Mark Klimek NCLEX Pharm

Mark Klimek NCLEX Pharm Never hold the hormone for what patient? Ans- patient who is NPO with mydexema Addison's disease easy way to remember Ans- Add a Sone (sone = steroid) Best default order for click and drag order questions? Ans- Hold ..... med Assess ..... what med does Prepare ...... the correction Call ..... or notify Rarely if ever answer ... Ans- call Doctor, NCLEX wants you to think critically INR lab values Ans- 2-3, critical value if off, potential for patient to bleed. Use default order for order ?'s (hold all coumadin, assess for bleeding, prepare Vit K (antidote for Coumadin), Call or notify Potassium lab values Ans- 3.5-5.3 If low it is a critical lab to worry about assess the heart and then prepare to give K if high, hold all K, assess heart (EKG), give D5W and reg insulin, call if really high, hold, assess, prepare, call STAT Get someone else involved! Dangerous!! If question says there is pitocin running and there are complications Ans- stop pit first then LIONpit Pain meds in labor Ans- know your peaks for IV, IM, PO, Subling. If baby is likely to be born when the pain med is peaking don't give! Why? Respiratory depression in baby OB medications tocolytics Ans- stop contractions, Brethine causes maternal tachycardia, Nifedipine (dipine - CCB) causes Hypotension and headache OB medications oxytocics Ans- makes labor more intense, Pitocin, Methergine, Cervidil OB medications Fetal/Neonatal Lung meds Ans- Betamethasone, speeds the development of the baby's lungs, given to Mom before baby is born, given IM, will increase the blood sugar of Mom Survanta (surfactant) Ans- given to baby after baby is born given trastracheal through the airway develops lungs Med hints for IM injections Ans- Look for 1's in both parts (the 1 looks like an I), guage and length, 21 g, 1 inch means IM Med hints for SQ injections Ans- look for 5's in both parts (the 5 looks like an S), guage and length, 25 g, 5/8 inch means SQ Drawing up Insulin rules Ans- R then N, Draw up R then N, NRRN the whole process Pressurizing Insulin rule Ans- put air into N then R , NRRN the whole process If 70/30 insulin it is Ans- 70% N and 30% R, may have to make your own on boards, no 70/30 on the floor Heparin is given IV or SQ NOT PO, info re: Heparin Ans- works immediately, labs Ptt or any clotting or bleeding time, antidote: protamine sulfate, course: 21 days, pregnancy: YES (Class C pregnancy drug, use caution) Coumadin is given PO, info re: Coumadin Ans- takes days to work, labs ONLY PT-INR, antidote: Vit K (think Koumadin), course: forever, prengancy: NO (never use) If a diuretic ends in the letter X it is a potassium Ans- wasting drug plus Diurel Baclofen/ Flexoril Ans- muscle relaxant, think on your back loafin'! makes a patient drowsy, weak muscles, don't drink, don't drive, don't care of kids under 12 Piaget's stage Sensorimotor age 0-2, totally When can a child give themselves their own insulin shot? Ans- 7 What 2 parts are always irrelevant in a prioritization question? Ans- age and gender (NCLEX is testing discrimination against agism), age only important for peds All psych drugs cause Ans- low BP and weight change (usually gain) Phenothiazines Ans- all end in 'zine Ex: Thorazine, Compazine, they are major tranquilizers so think safety 'Zines for the Ans- Zanny In large doses Phenothiazines are Ans- anti-psychotics In small doses Phenothiazines are Ans- anti-emetics Side effects of Phenothiazines Ans- Anticholinergic (dry mouth), Blurred vision, Constipation, Drowsiness, Extrapyramidal syndrome (parkinsons), Fotosensitivity, aGranulocytosis (low WBC's) #1 problem or concern for patient taking Phenothiazines Ans- SAFETY Deconoate drug is Ans- a long acting IM form given to non compliant patients Tricyclic Antidepressants are Ans- mood elevators to treat depression Examples of Tricyclic anti depressants Ans- Elavil, tofranil, aventyl desyrel Side effects of Tricyclic medications Ans- Anticholinergic(dry mouth), Blurred Vision, Constipation, Drowsiness, Euphoria HInt: Elavil starts with E so this group goes through E How long does a tricyclic need to be taken before results are seen? Ans- 2-4 weeks Benzodiazepines are for Ans- anti anxiety, they are minor tranquilizers, have 'zep in the name, EX: Diazepam (Valium), plus Xanax, Often given pre op, muscle relaxant, alcohol withdrawal, seizures, facilitates mechanical ventilation Benzodiazepines works Ans- quickly, must not take for 6 weeks, keep on Valium until Elavil kicks in Side effects for Benzodiazepines Ans- Anticholinergic (dry mouth), Blurred Vision, Constipation, Drowsiness Number one nursing concern for patient taking Benzo's is Ans- als