Nclex Avenue

Let's talk about Lithium 🙂

Adenosine is the appropriate medication for Supraventricular tachycardia (SVT) The exact dosage for adenosine should be 6 mg the first time, 12 mg the second time, and 12 mg the third time. These administrations should be a rapid push followed by 20 mL of normal saline. The half-life of adenosine is very short, so this is why timely administration is necessary.

When caring for a client with a tracheostomy, the nurse should have the necessary safety equipment at the bedside, and this includes:

> Two extra inner cannulas - one fitting the client > and one smaller size.
> Obturator
> Suction equipment
> Oxygen source/tank

📌 Pharmacology

Long-term therapy with a proton pump inhibito, (eg, omeprazole, pantoprazole, esomeprazole) may decrease the absorption of calcium and promote osteoporosis. A bone density test can assess if the patient already has osteoporosis Hospitalized patients alsso have an increased risk of diarrhea caused by Clostridium dificile. PPls cause suppression of acid that otherwise would have prevented pathogens from more easily colonizing the upper gastrointestinal tract. This leads to increased risk of pneumonias

📌 Pharmacology

Levothyroxine is the first-line treatment for hypothyroidism during pregnancy to maintain adequate levels of maternal thyroid hormones, which are critical for fetal brain development. Symptoms of hypothyroidism typically begin to improve approximately 3-4 weeks after initiating levothyroxine. Therapy should not be stopped, even if symptoms resolve.

Clients taking ethambutol must have baseline and periodic eye examinations during therapy as optic neuritis is a potentially reversible adverse effect.

Meningitis can be bacterial or viral. Usually, both types present with similar symptoms. The most common bacteria responsible for meningitis in young children are S. pneumoniae, N. meningitidis, H. influenzae, and group B Streptococcus. While viral meningitis does not need isolation, suspected cases of bacterial meningitis must be placed on droplet isolation.

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The normal hemoglobin is 14-18 g/dL for males and 12-16 g/dL for females. A transfusion of packed red blood cells (PRBCS) is typically prescribed once the hemoglobin drops below 7 g/dL. One unit of packed red blood cells will raise the hemoglobin by 1 g/dL.

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Two Basic Rules in Blood Transfusion

1. "4 hour rule"

- transfusion must be completed with 4 hours of removal of blood products from controlled temperature storage.

2. "30 minutes rule"

- the nurse must initiate the transfusion within 30-minutes of receiving it from the blood bank.

Preeclampsia occurs when a woman develops high blood pressure after 20 weeks of gestation.

📌Critical Care

An automated external defibrillator (AED) should be used as soon as it is available. Adult AED pads can be used on a pediatric client if pediatric pads are unavailable, as long as they do not overlap or touch. One pad is placed on the chest and the other is placed on the back "sandwiching the heart".

Supraventricular tachycardia is a regular, narrow QRS complex tachycardia with a rate of around 150-220/min. The best treatment is vagal maneuvers and adenosine IV push.

Furosemide is a loop diuretic than can be used to treat hypercalcemia by enhancing renal calcium exertion. Thiazide diuretics may cause increased serum calcium levels.

💊Colfosceril Palmitate

• is administered to treat a newborn with Respirstory Distress Syndrome (RDS).

HOLD calcium Channel Blockers if Systolic BP is < 100.

📌Critical Care

Recently extubated patients are immediately placed on humidified oxygen and monitored for aspiration, airway obstruction, and respiratory distress. Patients should remain NPO until swallowing function has been evaluated. In addition, patients should be given routine oral care as well as instructions on coughing, deep breathing, and use of incentive spirometry

🩸Transfusion

Each unit of PRBCs increases the hemoglobin by 1 g/dL and hematocrit by 3% around 4-6 hours after completion of a blood transfusion.

Normal Urine specific gravity is 1.005 to 1.030, In dehydrated clients, there are more particles in the urine, creating a higher urine specific gravity.

📌 Prenatal Care 🤰

Fetal heart tones are generally first heard around 10-12 weeks of gestation. Women typically have their first ultrasound at this time to confirm fetal age and to verify cardiac activity.

DRUG toxicity Antidote

1. Naloxone - Opiod toxicity

2. Flumazenil - Benzodiazepine toxicity

3. Calcium Gluconate - Magnesium toxicity

4. N-acetylcyteine - Acetaminophen toxicity.

5. Succimer - Lead toxicity

The procedure for checking the client's blood glucose levels in the correct sequential order are as follows:

1. Verify and confirm that the code strip corresponds to the meter code.

2. Disinfect the client's finger with an alcohol swab.

3. Prick the side of the finger using the lancet.

4. Turn the finger down so the blood will drop with gravity.

5. Wipe off the first drop of blood using sterile gauze.

6. Collect the next drop on the test strip.

7. Hold the gauze on the client's finger after the specimen has been obtained.

8. Read the client's blood glucose level on the monitor.

An ectopic pregnancy is an extrauterine pregnancy. Almost all ectopic pregnancies occur in the fallopian tube, but other possible sites include cervical, interstitial, hysterotomy (cesarean) scar, ovarian, or abdominal. Manifestations of an EP include unilateral abdominal (pelvic) pain, vaginal bleeding, and a positive pregnancy test. Rapid management is needed because life-threatening intraabdominal bleeding may occur. For EP's that have not ruptured and the woman is stable, methotrexate may be used. If that is not the case, surgical management will be necessary.

Tuberculin Skin Test or Mantoux Test
Interpretation

》Induration measuring 15 mm or more is considered to be a positive reaction in children 4 years or older who do not have any risk factors.

》Induration measuring 10 mm or more is considered to be a positive reaction in children younger than 4 years and in children with chronic illness or at high risk for exposure to tuberculosis.

》Induration measuring 5 mm or more is considered to be positive for the highest-risk groups, such as children with immunosuppressive conditions or human immunodefi- ciency virus (HIV) infection

The correct sequence of ambulating upstairs while using a cane👨‍🦯 is moving the good leg first and then the cane and the bad leg together.

📌Child Care

In Sickle Cell Crisis, administration of MEPERIDINE for pain is avoided because of the risk of normeperidine-induced seizures.

📌Child Care

Chest physiotherapy is an important component of treatment for clients with cystic fibrosis. A high-frequency chest wall oscillation vest is a common method of performing CPT, but treatments should occur 1 hour before or 2 hours after eating to avoid gastrointestinal upset (e.g nausea, vomiting).

📌Child Care

Atopic dermatitis (eczema) is a chronic skin disorder manifested in infants by pruritus, dry skin, and red, crusted, scaly lesions. The priority management is to prevent scratching as this would promote formation of new lesions and predispose to secondary infections.