ACID REFLUX (GERD)

1. What is the primary  Heartburn (Pyrosis)

symptoms?

2. What test confirms GERD?  Barium swallow fluoroscopy

3. What malfunction allows  Lower esophageal sphincter

reflux in GERD?

4. What is the client teaching?  Low fat, high protein diet, take antacids,
avoid lying flat after meals

ACQUIRED IMMUNODEFICIENCY
SYNDROME
(AIDS)
1. What is the virus that causes  Human Immunodeficiency Virus (HIV)
AIDS?

2. How is HIV transmitted?  Sexual intercourse

 Direct contact with infected blood/bloody
fluids (body fluid- semen, breast milk)
 mother gives birth to baby

3. What are the symptoms of  Fever, weight loss, night sweats, diarrhea,
HIV? fatigue

4. How is the presence of HIV  Screening is done FIRST to see if HIV

confirmed? antibodies are present. The test is performed to
specifically identify the HIV antibodies.

5. What is the screening test?  ELISA

6. What confirms the screening  Western Blot

test?

7. How does HIV attack the  It attacks the immune system by destroying
body? the T-lymphocytes. The virus also rapidly self-
replicates.

8. What is so important about  T cells help immune system + recognize and

T- Lymphocytes? fight pathogens
1
 9. What is another name for T-  CD4 cells
lymphocytes?

10. Why is the CD4 count  The lower the CD4 count, the more damage
important? the virus has done to the body

11. What is the normal CD4  700- 1000

count?

12. What is the normal CD4  Anything above 500, client is considered in
count in client with HIV? good health. If below 500, HIV has progressed
to AIDS.

13. If a client’s CD4 count is  Opportunistic infections

below 200, client is at risk
for what?

14. List some opportunistic  Oral pharyngeal candida infection (mouth

infections fungus)
 Kaposi’s sarcoma (Skin CA)
 Pneumocystis pneumonia
 Cytomegalovirus (Blindness)
 Meningitis

15. What is the goal of HIV  To interfere with the virus replicating
medications?

16. The most important  ZIDOVUDINE (AZT, Retrovir)

medication to know is?

17. Which isolation precaution  Universal precautions

are used with HIV?  Patients do not have to tell you they have
HIV, treat everyone as if they are infected.

18. How do the precautions  If the client h as low CD4 count and is at
change with AIDS? risk for opportunistic infection:
- Private Room
- Reverse Isolation
 RN wears:
a. Gown
b. Goggles
c. Mask
When in direct contact with blood
or bloody fluids

2
 ACUTE RENAL
FAILURE
1. What is the definition of  Sudden loss of kidney function to excrete
acute renal failure? toxins and regulate fluids/ electrolytes

2. What are some possible  Infection, obstruction, shock

causes of ARF?

3. There are three phases; what  Oliguric, diuretic, recovery

are they?

4. During oliguric phase, what  This phase last 1 to 2 weeks. Low urine
will you see? output <400, hyperkalemia, hypertension,
elevated BUN/Creatinine, fluid overload

5. What other two electrolytes  Sodium and Potassium

will be elevated?

6. The diuretic phase is  Urine output slowly returns, hypokalemia,

second; what will you see? hypotension, BUN/Creatinine decreases but
still elevated.

7. What does recovery phase  The kidneys are recovering through a slow
mean? process. Urine output increases and BUN is
normal.

8. What are the nursing  Daily weights, strict I & O’s, treat the
interventions? causes of renal failure, and diuretics.

9. What is the best diet for  High carb, low protein

client with ARF?

ALLERGIES

1. Clients allergic to latex may  Banana, kiwi, chestnut

also be allergic to which
foods?

2. What standard hospital  BP cuffs, gloves, steth. Tourniquets, band-

equipment contains latex? aid, and indwelling catheter

3. What allergy is  Iodine/shellfish allergy

contraindicated for IV
3
 contrast dye?

AMPUTATIO
N
1. What are the major  Infections, skin breakdown, phantom limb
complications of having an pain, joint contractures
amputation performed?

2. What is the positioning for  Elevate first 24 hours, then prone

post-op care?

3. AKA (above the knee)  position twice daily to prevent hip flexion
amputation

4. BKA (below the knee)  Elevate foot of bed first 24 hours, then
amputation prone position twice daily to prevent hip
flexion.

5. What should you  Expressing feelings about lost limb

encourage?

6. What is phantom limb pain?  Pain felt in an area that has been amputated

ANEURYSM

1. True of false? An aneurysm  True

is a dilation formed at a
weak point on the wall of an
artery.

2. What are the symptoms of  Most aneurysms inside the body have no
aneurysms inside the body symptoms

3. What sound would be heard  A blowing bruit

on auscultation?

4. What are some of the risk  Arteriosclerosis (Hardening), infection

factors? (syphilis), smoking, HTN

5. What is the treatment for an  Surgery- depends on size, strict blood

aneurysm? pressure control wit medications

6. What are the signs of a  Severe pain, N&V, tachycardia, decreased

4
 ruptured aneurysm? LOC, hypotension

7. List important NCLEX  Avoid straining, lifting pr exerting, take

teaching points medications on schedule, report severe
back/flank pain

ANOREXIA
NERVOSA
1. The primary symptoms of  Starvation
illness is?

2. What is the perception of  Distorted

the body?

3. At what age does this  Adolescent

disease occur?

4. What is the usual  Perfectionist, overachievers, low esteem

personality type?

5. What is a major cardiac  Arrythmias

complication of anorexia

6. What is the major  Amenorrhea

gynecological complication
of anorexia?

7. What treatment is involved  Small, frequent meals with in-patient

in recovery? counselling and milieu therapy

APPENDICITI
S
1. Commonly seen in what age  10-30 years old
range?

2. What is the classic sign of  Acute right lower abdominal pain

appendicitis? - Signs of Appe
 ROVSING SIGN (abd rebound
tenderness)
 McBURNEY’S SIGN (abd pain
that radiated to the umbilicus)
 OBTURATOR SIGN (RLQ pain
when flexing the leg)
5
  PSOAS SIGN (RLQ when
elevating the leg)
 DUNPHY’S SIGN (RLQ pain
when coughing)

3. What are some other signs/  Loss of appetite, nausea, vomiting, low-
symptoms? grade temperature

4. Localized tenderness is  McBurney’s point

found where?

5. What are the tests to  Complete history and physical exam with
determine appendicitis? WBC count (it will be elevated)

6. What is the treatment for  Immediate surgery to remove appendix, IV

appendicitis? antibiotics, Semi-fowler’s position, NPO to rest
gut
 No pain meds as it masks Peritonitis

7. What is the general  NPO status, no heat on abdomen, assess

treatment for any acute abdominal distention, IV fluid therapy
abdominal pain?

ARTERIAL BLOOD
GAS
1. Where are most samples  Radial artery in wrist
drawn from?

2. How long should pressure  5 minutes

be applied after collecting a
sample?

3. Which test should be  Allen’s test (occlusion of both radial &

performed before collecting ulnar)
an ABG on a client?

ASPERGER’S
SYNDROME
1. This syndrome is form of?  Autism

2. Treatment focuses on  Communication/ patient social skills

improving?

6
 ASTHM
A
1. An obstructive airway  Spasm, inflammation
disease caused by ______
and _______ of the
bronchioles?

2. What are the signs of  SOB, tachycardia, expiratory wheezes, and

asthma? possibly a cough

3. When will the client  At night

experience the cough?

4. What is the primary  To identify allergen

treatment goal?

5. What medications work best  Anti-inflammatory

for treatment?  Corticosteriods bronchodilators
 Leukotriene modifiers
 Metered dose inhalers

6. Which should you give  Bronchodilator

first--- the steroid or
bronchodilator--- when
treating asthma?

7. What are leukotriene  They are drugs used to block the chemical
modifiers? leukotriene, which reduces inflammation

**STEPS TO USE METERED NCLEX Teaching Question

DOSE INHALER**

1. Shake the inhaler well 2. Remove the cap

before use (3 or 4 shakes)

3. Breathe out, away from the 4. Bring the inhaler to your mouth. Place
inhaler. it in your mouth between your teeth and
close your mouth.

5. Start to breath in slowly. 6. Remove the inhaler from your mouth

Press the top of your inhaler and hold your breath for about 10 sec,
once and jeep breathing in then breath out.
slowly until you have taken
a full breath (3-5 sec).
7
  If patient cannot tolerate
bitter taste or are
experiencing side effects,
they may need a spacer.

 Rinse mouth after each dose  Client should wait only one minute
to prevent thrush. each puff

AUTONOMIC
DYSREFLEXIA
1. Autonomic dysreflexia  Spinal cord injury (T5 or above)
occurs in clients with what
kind of injury?

2. What can cause autonomic  Nauseous stimuli such as full bladder or

dysreflexia fecal impaction

3. Why is autonomic  Life-threatening due to clients becoming

dysreflexia so serious? extremely hypertensive

4. What are the signs of  Increase in BP 40 mmHg, headache,

autonomic dysreflexia? bradycardia blurred vision, sweating

5. What should be done during  First place the client in high Fowlers
an episode?  Check for bladder distention
 Loosen restrictive clothing

6. What is the treatment?  Removal of stimuli

 Patient needs to void/bowel movement

BELL’S
PALSY
1. Bell’s palsy effect which  CN 7
cranial nerve?

2. What does the client with Temporary facial paralysis that affects
bell’s palsy suffer from? chewing eating, and closing the eyes.

3. What is the treatment for  Wear eye patch at night

bell’s palsy?  Use artificial tears
 Wear glasses to protect the eye
- Steroids to reduce edema and swelling

8
 BENIGN PROSTETIC HYPERPLASIS
(BPH)
1. BPH is caused by?  The cause is unknown, but it’s an
enlargement of the prostate gland.

2. Because the prostate blocks  Straining to urinate, decreased urine stream,

the urethra opening, clients feeling like they have to go all the time,
will feel and see what when dribbling urine flow.
they urinate?

3. Who usually gets BPH?  Men usually > 50

4. What is the best way to  Rectal exam, physician will feel a pea-sized
asses for BPH? nodule

5. What is the common  Transurethral resection of the prostate

surgical treatment for BPH? (TURP)

6. How is TURP performed?  A scope goes through the penis and removes
part of the prostate

7. After the procedure, what is  Bleeding: monitor for hemorrhage

the client at risk for?

8. All clients will get a _____  Three-way (lumen) foley catheter

before a TURP.

9. What are the three lumens?  Inflating the balloon, inflow of solution, and
outflow of the urine

10. What will the doctor order  Continuous Bladder Irrigation (CBI)
to be done after a TURP?

11. What is the goal of the  Reduce/ prevent blood clot formation
bladder irrigation?

12. Will an incision be made  No, irrigation will be done using the in-
during the irrigation? dwelling catheter.

13. What type of fluid is used to  Isotonic sterile saline

irrigate the bladder?

14. What color do you want the  Light pink

urine to be?

9
 15. During CBI what must the  Bladder distention
client be monitored for?  Fluid overload/*Hyponatremia
 Blood loss

16. If bladder spasms occur,  Belladonna/opium suppositories or Ditropan

give _____ or _______.

17. The best position for this  Lying flat because sitting up puts pressure
client post-op is? on the bladder

18. List some discharge  Drink 2 to 3L of fluids per day.

instructions  No lifting or straining.
 If bright red clots are present, call HCP
 Do Kegel exercise to strengthen pelvis
muscles.

BLOOD
ADMINISTRATION
1. What must be received  Signed written consent
before a transfusion is
started?

2. What blood type is  Type O Negative

considered universal and
can be used for all blood
donors?

3. What blood type is  Type AB Positive

considered the universal
recipient and can receive all
blood?

4. What is the most common  Hepatitis B

infection spread through
blood transfusion?

5. In order to determine donor  Type and cross matching

compatibility, what must be
done?

6. What must be done to  Take vital signs

determine a client’s baseline
before starting the
transfusion?
10
 7. What size IV must the client  18G with a filter needle
have?

8. How many nurses confirm  2 RN

the unit of blood?

9. How long after blood is  30 minutes

removed from bank’s
refrigerator do you gave to
start it?

10. How long must you stay  15 minutes- crucial for reaction
with the client after
transfusion is started?

11. How many mLs are in one  About 250mL

unit of PRBC?

12. What are the signs of an  Restlessness, nausea, hives, SOB, fever,
adverse reaction? chills, back pain

13. What do you do if an  Stop blood and run the NSS that hangs with
adverse reaction occurs? blood, do vitals, notify the HCP and blood
bank. Make sure urine and blood cultures are
done.

14. Why mist you run blood at  Because running blood fast can cause fluid
slow rate? overload

15. What drug is also used to  Epogen (Epoetin Alfa)

treat anemia because it
increases RBC production?

16. Clients taking Epogen  Hypertension and seizures

should be monitored for
what?

BLOOD PRESSURE

1. What is blood pressure?  Force of blood flowing through the arteries

2. What is the recommended  120/80 mmHg

BP?

11
 3. What are the top and bottom  Systolic and diastolic pressure
values?

4. Define the terms: systolic  Systolic- pressure while heart beats

and diastolic pressure.  Diastolic- pressure while heart rests

5. Which value determine if a  Diastolic- if the pressure of the heart is

person has HTN? elevated at rest, then HTN is present

6. What are the risk factors for  African American, obesity, anxiety,
HTN? diabetes, smoking

7. What are the physical signs  Blurry vision, headache, chest pain; but
of HTN? remember that HTN is called a silent KILLER
because most people don’t have the symptoms.

8. How can the size of the BP  If it is too small, the BP will be higher than
cuff affect the BP reading? it really is. If it is too big, the BP will be lower
than it actually is.

9. What is the pulse pressure?  The difference between systolic and

diastolic numbers

10. What is the mean arterial  Diastolic pressure (+) 1/3 of pulse pressure;
pressure? this value should be greater than 60.

11. Before you give a BP meds,  Blood pressure and pulse rate
always check _____ and
_______ ?

12. Hold the medication if  100, 60

systolic BP is less than ____
or HR is less than _____.

13. What classes of medication  Diuretics, beta blockers, calcium channel

are used for HTN? blockers, vasodilators

14. Medications that end in  ACE inhibitors

“pril” are?

15. ACE inhibitors correct heart  Decreasing- they also promote vasodilation
failure by _______ after by inhibiting the production of angiotensin.
load.

16. __________ is an adverse  Angioedema

12
 reaction seen with the use of
ACE inhibitors.

17. Signs of angioedema are?  Swelling of the lips and mouth

18. Clients may also have a  Cough

persistent, nagging
________.

19. Which is more dangerous in  Swelling of the lips and mouth may indicate
angioedema: a cough or laryngeal angioedema. A compromised airway
swelling of the lips and is the priority.
mouth?

20. Medications that end in  Beta blockers

“olol” are?

21. Clients who take anti-HTN  Sit in chair or at a bedside for 30 minutes
meds should be taught what after taking medication to adjust to a lower
method to avoid falling? circulation pressure.

22. What herbal meds is used to  Garlic

lower the BP?

23. Clients taking anti-HTN  True. These things can cause dizziness.
should avoid hot showers,
baths, and weather. True or
false?

24. What is the best diet for a  Low-sodium, low fat

HTN client?  DASH diet

BREAST
FEEDING
1. Breast feeding moms will  Abdominal cramps
often feel what while
feeding the baby?

2. This is due to release of?  Prolactin and oxytocin

3. What is the best way to burp  While he/she is sitting up

a baby?

4. What are the benefits of  Passive immunity, quicker weight loss in

13
 breastfeeding? mother after birth, increase in bonding,
economically low cost

BUERGER’S DISEAS
(Thromboangitis Obliterans)

1. This disease is the  Hands and feet

obstruction and
inflammation of blood
vessels mainly where?

2. Clients present with what  Pale, blue cold hands and feet; they may
symptoms? tingle or be painful.

3. Who is most at risk for the  Males who smoke or chew tobacco
disease?

4. What are the treatment  There is no cure, only symptom control;

goals? teach client to stop smoking, dress
appropriately for the weather, and try to reduce
life stressors.

BULIMIA
NERVOSA
1. What is the eating cycle  Binge eating followed by purging
involved?

2. Will you be able to see  Client usually remains at a normal wt

physical changes or wt loss?

3. Besides purging, what other  Vomiting, enemas, drugs (speed), diuretics,

methods are used to lose diets, and pills
weight?

4. What are the medical  Tooth decay, electrolyte imbalances, ulcers,

complications associated cardiac arrythmias
with bulimia nervosa?

5. Safety is a concern in clients  Suicidal thoughts

with bulimia nervosa
because of?

6. List the treatment goals  Encouraging talking, safety and assessing

14
 suicidal potential, establishing a diet plan,
supervision during meal time, and
antidepressants may also be prescribed.

BURNS

1. What are the two age group  Children and elderly

most at risk for suffering a
burn injury?

2. What are the four types of  Chemical, electrical, thermal, radiation

burns?

3. If the face/neck has been  Airway obstruction

burned, what is the nursing
priority?

4. You use what rule to  Rule of nine

estimate the body surface
area that has been burned?

5. What is each burn % in

adults?
a. Head  9% (4.5 each front/back)
b. Chest  9% (front)
c. Abdomen  9% (Front)
d. Each arm  9% (front and back)
e. Each leg  9% (front) 18% (front and back)
f. Each palm  1%
g. Genitals  1%

6. Classification of burns
a. First degree (Superficial  Skin pink/red, painful (e.g. sunburn)
partial thickness)
b. Second degree (Deep
partial thickness)  Skin red/white, blisters, swelling
c. Third- degree (full
thickness)
 Skin black/Brown, edema, all layers of skin
burned, grafting needed

7. What is the formula used to  Parkland formula

determine fluid replacement

15
 for the first 24 hours?

8. What is the Parkland  4mL of LR x wt(kg) x % of body burned

formula?

9. How much of this fluid do  ½ of total volume

you give in the first eight
hours?

10. How much fluid do you  ¼ of total volume

give for the second eight
hours?

11. How much fluid do you  ¼ of the total volume

give for the third eight
hours?

12. Should you burst of blister?  No

13. What is the best route for  IV

pain meds?

14. What diet is appropriate for  High calorie, high protein

burn clients?

15. What is a common  Hypokalemia or hyperkalemia; both can be

electrolyte problem in seen in clients with burns.
clients with burns?

16. Due to prolonged stress,  Curling’s ulcers

clients at the risk for what
type of ulcers?

17. What medication should be  Pain medication

given before dressing
changes?

CANCER

1. True or false? Cancer is an  True – growth of cells is uncontrolled

abnormal growth of cells.

2. When the cancer cells  Metastasis

travels from the original
16
 location to new place, what
is it called?

3. What acronym is used to  CAUTION

describe the warning signs
of cancer?

4. What do the letters stand  Change in bowel or bladder

for?  Any store that does not heal
 Unusual bleeding or discharge
 Thickening in the breast
 Indigestion
 Obvious change in wart
 Nagging cough or hourseness

5. What are the two ways to  Bygrading or staging

describe tumor?

6. What is the difference  Grading describes a tumor by the cells.

between the two? Staging describes the progression of a tumor by
the clinical symptoms

7. What are the three types of  External unsealed, internal sealed, and
radiation treatment? internal

8. What precautions must be  Private room/bathroom

taken for a client receiving  Limit visitors, rotate nursing staff who
radiation treatment? provide care, place sign at the door and bedside

9. What is the most dangerous  Sealed internal radiation because a solid

type? radioactive implant is placed inside the tumor

10. What additional precautions  All body fluids are radioactive; uses are
must be taken for clients those clean up, gloves/gown
receiving sealed radiation?

11. Chemo therapy works by  Wall

destroying the cell

12. What are the side effects of  Nausea, anorexia, alopecia, stability,
chemotherapy? decreased bone marrow and platelets

13. Why is Reglan  To reduce nausea

(Metrocopromide) given?

17
 14. Is alopecia from  No, it’s temporary
chemotherapy permanent?

15. Is the sterility chemotherapy  Yes

permanent?

16. Clients with cancer will also  Neutropenic precautions

need?

17. What are the neutropenic  Strict hand washing

precautions?  No visitors who are sick
 No children
 No raw food, no live plants
 No free- standing water

18. What is Neupogen  Drug used to treat neutropenia; monitor

(Filgastrim) WBCs

19. When is the best time to do  One week after menstruation

BSE?

20. When is the best time to do  The same day each month
TSE?

21. If a client has had a  No IV or BP

mastectomy, can you take
BP on the affected side?

22. List some other post-  Elevate the affected extremity, no initial
mastectomy patient exercise after surgery, encourage discussion for
education tips. positive self- image

CAR SEATS

1. What are the criteria for a If they are under 4 years or 40 pounds
child to be in a car seat?  If no backseat, do not put the baby in
car

CATARACTS

1. What are the signs of  Milky/white lens, painless, blurred vision

cataract?

18
 2. How are they treated?  No treatment until vision is severely
impaired

3. During surgery, what is  The cataracts are removed and new lens
done? may be implanted

4. After surgery, will vision be  Only if new lens is placed. If no lens is

corrected? placed, the client will need glasses/contacts

5. After surgery, what is the  To check for hemorrhage of the eye. Place
main concern? client in semi-Fowler’s position

6. What do you tell clients to  Coughing, sneezing, bending over at the

avoid? waist, straining, rubbing eye, or crying. No
lifting greater than 5 pounds

7. How should the post-op  Sleep on unaffected side or, if surgery was
client sleep? on both eyes, sleep on back. Use eye shiel at
night to protect the eye/s

CELIAC
DISEASE
1. In celiac disease,  Fats
malabsorption of _______
occurs

2. Foods containing ________  Gluten

must not be eaten

3. What foods contain gluten?  BROW (barley, rye, oats, wheat)

4. The client’s abdomen is  Distended

often?

5. What does the client stool  Smelly, pale, bulky; expect lots of gas with
look like? some diarrhea

6. The best food substitute are?  Corn and rice

CERBROVASCULAR ACCIDENT
(CVA)
1. Define the term CVA?  Reduction of cerebral blood flow and
oxygen causing brain cell damage.

19
 2. The three most common  Embolism, hemorrhage, thrombus
causes of CVA are?

3. What are the signs of a  Clients complain of headache, nausea,

CVA? nuchal rigidity, HTN, slow bounding pulse,
Cheyne-stokes respirations, speech changes,
facial droop

4. What is the difference  TIA is a temporary period of neurologic

between CVA and Transient deficit. It has similar signs as a CVA, but
Ischemic Attack (TIA)? symptoms will all resolve

5. What is agnosia?  Inability to use an object correctly

6. Expressive aphasia occurs  Client cannot communicate properly

when (Aphasia can be expressive or receptive)

7. If the left hemisphere is  Right side

affected, you will see
weakness on the

8. If the right hemisphere is  Left side

affected, you will see
weakness on the

9. Remember to place the  Unaffected side

client’s belongings on the

10. The test used to determine a  CT scan, EEG, and cerebral

CVA are?

11. What are the nursing  Monitor V/S, neuro checks, watch for
assessment? seizures, monitor for ICP, check ability to
swallow

12. What complication of the  Corneal abrasions because lacrimal glands

eyes can a client with a will not produce secretions
CVA have?

13. What is the activity level for  Strict bed rest

this client?

14. How should the room  Quiet, peaceful, with objects within reach
environment be? on unaffected side

20
 15. How do you position the  Turn q 2hrs on unaffected side, 20 mins on
CVA client? affected side, make sure to elevate affected
extremities

16. Why would a thrombolytic  To dissolve a clot

be given?

17. Do not give thrombolytics if  Hemorrhage

the cause is

18. What other Medication’s  Anti-hypertensive, anticoagulants (not for

may be prescribed to treat a hemorrhage stroke) and anti-convulsant
CVA?

19. The anticoagulants like  No, the only thing the blood; they do not
comedy in an aspirin dissolve clots
dissolve clots?

CHRONIC OBSTRUCTIVE PULMONARY

DISEASE
(COPD)
1. What are the three disorders  Asthma, bronchitis, emphysema
that make up COPD?

2. What are the  SOB with activity, wheezing, productive

signs/symptoms of COPD? cough, cyanosis

3. What would the ABG of a  Hypoxemia

client with COPD show?

4. What does the chest of a  Barrel chest

client with COPD look like?

5. What was the fingers of a  Clubbed

client with COPD look like?

6. Due to SOB with activity  Weight loss

clients may experience
_________ because of
difficulty eating

7. Why must you assess the  COPD keep a high level of CO2 in the
amount of O2 your COPD blood; breathing is controlled by this fact
client receives?
21
 8. A client with COPD should  2Lpm
not receive 02 by NC at
greater than?

9. Control the SOB, the _____  Pursed lip breathing

technique should be taught

CHRONIC RENAL
FAILURE
1. Chronic renal failure is  True
progressive and irreversible.
True or false?

2. What are possible causes of  Hypertension, DM 2, frequent infection,

CRF? renal/urinary obstruction

3. What signs/symptoms with  Decreased urine output, hypertension,

clients show? decreased urine specific gravity, fluid overload

4. What is uremic frost?  Urea crystals that came through the skin
with perspiration

5. Where would you see this  Face, underarms, groin; teach client to
frost? watch skin with plain water

6. What are the nursing  Modification of diet, give diuretics,

interventions for chronic Antihypertensives, monitor BUN and
renal failure? creatinine, daily weight

7. Clients may need _____ to  Dialysis

assist with waste removal

8. What is the best diet for  High carb, low protein; the goal of this diet
CRF? is to provide energy while decreasing protein
metabolism

COMPAZINE
(PROCHLORPERAZIN
E)
1. Compazine belongs to each  Phenothiazines
class of antipsychotics?

2. This drug in smaller doses  Nausea and vomiting

22
 can be used as an anti-
emetic, which means it
suppresses

3. It will make you ______, so  Drowsy

avoid driving and operating
heavy machinery

4. The routes of administration IM (decorate form)

are IV, IM, PO. Which route
last longer?

5. As with all antipsychotic  Extrapyramidal

drugs, clients may be
monitored for _____
reactions

6. What are extra pyramidal  Dystonia, tardive dyskinesia, akathisia

reaction?

7. What class of medication  Anti-Parkinson’s (ex: Cogentin-

can be given to decrease benzotripine)
extrapyramidal reactions?

8. What herbal medication is  Kava Kava

contra indicated with
Compazine?

CORTICOSTEROID
S
1. Most corticosteroids ends in  SONE

2. What are some examples of  Dexamethasone, Cortisone, prednisone

corticosteroids?

3. What are the primary  To decrease inflammation and hormone

functions of corticosteroids? replacement

4. What should you teach  To gradually decrease you; don’t abruptly

clients about stopping stop
corticosteroid therapy?

5. What must be monitored  Potassium level, glucose level, I and O

while the client is taking
23
 steroids?

6. Corticosteroid may cause  Cushing syndrome

symptoms of

7. Corticosteroids will also  Wound

delay ________ healing

8. If the client is NPO for  Yes, during surgery, stress and illness in the
surgery should you still give body increase the need for corticosteroids. In
the steroid? all other situations, do not take steroids an
empty stomach

CRANIAL
NERVES
What Nerve What it Controls

! Olfactory Sense of smell

II Optic Vision

III Occulomotor
IV Trochlear Eye movement
V Abducens

VI Trigeminal Sensation of the face

VII Facial Expressions of the face

VIII Acoustic Hearing and balance

IX Glossopharyngeal Gag and swallow

X Vagus Gag and parasympathetic

XI Spinal Accessory Back and neck muscles

XII Hypoglossal Tongue

1. The client is unable to  CN XI Accessory

shrugged his shoulders;
which nerve is
dysfunctional?
24
 2. Client is unable to smell his  CN 1 Olfactory
morning coffee; which
nerve is dysfunctional?

3. A client is an able to  CN VII Facial

distinguish between salty
and sweet taste; which nerve
is dysfunctional?

CROHN’S
DISEASE
1. Crohn’s disease is an _____  Inflammation
of the bowels

2. Can Crohn’s disease be  No, symptoms frequently will reoccur

cured with surgery?

3. Crohn’s disease affects the  True

digestive tract from the
mouth to anus. True or
false?

4. What are the symptoms of  Abdominal pain, diarrhea, weight loss

Crohn’s disease?

5. Excessive they are you will  Hypokalemia

cause what electrolyte
Imbalance?

6. What foods should be  Dairy products and high fiber meals, which
avoided and why? may worsen diarrhea

7. Crohn’s disease can lead to  Colon

what kind of cancer?

8. What are the treatment  Drugs and nutrition to reduce inflammation

goals?

CYSTIC
FIBROSIS
1. In cystic fibrosis, the _____  Mucous producing
or exocrine glands are
affected
25
 2. How does cystic fibrosis  The mucus will become thick and sticky and
abnormally change mucous cause obstructions
glands secretions?

3. What are the two systems  RESPIRATORY- Mucus gets trapped in

most affected by cystic the lungs
fibrosis?  DIGESTIVE- Mucus blocks the pancreas
and digestive enzymes, making the absorption
of nutrients a very difficult

4. What are other ways to  Chest x-ray, stool analysis, pulmonary

diagnose cystic fibrosis? function test

5. How does poor absorption  It causes steatorrhea( greasy, foul smelling,

of fight in the digestive tract pale stool)
change the appearance of
stone?

6. _________ are given with  Pancreatic enzymes

each meal to help with
absorption of nutrients

7. What is the most  High calorie, high protein

appropriate diet for cystic
fibrosis

8. ________ It’s a common  Postural drainage

technique used to clear thick
mucus from the lungs. This
is important for preventing
respiratory infections

9. What should parents already  They should get genetic counseling because
have a child with cystic cystic fibrosis is hereditarily
fibrosis do before having
another child?

DIABETIC TEACHING

1. Which type of diabetes is  Type 2 diabetes mellitus

controlled mostly by diet
and exercise?

2. Which type of diabetes is  Type 1 diabetes mellitus

26
 controlled mostly by
insulin?

3. What should you teach  Have HCP cut toenails;

diabetics about foot care?  Cut toenails straight across
 Inspect feet daily for sores
 Keep skin clean and dry

4. If a diabetic vomits after  Monitor blood sugar into not repeat the
taking PO insulin, what dose. The medication may have been absorbed
should they do?

5. How often should a diabetic  Yearly; diabetes can cause retinopathy

get an eye exam?

6. What is insulin  It is the result of not rotating SQ insulin

lipodystrophy? sites. If the client injects in the same place
repeatedly, a fatty mass will appear, decreasing
insulin absorption in that area. Each injection
site rotation

7. Do you need to aspirate if  No

injecting insulin SQ?

8. Exubera is an _____ insulin.  Inhaled

Exercising ______ blood
glucose  Lowers

9. Alcohol, oral  Lower

contraceptives, aspirin, and
MAOI ______ blood
glucose

10. Infection, dehydration,  Increase

stress, and surgery ______
blood glucose

11. What do you give when  Glucagon (IV or IM)

your client is hypo glycemic
and unconscious?

DIGOXIN (LANOXIN)

1. Why is digoxin prescribed?  To treat heart failure and arrhythmias

27
 2. Digoxin is a  Cardiac glycosides

3. Always hold digoxin if the  60bpm

heart rate is less than

4. What is the therapeutic  0.5-2 *greater than 2= TOXIC

blood range?

5. What are the signs of  Seeing yellow spots, nausea, vomiting, and
digoxin toxicity? abdominal pain

6. How is digoxin toxicity  Go to the below word; in severe cases, give

treated? activated charcoal or DIGIBIND

DIURETIC
S
1. What are the three ways  PO, IV, IM
diuretic can be given?

2. Why are diuretics  Chronic heart failure

prescribed?  Fluid overload
 Renal failure

3. When should clients take  In the morning to prevent nocturia

this medication?

4. Why should clients take  It’s taken in the evening; clients will be
diuretics during this time? going to the bathroom all night

5. What should the clients be  Dehydration, low K, hyponatremia, and

monitored for? weight loss

6. Loop and thiazide diuretics  Potassium, sodium, chloride

inhibits which electrolytes?

7. Lasix (furosemide) is a ____  Loop

diuretic

8. Thiazide diuretics are  Sulfa drugs

contraindicated in clients
allergic to?

9. ______ is an osmotic  Mannitol (Osmitrol)

diuretic used to reduce ICP

28
 10. Because money to decrease  Glaucoma
intracranial pressure, it can
also be used to treat

11. Mannitol crystallizes at  Filter

room temperature; you will
need a _____ needle to draw
up

12. Spironolactone (Aldactone)  Potassium

is a _____ sparing diuretics

13. Because Spironolactone  Hyperkalemia

helps the body retain
potential, the client i is at
risk for?

14. If your client’s K=3.0 and  Only give the spironolactone. The
Lasix and Spironolactone potassium is low and Lasix will only create
are bot ordered, how would more potassium loss
you proceed?

15. To accurately measure urine  Indwelling (Foley) catheter

output, a patient _____ may
be given

DONNING STERILE
ITEMS
1. Gather all the necessary 2. Wash and dry hands
supplies

3. Place package on dry waist- 4. Open package using outer 1 inch

high surface margin, facing gloves towards you

5. With two fingers on non- 6. Place glove on dominant hand

dominant hand, pick up cuff
of first glove

7. Slide gloved fingers into the 8. Place non-dominant hand into the
cuff of the other sterile glove, making sure not to touch the
glove outside of the glove

9. With both hands gloved,

touch only sterile area to
29
 adjust for comfort

EPIGLOTTITIS

1. What is epiglottitis and what  It is a lap of skin at the base of the tongue. It
does it do? opens and closes during breathing

2. What is the cause of  Haemophilus influenzae

epiglottitis?

3. Is this a virus or bacteria?  Bacteria

4. What is the usual age if  2-5 years old

children who get
epiglottitis?

5. What are the signs of  3D’s (Drooling, dysphagia, dysphonia- no

epiglottitis? voice)

6. What will the child look like  Sitting upright; tongue protruding; drooling;
during an episode of shallow rapid breathing
epiglottitis?

7. Can epiglottitis be treated at  No, child must go to the hospital

home? immediately

8. When assessing the airway  NO, never put anything in the mouth to
can you use a tongue assess
depressor or tongue blade?

9. If the child cannot breathe,  Intubation

what might be done?

10. What medication will be  Antibiotic therapy

given to treat epiglottitis?

11. How can epiglottitis be  By getting the H. Influenza vaccine

avoided?

GENITAL
HERPES
1. How is genital herpes  Through sexual contact or during birth
30
 spread?

2. What are the symptoms for  Painful, vesicular lesions

males?

3. What are the symptoms for  Painful, vesicular lesions

females?

4. Are these lesions always  No, they come and go

present on the body?

5. If lesions are present in a  CS

pregnant woman, how
should she deliver?

6. What triggers outbreaks of  Stress, anxiety, high emotions

genital herpes?

7. How often should a woman  Every 6 months

with herpes get a pap
smear?

8. Can genital herpes be  No cure. Acyclovir

cured? What is the
treatment?

GLAUCOMA

1. How does glaucoma affect  Blurry and tunnel vision noted.

vision? There will be halos around light.

2. This condition can be acute  Increase IOP

or chronic due to

3. ______ is the simple,  Tonometry

painless procedure used to
measure IOP

4. What are the two types of  Open and closed angle

glaucoma

5. Which one is painful?  Closed angle is painful and also the most
common

31
 6. State the class of drug used  Miotics
to constrict the pupil and let
aqueous humor flow.

7. Give an example of miotic  Timoptic or pilocarpine

8. Why might diuretic be given  To decrease aqueous humor production

to clients with glaucoma?

9. What diuretic is usually  Mannitol (Osmitrol) because it is an osmotic

prescribed? diuretic

10. Never give ______ because  Mydriatics

they dilute the pupil

11. If surgery is required, what  Hemorrhage

should you monitor for post-
op?

12. What post-op teaching  No straining, heavy lifting, crying, or

should be done? rubbing eyes

IMMUNIZATIONS

Birth Hep B1

2 months Hep B2, DTap, Hib, IPV, PCV

4 months All 2 months immunization except Hep B

6 months All 2 months immunizations

12 months MMR1, Hib, PCV, Varicella

1. Tetanus and diphtheria are  2 months

optional vaccinations; what
is the earliest age they can
bi given?

2. What is a booster shot?  An additional dose of vaccination to

increase effectiveness.

3. What are the side effects of  Low-grade fever, tenderness, swelling at the
32
 immunization? site, child may become irritable

4. What medication should be  Tylenol (Acetaminophen)

given for these effects?

5. Never give ________ to  Aspirin

children experiencing these
effects

6. When should the meningitis  Before going to college

vaccination be given?

7. If an adult woman receives  Wait three months before pregnancy

MMR shot, what should you
teach her?

8. How soon can a child get  Not until 6 months

influenza vaccination?

9. Do not give MMR if the  Eggs or Neomycin

client is allergic to?

10. Do not give the influenza  Eggs

vaccination if the client is
allergic to?

11. What is active immunity?  Stimulating the body to produce antibodies

by giving vaccines

12. What is Passive immunity?  Antibodies that are formed in another body
but passed down for short-term use (ex. Breast
milk)

INFLAMMATORY BOWEL
DISEASE
Two Primary Types

Crohn’s Disease Ulcerative Colitis

Anywhere int the digestive tract Primary colon

from mouth to anus

33
3-4 semi-soft stools, no blood, Bloody diarrhea
anorexia, fistulas Weight loss
Location
Associated with smoking Non-smokers

Anti-inflammatory steroids Anti-inflammatory steroids Signs

NPO status- bowel rest NPO status- bowel rest
Surgery will not help; disease will Surgery to remove affected Lifestyle
reoccur area

INCENTIVE SPIROMETRY Treatment

1. Incentive spirometry is a  Deep breathing

method of?

2. Instruct the client to place  Lips

____ tightly around the
mouth piece.

3. Incentive spirometry is used  Atelectasis

after surgery to prevent?

INCREASED ICP

1. What is the normal ICP  5-15 mmHg

range?

2. What are the common  Trauma, hemorrhage, edema, tumors

causes of ICP?

3. What do you asses?  Level of consciousness (it decreases as ICP

increases)

4. This is the earliest sign of  Decreased level of consciousness

ICP?

5. The client will often appear?  Restless, agitated, complaining of headache

6. What will babies physically  Bulging fontanelles

present with?

7. Late signs of ICP are?  Unilateral pupil dilation, hypotension,

bradycardia

34
 8. Clients may complain of?  Projectile vomiting without nausea

9. How will the V/S appear  Increase BP, temp, HR

with ICP?  Increase then decrease RR

10. What is widening pulse  When systolic blood pressure goes up and
pressure and how is it diastolic continues to go down so that they
related? become further apart (ex. 135/40 is a bad sign)

11. What is Cushing’s Triad?  Three things; widening pulse pressure,

Cheyne stoke respirations, and bradycardia

12. Initiate what precautions?  Seizure

13. Elevate head of bed to?  10-30 degrees, to promote jugular venous
flow

14. What medications will be  Anticonvulsants

prescribed?  BP meds
 Corticosteroids
 Diuretics

15. Tell the client not to  Strain, cough or sneeze

INSTILLATION OF EAR
MEDS
1. Medication should be _____  Room- too hot or cold will have side effects
temperature? of nausea, dizziness

2. What position should the  Supine, with the affected ear up

client be in when receiving
ear medication?

3. When administering ear  Up

meds to an adult, draw the
pinna back and?

4. When administering ear  Down

meds to an adult, draw the
pinna back and?

5. How long should the head  5 minutes

be tilted to allow meds to
travel the ear canal?
35
 INSTILLATION OF EYE
MEDS
1. When giving eye meds, do  Apply pressure
this to prevent meds from
going into the nasal passage

2. Pull the _____ eye lid down  Lower, cheek

against the _____.
Squeeze the drop in the  Conjunctival sac

3. If more than one drops is  3-5 minutes

prescribed, wait ______
minutes before applying
another drop

4. Do not let the ____ touch  Medication bottle, eyeball

the ____

IV THERAPY

1. Why are IV fluids used?  They are quick way to replace nutrients,
water, and electrolytes

2. What are the three types of  Isotonic, hypotonic, hypertonic

IV fluid?

3. Describe isotonic fluid/give  Isotonic fluid is the same as the inside of the
example cell
 -.9% NSS, LR, D5W

4. Why would you give  DKA, burns to replace Na and Cl

isotonic fluid? *0.9% NS always hung with blood**

5. Describe hypotonic/give  Hypotonic fluid is less concentrated than the

examples cell. This would cause water to move into the
cell
 0.45% NSS

6. Why would you give  DHN, Hypernatremia; lowers BP

hypotonic fluid?

36
 7. Why should this fluid be  Because rapid increase in fluid shifting into
monitored closely? the cells can cause cellular and cerebral edema

8. Describe hypertonic  Hypertonic fluid is more concentrated than

fluid/give example cell. This would cause water movement out of
the cell.
 5% NS, D5%NS, D5%LR

9. Why would you give  Hyponatremia, nutrition

hypertonic fluids?

10. Why should this fluid be  Because it can cause electrolyte imbalance
monitored? and DHN

11. Before you start IV fluids,  IV- make sure it is patent

assess clients

12. If the IV is infiltrated, what  Cool, swollen, tender, painful at the site
would you see?

LAMINECTOM
Y
1. Surgery is the removal of  Bone
_______ so the spinal cord
can be seen

2. To move the client after  Log roll

surgery, _______ this client

LEAD
POISONING
1. What is the highest risk  Age; younger kids put things in their mouth
factor in ingesting lead?

2. What is the most likely  Lead paint chips

ingested item to cause lead
poisoning?

3. The most dangerous side  Mental retardation

effect of ingesting lead is

4. What are the signs of lead  Signs are more serious if greater amount is
poisoning? ingested: headache, abdominal pain, fatigue,
37
 muscle weakness, and respiratory depression

5. How do you treat lead  Chelating agents

poisoning?

6. How are these agents given?  By receiving many IM injections

7. Do not give ____ to induce  Ipecac

vomiting

LEGAL ISSUES

1. Negligence is when a nurse  Not provide appropriate care according to

does set standards

2. If a nurse does a treatment  Battery

without consent, it is an
example of?

3. If you client falls out of bed  Neglect

because you forgot to put
the side rails, this is?

4. Any NCLEX question that  Assault

has the word “threat”,
“think”?

5. Advanced directives are  Allow the client to direct how/what care

important because they they are to receive if they become unable to
make decisions

6. Are advance directives  NO

mandatory for a client?

7. The document that  Durable power of attorney

specifically names a person
to make decisions on
another person’s behalf is

8. The client must be _____ to  Sound mind

write a will

LUNG SOUND

38
 1. What is the cause of  Fluid or secretions in the airway
crackles?

2. When do you hear crackles?  On inspiration (sound like rice krispies in

milk)

3. What are some possible  Pneumonia, edema, or bronchitis

causes of crackles?

4. What is another name for  Rales

crackles?

5. What are the characteristic  High-pitched musical sounds

of wheezes?

6. When do you hear wheezes?  On inspiration and expiration

7. What are the possible cause  Asthma, smoking, allergic reactions

of wheezing?

8. Wheezes can be heard  Stethoscope

without a ?

9. What are the characteristics  High-pitched harsh sound heard in UPPER

of stridor? airway

10. What is the cause of stridor?  Laryngeal spasm or swelling, croup and
epiglottitis

11. Stridor is often confused  Wheezing

with?

12. Which age group is stridor  Children

often seen?

LYME
DISEASE
1. This type of infection is  Bite from a tick
caused by?

2. How long after a bite can  Between 4-6 weeks after the bite
you test for this disease?

3. What is the treatment plan?  Take antibiotics-

39
 *DOXYCYCLINE (adults)
*AMOXICILLIN (children)

MASLOW’S
HIERARCHY
1. What are the most important  Physiological needs
factors in order?  Safety and security
 Love and belongingness
 Self-esteem
 Self-actualization

MASTECTOMY

1. This surgery is done to  Breast tissue or nipple

remove?

2. After surgey, ____ the  Elevate, lymphedema

affected arm to prevent?

3. No ____ in the affected arm  BP, venipuncture

4. Always assess site for signs  Infection

of _____ after surgery

5. Late signs of infection  Swelling, redness, fever, chills, elevated

WBC count

6. Encourage client to do  Self-breast exam

_____ on the remaining
breast

MEDICATION
ADMINISTRATION
1. What are the six right of  RIGHT: client, medication, documentation,
medication administration? time, dose, route

2. What 2 verifiers do you ask  Name and birthdate

client before giving a meds?

3. Do not give a medication if  You don’t know what it does. Trust me,
clients ask! If you can’t give them answer, then
they won’t trust you!
40
 4. Do not store medication  At the bedside

5. Can you give meds prepared  No, never do this! It is illegal.

by another RN?

6. What does It mean if a  It means give only when needed

medication is PRN?

7. Do not _____ sustained-  Crush

release capsule or enteric-
coated tablets

8. What should a nurse do if  Notify the HCP, DO NOT document int the
he/she administers wrong client’s chart and complete an incident report
med? form. These are not part of the client’s record.

MENIERE’S
SYNDROME
1. What are the symptoms?  Tinnitus, unilateral hearing loss, and
dizziness

2. What are the causes?  Viral, bacterial infections, and allergic

reactions

3. Describe Meniere’s attacks?  Severe, sudden attacks that may cause

permanent hearing loss. Nausea and vomiting
can also be present.

4. What is the best  Bed rest in a quiet room, moving head

environment for a client slowly, sedatives can be given to keep client
with this syndrome? calm. Low-playing music helps with tinnitus.

5. What should the diet be?  Low Na

6. Is surgery needed>  In severe cases a removal of the labyrinth

(or labyrinthectomy) is performed

MENINGITIS

1. What is meningitis?  Inflammation of arachnoid and pia mater of

the brain/spinal cord

2. How is it transmitted?  Direct contact and droplet

41
 3. What are the S/Sx?  Nuchal rigidity, tachycardia, headache,
N&V

4. Meningitis can also cause?  Increased ICP

5. What two physical signs are  Positive Kernig’s and Brudzinski

positive?

6. What are the nursing  Monitor LOC, vitals, initiate seizure prec,
interventions? maintain isolation, elevate HOB

7. What meds are prescribed?  Antibiotics and analgesics

MONGOLIAN SPOTS

1. What are these spots look  Bluish-black spots on body

like?

2. Where can you find these  On the back and buttocks of newborns
spots?

3. In what race are these spots  Asian and African American

mostly seen?

4. Are they harmful and how  No. They are normal in newborns and they
long do they appear? gradually fade over time

MULTIPLE
SCLEROSIS
1. True or false? MS is a  True
chronic progressive
degenerative disease of the
NS?

2. What part of the NS is  The problem with demyelinization of the

affected? matter of the brain and spinal cord

3. Is there a cure for MS?  None

4. What are the signs of MS?  Muscle spasms, weakness, bowel/bladder

dysfunction, numbness in the extremities, and
visual disturbances

42
 5. What meds will be given for
spasm?
6. What med will be given to
reduce the amount of time a
client experiences
exacerbated symptoms?
7. If you were at a MS
conference, what would you
teach?
MUNCHAUSEN
SYNDROME
1. What is the definition of this
syndrome?
2. What is Munchausen by
proxy?
3. Noted for NCLEX
MYESTHENIA GRAVIS
1. True of false? MG is an
autoimmune disease that
results in extreme fatigue
and muscle weakness?
2. What is the malfunction in
the body?
3. Is there a cure for MG?
43
 Baclofen (Lioresal)
 Corticosteroids
 Start regular bladder bowel program
 Avoid stressful situations
 Eat a well-balanced diet
 Initiate speech/physical therapy
 Remove safety hazards in home
 A psychiatric disorder that causes a person
to self-inflict injury/harm to his/her own body.
The person may also say that he/she has a
mental disorder.
 An individual, typically a mother,
intentionally causes or makes up an illness in
child under care for attention
 The child will have issues with no explained
etiology. Treatment of the issue does not help.
Assessment indicate child is healthy, symptoms
get better when child is away from the
caregiver.
 Nursing priority: Protect the child!
 True
 There are decreased levels of acetylcholine
present
 None
 4. What are the S/Sx?  Difficulty talking, chewing, weak eye
muscles, visual disturbances, unsteady gait

5. Do symptoms of MG  Yes, they do

worsens with activity?

6. The _______ test is  Tensilon

performed to diagnose MG

7. If the client’s muscle is  Positive

increased, the test is ____
for MG

8. What meds will be given?  Anticholinesterase/Plasmapheresis

9. What would you teach a a  Take meds 30 ins before eating, cough/deep
MG conference? breath, exercise, conserve energy by doing
multiple short tasks. Try to decrease stress,
infections, and unhealthy habits

MYOCARDIAL
INFARCTION
1. What is the cause of an MI?  Decreased O2 supply in the heart

2. Where is the pain felt?  Substernal (sudden, crushing radiating to

jaw, shoulders, and back) and lasting longer
than 30 minutes

3. My pain is not relived by  Rest or nitroglycerine

______ or _______

4. What changes would you  ST elevation, inverted T waves

see on an EKG?

5. What lab values will be  CK-MB, CPK, Troponin, LDH, WBC

elevated?

6. What meds are given for  M.O.N.A

MI?  Morphine
 O2
 Nitroglycerine
 Aspirin

7. What activity is prescribed  Bed rest

44
 for this client?

8. What is angina pectoris?  Chest pain d/t heart not receiving enough
O2

9. Where is the pain located?  The same area of the chest as seen in MI

10. What are the common cause  Early morning activity (shoveling snow),
of angina? heavy meals, stress, exercise, and smoking

11. How is stable angina  Chest pain that has a typical onset, location,
different from an MI? lasts for 3-5 mins and is relieved by
Nitroglycerine/rest

12. What is unstable angina?  It is chest pain that occurs while the client is
resting

13. How is angina diagnosed?  Cardiac cath, coronary artery bypass,

exercise/thallium stress test, EKG with no ST
elevation

14. What should you teach a  How to take Nitrogly for pain (can take up
client who has an angina? to 3 tabs SL)
 Diet and modification (Low cholesterol)
 Exercise
NEOMYCIN SULFATE
 Stop smoking

1. What is it?  It’s an aminoglycoside- reduce the number

of bacteria in the colon

2. Why does it matter?  It’s given for the GI tract before surgery

3. How is it used in clients  It is used to treat this disease when ammonia

with hepatic levels are elevated in the liver
encephalopathy?

NEUROLEPTIC MALIGNANT
SYNDROME
1. When does this syndrome  It could occur any time a client is on anti-
occur? psychotic meds, most commonly when
treatment begins or doses are increased

45
 2. What are the signs of NMS?  Tachycardia, extreme fever, altered LOC,
seizures, muscle rigidity, elevated lab values
(WBC, LFT)

3. What is the treatment?  Discontinue meds. Initiate safety and

seizure prec. Give antipyretics to reduce fever.

NG TUBE

1. What position should the  High-fowlers with head tilted forward

client be in during NG tube
placement?

2. The NG tube goes from?  Nose to stomach

3. What is a Salem sump?  Double lumen of NG tube used to

decompress the stomach

4. What are the measuring  Tip of the nose to earlobe to xiphoid process
points for determining
length of insertion?

5. If the client starts to gag  Yes, wait until patient stops

during placement, should gagging/coughing, then continue to advance;
you continue the procedure? offer water to help the tube go down

6. What should be done before  X-ray, aspirate for gastric content (pH
using NG tube for the first should be >4)
time?

7. If the NG tube is to suction,  Yes, for at least 30 mins

should you turn off the
suction when meds are
given PO?

8. If a patient vomits during  Yes, wait for a few minutes, then proceed.
the procedure, should you Let the patient know that they will feel better
keep going with the NG once the NG is in place.
tube?

NITROGLYCERI
N
1. What is the action of  Systemic/coronary vasodilation
46
 nitroglycerin?

2. What conditions are treated  Angina, BP, CHF

by nitrogly?

3. If Nitrogly is given Give an additional tablet in 5 mins. You can

sublingually for angina pain give up to 3 tablets over 15mins.
and it is not relievd, what  Activate EMS after first dose
should you do?

4. If Nitrogly is given SL and  Yes, it means the tablet is fresh

the client complains of a
stinging sensation, is that
normal?

5. What is the number one  Headache

complaint when taking
Nitrogly?

6. What are the common S/E?  Hypotension, tachycardia, dizziness, and

syncope

7. If a client has on a  Yes, to prevent skin irritation

transdermal ointment or
Nitrogly patch, should you
rotate sites during
application?

8. Do not place a Nitrogly  Pacemaker

patch over a

9. You should take off the  MRI scan

client Nitrogly patch before
having a?

10. Should a client take  Yes, to prevent chest pain

Nitrogly prophylactically
before sex?

11. If your male client is taking  Don’t take with Nitrogly

Viagra (Sildenafil), what
should you tell him?

12. IV Nitrogly and all IV  Infusion pump

dysrhythmics should be
47
 placed on an?

13. What is Verapamil (Isoptin)  Blood pressure and angina

used for?

NSAIDs

1. What does it stand for?  NSAIDs

2. What type of drugs are  Aspirin and aspirin-like drugs

they?

3. What do they do?  Reduce pain and body temp, and inhibit
platelet aggregation

4. Clients should take NSAIDs  Water, milk

with a full glass of ______
or ______ to prevent
stomach irritation.

5. Aspirin toxicity will cause  Tinnitus

______ in the ears.

6. Teach clients to avoid  Alcohol

_____ when taking NSAIDs
to decrease stomach
irritation.

7. NSAIDs increase/decrease  Increase

bleeding potential.

8. How soon should a client  1 week

stop taking NSAIDs before
having surgery?

9. Kids shouldn’t take  Reye’s syndrome

NSAIDs when they have
flu-like symptoms d/t risk
of?

ORTHOSTATIC
HYPOTENSION
1. What is it?  Systolic or diastolic BP drops more than
48

2. How will client feel?
3. How to assess for
orthostatic hypotension?
4. What is the treatment?
OSTEOARTHRIT
IS
1. What is osteoarthritis?
2. Osteoarthritis is the ____
form of an arthritis seen in
elderly
3. What joints in the body are
most affected?
4. What are the S/Sx of
osteoarthritis?
5. Is the pain from
osteoarthritis relieved by
activity or rest?
6. Hard nodes will develop on
the joints of the fingers,
creating deformities. may
What is this called?
7. What is the primary
medication given for pain?
8. _______ may be injected
into the joints to treat
osteoarthritis. What should
you teach the client
concerning activity?
49
10mmHg and HR increases by 10-20 when
client changes position (lying, sitting, and
standing)
*BP down, HR up
 Dizzy, light-headed, unsteady
 Check BP while client is lying down, sitting
up, and standing. Wait 5minutes between
measurement
 IV fluids for volume replacement
 Degenerative disease of the joints
 Number one
 Weight- bearing joints- knee, hips, fingers,
back
 Limited joint mobility, joint pain, joint
stiffness
 Rest
 Heberden’s nodes
 NSAIDs
 Corticosteroids
 Exercise- stop if pain occurs
 Try to lose weight to help take stress off
joints
 Use hot/cold therapy to help with pain.
 Assistive devices (canes, braces) will help with
mobility

9. What surgery may be  hip/knee replacements

required?

OTITIS
MEDIA
1. This is an infection of the?  Middle ear

2. Why are children more  Because their Eustachian tubes are shorter
prone to this? than those of adults

3. What are the signs?  Fever, loss of appetite, rolling head from
side to side (promotes ear drainage)

4. What is the treatment?  Analgesics and antibiotics

O2 DELIVERY
SYSTEMS
1. What is the range of the  Flow rate from 1-6Lpm
flow rate for nasal cannula?

2. Why keep O2 flow rate  Nares and mucosa dry out when the rate is
below 6Lpm? high

3. What are the benefits of  Client can still eat, drink, talk
using a nasal cannula?

4. How often should the nasal  Every day

cannula be changed?

5. What should be inspected  Skin on face, nares, ears

daily d/t irritation?

6. What is the flow rate range  6-10Lpm

for a simple mask?

7. When applying the mask,  Make sure it fits properly, covering mouth
what must be done? and nose

8. Clients wearing face mask  Claustrophobic

may feel

50
 9. What makes a Venturi mask  It allows you to control how much room air
different from a regular face you want to mix with O2
mask?

10. Always use Venturi mask  COPD because you want the specific O2
for clients with concentration

11. A partial rebreather mask  Reservoir bag

looks like a face mask with
a _______ attached it

12. Like the other forms of O2  Room air, pure oxygen

delivery, the partial
rebreather allows ________
to mix with _______

13. The reservoir bag should be  At all times (important point!!!)

inflated when?

14. The non-rebreather mask  Room air

does not allow ______ to be
inhaled

15. How would you assess to  Pulse oximetry, client’s RR and pattern,
see if the O2 delivery ABG
system is effective?

16. Do not use _____ for a  Petroleum jelly can set the client’s face on
moisturizer fire! Use water-soluble jelly

PACEMAKER
S
1. What do they do?  Conduct electrical activity and maintain HR

2. If you were at a conference  Check pulse daily

on a pacemaker, what
should you teach?
 Avoid large magnetic field (MRI, industrial
equipment)
 Household appliances are okay.
 Avoid contact sports
 Report signs of dizziness, fatigue, or SOB to
HCP

PANCREATITIS

51
 1. What is the number one  Alcohol abuse
cause of acute pancreatitis?

2. What are the symptoms?  Abdominal pain, nausea, vomiting, board-

like abdomen
 Skin discoloration
*Cullen’s sign- ecchymosis on the umbilicus
*Grey Turner’s sign- ecchymosis on the flank
area

3. Does eating make the pain  Worse, especially fatty foods

better or worse?

4. What liver enzymes are  Lipase and amylase

elevated with pancreatitis?

5. What are the nursing  Make client NPO

interventions?  NG tube to decrease gastric distention, IV
fluids, antacids
 Teach client to stop drinking

6. How do you treat the pain?  Demerol or Dilaudid

7. Never give this for pain.  Morphine; it was thought to cause spasms in
Why? the pancreatic duct and sphincter of odi

PARACENTESIS

1. This is an invasive  Informed consent

procedure. Make sure the
client has

2. This procedure collects fluid  Peritoneal cavity of abdomen

from where?

3. What to do before  Measure abdomen, weigh, and take V/S.

procedure? Have client void to empty bladder

4. What position should the  Sitting on edge of bed

client be in during this
procedure?

5. What do you do after the  Monitor V/S, measure fluid collected, apply
procedure? sterile dressing to insertion site and monitor
52
 bleeding
 Make sure urine is not bloody

PARKINSON’S
DISEASE
1. This disease is caused by a  Dopamine
depletion of?

2. What are the signs of  Bradykinesia, tremors in hands and feet at

Parkinson’s disease? rest, rigidity, shuffling steps, loss of balance

3. Is this disease process fast  Slow, progressive

or slow?

4. What are the nursing  Assess neuro status and swallowing ability,
interventions? safety, assist with ambulation, encourage
fluids, high-calorie and fiber meals, low-
protein diet

5. What meds are prescribed?  Anti-Parkinson’s, Anti-cholinergic

6. When taking anti-  Fiber, constipation

cholinergic, clients should
increase ________ to avoid
_____

7. What other side effects of  Blurred vision, dry mouth, photophobia,

anti-cholinergics? tachycardia

8. What meds will be given to  Levodopa or Carbidopa-levodopa

replace dopamine?

9. Do not take dopamine  MAOIs

replacement meds with
_____, as this may cause a
HTN crisis

10. Teach clients taking  Low protein diet

Parkinson’s drug to follow
what diet?

11. What vitamins should be  B6- which blocks the medication effect
avoided in the diet?

53
 PEPTIC ULCER
DISEASE
1. What bacteria is responsible  H. pylori
for most peptic ulcers?

2. Where are most peptic ulcer  Gastric and duodenal

found?

3. When a client has ulcers,  *Coffee ground

what will the vomit look
like?

4. When a client has ulcers,  *Black tarry

what will the stool look
like?

5. What meds should be  NSAIDs

avoided?

6. Is Tylenol (acetaminophen)  No
a NSAID?

ULCERS
GASTRIC DUODENAL

Stomach Duodenum Where are the

ulcers?

No, normal production Yes, increased production Does stomach acid

increase?
Where does the
Mid-epigastric region Mid-epigastric pain pain occur?
When does the pain
With meals or after eating On an empty stomach occur?
“starve a gastric ulcer” “feed a duodenal ulcer”

7. What type of meds will be  H2 blockers and PPI

given to decrease gastric
acid production in duodenal
ulcers?

54
 8. What are the meds example  Zantac (Ranitidine)
of H2 blockers?  Tagamet (Cimetidine)

9. What are meds examples of  Generic ending in “zole”

PPI?  Nexium (Esomeprazole)
 Protonix (Pantoprazole)
 Prilosec (Omeprazole)

10. ______ are prescribed to  Antacids

neutralize gastric acid.

11. What should you teach  Smoking and alcohol

clients with ulcers to avoid?

PERIPHERAL ARTERIAL DISEASE

(PAD)
1. PAD Is an occlusive disease  Lower extremities
of the

2. Does the damage to  Below

surrounding tissue occur
above or below arterial
occlusion?

3. Would you feel a pulse in  No, it would be absent

leg with PAD?

4. What would the leg look  Hairless, cool, pale, thick toenails
like?

5. What is intermittent  Muscle pain from decreased blood supply;

claudication? pain comes and go

6. Teach client not to?  Smoke, wear tight clothes, apply directly to
legs

7. Teach client to?  Exercise, inspect skin daily, take prescribe

meds

8. What procedures improve  Bypass surgery, angioplasty

PAD?

9. What does a leg with a  Brown/purple discoloration, edema,

venous occlusion look like? weeping fluid
55
 PHEOCHROMOCYTOM
A
1. A tumor that produces an  Epinephrine, norepinephrine
excessive amount of?

2. This is a problem with what  Adrenal gland

gland?

3. Clients will experience?  Sustained hypertension, H/A, sweating,

weight loss, hyperglycemia

4. Treatment for  Surgical removal of one or both adrenal

pheochromocytoma is? glands

5. What will the patient need  Glucocorticoid replacement

to take after surgery?

PHLEBITIS

1. What is phlebitis?  Inflammation of vein

2. Does it look like?  Read, warm, painful area, streaks up the arm

3. What is the treatment for  Remove the IV, apply warm towel, assess
this? for infection

PIAGET’S THEORY of
COGNITIVE BEHAVIOR

Age/stage Characteristics

Birth to 2 years – Sensorimotor Child learns about reality by interacting with

his/her environment

2 to 7 years- Preoperational Moves on to pretty logical thinking; learns

past, present, future. No abstract thinking yet

7 to 11 years- Concrete Moves logical thinking: able to classify and

sort facts. Abstract thinking available

11 to adults- Formal Able to think and learn as an adult; concrete

and abstract reasoning
56
 PLACENTA PREVIA vs ABRUPTIO
PLACENTA
1. What is abruptio placenta?  When the placenta detaches itself from the
uterine wall

2. What is placenta previa?  The placenta is covering or near the cervix,

blocking opening to vagina

Signs Risk factors Dangers Nsg Intvns

Sudden, HTN, Decreased O2 Bed rest
Abruptio painful Diabetes, and nutrients to CS is baby is term
placenta bleeding with smoking, the fetus Frequent vitals
contractions alcohol Blood transfusion
Premature birth
and uterine (ETOH) may be needed so
tenderness abuse,
Blood clots type and cross match
drug abuse mother

Sudden,
painless, Previous Maternal Bed rest
bleeding, CS, multi hemorrhage C-section if baby is
Placenta bright red in term
parity, older Premature labor
Previa color Frequent vitals
Usually seen
age mother
Blood transfusion
in third may be needed so
trimester type in crossmatch
mother

3. Both conditions will require  Frequent vitals

what 3 interventions?  Fetal UTZ
 Fetal heart monitoring

4. Which condition has more  Placenta previa

bleeding?

5. Which condition will create  Abruptio placenta

a rigid board-like abdomen?

6. Abruptio placenta causes  Disseminated intravascular coagulation

which blood clotting
disorder?

7. If a pregnant client is  Vaginal examination

57
 bleeding vaginally, what
must you NEVER do?

PLEURAL
EFFUSION
1. Pleural effusion is the  Fluid
collection of what in the
pleural space?

2. What are the signs?  Sharp pain on inspiration, SOB, tachycardia,

decreased breath sound
 X-ray needed to confirm

3. What is the treatment?  Find the cause, monitor breath sounds, high-
fowler’s position,
 Thoracentesis

4. After thoracentesis is  Chest tube

performed, what may be
needed temporarily?

5. What medication do you  Diuretic

give if the fluid is not a
large enough amount to
perform a thoracentesis?

POLYCYTHEMIA
VERA
1. What is polycythemia vera?  Disorder that results in increased number of
Erythrocytes, Leukocytes, and Platelets
 Result= thick blood

2. What will the client  Headache, SOB, weakness

complain of?

3. On assessment, what will  Purple/red complexion, enlarged spleen,

you find? increase Hgb

4. What is the main treatment?  Phlebotomy (blood draws several times a

year)

POST TRAUMATIC STRESS DISORDER

(PTSD)
58
 1. What causes PTSD?  Any traumatic event can cause PTSD

2. What are the signs  Nightmare, anxiety attacks, sleep

associated with PTSD? disturbances, memory loss, or hyper vigilance

3. These clients will often  True; patients will isolate themselves

seem detached. True or
false?

4. Clients with PTSD are at  Substance abuse

increased risk for?

5. What is the treatment for  Therapy to discuss feelings

PTSD?  Anxiety/depression meds
 Support groups

PREGNANCY
STUFF
1. RhoGam is given to  Negative, positive
pregnant clients who are Rh *RhoGam prevents the mom from developing
______ but whose baby is antibodies against future Rh-positive babies
Rh __________

2. When is RhoGam given?  28wks gestation and within 72hrs after

delivery (given twice)

3. Do you give RhoGam if the  Yes, if pregancny is >13 weeks

client has a miscarriage?

4. Do you give RhoGam to  No, never nor to the father

infant?

5. What are Tocolytics?  Drugs given to stop preterm labor

6. What is the mnemonic used  It’s Not My Time

to remember the four drugs
that can be used for preterm
labor?

7. What drugs do the letters  Indomethacin (NSAID)

stand for?  Nifedipine (CCB)
 Magnesium Sulfate
 Terbutaline

59
 8. When giving these meds,  FHR/maternal vital signs
what must you monitor
closely?

9. Magnesium sulfate will  Urine output, deep tendon reflexes, and

decrease? respiration

10. If a client is given  Tachycardia

Terbutaline, watch out for?

11. What two drugs do you  Quinolones, Tetracyclines

never give to pregnant
client?
Think “Two QTs say no to OB’s”

12, The umbilical cord of newborn  2 arteries, 1 vein

contains?

FETAL HEART
RATE
Variable decelerations Cord compression

Early decelerations Head compression

Accelerations Oxygenation is Ok

Late decelerations Placental insufficiency (bad sign)

PRESBYCUSI
S
1. This is a form of?  Hearing loss

2. Is Presbycusis a natural  Yes

process?

3. What voice tones are  High tone

hardest to hear?

4. How should the nurse  Facing them, encourage to wear hearing aid
communicate with the
client?

60
 PRESSURE
ULCERS
1. How would you describe a  Red, warm, intact skin that doesn’t blanche
stage 1 pressure ulcer?

2. What is an example of a  Looks like a sunburn

stage 1 pressure ulcer?

3. How would you describe a  Superficial damage to the skin (epidermis or

stage 2 pressure ulcer? dermis)
 There will be a break in the skin

4. What is an example of a  Abrasion, blisters, shallow craters

stage 2 pressure ulcer?

5. How would you describe a  Skin is deeply damaged, wounds show

stage 3 pressure ulcer? muscles, tissues, and ligaments

6. What are the nursing  Turn pt q 2hrs

interventions to prevent  Keep skin dry and clean
pressure ulcers from  Proper diet and hydration
developing?  Inspect skin and document

RADIATION
THERAPY
1. What are the types of  External (outside body)
therapy?  Beam and sealed
 Internal (inside body)

2. What are the side effects?  Alopecia, fatigue, skin irritation

3. Clients receiving beam  Unsealed soap, water; pat dry

radiation should wash area
with?

4. Clients receiving radiation  Private room and bathroom

therapy needs?

5. No to visitors who are?  Pregnant or small kids

6. Can a woman with removed  Yes, 7-10 days after removal

cervical implant have sexual
intercourse?
61
 RAYNAUD’S
DISEASE
1. What is it?  Vasospasm of arteries of the upper/lower
extremities

2. What body parts are most  Fingers, toes, and cheeks

affected?

3. What does the client feel?  Numbness, tingling, and swelling; area may
feel cold

4. What are the treatments?  Monitor pulses, vasodilators, avoid cold and
stress, quit smoking, wear warm clothes

RETINAL
DETTACHMENT
1. Will clients experience pain  No, it is painless
if the retina detaches?

2. Is this a serious condition?  Yes, this is an emergency

3. What are the signs of  Blurred vision, floaters, flashes of light,

detached retina? black spots

4. What is the treatment for a  Surgery to attach retinas

detached retina?

5. What are the nursing  Cover both eyes with patches

interventions?  No coughing, sneezing
 Strict bed rest
 Keep head of bed elevated

RHEUMATOID
ARTHRITIS
1. True or false? RA is a  True
chronic systemic
inflammatory disease that
affects the joint?

2. What are other symptoms  Fatigue, wt loss, low grade fever

associated with RA?

62
 3. Is there a particular age  No, it can occur at any age
group that is affected?

4. What factor will be found in  Rheumatoid fever

the blood of a clients with
this form of arthritis?

5. What else will be elevated  Joints in the hands, wrists, feet, elbows,
in the blood shoulders

6. Due to inflammation of the  Joint deformities

synovial membranes, which
damages cartilage, what is
seen>

7. What is the primary drug  NSAIDs

therapy?

8. Should you encourage this  Yes, activity helps the pain

client to exercise?

SEIZURE
PRECAUTIONS
1. If your child is having a  To keep the client safe
seizure, what is the main
goal?

2. True or false? You should  True

mark the time and note the
client behavior

3. Should you restrain a client  No, do not restrain

for safety during seizure?

4. What should you do to a  Turn head to side, lie bed flat, pad head with
client during a seizure? pillow

5. Should you put anything in  No, never do this

the client’s mouth to prevent
the client from swallowing
his/her tongue?

SHINGLES (Herpes Zoster)

63
 1. This viral infection is  Varicella
caused by what virus?

2. What are the signs of herpes  Itching vesicles grouped together on top of a
zoster? red rash, painful to touch, low grade fever,
malaise

3. How are shingles spread?  The vesicles contain fluid that transmits the
virus

4. Where is the rash usually  Along a dermatome

located?

5. What is a dermatome?  An area of skin that gets all of its

innervations by a single spinal nerve

6. What are some areas of  Face, trunk, back

dermatomes?

7. Will the rash and vesicles be  Unilateral

unilateral or bilateral?

8. What are the Isolation Prec  Respiratory Isolation

for Herpes zoster?

9. What is the treatment for  Analgesics

shingles?  Supportive care
 Cool compresses
 Try to keep vesicles intact

10. What may be seen after the  Scarring

vesicles have healed?

SICKLE CELL
ANEMIA
1. Is this autosomal trait  Recessive; most commonly seen in African
recessive or dominant? Americans

2. How is this condition  A child receives the gene from both parents
inherited?

3. How long do sickled RBCs  6-20 days; normal is 120

live compared to normal
64
 RBCs?
4. What does this put the
patient at risk for?
5. What test determines sickle
cell anemia?
6. The acute exacerbation of
sickle cell anemia is called?
7. The most common cause is?
8. This causes the sickle blood
to do what?
9. How do you treat a sickle
cell crisis?
10. During a sickle cell crisis,
which intervention is done
first? Give O2 or hydration?
STARTING AN IV
1. Inform client about
procedure and indication
3. Wash and dry hands
5. Apply torniquet
7. Clean the area with alcohol
9. Advance the catheter
11. Remove the torniquet
65
 Anemia
 Hgb- shows anemia
 Sickle testing of blood
 Sickle cell crisis or vaso-occlusive crisis
 DHN
 Clot
 Hydrate with oral and IV fluids, give O2 to
increase tissue perfusion; a blood transfusion
may be needed
 give pain meds- very painful
 Hydrate with IV fluids; remember, during a
crisis the blood is clumped together, so the goal
is to decrease the viscosity of the blood.
 O2 will not reverse the cause; it will only
prevent more clumping
2. Gather supplies
4. Use Universal Precautions- wear gloves
6. Locate a vein
8. Position and insert needle, looking for a
flash of blood
10. Release the torniquet
12. Secure the catheter and start IV fluids
as ordered
 13. Document

STERILE
TECHNIQUE
1. What can never be  Skin
considered sterile, only
clean?

2. Never turn what on a sterile  Back

field?

3. If a nurse has on face mask  No, because once the gloves touch the mask
and sterile gloves, is it okay they are no longer sterile
to adjust the face mask with
a gloved hand?

4. A sterile gown is only sterile  Waist to shoulder

from?

5. If a sterile wrapper becomes  Wet

_______ the entire package
is no longer sterile

TARDIVE
DYSKINESIA
1. This is a side effect of what  Antipsychotics
medication?

2. What will you see?  Chewing motion with mouth, tongue

sticking in and out, involuntary movement of
arm/leg

3. What class of meds can you  Anti-Parkinson’s

give to decrease the effects?

TOTAL PARENTERAL
NUTRITION
1. A client’s nutrients are  Veins
supplied through?

2. Why would a client need  If GI wasn’t working properly

TPN?
66
 3. What needs to be monitored  Blood sugar; d/t dextrose in TPN
closely?

4. IF TPN suddenly increased,  Hyperglycemia d/t gradual increased rate of

client is at risk for? infusion

5. What other electrolyte  Hyperkalemia, hypermagnesemia,

imbalance can TPN cause? hyperphosphatemia

6. How often do you change  Ever 24 hours

the TPN bag?

7. What meds can be hung  None; never do this

with the TPN tubing?

8. Why must tubing be  To decrease risk for sepsis

changed daily?  TPN increases risk for bacteria to form in
tubing

9. Elevation in temperature is a  Infection

sign of?

10. Why must TPN be gradually  To prevent hypoglycemia

decreased?

11. IF TPN is unavailable,  10% Dextrose water

which IV fluid can be hung
as a temporary substitution?

TRACHEOSTOM
Y
1. What is tracheostomy?  A surgical procedure that creates an open
airway in the trachea

2. What are the indications for  Upper airway obstructions (increased

a tracheostomy? mucous)

3. What is the created oping  Stoma

called?

4. What must the nurse always  An obturator, a stiff plastic device used for
have in bedside? inserting the inner cannula

5. Is suctioning a client with  Sterile

67
 trach a clean or sterile
procedure?

6. What should the nurse  Hyperoxygenate wit 100% O2

always do before suctioning
a client with a trach?

7. What should the nurse  Reoxygenate with 100% O2 2-3 times

always do after suctioning a during inhalation
client wit trach?

8. If a client coughs strongly  Keep airway open by reinserting obturator

and the trach becomes or grabbing retention sutures. Give O2 if
dislodged, what is the initial airway is lost!!!
nursing action?

9. If a client is NOT on  No, it should be deflated so as not to block

ventilator, but has a trach, airway
should the inner cough be
inflated?

TRIMETHOPRIM-SULFAMETHOXAZOLE
(BACTRIM)
1. What is this medication  To treat bacterial infections, most
used for? commonly UTI

2. What are the  Kidney or liver failure

contraindications for taking
Bactrim?

3. The severe inflammatory  Steven-Johnson syndrome

skin d/o caused by Bactrim
is called?

4. During this allergic reaction  Severe skin lesions; blisters; swelling of the
what will you see? throat, lips, tongue; fever; headache; rash
*Lesions can be internally on organ as well

TUBERCULOSIS (KOCH
DISEASE)
1. What organism is the cause  Mycobacterium tuberculosis
of TB?

68
 2. What are the signs of active  Productive cough, night sweats, chills,
TB? weight loss, low-grade fever

3. What test is administered by  Mantoux, also called PPD

injecting a small amount of
tuberculin intradermally?

4. The Mantoux test is  10mm

considered positive if the
induration (raised skin) is
greater than?

5. What is the appropriate  Airborne precaution

isolation precaution?

6. The clients negative  6 air exchange per hour

pressure room should have
how many fresh air changes
per hour?

7. STRIPE is the mnemonic  Streptomycin

for TB antibiotics  Rifampicin
 Isoniazid
 Pyrazinamide
 Ethambutol

5. What is the most common  Peripheral neuritis

side effects of TB
antibiotics?

6. What are the other side  Muscle aches, G.I. disturbances, dizziness
effects?

7. What color will Rifampicin  Red or orange

turn urine, sweat, and tears?

8. When taking TV antibiotics,  Vitamin B6

what vitamin will be
depleted?

9. Teach the client to avoid  Alcohol

______ to reduce the risk of
hepatotoxicity

69
 10. Clients taking TB antibiotics  Drug-induced
are at risk for _____
hepatitis

11. How many consecutive 3

sputum cultures need to be
negative for the client to be
non-contagious?

ULCERATIVE
COLITIS
1. What is the cause of this  Cause is unknown
disease?

2. What is the  Inflammatory bowel disease affecting the

pathophysiology? large intestine/rectum

3. What are the signs or  Abdominal pain, bloody diarrhea (20

complaints from clients? stools/day) Nausea/vomiting, weight loss

4. How is a ulcerative colitis  Colonoscopy

diagnosed?

5. What are the treatments?  Corticosteroids to reduce inflammation,

removal of large intestine and rectum

6. What will the client need  Ileostomy

after surgery?

7. What is the most  Low fiber; Teach clients to avoid fiber,

appropriate diet for this fatty/greasy foods to decrease diarrhea. Teach
condition? clients to avoid alcohol (ETOH) and caffeine,
but increase fluid intake

VITAMINS

1. What are the fat soluble  A, D, E, K

vitamins?

2. What are the water soluble  B (2, 6, 12) C, folic acid

vitamins?

3. Water soluble vitamins  Stored

70
 cannot be ______ in the
body by the liver

4. Which vitamin is important K

clotting blood?

5. What are important food  Green leafy vegetables

sources of vitamin K?

6. This vitamin is important in  Vit A

monitoring eyesight?

7. What are important food  Oranges, dark green leafy vegetables

sources of vitamin A?

8. In Pernicious anemia, the  Vitamin B 12 (will see paresthesia in hands

missing intrinsic factor and feet with this deficiency)
inhibits absorption of what
vitamin?

9. Iron supplements should be  Vitamin C

taken with what vitamin to
promote absorption?

RELIGION

- What to know about  Saturday worship, No alcohol, no pork,

Adventist? sometimes no meat, baptism as adults

- What to know about Muslims?  No pork, do not do an autopsy

- What to know about Orthodox  Religious leader is called Rabbi, not priest.
Jews? Only other orthodox Jews can touch the dead

- What do you know about  Religious leader is called Priest. Infant

Roman catholic? baptism, call before death for last sacrament

- How would you do post  Do not give the body a full bath (clean
Mortem care? visible soil)
 Race head of bed to 30° in place pumps
down to prevent discoloration
 Put in any dentures if any
 Properly id the body
 Maintain vital organs/skin integrity, remove
71
 IV/ tubes; replace with Band-Aids unless
religious preference is to keep them in

DONNING PPE DOFFING PPE

1st Wash hands 1st Gloves

2nd Gown 2nd Goggles (if present)

3rd Mask 3rd Gown

4th Goggles (if needed) 4th Mask

5th Gloves 5th Wash Hands

**When you are taking PPE off, take it off

alphabetically

PHARMACOLOGY

72
 This Photo by Unknown Author is licensed under CC BY

TOP 100 NCLEX DRUGS YOU MUST

NEED TO KNOW!!!

73
 ALLERGY MEDICATIONS

Drug Benadryl (Diphenhydramine)

Routes - PO, IV, IM
Use - This is an anti-histamine that can also be used a sedative- some
travel nurse takes it to sleep on the plane
- Allergic reaction: Doctor will prescribe this medication to patients
if they need to take a medication which they are allergic (for
example, blood or IV contrast before a CT scan). If a patient is
having a severe allergic reaction, give EPINEPHRINE!
- Benadryl can also be given to reduce nausea/vomiting in CA pt

Dug Claritin (Loratidine)

Routes - PO
Use - Anti-histamine, common colds, rhinitis
NCLEX Tips - Will cause dry mouth
- Give with food and water
- Will cause drowsiness; avoid alcohol
- Do not give the nursing woman

Drug Zytec (Cetirizine)

Routes - PO
Use - Antihistamine, common colds, rhinitis
NCLEX Tip - Same as Claritin

Drug Allegra (Fexofenadine)

Routes - PO
Use - Anti-histamine, common colds, rhinitis
NCLEX Tip - Same a

74
 ANALGESICS
Non-opioid type
Drug ACETAMINOPHEN NAPROXEN NSAIDs ASPIRIN
Example - Tylenol - Aleve - Motrin - Bayer
- Ibuprofen
Uses - Mild/moderate pain - Mild/moderate - Mild/moderate pain - Mild/moderate pain
- Fever pain - Fever - Fever
- Arthritis (gout or - Fever - Arthritis (gout or rheumatoid) - Arthritis (gout or
rheumatoid) - Arthritis (gout or *Blood thinner rheumatoid)
rheumatoid) *Blood thinner
NCLEX Tip - Can cause liver - Take with food; will - -Take with food; will cause G.I. - Do not give with other
toxicity cause G.I. ulcer ulcer anticoagulants
- Do not give the liver - Do not give NSAID and aspirin - Do not give the children with
failure or renal failure together flu like symptoms because of
patients - - Stop taking one week before Reye’s syndrome
*Antidote: Mucomyst surgery - - stop taking one week before
(Acetylcysteine) In general, all Narcotics:
Reduce pain
surgery
**Ca cause dependence
Reduce Respiration

Opioid/Narcotic Type Should not be taken with alcohol

Cause constipation

Drug MORPHINE DILAUDID CODEINE DEMEROL PERCOCET

Hydromorphone Meperidine HCL Oxycodone
NCLEX - Hold if respiratory - Reduce respirations - Used as a cough - Do not give with - Has Tylenol in it;
Tip are below 10; will - This is not morphine; suppressant patients with OK to give if allergic
cause respiratory You cannot interchange head injuries; to aspirin
depression them *Take with food to can increase - Percodan has aspirin
- Watch out - Dilaudid is many more prevent intracranial in it instead of
constipation times stronger than nausea/vomiting pressure Tylenol; do not give
morphine if patient is allergic

75
 ANTIBIOTICS
Antibiotics Examples How they help How they harm
AMINOGLYCOSIDE - Vancomycin - Very powerful - Cause ototoxicity/nephrotoxicity
S - Streptomycin antibiotic - Hearing: ringing, dizziness
- Gentamycin - Gram (-) bacteria - Do not give to pregnant
such as - Need to know the PEAK/TROUGH
meningitis, Peak: IV- 30 PO- 1hr
infective Trough: 30mins before
endocarditis, - Antidote: CALCIUM GLUCONATE
septicemia
PENICILLIN - Penicillin - Gonorrhea - Ask about allergy; Ask about any kind of reaction such as itching,
- Amoxicillin - Pneumonia rash, hives- DO NOT GIVE IF ANY reactions have occurred
- Ampicillin - UTI - First time a patient takes PCN, stay with them just like blood
- Do not mix with Aminoglycoside
- Antidote: EPINEPHRINE
TETRACYCLINES - Doxycycline - UTI - Photosensitivity, nephrotoxicity, hepatotoxicity
- Demecycline - Pneumonia - Keep out of direct sunlight, monitor liver enzymes, monitor kidney
- Gonorrhea function, labs and urine output
- Do not give if pregnant or nursing; Do not give wit cow’s milk
Be careful; some have Give if allergic to PCN - Do not give to children under 12; will cause teeth to turn black;
“mycin” ending Give this meds with a straw
(achromycin) - Avoid giving with Lasix
CEPHALOSPORINS - Acnef - Gram (-) bacteria - Side effects: Remember that Cephalosporins will leave you HAIRY
- Keflex (UTI, Pneumonia, Hyperglycemic
Gonorrhea) Aanaphylactic Shock (if allergic)
Do not give if allergic to Increased blood sugar
PCN!!!! Renal px (nephrotoxic)
We must tell our patients that they have to continue their antibiotics even though they are feeling better. Yellow poop (diarrhea)
- Anridote: EPINEPHRINE

ANTI-COAGULANTS

HEPARIN COUMADIN
76
 Onset Less than 1 hour 4-10 days
Short term/Long term Short term Long term
Routes IV or SQ PO only
Labs to watch PTT INR or PT
ANTIDOTE Protamine Sulfate Vit K
Can I give during pregnancy? Yes, you can give No, don’t give there is a baby in there!
Will this meds break down a clot? No No

 Be careful; some herbal meds can interfere with blood thinners

 Tell pts to stop taking 2 weeks before surgery
 Frequent blood draws will be needed during initiation of treatment

Sorry You Are Not My Type! ANTIDOTES

Blood Type Compatible With Magnesium Sulfate Calcium Gluconate
A A or O
Tylenol Mucomyst
B B or O
Insulin Glucagon
O O
Morphine (Other Narcotics) Narcan
AB A, B, O
Coumadin Vitamin K
Heparin Protamine Sulfate
Hyperkalemia Insulin, Kayexalate

ANTI-CONVULSANTS
In general, all anti-convulsants:
 Can become toxic in the body system
 Cause drowsiness
 Should not be taken with Antacids; this will decrease absorption
 Can elevate Blood glucose
77
  Any change the urine to light rust color, but it is not dangerous to the patient
 Will still allow the patient to have a seizure despite being on meds…..Watch out for them!!!
*If your patient is on anti-convulsants, initiate seizure precautions

Drug PHENOBARBITAL DILANTIN DEPAKENE VALIUM

Other Names - Barbiturate - Phenytoin - Valproic Acid - Diazepam
NCLEX Tips - Decrease BP - Do not give wit food - Hepatotoxic - This is a PSYCH med
and - Do not take with oral - WoF: Abdominal that can also be used for
Respirations contraceptives (they will not cramping seizures
work) - This is the DoC for
- If you are giving this meds STATUS
IV, you can only give with EPILEPTICUS
NS

ANTI-PARKINSON’S

Most Parkinson’s medications either increase Dopamine in CNS or are Anti-cholinergic, which means they block the cholinergic receptors in the CNS. The
overall goal is to reduce the muscle rigidity and tremors you see in Parkinson’s disease.

Drugs COGENTIN SINEMET LEVODOPA

Mechanism of Anticholinergic Increase Dopamine Increases Dopamine
Action
NCLEX Tips Can be given to help with extra- Need to eat low Do not take with MAOI- ca
pyramidal symptoms with psych meds protein meals cause HTN crisis.
such as Compazine Avoid B6 Vitamins

78
 ABCDs of Side Effects
A- Altered vital signs (tachy, hypotension), altered urine color
B- Blurry vision
C- Constipation, confusion
D- Dry mouth, dizziness
 Teach clients to self- monitor improvement of Parkinson’s symptoms.
 Tell clients NOT to stop taking this medication abruptly.

CARDIAC MEDICATIONS

If a patient becomes allergic to ACE inhibitor they can take ARBs. This drug can be taken with food or on an empty stomach.

Drugs Angiotensin receptor blocker’s (ARBs) ACE inhibitors

Name - Drugs that and in “sartan” - Drugs that end in “pril”

 Lpsartan (Cozaar)  Lisinoprol (Zetril)
 Valsartan (Diovan)  Captopril (Capoten)
 Irbesartan (Avapro)  Enalapril (Vasotec)
Action - Blocks the effect of angiotensin 2 at the receptor - Laugh enzymes that convert angiotensin 1 into
side angiotensin 2
*Angiotensin 2 is a super powerful vasoconstrictor that will
increase the BP
Angiotensin 2 also causes the secretion of additional blood
pressure elevating hormone in the adrenal glands, called
aldosterone
Effects - Lowers BP and the workload of the heart. Vessels - Lowers BP and workload of the heart. Vessels (arteries
(arteries and veins) dilates and veins) dilate
- Helps kidneys excrete sodium and water - Help kidneys excrete sodium and water

Contraindications - Patient with hyperkalemia or renal failure - Patient with hyperkalemia or angioedema (noticed the
- Pregnancy or breast-feeding dry cough)
- pregnancy or breast-feeding

79
 CARDIAC MEDICATIONS
These drugs will affect the rhythm of the heart; some will slow it down; some will speed it up. Don’t focus on how they were just know the results!
Anti-arrhythmic Action
Amiodarone Used for afib – slows the heart rate
Atropine Used for bradycardia – speeds the heart rate (can also be used for
Asystole after epinephrine)
Cardiazem/Diltiazem (also a CCB) Used for afib – slows the heart rate
Digoxin Used for afib – slows the heart rate
Epinenephrine Used for absent heart rate (asystole) – speeds the heart rate
Lidocaine Use for Vtach/Afib- slows the heart rate
If a patient has a Vfib/Vtach, the best treatment is the defib!!!
ReMar’s Tip: Atropine can also be used as an eyedrop. It dilates the pupil (mydriatic)

CARDIAC MEDICATIONS

Drugs BETA BLOCKERS CALCIUM CHANNE BLOCKERS

Name - End in “olol” - End in “pine”

 Metropolol  Amlodipine
 Atenolol  Nifedipine
Action - Black epinephrine and norepinephrine - Block ion calcium from crossing
from binding to beta receptors on into the cell
nerves
Effects Decrease Decrease
The effects for BB and CCB are the BP, PULSE BP, PULSE
same! CONTRACTILITY CONTRACTILITY

80
 Contra indications - Asthmatics - MI history
- Diabetics

BB/CCB treat the same things  HTN, Angina,

Arrhythmia

Beta blockers only will treat glaucoma (Timolol

is the medication)

CARDIAC MEDICATIONS

Cardiac drug
Name DIGOXIN
Action - Nobody really knows exactly how Digoxin works; However, there are many theories

Effects - Slows down the heart, increases BP tissue perfusion

Contra - Always take an apical pulse hold if it’s our is less than 60 in adults and less than 90 in
indications infants.
- Therapeutic level is 1–2. It’s greater than 2, patient is toxic.
- Signs of digoxin toxicity: client will see yellow spots, nausea, vomiting, and
abdominal pain.
- If patient is toxic, give activated charcoal or Digibind.

CARDIAC MEDICATIONS
81
 Cardiac Drug NITRATES
Name - Nitroglycerin, Imdur, Isordil
Action - Vasodilators to reduce preload and afterload of the heart
Effects - No worries BP and increases oxygenation of tissues
Contra-indications - Do not take with Viagra. How client can take one or the other, but never both.
- If given Nitro SL, a nurse can give only up to 3 tablets over 15 minutes. Give one tablet
every 5 minutes.
- If giving nitroglycerin via patch, never placed over a pacemaker and removed before
patient goes into MRI.
- If the HCP orders nitro IV, please on an infusion pump always!

*Yes, patients will complain of a headache after you give them nitroglycerin because all the vessels dilate, even the ones in the head. If you get the
nitroglycerin paste on your hands, you will get a headache too, so wear gloves. 

NCLEX Cardiac Drug Tips

Anytime you give a cardiac medication, watch for headaches, hypotension
Before you give them, check BP and heart rate

Tell heart patients to stay away from caffeine (Pepsi, Coca-Cola, tea, coffee) and nicotin

ALERT!!!!!

All this medication if the systolic blood

pressure is less than 100, or heart rate is
less than 60.

DIURETICS

82
 Type Loop Thiazide Osmotic Potassium Sparing Carbonic Anhydrase
Inhibitors
Examples - Lasix Hydrochlorothiazide - Mannitol - Aldactone - End in “lamide”
(Furosemide) (Acetazolamide)

NCLEX - Most efficient fast - Acts mainly on - These are used - Used orally; not - Blocks carbonic
Tips acting the distal tubes to get rid of as strong as the anhydrase in the
- PO or IV - Is not fast- water instead others proximal tubes
- WoF: acting diuretic of sodium; - WoF: - Not much used as
Hyperkalemia, - Used orally great for Hyperkalemia a diuretics; better
Hypotension - WoF: increased ICP *Do not give to patients for an open angle
Hypokalemia with DM glaucoma or
*Can’t take Lasix if - Teach pts to metabolic
allergic to Sulfa drugs *Do not give to clients avoid foods high alkalosis
with renal failure in K

NCLEX Tip for Diuretics

 Monitor weight (do daily weights at the same time)

 Strict I & O
 Give diuretics in the morning to avoid nocturia
 Most diuretics will cause ORTHOSTATIC
HYPOTENSION
 Normal Potassium Level: 3.5-5

83
 GI Medications

Stops Nausea & Vomiting

Drug Teaching
Zofran (Ondansetron) Give 30 mins before chemo/ 1hr before radiation
Compazine/Promethazine *Psych meds that can be used for nausea

Starts Nausea & Vomiting

Drug Teaching
Ipecac Syrup Used for ingestion of poisons or overdoses.
Call poison control center FIRST!!!

Stops Diarrhea
Drug Teaching
Lomotil or Imodium Watch for constipation.
Be cautious if giving to patient with C. diff or other infectious diarrhea.

Starts Diarrhea
Drugs Teaching
Lactulose PO laxative that is given to reduce Ammonia levels; works
within 15 minutes.
Kayexalate PO laxative that is given to reduce Potassium levels; works
within 15 minutes.

Stops Stomach Acid

Drug Examples Teaching
Antacids Maalox, Tums, Milk of Magnesia Give 1 hr after meals. Take with full glass of
water.
H2 blockers Pepcid, Tagamet, Zantac Give with or before meals.
PPI Omeprazole, Pantoprazole Give before meals in the morning.
*Other drugs ending in “prazole”

Protects the mucosal lining of the stomach

Drug Teaching
Sucralfate or Carafrate Give PO and take on an empty stomach. Do not give with
Coumadin or Dilantin.

If you have a patient on multiple GI medication (example: PPI, antacids) give them 1 hr apart from each
other.

INSULINS

84
 Types Generic Name Onset Peak Duration
Rapid Acting Novolog Less than 15 1 hour 3 hours
Humalog minutes
*Give wit meals

Short Acting Novolin R (Regular) 1 hour 2 hours 4 hours

“clear” *Only one that can
be given IV route

Intermediate NPH 4 hours 8 hours 12 hours

“cloudy”

Long Acting Lantus Slow absorption No peak 24 hours

Cannot mix this
with any of the
others

Oral Antidiabetic Agents- Examples: Metformin, Byetta, Glucophage, Avandia

Client Teachings:
- Contraindicated meds
- Coumadin
- Oral contraceptives
- Corticosteroids

Must be used in conjunction with diet and exercise, comes in

tablet form.

Give 30 minutes before meals.

Do not give to type 1 DM.

Side effects: Renal complications

GI disturbance (diarrhea, nausea)

Headache

Weight gain

85
 Top NCLEX Herbs!
NATURAL ALTERNATIVES
Herbal Action Patient Teaching

St. John’s Wort Treats depression/anxiety Interacts with SSRI

Sun sensitivity
Garlic Lowers BP/cholesterol Interacts with Coumadin and Aspirin
Gingko Biloba Improves memory Thins the blood
Do not take wit Coumadin and Aspirin
Do not take with seizure history
Echinacea Immune- boosting function Can cause liver toxicity in renal patients, not effective
with HIV
Ginger Relieves nausea and vomiting Do not take if history of DVT
Interacts with blood thinners
Treats menopausal symptoms Contraindicated in pregnancy, will cause premature labor
Black Cohosh

Kava Kava Treats insomnia, muscle pain Decrease Parkinson’s disease meds
Saw Palmetto Used for prostate health No specific patient teaching

All herbal medication that start with Letter G thin the blood; do not give with Coumadin, Aspirin, Heparin.

MATERNITY
Start Contractions Pitocin/Oxytocin

NCLEX Tips Stop Ptocin when contractions are 60 seconds apart.

Monitor fetal HR every 15 minutes.
Stop Contractions Ritodrine or Terbutaline

NCLEX Tips Both drugs will cause tachycardia in mom and baby.

86
Lower BP in Pre- Magnesium Sulfate
eclampsia/Eclampsia
This medication decreases respirations, reflexes, and urine output.
NCLEX Tips Foley catheter may be needed to monitor urine output.
Monitor reflexes and respirations.

Stops Post- Partum Hemorrhage Methergine

This medication is a strong vasoconstrictor used to stop uterine

NCLEX Tips bleeding. Do not give it to pregnant women wit Cardiovascular
disease, HTN, or pre-eclampsia/eclampsia; will severely
increase blood pressure.

RESPIRATORY MEDICATIONS

Drugs Theophylline Albuterol Singular Advair Diskus

Aminophylline Montelukast (Fluticasone
Propionate)
Class of Bronchodilator Bronchodilator Bronchodilator Bronchodilator
Drug
Will cause Used for Do not give for Do not give for
NCLEX tachycardia. acute/severe asthma severe asthma severe asthma
Tips attacks. attacks. attacks.
Monitor for toxicity.
Will cause This medication After opening,
Normal level: 10-20 tachycardia. takes a long time to Diskus is good for 1
work. month.
May cause tremors. Give I the evening.
Never exhale into
the Diskus.
 All bronchodilators relax smooth muscles.
 Always give bronchodilators first before you give steroids when doing breathing treatments.
 Remember that with aerosol therapy the amount of medication the client actually receives cannot
be measured. However, aerosols work the fastest by going straight to the lungs.

Drug Beclomethasone (Beclovent)

Class of Drug Corticosteroid

NCLEX Tips Used for chronic asthma
Helps produce surfactant

 Beclomethasone does not relax smooth muscles in the lungs; this medication is a a steroid, so use
with a metered dose inhaler.

Drugs Survanta
Class of Drug Lung surfactant
NCLEX Tips Use for respiratory distress neonates. Given through the
ET tube.
87
 PSYCHIATRIC MEDICATIONS

The next 4 meds work on anxiety/depression If client overdose on Benzodiazipines, give FLUMAZENIL
Short term meds for anxiety/depression.

Benzodiazepines Medications that end in “zepam”

Clonazepam (Klonopin)
Diazepam (Valium)
Lorazepam (Ativan)
Temazepam (Restoril)
NCLEX Tips - Very addictive
- Short term use only
- Do not stop taking abruptly
- Watch for respiratory depression
- Side effects are ABCDS:
A- Altered V/S (brady, low BP)
B- Blurry vision
C- Constipation; confusion
D- Dry mouth; dizziness
S- Stasis of urine, sedation

Selective Serotonin Reuptake Inhibitors

(These medications help you keep NCLEX Tips
Serotonin in the system longer, which
makes you happier  )
Prozac Cause suicidal ideation in children; will cause
insomnia, give early before 2pm.
Celexa Do not take alcohol or drive with this medication
Zoloft Do not give Antabuse, but can be given in the evening
Effexor Do not give with Lithium or Tagamet, will cause
insomnia, give early

All SSRI can cause Serotonin Syndrome or Serotonin Overload if too much of the drug is given.
Never, ever, ever give an SSRI with an MAOI!!!! Ever!!!!

Monoamine Oxidase Inhibitors Marplan

(These meds help you hold onto Nardil
Norepinephrine, Dopamine, and Parnate
Serotonin longer, which makes you (Only drugs you need to know)
happier  )
Side Effects ABCDS
Contraindications Never give MAOI with SSRI
This meds takes 4-6 weeks to work
Know dietary restrictions; your pt will not be allowed to eat
anything with TYRAMINE in it while taking an MAOI.

Tyramine-Restricted Diet

Just remember the things the patient can’t have

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 Meats No organ or preserved
Grains No grains with active yeats
Vegetables No BAR (Banana, Avocados, Raisins)
Fruits No BAR again
Dairy No cheese except cottage
No yogurt
Sweeys/oils No coffee, tea, or chocolate
Condiments No soy sauce

Psychiatric Medications

These medications below are Anti-psychotic and will help patient with problems associated with
Schizophrenia (delusion, hallucination, and paranoia)

Phenothiazines

Examples: Thorazine, Compazine, Stelazine, Promathezine

Route: Given PO, IV, or IM (IM last longer)

Phenothiazines are Typical Antipsychotics

Typical Antipsychotics works best on the “Positive Psychotic Symptoms”
Other examples of Typical drugs are Haloperidol (Haldol), Thiothixene (Navene), Perphenazine
(Trilafon), and Chlorpromazine (Thorazine).
Typical anti-psychotics are also called First-Generation anti-psychotic (because these drugs were the first
kinds of medications to be given)

Caution! First-generation or typical antipsychotics cause NEUROLEPSIS!!

What does neurolepsis means? Altered mental status, decreased LOC, poor
mental skills

Side Effects: ABCDS+ extra pyramidal symptoms

Nursing Assessments: Monitor for tardive dyskinesia

Monitor V/S with temp

What drug can we give to lessen the S/E of a first- Cogentin (Benzotripine), a Anti-Parkinson
generation antipsychotic? medication

Nursing Care: Stop medication, flush meds out of system, control temperature!

Psychiatric Medications
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Now that you know Typical Psych drugs, lets learn about ATYPICAL
Atypical Antipsychotic are also known as Second-Generation Antipsychotics.

Examples: Clozapine (Clozaril), Olanzipine (Zyprexa), Risperidone (Resperda), Quetiapine (Deroquel),

Aripirazole (Abilify)- KNOW THESE MEDS!!!!
Most of these drugs end in “Pine”
Atypical Anti-psychotics still have ABCDS!!!!
Atypical Anti-psychotics have fewer EPS.
Monitor your patient for metabolic changes.
Atypical antipsychotic can cause:
1. Hyperglycemia or DM
2. Dyslipidemia
3. Weight gain

When your patient is on Atypical Antipsychotic medications, monitor them for AGRANULOCYTOSIS
(low WBCs). If they have Agranulocytosis, they will complain of fever, body ache, chills, sore throat.
Basically, signs of the flu |

When doing room assignments with Psych pts, remember to put like pts together.
 Depressed with depressed
 Manic with manic
 Suicidal patients are ALONE!!!!

TV Drug to Know

It’s important to know what they treat and what to watch out for.

Drug Indications Patient Teaching

Boniva Do not take with Nitroglycerin!!
(Ibandronate) Osteoporosis May cause sudden drop in BP
Fosamax Can cause kidney stones
(Alendronate) Osteoporosis Make sure to drink 8 glasses of water per day
Viagra/Cialis Do not give during pregnancy
(Sidenafil/Tadalafil) Erectile dysfunction Clients with HIV can take
Zyloprium Need to do platelet count
(Allopurinol) Anti-gout Excessive bleeding
Severe confusion
Botox
(OnabutulinumtoxinA) Temporary muscle May cause insomnia/seizure
relaxant
Plavix Doubles the risk of heart attack and stroke
(Clopidogrel) Blood thinner Removed from market

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 Wellbutrin
(Bupropion) Antidepressant May cause insomnia/seizure
Vioxx Double the risk of heart attack and stroke
(Rebecoxib) Arthritis Removed from market

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