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Urolithiasis NCLEX Review

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A quick review of Urolithiasis  (By: AllNursingNotes)

What is Urolithiasis?

it is a condition where urinary calculi is formed anywhere within the Urinary System.  It is the process of forming stones in the kidney, bladder, and/or ureters (urinary tract).

Causes of Urilothiasis:

  • Not drinking enough water. When you don’t drink enough water, the salts, minerals, and other substances in the urine can stick together and form a stone. This is the most common cause of Urilothiasis.
  • Medical conditions. Many medical conditions can affect the normal balance and cause stones to form. Examples include gout and IBS, such as in Chron’s disease.

DIAGNOSIS:

Physical examination– There is flank tenderness (side of the body between the ribs and hips).

Urinanalysis may detect blood in the urine.

Computerized tomography (CT) scanning of the abdomen without oral or intravenous contrast dye is the most commonly used diagnostic test.

Ultrasound can be another way of looking for kidney stones and obstruction.

Abdominal X-Ray is used to track its movement down the ureter toward the bladder.

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Amyotrophic lateral sclerosis (ALS) NCLEX Review

 

 

NCLEX Review on GERD

Gastroesophageal Reflux Disease    (By: AllNursingNotes)

Gastroesophageal Reflux Disease or GERD occurs when the reflux of stomach acid and contents has a “reflux” back into the esophagus.

Now lets look at some of the major causes of GERD:

  • This is usually caused due to the weakness within the lower esophageal sphincter or LES.
  • This acid, can affect the lining of the esophagus and eventually cause pain to the patient.

Assessment:

  • Belching (eructation)
  • Flatulence
  • Chest Pain
  • Dysphagia
  • HeartBurn (burning and stinging sensation in the upper midsternum).

Diagnostic Tests:

  • pH Monitoring is one of the accurate diagnostics (NG tube is used)
  • A pH of less than 4 in the LES is a diagnosis of GERD
  • Endoscopy
  • Barium Swallow

Management:

  • Avoid food that are irritants such as (spicy foods, chocolate, fats)
  • Small frequent meals
  • Not lie down 2-3 hours after eating.
  • Avoid Alcohol

Medications:

  • Antacids (Mylanta)
  • Proton Pump Inhibitors (Protoix, Nexium)
  • Histamine Blockers (Pepcid, Axid)
  • Prokinetic Drugs (increases gastric emptying) (Reglan)

Procedures:

These procedures are important to know for the NCLEX.

Stretta- inhibits the vagus nerve activity in the GI system.

♣ Laproscopic Nissen Fundoplication (LNF)– fundus of the stomach is wrapped around the esophagus to support the LES.

♣ Post Op:

  • Elevate the head of bed to prevent respiratory problems.
  • Monitor the NG tube

After the procedure: the stomach size is smaller.

– Long term reflux of the acid in GERD patients can cause Barrett’s Esophagus.

NCLEX Review on Hepatitis

Hepatitis is a very important topic in the NCLEX.

Hepatitis is basically a viral infection that causes  inflammation of the liver cells.

Classifications of Hepatitis Virus and its way of TRANSMISSION:

(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 D (transmitted through oral/fecal/water route)
Hepatitis E (transmitted through oral/fecal/water route)

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* .

Keep in mind: ↓↓↓↓↓↓↓↓

Hepatitis B and Hepatitis C is connected with cirrhosis and liver cancer.

Blood and Blood Products before 1992 were not screened for Hepatitis.

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 Cirrhosis

So what is cirrhosis and why is it very important to review for the the NCLEX ?

Cirrhosis is basically scarring of the liver.  It occurs when there is severe hepatic inflammation or necrosis.

Common causes of cirrhosis:

  • Alcohol
  • Hepatits C
  • Hepatitis B

Complications of Cirrhosis:

(It is very important to understand these complications for the NCLEX.)

Portal Hypertension

An increase in the pressure in the portal vein.  It is usually due to an obstruction of blood flow within the portal vein.

Ascites

– an accumulation of fluid within the peritoneal cavity.

– there will be retention of water and sodium in the body.

Esophageal Varices

– occurs when thin walled esophageal veins become distended from an increase in pressure.

Jaundice

– is caused by hepatic cirrhosis.  Develops because the liver cells cannot effectively excrete bilirubin.

Portal-Systemic Encephalopathy

– a manifestation by neurological symptoms

Physical Assessment

in patients with Cirrhosis:

  • Fatigue
  • Abdominal pain
  • Weight Loss
  • Asterixis

Laboratary Assessment:

There will be an increase in serum levels of (AST)/ Aspartate aminotransferase, (ALT) / Alanine aminotransferase and (LDH) / Lactate Dehydrogenase.

♣ Interventions:

– depends on the SYMPTOM and the COMPLICATION.

FOR ASCITES

  • Intervention for ascities includes *PARACENTESIS – if diet and drug management fails.

♠ PARACENTESIS

– The procedure is performed in the bedside.

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Try to Sit Alone to study for the NCLEX

I understand that you are now quite scared and at the same time quite excited to be taking your NCLEX Exam.  You have been stressed out all week, better yet, all month.  Not to mention you have to deal with  the problems of our daily lives, and how many of them would be eased if we could learn to sit alone, in a quiet empty room, with contentment and not worry about the NCLEX.

♣ You are content, and need nothing else. It solves a lot of problems.

♠ Can you sit alone in an empty room? Can you enjoy the joy of quiet?

Most of us have trouble sitting alone, quietly, doing nothing. We have the need to do something, always worried about what can happen on the day of the NCLEX exam. Sitting still can be difficult if you haven’t cultivated the habit.

After hours of reviewing for the NCLEX, I learned to just sit. Even for a few minutes, I just try to listen to my thoughts, to be aware of your urges to worry and be concerned.  You need to learn to watch yourself, by just trying to sit still and not act on any negative urges.

I have learned to be content with stillness, which can benefit my mental state for the NCLEX.

 

             The NCLEX Exam is your SuperBowl, you have done and (practiced) everything you can do and have now reached your big day.  All of the hard work and training for the NCLEX is all over, it’s now time for the Big Show.  At this point in time you are more prepared than you ever was and ever will be.  Do not be nervous, there is no reason to be anxious since the cat is out the bag.  What you should now do is just to remember that everything is going to fine.  Do not try to make yourself anxious by thinking  or trying to remember all the different norms and values, just relax.

So what exactly to do once you get to the Test Center:

  • Take a deep breath in and out and just Relax.
  • Show Your ID to the NCLEX Lady, get you palm lasered and fingerprinted.
  • Once you get into the Computer you will be doing some practice tests.
  • Once the actual questions starts, just try to focus and try not to get distracted.

 

Don’t think too hard.  It’s your Superbowl, enjoy it.  You are already winning.

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