nclex review points (+tips, tricks)

105 flashcards

blood pressure

120/80 - 140/90

pulse/heart rate

60 - 100

temperature

97.7 - 99F ≥100.4 = fever

peripheral pulse ox

95-100%

pH

7.35-7.45

pO2 partial pressure of oxygen - blood measurement

80-100 mmHg

pCO2 partial pressure of carbon dioxide - blood measurement

35-45 mmHg

HCO3 bicarb

22-26

WBC kids aged - are always getting sick

4,000 - 11,000 (4 - 11)

Platelets

150,000-400,000 <50,000 is critical and requires transfusion. >50,000 does not warrant transfusions.

absolute neutrophil count - ANC

2200 - 7700 <1000 = neutropenia <500 = seriously critical

eosinophils

1 - 2% ↑ in allergic reactions, parasites

leukocytes

4k- 11k <4000 = leukopenia

albumin

3.5-5 g/dL supes important for fluid balance; prevents fluid from leaking outside of vascular space

blood urea nitrogen - BUN if they've got nice BUNs, they'd rate a...

7-20 urea nitrogen waste; measurement of kidney function

creatinine, male

0.6-1.3

creatinine, female

0.5-1.1

hemoglobin male think puberty; women go through it first, men start around...

13 - 18 <7-8 indicates transfusion

hemoglobin female think puberty; men start later, women begin around...

12 - 16 <7-8 indicates transfusion

alanine transaminase - ALT

10-40 U/L liver enzyme; ↑ = liver probs

aspartate aminotransferase - AST

8-40 U/L liver enzyme; ↑ = liver probs

urine specific gravity

1.005-1.030 ↑ = dehydration, etc. ↓ = DI, SIADH, uncontrolled diabetes, etc.

erythrocyte sedimentation rate - ESR

<30 mm/hr ↑ = acute inflammation

c-reactive protein - CRP

<0.3 mg/dL ↑ = inflammation

BMI

18.5-24.9

urine output

0.5-1 mL/kg/hr or >30 mL/hr 24h = ≥720 mL/day

CD4

500-1200 ≥200 = AIDS

glasgow coma scale - GCS

15 3-8 are not happy numbers but also a rock has a GCS of 3

deep tendon reflexes - DTRs

2+ - important to monitor with magnesium in pregnant patients. - magnesium toxicity results in hyporeflexia

thyroid stimulating hormone - TSH T3 T4

TSH: 0.4-4.2 T3: 70-204 T4: 0.8-2.7

fasting total cholesterol

<200 mg/dL

low-density lipoprotein - LDL

<100 mg/dL - the lower the better low because we want it low

triglyceride Level

<150 mg

high-density lipoprotein - HDL

>40 mg high because we want it high

mean arterial pressure - MAP

70-105 ≥60 in order to have perfusion to vital organs.

MAP formula

(SBP + 2DBP)/3

troponin + meaning

0-0.04 ng/mL the most specific indicator of myocardial infarction (MI) - serum levels increase by 4-6 hrs after MI - return to baseline 10-14 days after MI

D-dimer

measurement of protein fragment produced when b clot dissolves indication of embolism (stroke, pulmonary, etc.)

b-type natriuretic peptide - BNP

<100 is normal hormone/protein produced in ventricles when cardiac muscle under stress or increased pressure (fluid overload, HF, etc.) 100 - 300 indicates HF

cardiac output - CO

4-8 L/min

central venous pressure

2-8 mmHg ↑ = ↑fluid (r-side HF)

pulmonary artery wedge pressure - PAWP pulmonary artery occlusion pressure - PAOP (kaplan)

6-12 mmHg ↑ = l-side HF

pulsus paradoxus

exaggerated fall in systemic BP >10 during inspiration

activated partial thromboplastin time - aPTT

25-35 normal 46-70 heparin target measurement of heparin effectiveness ↑ = r/f hemorrhage

prothrombin time - PT

11-16 seconds general bleeding things

international normalized ratio - INR

2-3 therapeutic level for warfarin ↑ = r/f hemorrhage ↓ = ↑ clotting. affected by antibiotics.

fasting glucose

70-100 mg/dL

target BP for a patient with diabetes

140/90 mmHg

ideal HbA1C + meaning

<7% for diabetics 4-6% for non-diabetics glycemic control over the past 3 months

If a patient is on nutrition support such as TPN, where would you like their glucose levels?

Between 140-180

sodium - Na

135-145

calcium - Ca Call ___ (roughly)

9.0-10.5 (9-11)

phosphorous - P fossils...these must be at least - million years old...

2.5-4.5

potassium - K

3.5-5.0

magnesium - Mg magnum condoms: for men who are - x bigger...

1.5-2.5

Infant (0-1 yr) # of wet diapers

6-10/day or 1 every 4hrs best indication of adequate fluid intake.

Infant (0-1 yr) infant urinary output

2 ml/kg/hr

Infant (0-1 yr) newborn head circumference

12.5-14.5 in (32-37 cm)

Infant (0-1 yr) pulse/heart rate

100-160

Infant (0-1 yr) respiratory rate

30-60 may have periodic pauses that last less than 20 seconds - totally normal

Infant (0-1 yr) hemoglobin

12.5-20.5 g/dL

Infant (0-1 yr) temperature range

97.7-99.7 F

Infant (0-1 yr) blood glucose

40-60 mg/dL within the first 24 hours after delivery.

7 rights of drug administration

right patient right drug right dose right route right time right documentation right indication

cranial nerve I

olfactory smell

cranial nerve II

optic vision

cranial nerve III

oculomotor eye muscles - eyelids, lens, pupils

cranial nerve IV

trochlear trochlear muscle (eye) - turns eyeball down, out

cranial nerve V

trigeminal three on the face = - ophthalmic - sensory - scalp, forehead, upper eyelids, eyes - maxillary - sensory - buccal, maxilla, teeth, gums, lower eyelid - mandible - mixed nerve - sensation from mandible, tongue; motor control of muscles of mastication

cranial nerve VI

abducens lateral rectus (eye muscle) - six-pack abs

cranial nerve VII

facial taste buds, facial muscles, tears, salivary glands

cranial nerve VIII

vestibulocochlear inner ear - hearing, balance (8 is curvy and shaped like an ear)

cranial nerve IX

glossopharyngeal posterior tongue, pharynx - swallowing

cranial nerve X

vagus internal organs; basically pharynx down lucky number 10 goes to vegas

cranial nerve XI

accessory neck, back muscles accessories, s/a necklace, go on your neck and back (just go with it)

cranial nerve XII

hypoglossal motor function of tongue

lithium normal, toxicity

0.6-1.2 mEq/L = therapeutic index >1.5 mEq/L = toxic

ammonia

35-65

total bili

0.0-1.5

total protein

6-8

urine pH

4.6-8.0 avg 6.0

glomerular filtration rate - GFR

90-120 mL/min

digoxin level

0.8-2.0 ng/mL

mag sulfate

titrate to maintain 4-8 levels obtained 1h s/p loading dose, q6h

phenobarb

10-30

theophylline

10-20

chloride *temp to go swimming

95 - 105

7 common applications of droplet precautions

- pertussis - pneumonia - influenza - group A strep - diphtheria - mumps - rubella

which diseases warrant airborne precautions? TV (used to) come over the air...

I want my MTV! - Measles - Tuberculosis - Varicellas: chicken pox, shingles

donning PPE order:

1. gown 2. mask 3. goggles 4. gloves

doffing PPE order: (alphabetical)

1. gloves 2. goggles 3. gown 4. mask

ROME stands for:

ABG interpretation: Respiratory Opposite Metabolic Equal

metabolic acidosis ABG

pH ↓ PaCO2 ↓ HCO3 ↓

metabolic alkalosis ABG

pH ↑ HCO3 ↑

respiratory acidosis ABG

ph: ↓ PaCO2: ↑

respiratory alkalosis ABG

ph: ↑ PaCO2: ↓

5 causes of metabolic acidosis

1. GI bicarb loss (if it's coming out your ass, you're acidotic) 2. DKA 3. lactic acidosis (e.g., sepsis, hypoperfusion) 4. renal failure (e.g., inability to regulate HCO3 levels) 5. salicylate toxicity (aspirin OD)

common cause of metabolic alkalosis

loss of gastric contents - the other end of things: vomiting, NG suction, etc.

6 causes of respiratory acidosis

they're all hypoventilation: 1. drug OD 2. oversedation 3. anesthesia (which is really just oversedation but on purpose, tbf) 4. COPD (can't breathe) 5. chest trauma (also can't breathe) 6. OSA (probably fat and can't breathe)

common cause of respiratory alkalosis

hyperventilation e.g., pain, anxiety, etc.

hyperkalemia increases everything except __ and hypokalemia decreases everything except and __

hyperkalemia increases everything except HR and UO hypokalemia decreases everything except HR and UO

hypercalcemia (and mag) __ everything (↑ or ↓) hypocalemia (and mag) __ everything (↑ or ↓) it's the opposite of the prefix

hyper- Ca & Mg decrease ↓ everything (tetany) hypo- Ca & Mg increase ↑ everything

antidote for potassium

kayexalate

teaching points for walking w cane: - hold cane on __ side to provide max support - cane handle level w _______

- hold cane on strong side - level w the greater trochanter

teaching points for crutches: - # - # fingers-width space between axilla and padding - support body weight on __ and __, not axillae - handgrip should allow for # - # degrees flexion of the elbow

- 3 - 4 fingers-width space between axilla and padding - support body weight on hands and arms, not axillae - handgrip should allow for 20 - 30 degrees flexion of the elbow