NUR 280 Comp Review- comp 1,
comp 2, comp 3 - {NEWLY
UPDATED DOC} Download To
Score An A
,NUR280 COMP 2 REVIEW
Prioritization- acute has a higher priority than chronic
o Suddenly, new onset, just developed
Lab values!!! – don’t just know the ranges, but know how your patient is going to
present if they are high/low
o Hypocalcemia-Decreased HR, hypotension, decreased peripheral pulses,
hyperactive bowels, cramping causes by diet, parathyroid disease,
anticonvulsants, renal failure.
o Hypercalcemia- Increased HR, bounding pulses, muscle cramps, N&V, caused by
TB or other respiratory issues, dehydration, diuretics and parathyroid disease.
o Hypomagnesemia- Tetany and positive chop sticks signs, caused by chronic
alcohol abuse and GI losses.
o Hypermagnesemia decreased deep tendon reflexes(OB/GYN), hypotension,
bradycardia, bradypnea, and asystole, caused by excessive intake of Mg but most
commonly causes by renal failure.
o Hypokalemia-Psychosis, muscle cramps, palpitations and uncontrolled diabetes,
caused by diarrhea, vomiting, alcohol abuse, excessive laxative use, Cushing’s
Disease diuretics and anything that relates to metabolic alkalosis.
o Hyperkalemia- Arrhythmias, fatigue caused by DKA, metabolic acidosis,
Addison’s disease, severe burns, ACE inhibitors.
o Hyponatremia- headache, neuro changes, seizures caused by excess water; DI, or
renal failure or drinking too much water.
o Hypernatremia- Excessive thirst, dry mouth, neuro changes caused by loss of
water through skin, heatstroke.
Also know dig toxicity s/s and lithium toxicity s/s
o Digoxin toxicity- 0.5-2.0 is therapeutic level. Anything greater is toxicity!
Things to remember about dig: take apical pulse for 1 full minute before
administering. Eat foods high in potassium. Digibind is antidote. Monitor
renal efficiency and electrolytes
Digoxin is to increase contractility of the heart
Dig toxicity- tachycardia, anorexia, n/v, visual disturbances (halos),
dysrhythmias!
o Lithium toxicity- 1.0-1.5 is therapeutic level. Anything greater is toxicity!
Things to remember about lithium: blood levels must be monitored
frequently, take with meals to reduced GI distress, takes 1-2 weeks to get
in therapeutic level. Should have consistent fluid and sodium intake
(2500-3000 mL/day)
Lithium is a mood stabilizer- used for bipolar
Toxicity- vomiting, diarrhea, drowsiness, muscular weakness, ataxia.
Newborn care prioritization
o Heat loss is critical!
o Respiratory distress- airway!!!!
, Bulb suctioning- mouth first and then nose!
o Apgar score
Heart rate, respiratory effort, muscle tone, reflexes, color.
0-3 poor, 4-6 fair, 7-10 excellent.
o Bonding- how is mom reacting to baby? Watch for postpartum depression!!!
o Shots and drops- vitamin K drops in eyes, and hep B shot
o Umbilicus care- 2 arteries and 1 vein
Keep it dry, open to air, don’t submerge it.
Dab it dry- no alcohol or other substance use
IV solution is running late- don’t increase the rate! - fluid overload
Besides checking iV site, priority patient assessment is respiratory
o Crackles!!!!
How are Thyroid storm, organ rejections, and infection alike- increase in temperature!
o Tachycardia,
o Hyperpyrexia (high fever)
Thyroidectomy- have emergency trach kit and ambu bag at bedside
o Low or semi-fowler’s
o Support head, neck, and shoulders to prevent flexion or hyperextension of suture
line; elevate head of bed to 30 degrees
o Trach set and suction supplies at bedside
o Give fluids as tolerated.
o Complications:
Laryngeal nerve injury- detected by hoarseness
Thyoidtoxicosis- increased temperature, increased pulse, hypertension,
abdominal pain, diarrhea, confusion, agitation, seizures
Treatment- hypothermia blanket, oxygen, potassium iodine, PTU,
propranolol, hydrocortisone, acetaminophen; also caused by
trauma, infection, palpation, RAI therapy
Hemorrhage- check back of neck and upper chest for bleeding
Respiratory obstruction
Tetany (from decreased calcium from parathyroid involvement- Chvostek’s
and Trousseau’s sign
Have IV calcium gluconate or IV calcium chloride available
Parathyroid gland removal along with thyroid- hypocalcemia- chovasetk and trousseau’s
sign
o CATS!!! - hypocalcemia
What do ACE inhibitors, Addison’s disease, and potassium sparing diuretics-
hyperkalemia
o ACE inhibitors- causes decreased BP, decreased aldosterone secretions- sodium
and fluid loss this causes high levels of potassium (end in –pril)
comp 2, comp 3 - {NEWLY
UPDATED DOC} Download To
Score An A
,NUR280 COMP 2 REVIEW
Prioritization- acute has a higher priority than chronic
o Suddenly, new onset, just developed
Lab values!!! – don’t just know the ranges, but know how your patient is going to
present if they are high/low
o Hypocalcemia-Decreased HR, hypotension, decreased peripheral pulses,
hyperactive bowels, cramping causes by diet, parathyroid disease,
anticonvulsants, renal failure.
o Hypercalcemia- Increased HR, bounding pulses, muscle cramps, N&V, caused by
TB or other respiratory issues, dehydration, diuretics and parathyroid disease.
o Hypomagnesemia- Tetany and positive chop sticks signs, caused by chronic
alcohol abuse and GI losses.
o Hypermagnesemia decreased deep tendon reflexes(OB/GYN), hypotension,
bradycardia, bradypnea, and asystole, caused by excessive intake of Mg but most
commonly causes by renal failure.
o Hypokalemia-Psychosis, muscle cramps, palpitations and uncontrolled diabetes,
caused by diarrhea, vomiting, alcohol abuse, excessive laxative use, Cushing’s
Disease diuretics and anything that relates to metabolic alkalosis.
o Hyperkalemia- Arrhythmias, fatigue caused by DKA, metabolic acidosis,
Addison’s disease, severe burns, ACE inhibitors.
o Hyponatremia- headache, neuro changes, seizures caused by excess water; DI, or
renal failure or drinking too much water.
o Hypernatremia- Excessive thirst, dry mouth, neuro changes caused by loss of
water through skin, heatstroke.
Also know dig toxicity s/s and lithium toxicity s/s
o Digoxin toxicity- 0.5-2.0 is therapeutic level. Anything greater is toxicity!
Things to remember about dig: take apical pulse for 1 full minute before
administering. Eat foods high in potassium. Digibind is antidote. Monitor
renal efficiency and electrolytes
Digoxin is to increase contractility of the heart
Dig toxicity- tachycardia, anorexia, n/v, visual disturbances (halos),
dysrhythmias!
o Lithium toxicity- 1.0-1.5 is therapeutic level. Anything greater is toxicity!
Things to remember about lithium: blood levels must be monitored
frequently, take with meals to reduced GI distress, takes 1-2 weeks to get
in therapeutic level. Should have consistent fluid and sodium intake
(2500-3000 mL/day)
Lithium is a mood stabilizer- used for bipolar
Toxicity- vomiting, diarrhea, drowsiness, muscular weakness, ataxia.
Newborn care prioritization
o Heat loss is critical!
o Respiratory distress- airway!!!!
, Bulb suctioning- mouth first and then nose!
o Apgar score
Heart rate, respiratory effort, muscle tone, reflexes, color.
0-3 poor, 4-6 fair, 7-10 excellent.
o Bonding- how is mom reacting to baby? Watch for postpartum depression!!!
o Shots and drops- vitamin K drops in eyes, and hep B shot
o Umbilicus care- 2 arteries and 1 vein
Keep it dry, open to air, don’t submerge it.
Dab it dry- no alcohol or other substance use
IV solution is running late- don’t increase the rate! - fluid overload
Besides checking iV site, priority patient assessment is respiratory
o Crackles!!!!
How are Thyroid storm, organ rejections, and infection alike- increase in temperature!
o Tachycardia,
o Hyperpyrexia (high fever)
Thyroidectomy- have emergency trach kit and ambu bag at bedside
o Low or semi-fowler’s
o Support head, neck, and shoulders to prevent flexion or hyperextension of suture
line; elevate head of bed to 30 degrees
o Trach set and suction supplies at bedside
o Give fluids as tolerated.
o Complications:
Laryngeal nerve injury- detected by hoarseness
Thyoidtoxicosis- increased temperature, increased pulse, hypertension,
abdominal pain, diarrhea, confusion, agitation, seizures
Treatment- hypothermia blanket, oxygen, potassium iodine, PTU,
propranolol, hydrocortisone, acetaminophen; also caused by
trauma, infection, palpation, RAI therapy
Hemorrhage- check back of neck and upper chest for bleeding
Respiratory obstruction
Tetany (from decreased calcium from parathyroid involvement- Chvostek’s
and Trousseau’s sign
Have IV calcium gluconate or IV calcium chloride available
Parathyroid gland removal along with thyroid- hypocalcemia- chovasetk and trousseau’s
sign
o CATS!!! - hypocalcemia
What do ACE inhibitors, Addison’s disease, and potassium sparing diuretics-
hyperkalemia
o ACE inhibitors- causes decreased BP, decreased aldosterone secretions- sodium
and fluid loss this causes high levels of potassium (end in –pril)
