Nurse Ton

14/06/2023

GAIT DISORDERS
Nursing Quiz

11/06/2023

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08/06/2023

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03/06/2023

The BRAIN
Nursing Quiz

01/06/2023

SURGICAL REMOVAL
Nursing Quiz

31/05/2023

Medical Terminologies
Nursing Quiz

30/05/2023

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16/05/2023

NCLEX-RN #136
Question and Answer w/ Rationale

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16/05/2023

NCLEX-RN #135
Question and Answer w/ Rationale

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16/05/2023

NCLEX-RN #134
Question and Answer w/ Rationale

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16/05/2023

URINARY INCONTINENCE

Pathophysiology
👉🏽Stress incontinence
👉🏽Poor closure of sphincter muscles
👉🏽Common during laughing or coughing
👉🏽Urge incontinence
👉🏽Overactive bladder causing loss of function
👉🏽Nocturnal enuresis (bed-wetting)

Signs and Symptoms
👉🏽Dribbling
👉🏽Urgency/frequency
👉🏽Poor control

Interventions
👉🏽No caffeine, no alcohol (stress incontinence)
👉🏽Kegel exercises (pelvic muscle)
👉🏽Urination schedule (urinate every 2 hours)
👉🏽Pharmacological (tolterodine)

15/05/2023

14/05/2023

🦠HUMAN IMMUNODEFICIENCY VIRUS (HIV) and
🦠 ACQUIREDIMMUNODEFICIENCY SYNDROME (AIDS)

PATHOPHYSIOLOGY
RETROVIRUS: integrates into the DNA of the host CD4 cell (T cell)

SIGNS AND SYMPTOMS
🦠Flu-like (early signs of seroconversion)
🦠Elevated viral load (undetectable is the goal)
🦠Decreased CD4 count (less than 200 means AIDS)
🦠Monitor for signs of comorbidities due to the medications
(liver andkidneys).
🦠Opportunistic infections in AIDS
(pneumocystis jirovecii, Kaposi’ssarcoma—purple, black lesions)

INTERVENTIONS
🦠Pre-exposure prophylaxis (PrEP)
given to high risk individuals at risk forinfection
🦠PrEP also given to newborns birthed by an HIV-positive mother
🦠Post-exposure prophylaxis (PeP) given to healthcare workers who get stuckby a needle (administered within 48 hours)
🦠Antiretroviral medication
🦠Vaccinations (pneumonia, flu, meningitis)

14/05/2023

Nurse Ton QuickNote:

1. Veracity

Truth telling

2.Autonomy

Freedom of choice, self determination and privacy

3. Beneficence

Duty to promote well being of others

4.Nonmaleficence

"do NO HARM"

5.Justice

Fairness

6. Paternalism

Decide for the best interest of the client

7. Fidelity

Faithfulness/loyalty

14/05/2023

ALLERGIES

PATHOPHYSIOLOGY
-Histamine response to a harmless trigger
-Triggered by food, environment, animals, etc.

SIGNS AND SYMPTOMS
-Seasonal allergies (allergic rhinitis)
-Atopic dermatitis
-Anaphylaxis (airway risk)
-Allergy testing (intradermal, patient must stay at the clinic immediately
after injection; every visit)

INTERVENTIONS
-Antihistamines (diphenhydramine, fexofenadine)
-EpiPen (IM injection may be given through clothes)

13/05/2023

HEMOPHILIA

Pathophysiology
✓Genetic bleeding disorder caused by a lack of factor VIII
✓Hemophiliacs do not bleed any faster than normal, but they clot slower.
✓X-linked recessive disorder (affects men more than women)

Signs and Symptoms
✓Spontaneous bleeding
✓Prolonged coags
✓Long-term joint destruction

Interventions
✓Inpatient: bleeding precautions with factor VIII infusions
✓Avoid activities with a high risk of trauma (contact sports).
✓Peripheral injuries do not warrant an ER visit.
✓Central injury (organs) or head injury warrants an ER visit.

13/05/2023

🩸THALLASEMIA🩸

🩸PATHOPHYSIOLOGY
Genetic blood disorder
Abnormal RBCs

🩸SIGNS AND SYMPTOMS
Anemia
Bone deformities, dark urine, jaundice

🩸INTERVENTIONS
Pharmacological
Blood transfusions
Bone marrow transplant

13/05/2023

🩸DISSEMINATED INTRAVASCULAR COAGULATION (DIC)

🩸PATHOPHYSIOLOGY
-Minor trauma causing platelets to be used up
-Complication of sepsis

🩸SIGNS AND SYMPTOMS
-Abnormal bleeding: oozing from IV sites (patient complaining of wetness on arm or dried blood)
-Bleeding can be external and internal.
-Prolonged aPTT and PT/INR

🩸INTERVENTIONS
-Treat the underlying problem (stop the bleed).
-Platelets and FFP

11/05/2023

🛡️IMMUNOLOGY🛡️

🛡️HUMORAL IMMUNITY:
-Antibodies or immunoglobulins
(gained by colostrum andbreast milk at birth)

🛡️ACQUIRED IMMUNITY:
-Learned by infection or vaccination

🛡️CELL-MEDIATED IMMUNITY:
-B and T cells (problem in HIV/AIDS)

🛡️HERDIMMUNITY:
-Indirect protection when the majority of a
population is vaccinated

11/05/2023

🩸BLOOD TYPING🩸
O, A, B
-A and B: dominant alleles
-O neg: universal donor
-AB pos: universal recipient
-Rh factor: dominant allele

🩸BLOOD COMPONENT CHANGES
-LEUKOCYTOSIS: increase in WBC
-ERYTHROCYTOSIS: increase in RBC
-THROMBOCYTOSIS: increase in platelets
-PANCYTOPENIA: universal decrease of blood components

🩸BLOOD DYSCRASIAS
-Changes in the complete blood count (CBC)
-Typically an adverse effect of a medication

11/05/2023

🫀CARDIAC MARKERS🫀

🫀TROPONIN
-By-product of dead heart muscle
-If high: myocardial injury/infarction

🫀CREATINE KINASE
-Inflammation of muscles
(MI, rhabdomyolysis, autoimmunity)

🫀BRAIN NATRIURETIC PEPTIDE (BNP)
-Hormone released by ventricles when stretched
-If high: heart failure

11/05/2023

🩸TRANSFUSION REACTIONS🩸

🩸ALLERGIC REACTION

🩸MINOR: localized rash (individual area), pruritus
-Slow the drip rate and notify the HCP for an antihistamine
(diphenhydramine).

🩸MAJOR: diffuse or generalized rash (all over), difficulty breathing, sweating,complaints of feeling hot.
-Stop the drip, flush normal saline through alternate tubing, and call the
HCP.
-Epinephrine may be needed.

🩸HEMOLYTIC/CYTOTOXIC REACTION

-Incompatible blood (ABO mismatch)
-Flank/back pain (costovertebral)
-Fever
-Dark-colored urine (cola-colored)
-Stop the drip, flush normal saline through alternate tubing, and call the HCP.
-Send remaining blood to blood bank for analysis.

11/05/2023

💦FLUID AND ELECTROLYTES💦

OSMOSIS: Water moves into higher solute concentrations
(water follows salt).
DIFFUSION: Movement of molecules from low to high concentration
HYPEROSMOLAR: Higher concentration than blood
ISO-OSMOLAR: Sameconcentration as blood
HYPO-OSMOLAR: Lower concentration than blood (diluted)

CRYSTALLOIDS

3% and 7% NaCl
💦Hypertonic solution (higher concentration than blood)
💦Used in severe hyponatremia and increased intracranial pressure (ICP)
💦Causes water to shift into the vasculature
💦Risks to dehydrate the surrounding cells
💦Do not use in hypertension (remember, low salt).

0.9% NaCl (Normal Saline)
💦Isotonic solution (same concentration as blood)
💦Used in dehydration and hypovolemia (“fill up the tank”)

0.45% NaCl (Half-Normal Saline)
💦Hypotonic solution (lower concentration than blood)
💦Often combined with dextrose to maintain iso-osmolality

Lactated Ringer’s (LR)
💦Isotonic solution
💦Contains potassium, chloride, sodium, and calcium
💦Used in trauma, volume loss, and especially burns
💦Alkalizing agent used to counteract acidosis (contains bicarb)

Dextrose 5% and 10%
💦Glucose-containing solution
💦Becomes hypotonic once the dextrose is metabolized out
💦Typically combined with other salines
💦Used in hypoglycemia (often severe infection)
💦Contained in vials such as D5 (50%), pushed IV for hypoglycemic protocol

COLLOIDS

ALBUMIN
💦Responsible for 60% of blood osmolality (maintaining blood concentration)
💦Serum protein created by the liver
💦Also given via IV like crystalloids
💦Commonly used in liver failure, burn victims, and general
hypoalbuminemia

BLOOD PRODUCTS

PLATELETS
💦Given for thrombocytopenia (cancer, infection, sepsis, liver failure, heparin induced thrombocytopenia, disseminated intravascular coagulation)

FRESH FROZEN PLASMA (FFP)
💦Contains everything but red blood cells
💦Patient has normal hemoglobin, does not require RBCs

PACKED RED BLOOD CELLS (PRBCS)
💦Given for anemia (low hemoglobin)
💦Hemorrhage

WHOLE BLOOD
💦Entire composition of blood (plasma and RBCs)