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25 cardsNCLEX-RN (National Council Licensure Examination for Registered Nurses)
NCLEX-RN Nursing Priorities and Key Points
25 flashcards on priority setting, delegation, isolation precautions, drug monitoring and emergency care. Study material written for practice, not the official exam.
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Priority order for nursing problems
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1
Priority order for nursing problems
Airway, breathing, circulation first; then acute before chronic; unstable before stable.
2
Tasks that may be delegated to unlicensed assistive personnel
Routine tasks for stable clients: vital signs, bathing, feeding, turning. Not assessment, teaching or IV medications.
3
Airborne precautions: examples
Tuberculosis, measles, varicella. Negative-pressure room and a fitted N95 respirator.
4
Droplet precautions: examples
Influenza, pertussis, meningococcal meningitis. Surgical mask within about 3 feet.
5
Contact precautions: examples
MRSA, C. difficile, scabies. Gloves and gown; soap and water for C. difficile.
6
Order for removing PPE
Gloves, goggles, gown, then mask. Perform hand hygiene.
7
Live vaccines: avoid in
Pregnancy and immunocompromised clients. Examples: MMR, varicella, intranasal influenza.
8
Furosemide: key nursing points
Watch for hypokalemia, low blood pressure and ototoxicity. Weigh daily.
9
Digoxin: key nursing points
Check the apical pulse for 1 minute and hold if under 60. Toxicity: nausea, yellow vision, arrhythmia. Check potassium.
10
Warfarin: monitoring and antidote
Monitor INR (target 2 to 3). Antidote: vitamin K.
11
Heparin: monitoring and antidote
Monitor aPTT. Antidote: protamine sulfate.
12
Insulin that can be given IV
Regular insulin only.
13
Hypoglycemia treatment (alert client)
15 grams of fast-acting carbohydrate, recheck in 15 minutes, repeat if below 70 mg/dL.
14
Signs of diabetic ketoacidosis
High glucose, fruity breath, Kussmaul respirations, dehydration. Treat with fluids, insulin and potassium monitoring.
15
Lithium: therapeutic range
0.6 to 1.2 mEq/L. Keep fluid and sodium intake steady.
16
ACE inhibitor adverse effects
Dry cough, hyperkalemia, angioedema (emergency).
17
Opioid safety
Check the respiratory rate; hold if under 12. Reversal: naloxone.
18
Magnesium sulfate in preeclampsia
Watch reflexes, respirations and urine output. Antidote: calcium gluconate.
19
Postpartum hemorrhage: first action
Massage the fundus if the uterus is soft.
20
Apgar score
Assigned at 1 and 5 minutes: heart rate, respiration, muscle tone, reflexes, color.
21
Cushing's triad
High blood pressure with wide pulse pressure, bradycardia, irregular breathing: late sign of raised intracranial pressure.
22
Parkland formula
4 mL x kg x percent burned over 24 hours; half in the first 8 hours.
23
Epiglottitis: what to avoid
Never examine the throat with a tongue blade; keep the child calm and prepare airway support.
24
Anaphylaxis: first-line drug
Intramuscular epinephrine.
25
Teach-back method
Ask the client to explain the instructions in their own words to confirm understanding.
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