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Welcome,future rn!

Cardiovascular

You’re caring for a patient prescribeddigoxin. What are your nursingconsiderations?

Therapeutic range is 0.5-2S/S of toxicity: vision changes, N/V Antidote: Immune Fab

The patient is in ventricular tachycardiawith no pulse. What is you priorityintervention?

Defibrillate! Give amiodarone or lidocaine

You’re caring for a patient prescribed abeta blocker. For what reasons wouldyou not administer the medication?

Systolic BP below 90HR below 50 History of asthma or COPD

Your patient with hypertension isprescribed the DASH diet. Whateducation would you include?

Eating vegetables, fruits, whole grains Fat-free or low-fat dairy productsFish, poultry, beans, nuts, and vegetable oils Limit red meats.

Your patient is having a AAA. What typeof symptoms would you expect?

Often asymptomatic, but patients mayfeel their heart beating, or back and/orabdominal pain.

Your patient is prescribed furosemide for heart failure. What is your priority actionprior to giving?

Check serum electrolytes, especially potassium!

Gastrointestinal

You are caring for a patient experiencingan ulcerative colitis exacerbation, whatare you MOST worried about?

Fluid and electrolyte imbalances due to the diarrhea.

Your patient with end stage liver cirrhosishas a sengstaken-blakemore tube. Whatare you nursing considerations?

If the patient has difficulty breathing, usescissors to cut the sangstaken-blakemoretube and remove it immediately!

Cullen’s sign and Grey Turner signcorrelate with which medical condition?

Pancreatitis

Musculoskeletal

For acetaminophen (tylenol), what is themax daily dose and what is the antidote?

The max daily dose is 4 grams If overdose, the antidote is acetylcysteine

Which side of the body should the patient hold the cane?

The cane is used on the stronger side

You patient has a HALO vest, what areyour safety considerations?

Pin site care Taping a wrench to the vest - in case youneed to take it off for CPR

Your patient has a fracture. A cast isplaced while there is still a lot swellinghappening, what is the patient at risk for?

Compartment Syndrome

Hematologic

Name three facts you know foradministering a blood transfusion.

2 RNs to check bloodStay for the first 15 minutes4 hours max to infuseNS and Y tubing usedNo other meds administered with it20 gauge or larger IV/ central lineIf transfusion reaction suspected stop infusion

What instructions would you give yourpatient about taking iron?

Iron should be taken with vitamin C, suchas citrus juice or tomato juice forincreased absorption. Also, it is best absorbed when taken onan empty stomach.

What is the cause of DIC?

Tissue Trauma (examples include severeinfections and cancer)

Immunologic

What labs are important to monitorfor a patient diagnosed with HIV?

CD4 Count&Viral Load

What complications would youassess for with patients diagnosedwith ALS, guillain- barre syndrome,or myasthenia gravis?

Respiratory complications

You suspect your patient isexperiencing an anaphylacticreaction, what would you do andwhy?

Administer epinephrine

Oncology

Many NCLEX questions for oncologywill be about therapeuticcommunication. Name some facts you know regardingtherapeutic communication.

Don't start a statement with "why"Open-ended questionsDon't give adviceAllow patient time to answerRestating

Your patient receiving cancertreatment is found to havethrombocytopenia. What will you dofor this patient?

Risk for bleeding:Bleeding precautions, avoid aspirin,platelet transfusion

How do we prevent Tumor LysisSyndrome (TLS)?

Hydration

Endocrine

What symptoms would you assessfor a patient with SIADH?

Oliguria Decrease serum specific gravity Increased urine specific gravity (s... soaked!)

Why is the peak so important toknow when administering insulin?

This is when the patient is it highestrisk of hypoglycemia

What would you anticipate beingprescribed for a diabetic patient withDKA?

IV insulin regular IV fluids

Would you expect cortisol levels withAddison’s Disease to be high or low?

Addison's disease - low cortisol levelsCushing’s syndrome - high cortisol levels

Genitourinary

Your patient requires a urinary foleycatheter. What are the best steps youcan take to prevent a CAUTI?

Cleanse peri area and catheter Remove the catheter ASAPKeep the catheter drainage bagbelow the level of the bladderMake sure there are no kinks

You’re caring for a patient with BPHwho has undergone a TURPprocedure (with CBI). What will youinclude in your care?

Pain management Monitoring bladder irrigationMonitor I&O Measure true urine outputMonitor for bleeding and clots

You are teaching your patient aboutwhat to monitor for when doingperitoneal dialysis at home. What doyou include?

Monitor for peritonitis: redness,swelling, and tenderness and reportimmediately.

What is the most common firstindication of an acute kidney injury?

Decreased urine output - oliguria

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