Professional Documents
Culture Documents
1 - Yellow Book
1 - Yellow Book
MK
Yellow Book
1- Rule of the B's: If the ____ and the _____ are ______ in the same direction then it is meta_____
↓= acidosis; ↓= metabolic
↑= alkalosis; ↑= metabolic
↓= acidosis; ↑= respiratory
5- You are providing care to a client with the following blood gas results: pH 7.32, CO2 49, HCO3 29, PO2 80, and SaO2
90%. Based on these results, the client is experiencing: ______________________
↓= acidosis; ↑= respiratory
6- MACKussmaul?
8- Up
hypokalemia, alkalosis, HTN, Tachycardia, Tachypnea, Seizures, Irritability, Spastic, Diarrhea, Borborygme, hyperreflexia,
etc
9- Down
hyperkalemia, acidosis, htn, bradycardia, constipation, absent bowel sounds, flaccid, bradypnea
10- Causes of acid-base imbalances: First ask yourself, "Is it _______?" If yes, then it's _______. Then ask yourself: "Are
they _______ or _______. If _______, pick _______. If _______, pick _______
11- Causes of acid-base imbalances: If it's not lung, then it's _______. If the patient has _______ _______ vomiting or
suction, pick _______. For everything else that isn't lung, pick _______ _______. When you don't know what to pick,
choose _______
12- High pressure alarms are triggered by _______ resistance to air flow.
Increased
13- High pressure alarms are triggered by increased resistance to airflow and can be caused by obstruct ions of three
types: _______ action, _______ action, _______ action
(kinked tube) unkink, (water in tube) empty, (mucus in airway) cough and deep breathe
14- Low pressure alarms are triggered by _______ resistance to airflow.
Decreased
15- Low pressure alarms are triggered by decreased resistance to airflow and can be caused by disconnections of the
_______ or _______
tubing (reconnect it), oxygen sensor tube (reconnect it UNLESS tube is on the floor- bag them and call RT if this happens)
High
Low
1. Physiological
2. Safety
3. Comfort
4. Psychological (problems within the person)
5. Social (problems with other people)
6. Spiritual
Denial
Anger
Bargain
Depression
Acceptance
Denial
23- Denial is the _______ to accept the _______ of their problem
refusal, reality
24- Treating denial: _______ it by pointing out to the person the difference between what they _______ and what they
_______. In contrast, _______ the denial of loss and grief
25- Dependency: When the _______ gets the Significant Other to do things for them or make decisions for them
Abuser
26- Codependency: When the _______ _______ derives positive _______ from doing things for or making decisions for
the _______
27- When treating dependency/codependency: Set _______ and _______ them. Agree in advance on what requests are
allowed, then enforce the agreement
limits, enforce
28- When treating dependency/codependency: Work on the _______ of the codependent person
self-esteem
29- Manipulation: when the _______ gets the _______ _______ to do things for him/her that are not in the _______
_______ of the _______ _______. The nature of the act is _______ or _______ to the _______ _______
abuser, significant other, interest, significant other, harmful, dangerous, significant other
limits, enforce
Psychosis, B1
preventable (take vitamin) arrestable (take vitamin) irreversible (kills brain cells)
Aversion
2 weeks
36- Patient teaching with Antabuse/Revia: Avoid _______ forms of _______ to avoid _______, _______, _______
mouth wash, cologne, perfume, aftershave, elixir, most OTC liquid medicines, insect repellant, vanilla extract,
vinagerettes, hand sanitizer
38- Every alcoholic goes through _______. Only a minority get _______
40- Patients with _______ are not a danger to themselves or others. Patients with ________ are dangerous to self and
others
AWS
DT
43- AWS or DT: Regular diet
AWS
44- AWS or DT: Clear liquid or NPO diet (risk for aspiration)
DT
AWS
DT
AWS
48- AWS or DT: Usually restrained with either vest or 2 point (1 arm and 1 leg)
DT
Both
Both
Both
52- For Aminoglycosides, think " __ ____ ___ _____"
54- All aminoglycosides end in _______, but not all drugs that end in _______ are aminoglycosides .
mycin, mycin
mice= ears
58- What is the toxic effect of aminoglycosides and what must you monitor?
59- The human ear is shaped like a _______ so another toxic effect of aminoglycosides is _______ so monitor _______
60- The number "___" drawn inside the ear reminds you of cranial nerve ___ and frequency of administration ___
8, 8, Q8H
Neo- Kan
63- What is the reason for drawing Trough and Peak levels?
Not necessary
STAPH B
Small Pox
Tularemia
Anthrax
Plague
Hemorrhagic illness
Botulism
All others
73- When it comes to Biological Agents: Category __ is _______, Then Category __, Then Category __
A, the worst, B, C
75- Tularemia
chest symptoms
dies from respiratory failure treat with streptomycin Category A
76- Anthrax
spread by inhalation
looks like the flu
dies from respiratory failure
treat with supro, PCN, and streptomycin Category A
77- Plague
spread by inhalation
has the 3 H's: Hemoptysis (coughing up blood), Hematemesis (vomiting up blood), Hematochezia (blood in stool)
dies from respiratory failure and DIC (bleed to death)
treat with Doxycycline and Mycins
no longer communicable after 48 hours of treatment
Category A
78- Hemorrhagic illnesses
79- Botulism
it is ingested
has 3 major symptoms: descending paralysis, fever, but is alert dies from respiratory arrest
Category A
80- What are some examples of chemical agents that cause bioterrorism?
Mustard gas
Cyanide
Phosgine chlorine
Sarin
82- What is the primary symptom of Cyanide and how do you treat it?
Choking
84- What are the symptoms of Sarin (hint it's a nerve agent)?
BB SLUDGE- just remember every secretion in your body is being excre ted excessively
Bronchospasm
Bronchorrhea
Salivating
Lacrimating (tears)
Urination
Diaphoresis/ Diarrhea
G.I upset
Emesis
85- What do you use when cleansing patients exposed to chemical agents?
All chemical agents require only soap and water cleansing except Sarin, which requires bleach.
Biological Agents
Chemical Agents
88- How does decontamination work?
89- Calcium Channel Blockers: they are like ________ for your heart. What does that mean?
Negative
91- Inotropic
strength of heart
strong heartbeat
weak heartbeat
94- Chronotropic
rate of heartbeat
fast heartbeat
slow heartbeat
97- Dromotropic
conductivity of heart
excitable heart
blocks/slows conduction
100- Positive Inotropic, Chronotropic, and Dromotropic is seen with which medications?
101- Negative Inotropic, Chronotropic, and Dromotropic is seen with which medications?
103- What are some of the side effects of Calcium Channel Blockers?
Headache
Atrial
107- Asystole
115- When dealing with an IV push drug if you don't know go ____ except ________!
slow, adenocard
ABCD
Adenocard/adenosine
Betablocker (end in lol)
Calcium Channel Blocker
Digitalis/Digoxin (lanoxin)
you defib
Asystole
122-
atrial fibrillation
123-
atrial flutter
124-
Supraventricular tachycardia
126-
ventricular fibrillation
127- The purpose for chest tubes is to re-establish _______ pressure in the pleural space.
negative
Air
Blood
130- In the pneumohemothorax, the chest tube removes ____ and _____.
131- When the chest tube is ______ (____) for ___. aka ____
132- When the chest tube is ______ (___) for _____ aka ____
133- How many chest tubes and where for unilateral pneumohemothorax?
134- How many chest tubes and where for bilateral pneumothorax?
135- How many chest tubes and where for post-op chest surgery/chest trauma?
136- In routine _____ clamp chest tube. In emergency _____ the chest tube
NEVER; CLAMP
Good
141- If there's bubbling in the water seal and it's continuous it is...
Bad
Bad
Good
144- Rules for clamping the tube: never clamp longer than __________ without Dr's order use ________________
TRouBLe, No TRouBLe
146- R-L
147- B
Blue
148- T
Trunkus arteriosis, Trans. position of great vessels, Tetrology of Fallot, Tricuspid stenosis, TAPZ, Left ventricular
hyperplasmic syndrome
150- What are some examples of "No TRouBLe" congenital heart defects?
151- Akk CHD kids will have 2 things, whether TRouBLe or No TRouBLe...
1. Murmurs
2. Echocardiogram
152- Four defects present in Tetralogy of Fallot are...
VarieD
PictureS
Of A
RancH
Ventricular Defect
Pulmonary Stenosis
Overriding Aorta
Right Hypertrophy
2-3 fingerwidths below anterior axillary fold to a point lateral and slightly in front of foot
154- When the handgrip is properly placed, the angle of elbow flexion will be ____ degrees
30
159- Use the _____ numbered gaits when weakness is _______ distributed. ___ point for mild problems and ___ point
for severe
even, evenly, 2, 4
160- Use the ___ numbered gait when one leg is ______
odd, effected
161- Stairs: which foot leads when going up and down stairs on crutches? ______ with the _______ and _______ with
the _____. The crutches always move with the ____ leg
165- What is the correct way to get up from a chair using a walker?
166- What is the difference between a non-psychotic person and a psychotic person?
a non-psychotic person has insight (know they're sick and that it's messing them up) and is reality based (they see reality
the same way as you) and a psychotic person has no insight and is not reality-based.
167- Delusion
172- Hallucination
auditory (hearing), tactile (feeling), visual (seeing), gustatory (tasting), and olfactory (smelling)
174- Illusion
With illusions there is a referent in reality (something to which they can refer to)
176- When dealing with a patient experiencing delusions, hallucinations or illusions, first ask yourself, "What is their
problem?" (what are the different problems that could be going on?)
schizophrenia, schizoaffective (mood disorder thought process), major depression, and mania
178- With a functional psychosis the patient has the potential to learn reality. How can you teach reality to a functional
psychotic?
1. acknowledge feelings
2. present reality
a. positive- what is reality
b. negative- what is not reality
3. set a limit
4. enforce the limit
People with Alzheimer's, Wernicke's, Organic Brain Syndrome, and dementia. This patient has a brain destruction
problem and cannot learn reality
1. Acknowledge feeling
2. Redirect- get them to express the fixation that they are expressing inappropriately to appropriately
Temporary episodic secondary dramatic sudden onset of loss of reality due to chemical imbalance (UTI, thyroid
imbalance, electrolyte imbalance)
1. Acknowledge feeling
2. Reassure them of safety and temporaryness
186- Neologisms
When a PSYCHOTIC refuses to change their clothes or leave the room. *don't make a psychotic do something they don't
want to do
Feeling
Reassure
Redirect
Reality
1. Diet
3. Oral hypoglycemics
2. Activity
Lower
201- Insulin Type: R
Insulin Lispro
Fastest
Onset: 15min
Peak: 30min
Duration: 3hrs
Long acting
Slow absorption
No peak
Duration: 12-24hr
206- Exercise ________ insulin: if more exercise, need _________ insulin. If less ex ercise, need __________ insulin
208- Low blood sugar in Type I Diabetes Mellitus (insulin shock) is caused by:
209- Why is low blood sugar in Type I Diabetes Mellitus (insulin shock) dangerous?
210- Signs and symptoms of low blood sugar in Type I Diabetes Mellitus (insulin shock):
Cerebral impairment, vasomotor collapse, cold, clammy, slow reaction time, "drink shock"
211- Treatment for low blood sugar in Type I Diabetes Mellitus (insulin shock):
212- High Blood Sugar in Type I Diabetes Mellitus/ DKA/ Diabetic Coma is caused by:
213- Signs and symptoms of High Blood Sugar in Type I Diabetes Mellitus/ DKA/Diabetic Coma
Dehydration
Ketones, Kussmaul Breathing, high K+
Acidosis, Acetone breath, Anorexia
214- Treatment for High Blood Sugar in Type I Diabetes Mellitus/ DKA/ Diabetic Coma
Insulin IV (R)
IV rate flow 200mg/hr
217- Signs and symptoms of High Blood Sugar in Type II Diabetes Mellitus
Rehydration
220- Which lab test is the best indicator of long-term blood glucose control (compliance/effectiveness/adherence)?
226- Kernicterus
227- Opisthotonos
position of slight extension in neck seen in patients with Kernicterus. (Bad sign)
Post-Op gastric surgery complication in which gastric contents dump too quickly into the duodenum
Regurgitation of acid into esophagus, because upper stomach herniates upward through the diaphragm
230- Hiatal Hernia or Dumping Syndrome: Gastric contents move in the right direction at the wrong rate
Dumping Syndrome
231- Hiatal Hernia or Dumping Syndrome: Gastric contents move in the wrong direction at the right rate
Hiatal Hernia
232- Hiatal Hernia or Dumping Syndrome: GERD like symptoms when supine and after eating
Hiatal Hernia
236- Kalemias do the ______ as the prefix except for ___________ and __________
Hyperkalemia=
Hypokalemia=
opposite
Hyper=↓
Hypo= ↑
Hypocalcemia
1. Chvostek's Sign= cheek tap→ facial spasm
2. Trousseau's Sign= BP cuff→ carpal spasm
opposite
Hyper= ↓
Hypo= ↑
240- If symptom involves nerve or skeletal muscle, pick ________. For any other symptom, pick __________ ( generally
anything effecting ____________)
241- HypErnatermia
242- hypOnatremia=
Potassium
246- Not more than ______ of K+ per liter of IV fluid
40mEq
248- Kayexalate
249- In a patient with hypercalcemia, which monitor pattern would be the most likely threat?
A. Paroxysmal atrial tachycardia with decreased ST segments
B. Bradycardia with 2nd degree Mobitz Type II Block & elevated ST segment
C. Frequent PAC's with multifocal coupling of PVC's and tall T-waves
D. First degree heart block with decreased ST segment and inverted T-waves
D. First degree heart block with decreased ST segment and inverted T-waves
250- Hyperthyroidism=
weight loss, diarrhea, ↑HR, hot, heat intolerance, HTN, exophthalmos (bulging eyes- Don Knopps)
252- Hyperthyroidism is also known as ____________________. So remember _____ yourself into the ______
surgical removal
257- Total thyroidectomy- need lifelong ________ replacement. At risk for ___________
thyroid storm
extremely high vital signs, extremely high fever, psychotically delirious. This is a medical emergency
Tetany; Storm
262- Post operation risks for total and subtotal thyroidectomy in first 12 hrs
airway/breathing, bleeding
thyroid storm
Metabolism
Myxedema
Anesthesia is very high risk and do not hold thyroid pills when NPO
A, C
Under-secretion
add-a-sone
moon face, hirsutism (↑ body hair), water retention, gynecomastia (man boobs),
buffalo hump, central obesity (small skinny limbs),↓ bone density, easy bruising,
irritability, immunosuppression
Herpes, Enteric (Rotavirus, Shigellosis), Staph (MRSA), RSV (transmitted via droplet but contact because kids put mouths
on everything)
___ Private Room ___ Mask ___ Special Filter Respirator Masks ___ Handwashing ___ Gown ___ Gloves
___ Eye/Face Shield ___ Disposable Supplies ___ Negative Air Flow ___ Pt wear mask when leaving room
Private Room (most important); Gloves; Gown; Handwashing; Disposable supplies (BP cuff); Stethoscope can
be taken from room to room as long as sterilized after use
___ Private Room ___ Mask ___ Special Filter Respirator Masks ___ Handwashing ___ Gown ___ Gloves
___ Eye/Face Shield ___ Disposable Supplies ___ Negative Air Flow ___ Pt wear mask when leaving room
Private Room; Mask (most important); Gloves; Handwashing; Pt wear mask when leaving room; Disposable
supplies
___ Private Room ___ Mask ___ Special Filter Respirator Masks ___ Handwashing ___ Gown ___ Gloves
___ Eye/Face Shield ___ Disposable Supplies ___ Negative Air Flow ___ Pt wear mask when leaving room
Private room (door closed); Mask; Gloves; Gown; Handwashing; Special Filter Respirator Masks (for TB only-
and not supposed to leave room unless they have to); Pt wear mask when leaving room; Disposable supplies;
Negative air flow (most important); Everyone that enters the room must wear a mask
286- Unless otherwise specified, assume that PPE includes:
287- The proper place for donning PPE is ________ the room and doffing PPE is _________ the room
outside, inside
1. ___________
2. ___________
3. ___________
4. ___________
1. Gown
2. Mask
3. Goggles
4. Gloves
(Start low and go high)
289- The proper order for removing PPE is:
1. ___________
2. ___________
3. ___________
4. ___________
1. Gloves
2. Goggles (from behind)
3. Gown (from behind)
4. Mask
(From behind- outside room) (alphabetical order)
290- In airborne and droplet precautions only, the mask is removed _______ the room and the patient removes mask
________ the room.
outside, inside
hand-washing
Scrubbing
hand-washing
Scrubbing
hand-washing
296- Hand-washing or Scrubbing: not allowed to touch handles
Scrubbing
297- Hand-washing or Scrubbing: use when entering/leaving room, before/after glove use, whenever hands get soiled
hand-washing
Scrubbing
hand-washing
Scrubbing
Only substitute for handwashing, enter/leave room, before/after gloves, NEVER substitute after soiling hands
302- Can you use an alcohol-based solution after using the restroom?
303- Dry hands from ________ to _________. Turn water off with _____ paper towel
dominant
outside
inside
roll
inside
abducted
outside
INside
OUTside
People who have multiple problems in the same division of care Ex: COPD, arthritis, cancer of bowel (all medical
problems)
1. Patients with multidimensional needs (physical, intellectual, emotional, social, spiritual) - Ex COPD, homelessness, &
schizophrenia (need medical, SW, and psychiatrist)
2. Patients who need rehabilitation (PT, SW, OT, Speech will be affected)
311- What are the 3 principles to consider when choosing appropriate toys for kids?
1. is it safe
2. is it age-appropriate
3. is it feasible (can you actually do it? - specific to child's situation)
312- What are some safety considerations when it comes to kids toys?
313- What is the BEST toy for 0-6 months old (sensorimotor)?
musical mobile
314- What is the 2nd BEST toy for 0-6 months old (sensorimotor)?
315- What is the BEST toy for 6-9 months old (object permanence)?
316- What is the 2nd BEST toy for 6-9 months old (object permanence)?
318- Remember with 9-12 months old ___________ activity with _________
purposeful, objects
319- Avoid answers with the following words in them for children 9 months and younger:
fine motor skills (fingers) and balance (dance, ice skating and tumbling)
Pretend
327- School age (7-11 years) aka _________ are characterized by the 3 C's:
1: ____
2: ____
3: ____
Concrete
1. created/creative (give blank paper; get them involved)
2. competitive (winners and losers)
3. collective (baseball cards and barbies)
328- Adolescents (12-18 years)- their "play" is _______ _______ _____________. Allow adolescents to be in each others'
rooms unless one of them is :
1.
2.
3.
329- When given a variety of ages to choose from always go __________ because children ________ when sick and you
want to give them __________________________________
330- Creatinine
0.6-1.2 → If elevated it's abnormal but not too worrisome (just means kidneys are failing)
332- INR (International Normalized ratio)
Monitors Coumadin (Warfarin) therapy (Coumadin and War Fare make you bleed)
2-3
↑INR= bleed risk
≥4 is critical
3.5-5.0
Critical
Assess heart
Prepare to give Potassium
Call the Dr
Deadly Dangerous
Do all of the following at once: Hold Potassium, assess heart, prepare Kayexalate/D5W, Call Dr (will need a team to
address this)
7.35-7.45
341- What is the therapeutic range for BUN (blood urea nitrogen)?
Be concerned
Check for dehydration
343- What is the therapeutic range for Hgb (hemoglobin)?
35-45
80-100
Critical
Sign of respiratory insufficiency
Assess respirations
Give Oxygen
95-100
356- BNP
<100
135-145
5,000-11,000
<200= AIDS
Leukocytosis
365- What are some other names for low WBC count?
Leukopenia
Neutropenia
Agranulocytosis
Immunosuppression
Bone Marrow Suppression
Critical- immunosuppressed
Neutropenic precautions
Critical-immunosuppressed
Neutropenic precautions
368- What do you do if CD4 <200?
Critical- immunosuppressed
Neutropenic precautions
150,000-400,000
Critical
Assess for bleeding
Bleeding Precautions
No unnecessary venipuncture- injection or IV. Use small gauge Handle patient gently (use drawsheet)
Use electric razor
No toothbrushing or flossing
No hard foods
Well-fitting dentures
Blow nose gently
No rectal temp, enema, or suppository
No aspirin
No contact sports
No walking in bare feet
No tight clothing or shoes
Use stool softener. No straining
Notify MD of blood in urine, stool
374- What is the therapeutic range for RBC's?
When lab values are Critical or Deadly Dangerous or if bad symptoms during assessment
377- Laminectomy
"Ectomy"= removal of
"lamina"= vertebral spinus processes
379- What are the 3 signs and symptoms of nerve root compression?
Pain
Paresthesia (numbness & tingling)
Paresis (muscle weakness)
cervical (neck)
thoracic (upper back)
lumbar (lower back)
389- Laminectomy with fusion involves taking a _____ ______ from the ______ ______. Of the two incisions, which site
has the most:
Pain?
Bleeding/Drainage?
Risk for infection?
Risk for rejection?
390- Surgeons are using cadaver bone from bone banks. Why?
Because it gets rid of 2nd incision and cuts recovery time in half
391- What are some temporary restrictions (6 wks) with discharge teaching?
1. Laminectomy patients will never be allowed to lift by bending at the waist (use their needs)
2. Cervical laminectomy patients will never be allowed to lift objects above their heads
3. No horseback riding, off-trail biking, jerky amusement park rides, etc.
Take the first day of the last menstrual period (LMP) Add 7 days. Subtract 3 months
25-31 lbs
12
398- Fundus typically reaches the umbilical (navel) level at week ______
20-22
1st trimester
east dry carbs, cracker before out of bed, and avoid empty stomach
1st/3rd
void Q2H
2nd/3rd
pelvic tilt exercises
(put foot on stool then back again)
406- Dilation
407- Effacement
408- Station
relationship of fetal presenting part to mom's ischial spine (tightest squeeze for baby head)
negative= above spine
positive= below spine
409- Engagement
411- Presentation
labor- dilate and phase cervix (3 phase of labor-- latent, active, transitional)
delivery of baby
delivery of placenta
c-section
417- Latent:
CM dilated?
CXN freq?
Duration?
Intensity?
0-4cm
5-30 min
15-30 sec
mild
418- Active:
CM dilated?
CXN freq?
Duration?
Intensity?
5-7 cm
3-5 min
30-60 sec
Moderate
419- Transition:
CM dilated?
CXN freq?
Duration?
Intensity?
8-10 cm
2-3 min
60-90 sec
Strong
420- Contractions should not be longer than ____ seconds or closer than eve ry ___ minutes.
90; 2
strength of contraction. Palpate with fingers of one hand over the fundus
424- What complication of labor is indicated if the mom is having painful back pain?
Push head back in off cord and position in knee-chest or Trendelenburg (hips up, shoulders down). Prep for c-section
427- Do not administer a SYSTEMIC pain medication to a woman in labor IF the baby is likely to be ______ when the
_______ is _________
no crisis
bad
LION pit
record it
432- What do you do with late decelerations?
bad
LION pit
HR ↓
436- What do you check for with the delivery of the placenta?
437- During the ___ stage (recovery stage) (first 2 hours after delivery) what __ things do you do ___ times an hour
4th, 4, 4
438- What is the tone, height and location of the uterus postpartum?
Rubra
Serosa
Milia
Epstein’s pearls
446- Bluish-black macules appearing over the buttox and/or thighs of darker-skinned neonates
Mongolian spots
447- Red papular rash on baby's torso which is benign and disappears after a few days
hemangiomas
449- Swelling caused by bleeding between the ostium and periosteum of the skull. This swelling does not cross suture
lines
Cephalohematoma
450- Edematous swelling on scalp caused by pressure during birth. This swelling may cross suture lines. It usually
disappears in a few days
caput succedaneum
451- Normal, physiologic jaundice appears after 24 hours of age and disappears at about one week of age
Hyperbilirubinemia
452- Whitish, cheese-like substance which appears intermittently over the first 7-10 days
453- Normal cyanosis of baby's hands and feet which appears intermittently over the first 7-10 days
acrocyanosis
454- Generic term for birthmark
1. nonblanchable port wine stain
2. blanchable pink "stork bites"
nevus/nevi
1. nevus flammeus
2. telangiectatic nevi
Pitocin (Oxytocin)
S/E- uterine hyperstimulation
Cervidil (Prostaglandin)- dilates cervix
S/E- uterine hyperstimulation
Betamethasone (steroid)- give to mother IM; give before baby after viability. can repeat
S/E- ↑BS
Survanta- give to baby after baby is born (transtracheal)
-works immediately
-can only take for 21 days
-antidote: -Protamin sulfate (heParin)
-labs: PTT and all clotting and bleeding times -http--> Ptt Heparin
-can use in pregnancy
-pregnancy class C
462- Coumadin
-takes days
-can take for
-entire life
-PO only
-antidote: vitamin K -labs: PT, INR
-can't use if pregnant -class x pregnancy
Muscle relaxant
1. cause fatigue
2. cause paresis (muscle weak)
3. do not drink alcohol
4. do not drive a car
5. do not watch kids under age 12
When you are on Baclofen you are on your back "loafin"
464- Sensorimotor
Age: 0-2y/o
Characteristics: totally present-oriented. Only think about what they are sense or are doing right now
Teaching Guidelines:
When: as it happens
What: you are doing now
How: tell them what you're doing as you're doing it
465- Pre-Operational
Age: 7-11y/o
Characteristics: Rule-oriented. Live and die by the rules! Cannot abstract
Teaching Guidelines:
When: days ahead of time
What: you're gonna do and skills
How: age appropriate reading and A/V material, role play is ok
Stage 2
Stage 3
Stage 4
472- _______ beats _______
acute, chronic
unstable, stable
1. hemorrhage
2. hypoglycemia
3. fever ≥104
4. pulselessness or breathlessness
478- The more _____ the ______, the higher the priority
vital, organ
Most vital→ brain → lungs → heart → liver → kidney → pancreas
-Starting an IV
-Hanging or mixing IV meds
-Evaluating an IV site
-Giving an IV push/PB meds
-Giving a blood transfusion
-Performing assessments that require inferences/judgments (can gather data) - can make observations about stable
people but cannot make assumptions
-Plan of care
-Developing or performing teaching (can reinforce and review)
-Taking verbal orders from MD or transcribing orders
481- Do not delegate to ___________: _______ responsibilities. They can only do what you _______ them to do .
purpose: for the nurse to explore his/her feelings. to prevent judgmental, intolerant reactions
length: begins when you learn you are going to be caring for someone and ends when you meet them
correct answer: "the nurse will explore his/her feelings about..."
on admission
Whenever a patient displays any notion of suicide or harm you MUST inquire about it
Must get a safety contract
*activities with other people that doesn't require interaction
If pacing Psych→ reduce stimulation (clear the room), make observation, offer presence
*need reality based activities but not competitive; should be with other people
490- Psych Treatment Protocol for Bipolar
Mania's can't go to work or maintain family order whereas a hypo manic can
-finger foods are best; especially ↑ calorie
-8hrs of sleep. Encourage naps
*exercise the gross motor that is non competitive
In psych: need to be evaluated within 1 hr. Must be constantly observed Not psych: observe every 15 min. No
evaluation. Need Dr order Q24h
It takes 5 people to control a violent client. One for each limb and head. Only one person talks. The person is given a few
seconds to deescalate
495- Phenothiazines
Remember ABCDEFG...
A= anticholinergic (dry mouth)
B= blurred vision and bladder retention
C= constipation
D= drowsiness
E= EPS (tremors, parkinsonian)
F= "f"otosensitivity (skin burns)
G= aGranulocytosis (low WBC count- immunosupressed)
Teach patient to report sore throat and signs and symptoms of infection to doctor
Never stop the zine
Never stop the zine
501- Benzodiazepines
A= anticholinergic
B= blurred vision
C= constipation
D= drowsiness
Antidepressants
Depression is thought to be caused by deficiency of norepinephrine, dopamine, and serotonin in the brain. Monoamine
oxidase is the enzyme responsible for breaking down norepinephrine, dopamine, and serotonin. MAO Inhibitors prevent
the breakdown of these neurotransmitter a and thus restore more normal levels and decrease depression
Drug names: MARplan, NARdil, PARnate
A= anticholinergic
B= blurred vision
C= constipation
D= drowsiness
To prevent sever, acute, sometimes fatal hypertensive crisis, the patient MUST avoid all foods containing tyramine
Foods containing tyramine:
Fruits and veggies- remember salad "BAR"→ avoid Bananas, Avacados, Raisins (any dried fruits);
Grains: ll okay except things made from active yeast
Meats: no organ meats- liver, kidney, tripe, heart, etc. no preserved meats- smoked, dried, cured, pickled, hot dogs
Dairy: no cheese except mozzarella and cottage cheese (no aged cheese) Other: no alcohol, elixirs, tinctures
(iodine/betadine), caffeine, chocolate, licorice, soy sauce
506- Lithium
508- Prozac
A= anticholinergic
B= blurred vision
C= constipation
D= drowsiness
Causes insomnia, so give before 12 noon. If BID, give at 6am and 12 noon
When changing the dose of Prozac for an adolescent or young adult, watch for suicide
Tranquilizer
Also has a decanoate form
Long acting IM form given to non compliant patients
A= anticholinergic
B= blurred vision
C= constipation
D= drowsiness
E= EPS
F= fotosensitvity
G= aGranulocytosis
Elderly patients may develop NMS from overdose. NMS is Neuroleptic Malignant Syndrome - a potentially fatal
hyperplasia (fever) with temp of 104.0. Dose for elderly patient should be half of usual adult dose. Safety concerns r/t
side effects
Atypical antipsychotic
Used to treat severe schizophrenia
Advantage: it does not have side effects A-F
Do not confuse with Klonopin (clonazepam)
513- Side effects of Clozaril