NCLEX Prep/passers Support Group.".

Principles of Positioning

Drug: ADENOSINE
Indications:
* Stable Supraventricular tachycardia
* Ventricular tachycardia (monomorphic)
TIP: Doses should be administered and followed with a rapid flush as fast as possible

Drug: AMIODARONE
Indications:
* Ventricular Tachycardia (VT)
* Ventricular Fibrillation (VF)
* Stable Supraventricular Tachycardia
note: Initiate the use of Amiodarone only after the first line treatments (defibrillation/cardioversion and epinephrine) have failed to treat

Drug: ATROPINE
Indication : Symptomatic Bradycardia
contraindicated: angle closure glaucoma

Drug: DILTIAZEM
Indications:
* Narrow complex tachycardia
* Angina Pectoris

Drug: DOPAMINE
Indications:
* Symptomatic bradycardia
* Severe hypotension
Contraindicated: Compromised renal function

Drug: EPINEPHRINE
Indications:
* Pulseless Ventricular Tachycardia (pVT)
* Ventricular Fibrillation (VF)
* Asystole
* Pulseless Electrical Activity (PEA)
* Bradycardia
Contraindicated: angle closure glaucoma

Drug: LIDOCAINE
Indication: 2nd line agent if amiodarone is unavailable

Drug: MAGNESIUM
Indication: torsades de pointes (polymorphic VT associated with a prolonged QT interval), hypomagnesemia, and digitalis toxicity

Drug: PROCAINAMIDE
Indication:
* Ventricular tachycardia with a pulse
* Supraventricular tachycardia
* Atrial fibrillation
* Atrial flutter

Drug: SOTALOL
Indication : Life-threatening ventricular arrhythmias

🧠DIVERTICULAR DISEASE

- a condition in which there are sac-like protrusions in the large intestine (diverticula).
- the left (descending, sigmoid) colon is the most common area for diverticula to develop.

DIVERTICULOSIS
- is characterized by the presence of these protrusions; the client is asymptomatic and may not even be awaee of the condition.

DIVERTICULITIS
- occurs when diverticula become infected and inflamed.
- complications include:
🔹abscess
🔹fistula formation
🔹intestinal obstruction
🔹peritonitis (progressive pain im other quadrants of the abdomen, rigidity, guarding, rebound tenderness and is a potentially lethal complication and should be reported immediately)
🔹sepsis

Diverticular bleeding occurs when a blood vessel next to one of these pouches bursts; this may cause blood in the stool.

The etiology of diverticular disease has been linked to chronic constipation, a major cause of excess intracolonic pressure. Preventing constipation may help reduce the risk of diverticula forming and becoming inflamed.

❇️Measures to prevent constipation include:
☑️ Diet high in fiber (whole grains, fruits, vegetables)
☑️ Daily intake of at least 8 glasses of water or other fluids
☑️ Exercise
☑️ A fiber supplement such as psyllium or bran may be advised.
In the past, clients have been taught to avoid consuming seeds, nuts, and popcorn; however, current evidence does not indicate that avoidance of these foods will prevent an episode of diverticulitis.

❇️Acute care for diverticulitis focuses on allowing the colon to rest and the inflammation to resolve. This includes:
☑️ NPO status - more acute cases require complete rest of the bowel. Less severe cases may be handled at home, and clients may tolerate a low-fiber or clear liquid diet.
☑️ IV fluids to prevent dehydration when NPO.
☑️ Pain relief via IV medications to maintain NPO status.
☑️ Preventing increased intraabdominal pressure to avoid perforation and rupture.
☑️ Preventing increased intestinal motility - avoid laxatives and enemas.
☑️ IV antibiotic therapy - to cover the gram-negative and anaerobic organisms that reside in the colon and contribute to diverticulitis; these commonly include metronidazole (Flagyl) plus trimethoprim/sulfamethoxazole (TMZ) (Bactrim or Bactrim DS; Septra) or ciprofloxacin (Cipro).

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The student nurse is reviewing IV tubing principles with the preceptor. The student is correct in stating which of the following as the biggest risk to connecting and disconnecting secondary tubing multiple times?
1.The medication is at risk of spilling out of the tubing

2.The client could develop a catheter-related bloodstream infection

3.The chances of administering medication to the wrong client increases

4.The client may injure him or herself with the IV tubing when it is disconnecte

The nurse is caring for a woman with Graves’ disease who communicates she is very self-conscious about her exophthalmos. Which response by the nurse reflects the integration of the Theory of Transpersonal Nursing?

1.It seems like this is really bothering you. I have time to talk about it. Tell me more about how you are feeling."

2.Everyone has their own insecurities. I promise no one is even looking at it!"

3.I can relate. Let me tell you about this time that I had surgery and felt really unattractive."

4.It sounds like you are having a hard time. Would you like me to refer you to a social worker?

The nurse has just received the shift report and is preparing to make rounds. Which of the following clients should be seen first?
1. The client three days after a coronary artery bypass surgery with a fever of 100.2 degrees
2.The client with a cerebral aneurysm and an O2 sat of 99 percent
3.The client admitted an hour ago with shortness of breath
4.The client being prepared for discharge after a femoral popliteal bypass graft

A nurse is caring for a pregnant client who has been diagnosed with anemia. What management plan should the nurse anticipate?
1.Monthly blood transfusions

2.Complete blood counts twice a month

3.Weekly blood pressure

4.Platelet counts twice a month

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