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Nclex High Yield review exam A+ latest 2024 updated
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Nclex High Yield Review A+ 2024DI NO ADH NOTES
Specific gravity Low High
Serum sodium High Low “FOA”
LOA/Seizures
Serum High Low
osmolality
H&H High Low One main cause of siadh
sm cell lung cancer
Tx: Desmopressin Hypertonic saline Correct sodium slowly to
0.3% NS prevent CPM central
pontine myelinolysis aka
locked in syndrome
PPE DONNING reverse, mask OFFING abc order
2nd
Gown Gloves
Mask/respirator Goggles
Goggles/face shield Gown
Gloves Mask
Isolation precautions
Standard
o Hand hygiene
o Gloves
o WHO:
All pts
Risks of contact w/fluids
Contact
o Direct physical contact
Standard precautions + Gown
o WHO:
MRSA
VRE
C-Diff
Droplet
o Transmission
Droplets from sneezing or coughing
o Standard precautions + Surgical Mask
o WHO:
Meningitis
Pertussis
Influenza
Airborne “MTV”
o Transmission
, Nclex High Yield Review A+ 2024
Breathing – airborne particles
o Standard precautions + N95 Respirator or Hood
o WHO:MTV
Measles
TB
Varicella
MMR-measles-mumps-rubella vaccine is a live vaccine &contraindicated in
pregnancy due to the risk of teratogenic effects to the fetus. Clients should get
vaccine in the postpartum period. Avoid preg for at least 1-3 months after
immunization.
Indirect Coombs Testscreens for Rh sensitization in Rh-negative mothers. If the test
results are positive, the fetus and subsequent pregnancies are at risk for serious
complications.
o Rh immune globulin (eg, RhoGAM) given at 28 weeks’ gestation & w/in 72
hrs postpartumas well as any time there is maternal trauma.
Autonomic dysreflexia (spinal cord injuries of T6 & above at risk) uncompensated
sympathetic nervous system stimulation.
o Classic signs include hypertension (up to 300 mm Hg systolic)
o throbbing headache
o diaphoresis above the level of injury
o bradycardia (30-40/min)
o piloerection ("goose bumps"), flushing, and nausea.
life-threatening immediate intervention to prevent complications (eg, hypertensive
stroke, seizures).
most common cause bladder irritation due to distention client needs to be
catheterized or the possibility of a kink in the existing catheter must be assessed. Bowel
impaction can also be a cause; a digital rectal examination should be
performed. Constrictive clothing should be removed to decrease skin stimulation.
Notify HCPalpha-adrenergic blocker or an arteriolar vasodilator (eg, nifedipine) may
be prescribed.
HA associated w/autonomic dysreflexia, typically due to severe hypertension & often
resolve after BP has been treated.
Elevate HOB 45 degrees or high Fowler's to lower BP.
NSAIDs (eg, indomethacin, ibuprofen, naproxen, ketorolac)
o Nephrotoxicavoid in clients with kidney disease should not take a
different/other NSAID meds at same time.
Addison’s Assessment MnemonicUnder-secretion of adrenal cortex rarest endocrine
disorder
Hyper-pigmented skin (very tan/look healthy)bronze/tan
Don’t adapt well to stress
Low BP & Low glucose = shock
o TX: steroids glucocorticoids, end in -SONE
, Nclex High Yield Review A+ 2024
prednisone
methylprednisone
S- Sugar and sodium low
T- Tired and muscle weakness
E- Electrolyte imbalance of high potassium & high calcium
R- Reproductive change
O- lOw blood pressure
I- Increased pigmentation of the skin
D- Diarrhea and nausea, Depression
Cushing’s Assessment Mnemonic Over-secretion of adrenal cortex
S/S of steroids same as S/S of Cushing’s
o Moon face
o Hirsutism -excess hair
o Central/truncal obesity
o Gynecomastia man boobs
o Buffalo hump kyphosis
o Atrophy of extremity muscles
o Retain Na & Water
o Hypokalemia
o Striae stretch marks (purplish)
o HYPERglycemia high serum glucose
o Bruise easily
o Easily irritable
o Immunosuppressed
TX: if primary or secondary tumor need to get rid of tumorAdrenalectomy
(bilateral removes all), which ends up causing Addison’s
Labs check cortisol & ACTH
S- Skin fragile
T- Truncal obesity with small arms
R- Rounded face
E- Ecchymosis, Elevated blood pressure
S- Striae on the extremities and abdomen (Purplish)
S- Sugar extremely high
E- Excessive body hair especially in women, Electrolytes imbalance: hypokalemia
D- Dorsocervical fat pad (Buffalo hump), Depression
Milieu Therapy providing a therapeutic and social environment
ICP in clients w/ increased ICP, HOB should be elevated 15 to 30 degrees & the head placed
at midline to promote venous outflow.
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