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NCLEX REINFORCEMENT JAN 2024
SIDE NOTES:
โ CVP-8-15 2 to mm hg in water โ Sodium nitroprusside- EMERGENCY! โ GI solution=D5050(hypertonic)+insulin= Hypertonic is used to shrink the cell and it has sugar=insulin is used to counteract the amount of glucose the D5050 has=used in patient that has Hyperkalemia โ NSS-Isotonic โ Lugol's solution is high in iodine-SOS-thyroidectomy to prevent bleeding. โ Lobectomy=5 lobes total=right 3= left is 2 because of the heart. โ Incentive spirometry=Give pain meds 30 mins before so no pain while doing the spirometry.
INFLUENZA
โ -Droplet precaution โ -Flu-trangkaso โ -Duration of disorder: 1 week=Peak Day 1 โ -S/SX: โ High grade fever โ generalized body weakness โ Headache โ N/V โ Loss of Appetite โ -Mode of transmission: โ Phlegm or sipon โ Less than 5mm โ -MGMT: โ Simple mask โ Room in a semi private โ Distance 3-6 feet โ Annual flu vax โ NO TO PREGNANT intranasal influenza! โ Reyeโs syndrome may occur
PAVLIK HARNESS
โ A soft brace โ is a โdynamic brace,โ meaning that it is not rigid and allows your baby to move their legs. โ Indicated from developmental Hyp Dysplasia (Problem in the muscle r/t hip disc or acetabullum โ For newborn โ -Hallmark sign: โ Asymmetric gluteal thigh, labial folds โ Shortening of affected legs โ Ortolani sign= if (+) there is a palpable clunk as the hip reduces back into position โ Barlows signs=if (+) it can be easily dislocated of the acetabulum. โ -Goal of Treatment: โ Dapat nakabukaka palagi! โ DO NOT REMOVE until HCP say so!
โ Sponge bath is best
MILWAUKEE OR BOSTON BRACE
โ Curvature of the spine โ Common in female โ Positional Scoliosis=Due to improper body mechanics, buhat ng mabibigat โ GOT: Alignment of the spine
MYOCARDIAL INFARCTION
โ -PRIORITY!!!
โ -Chest pain=hypoxia=NO O2=for 10 mins! โ -Rx: โ History of Angina=within 5 mins (Unresolved) โ Weak vavles โ -Hallmark sign โ Levine sign=fist on the chest โ Feeling of impending doom โ Left sided jaw pain โ Labs: Cardiac markers (CK-MB, Troponin I and other letters) โ DM=pag sumakit ang tiyan possible MI look at the patients! โ -MGMT: โ M.O.N.A.T. โ Morphine=FIRST TO GIVE! Must be 0/10 pain scale. Because a little chest pain still means no oxygen in the heart! โ Oxygen therapy โ Nitroglycerin โ max of 3 doses โ 5mins interval โ CALL THE EMT after first dose! EVERY SECOND COUNTS! โ DO NOT COMBINE Sildenafil=risk for fatal hypotension! โ Dark colored bottle โ 6 month duration โ PATCH of NTG: โ Patch on=12-16hrs โ Patch I โ Patch off=8 hrs (Bedtime) โ -Do not remove when taking a shower โ -Pagsuot naka gloves=might transfer to you! โ -fold the patch during discard โ -Site of patch=chest or upper arm=clip if hairy โ Aspirin โ risk for bleeding โ Reyeโs Syndrome=bleeding of brain and liver โ Thrombolytic โ Clot busters โ SAMU โ Streptokinase
โ MERS-COV =
โ COVID = Quarantine โ Pneumonia = rusty sputum-QT complex โ Legionnaireโs = nosocomial infection (Hospital infection) โ Bronchiolitis = RSV (Respiratory Syncytial Virus) โ Croup = Barking cough โ Epiglottitis = Drooling
THERAPEUTIC COMMUNICATION
โ Extract info โ Gain rust and rapport โ Techniques โ Eye contact โ Opened Question โ Rephrasing โ Silence offering oneself. โ Active listening
MUNCHAUSEN SYNDROME
โ Factitious disorder โ faking symptoms to gain advantage
GALACTOSEMIA
โ disorder in newborns โ main problem: Conversion of Galactose to glucose โ increase galactose in the blood will cause multiple organ problems โ S/SX: โ Brain damage โ Cataracts โ Liver problem=jaundice may occur โ Kidney problem โ Loss of appetite โ DX: โ Gothrie test=Heel prick specimen
ALZHIEMER DISEASE
โ -Atherosclerotic of the brain โ -General intellectual dysfunction โ -R/FX: โ Old age โ Lack of sleep โ HX of chronic alcoholic=increase toxic substances โ -S/SX: โ ALL THE AโS! โ Amnesia=forgetfulness โ Aphasia=improper communication โ Apraxia=improper movement โ Agnosia=inability to recall things, place or persons โ -MGMT: โ Always promote safety=structured environment
โ Well-lit environment โ Electric cord management โ Removal of floor rugs โ Door lock above the eye level โ Nonskid shoes โ Small frequent foods=canโt remember what they ate โ Lookout for wondering=sundowning phenomenon, happens at night โ -MDX: โ Memantine โ Aricept โ Cognex โ Donepezil HCL
CARDIAC CATHETERIZATION
โ -Coronary Angiogram โ -Site: Femoral artery โ -Purpose to visualize heart damage using contrast medium (dye) โ Insertion of cardiac cath โ Normal=fluttery feeling โ Flushed=warm feeling โ Desired to cough โ Palpitation โ -MGMT: โ Avoid: SOS (Shellfish, Oyster, Shrimp) โ After procedure=increase OFI to flush the dye โ Hold Biguanides=lactic acid โ Post op position=falt on bed and leg should be straight and extended โ Use sandbag for pressure โ -CX: โ Bleeding=apply manual pressure โ Occlusion=mas malamig yung affected leg โ Infection=fever and sore throat
OSA (OBSTRUCTIVE SLEEP APNEA)
โ obstruction of airway during sleeping โ Hallmark sign: Loud snoring and consistent! โ R/FX: โ Obesity โ Short neck โ Alcoholism โ Eating heavy meals during diner โ S/SX: โ Excessive daytime sleepiness โ Waking up during the night โ Poor concentration during the day โ Decrease interest in sexual intercourse. โ MGMT: โ Taking a nap โ No alcohol โ Cut ng food sa gabi โ CPAP=Continuous Positive Airflow Pressure โ O โ Snuggly fit
FIDELITY
โ faithfulness, doing the duty and commitment
