NCLEX TIPS

Topics: Blood pressure, Obstetrics, Erikson's stages of psychosocial development Pages: 10 (4349 words) Published: October 28, 2014

NCLEX TIPS:
When taking a histamine blockers (ex. Tagamet), small frequent feedings are not necessary; should avoid meat extracts, aspirin, alcohol, and caffeinated beverages. Risk factors for developing pneumonia: advanced age, immunosuppressed status, underlying lung disease, bedridden, and post-op. When patient is undergoing paracenthesis it’s important that the nurse places a blood pressure cuff on patient’s arm prior to procedure and leave in place through immediate post-procedure time. Shock may occur because of removal of fluid. Sickle Cell anemia: Painful joints, swelling, fever, tachycardia, could potentially have cardiac murmurs. Usually Hgb between 7 -10 and sickle cell will be seen in blood smear. Osteomylitis and pneumonia are common complications of sickle cell anemia. During sickle cell crisis 3-5 liters of fluids is recommended for the adult and for child 1600 ml/m2/day. AMPUTATION

First 24 hours: Elevate the foot of the bed to reduce edema; then keep bed flat to prevent hip flexion contractures, if prescribed by physician. After 24 to 48 hours postoperatively, position the client prone to stretch the muscles and prevent hip flexion contractures, if prescribed. To prevent hip flexion contractures, DO NOT elevate the residual limb on a pillow. Maintain surgical application of dressing, elastic compression wrap, or elastic stump shrinker as prescribed to reduce swelling, minimize pain, and mold the residual in preparation for prosthesis. Wash the residual limb with mild soap and water, as prescribed, and dry completely. Massage the skin toward the suture line to mobilize scar and prevent its adherence to underlying bone. Below the knee (BKA)

Prevent edema
Lay the patient prone for 25 min every 3-4 hours
Legs should be aDDucted to prevent flexion contractures
Do not allow the limb to hang over the edge of the bed
Discourage long periods of sitting to lessen complications of knee flexion Above the knee (AKA)
Prevent internal or external rotation of the knee
Place a sand bag, rolled towel, or trochanter roll along the outside of the thigh to prevent external rotation CEREBROSPINAL FLUID
Acts as a protective cushion; aids in the exchange of nutrients and wastes. Normal pressure is 50 to 175 mm H20
Normal volume is 125 to 150 mLLYME’S DISEASE
Multisystem infection acquired from a tick bite (ticks live in wooded area and survive by attaching to a host) causing systemic symptoms, more common during the summer months seen in the eastern part of the U.S. Gently remove the tick with tweezers, wash the skin with antiseptic, flush tick down the toilet. Perform a blood test 4 to 6 weeks after a bite to detect the presence of the disease. Antibiotics will be given immediately for 3 to four weeks.

Stages of Lyme disease:
First Stage:
Symptoms can occur several days to months following the bite. A small red pimple develops that may spray into a ring-shaped rash; it may occur anywhere in the body. Rash may be large or small or it may not occur at all. Flu-like symptoms occur: Headaches, stiff neck, muscle aches, fatigue, intermittent fever. Second Stage:

Occurs several weeks following the bite if not controlled during the first stage Joint pain occurs
Cardiac complications and neurological disorders
Third Stage:
Large joints become involved
Arthritis progresses
Teach client about prevention especially in those areas where dear tick is prevalent: Cover all exposed skin when in wooded areas
Check exposed areas for presence of ticks after being in woods Use insect repellent
Wear light color clothing see they can see deer ticks
**LPN’S know normal and abnormal and they also know sterile procedures. Assign to LPN stable patients with stable outcomes** **Nursing assistants will get standards unchanging procedures** ENDOTRACHEAL TUBES:

Used to maintain a patent airway and are indicated when the client needs mechanical ventilation. If client requires artificial airway for longer than 10 to 14...
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