NCLEX Study Guide / NCLEX review class
Erik Erickson
If Infancy
The Toddler
PRESCHOOLER Preschooler
Stops School Age
Acting Adolescence
YOUNG Young Adulthood
ADULTHOOD Aduilthood
Ensues Elderly
Infancy 0 – 18 months Trust vs Mistrust
Toddler 18 months – 3 yrs Autonomy vs Self Doubt
Preschooler 4 - 6 yrs Initiative vs Guilt
School Age 6 – 12 yrs Industry vs Inferiority
Adolescence 13 – 18 yrs Identity vs Role Confusion
Young Adulthood 19 – 39 Intimacy vs Isolation
Adulthood 40 – 64 Generativity vs Stagnation
Elderly 65 and over Integrity vs Despair
Do’s Don’ts
Stay and Protect Lie
Tell the Truth Make False Promises
Use simple terms (check development status) Put down patient
Seek information Enhance Negative behavior
(mental illness symptoms)
Be Judgemental
,Locus of Decision Making – When RN can make own judgements
When to turn comatose patient
Type of feeding schedule (via tube)
Force patient to take meds when they threaten to harm someone
Plan care with Chronically Ill patients to effect lifestyle changes (99% of
decision making is this way)
INFORMATION NOTE: All behavior has meaning. The meaning is to reduce
anxiety.
Those at most risk for Gall Bladder Surgery
FFFF
Fair
Fat
Fifty
Female
Growth and Development
Infancy 0 – 18 months Trust vs Mistrust
Physiological care most important
Diarrhea can be devastating. (Baby 50 – 80% water)
May lead to:
Dehydration
Fluid / Electrolyte Imbalance
Metabolic Acidosis
1st priority to isolate baby who could have infection
1st six months baby only needs breast milk
Iron stored in utero not needed for six months
Baby would get iron supplement if born @ 35 weeks
Give new foods one at a time to check for allergens
Baby doubles weight in first six months
Baby gains weight at 6 to 8 ox / week
Baby Triples weight by 1 yr
If weight gain not adequate = Failure to Thrive
,Typical Problems at this age:
CLEFT PALATE / LIP
Not much known about causes
Ducky Nipple used for sucking
Cleft Lip closed at 6 to 12 weeks
Cleft Palate closed at 12 to 18 months
Waiting for maximum growth before speech age
Baby can breast feed with either problem
Cleft Lip = cheiloplasty
Cleft Plate = Palatoplasty
Post op care is to avoid trauma to surgical site
Prevent baby from touching surgical site
Keep site clean / avoid infection
PKU
Can cause mental retardation
Some symptoms can include behavior changes that mimic psychosis
No enzyme to digest Phenalalanine.
Builds up and causes cessation of brain growth
Guthrie Blood Test is for PKU. Tests for excessive amounts of
Phenylalanine
Performed within 7 days after birth as a HEEL STICK just after baby eats
some protein
Tx = low phenylalanine diet. Levels checked
Nutrasweet & Equal become phenylalanine in the body
12 oz can of diet drink doesn’t raise levels much
Very Restrictive Diet Initially till 14 yrs old
At 14 yrs old brain gorwth 80%
Brain fully formed at 18
NO restaurants, NO Parties
Diet = 1 % protein / veggies (Protein contains a lot of Phenylalanine)
Celiac Dsiease (Think Gluten Intolerance)
Effects small intestines
Malabsorption Syndrome (teacher says metabolism problem)
Teacher says no enzyme to digest gluten
Gluten found in Wheat, Rye, Barley, Oats (BROW)
First evidence of problem = failure to thrive, diarrhea
Stool are oily, foul smelling, and frothy
Corn and rice substituted for other grains.
Cystic Fibrosis (Think Genetic Anomoly)
Autosomal Recessive Trait (both parents have recessive gene)
Earliest manifestation = meconium Ilieus in newborn
Meconium Ileus = small intestine blocked by thick mucousy meconium
, Mucous also blocks pancreatic ducts blocking enzymes to duodenum
Causes impairment of digestion and absorption
Stool can be bulky, frothy, oily, and foul smelling (undigested fat =
steatorrhea)
Often associated with prolapse of rectum and impaction / intestinal
obstruction
Thick mucous builds up in lungs. Hard to expectorate
Patient has high concentration of Na and Cl in sweat
Patients fed high calorie, high protein, low fat meals
Need to take pancreatic enyzmes with EVERYTHING THEY EAT
SIDE NOTES: Preterm is not same as Premature
Premature = < 5 lbs
If child doesn’t prefer mom at 2 yrs old think child abuse
There are 3 autosomal recessive illnesses
Taysachs
Sickle Cell
Cystic Fibrosis
There are 3 types of patients who should eat salty snacks
Cystic Fibrosis
CHF using Lasix + dehydration from heat
Pts on Lithium
EXAM TIP: Notifying the Physician is the last resort. There is usually something for a
NURSE to do before calling them.
Erik Erickson
If Infancy
The Toddler
PRESCHOOLER Preschooler
Stops School Age
Acting Adolescence
YOUNG Young Adulthood
ADULTHOOD Aduilthood
Ensues Elderly
Infancy 0 – 18 months Trust vs Mistrust
Toddler 18 months – 3 yrs Autonomy vs Self Doubt
Preschooler 4 - 6 yrs Initiative vs Guilt
School Age 6 – 12 yrs Industry vs Inferiority
Adolescence 13 – 18 yrs Identity vs Role Confusion
Young Adulthood 19 – 39 Intimacy vs Isolation
Adulthood 40 – 64 Generativity vs Stagnation
Elderly 65 and over Integrity vs Despair
Do’s Don’ts
Stay and Protect Lie
Tell the Truth Make False Promises
Use simple terms (check development status) Put down patient
Seek information Enhance Negative behavior
(mental illness symptoms)
Be Judgemental
,Locus of Decision Making – When RN can make own judgements
When to turn comatose patient
Type of feeding schedule (via tube)
Force patient to take meds when they threaten to harm someone
Plan care with Chronically Ill patients to effect lifestyle changes (99% of
decision making is this way)
INFORMATION NOTE: All behavior has meaning. The meaning is to reduce
anxiety.
Those at most risk for Gall Bladder Surgery
FFFF
Fair
Fat
Fifty
Female
Growth and Development
Infancy 0 – 18 months Trust vs Mistrust
Physiological care most important
Diarrhea can be devastating. (Baby 50 – 80% water)
May lead to:
Dehydration
Fluid / Electrolyte Imbalance
Metabolic Acidosis
1st priority to isolate baby who could have infection
1st six months baby only needs breast milk
Iron stored in utero not needed for six months
Baby would get iron supplement if born @ 35 weeks
Give new foods one at a time to check for allergens
Baby doubles weight in first six months
Baby gains weight at 6 to 8 ox / week
Baby Triples weight by 1 yr
If weight gain not adequate = Failure to Thrive
,Typical Problems at this age:
CLEFT PALATE / LIP
Not much known about causes
Ducky Nipple used for sucking
Cleft Lip closed at 6 to 12 weeks
Cleft Palate closed at 12 to 18 months
Waiting for maximum growth before speech age
Baby can breast feed with either problem
Cleft Lip = cheiloplasty
Cleft Plate = Palatoplasty
Post op care is to avoid trauma to surgical site
Prevent baby from touching surgical site
Keep site clean / avoid infection
PKU
Can cause mental retardation
Some symptoms can include behavior changes that mimic psychosis
No enzyme to digest Phenalalanine.
Builds up and causes cessation of brain growth
Guthrie Blood Test is for PKU. Tests for excessive amounts of
Phenylalanine
Performed within 7 days after birth as a HEEL STICK just after baby eats
some protein
Tx = low phenylalanine diet. Levels checked
Nutrasweet & Equal become phenylalanine in the body
12 oz can of diet drink doesn’t raise levels much
Very Restrictive Diet Initially till 14 yrs old
At 14 yrs old brain gorwth 80%
Brain fully formed at 18
NO restaurants, NO Parties
Diet = 1 % protein / veggies (Protein contains a lot of Phenylalanine)
Celiac Dsiease (Think Gluten Intolerance)
Effects small intestines
Malabsorption Syndrome (teacher says metabolism problem)
Teacher says no enzyme to digest gluten
Gluten found in Wheat, Rye, Barley, Oats (BROW)
First evidence of problem = failure to thrive, diarrhea
Stool are oily, foul smelling, and frothy
Corn and rice substituted for other grains.
Cystic Fibrosis (Think Genetic Anomoly)
Autosomal Recessive Trait (both parents have recessive gene)
Earliest manifestation = meconium Ilieus in newborn
Meconium Ileus = small intestine blocked by thick mucousy meconium
, Mucous also blocks pancreatic ducts blocking enzymes to duodenum
Causes impairment of digestion and absorption
Stool can be bulky, frothy, oily, and foul smelling (undigested fat =
steatorrhea)
Often associated with prolapse of rectum and impaction / intestinal
obstruction
Thick mucous builds up in lungs. Hard to expectorate
Patient has high concentration of Na and Cl in sweat
Patients fed high calorie, high protein, low fat meals
Need to take pancreatic enyzmes with EVERYTHING THEY EAT
SIDE NOTES: Preterm is not same as Premature
Premature = < 5 lbs
If child doesn’t prefer mom at 2 yrs old think child abuse
There are 3 autosomal recessive illnesses
Taysachs
Sickle Cell
Cystic Fibrosis
There are 3 types of patients who should eat salty snacks
Cystic Fibrosis
CHF using Lasix + dehydration from heat
Pts on Lithium
EXAM TIP: Notifying the Physician is the last resort. There is usually something for a
NURSE to do before calling them.
