001-010.pdf

‫المذكرة هدفها‪...‬‬ ‫تذاكرها امتي ‪...‬؟‬ ‫المضمون ‪...‬؟‬ ‫‪١٨‬‬ ‫‪١٨‬‬ ‫(ربنا يوفقنا جميعا وال تنسونا من صالح دعائكم(‬ ‫‪2‬‬ v PDF Index: v Strategy Insight for INCLEX exam. v Delegation v Ethics and Electrolyte v Acid -Base v Infection control …………Still v Respiratory v Phar...

‫المذكرة هدفها‪...‬‬ ‫تذاكرها امتي ‪...‬؟‬ ‫المضمون ‪...‬؟‬ ‫‪١٨‬‬ ‫‪١٨‬‬ ‫(ربنا يوفقنا جميعا وال تنسونا من صالح دعائكم(‬ ‫‪2‬‬ v PDF Index: v Strategy Insight for INCLEX exam. v Delegation v Ethics and Electrolyte v Acid -Base v Infection control …………Still v Respiratory v Pharmacology v Renal v Maternity v Mental health v Pediatrics v Endocrine v Lab value v Musculoskeletal v Integumentary v Neurological 3 v Strategy Insight 1-The first thing you should know The NCLEX is Just a Safety Exam, if You are a safe nurse, you will Pass on the NCLEX. 2- Second thing the Study Plan: • Study Calendar, Focus on Your time and take it Seriously. • Study on the Morning and the Evening. (Only 60 Questions per day and write down the list of Topics that you got Wrong then review the rational on the Evening» • Always use one notebook. Don’t Use many resources. • Focus on Your Key numbers at least 1,200 questions. NCLEX Mindset: • On the exam expect to get all the NCLEX questions. • Expect the first 10 to 15 Questions to be very hard. • Do not Expect to Know everting. • Do not change the First answer, if you are not 10000% sure that you’re correct. • Where Your Focus goes, Your energy Flows. (Focus on Preparing not in Passing) • Put in Your mind you already Passed. ‫• الكالم ال جاي اقرئه ممكن متفهموش ف األول بس اقرئه بتركيز هتتعلم ازاي تحل‬ ‫السؤال في نكلكس ممكن دلوقت يكون بنسبالك فلبيني الكن اما تحل اسأاله في نكلكس‬ ‫هتفتكر الكالم ده‬ 4 v SATA Questions. • Means select all that apply.  First Rule Ask yourself about safety Principles. • Simply Ask: • what kills this patient first…? What harms first? • then you must Look at the Key words like  (New, Sudden, abrupt, rapid) If you See those keywords this never a good thing you need to assess, intervention or educate the client immediately here.  Second rule: • If in doubt, go without which mean: ➢ If you don’t know, just don’t select it. Always ask yourself if it’s necessary in terms of Safety or not. v NCLEX test taking strategies: • Avoid Using absolutes on the NCLEX like « always, Never, must, cure» it's always typically to be wrong in the answer. • The NCLEX does not like absolutes. • The NCLEX will not suddenly Cure or heal your client. • Don’t read into the Question. o use only what they give you in the question. o Don’t add extra meaning. • Always Least invasive First to most invasive procedure is always last. • Assessment comes first and interventions or even treatment comes second. 5 • Always assess the Patient First before assessing machines or even equipment. • The Answer that delays the Care or even treatment is Usually wrong. • if two answer choices are exact opposite, so one is probably the answer. • if two options are very similar or saying the same thing so both are noncorrect. • If one part of the answer option is wrong, so the whole answer option is wrong. vTherapeutic communication: • Assess the Clients feelings by ask open- ended Questions. • We provide information. Don't tell the Client after medication everything will be ok. v Priority actions vs best actions:  The priority means: o What you Will do right now to save the client from dying. Ask about What Kills your client right now?  The best action: o Asking For you to only do one thing and nothing else. Just think How Can I fix this problem in one only. 6 v Lecture two v Prioritization and delegation v For Prioritization, Remember, unstable client comes first on the answer. • Unstable clients mean. o This is acute patient there is change happened. • Stable Clients o Have no Changes and are long term. Client. With Long term Conditions. as Chronically Conditions. v Six Words for NCLEX Priority Clients That Indicate instability) unstable client: • New, Sudden, Worsening, rapid, return to the Floor after any Procedure, Post operative after Surgery. • New such as patient new diagnosis: • Even his Vital signs are Stable. It Consider Unstable because It's new. *Always Remember. The NCLEX will not cure Your Client. v Maslow's Hierarchy of needs.  He identifies the level of human needs, The main Point here is that he addresses physical needs, before psychosocial needs.  In case of a group, how to Prioritize of Chronically ill Clients IF you get Four clients and all are critical. o You must Start Prioritizing the order of most important organs in the body to the least important. it's not always about the ABCs here. Your priority organ here First, Brain. Second, lungs. Third, Heart. 7  in Case of a single Client, not a group. o This Is Where ABCs Work. • How about to Prevent injury just some tips here for attention: o Low glucose levels, less than 70, the brain will die. o Any Creatine level over 1.3 dead kidney. o Infection any Temp that is high, especially for those who have weak immunity, Chemo, immunosuppressants, neutropenic precaution’s any slight increase in temperature will kill him even 100.7. o NCLEX Toxic Lab level: o Digoxin, Lithium, Phenytoin. v (4) Pain: • Think when will Pain Kill? When will pain harm the Client detrimentally? o You must prioritize the Pain based on the area involved. ▪ IF there is two Client just ask yourself: ▪ Who Will be harmed First? What the Worst thing that Can happen? ▪ You must think, what client losses of life or loss Limb First? v (5) What the ABCs really mean:  (A)- for airway:  Stridor: means Any threat Swelling, even noisy, Squeaky breathing you must think no Airway after any threat Surgery especially Thyroidectomy or even Parathyroid. v Hypoxia:  Means low oxygen. 8  What about hypoxia? o What's the First Sign of Low oxygen. o Is it a Low Pulse (NO) o Is it a low Cap refill. (No)  On NCLEX the first Indicator: o Clinical Manifestation of Low oxygen is Change in mental Status Level consciousness, agitation, Confused.  (B)-For Breathing Normal is 𝐩𝐚𝐜𝐨𝟐 = 35-45: • High Carbon dioxide, 45 or more means hypercapnic respiratory failure. • CO2 above 45 means hypercapnic respiratory failure.so, much CO2 that carbon dioxide it turns into carbon diacid that turns the body to an acidic state and shuts off the breathing.  (C) Circulation: o We're talking about heart and blood vessels. So, Vital Signs are important. o So, What Kills First? o Think Pulses: • No Pulses has no Perfusion especially in the extremities. o Blood pressure: o What BP Will Kill on the NCLEX? o Low BP→ Shock means Low oxygen to the body. o High BP →over 180 systolic Stroke its brain bleeding.  One other thing in Circulation: Bleeding→Internal bleeding in the abdomen this Indicates bleeding in the Abdominal area after any surgery any type of trauma or even acute condition. 9  Labs For bleeding: • Platelets Under 150,000 is thrombocytopenia the blood Cannot Clot (is very risky if any under 150 clients bleed out and die)  What about giving blood thiners like heparin even Warfarin? • PTT Levels and INR must be assessed. • If it's too high, Think Clients bleed out and die. v Part two Delegation " RN, LPN, LVN" v RN Never Delegate What U EAT:  U→unstable Client: • Ex→New admission, Sudden, Worsening, Return to the Floor Fresh Post operative.  E→Evaluation: • Ex→Interpreting blood Valve. Trending Vital Signs Trend’s Pain levels  A →Assessment: • Do not delegate initial, First, Primary assessment. • You can delegate secondary Follow up assessment.  T→Teaching: • Only RN Can do initial, First, Primary teaching. • They Can do Secondary teaching. Follow up teaching.  Legally speaking Whenever you are delegate: • Always Follow up and reassess tasks that you delegate. • Legally this is negligence, negligence is not good outcome. 10