic range: 4-8 mg/dL.

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Nonstress Test (NST)

Monitors fetal heart rate in response to fetal movement.

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Reactive NST

Normal NST result; fetal heart rate increases with fetal movement.

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Nonreactive NST

Abnormal NST result; fetal heart rate does not increase with fetal movement.

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NST Timeframe

NST is commonly performed after 28 weeks in gestation.

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Stress Test Induction

Induces uterine contractions to assess fetal response to labor.

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Stress Test Timeframe

Stress test is performed after 34 weeks in gestation.

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Negative Stress Test

Normal stress test; fetal heart rate does not slow during contractions.

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Positive Stress Test

Abnormal stress test; fetal heart rate slows during contractions.

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Biophysical Profile (BPP)

Nonstress test plus ultrasound assessing five areas of fetal health.

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BPP Components

Five areas are assessed: movement, breathing, muscle tone, heart rate, and amniotic fluid.

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BPP Scoring

Each area is scored 0 (abnormal) or 2 (normal).

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Normal BPP Score

Scores of 8-10 indicate a normal fetal health.

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Borderline BPP Score

A score of 6 indicates a borderline fetal health.

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Patient safety first step

Prioritize avoiding harm to the patient and ensuring treatment is not withheld

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Acute onset confusion (older)

Rapid-onset confusion in an older adult, often a sign of a urinary tract infection (UTI).

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Restlessness/agitation/decreased LOC

Signs of worsening condition; clues indicating potential deterioration.

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Addison's disease

A hormonal disorder characterized by bronze-colored skin.

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IBS (Irritable Bowel Syndrome)

GI disorder marked by pain, diarrhea, or constipation.

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Anaphylaxis

Severe allergic reaction with tachycardia (fast heart rate) and wheezing.

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Increased ICP (Intracranial Pressure)

Elevated pressure inside the skull, often presenting with Cushing's Triad.

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Cushing's Triad

High blood pressure, slow heart rate, and slow breathing.

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Angina

Chest pain due to reduced blood flow to the heart.

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Appendicitis

Inflammation of the appendix, often with rebound tenderness.

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Asthma

Respiratory disorder characterized by expiratory wheezing.

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Bulimia

Eating disorder with 'chipmunk cheeks' (characteristic swelling).

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BPH (Benign Prostatic Hyperplasia)

Non-cancerous prostate growth, often with increased nighttime urination.

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Cataracts

Eye condition causing blurry vision.

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Cushing's disease

Disease characterized by a 'moon face' and/or 'buffalo hump'.

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Cystic fibrosis

Genetic disorder with salty skin, affecting respiratory & digestive systems.

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Cystitis

Inflammation of the bladder, often causing burning urination.

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Diabetes Mellitus

Metabolic disorder with symptoms such as excessive urination, thirst, & hunger.

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DKA (Diabetic Ketoacidosis)

Metabolic complication of diabetes with high blood sugar and ketones.

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DVT (Deep Vein Thrombosis)

Blood clot in a deep vein, often in the legs, with Homan's sign possibly present.

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Emphysema

Lung disease with barrel chest deformity.

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Epiglottitis

Inflammation of the epiglottis, causing difficulty swallowing, breathing, and drooling.

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Glaucoma

Eye condition causing blurry vision and often a halo vision symptom.

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Guillain-Barré Syndrome

Immune system attacks nerves, causing ascending muscle weakness.

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Hyperglycemia

High blood sugar, often with acetone breath.

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Hyperthyroidism

Overactive thyroid, often with bulging eyes.

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Hypocalcemia

Low calcium levels with Chvostek and Trousseau signs potentially present.

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Intussusception

A bowel obstruction where one part of the intestine telescopes into another, often presenting with a mass on the right side.

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Kawasaki Syndrome

Childhood inflammatory disorder characterized by a 'strawberry tongue'.

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Leprosy

Infectious disease characterized by a 'lion's face' appearance.

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Liver cirrhosis

Advanced liver disease characterized by spider veins.

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Measles

Viral infection characterized by Koplick's spots (small white spots).

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Meningitis

Inflammation of the meninges, possibly with Brudzinski's and Kernig's signs.

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Myasthenia Gravis

Autoimmune disorder causing progressive muscle weakness.

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Myocardial infarction

Heart attack with chest pain, possibly radiating to other areas.

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Pancreatitis

Inflammation of the pancreas, potentially with Cullen's sign.

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Parkinson's Disease

Movement disorder characterized by tremors.

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Pernicious anemia

Vitamin B12 deficiency, with a 'beefy red' tongue as a sign.

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Pneumonia

Lung infection, sometimes with 'rust-colored' sputum.

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Sepsis

Severe body reaction to an infection, often with tachycardia, hypotension, and SOB (shortness of breath).

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Shock

Life-threatening condition with tachycardia, tachypnea, and hypotension.

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TEF (Tracheoesophageal Fistula)

Congenital birth defect with characteristic cyanosis, choking, and excessive drooling.

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Ulcerative colitis

Inflammatory bowel disease marked by bloody diarrhea.

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Epidural puncture

Procedure involving insertion near the dura mater, best positioned in the side-lying position.

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Lumbar puncture

Procedure used to collect spinal fluid, commonly performed with the patient in the lateral recumbent fetal position.

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Post-Lumbar Puncture Positioning

Patient is best placed supine to avoid headaches or fluid leaks.

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Pulmonary Embolism

Blood clot in the lungs, best positioned in the left side-lying.

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Shortness of breath

Airway management, high fowlers (HOB) position preferred.

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Lung biopsy

Procedure on the lungs; side-lying or elevated arms.

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Chest tube insertion

Procedure that requires the arm to be raised.

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NG tube placement

Procedure for administration, high fowlers for proper positioning.

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Tube feeding

Patient with decreased LOC, place patient on right side with elevated HOB (head of bed position) to prevent aspiration.

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Dumping syndrome prevention

Eat in low-fowlers, lie down after meals for 30 minutes.

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Hiatal Hernia Position

Fowler or semi-Fowler position to minimize regurgitation.

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Post-Thyroidectomy Positioning

Low semi-fowlers position recommended for proper positioning.

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Post-Myringotomy Positioning

Lay on the affected ear side for optimal drainage.

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Post-Cataract Surgery Positioning

Lay on the unaffected side to minimize pressure.

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Continuous Bladder Irrigation

Keep leg straight for proper positioning.

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Internal Radiation Positioning

Bedrest while implant in place to prevent movement.

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Heat Stroke Positioning

Lay flat with legs elevated.

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Total Hip Replacement Positioning

Sleep on unaffected side; maintain hip abduction; don't elevate HOB more than 45 degrees.

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Buck's Traction Positioning

Elevate foot end of bed to maintain counter-traction.

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Amputation Positioning

Elevate for first 24 hours; position prone daily to increase hip extension.

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Back Pain Positioning

Use Williams' position.

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MI Positioning

Semi-Fowler's position is recommended for better breathing.

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Autonomic Dysreflexia positioning

Elevate HOB (head of bed) to relieve pressure from the injury.

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Head Injury Positioning

Elevate the head of the bed to 30 degrees to decrease intracranial pressure.

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Post-Supratentorial Surgery Positioning

Elevate HOB to 30-45 degrees.

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Post-Infrantentorial Surgery Positioning

Lay flat and use lateral positioning (either side).

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Peritoneal Dialysis (inadequate outflow)

Turn patient side to side and check for kinks in the tubing.

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Enema Positioning

Place patient on left side with knees flexed (Sim's position).

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Post-Appendectomy Positioning

Right side with knees flexed.

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Paracentesis Positioning

Place patient in high fowlers (HOB 45-90 degrees).

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Thoracentesis Positioning

Sit at the edge of the bed, lean forward, and rest arms on table.

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Spina Bifida Positioning

Position in prone position to minimize risk of sac rupture.

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Infant Cleft Lip Positioning

Side, supine, or upright infant seat to prevent suture line damage.

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NCLEX Exam

National Council Licensure Examination for Registered Nurses

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SATA Questions

Select All That Apply questions, common on the NCLEX, requiring multiple answer selection.

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Prothrombin Time (PT)

Blood test measuring clot formation speed; dependent on Vitamin K.

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INR

Used to monitor warfarin therapy, regulating blood clotting.

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Warfarin

Blood thinner that modifies clotting speed; vitamin K antagonist.

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PTT

Partial Thromboplastin Time, a test to assess the effectiveness of heparin.

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Isotonic solution

A solution with no osmotic pressure; cells maintain the same volume.

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Hypotonic solution

A solution drawing water into cells, causing cell swelling.

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Intracellular fluid

Fluid within cells

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Extracellular fluid

Fluid outside of cells; includes interstitial, connective, and blood.

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Cleft Palate in Infant

A birth defect where the roof of the mouth (palate) doesn't completely form.

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Unreassuring FHR in Labor

A fetal heart rate pattern that suggests potential distress during labor.

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Prolapsed Cord

The umbilical cord comes down before the baby during birth, potentially blocking oxygen.

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Allen's Test

A test to assess the adequacy of blood flow in the hand by temporarily occluding the radial and ulnar arteries.

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Cullen's Sign

Ecchymosis (bruising) around the umbilicus, suggesting internal bleeding, often seen in pancreatitis.

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Turner's Sign

Grayish-blue discoloration on the flanks, indicative of internal bleeding due to pancreatitis.

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Murphy's Sign

Pain during palpation of the gallbladder area, suggestive of cholecystitis (gallbladder inflammation).

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McBurney's Point

Specific point in the lower right quadrant of the abdomen, pain at which point suggests appendicitis.

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LLQ Pain

Pain in the lower left quadrant of the abdomen, can point to diverticulitis. Scrutinise for any food related factors

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Guthrie Test

A newborn screening test performed on a heel prick sample to check for phenylketonuria (PKU).

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Babinski Sign

Neurological assessment of the bottom of the foot, evaluating normal neurological function .

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Beck's Triad

A group of three clinical signs suggestive of cardiac tamponade (fluid accumulating around the heart) - hypotension, JVD, and muffled heart sounds.

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Halo Sign

A diagnostic sign of a head injury where a bloody circle is surrounded by a yellow border, indicating the presence of cerebrospinal fluid.

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ERCP

Endoscopic retrograde cholangiopancreatography examines the pancreas, liver, gallbladder, and bile ducts.

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ABCs

Airway, breathing, and circulation – the first priorities in emergency situations.

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Maslow's Hierarchy

A theory of needs, prioritizing physiological needs (ABCs) over higher-level needs like safety and psychological comfort.

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Do not assess in distress

Focus on immediate and life-saving care, rather than evaluation, when a person is in a state of crisis..

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Amniocentesis

A procedure to collect amniotic fluid for testing during pregnancy.

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Epidural

Anesthesia administered during childbirth.

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C-section

Surgical delivery of a baby.

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Placenta abruption

Premature separation of placenta from uterus.

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Placenta previa

Placenta covers the cervix.

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Amniotic fluid

Fluid surrounding the fetus.

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Folic acid

Vitamin important for pregnancy and preventing anemia.

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NSAID's

Medication to reduce pain/inflammation.

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Acetaminophen

Common pain reliever/fever reducer.

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Magnesium sulfate

Medication used to treat preeclampsia.

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Nonstress test

Monitor fetal heart rate response to movement.

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Reactive NST

Normal fetal heart rate response to movement.

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Nonreactive NST

Fetal heart rate doesn't adequately respond to movement.

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Stress test

Induces contractions to assess fetal response during labor.

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Biophysical profile

Comprehensive test assessing fetal well-being.

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Standard Precautions for HIV

Procedures to prevent the spread of HIV and other bloodborne pathogens.

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HIV Diagnosis Tests

Positive ELISA, Western blot, and PCR tests confirm HIV.

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AIDS Development

Without treatment, HIV can progress to AIDS.

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AIDS Symptoms

AIDS symptoms include low WBC, CD4, platelets, weight loss, fever, night sweats, and infections.

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AIDS Treatment

Strict adherence to antiretroviral therapy is crucial.

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AIDS Diagnosis Criteria

An official diagnosis is made when CD4+ cells fall below 200 cells/mcl.

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HIV Incubation Period

The time between HIV infection and the development of AIDS is variable, but typically within 10 years.

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Systemic Lupus Erythematosus (SLE)

An autoimmune disease causing inflammation and tissue damage.

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SLE Symptoms

Symptoms include butterfly rash, joint pain, fever, fatigue, and nephritis.

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SLE Triggers

Sunlight, stress, drugs, and pregnancy can trigger SLE.

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SLE Nursing Interventions

Teach patients to avoid sunlight exposure, administer steroids, and use mild soap.

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Radiation Therapy and Leukopenia

Radiation therapy can cause low white blood cells (leukopenia), increasing risk of infection.

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Metastasis Common Sites

Cancer spreads commonly to the liver, brain, bone, lung, and lymph nodes.

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Breast Cancer Modifiable Risk Factors

Alcohol, smoking, sedentary lifestyle, and poor diet increase breast cancer risk.

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Breast Cancer Non-Modifiable Risk Factors

Genetic mutations (BRCA1/2), family history, and age at menarche/menopause can influence breast cancer risk.

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Breast Self-Exam

Monthly breast self-exams are crucial for early detection of lumps or changes.

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Rifapentine (Prifin)

A medication often used for 6+ months which can cause orange-colored body fluids; should be taken with meals.

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Pneumothorax

Lung collapse due to air trapped in the pleural space between the lungs and chest

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Open Pneumothorax

Air freely circulates into the pleural space.

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Closed Pneumothorax

Air in the pleural space doesn't increase.

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Tension Pneumothorax

Air cannot escape the pleural space, compressing the lung and shifting the mediastinum.

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Nasopharyngeal Airway

A tube used to keep the upper airway open in alert or semiconscious patients.

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Blood Flow (Heart)

Tricuspid → Pulmonic → Mitral → Aortic.

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Heart Sound Pathway

APE to Man (Aortic, Pulmonary, Erb's Point, Tricuspid, Mitral).

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Unstable Angina

Minor blockage causing chest pain, typically relieved by medicine.

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NSTEMI

Partial blockage causing ischemia and heart muscle damage; elevated biomarkers.

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STEMI

Full blockage leading to infarction; elevated biomarkers, ST elevation on EKG.

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Angina

Chest pain caused by reduced blood flow to the heart.

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Prinzmetal's Angina

Rest-occurring chest pain, often at night; triggered by factors.

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Myocardial Infarction

Blocked blood flow to heart; ECG shows ST elevation.

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MONA

Treatment for MI: Morphine, Oxygen, Nitroglycerin, Aspirin.

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Heart Failure

Heart cannot pump enough blood, blood backs up in body or lungs.

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Right-sided Heart Failure (Cor Pulmonale)

Caused by left-sided failure; causes peripheral edema, JVD, and weight gain.

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Left-sided Heart Failure

Blood backs up in the lungs; causes pulmonary edema, dyspnea, and crackles.

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Cardiac Tamponade

Fluid buildup around the heart, impeding pumping.

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Pericarditis

Inflammation of the outer heart layer; friction rub often present.

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Forceful Vomiting Causes

Conditions that cause forceful vomiting, often leading to dehydration.

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Pyloromyotomy

Surgical procedure to treat forceful vomiting, usually caused by pyloric stenosis.

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Intussusception

Intestine telescopes into another portion, causing obstruction.

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Intussusception Symptoms

Abdominal pain (raising legs up), currant jelly stools, sausage-shaped mass, vomiting.

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Hirschsprung's Disease

Absence of ganglion cells in the colon and rectum, leading to obstruction.

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Hirschsprung's Disease S/sx (Infants)

No meconium within 24 hours, vomiting, distended abdomen.

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Hirschsprung's S/sx (Older children)

Constipation, ribbon-like stools, abdominal distention, increased pain.

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Reye Syndrome Cause

Severe encephalopathy, hepatic dysfunction, triggered by viral infections and aspirin.

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Reye Syndrome Symptoms

Lethargy, vomiting, diarrhea, confusion.

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HIV Transmission in Children

Children born to HIV-positive mothers need antiretroviral treatment.

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Sickle Cell Anemia Interventions

Treatment mainly focuses on fluids and pain relief.

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Leukemia

Cancer of the blood cells or bone marrow.

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Leukemia Symptoms

Epistaxis (nosebleeds), hyperplastic gums, increased white blood cells, weakness.

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Hemophilia

Inability to form blood clots, due to a genetic disorder.

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Hemophilia Symptoms

Excessive bleeding, bruising, nosebleeds, blood in stool or urine.

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Von Willebrand Disease

Bleeding disorder due to low levels of von Willebrand factor, affecting coagulation.

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Epiglottitis Cause

Airway obstruction, a medical emergency.

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Epiglottitis Symptoms

Fever, barking cough, difficulty swallowing, drooling, restlessness, tripod position.

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Bronchiolitis Cause

Respiratory infection from RSV (respiratory syncytial virus), creating thick secretions.

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Bronchiolitis Symptoms

Cough, runny nose, congestion, rapid breathing, wheezing.

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Cystic Fibrosis

Inherited disease, causing thick mucus, leading to lung, digestive, and reproductive issues.

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Cystic Fibrosis Symptoms

Respiratory infections, lung congestion, meconium ileus, oily/bulky stools, salty skin.

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Congestive Heart Failure (CHF)

Heart cannot adequately pump blood, leading to fluid buildup in the body.

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CHF Symptoms

Shortness of breath, rapid breathing, bluish skin, weight gain, edema, feeding difficulties, enlarged liver.

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Normal Systolic BP

120 mmHg, measures the pressure in arteries when the heart contracts.

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Normal Diastolic BP

80 mmHg, measures pressure in arteries when the heart rests between beats.

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Normal Heart Rate (HR)

60-100 beats per minute (bpm).

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Normal Respiratory Rate (RR)

12-20 breaths per minute.

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Normal Temperature (T)

97.8-99°F (36.5-37.2°C).

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Normal SpO2

95-100% for healthy adults, may vary in certain conditions like COPD.

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Intradermal Injection Angle

10-15 degrees.

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Subcutaneous Injection Angle (Normal/Overweight)

90 degrees.

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Subcutaneous Injection Angle (Thin)

45 degrees.

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Intramuscular Injection Angle

90 degrees.

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Intravenous Injection Angle

25 degrees.

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Normal Sodium (Na+)

135 - 145 mEq/L

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Normal Potassium (K+)

3.5 - 5.0 mEq/L

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Normal Phosphate (Phos)

2.5-4.5 mg/dL

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Normal Calcium (Ca+)

9-11 mg/dL

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Normal Magnesium (Mg+)

1.5-2.5 mg/dL

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Normal Blood Glucose

70-100 mg/dL

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Normal Blood Urea Nitrogen (BUN)

7-20 mg/dL

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Normal Creatinine (Cr)

0.6-1.2 mg/dL

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Normal Bicarbonate (HCO3)

22-26 mEq/L

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Normal Partial Pressure of Oxygen (PaO2)

80-100 mmHg

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Normal Partial Pressure of Carbon Dioxide (PaCO2)

35-45 mmHg

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Normal pH

7.35-7.45

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Normal Hemoglobin (Hgb)

F: 12-16 g/dL, M: 13-18 g/dL

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Normal Hematocrit (HCT)

F: 36-48%, M: 39-54%

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Normal White Blood Cells (WBC)

4.5-11 x10^3/µL

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Normal Platelets (PLT)

150-450 x10^3/µL

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Normal Prothrombin time (PT)

10-13 seconds

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Normal Partial Thromboplastin time (PTT)

25-35 seconds

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Normal INR

0.8-1.2

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Normal Total Bilirubin

0.1-1.2 mg/dL

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Normal Alanine aminotransferase (ALT)

7-56 U/L

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Fetal Heart Rate Decelerations

A decrease in fetal heart rate during labor, often caused by temporary reductions in blood flow through the umbilical cord. They are significant as they could indicate inadequate oxygen supply to the baby.

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Early Decelerations

Types of fetal heart rate decelerations that occur during uterine contractions, usually related to head compression.

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Accelerations

Increases in fetal heart rate that usually indicate good oxygenation.

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Cord Compression

A situation during labor where the umbilical cord is compressed, reducing blood flow to the fetus.

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Head Compression

A decrease in fetal heart rate during uterine contractions caused by pressure on the baby's head.

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Normal Fetal Oxygenation

Adequate flow of oxygen to the baby during labor.

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Mom's Blood Pressure (BP)

Systolic pressure 120 mmHg, Diastolic pressure 80 mmHg

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Baby's Systolic BP

60-80 mmHg

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Mom's Heart Rate (HR)

60-100 bpm

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Baby's Heart Rate (HR)

110-160 bpm (can be 180 if crying, 100 if sleeping)

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Mom's Respiratory Rate (RR)

12-20 breaths/min

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Baby's Respiratory Rate (RR)

30-60 breaths/min

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Mom's Temperature (T)

97.8-99°F (36.5-37.2°C)

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Baby's Temperature (T)

97.7-99.5°F (36.5-37.5°C)

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Post-HR assessment

Keep finger on pulse while assessing respiration

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MAP

Equal to the number of weeks of gestation or higher

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Late Placental Insufficiency

A condition where the placenta stops providing adequate nutrients and oxygen to the baby during pregnancy.

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Obstetrical Emergencies

Unexpected medical situations during pregnancy, childbirth, or postpartum.

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Preeclampsia/Eclampsia

A pregnancy complication with high blood pressure and possible seizures.

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Eclampsia

Seizures associated with preeclampsia.

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Postpartum Hemorrhage (PPH)

Heavy bleeding after childbirth.

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Apgar Score 0 Points

Indicates a severely compromised baby at birth, marked by no response. Muscle tone is absent.

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Apgar Score 1 Point

Indicates a baby's condition requiring care after birth, marked by minimal or weak response. Flexed arms and legs are present.

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Apgar Score 2 Points

A baby scoring 2 points on the Apgar scale has a strong response after birth; active.

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Stages of Labor

The different phases a woman experiences during childbirth, including contractions, dilation, and delivery.

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1st Stage of Labor

The stage of labor that includes regular contractions and ends with the cervix fully dilating to 10 cm.

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2nd Stage of Labor

The stage where the cervix is fully dilated (10 cm) and the baby is delivered.

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3rd Stage of Labor

The stage where the placenta is expelled after the baby.

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4th Stage of Labor

The recovery period after delivery, lasting about 4 hours.

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Breathing pattern during labor

Irregular breathing pattern often seen, newborns are generally abdominal breathers.

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Respiratory Distress Signs

Visible indicators of breathing difficulties (e.g. retractions, nasal flaring, grunting).

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Fetal Monitoring

A tool used to assess the well-being of the fetus.

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Non-reassuring FHR Patterns

Fetal heart rate patterns indicating potential problems.

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Early decelerations

Fetal heart rate deceleration that mirrors the contraction pattern.

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Late decelerations

Fetal heart rate deceleration that occurs after the contraction.

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Variable decelerations

Fetal heart rate deceleration that varies in shape and timing.

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Uterine Rupture

A condition where the wall of the uterus breaks open, often due to pressure.

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Misoprostol

A medication that stimulates uterine contractions and helps ripen the cervix.

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Oxytocin

A medication that stimulates uterine contractions.

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Terbutaline (Brethine)

A medication that halts uterine contractions.

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Nifedipine (Procardia)

A medication that halts uterine contractions and prevents seizures.

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Magnesium Sulfate

A medication for preventing and controlling seizures.

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APGAR score

A quick assessment of a newborn's health at 1 and 5 minutes after birth, evaluating vital signs and responsiveness.

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Floppy

A condition indicating minimal response to stimulation.

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Skin Color

Describes the color of the baby's skin.

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Acrocyanosis

Bluish discoloration, especially of hands and feet, in newborns.

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Respiration(Effort)

Describes the baby's breathing effort.

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Scoring

Assessment of a newborn's health, giving intervention levels

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Interventions

Actions taken to improve a patient's condition or health.

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STAT delivery

Delivery required immediately due to critical circumstances.

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Cleft Palate (Infant)

Incomplete closure of the palate in an infant, often requiring surgical intervention.

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Unreassuring FHR (Labor)

Abnormal fetal heart rate patterns during labor, warranting immediate intervention.

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Prolapsed Cord

Fetal umbilical cord presenting before the baby, requiring immediate intervention.

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Allen's Test

A test to determine adequate blood flow in the hand by checking ulnar circulation after radial artery blockage.

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Cullen's Sign

Bluish discoloration around the umbilicus, often indicative of internal bleeding, particularly in pancreatitis.

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Turner's Sign

Grayish-blue discoloration on the flanks often associated with internal bleeding/pancreatitis.

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Murphy's Sign

Pain during palpation of the gallbladder area, indicative of cholecystitis (gallbladder inflammation).

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McBurney's Point

RLQ (right lower quadrant) pain, suggestive of appendicitis.

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Guthrie Test

A neonatal heel prick test for Phenylketonuria (PKU).

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Babinski Sign

Reflex test on the sole of the foot to assess for neurological issues.

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Beck's Triad

A classic triad of cardiac tamponade: hypotension, jugular venous distension (JVD), and muffled heart sounds.

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Halo Sign

Indicative of head injury with CSF and blood showing concentric ring patterns.

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ERCP

Endoscopic Retrograde Cholangio Pancreatography: a procedure for examining the pancreas, liver, gallbladder, and bile ducts.

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Priority ABCs

The first steps of care; Airway, Breathing, Circulation, in any clinical emergency.

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Maslow's Hierarchy

A framework that organizes human needs, starting with physiological essentials (ABCs) to self-actualization.

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RACE

A fire safety procedure: Rescue, Alarm, Contain, Extinguish.

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Primary Prevention

Preventing diseases or injuries before they occur.

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Secondary Prevention

Treating injuries or diseases after they've happened.

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Tertiary Prevention

Follow-up care of a patient for recovery.

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Nursing Process Steps

Assessing, Diagnosing, Outcome/Planning, Implementing, Evaluating.

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Pulse Strength 0

Absent pulse.

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Pulse Strength 1+

Weak pulse.

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Pulse Strength 2+

Normal pulse.

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Pulse Strength 3+

Bounding pulse.

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Allen's Test

A test to check for sufficient blood flow before ABG.

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Burn - Airway

Maintain a patent airway, which is the first priority.

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Rule of 9s

A method to estimate burn surface area.

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Parkland Formula

Calculates a burn patient's total fluid requirement for 24 hours.

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1st Degree Burn

Red and painful burn.

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2nd Degree Burn

Blisters and edema present.

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3rd Degree Burn

No pain due to nerve damage.

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Blood Type O-

Universal blood donor.

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Blood Type AB+

Universal recipient.

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Compartment Syndrome

Increased pressure restricting blood flow to an extremity.

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Sucking Stab Wound

Open chest wound allowing air to enter.

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Chest Tube

Drains fluid and air from the pleural space.

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Blood Transfusion Precautions

Monitor patient closely for the first 15 minutes and for signs of a reaction.

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Don and Doff

Order to put on (don) and take off (doff) protective clothing.

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Mammography Use

Helps detect breast cancer early

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Breast Cancer Treatment

Depends on cancer stage, includes surgery, chemo, radiation, or hormonal therapy

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Post-Mastectomy Care

Elevating the arm, avoiding heavy lifting, and restricting constricting clothing are essential to prevent lymphedema

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Testicular Cancer Sign

Small, hard lump on the testicle

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Testicular Cancer Risk

Undescended testicle or late descent, increased risk of testicular cancer

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Testicular Self-Exam

Monthly self-exam recommended for men age 14 and older

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Multiple Myeloma

Cancer of plasma cells in the blood

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Multiple Myeloma Effect

Myeloma cells interfere with antibody production, causing infection susceptibility

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Radioactive Iodine Precautions

Requires significant fluid intake, limited contact with others, and restrictions on certain individuals

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Immunosuppression in Oncology

Oncologic medications often cause immunosuppression, requiring infection prevention strategies

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Tumor Lysis Syndrome

Release of tumor contents into the bloodstream, with potential electrolyte imbalance (hyperkalemia)

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Thrombocytopenia Precautions

Precautions against bleeding, using soft-bristled toothbrushes and avoiding certain medications in cancer patients

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Iron Deficiency Anemia Treatment

Iron supplementation, often with vitamin C, taken orally or via Z-track IM (Intramuscular)

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Pernicious Anemia Need

Lifelong vitamin B12 supplementation due to a lack of intrinsic factor

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Pernicious Anemia Symptoms

Tachycardia, pallor, and a beefy red tongue

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Multidrug Resistant Organism (MDRO)

An organism that is resistant to multiple antibiotics.

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Respiratory Infection

Infection affecting the lungs, airways, or trachea.

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Skin Infection

Infections affecting the skin, like herpes, impetigo, or scabies.

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Wound Infection

Infection affecting a surgical wound or injury.

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Enteric Infection

Infection affecting the intestines, sometimes caused by C. diff.

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Eye Infection

Conjunctivitis or another infection that affects the eyes.

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Droplet Precautions

Precautions to prevent transmission of germs via droplets.

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Personal Protective Equipment (PPE)

Protective clothing to prevent infection.

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Airborne Precautions

Precautions to prevent transmission of germs via airborne droplets

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Sepsis

Severe response to infection.

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Streptococcal Pharyngitis

Sore throat due to a bacterial infection

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Pneumonia

Infection of the lungs that causes inflammation.

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Pertussis

Bacterial infection of the respiratory system causing severe coughing fits.

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Increased Respirations

Faster breathing may be the first sign of ARDS.

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Cerebral Hypoxia

Lack of oxygen to the brain.

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Restlessness and Irritability

Early signs of cerebral hypoxia.

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Respiratory Status

Assessment of breathing; including breath sounds and oxygen levels.

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Asthma

Narrowing and swelling of airways; difficulty breathing.

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COPD

Chronic lung disease.

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Bronchitis

Inflamed bronchioles; increased mucus.

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Barrel Chest

Specific chest shape of people with COPD.

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Emphysema

Destruction of alveoli, resulting in loss of elasticity.

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Pursed-Lip Breathing

Breathing technique to promote CO2 elimination.

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Empyema

Pus in the pleural cavity.

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Acute Respiratory Distress Syndrome (ARDS)

Fluid buildup in the alveoli preventing oxygen exchange.

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Forceful Vomiting Cause

A medical condition causing forceful vomiting, often requiring surgery for treatment.

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Intussusception

Intestine telescopes inside itself, causing obstruction.

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Hirschsprung's Disease

Lack of nerve cells in the colon/rectum causing obstruction.

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Reye Syndrome

Serious disorder affecting the brain and liver, often linked to viral infections and aspirin use.

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HIV in Children

Children born to HIV-positive mothers should receive antiretroviral treatment.

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Sickle Cell Anemia Interventions

Treatment focuses primarily on providing fluids and pain relief.

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Leukemia

Cancer affecting blood or bone marrow.

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Hemophilia

Genetic clotting disorder leading to excessive bleeding.

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Von Willebrand Disease

Bleeding disorder due to low levels of von Willebrand factor.

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Epiglottitis

Airway obstruction, a medical emergency.

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Bronchiolitis Cause

Respiratory infection often caused by RSV causing thick secretions.

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Cystic Fibrosis

Genetic disorder causing thick, sticky secretions.

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Congestive Heart Failure (CHF)

Heart struggles to pump blood adequately.

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Cyanotic Heart Disease

Unoxygenated blood enters systemic circulation.

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Acyanotic Heart Disease

Oxygenated blood enters systemic circulation.

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Pleuritic chest pain

Sharp, stabbing chest pain worsened by breathing

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ST elevation and T-wave inversion

ECG findings suggesting heart muscle damage or ischemia

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Myocarditis

Inflammation of the heart muscle, often viral

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Endocarditis

Inflammation of the heart's inner lining

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Peripheral Arterial Disease (PAD)

Narrowing of arteries, often in the legs, from plaque

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Coronary Artery Disease (CAD)

Narrowing of coronary arteries, reducing blood flow to the heart

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Scleroderma

Disease causing abnormal blood flow, often triggered by cold

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Fat Embolism

Fat released into bloodstream, often after fractures

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Deep Vein Thrombosis (DVT)

Blood clot in a deep vein, often in the legs

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Decorticate Positioning

Abnormal posture; arms flexed, legs extended

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Decerebrate Positioning

Abnormal posture; arms and legs extended

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Seizures

Sudden, uncontrolled electrical activity in the brain

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Status Epilepticus

Continuous or repeated seizures without regaining consciousness

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Stroke

Interruption of blood supply to the brain

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Ischemic Stroke

Stroke caused by a blocked blood vessel

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Hemorrhagic Stroke

Stroke caused by a ruptured blood vessel

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Aneurysm

Bulge in a blood vessel that can burst

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Parkinson’s Disease

Central nervous system disorder causing motor problems

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Increased ICP

Pressure buildup inside the skull

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Meningitis

Inflammation of the brain and spinal cord membranes

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Guillain-Barré Syndrome

Immune system attacks nerves, causing paralysis

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Multiple Sclerosis

Chronic disease affecting brain/spinal cord, attacking the myelin sheath

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Myasthenia Gravis

Weakness of muscles, caused by altered acetylcholine

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Myasthenia Crisis

Medical emergency marked by worsening muscle weakness

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Cholinergic Crisis

Excessive acetylcholine, often from medication

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Amyotrophic Lateral Sclerosis (ALS)

Progressive nerve cell degeneration affecting voluntary movement

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Autonomic Dysreflexia

Severe hypertension in patients with spinal cord injuries

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Basilar Skull Fracture

Fracture of bones at the base of the skull

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Wernicke's Encephalopathy

Neurological disorder caused by thiamine deficiency

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Spinal Cord Injury

Damage to the spinal cord, causing paralysis

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Immunoglobulins

Antibodies that provide immunity

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Sepsis

Severe, uncontrolled immune response to infection

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Study Notes

NCLEX Study Guide

  • This guide provides information to pass the NCLEX exam.
  • It covers various nursing topics, including advice for studying, a study schedule, must-know labs and vital signs, hallmark signs, patient positioning, diagnostic tests, general nursing, medical surgical, critical care, pediatrics, maternity, mental health, leadership, and pharmacology.

Advice for NCLEX

  • Plan to study for at least one month.
  • Knowledge of disease processes and pharmacology is crucial, but understanding the questions is paramount.
  • Mastering Select All That Apply (SATA) questions is important, as they account for a significant portion of the exam (75%).
  • Recommended resources include U-World and Nurse Achieve.
  • U-World is highly recommended for comprehensive practice questions.
  • Nurse Achieve utilizes the CAT testing format, mirroring the NCLEX's format and adhering to updated COVID-19 related regulations. A few CAT exams a couple of weeks before your exam is highly recommended.
  • Review materials from your nursing program if needed.

NCLEX Study Schedule

  • The provided schedules outline daily study topics for Medical Surgical, Critical Care, Pediatrics, and Maternity. Mental Health, Leadership and Pharmacology also have specific study days. Review previous concepts and practice questions each day.

Must Know Labs and Vital Signs

  • Provides a list of essential lab values (Potassium, Sodium, Calcium, etc) and their normal ranges.
  • Also includes normal ranges for crucial vital signs (blood pressure, heart rate, respiratory rate, temperature).

Must Know Hallmark Signs

  • Lists hallmark signs associated with various medical conditions, such as Addison's disease, anaphylaxis, appendicitis, asthma, and more.

Patient Positioning

  • Outlines various essential patient positioning techniques for different medical procedures and conditions (e.g., lumbar puncture, pulmonary embolism, and others).

Diagnostic Signs/Tests

  • Explains diagnostic tests like Allen's test, Cullen's sign, and Murphy's sign, focusing on their relation to specific medical conditions.

General Nursing

  • Covers crucial aspects for general nursing practice, including ABC (airway, breathing, and circulation), Maslow's hierarchy, and the nursing process (assessment, diagnosis, planning, implementation, and evaluation).
  • Includes order of assessment (inspection, auscultation, palpation, and percussion)

Medical-Surgical and Critical Care

  • Provides detailed information about medical and surgical conditions as well as critical care considerations, including pneumonia, pneumothorax, and shock.
  • Discusses important topics and crucial nursing interventions specific to these areas.

Pediatrics

  • Includes vital insights into common pediatric conditions like Reye Syndrome, Asthma, and infectious diseases.
  • The use of appropriate precautions and interventions tailored for pediatric patients are emphasized.

Maternity

  • Detail information regarding gestation, terminology, stages of labour, interventions, tests, and conditions.
  • Includes fetal heart rates and their implications during pregnancy.

Mental Health

  • Provides a comprehensive overview of various mental health conditions, including delirium, dementia, magical thinking, schizophrenia, anxiety disorders, PTSD, personality disorders, as well as important nursing knowledge and interventions.

Leadership

  • Explains the roles and responsibilities of different nursing levels (RN, LPN, CNA/UAP) and the principles of delegation.
  • Includes details on advanced directives and ethical considerations within the context of nursing.

Pharmacology

  • This section presents a comprehensive list of various medications, including their classifications, uses, and side effects.

Studying That Suits You

Use AI to generate personalized quizzes and flashcards to suit your learning preferences.

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NCLEX Study Guide 2024 PDF

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