- It takes 3 things to pass the NCLEX exam
- Knowledge
- Confidence
- Exam Proficiency
- You can’t apply what you don't know, but you have to be able to apply what you do
know.
- Go with majority: if something is 75% fatal, consider it fatal.
- If you try to learn everything you will master nothing.
Lecture 6 Drug toxicity’s, Dumping Syndrome vs. Hiatal Hernia, Electrolytes
Drug Toxicity’s
- Drug toxicity’s is one of the biggest areas that can cause patient harm.
Medication Use Therapeutic Toxic Levels
Levels
Used in anti-mania,
Lithium Medication used in 0.6 -1.2 Greater than or equal to 2
bipolarism.
Lanoxin Used to treat A-fib, and 1-2 Greater than or equal to 2
(Digoxin) congestive heart failure.
Used to treat airway
spasms that cause
Aminophylline airway constriction. 10 – 20 Greater than or equal to 20
Given first, then a
bronchodilator.
Dilantin Used to treat seizures. 10 - 20 Greater than or equal to 20
(Phenytoin)
Waste product of red Adult: elevated levels
blood cell breakdown.
Bilirubin In adults it is abnormal Adult: 1-2 Newborn: The toxic level is
(waste to have a high bilirubin. 20, however a newborn
product of In newborns the Newborn: less with 14 and above is cause
RBC bilirubin is elevated than 10 for concern
breakdown) because they are
breaking down RBC’s
from the mother blood
stream.
, -Kernicterus:
- Bilirubin in the brain.
- Jaundice is caused by Bilirubin in the skin and is a sign of elevated Bilirubin
levels.
- When Bilirubin levels in a newborn reach around 20, the bilirubin enters
the brain and spinal cord and irritates the brain.
- The bilirubin causes aseptic meningitis and aseptic encephalitis.
- Opisthotonos:
- This is a position the newborn assumes due to the irritation of the bilirubin
on the brain and meninges.
- The newborn hyperextends.
- The neck will begin to extend backwards and the heels will arch
towards their head
- The newborn should be placed on its side.
Pathological Jaundice vs. Physiological Jaundice:
- Pathological Jaundice: the bilirubin is high and jaundice at birth. (Bad)
- Physiological Jaundice: the bilirubin is normal at birth and goes high 2 – 3
days after birth causing jaundice. (typical)
Dumping Syndrome vs. Hiatal Hernia
- Hiatal Hernia:
- The upper part of the stomach has herniated through the diaphragm.
- The stomach then has two chambers, one inside the abdominal
cavity and the other in the thoracic cavity.
- This causes gastric acid to be regurgitated back up into the esophagus.
- The gastric contents move in the wrong direction at the right rate.