0789737051_tearcard.qxd

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. Variable decelerations—Are noted as V-shaped on
the monitoring strip. Variable decelerations can occur anytime during monitoring of the fetus. They are caused by cord compression. The intervention is to change the mother’s position; if pitocin is infusing,stop the infusion; apply oxygen; and increase the rate of IV fluids. Contact the doctor if the problem persists.
. Late decelerations—Occur after the peak of the
The NCLEX-RN® Cram Sheet
contraction and mirror the contraction in length andintensity. These are caused by uteroplacental insuffiency. The intervention is to change the mother’s . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
16. Therapeutic drug levels
position; if pitocin is infusing, stop the infusion; applyoxygen;, and increase the rate of IV fluids. Contact the This cram sheet contains the distilled, key facts about the licensure exam. Review this information just before you enter the testing center, paying special attention to those areas where you feel you need the most review.
21. TORCHS syndrome in the neonate—This is a combination
You can transfer any of these facts from your head onto a blank sheet provided by the testing center. We also of diseases. These include toxoplasmosis, rubella (German recommend reading the glossary as a last-minute cram tool before entering the testing center. Good luck.
measles), cytomegalovirus, herpes, and syphyllis. Pregnantnurses should not be assigned to care for the client with 17. Vital signs (adult)
GENERAL TEST INFORMATION
NORMAL LAB VALUES
22. STOP—This is the treatment for maternal hypotension
1. Minimum 75/maximum 265—The maximum time allotted
12. Serum electrolytes—It is important for you to remember
for the test is 6 hours. Don’t get frustrated if you need to these normal lab values because they might be included in take the entire number of items or take the entire allotted . Blood pressure: 110–120 (systolic); 60–90 (diastolic) time. Get up and move around and take breaks if you need 2. Turn the client on the left side.
18. Maternity normals
2. Take deep breaths and imagine yourself studying in
4. If hypovolemia is present, push IV fluids.
your favorite location—Take a small item with you that
you have had with you during your study time.
23. Anticoagulant therapy and monitoring
3. Read the question and all answers carefully—
. Contractions: normal frequency 2–5 minutes apart; . Coumadin (sodium warfarin) PT: 10–12 sec. (control).
Don’t jump to conclusions or make wild guesses.
normal duration < 90 sec.; intensity < 100 mm/hg.
. Antidote: The antidote for Coumadin is vitamin K.
4. Look for keywords—Avoid answers that include always,
. Amniotic fluid: 500–1200 ml (nitrozine urine-litmus . Heparin/Lovenox/Dalteparin PTT: 30–45 sec. (control).
never, all, every, only, must, no, except, or none.
13. Hematology values
paper green/amniotic fluid-litmus paper blue).
. Antidote: The antidote for Heparin is protamine 5. Watch for specific details—Avoid vague answers.
. Apgar scoring: A = appearance, P = pulses, G = grimace, A = activity, R = reflexes (Done at 1 and 5 . Therapeutic level: It is important to maintain a 6. Eliminate answers that are clearly wrong or incorrect—
minutes with a score of 0 for absent, 1 for decreased, bleeding time that is slightly prolonged so that Eliminating any incorrect answer increases the probability clotting will not occur; therefore, the bleeding time of selecting the correct answer by 25%.
. Hgb: 12–16 gms women; 14–18 gms men . AVA: The umbilical cord has two arteries and one with mediication should be 1 1/2–2 times the control.
7. Look for information given within the question and the
14. ABG values
vein. (Arteries carry deoxygenated blood. The vein answers—For example, the phrase “client with diabetic
*The control is the premedication bleeding time.
ketoacidosis” should bring to mind the range of 7.35–7.45 19. FAB 9—Folic acid = B9. Hint: B stands for brain (decreases
24. Rule of nines for calculating TBSA for burns
the incidence of neural tube defects); the client should 8. Look for the same or similar wording in the question
begin taking B9 three months prior to becoming pregnant.
and the answers.
20. Abnormalities in the laboring obstetric client—
9. Watch for grammatical inconsistencies—Subjects and
15. Chemistry values
Decelerations are abnormal findings on the fetal monitoring verbs should agree, meaning singular subject, singular verb or plural subject, plural verb. If the question is an incomplete sentence, the correct answer should complete Early decelerations—Begin prior to the peak of the
the question in a grammatically correct manner.
contraction and end by the end of the contraction.
They are caused by head compression. There is no 10. Don’t read into questions—Reading into the question
need for intervention if the variability is within normal can create errors in judgment. If the question asks for an range (that is, there is a rapid return to the baseline immediate response or prioritization of action, choose the fetal heart rate) and the fetal heart rate is within answer that is critical to the life and safety of the client.
*Information included in laboratory test may vary slightly 11. Make an educated guess—If you are unsure after
carefully reading the question and all the answers, chooseC or the answer with the most information.
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CULTURAL AND RELIGIOUS CONSIDERATIONS
. pH up, CO down, and HCO down = respiratory LEGAL ISSUES IN NURSING
. Proton pump inhibitors: Esomeprazole (Nexium),
lansoprazole (Prevacid), pantoprazole (Protonix), IN HEALTH CARE
Review common legal terms: tort, negligence, malpractice, . pH up, CO up, and HCO up = metabolic alkalosis 25. Arab American cultural attributes—Females avoid eye
. Anticoagulant drugs: Heparin sodium (Hepalean),
contact with males; touch is accepted if done by same-sex 32. Addison’s versus Cushing’s—Addison’s and Cushing’s
Legalities—The RN and the physician institute seclusion enoxaparin sodium (Lovenox), dalteparin sodium healthcare providers; most decisions are made by males; are diseases of the endocrine system involving either protection. The MD or the hospice nurse can pronounces Muslims (Sunni) , refuse organ donation; most Arabs do not overproduction or inadequate production of cortisol: eat pork; they avoid icy drinks when sick or hot/cold drinks 40. Drug schedules
. Treatment for the client with Addison’s: increase together; colostrum is considered harmful to the newborn.
39. Types of drugs
sodium intake; medications include cortisone . Schedule I—Research use only (example LSD)
*The generic name is listed first with the trade name 26. Asian American cultural attributes—They avoid direct
. Schedule II—Requires a written prescription
eye contact; feet are considered dirty (the feet should be . Treatment for the client with Cushing’s: restrict touched last during assessment); males make most of . Angiotensin-converting agents: Benazepril
sodium; observe for signs of infection.
the decisions; they usually refuse organ donation; they (Lotensin), lisinopril (Zestril), captopril (Capoten), . Schedule III—Requires a new prescription after
generally do not prefer cold drinks, believe in the “hot-cold” 33. Treatment for spider bites/bleeding—RICE (rest, ice,
enalapril (Vasotec), fosinopril (Monopril), moexipril six months or five refills (example codeine) (Univas), quinapril (Acupril), ramipril (Altace) . Schedule IV—Requires a new prescription after
27. Native American cultural attributes—They sustain eye
34. Treatment for sickle cell crises—HHOP (heat, hydration,
Beta adrenergic blockers: Acebutolol (Monitan,
contact; blood and organ donation is generally refused; they Rhotral, Sectral), atenolol (Tenormin, Apo-Atenol, . Schedule V—Dispensed as any other prescription
might refuse circumcision; may prefer care from the tribal Nova-Atenol), esmolol (Brevibloc), metaprolol or without prescription if state law allows (example shaman rather than using western medicine.
35. Five Ps of fractures and compartment syndrome—
(Alupent, Metaproterenol), propanolol (Inderal) These are symptoms of fractures and compartment . Anti-infective drugs: Gentamicin (Garamycin,
28. Mexican American cultural attributes—They might avoid
41. Medication classifications commonly used in a
Alcomicin, Genoptic), kanamycin (Kantrex), neomycin direct eye contact with authorities; they might refuse organ medical/surgical setting
(Mycifradin), streptomycin (Streptomycin), tobramycin donation; most are very emotional during bereavement; . Antacids—Reduce hydrochloric acid in the stomach
believe in the “hot-cold” theory of illness.
Benzodiazepine drugs: Clonazepam (Klonopin),
. Antianemics—Increase red blood cell production
29. Religions beliefs
diazepam (Valium), chlordiazepoxide (Librium), . Anticholenergics—Decrease oral secretions
Jehovah’s Witness—No blood products should
. Anticoagulants—Prevent clot formation
. Phenothiazine drugs: Chlopromazine (Thorazine),
. Hindu—No beef or items containing gelatin
prochlorperazine (Compazine), trifluoperazine Anticonvulsants—Used for management of
36. Hip fractures—Hip fractures commonly hemorrhage,
(Stelazine), promethazine (Phenergan), hydroxyzine . Jewish—Special dietary restrictions, use of
whereas femur fractures are at risk for fat emboli.
. Antidiarrheals—Decrease gastric motility and
37. Profile of gallbladder disease—Fair, fat, forty, five
. Glucocorticoid drugs: Prednisolone (Delta-Cortef,
30. Therapeutic diets
pregnancies, flatulent (actually gallbladder disease can Prednisol, Prednisolone), prednisone (Apo-Prednisone, . Antihistamines—Block the release of histamine
. Renal diet—High calorie, high carbohydrate, low
Deltasone, Meticorten, Orasone, Panasol-S), . Antihypertensives—Lower blood pressure and
protein, low potassium, low sodium, and fluid betamethasone (Celestone, Selestoject, Betnesol), TIPS FOR ASSIGNING STAFF DUTIES
Mymethasone, Dalalone), cortisone (Cortone), . Anti-infectives—Used for the treatment of infections
. Gout diet—Low purine; omit poultry (“cold chicken”)
38. Management and delegation
hydrocortisone (Cortef, Hydrocortone Phosphate, medication for acute episodes: Colchicine; Bronchodilators—Dilate large air passages in
. Delegate sterile skills such as dressing changes to Cortifoam), methylprednisolone (Solu-cortef, Depo- the RN or LPN. Where nonskilled care is required, Medrol, Depopred, Medrol, Rep-Pred), triamcinolone . Heart healthy diet—Low fat (less than 30% of
you can delegate the stable client to the nursing (Amcort, Aristocort, Atolone, Kenalog, Triamolone) . Diuretics—Decrease water/sodium from the Loop
assistant. Choose the most critical client to assign to . Antivirals: Acyclovir (Zovirax), ritonavir (Norvir),
the RN, such as the client who has recently returned 31. Acid/base balance
saquinavir (Invirase, Fortovase), indinavir (Crixivan), . Laxatives—Promote the passage of stool
from chest surgery. Clients who are being discharged abacavir (Ziagen), cidofovir (Vistide), ganciclovir . Miotics—Constrict the pupils
. ROME (respiratory opposite/metabolic equal) is a should have final assessments done by the RN.
quick way of remembering that in respiratory . Mydriatics—Dilate the pupils
. The PN, like the RN, can monitor clients with IV acid/base disorders the pH is opposite to the other Cholesterol-lowering drugs: Atorvastatin (Lipitor),
. Narcotics/analgesics—Relieve moderate to
components. For example, in respiratory acidosis, therapy, insert urinary catheters and feeding tubes, fluvastatin (Lescol), lovastatin (Mevacor), pravastatin the pH is below normal and the CO is elevated, as apply restraints, discontinue IVs, drains, and sutures.
(Pravachol), simvastatin (Zocar), rosuvastatin (Crestor) is the HCO (respiratory opposite). In metabolic For room assignments, do not coassign the Angiotensin receptor blocker drugs: Valsartan
disorders, the components of the lab values are the post-operative client with clients who have vomiting, (Diovan), candesartan (Altacand), losartan (Cozaar), same. An example of this is metabolic acidosis.
diarrhea, open wounds, or chest tube drainage.
In metabolic acidosis, the pH is below normal and Remember the A, B, Cs (airway, breathing, circulation) . Cox 2 enzyme blocker drugs: Celecoxib (Celebrex),
the CO is decreased, as is the HCO . This is true in when answering questions choices that ask who would you see first. For hospital triage, care for the Histamine 2 antagonist drugs: Cimetidine
pH down, CO up, and HCO up = respiratory acidosis client with a life-threatening illness or injury first.
(Tagamet), famotidine (Pepcid), nizatidine (Axid), For disaster triage, choose to triage first those clients . pH down, CO down, and HCO down = metabolic who can be saved with the least use of resources.
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