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.

Join Our Private NCLEX Group

 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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Score High in Your NCLEX: MAOI Inhibitors Must-Knows

MAOI Inhibitors Must-Knows

According to studies, depression affects more than 120 million individuals around the world. This mental disorder, unfortunately, disturbs one’s quality of life, relationships and social skills. Worst of all, it has led to approximately 850,000 cases of suicide worldwide.

Because of the prevalence of this disease, it is your responsibility as a nurse to familiarize yourself – as well as your clients – with anti-depressant medications, such as MAOI Inhibitors.

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Signs of Depression

Indications for Use

MAOI inhibitors are anti-depressants that affect neurotransmitters that serve as linkages between neurons. It addresses depression symptoms by altering the levels of such brain chemicals.

MAOI inhibitors prevent the synthesis of monoamine oxidase, which eliminates dopamine, serotonin and epinephrine from the brain. With higher levels of the aforementioned neurotransmitters, enhanced mood is experienced.

Examples of MAOI inhibitors are Phenelzine (Nardil), Selegilin (Emsam), Isocarboxazid (Marplan) and Tranylcypromine (Parnate.)

Nursing Considerations

Before administering MAOI inhibitors, the nurse should take the history of the patient. Pertinent information that should be noted are hypersensitivity to MAOI inhibitors, seizure disorders and cerebrovascular defects. Disorders such as cardiovascular disease, hypertension and hyperthyroidism should be documented as well.

As for physical examination, the nurse should obtain the client’s vital signs, reflexes, affect, orientation and urine output. Skin color and the presence of skin lesions should be checked as well. Laboratory tests that should be obtained include CBC, urinalysis, thyroid function tests, ECG and EEG.

NCLEX Nursing Interventions

The most important nursing intervention for patients taking MAOI inhibitors is to ensure that they limit the intake of tyramine-rich foods. Tyramine, whose breakdown is impeded by MAOI inhibitors, can lead to a hypertensive crisis. Symptoms include elevated BP and severe headache. At the sign of this, immediately discontinue the drug and inform the doctor.

Consequently, make sure to control the patient’s intake of cheese, alcohol, banana, liver and fermented/smoked food products. In anticipation of a hypertensive crisis, keep alpha-adrenergic blocking drugs and phentolamine at bay.

Apart from the symptoms of hypertensive crisis, MAOI inhibitors should also be discontinued at the first sign of hepatic dysfunction (jaundice.)

Important NCLEX Teaching Points

Nurses are health educators, so when teaching patients taking MAOI inhibitors, remind them to take the drug as prescribed.  Advise them not to discontinue use abruptly.

As it has been emphasized, instruct your patients to avoid tyramine-rich foods while taking MAOI inhibitors, up to 2 weeks after therapy. Alcohol, appetite suppressants and over-the-counter drugs should be averted as well.

Additionally, make sure to educate your patients about the expected side effects of MAOI inhibitors, which are:

  • Dizziness
  • Weakness/fainting resulting from an abrupt positional change
  • Drowsiness
  • Blurred vision (reversible)
  • Nausea and vomiting
  • Loss of appetite
  • Emotional or mental changes
  • Irritability/ nervousness

Patients should be informed about the warning signs that warrant immediate physician/nurse attention as well. They include:

  • Headache
  • Rashes
  • Darkened urine
  • Pale stools
  • Eye/skin yellowing
  • Chills and fever
  • Sore throat

Your patient’s recovery depends on your knowledge, skills and passion as a nurse. Enhance your mind and become an excellent nurse with the practice NCLEX questions at nclexpreceptor.com.

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References:

http://www.mayoclinic.org/diseases-conditions/depression/in-depth/maois/art-20043992

http://web.squ.edu.om/med-Lib/MED_CD/E_CDs/Psychiatric%20Nursing%20Care%20Plans/monographs/phenelzine%20sulfate.htm

http://assistednursingcare.net/monoamine-oxidase-inhibitors-maois-an-antidepressant-and-its-contraindications/

 

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Vitamin K – Pass the NCLEX on your First Time by Mastering this Drug

Master Vitamin K

Vitamins are essential for everybody’s health. So if you are an aspiring nurse, you definitely have to master these vital substances.

Now that you are about to take your NCLEX, remember that you need to be familiar with the common drugs, such as Vitamin K. Often found in NCLEX tests, you can memorize its important points by reading through the rest of this article.

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Indications for Use

Also known as Phytomenadione, Vitamin K is a medication that works similar to the natural vitamin found in green leafy vegetables and fish. It is needed for the synthesis of clotting factors that prevent excessive bleeding.

Vitamin K is prescribed in patients who suffer from an overdose of oral anti-coagulants, such as Coumadin and Inandione. It is also used in individuals who suffer from hypoprothrombinemia resulting from the intake of oral antibiotics and Vitamin A.

Those with disorders resulting to the malabsorption and inadequacy of Vitamin K, such as ulcerative colitis and obstructive jaundice, are also treated with the said drug.

Vitamin K is also an essential medication for newborns, as it is used in the treatment of neonatal hemorrhagic disease.

Vitamin K FoodsNursing Considerations

As a nurse, you are responsible for monitoring the patient who will receive Vitamin K. You should take a comprehensive history, specifically noting if he has allergies. For female patients, establish if they are pregnant, planning to be pregnant or lactating, as it can cause jaundice and other conditions to the fetus/neonate.

Since Vitamin K helps in the synthesis of clotting factors, you should check the patient’s PT and INR tests every so often.

NCLEX Nursing Interventions

As it has been established, you should religiously monitor your patient’s PT/INR response. After all, the result will dictate the duration, frequency and dose of Vitamin K.

The effectiveness of the drug is evidenced by the following responses:

  • Shortened PT/INR, bleeding and clotting times
  • Decreased bleeding tendencies

Important NCLEX Teaching Points

When dealing with patients taking Vitamin K, it is vital to remind them to maintain a normal diet. Remind them to avoid increasing the intake of Vitamin K-rich foods (i.e. green leafy vegetables, fish, meat and eggs,) especially if the treatment regimen has already been stabilized.

It is also important to inform patients taking Vitamin K that they might develop temporary resistance to anticoagulants similar to Coumadin. Should this oral medication be needed, a larger dose – or heparin even – might be prescribed instead.

Vitamin K is an essential drug, commonly seen in many hospital floors. Boost your nursing knowledge and obtain that most-awaited license by going through the practice NCLEX questions here at nclexpreceptor.com.

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Resources:

http://www.mayoclinic.org/drugs-supplements/vitamin-k-oral-route-parenteral-route/description/drg-20069592

http://www.robholland.com/Nursing/Drug_Guide/data/monographframes/P045.html

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