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nclex review hamatological system

Hematological System

Hey guys today I want to go over the Hematological disorders that we will most likely encounter in your NCLEX exam.  So First lets go over a quick overview of the hematological system.  Now we all know that The Hematologic system is mainly composed of just the blood and plasma (So on the basic level the  components of the hematological system is just blood and plasma).  Lets look at the blood and the essential values that we need to know for the NCLEX.  The BLOOD is composed of several primary components

RBC (RED BLOOD CELLS/ERYTHROCYTES)
WBC (WHITE BLOOD CELLS/ Leuokocytes)
PLATELETS (THROMBOCYTES)

Lets look at the important blood values that we need to really know for the nclex.

CBC (COMPLETE BLOOD COUNT)

RBC’S= 4.2-6.2 million cells per microliter
HGB= 11.5- 17.5 Grams per deciliter
HCT= 36%- 52%

So again its very important to know our blood values by heart for the nclex.  And its very essential that we know our values to determine if its normal or abnormal so we can further assess our patients’ condition.   We can ask ourselves what can be the reasons for the High and Low Values of these components.  First lets analyze the red blood cells or rbc’s.   If we have a patient with cancer or Polycythemia Vera which is a bone marrow disease that leads to an abnormal increase in the number of blood cells (primarily red blood cells) of our patient, then the values of our patient’s red blood cell will obviously increase.
Now on the opposite side, what condition do you think tends to bring the red blood cell to be lower than normal: obviously anemia would come in mind.  Now lets look at our white blood cells or our WBC values.  The most common causes of increase of our WBC which we are all very familiar with is Infections.  So why is that , well as we all know our WBC or leukocytes is a vital part of the immune system that basically helps our bodies fight off any infection. So during an infection, our body physiologically will circulate more WBC’s in the blood and transport it to the area where an infection has developed

On the opposite spectrum, lets look at the circumstances of our patient in having a decrease in WBC count.  There are various of Autoimmune disorders such as Lupus which comes in to mind which is a disease of the immune system that leads to long-term or (chronic) inflammation that can destroy the white blood cells or decrease the WBC’s.

Now lets go on our next topic and go over one of the most important hematological disorder that we might encounter in the NCLEX exam which is ANEMIA.  We can basically define Anemia as a decrease in the number of red blood cells (RBCs) or if the patient has less than the normal quantity of hemoglobin within the blood.   So, with this disease THERE IS A DECREASE NUMBER OF RBC’S.   As a result, there will be a low amount of oxygen circulation within the body.

General symptoms of anemia:
– weakness
– fatigue,
– pale skin

As we know from nursing school There are several types of anemia:

– Sickle Cell Anemia
– Pernicious Anemia
– Aplastic Anemia
– Iron Deficiency Anemia

Now first lets go ahead and look at SICKLE CELL ANEMIA

  • – SICKLE CELL ANEMIA IS AN AUTOSOMAL RECESSIVE GENETIC DISORDER
  • – AN ABNORMAL SHAPE OF THE RBC’S (SICKLE CELLS).

So basically the cell has an abnormal kind of rigid, sickle shape and because of this it causes a decrease in the cells ability to be flexible and move freely in the body which results in the cell getting stuck within the circulation which is then manifested in pain and other various complications in our patient.

I will continue this review regarding anemia on the next few upcoming videos.  Again I want to thank you guys for taking the time to invest in making sure that you pass your NCLEX.

 

 

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hypert

HYPERTENSION

Lets continue on with the second segment of this series and go over one of the most important topics that we need to know for the NCLEX which is HYPERTENSION

so lets begin by defining HYPERTENSION?  what is hypertension
– we can simply define it as A SIGNIFICANT AMOUNT OF PRESSURE WITHIN THE BLOOD VESSELS
– in which a blood pressure EXCEEDS 140 MMHG (millimeters of mercury) SYSTOLIC AND 90 MMHG DIASTOLIC,

* as a nurse we can educate and Remind the patient that lifestyle changes such as smoking cessation and proper diet is essential.

we also know that HYPERTENSION CAN LEAD TO

  • – Aneurysms
  • – Atherosclerosis
  • – Heart Failure
  • – Myocardial Infarction

Now our patient can have what we call a primary hypertension or the patient can also have
what we call a Secondary Hypertension which is usually caused by:
– Cushing’s Disease ( now remember that Cushing’s Disease is usually due to our patient having Too much Glucocorticoids)
– Brain Tumors
– Pheochromocytoma

Now lets go over the meat and potatoes of hypertension that we need to know for the NCLEX which
are the Pharmacology Drugs for Hypertension:

Lets first go over diuretics

DIURETICS

– Now basically diuretics Helps get rid of the sodium and fluid in the body.
– and it does this by interfering with the sodium absorption in the kidney.
–  as a result Increases the urine output.  Decreases the preload and afterload.

MAJOR SIDE EFFECTS:

  • now as a side effect or opposite reaction from these effects from diuretics our patient is at risk for having
  • – HYPONATREMIA
  • electrolyte disturbance in which the sodium ion concentration in the plasma is lower than normal.
  • yponatremia is generally defined as a serum level of less than 135 mEq/L and is considered severe when the serum level is below 125 mEq/L
  • milliequivalents per liter.
  • – ORTHOSTATIC HYPOTENSION
  • – DEHYDRATION

TYPES OF DIURETICS

(Drugs that you will ENCOUNTER IN THE NCLEX EXAM)

  1. POTTASIUM SPARING DIURETICS such as
    SPIRONOLACTONe (ALDACTONE)
  2. LOOP DIURETICS such
    FUROSEMIDE (LASIX)
  3. OSMOTIC DIURETICS
    and the most common drug is MANNITOL
  4. Lastly we have THIAZADE DIURETICS
    HYDROCHLOROTHIAZIDE (HYDRODIURIL)

We need to inform our patient that thiazides can
CAUSES THE DEPLETION OF SODIUM AND WATER.
CAN INDUCE HYPERGLYCEMIA

Now lets go over another group of medications
♣ BETA (ADRENERGIC) BLOCKERS

As you have learned in Nursing School, beta adrenergic blockers are drugs that help lower blood pressure, pulse rate and cardiac output.  Beta Blockers are an important set of drugs to know for the NCLEX.  Sometimes,there are also other uses of beta blockers
such as treating migraine headaches, treating glaucoma and can also be used to treat myocardial infarctions.

So, since beta blockers is an essential part of the NCLEX we need to understand how this medication functions
Well,  beta blockers simply act by blocking the sympathetic vasomotor response eventually decreasing the Blood pressure in the body.  For the NCLEX, try to remember that beta blockers usually end with the syllable (olol).  Potential side effects of beta blocker that is necessary to know for the NCLEX would include: Orthostatic hypotension, bradycardia, nausea and vomiting, diarrhea and some of the symptoms may MASK hypoglycemia.

Remember the NURSING INTERVENTIONS FOR CLIENTS TAKING BETA BLOCKERS:

With all this in mind, we need to Make sure that we monitor the client’s blood pressure, heart rate and rhythm, before administering the beta blocker.  we should also Monitor the client for signs of edema and assess the lungs sounds for signs of rales and ronchi.  When patient are taking beta blockers, it is also very important to monitor the changes in lab values such as (protein, BUN and creatinine) which can indicate nephrotic syndrome.

 

 

 

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NCLEX Pharmacology Review

NCLEX Review: Neurological Medications 

MAOI  (Monoamine oxidase inhibitors)

Important Medications in the NCLEX includes

  • Parnate (tranylcypromine sulfate)
  • Nardil (phenelzine sulfate)
Side Effects of MAOI

MAOI Side Effects

  • Dizziness
  • Dry mouth
  • Diarrhea
  • Weight gain

Remember: Do not take MAOI’s with TCAs and SSRIs

NCLEX Review: Remember to limit foods that contain high levels of tyramine, such as cheese, pickled foods, beer and wine

MAOIs or Monoamine oxidase inhibitors act by inhibiting the activity of monoamine oxidase, thus preventing the breakdown of monoamine neurotransmitters and thereby increasing their availability. Which gives off positive effects on depression and anxiety. so again basically MAOI’s helps balance certain brain chemicals called neurotransmitters and it does this by reducing the amount of monoamine oxidase which the substance that breaks down the neurotransmitters, hence there would be more neurotransmitter in the brain which helps decrease the symptoms of depression.

Now the 2 important MAOI’s drugs that you might encounter in your NCLEX exam includes:

  1. Parnate  (tranylcypromine sulfate)
  2. Nardil  (phenelzine sulfate)

As we learn from our Psych class back in nursing school, We as nurses don’t usually offer MAOI because of the lethal dietary and drug interactions (and this is the most important thing that we have to know for the NCLEX in reagards with MAOI and this is also a big reason why MAOI is usually used as last line of treatment and is used only when other classes of antidepressant drugs (for example SSRI and TCA’s) have failed.

NCLEX Review Neurological Pharmacology

We need to know for the NCLEX that our patient needs to limit foods that contain high levels of tyramine, such as cheese, pickled foods, beer and wine.  And here is why…. well because Tyramine is an amino acid that helps regulate blood pressure. So basically if we combine tyramine with MAOIs the interaction cause dangerously severe high blood pressure it can trigger a hypertensive crisis… and we don’t want that on our patient.

So again, the biggest tip we can take away from this video is to remember that when giving MAOI’s… avoid food with high levels of tyramine…. so no cheese, pickles and beer or wine.

Study Hard and Good Luck  : )

 

 

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