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NCLEX Review Infection Control

NCLEX Review on Safety and Infection Control

NCLEX Review:  Infection Control

When we are talking about Safety and Infection Control we need to simplify things and really understand what is safety and infection control and what the NCLEX wants us to focus on with this topic.  It is very important to realize that  The “Safety and Infection Control” now makes up about 10 -14% of the questions in the entire NCLEX Exam  This is a huge part of the exam, which means that it can be a factor for us either passing or failing the NCLEX exam.

So lets simplify the SAFETY AND INFECTION CONTROL information that we need to know for this NCLEX Review.  So the first thing that we need to learn is to understand and simplify each category and correlate  which particular disease belongs to each particular category.  We have to know this by heart, and to do this we really need to know the basics of each diseases.

So first lets go over the STANDARD PRECAUTIONS

Standard precautions simply are the basic level of infection control that should be used in the care of all patients all of the time.  Basically we use standard precautions in the care of all patients, in order to reduce the risk of transmission of microorganisms.

It is also called UNIVERSAL Precaution.

NCLEX Review:  Review on Safety and Infection Control

Personal protective equipment (PPE) that we need  includes: Gowns, Mask and Eye protection

Now lets go over the meat and potatoes of Safety and Infection Control in the NCLEX Exam which is knowing all the necessary precautions.  And obviously  in order to be successful in the NCLEX, you have to know this by heart.

The three main transmission based precautions aree Contact precautions– Droplet precautions and Airborne precaution

Lets begin with Contact Precaution.  It is pretty much self explanatory in a sense that it is transmitted through usually skin to skin contact. Now the major diseases that exist that enables the organism to be transferred through contact precaution that you will most likely encounter in your NCLEX exam includes mostly skin infections.  Since the skin is the number one barrier during a contact.

  • Varicella zoster

  • Herpes simplex

  • Impetigo

  • Scabies, Staphylococcus

Now lets take a look at Droplet precaution which can occur from a source such as a person during coughing, or sneezing or  talking,  Now these Droplets that contain the microorganisms can generally travel no more than 3 feet from the patient.

What Diseases can we usually see that involves droplet precuations in the NCLEX?

These disease can include

* Diptheria

* Streptococcal pharyngitis/tonsillitis

* Meningitis

* Mumps

* Pertussis

* Scarlet fever

 

Lastly, lets go over the AIRBORNE PRECAUTIONS

NCLEX DISEASES: AIRBORNE PRECAUTIONS

DISEASES that you will most likely encounter in the NCLEX.

* TB (m. Tuberculosis) 

* Measles (rubeola)

* Chicken Pox (varicella)

* Shingles (disseminated zoster)

 

Remember that with TB – Tuberculosis you will need a:

  • PRIVATE ROOM

  • NEGATIVE PRESSURE WITH 6-12 AIR EXCHANGES PER HOUR

So its basically a negative pressurized room.  What this does is that it enables a ventillation system that generates negative pressure to allow air to flow into the room and not allow the pathogens to escape.

  • MASK

NCLEX Priority: Make sure to wear our speacial mask which is the N95 MASK FOR TB.

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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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NCLEX Review Shownotes:

Understand that the Nervous system includes the Central Nervous System (CNS), the Peripheral Nervous Sytem (PNS) and the Autonomic Nervous System or the (ANS).

When I say the CENTRAL NERVOUS SYSTEM, We can simplify at as the BRAIN and the SPINAL CORD.

The PERIPHERAL NERVOUS SYSTEM on the other hand, contains the CRANIAL NERVES and the SPINAL NERVES.

  • WHEN WE TALK ABOUT THE AUTONOMIC NERVOUS SYTEM, WE ARE BASICALLY TALKING ABOUT THE “SYMPATHETIC” (FIGHT OR FLIGHT) SYSTEM OR THE “PARASYMPATHETIC” SYSTEM.
  • .THE BASIC COMPONENT OF THE NERVOUS SYSTEM IS THE NERVE CELL OR NEURON

NEURON

– is the primary component of the nervous system.

– it is composed of cell body (gray matter), axon and dendrites.

BRAIN  (Central Nervous System: Brain and Spinal Cord).

CEREBRUM- Outermost area (cerebral cortex) is gray matter, deeper area is composed of white matter

  • TWO HEMISPHERES: LEFT AND RIGHT AND EACH HEMISPHERE IS DIVIDED INTO TWO LOBES.

FRONTAL LOBE

  • PERSONALITY, BEHAVIOR
  • HIGHER INTELLECTUAL FUNCTIONING
  • BROCA’S AREA: (MOTOR SPEECH AREA)

PARIETAL LOBE

  • POSTCENTRAL GYRUS: REGISTERS SENSATION (TOUCH, PRESSURE)
  • INTEGRATES SENSORY INFORMATION

TEMPORAL LOBE

  • HEARING, TASTE, SMELL (HINT: LOCATION OF EARS – CLOSE THE TEMPLES)
  • WERNICKE’S AREA: SENSORY SPEECH AREA
  • (UNDERSTANDING, FORMATION OF LANGUAGE)

OCCIPITAL LOBE

  • VISION

Peripheral Nervous System- composed of Spinal Nerves (31)

Autonomic Nervous System- part of the Peripheral Nervous System

  • REGULATES FUNCTIONS OCCURRING AUTOMATICALLY IN THE BODY.
  • ANS REGULATES SMOOTH MUSCLE, CARDIAC MUSCLE AND GLANDS.

IT IS NOT NECESSARY TO KNOW EVERY PHYSIOLOGY FOR EVERY SINGLE PART OF THE BRAIN.  BUT JUST IN CASE WE END UP GETTING LOW LEVEL QUESTIONS ON THE EXAM, THEN IT IS IMPORTANT THAT WE UNDERSTAND THE BASIC CONCEPT AND FUNCTION OF EACH AREA. IT WOULD ALSO BE A GREAT IDEA TO KNOW THE CRANIAL NERVES.

Quick NCLEX Overview:

EYE AND EAR DISORDERS

GLAUCOMA

Glaucoma: there is an increased of intraocular pressure in the eye.

There are two types:

  1. OPEN ANGLE GLAUCOMA OR “PRIMARY” GLAUCOMA
  2. PRIMARY ANGLE GLAUCOMA.

Open angle glaucoma is slow in onset and chronic, while the primary angle glaucoma needs immediate treatment.

Open Angle Glaucoma

Bilateral

Acute Angle-closure Glaucoma

Unilateral

TREATMENT

Beta Adrenergic Blockers

Cholinergic Agents (Pilocarpine) ♣ (Make sure to know this for the NCLEX)

AVOID ANTICHOLINERGICS (Atropine)

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NCLEX Review of Endocrine Medications

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[youtube http://youtu.be/l9ePztPoSwQ w=400&h=300]

NCLEX Review Notes:

A quick NCLEX Review on Pituitary Gland Disorders

Pituitary Gland Disorders

HYPOPITUITARISM

Insuffecient quantities of anterior pituitary gland hormones.

ASSESSMENT

  • Lethargy
  • Hypothermia
  • Weight loss
  • Amenorrhea
  • Dry Skin
  • Hypotension

– Monitor the patient’s risk for infection.

Treatment

Surgery: if hypopituitarism is caused by a tumor.

Hormone therapy

  • Corticosteroids (cortisol)
  • Growth hormone
  • Sex hormones (testosterone for men and estrogen for women)
  • Thyroid hormone

HYPERPITUITARISM

Also called Acromegaly and Cushings’s Disease

ACROMEGALY
Often a result of a benign tumor

ASSESMENT

  • – large hands and feet
  • – protruding jaw and forehead

TREATMENT

  • Hypophysectomy
  • Corticosteroids
  • Elevate head at least 30 degrees.
  • Glucocoritcoids
  • Hormones
  • * Surgery ( Transsphenoidal Pituitary Surgery) to remove the pituitary tumor might be the best treatment.
Meds. used to control increased GH:
  • Octreotide (Sandostatin)
  • bromocriptine (Parlodel)

DISORDER OF THE POSTERIOR PITUITARY GLAND.

♣ DIABETES INSIPIDUS


– Hyposecretion of the ADH hormone.
Assessment:

  • POLYURIA (4-24 L/DAY)
  • POLYDIPSIA
  • DEHYDRATION
  • LOW URINE SPECIFIC GRAVITY 1.006 OR LOWER
  • FATIGUE
  • HYPOTENSION
  • TACHYCARDIA

– * Fluid Deficit is a priority

Medication:

  • VASOPRESSIN (PITRESSIN) *used as an antidiuretic hormone

Examples of Antidiuretic Hormones:

  • Desmopressin acetate
  • Vasopressin (Pitressin)

Side Effects (Antidiuretic Hormones)

  • Headache
  • Nausea & Vomiting
  • Water Intoxication
  • Hypertension
Vasopressin
  • it’s an antidiuretic hormone
  • prevent the loss of water from the body by reducing urine output and reabsorbing water in the body
  • (Increases BP)= by constricting (narrowing) blood vessels
Side Effects (VASOPRESSIN)
  • throbbing headache
  • stomach pain, bloating
  • dizziness, nausea
  • blanching of the skin
♦ Due to increase urine output -> pt. is in risk of HYPOVOLEMIC SHOCK.

♠ SIADH

♠ Syndrome of Inappropriate Antidiuretic Hormone (SIADH)

– excess ADH is being released

Assessment:

  • FLUID OVERLOAD
  • WEIGHT GAIN
  • HYPERTENSION
  • TACHYCARDIA
  • HYPONATREMIA

Interventions:

  • – Monitor fluid & electrolyte imbalance
  • – Fluid restriction.

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NCLEX Review: Neurological System

[youtube http://youtu.be/5AHvjKjCJhA w=400&h=300]

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Show Notes:

Lou Gehrig’s Disease/ Amyothropic Lateral Sclerosis (ALS)

Degeneration of the nerves that controls the voluntary muscles.

ASSESSMENT:

  • Muscle Weakness and Twitching
  • Fatigue
  • dysphagia
  • dysarthia (difficulty swallowing)
  • cramping

– Lowe extremities are usually involved late in the disease.

Treatment:

Riluzole (Rilutek)

Side Effects:

  • nausea, stomach pain, low fever, loss of appetite
  • dark urine, clay-colored stools, jaundice
  • fever, chills, body aches, flu symptoms

Antispasmodics

  • baclofen
  • diazepam

Interventions:

Conserve energy by spacing activities.

Small frequent feedings.

The Nervous System

NCLEX Review on the Neurological System

Time Management:

  • Make sure to read and understand the overview of the Nervous System:
  • Focus in understanding the causes and logic behind each disease.
  • Have an understanding of the signs and symptoms of the disease.
  • Know the medications and the rationale behind using those meds.

Understand that the Nervous system includes the Central Nervous System (CNS), the Peripheral Nervous Sytem (PNS) and the Autonomic Nervous System or the (ANS).

When I say the CENTRAL NERVOUS SYSTEM, We can simplify at as the BRAIN and the SPINAL CORD.

The PERIPHERAL NERVOUS SYSTEM on the other hand, contains the Cranial NERVES and the SPINAL NERVES.

  • WHEN WE TALK ABOUT THE AUTONOMIC NERVOUS SYSTEM, WE ARE BASICALLY TALKING ABOUT THE “SYMPATHETIC” (FIGHT OR FLIGHT) SYSTEM OR THE “PARASYMPATHETIC” SYSTEM.
  • .THE BASIC COMPONENT OF THE NERVOUS SYSTEM IS THE NERVE CELL OR NEURON

NEURON

– is the primary component of the nervous system.

– it is composed of cell body (gray matter), axon and dendrites.

BRAIN (Central Nervous System: Brain and Spinal Cord).

CEREBRUM- Outermost area (cerebral cortex) is gray matter, deeper area is composed of white matter

  • TWO HEMISPHERES: LEFT AND RIGHT AND EACH HEMISPHERE IS DIVIDED INTO TWO LOBES.

FRONTAL LOBE

  • PERSONALITY, BEHAVIOR
  • HIGHER INTELLECTUAL FUNCTIONING
  • BROCA’S AREA: (MOTOR SPEECH AREA)

PARIETAL LOBE

  • POSTCENTRAL GYRUS: REGISTERS SENSATION (TOUCH, PRESSURE)
  • INTEGRATES SENSORY INFORMATION

TEMPORAL LOBE

  • HEARING, TASTE, SMELL (hint: location of ears – close the temples)
  • WERNICKE’S AREA: SENSORY SPEECH AREA
  • (UNDERSTANDING, FORMATION OF LANGUAGE)

OCCIPITAL LOBE

  • VISION

Peripheral Nervous System- composed of Spinal Nerves (31)

Autonomic Nervous System- part of the Peripheral Nervous System

  • REGULATES FUNCTIONS OCCURRING AUTOMATICALLY IN THE BODY.
  • ANS REGULATES SMOOTH MUSCLE, CARDIAC MUSCLE AND GLANDS.

IT IS NOT NECESSARY TO KNOW EVERY PHYSIOLOGY FOR EVERY SINGLE PART OF THE BRAIN. BUT JUST IN CASE WE GO END UP GETTING LOW LEVEL QUESTIONS ON THE EXAM, THEN IT IS IMPORTANT THAT WE UNDERSTAND THE BASIC CONCEPT AND FUNCTION OF EACH AREA. IT WOULD ALSO BE A GREAT IDEA TO KNOW THE CRANIAL NERVES.

The CRANIAL NERVES

GLASCOW COMA SCALE

INCREASED INTRACRANIAL PRESSURE

MENINGITIS

ENCEPHALITIS

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Management and Delegation plays a big part in the NCLEX.   As a matter of fact “Management of Care” is about 16-22% of the entire exam.  Managment of care acording to NCSBN is composed of:
Direct care that enhances delivery.
– Advance Directives
– Interdisciplinary Team
– Confidentiality

If we really look at the big picture, if I am lucky enough to get the least number of questions in my exam which is about (75 Questions) that would mean that aproximately 13- 16 questions (spread out) out of the 75 questions would be in relation to management and delegation.  If we say we have mastered this area of the NCLEX, then this can SUPERBLY benifit us, and our chance of passing the NCLEX.

I personally do not look at Management & Delegation as something of a criteria of its own (even if NCSBN thinks it is).  Because “management and delegation” in the NCLEX is not in sync with the concept of “Management & Delegation” in regards with, lets say a Nurse Manager.  Management and Delegation in the NCLEX is more of delegating and planning of interventions and assignment based on a “Client’s Status” and another personel’s level of “Competency” (usual delegation between YOU the nurse, the LPN and the CNA).

To learn more about how to do well with management questions please please try NCLEX 26, you will be glad you did.

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