Nursing Board Exam Test Drill 1
Nursing Board Exam Test Drill 1
Nursing Board Exam Test Drill 1
Green tea - antioxidant (check if risk for A sign of improvement from dehydration would be a decreased urine
calculi-oxalates) specific gravity and a decreased/decreasing hematocrit. So the SG of
1.015 and a Hct of 46% would be the answer. It is the best answer of
Echinacea - immune stimulant (6-8 weeks only)(C/I in the two you had in you question.
SANDIMMUNE-Immunosuppressant) The normal urine SG is 1.003-1.035 (Usually between 1.010-1.025
with normal hydration and volume) (different texts give a slightly
Licorice - cough and cold different range).
SG 1.025-1.030+ (concentrated urine)
Ginger root - antinausea (C/I in Coumadin) SG 1.001-1.010 (dilute urine)
SG 1.001-1.018 in infants under 2 years of age
Ginkgo - improves circulation (C/I in anticoagulant, Specific gravity is a measurement of the kidney's ability to concentrate
headache side effect - check PT) urine. The range of urine's SG depends on the state of hydration and
varies with urine volume and the load of solids to be excreted under
Ma huang - bronchodilator, stimulant (Ephedra) standardized conditions; when fluid intake is restricted or increased, SG
measures the concentrating and diluting functions of the kidney. Loss
of these functions is an indication of renal dysfunction.
Digitalis Toxicity includes.. SG values usually vary inversely with amounts of urine excreated
N - nausea (decrease in urine volume = increase in specific gravity). However in
A - anorexia some conditions this is not the case.
V - vomiting
D - diarrhea EYE ABBREVIATIONS
A - abdominal pain OU- both eyes
OR- right eye
OS- left eye
Drugs which can cause URINE DISCOLORATION
Adriamycyn------ Reddish
Rifabutin--------- Red orange CUSHINGS (Hypersecretion of Adrenal Cortex Hormones)
Rifampicin------- Red orange
Bactrim---------- Red orange C = Check VS, particularly BP
Robaxin--------- Brown, Black or Greenish U = Urinary output & weight monitoring
Azulfidine------ Orange yellow S = Stress Management
Flagyl------------ Brownish H = High CHON diet
Dilantin---------- Pink tinged I = Infection precaution
Anti Psychotic-- Pinkish to Red brown N = Na+ restriction
Early signs of hypoxia: G = Glucose & Electrolytes Monitoring
R-restlessness S = Spousal support
A-anxiety
T-Tachycardia ADDISON'S (Hyposecretion of Adrenal Cortex Hormones)
Late signs of hypoxia: Always Remember the 6 A's of Addison's disease
B-bradycardia
E-extreme restlessness 1.) Avoid Stress
D-dyspnea 2.) Avoid Strenuous
In pedia- 3.) Avoid Individuals with Infection
F-feeding difficulty 4.) Avoid OTC meds
I-inspiratory stridor 5.) A lifelong Glucocorticoids Therapy
N-nares flare 6.) Always wear medic alert bracelet
E-expiratory grunting
S-sternal retractions
Respiratory Patterns Hirschsprung’s diagnosed with rectal biopsy looking for absence of
Kussmaul- fruity acetone breath odor ganglionic cells. Cardinal sign in infants is failure to pass meconium,
Cheyne-stokes- near death breathing pattern and later the classic ribbon-like and foul smelling stools.
Hypotension and vasoconstricting meds may alter the accuracy of o2 INFECTION CONTROL:
sats. Sample Test Item:
3. Which of the following methods should the RN utilize in patient with
An antacid should be given to a mechanically ventilated patient w/ an SALMONELLA?
ng tube if the ph of the aspirate is <5.0. Aspirate should be checked at O 1 Airborne Precautions
least every 12 hrs. O 2 Droplet Precautions
O 3 Neutropenic Precautions
Ambient air (room air) contains 21% oxygen. O 4 Enteric Precautions
The correct answer: 4.
The first sign of ARDS is increased respirations. Later comes dyspnea, Salmonella mode of transmission is fecal oral (enteric)
retractions, air hunger, cyanosis. Handwashing
Gloves must be used in handling bedpan and diapers
Normal PCWP is 8-13. Readings of 18-20 are considered high. Gown - if soiling is likely to happen.
Source of infection:
First sign of PE (pulmonary embolism) is sudden chest pain, followed Contaminated food and water.
by dyspnea and tachypnea. Remember - Transmission Based precautions:
A ir
High potassium is expected with carbon dioxide narcosis (hydrogen B orne, small particles are dispersed in the air like MTB, varicella
floods the cell forcing potassium out). Carbon dioxide narcosis causes C ontact, drug-resistant microorganisms
increased intracranial pressure. D roplet, large particles are dispersed into air, resp.infections except
resp syncytial
Pulmonary sarcoidosis leads to right sided heart failure. E nteric, fecal-oral like hepaA & salmonella
An NG tube can be irrigated with cola, and should be taught to family AGE APPROPRIATE GROWTH AND DEVELOPMENT
when a client is going home with an NG tube. (HOPPING WITH ONE LEG)
Sample test Item:
PRIORITY QUESTIONS (WHO TO SEE FIRST) 4. Which of the following is NOT a characteristic of a preschooler?
Sample Test Item: O 1 predominantly "parallel play" period
1. Which of the following clients should the nurse deal with FIRST? O 2 balances on 1 foot with eyes closed
o 1 A client who needs his daily vitamin O 3 skips on alternate feet
o 2 A client who needs to be suctioned O 4 jumps rope
o 3 A client who needs diaper to be changed The correct answer is: 1. Parallel play is more common in
o 4 A client who is being prepared for discharge TODDLERS.
Correct Answer: 2. A client who needs to be suctioned Preschooler (3-6 years)
PRIORITY (Use ABC) Gross motor development
Obstruction in the airway – secretions HOPS ON ONE (1) FOOT BY 4 YEARS
Need to be suctioned SKIPS & HOPS ON ALTERNATE FEET BY 5 YEARS
2. Delegation, RN, LVN, UAP, CNA PLAY : ASSOCIATIVE, IMAGINATIVE, MAGICAL THINKING,
Which of the following clients should the LPN be assigned to? SUPERHEROES (Remember the movie: Jingle All The way!)
o 1 A newly diagnosed patient with MYASTHENIC CRISIS FEAR: Intrusive procedures, venipunctures, IM injections, body
o 2 An immediate post-op client in PACU mutilation
o 3 A client awaiting medication for vitamins
o 4 A new admission for KIDNEY Transplant Patient Toxoplasmosis, where else you can contract this (thinking of cat litter
Correct Answer: 3-stable, A client awaiting medication for vitamins but it aint there)
Myasthenic Crisis – Unstable, Acute Respiratory Failure Sample test Item:
Immediate Post – op – Unstable, Risk for Complications, 5. To which of the following pregnant clients will be risk for
Kidney Transplant – Unstable, needs assessment for rejection TOXOPLASMOSIS?
DELEGATION: Remember the 5R's, Right Task, Right Person, Right Select all that apply:
Circumstance, Right Communication & Right Feedback) O 1 A pregnant client who eat raw meat.
RN Least stable, unstable, central catheters (hickman, broviac), O 2 A pregnant client handling cat litter of infected cats.
admission, discharge, health teachings, patient for transfer, blood O 3 A pregnant client gardening and cultivating soil exposed to cat
transfusion (2RNs) feces.
LPN Technical Doer, Stable, medications, wound dressing O 4 A pregnant client with low rubella titer
CNA Routine Care, Urine Dip Stix, Reporting to RN, Routine VS O 5 A pregnant client who have undergone external radiation.
UAP turning q2H, conducting group activities, ambulation O 6 A pregnant client with draining, painful vesicles in the external
For future USRNs genitalia.
This is for you... from the purkinje fibers of my heart.... The correct answers: 1, 2 & 3.
Room Assignment(Who to Share Room with) TOXOPLASMOSIS
Check: How do people get toxoplasmosis?
A ge A Toxoplasma infection occurs by:
Accidentally swallowing cat feces from a Toxoplasma-infected cat that (female: 190 to 420 mg/dL)
is shedding the organism in its feces.
This might happen if you were to accidentally touch your hands to your Insulin
mouth after gardening, (Regular, Humulin R)
cleaning a cat's litter box, or Type: Fast acting
touching anything that has come into contact with cat feces. Onset: ½ -1 hr
Eating contaminated raw or partly cooked meat, especially pork, lamb, Peak: 2-4 hr
or venison; Duration: 6-8 hr Insulin
by touching your hands to your mouth after handling undercooked (NPH, Humulin N)
meat. Type: Intermediate acting
Contaminating food with knives, utensils, cutting boards and other Onset: 2hr
foods that have had contact with raw meat. Peak: 6-12hr
Drinking water contaminated with Toxoplasma. Duration 18-26hr Insulin
Receiving an infected organ transplant or blood transfusion, though this (Ultralente, Humulin U)
is rare. Type: Slow acting
(From the internet-Division of Parasitic Disease) Onset: 4hr
Which of these statements by the nurse is incorrect if the nurse has the Peak: 8-20hr
goal to reinforce information about cancers to a group of young adults? Duration: 24-36hr Insulin
1. “You can reduce your risk of this serious type of stomach cancer by (Humulin 70/30)
eating lots of fruits and vegetables, limiting all meat, and avoiding Type: Combination
nitrate-containing foods.” Onset: ½ hr
2. “Prostate cancer is the most common cancer in American men with Peak: 2-12hr
results to threaten sexuality and life.” Duration: 24hr
3. “Colorectal cancer is the second-leading cause of cancer-related
deaths in the United States.”
4. “Lung cancer is the leading cause of cancer deaths in the United Central Venous Pressure: < 3 mm Hg = inadequate fluid and >11 mm
States. Yet it's the most preventable of all cancers. Hg = too much fluid
LABORATORY VALUES
MOTOR DEVELOPMENT
ELECTROLYTES
X. Vagus (S-M) Gag and swallow FLOW OF BLOOD THROUGH THE HEART
Parasympathetic activity
Inferior vena cava and superior vena cava – right atrium – tricuspid
XI. Spinal Accessory (M) Neck and back muscles valve – right ventricle – pulmonic valve – pulmonary artery – lungs –
pulmonary veins – left atrium – bicuspid valve (mitral) – left ventricle
XII. Hypoglossal (M) – aortic valve aorta – systemic circulation
Tongue movement
CARDIAC IMPULSES
On Old Olympus’ Towering Tops, A Finn And German Viewed Some
Hops Sinoatrial (SA) node – right and left atria (atria contract) –
Some Says Marry Money, But My Brother Says Bad Business Marry atrioventricular (AV) node – bundle his – bundle brabches – purjinje’s
Money fibers – ventricles contract.
Birth Hepatitis B
1 months Hepatitis B
2 months OPV, DPT, HIB
4 months DPT, HIB, OPV
Pulmonary capillary wedge pressure: 5 to 13 mmHg 6 months DPT, HIB, hepatitis B
Pulmonary artery pressure: systolic: 16 to 30 mmHg 12 months HIB, OPV
Diastolic: 0 to 7 mmHg 15 months MMR
Spinal pressure: 70 to 200mmH2O 18 months DPT
Morphine sulphate pediatric dose: 0.1mg/kg every 3 – 4 hour 12 – 18 months Varicella vaccine
4 -6 years DPT, OPV, MMR
11 – 12 years MMR ( if not administered at 4 -6 years)
SULFONYLUREAS 11 – 16 TD booster
For treatment of NIDDM
Sulfonylureas should not be given to patients with liver or kidney
failure. SPINAL CORD INJURY
Accummulation of drug will increase risk of hypoglycaemia. Cervical Injury:
C2 to C3 injury usually fatal
C4 is the major innervation to the diaphragm by th phrenic nerve
DURATION Involvement above th C4 causes respiratory difficulty and paralysis
of all the four extremities
tolbutamide C5 or below client may have movement in the shoulder
8h
Thoracic Level Injury:
Glycburide, glipizide loss of movement of the chest, trunk, bowel, bladder, and legs,
20 h, most potent depending on the level of injury
Leg paralysis (paraplegia)
chlorpropamide Autonomic dysreflexia with lesions above T6 and in cervical lesions
48 h Visceral distention from a distended bladder or impacted rectum
may cause reactions such as sweating, bradycardia, hypertension, nasal
stuffiness, and gooseflesh
Apothecary and Household System
Lumbar and Sacral Level Injuries:
Grain –gr 1 gr = 60 mg loss of movement and sensation of the lower extremities.
Dram – dr 5 gr = 300 mg S2 and S3 center on micturation; therefore below this level, the
Ounce –oz 15 gr = 1000mg or 1g bladder will contract but not empty (neurogenic bladder)
Minim – min, M, m 1/150 gr =0.4 mg Injury above S2 in males allows them to have an erection, but they
Quart – qt 1 oz = 30 mL are unable to ejaculate because of sympathetic nerve damage.
Pint – pt 1 dr = 4 mL Injury between S2 and S4 damages the sympathetic and
Drop – gtt 1 T = 15 mL or 3 tsp parasympathetic response, preventing erection and ejaculation.
Tablespoon – T or tbs 1 min = 1 gtt
Teaspoon – t or tsp 15 min = 1mL RULE OF NINE
Pound – lb 60 min = 1 dr
8 dr = 1 oz Head and neck 9%
1 qt = 1000mL or 1L Anterior trunk 18%
1 qt = 2 pt or 32 oz Posterior trunk 18%
1 pt = 16 oz Arms (9%) 18%
16 oz = 1 lb Legs (18%) 36%
2.2lb = 1 kg Perineum 1%
WILSON SYNDROME: Congenital defect in Ceruloplasmin, leading RESTLESS LEGS SYNDROME: Need to stretch legs at night before
to buildup of copper mental retardation, cirrhosis, hepatolenticular going to sleep; twitch in legs causing insomnia.
degeneration.
Herbal Plants
AMENNORRHEA-GALACTORRHEA SYNDROME: Non-
physiologic lactation, resulting from endocrinologic causes or from a 1) ALOE VERA
pituitary disorder. Aloe vera syn. A. barbadensis (Liliaceae)
The clear gel found inside the plant's leaf contains aloin, are both used
for medicinal and cosmetic purposes. It is a effective healer of wounds
CUSHING'S SYNDROME: Hypersecretion of cortisol secondary and burns, speeding up the rate of healing and reducing the risk of
symptoms and characteristics: infection. The brownish part containing aloin is a strong laxative,
* Fatness of face and trunk with wasting of extremities useful for short-term constipation. Aloe is present in many cosmetic's
* Buffalo hump formulae because its emollient and scar preventing properties.
* Bone decalacification
* Corticoid diabetes MAIN PROPERTIES: Heals wounds, emollient, laxative.
* Hypertension
2) ANGELICA
Angelica arcangelica (Umbelliferae)
PREMENSTRUAL SYNDROME: Abnormal sensation in breasts, Angelica has been used to reduce muscular spasms in asthma and
abdominal pain, thirst, headache, pelvic congestion, nervous irritability. bronchitis. It has also been shown to ease rheumatic inflammation, to
regulate menstrual flow and as an appetite stimulant. The stems are
Ocassionally nausea and vomiting. candied for culinary use.
MAIN PROPERTIES: Anti-inflammatory, digestive, antiseptic. MAIN PROPERTIES: Anti-inflammatory, antifungal, antibacterial,
digestive.
6) ARTEMISIA, WORMWOOD
Artemisia absinthium (Compositae) 12) BOLDO
Wormwood has a marked tonic effect on the stomach, the gallbladder Peumus boldus (Umbelliferae)
and in adjusting weak digestive problems. It is used to expel It activates the secretion of saliva and gastric juices. Boldine, one of its
roundworms and threadworms. By improving the functions of the constituents, induces the flow of bile as well as the total amount of
digestive system it helps in many conditions, including anaemia. It is
solids that it excretes. Its protective action over the hepatic cells has
also a muscle relaxant occasionally used to treat rheumatism. The been demonstrated "in vitro" and "in vivo". Boldo stimulates liver
leaves of wormwood have antiseptic properties which may derive fromactivity and bile flow and is chiefly valued as a remedy for gallstones
the azulenes that the plant contains. and liver or gallbladder pain. It is normally taken for a few weeks at a
time, either as a tincture or infusion. Boldo also has antiseptic
MAIN PROPERTIES: Bitter, carminative, muscle relaxant, antiseptic. properties which help in combating cystitis.
7) BASIL, HOLY BASIL MAIN PROPERTIES: Bile and liver activity stimulant, digestive.
Ocimum sanctum (Labiatae)
The herb has very important medicinal properties - notably its ability to 13) CALENDULA, MARIGOLD
reduce blood sugar levels. It also prevents peptic ulcers and other stress Calendula officinallis (Compositae)
related conditions like hypertension, colitis and asthma. Basil is also Marigold is one of the best herbs for treating local skin problems.
used to treat cold and reduce fever, congestion and joint pain. Due to its Infusions or decoctions of Calendula petals decrease the inflammation
anti-bacterial and fungicide action, basil leaves are used on itching of sprains, stings, varicose veins and other swellings and also soothes
skin, insect biting and skin affections. burns, sunburns, rashes and skin irritations. These remedies are
excellent for inflamed and bruised skin, their antiseptic and healing
MAIN PROPERTIES: Lowers blood sugar levels, antispasmodic, properties helping to prevent the spread of infection and accelerate the
analgesic, lowers blood pressure, reduces fever, fungicidal, anti- healing. Marigold is also a cleansing and detoxifying herb, and the
inflammatory. infusion and tincture are used to treat chronic infections. Taken
internally, it has been used traditionally to promote the draining of
8) BELLADONA, DEADLY NITIGHTSHADE swollen lymph glands such as tonsillitis.
Atropa belladonna (Solanaceae)
Herba bella dona, or "herb of the beautiful lady" is known for its MAIN PROPERTIES: Anti-inflammatory, astringent, heals wounds,
poisonous effects (belladonna increases heartbeat and can lead to antiseptic, detoxifying.
death), like many other plants it is an important and beneficial remedy
when used correctly. Belladonna contains atropine used in conventional 14) CAMPHOR
medicine to dilate the pupils for eye examinations and as an anesthetic. Cinnamomum camphora syn. Laurus camphora (Lauraceae)
In herbal medicine, deadly nightshade is mainly prescribed to relieve Camphor crystals have strong antiseptic, stimulant and antispasmodic
intestinal colic, to treat peptic ulcers and to relax distended organs, properties and are applied externally as unguents or balms as a counter-
especially the stomach and intestine. Deadly nightshade is also used as irritant and analgesic liniment to relieve arthritic and rheumatic pains,
an anaesthetic in conventional medicine. neuralgia and back pain. It may also be applied to skin problems, such
as cold sores and chilblains, and used as a chest rub for bronchitis and
MAIN PROPERTIES: Smooth muscle, antispasmodic, narcotic, other chest infections.
reduces sweating, sedative.
MAIN PROPERTIES: Antiseptic, antispasmodic, analgesic,
9) BENZOIN GUM expectorant.
Styrax benzoin (Styraceae)
Its trunk exudes a gum well known for its strong astringent and 15) CARDAMOM
antiseptic action. For this reason it is used externally to fight tissue Elettaria cardamomum (Zingiberaceae)
inflammation and disinfection of wounds. When taken internally, Cardamom is an excellent remedy for many digestive problems,
benzoin gum acts to settle griping pain, to stimulate coughing, and to helping to soothe indigestion, dyspepsia, gastralgia, colon spasms and
disinfect the urinary tract. Benzoin gum is widely used in cosmetics as flatulence. It has an aromatic and pungent taste and combines well with
an antioxidant in oils, as a fixative in perfumes and as an additive to other herbs and helps to disguise the less pleasant taste of other herbs.
soaps. When steam inhaled, it helps healing sore throats, head and chest
colds, asthma and bronchitis. MAIN PROPERTIES: Eases stomach pain, carminative, aromatic,
antispasmodic.
MAIN PROPERTIES: Antiseptic, astringent, anti-inflammatory.
16) CARDUS, MILK THISTLE, MARY THISTLE
10) BERGAMOT Carduus marianus syn. Silybum marianum (Compositae)
Citrus bergamia syn. C. aurantium var. bergamia (Rutaceae) Milk thistle has been in use as a remedy for liver problems for
Bergamot oil, expressed from the peel, assists in avoiding infectious hundreds, if not thousands, of years. It is used in a whole range of liver
diseases. In cosmetics it is used in preventing oily skin, acne, psoriasis and bladder conditions including hepatitis and cirrhosis. Recent
and acne. The oil (or constituents of it) is sometimes added to sun- research has confirmed that the herb has a remarkable ability to protect
tanning oils. Bergamot oil is also used to relieve tension, relax muscle the liver from damage resulting from alcoholic and other types of
spasms and improve digestion. poisoning. Today, milk thistle is widely used in the West for the
treatment of a range of liver conditions.
MAIN PROPERTIES: Disinfectant, muscle relaxant. MAIN PROPERTIES: Digestive, liver tonic, stimulates secretion of
bile, increases breast-milk production, antidepressant.
11) BITTER ORANGE
Citrus aurantium (Rutaceae) 17) CELERY, SMALLAGE
Its oil contains flavonoids which are anti-inflammatory, antibacterial Apium graveolens (Umbelliferae)
and antifungal. Bitter orange juice is rich in vitamin C which helps the More familiar as a vegetable than as a medicine, celery find its main
immune system. As an infusion, it helps to relieve fever, soothe use in the treatment of rheumatism, arthritis and gout. Containing apiol,
headaches and lower fever. It yields neroli oil from its flowers, and the the seeds are also used as a urinary antiseptic. Celery is a good
oil known as petitgrain from its leaves and young shoots. Both cleansing, diuretic herb, and the seeds are used specifically for arthritic
distillates are used extensively in perfumery. Orange flower water is a complaints where there is an accumulation of waste products. The
by-product of distillation and is used in perfumery and to flavor sweets seeds also have a reputation as a carminative with a mild tranquilizing
effect. The stems are less significant medicinally. Its oil is used as a culinary flavoring, a scent and medicine. Lemon
grass is principally taken as a tea to remedy digestive problems diarrhea
MAIN PROPERTIES: Anti-rheumatic, antispasmodic, diuretic, urinary and stomach ache. It relaxes the muscles of the stomach and gut,
antiseptic. relieves cramping pains and flatulence and is particularly suitable for
children. In the Caribbean, lemon grass is primarily regarded as a fever-
18) CHAMOMILE, GERMAN CHAMOMILE reducing herb. It is applied externally as a poultice or as diluted
Chamomilla recutita syn. Matricaria recutita (Compositae) essential oil to ease pain and arthritis.
Its flowers help to ease indigestion, nervousness, depressions and
headaches, being ideal for emotion related problems such as peptic MAIN PROPERTIES: Digestive, antispasmodic, analgesic.
ulcers, colitis, spastic colon and nervous indigestion. Chamomile's
essential oil have anti-inflammatory, anti-spasmodic and anti-microbial 25) DAMIANA
activity. It is an excellent herb for many digestive disorders and for Turnera diffusa syn. T. diffusa var. aphrodisiaca (Turneraceae)
nervous tension and irritability. Externally, it is used for sore skin and It has an ancient reputation as an aphrodisiac and is an excellent
eczema. Roman chamomile (Chamaemelum nobile) is a close relation, remedy for the nervous system acting as a stimulant and tonic in cases
used in a similar way. of mild depression. Damiana has a strongly aromatic, slightly bitter
taste. The leaves are used to flavor liqueurs and are taken in Mexico as
MAIN PROPERTIES: Anti-inflammatory, antispasmodic, relaxant, a substitute for tea.
carminative, bitter, nervine.
MAIN PROPERTIES: Nerve tonic, antidepressant, urinary antiseptic.
19) CHICORY
Cicorium intybus (Compositae) 26) DANDELION
As a tea or extract, chicory root is a bitter digestive tonic that also Taraxacum officinale (Compositae)
increases bile flow and decrease inflammation. Its roasted root is Known principally as a weed, dandelion has an astonishing range of
commonly used as a coffee substitute. Chicory is an excellent mild health benefits. The leaves, which can be eaten in salads, are a powerful
bitter tonic for the liver and digestive tract. The root is therapeutically diuretic. The roots act as a "blood purifier" that helps both kidneys and
similar to dandelion root supporting the action of the stomach and liver the liver to remove impurities from the blood. This effect seems to be
and cleansing the urinary tract. Chicory is also taken for rheumatic due to its potassium content. It also acts like a mild laxative and
conditions and gout, and as a mild laxative, one particularly appropriate improves appetite and digestion.
for children. An infusion of the leaves and flowers also aids the
digestion. MAIN PROPERTIES: Diuretic, digestive, antibiotic, bitter.
MAIN PROPERTIES: Antibiotic, expectorant, diaphoretic, MAIN PROPERTIES: Cardiotonic, diuretic, astringent, dilates blood
hypotensive, antispasmodic, expels worms. vessels, relaxant, antioxidant.
MAIN PROPERTIES: Sedative, relaxant, relieves muscle spasm, Find out what problems to anticipate-- and how a few simple steps can
relieves anxiety, lowers blood pressure. head them off.
75) VERBENA A clogged enteral feeding tube that can't be cleared must be replaced
Verbena officinalis (Verbenaceae) an unwelcome prospect for you and your patient. At the very least,
Verbena is used in mouth washes for infected gums and as a poultice he'll miss getting some of the fluid and nutrition he needs. At
for hemorrhoids. A tea has been used as a nerve tonic, to treat insomnia worst, if he's homebound or a nursing home resident, he'll need to
and to help digestion. It has tonic, restorative properties, and is used to travel to an appropriate facility for tube reinsertion and X-ray
relieve stress and anxiety, and to improve digestive function. confirmation of placement. The expression An ounce of prevention is
worth a pound of cure could have been coined by a nurse managing
MAIN PROPERTIES: Nervine, tonic, mild sedative, stimulates bile feeding tubes.
secretion, mild bitter.
In this article, we'll describe two simple ways you can keep feeding
76) WHITE WILLOW tubes patent: pump-assisted infusion of enteral formulas and frequent
Salix alba (Salicaceae) tube flushing. But first, let's review factors that can increase the
White willow is an excellent remedy for arthritic and rheumatic pain, risk of a clogged feeding tube.
affecting the joints like knees and hips.
Problems in the pipeline
MAIN PROPERTIES: Anti-inflammatory, analgesic, reduces fever,
anti-rheumatic, astringent. Feeding tubes can become clogged for one of these reasons:
Cranberry juice, carbonated beverages, meat tenderizers, enzymatic For Paranoid clients
solutions ... over the years, nurses have tried all sorts of remedies · Don’t argue with client (simply state that you don’t share his beliefs)
for clogged enteral tubes. But researchers who've studied various · Be reliable and consistent
preventive irrigants have learned something surprising: Nothing beats
plain water. In fact, acidic colas and cranberry juice can actually For Delusional clients
cause an obstruction by promoting formula coagulation. · Stay with client
· Don’t argue about the reality of delusions
The bottom line? Flushing the tube regularly with water remains the · Orient frequently to reality (place, situation)
most effective and practical way to prevent enteral, feeding tube · Assess potential for self harm
clogs.
For Somatization clients
Making it automatic · Respect client and his problems (client is not faking)
· Rule out physical basis for symptoms
A heavy nursing workload and lack of written policies and procedures · Help client express anxiety
for tube flushing can lead to inconsistency in tube flushing. So some
enteral pumps also have an automatic flush feature, which delivers a
preprogrammed amount of fluid, typically water, every hour. This DEFENSE MECHANISMS:
simulates the flushing action of a syringe and helps minimize residue 1. Conversion: A college student develops diarrhea on day of exam
buildup. 2. Regression: Returning to immature ways of dealing with stress:
crying, tantrums…
Automatic flushing doesn't just save nursing time--it's also more 3. Repression: Blocking of unacceptable urges and feelings from
effective. Two studies found clogging in 75% of gastrostomy tubes in awareness.
the manually flushed group, compared with only 5% in the 4. Denial: Blocking of unacceptable information or perceptions from
automatically flushed group. The results were even more dramatic for awarness.
nasogastric tubes: 91% in the manually flushed group clogged; none 5. Dissociation of affect: A girl laughs when telling about her failed
clogged in the automatic flush group. exam
6. Rationalization: Substituting an acceptable motive for attitudes or
Smooth sailing behavior for an unacceptable motive
7. Reaction formation: you want to “kick your bosses ass” but end up
By knowing which, factors predispose an enteral tube to clogging and kissing it.
taking a few preventive measures, you can keep your patient 8. Identification: A teenager dresses like Madonna and mimics her
comfortable- -and save yourself some time. behavior.
9. Projection: “ you are acting like a teenager, not I”
10. Introjection: A boy yells at his dog like his father does him
11. Displacement: Client is upset about disease and yells at nurse.
Psyche Nursing
Nurse gets upset and yells at nursing assistant
For Withdrawn clients 12. Undoing: “ magic,”
· Allow client to set pace
· Encourage social activities or games SIGNS AND SYMPTOMS
Hallucinations ANALYSIS:
Perception without external stimuli § Risk of injury due to cognitive deficits
§ Family/caregiver burnout
TERMS: IMPLEMENTATION:
1. Neologisms: invents new words: Schizophrenia § Support family caregivers
2. Echolalia: echoes words or sentences: Schizophrenia § Provide safe and familiar environment
3. Word Salad: jumble of words without meaning: Schizophrenia § Support client’s attempts at independence
4. Flight of ideas: rapid switching from topic to topic: Mania § Continually orient client to time, date and person
5. Confabulation: invents stories to fill memory gaps: Korsakoff § Advance directive should be drafted as early as possible
GRIEF DEPRESSION
PERSONALITY DISORDERS:
Behavior is inflexible across a broad range of situations
Behavior is markedly deviant from cultural norms
Significant distress and impairment of functioning
Features of psychoses
ANXIETY DISORDERS:
Clients are distressed and know that their symptoms are irrational.
Palpitations, tachycardia
Fear of dying
ASSESSMENT:
Feeling of worthlessness
Thoughts of death or suicide
Lethargy
Slow, muted speech
Anorexia, weight loss
Early morning awakening
ANALYSIS:
Risk of suicide
IMPLEMENTATION:
Dry mouth
Constipation
Urinary retention
BIPOLAR DISORDER:
Manic episodes alternate with episodes of major depression.
Some clients have only manic episodes, no depressive episodes.
ASSESSMENT:
Euphoria
Grandiose ideas
Uninhibited sexuality
Buying sprees
Psychomotor agitation
IMPLEMENTATION:
Lithium
Watch for signs of toxicity
Abdominal pain, nausea
Hand tremor
Ataxia, nystagmus
Slurred speech
ASSESSMENT:
Delusions
Hallucinations
“NEGATIVE SYMPTOMS”
Flat affect
Loss of interest
Ambivalence
Autism
CATATONIA:
IMPLEMENTAION:
MEDICATION:
Tongue protrusion
CLIENT EDUCATION:
DRUG ABUSE:
Abuse: recurrent use of drugs resulting in social failures at home, school or work, legal problems or hazardous situations.
Dependence: Tolerance (needs larger doses to achieve effect). Withdrawal symptoms.
INTOXICAITON WITHDRAWAL
Tremor, seizures
Epilepsy
Coma, death
Sedation Irritability
insomnia
Euphoria Dysphoria
Muscle aches
Anxiety
Paranoid ideas