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NCLEX Review on Hepatitis

Today we will be talking about one of the most common diseases that you might encounter in the NCLEX which is that of Hepatitis.

Hepatitis is inflammation of the liver tissue its as plain and simple as that
And believe it or not a good portion of the people who has the less severe type of hepatitis will show no symptoms whereas others develop the some of the more common symptoms such as yellow discoloration of the skin and eyes, which what we call jaundice
and this is due to the liver not being able to breakdown and get rid of Bilirubin which as a a yellow pigment that is formed when our bodies breakdown our red blood cells in the liver.

now also other most common symptoms can include:
poor appetite, vomiting, tiredness, abdominal pain, and diarrhea.

Now as we all know Hepatitis may be temporary (acute) or long term (chronic) depending on whether it lasts for less than or more than six months.

Acute hepatitis can sometimes resolve on its own, or progress chronic hepatitis, or if not treated can lead to acute liver failure.

Over time the chronic form may progress to scarring of the liver, liver failure, or liver cancer.

 

CLASSIFICATIONS of Hepatitis Virus and its way of TRANSMISSION:

Now there are actually 5 types which are hepatitis a b c d and e
but on this quick review we will only be looking at the first three.

(If we look at the transmission: HEPATITIS B AND C are the only ones transmitted through blood and sexual contact).

Hepatitis A (transmitted through oral/fecal/water route)
Hepatitis B (transmitted through blood/drug use/sexual contact/childbirth)
Hepatitis C (transmitted through blood/drug use/sexual contact/childbirth)

 

HEPATITIS A

– Incubation period usually lasts from 15-45 days.
– Transmitted primarily through fecal/ oral route.
– Prevention includes sanitation and handwashing.
– There is a vaccine available for Hepatitis A.
– Prevention against Hepatitis A includes:

PROPER HANDWASHING
AVOIDANCE OF CONTAMINATED FOOD AND WATER
RECIEVING THE HAV VACCINE

 

HEPATITIS B
– transmitted through blood to blood contact sexual contact or drug use (needles, razors).

– There is a vaccine available for Hepatitis B.

 

 

HEPATITIS C

– Hepatitis C is transmitted through blood to blood contact sexual contact or drug use (needles, razors)

– The patient can be asymptomatic and others are only diagnosed once abnormality is detected in the liver enzymes.

SYMPTOMS OF ACUTE HEPATITIS C

FEVER
FATIGUE
LOSS OF APPETITE
NAUSEA
VOMITING
ABDOMINAL PAIN
DARK URINE
CLAY-COLORED BOWEL MOVEMENTS
JAUNDICE (YELLOW COLOR IN THE SKIN OR EYES)
SOME OF THESE SYMPTOMS CAN ALSO BE PRESENT ON OTHER CLASSIFICATIONS OF HEPATITIS* .

NCLEX Review on Hepatitis

HEPATITIS B AND HEPATITIS C is connected with cirrhosis and liver cancer.

ENZYME-LINKED IMMUNOSORBENT ASSAY (ELISA) is the initial screening test for clients suspected of infected of the Hepatitis C (HCV) Virus.
LIVER BIOPSY can also be used to confirm the diagnosis of Hepatitis.
Treatment most often used for Hepatitis C is a combination of two medicines, INTERFERON AND RIBAVIRIN.

 

 

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NCLEX Review on ARDS

Hello everyone today we will be talking about Acute Respiratory Distress Syndrome (ARDS)

An Acute respiratory distress syndrome (ARDS) what occurs is that there is fluid that builds up in the tiny, elastic air sacs called (alveoli) in your lungs.

And what occurs is that the fluid keeps your lungs from filling with enough air, which means less oxygen reaches your bloodstream.

And in turn this deprives your organs of the oxygen they need to function.

Now understand that ARDS typically occurs in people who are already critically ill or who have significant injuries.

Now lets look at a few of the symptoms

NCLEX Review Notes on ARDS

Symptoms

The signs and symptoms of ARDS can vary in intensity and basically depending on the cause and severity:

So the patient would be hypoxic and would show signs of
Severe shortness of breath
Labored and rapid breathing
and there would be
– Presence of crackles or (rhonci)
when we assess the patient

The patient would also have a Low blood pressure
and also be somewhat lethargic and confused

 

Lets look at a few of the Complications with ARDS

If you have ARDS, you can develop other medical problems while in the hospital. The most common problems are:

Blood clots. This is very dangerous because it can cause a (pulmonary embolism).
Collapsed lung (pneumothorax). there fore In most ARDS cases, a ventilator is used to increase oxygenation.
Infections. Because the ventilator is attached directly to a tube inserted in your windpipe, this makes it much easier for germs to infect and further injure your lungs.

Diagnosis
There’s no specific test to identify ARDS. The diagnosis is based on the physical exam, chest X-ray and oxygen levels.

– Diagnosed through the X- Ray (Ground Glass) Appearance within the lungs and this is due to the fluid buildup.

– A noncardiogenic Pulmonary Edema.
excess fluid in the lungs

Lab tests

The lab test will also show a decrease in the oxygen level throughout the body.

Treatment

The first goal in treating ARDS is to improve the levels of oxygen in your blood. Without oxygen, your organs can’t function properly.

NCLEX Review

Oxygen

So there are various ways that we can give supplemental oxygen
and that includes Mechanical ventilation.
The mechanical ventilator pushes air into your lungs and forces some of the fluid out of the air sacs.

The common Mechanical Ventillation includes PEEP or positive end-expiratory pressure.
basically its A method of ventilation in which airway pressure is maintained above atmospheric pressure

Another method is the CPAP or Continuous positive airway pressure
Now with CPAP, it basically applies mild air pressure on a continuous basis to keep the airways continuously open.

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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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