UWORLD NCLEX review 100% CORRECT

UWORLD NCLEX review 100% CORRECT pericarditis Hallmark Sign? Correct Answer: inflammation of the pericardium, from an infection, Hallmark sign is *friction rub* Sit up and lean forward for pain. No coughing ...

UWORLD NCLEX review 100% CORRECT pericarditis Hallmark Sign? Correct Answer: inflammation of the pericardium, from an infection, Hallmark sign is *friction rub* Sit up and lean forward for pain. No coughing or laying down. Cardiac Tamponade What are the 3 signs? Correct Answer: - Acute compression of the heart caused by fluid accumulation in the pericardial cavity. - Life threatening as it depletes cardiac output Becks triad: 1. Hypotension 2. Muffled heart sounds 3. Neck vein distension Signs of a DVT Correct Answer: Unilateral edema Calf pain warmth/fever in area redness/erythema Lifestyle risk factors DVT Virchow Triad Correct Answer: No smoking, alcohol, or caffeine Elevate legs to promote venous return Exercise Stay Hydrated Abdominal Aortic Aneurysm What is it? What should nurses monitor? Treatment? Correct Answer: When the large blood vessel (aorta) that supplies blood to the abdomen, pelvis, and legs becomes abnormally large or balloons outward. Check the clients pulses Usually fixed via a stent inserted via groin. Dash Diet Correct Answer: Less sodium, sugar and cholesterol Example, salt, soda, and red meat. Diet to limit hypertension Supraventricular tachycardia Treatment? Correct Answer: #1 is vagul Cardiovert Adenosine Amiodarone ventricular tachycardia Correct Answer: Cardiovert Adenosine Amiodarone atrial fibrillation Correct Answer: Cardiovert is less than 72 hrs Amiodarone Anti-coagulants - AFIB THROWS CLOTS!! Atrial Flutter Correct Answer: No treatment Normal rhythm Premature Ventricular Contraction (PVC) Correct Answer: wide and bizare QRS Heart block Degree 1,2,3 Correct Answer: 1) PR interval gets continuously longer, missed QRS. No treatment needed. 2) PR interval is consistent, then missed QRS Treatment needed. Atropine, Epinepinephrine, pacing 3) PR interval is irregular and random, then missed QRS. Treatment needed. PACING required. diabetes insipidus (DI) Treatment med? Correct Answer: Low ADH secreted by Pituitary Gland, so you dont hold water = fluid volume deficit Polyuria = thirst Polydipsia= peeing alot! Leads to hypotension Hypernatremia= you pee so much diluted urine your blood holds onto sodium Hypotebnsion Treatment = Vasopressin, desmopressin Monitor NA, and urine output Addison disease Correct Answer: Adrenal Gland Disorder: Low cortisol, aldosterone, and androgens. - *Low cortisol* (glucosteriods)- so *hypoglycemia* leading to fatigue, *confusion*, weakness, weight loss. - *Low Aldosterone* (mineral corticoids) which controls BP, by holding sodium and excreting potassium. - So they will have *low NA* (confusion) and *high K* (arrhythmias). - Will be dehydrated and hypotensive. - *Androgens*- Will lose hair - Skin is hyper pigmented, bronzed Addison disease Correct Answer: Adrenal Gland Disorder: Low cortisol, aldosterone, and androgens. - *Low cortisol* (glucosteriods)- so *hypoglycemia* leading to fatigue, *confusion*, weakness, weight loss. - *Low Aldosterone* (mineral corticoids) which controls BP, by holding sodium and excreting potassium. - So they will have *low NA* (confusion) and *high K* (arrhythmias). - Will be dehydrated and hypotensive. - *Androgens*- Will lose hair - Skin is hyper pigmented, bronzed Addison disease Correct Answer: Adrenal Gland Disorder: Low cortisol, aldosterone, and androgens. - *Low cortisol* (glucosteriods)- so *hypoglycemia* leading to fatigue, *confusion*, weakness, weight loss. - *Low Aldosterone* (mineral corticoids) which controls BP, by holding sodium and excreting potassium. - So they will have *low NA* (confusion) and *high K* (arrhythmias). - Will be dehydrated and hypotensive. - *Androgens*- Will lose hair - Skin is hyper pigmented, bronzed Graves Disease Correct Answer: Hyperthyroidsim: - Hypertension, bounded pulse - Neuro= anxiety, resting tremors - GI= diarrhea weight loss, - hot/flushing, heat intolerance. - *Expothalmos* (bulging eyes) increases risk for dry eyes. Wear glasses, moisten eyes with tears, tape eyes shut at night if they cant close. Hyperthyroidsim diet Correct Answer: High calorie, high protein, high carb Avoid caffeine and spicy foods How do we treat Expothalmos? Correct Answer: - *Expothalmos* (bulging eyes) increases risk for dry eyes. Wear glasses, moisten eyes with tears, tape eyes shut at night if they cant close. Thyriod Storm Correct Answer: Life threatening condition which can occur after a stressful incident like a car crash HR, BP and Temp all increase. It's a STORM! Hypothryoidism (hashimoto) Correct Answer: Thyroids disorder - lethargic - Bradycardia - Weight gain - constipation - Cold intolerance - Dry skin, dry hair, hair loss Myexedma coma Correct Answer: Become lethargic to the point of comatose Low HR, RR, Temp, BP......Opposite of thyroids storm Will most likely have to *intubate* due to the enlargement of the tongue which will obstruct the airway Treatment of acute pancreatitis Correct Answer: *Place on NPO*- Food stimulates panreatic secretions. *Pain management* *Push fluids* *NG tube for suction* This all gives pancrease time to heal. A fever would be very concerning for someone with pancreatits. High glucose, pain and steathorrhea would be expected. Signs of pancreatitis Correct Answer: Cullen's sign (ecchymosis of the umbilicus), Grey Turner's sign (bruising of the flank). DKA Priority treatment?? Signs? Correct Answer: Patients in DKA have a glucose level of >250; - 1st treatment is to *hydrate* the patient via IV. This is done before IV Insulin drop as insulin will dehydrate them even more. - So Normal saline to hydrate 1st, then regular insulin. - Slowly discontinue insulin IV when glucose falls below 200 - Watch out for hypokalemia when IV is infusing, start an K IV when K levels are between 3.5-5 Signs= fruity breath, tachycardia, hyperventilation to blow off co2 from acidosis, and kassmuals breathing (deep). hyperosmolar hyperglycemic state Correct Answer: Similar to DKA, but takes place in patient with Type 2 Diabetes who can make some of their own insulin. Therefore, signs of DKA are missing like fruity breath and kassmuals respirations. Glucose level is > 600 Neuro if affected History of type 2 diabetes Signs of hypoglycemia Correct Answer: Glucose > 70: Tremors Pallor (you look white) Restless Diaphoresis/ sweaty Confused Metabolic syndrome Correct Answer: When you have 3 out of 5 conditions that increase the risk of heart disease, stroke, and diabetes. Its a cluster of risks. 1. Abdominal obesity...40inch waist men, 35 inch waist women 2. hyperglycemia.....>100 3. low levels of HDL....<50 4. High trigycerides....>150 4. Hypertension...>130/85 Isotonic solutions Correct Answer: 1). NS (0.9% NaCl) 2). Lactated Ringers Isotinic solution used to replace volume in hypervolemic patients and rehydrate them. polycethemia vera