QUESTIONS CONTINUALLY BEING ADDED (ONES WITH QUESTIONS WILL HAVE LINK-THIS IS STILL A WORK IN PROGRESS):
GROWTH & DEVELOPMENT
REVIEW OF SYSTEMS
Fluoroquinolone SnapShot-General Info About This Class
Certain suspected or confirmed bacterial pneumonia & other respiratory infections
Certain suspected or confirmed bacterial GI infections
Certain suspected or confirmed bacterial eye infections (in ophthalmic form)
Bacterial sinus infections
Urinary tract infections & pyelonephritis
There are many other uses for this class as it treats a variety of bacterial infections
SPECIFIC BACTERIAL COVERAGE
Pseudomonas aeruginosa (copra specifically)
POTENTIAL SERIOUS ADVERSE REACTION: (2)
Tendon rupture (black box warning)
Possible permanent peripheral neuropathy
Seizures potential (lowers threshold)
Myasthenia graves exacerbation
COMMON SIDE EFFECTS:
Renal dysfunction (dosing adjustments will need to be made)
CNS dysfunction disorders
” NSAIDs may enhance the CNS stimulatory effects of fluoroquinolone.” Increases the risk for seizures. “>(1)
Shortness of breath specifically when a patient lays down. These individuals will often sleep in recliners.
DIAGNOSIS MAY SEE THIS:
-Congestive heart failure
(There are other potential causes for orthopnea-these are just a few)
SOME PEARLS OF WISDOM: SOME THINGS EVERY NEW NURSE SHOULD KNOW
NOTE: The above is not intended as medical advice for patients. This is simply for educational purposes for medical professionals only. All patient should ALWAYS check with their primary care provider with any questions that they may have. This informational sheet does not serve as medical advice. As always, medical professionals should always call the on call provider if any clarifications are needed. State and hospital protocols should always be followed accordingly
Lactic acid-sometimes high
You start studying for Nclex all bright eyed and bushy tailed. All your highlighters are in a row, pens in place, notebook pads ready to go, and a plethora of snacks at your side. You are radiating study time energy like a LED light bulb.
But after several days of endless studying, you realize that you may or may not have actually learned anything at all in nursing school. And suddenly you even question yourself; am I even enrolled in nursing school? Did I take the wrong classes? Someone must have mixed up their major with mine. Or is this all just a studying nightmare that you haven’t woken up from yet? Then you slap your self and remember- yes, why yes, I am a nursing student. And I have so faaaarrrrrr to go. You realize that you are no longer a ball of studying energy, all “ready, set, go”. You are not that LED lightbulb, rather a person fiddling around in the dark without matches, just trying to rub 2 sticks together to make a damn camp fire.
When you start studying for Nclex, you feel like you are on the last mile of your marathon..you can see the finish line. Several days after studying, you realize that it wasn’t the finish line at all; you are actually only on mile 22 of 26. You have a mental breakdown, you throw yourself on the floor and began to look like Will Ferrell in the step brothers when he has a temper tantrum about his parents moving.You studied like a maniac and feel like you aren’t getting anywhere. You’ve even neglected some of your daily ADL’s for the sake studying for this test. You are still wearing your clothes that you were wearing from 4 days ago. You have forgotten what day it is. You are pretty sure you have developed a stage 2 pressure ulcer on your coccyx area from sitting so much while studying. You aren’t really sure if it’s you that smells or if it’s the stale food piling up insidiously near your study area. Your hair..well it looks like you got in a fight with it during the night. Your friends and family, well they think that you have secretly escaped to Puerto Vallarta to simply avoid this dreadful test. Let’s face it, you are a mess, moving at a snail pace, dramatically doubting yourself, and wondering “Why did I want to do this nursing thing again?”.
This is where you stop and picture how you will feel the day after the test. This is where you start putting things into perspective.
The reality is, that you just don’t know where to start. You haven’t prepared to study. You have no idea what to expect and you are telling yourself, studying for Nclex is going to kill me! But its not, and you are signed up for this, have made it this far, and will keep making it. You know more than you think you do. But I understand why it’s so easy to feel lost when studying for this test. But never fear, MedMadeEz is here-we’ve got your back! We know that it can be quite overwhelming. And sometimes you just need some direction.
So where to start? What should you expect on the Nclex exam? And where do you find this out? Although you should never expect that you will know all (or any) of the exact question (that’s called cheating), you can at least focus on what areas to study. This can boost your confidence and just help you feel more motivated. And maybe even free up some time for you to throw out that stale food piling up, comb your hair, change your clothes, take a bath, and talk to your family! This is exactly why it is a great idea to do a little research beforehand to determine which areas to focus. So we have done this for you!
An absolutely perfect resource is the The National Council of State Board of Nursing website. They have an AWESOME guide called: Detailed Test Plan for the National Council Licensure Examination for Registered Nurses .
I highly suggest you visit this site and read this guide (Guide link) before you determine how you are going to start studying for Nclex. Don’t start yourself frazzle-dazzled trying to figure it all out alone in the dark. Pictured below are 2 charts (with the same info, just pictured differently) from this “Detailed Test Plan Guide” guide. These are extremely valuable. The guide goes over these areas in detail.
We also have an Instagram-MedMadeEz that you can follow for studying questions. This can really help build your confidence as well. And help test what you know and what you don’t know.
Good luck in this journey to Nclex. You are almost there!! You’ve got this!
NCSBN.org: NCLEX-RN Examination, Detailed Test Plan for the National Council Licensure Examination for Registered Nurse, Candidate Version https://www.ncsbn.org/2016_RN_Test_Plan_Candidate.pdf
Please visit this site for more information!
Warfarin (coumadin) is a blood thinner that decreases the chance for a blood clot. Foods high in vitamin K can interfere with the efficacy of warfarin, thus making it more likely that one could clot. Vitamin K is involved in clot formation in the body.
There are also foods that can do just the opposite and increase the effects of Warfarin-making it more likely that an individual could develop a bleed (ex: intestinal). Examples of foods/drinks that may potentially interact:
DECREASE THE EFFICACY OF WARFARIN (Higher risk to clot)
INCREASE THE EFFECTS OF WARFARIN (Higher risk to bleed)
Disclaimer: This does not act as any form of medical advice. See your PCP for further education & recommends on foods, supplements, drinks to avoid while on this medication. This blog is for medical professional use only. This is not an all inclusive list.
DEFINE: A lung disease that is a combination of chronic bronchitis and emphysema. This disease limits airflow due to inflammation and C02 retention. These individuals often have a chronic cough, wheezing, shortness of air, and increased mucus production. The also generally have destruction of inter-alveolar septa destruction. Alveoli sacs are where 02 and C02 exchange happens.
2. Alpha 1 antitrypsin deficiency
3. Chemical irritant exposure
1. Shortness of air
3. Tight chest
4. Increased mucus production
PHYSICAL EXAM: (HALLMARK SIGNS=**)
1. Barrel chest
2. Clubbing fingernails
5. Decreased lung sounds
6. Thick sputum**
7. Percussion: hyper-resonance
1. Spirometry; FEV1/FVC ratio <70%
2. CBC- may see elevated hit
3. Pulse oximetry: Varies from patient to patient but often seen 88-92%
4. ABG: C02 is often elevated
6. Continuous pulse oximetry
7. A1-antitrypsin screen (specifically in those <45 yrs old)
8. CXR: Hyperinflation
10. Sleep studies
11. Sputum culture
STAGES: (FEV1=Amount of air that can be forcefully expelled in 1 second)
1. Stage 1- Mild FEV1 80% greater than or equal to this. May have some mild shortness of air and increase mucus. Also an ongoing chronic cough
2. Stage 2- Moderate FEV1 between 50-79%
3. Stage 3-Severe FEV! Between 30-49%
4. Stage 4- END STAGE Very severe. FEV1 <30%
5. Lung transplant. 02 around the clock
MEDICATIONS COMMONLY USED:
1. Short acting B-agonist: Example: Albuterol scheduled and PRN
2. Anticholinergic-example: Ipratropium, Tiotropium. These meds ease the airways
3. Long Acting B-agonist: Salmeterol, Formoterol
5. Oxygen (typical 2-3 L in pm)
1. IV steroids
2. Empiric antibiotic
3. 02 nasal cannula
RISK FOR ACUTE FLARES:
1. Recent URI
4. Environmental irritants
5. Weather changes
1. Vaccination- pneumovax & influenza recommended
2. Smoking cessation
3. Your airflow (in & out) is limited due to obstruction, thus you may have ongoing mild shortness of air. If you shortness of air suddenly increases you should be seen ASAP by a medical healthcare
provider (Emergency Room)
4. Pursed lip breathing
5. Avoid triggers: cold air, infections, air pollutants, cigarette smoke
6. Eat smaller more frequent meals
1. Chronic anemia
2. Respiratory failure
3. Right ventricular hypertrophy
4. Recurrent lung infections
5. Cor pulmonale: right sided heart failure secondary to COPD
DIFFERENTIAL DIAGNOSIS (Dx that can appear similar)
1. Congestive heart failure
3. Pneumonia: Fever, more acute
4. Asthma: may be younger.
5. Lung cancer
6. Chronic pulmonary embolism
8. Reactive airway
2. Blue Bloater
3. Pink Puffer
4. Hypoxic drive theory
1. American Lung Association http://www.lung.org/lung-health-and-diseases/lung-disease-lookup/copd/
2. National Heart, Lung, And Blood Institute http://www.nhlbi.nih.gov/health/health-topics/topics/copd
3. Medscape http://emedicine.medscape.com/article/297664-overview
4. COPD Foundation http://journal.copdfoundation.org
1. The 5-minute Clinical consult 2015 43rd Edition page 240. Alan J Crop MD, Bryon Veynovich. Editor in Chief Frank J Domino
2. Epocrates COPD May 2016
3. COPD Foundation http://www.copdfoundation.org/What-is-COPD/COPD-Facts/Glossary.aspx
4. Healthline, End-Stage COPD, Written by Rachel Nall, RN, BSN, CCRN Medically Reviewed by Mark R Laflamme, MD on November 19, 2015 http://www.healthline.com/health/copd/end-stage-copd#Overview1
5. UPMC Life Change Medicine http://www.upmc.com/patients-visitors/education/breathing/pages/chronic-obstructive-pulmonary.aspx
Update on May 2nd,2016