Master Calcium Gluconate with these Nifty NCLEX Tips

Calcium Gluconate-Nifty NCLEX Tips

Calcium is an important electrolyte in the body. Responsible for cardiac function, blood clotting, renal function and teeth/bone health, low levels of Calcium can be devastating to one’s health.  Calcium Gluconate is likely to be found on the NCLEX RN exam.

In individuals with hypocalcemia (amongst many other conditions), Calcium Gluconate is the drug of choice. As an aspiring nurse, it is important that you learn more about this drug before you take your NCLEX exam. Here are some pointers that can help you out.

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Indication for Use

To pass the NCLEX, nursing students should know indications for medications.  Calcium Gluconate is used in the treatment of disorders with negative calcium balance, including Vitamin D deficiency, hypoparathyroidism, neonatal tetany and alkalosis. It is also used in cardiopulmonary resuscitation and the prevention of hypocalcemia during blood transfusion.

Calcium Gluconate is prescribed in patients with acute lead colic, hypersensitivity reactions and insect bite/sting-induced muscle cramps. Apart from being an antidote to magnesium sulfate, Calcium Gluconate is also used in the treatment of hyperkalemia-related cardiac toxicity.

foods high in calciumNursing Considerations

Comprehensive nursing history-taking is a must prior to the administration of Calcium Gluconate. The presence of calcium allergy, hypercalcemia, renal calculi and digitalis toxicity should be noted.

As for physical examination, the nurse should perform vital signs, auscultation of lungs and bowel sounds, abdominal exam. He/She should check the client’s urinalysis and ECG exam prior to administering Calcium Gluconate as well.

Electrolyte tests should also be verified prior to Calcium Gluconate administration, as calcium and phosphorous levels usually vary inversely. Serum magnesium results should also be noted, as this electrolyte decreases along calcium depletion in the body.  Nurses can find NCLEX tips and practice NCLEX questions on www.nclexpreceptor.com.

NCLEX Nursing Interventions

It is important for nurses to know the best practice interventions to pass NCLEX. Prior to administering IV Calcium Gluconate, the nurse should check the injection as extravasation can lead to necrosis and irritation. Additionally, the patient’s ECG should be monitored during administration. This can help you detect the presence of hypercalcemia, which is demonstrated by a decreased QT interval and an inverted T wave.

When administering the Calcium Gluconate injection, watch out for peripheral vasodilation (marked by a fall in BP) and reports of a ‘burning’ sensation. Throughout therapy, you should observe the patient for signs of hypocalcemia or hypercalcemia.

Important NCLEX Teaching Points

If Calcium Gluconate is used by your patient for disorders of negative calcium balance, inform him that zinc-rich foods can inhibit thorough Calcium absorption. As such, advise him to avoid food such as soy, legumes, sprouts, nuts and seeds.

Most importantly, patients taking Calcium Gluconate should be educated about the signs of hypercalcemia (constipation, nausea, vomiting, poor appetite and pain.) Emphasize that he needs to report any of the following symptoms to a healthcare provider right away.

Calcium Gluconate is an essential drug. However, a nurse like you should know all the important pointers in order to administer it safely. Be a stellar nurse by going through the medication must-knows at nclexpreceptor.com.

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References:         

http://web.squ.edu.om/med-Lib/MED_CD/E_CDs/Principles%20&%20Practice%20of%20Intravenous%20Therapy/mg/Calcium_salts.htm

http://robholland.com/Nursing/Drug_Guide/data/monographframes/C010.html

http://wps.prenhall.com/wps/media/objects/3775/3866436/npf_charts/ch47/Calcium%20Gluconate.pdf

 

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Why NCLEX Exam and Real-World Nursing are NOT the Same

Nursing rational for the NCLEX Exam is NOT real-world nursing.

I am a registered nurse with over 12 years of healthcare experience.  I have vast experience preparing nurses to pass the NCLEX exam.  I am board certified through American Association of Critical Care Nurses and American Health Information Management Association.  I have worked in emergency medicine, cardio thoracic surgical services, nursing education, and nursing informatics.  I will discuss why you should not use your real-world nursing experience to answer NCLEX exam questions.

Imagine you are a nurse taking care of an elderly patient.  The patient appears disheveled and is anxious and confused.  Now imagine that during the fourth day of admission you approach the patient to administer their medications.  You notice that the patient’s armband is missing.  What is the BEST action that you should take?  This are the type of question you will see on the NCLEX exam.

1.      Have the patient’s roommate verify the patient’s name.

2.      Ask the patient to tell you their full name and date of birth.

3.      Ask another nurse to verify the patient’s name.

4.      Look in the chart at the picture of the patient.

Elderly Patient
How to pass NCLEX exam

In real life you may have to deal with a patient that frequently removes their armband.  And of course getting a new armband is like getting a full 30 minute lunch break…it just is not going to happen anytime soon.  Not to mention you have 10 other patients to pass medications and you are already 30 minutes behind because your patient with C-Diff needed to be cleaned up again.  Don’t be fooled by these type of questions on the NCLEX exam.

What are YOU going to do on the NCLEX exam?

Now in real life when you are in this situation you think to yourself…I will just ask another nurse to verify the patient’s name.  After all, someone had to give them their medications yesterday.  When you think about it, in real-world nursing most places don’t have a picture of their patients.  So the most logical real-world answer is to get another nurse to verify the patient, right?  NO, well not at least on the NCLEX exam.

NCLEX exam is expecting you to do what is taught in nursing text books.  NCLEX exam answers are based off of best practices.  The correct answer is look in the chart at the picture of the patient.  Does this answer require you to stop what you are doing? YES.  Does this answer require you to get even further behind passing your morning medications?  YES.  Does this answer ensure patient safety and the right thing to do?  YES.

I don’t have very good luck.  If I were in this situation and took the word of Nurse Jackie, she would later tell me “Oh that is Mr. Smith.  I thought you were pointing to Mr. Jones.  Mr. Jones always takes off his armband.  Mr. Smith has never done that before.”  While standing in the unemployment line after being fired I would then reconsider taking the time to go look at that picture that is in the chart.  You can find other NCLEX exam case scenarios and test prep material at www.NCLEXPreceptor.com

So what are YOU going to do?  I trust that YOU are going to look at the patient’s picture in the chart because it ensures patient safety and is a nursing best practice.  You are NOT going to do what they “usually” do on the unit at work.  As a board certified progressive care nurse I understand the stresses of nursing.  I work daily with other nurses that have felt the same way.  What I have found is that when nurses do what is best for the patient you are more likely to have better patient outcomes and advance the profession of nursing.

Learn NOT to use your nursing experience to pass the NCLEX exam. Review practice questions to pass the NCLEX exam.  Don’t use work experience to pass the NCLEX exam.  Use best practices on the NCLEX exam.

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 Post some examples of bad habits or bad nursing practices that you see at your job?

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Be a NCLEX Wizard with this Atropine Study Guide

Atropine Study Guide

NCLEX is not an easy exam, yet you can pass it with flying colors. More than just browsing through the major topics such as Medical and Surgical nursing, you need to be well-versed with the commonly-used medications in hospitals, hospices and healthcare centers.

One such example is Atropine Sulfate, a parasympatholytic agent. Also an anti-cholinergic and an anti-muscarinic medication, it is a medication that you might encounter in your forthcoming NCLEX exam.

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Parkinson's diseaseIndications for Use

Atropine is a multi-faceted drug known by the brands Atropisol and Isopto Atropine. Apart from the aforementioned uses, this Belladonna Alkaloid is also used as an antidote, an anti-parkinsonian, and a diagnostic agent.

Because of its numerous purposes, Atropine is prescribed for a variety of disorders. It is utilized in the treatment of Parkinson’s-related rigidity and tremor, closed head disorders, pylorospasm, colon hypermotility, biliary spasm, ureteral colic, bronchospasm, urinary tract disorders and peptic ulcer, to name a few.

As an antidote, Atropine is used to reverse mushroom poisoning and cardiovascular collapse secondary to parasympathomimetic drug overdose.

Nursing Considerations

Before giving Tegretol, the nurse should take the patient’s complete history. You should determine the presence of hypersensitivity, glaucoma, gastrointestinal disorders, arrhythmia, COPD, bronchial asthma, myasthenia gravis, brain damage, hypertension and hypothyroidism, among many others.

For physical assessment, you should check the patient’s vital signs, as well as lung sounds, urinary output and bowel sounds. Make sure to assess the client’s affect, orientation, reflexes, skin color/lesions and bilateral hand grip strength as well.

As for lab exams, the nurse should periodically check the results of the patient’s liver/kidney function tests and ECG.

NCLEX Nursing Interventions

Hyperpyrexia can occur with Atropine therapy. As a nurse, it is your responsibility to provide temperature control to circumvent this. Ensuring adequate hydration can also curb the onset of hyperpyrexia.

Urinary retention usually occurs with Atropine, therefore advise the patient to empty his bladder prior to the provision of the drug.

Important NCLEX Teaching Points

As a nurse, make sure to teach your client about what he can expect with regards to taking Atropine. For example, you should advise him to take the medication 30 minutes prior to a meal, in order to avoid overdosage.

As it has been established, hyperpyrexia can occur with Atropine. As such, remind your client to avoid hot environments as the drug might cause heat intolerance.

Educate your patient with the usual side effects of Atropine, which are confusion, dizziness, constipation, blurred vision, dry mouth, light sensitivity, urination difficulties and impotence (reversible.)

Most importantly, teach your client about warning signs – the presence of any should warrant immediate notification. These symptoms are hallucinations, abdominal distention, coordination loss, tremors, irregular heartbeat, eye pain, flushing, rashes, headache and swallowing/urinating difficulties.

Atropine might have many purposes, but you can conquer them all (and other difficult drugs as well) with the help of nclexpreceptor.com practice NCLEX questions.

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References:

http://web.squ.edu.om/med-lib/med_cd/e_cds/Nursing%20Drug%20Guide/mg/atropine_sulfate.htm

http://www.robholland.com/Nursing/Drug_Guide/data/monographframes/A084.html

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Medication NCLEX Questions: Be a Wizard of Pharmacology!

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 Top Medication NCLEX Questions in Pharmacology

Pharmacological and parenteral therapies comprise 13 to 19% of all NCLEX questions. Unfortunately, it is impossible to memorize all the drugs in the world – unless you have an eidetic memory. If you were not born a regular Sheldon Cooper, you can still become a wizard of pharmacology by focusing on these top 5 medications that usually appear in medication NCLEX questions:

  1. Ace Inhibitors

Heart disease is one of the leading causes of mortality and morbidity in the United States – and all around the world. As such, you can expect Ace Inhibitors to pop up in medication NCLEX questions every so often.

There are many Ace Inhibitors out there, but one thing you should know is that this family of drugs often ends in –pril (i.e. Captopril and Enalapril.) Medication NCLEX questions usually ask about common side effects, and with Ace inhibitors it is usually dizziness.

As a nurse, you need to be on the lookout for the development of throat or lip swelling in patients taking such drugs. After all, this is a rare yet very serious side effect that warrants the attention of the physician.

  1. Alpha Blockers

Another category of anti-hypertensive medications, Alpha Blockers are often included in medication NCLEX questions. Known to have the suffix –zosin or –losin, they are also used in patients with benign prostatic hyperplasia and Raynaud’s disease.

A common side effect of Alpha Blockers is orthostatic hypotension, or dizziness and low blood pressure that occur after an abrupt change in position (standing up from a lying or sitting position.) When you come across medication NCLEX questions pertaining to this, remember that your best measure is to advise your patient to change his position slowly in order to prevent this unpleasant side effect.

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  1. Antianginals

Antianginals are medications that dilate the peripheral veins and arteries. This effect makes them the drug of choice in patients manifesting angina pectoris, a symptom associated with ischemic heart disease. Such antianginals that might pop out in medication NCLEX questions are the following:

  • Nitrates – Nitroglycerin, Isosorbide Mononitrate and Isosorbide Dinitrate
  • Beta Blockers – Drugs with –olol suffix, examples include Metoprolol or Acebutolol
  • Calcium Channel Blockers – Dihydropine classes are characterized by the –dipine suffix
  1. Antidysrhythmics

True to its name, this drug deals with dysrhythmias or arrhythmias, heart conditions characterized by irregular heartbeats. Antidysrhythmic drugs that might appear in NCLEX questions include Sodium Channel Blockers (Procainamide, Lidocaine), Beta-Adrenergic Blockers (Propanolol), Potassium Channel Blockers (Amiodarone) and Calcium Channel Blockers (Verapamil, Adenosine). Aside from the different type of antidysrhythmic drugs, medication NCLEX questions might deal with nursing considerations associated with these medications. Here are some helpful pointers:

  • Monitor cardiac rate and rhythm when administering IV antidysrhythmics.
  • Observe for side effects, as these might indicate overdose.
  1. Antifungals

Antifungals, or drugs that combat fungal infections, are often incorporated in NCLEX questions. Often ending in the suffix –zole, antifungals are known to cause hepatotoxicity. As such, it is important to monitor the liver function tests of individuals who receive this kind of drug.

Even if there are many drugs in the world, you can answer medication NCLEX questions in Pharmacology with ease and confidence – just by remembering these tips. Put your skills to the test by sampling the Pharmacology medication NCLEX questions here at www.nclexpreceptor.com.

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