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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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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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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Important Things to Know About the RN NCLEX – Questions and Answers

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Congratulations, you have finally passed the hurdle that is Nursing School! While the thought of graduation should make you celebrate, you need to know that there is one more challenge you need to overcome: the NCLEX. Probably the most important requirement for all wannabe nurses, the NCLEX and the questions therein  are designed to ensure safety of the public in the hands of neophyte nurses like you.

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What is the NCLEX?

NCLEX is the acronym for National Council Licensure Examination. NCLEX questions are formulated by members of the National Council of State Boards of Nursing.

NCLEX questions come in two forms: the NCLEX-RN for Registered Nurses, and the NCLEX-PN for Practical Nurses.

Passing the NCLEX is a must for every aspiring nurse, as it measures the competencies of entry-level nurses. This helps determine the ability of such professionals to perform their duties safely and efficiently in the healthcare setting.

NCLEX Format

The computerized NCLEX questions test is an innovation introduced in April 1994. NCLEX questions are divided into four categories, and these cover the entire span of Nursing.

The NCLEX is not just a repository of randomly-assigned queries, it features a computer-adaptive format that spews questions based on your former answers. The difficulty will depend on you, the examinee, and the level of your Nursing knowledge.

NCLEX Questions and Exam Length

NCLEX questions and the entire exam vary in length. The minimum number of questions you need to answer is 75, while the maximum is 265.

You have a total of 6 hours to finish the NCLEX questions. This duration includes breaks (optional), as well as viewing of tutorials and answering sample questions. Remember that your six-hour allotment does not stop whenever you take breaks.

What to Expect During the Exam Date

On the exam date, you need to provide a scan of your palms, as well as fingerprints and a digital signature. You need to have your picture taken as well.

You need to surrender your Authorization to Test (ATT) when asked. This is the only item you can bring with you during the examination. You can store your valuables in a locker outside the testing area.

NCLEX Results

To ensure result accuracy, each exam is checked twice by the Board.

After answering NCLEX questions, the waiting time is approximately one month before you get the results from the State Board. If this is too long for you, you can get the unofficial result 2 days after you have taken the test. Getting your result through this method comes with an additional fee.

In case of failure, you will be sent a Candidate Performance Report that features a detailed account of your strengths and weaknesses. From this report you can determine which NCLEX questions you need to brush up on, before you take another round of the test.

NCLEX Passing Tips

Practicing NCLEX questions is one of the best ways for you to pass the exam. If you are looking for mind-boosting queries that can help you prepare for the test, then be sure to visit nclexpreceptor.com.

Now that you know everything there is to know about the exam, it is time for you to take the exam and answer the NCLEX questions! Good luck!

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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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Epogen Pointers: What You Need to Become an Excellent Nurse

Epogen Pointers for Excellent Nursing

Anemia is a condition characterized by the inadequacy of red blood cells, components that deliver oxygen to various parts of the body. This disorder is hallmarked by symptoms such as fatigue, dizziness, shortness of breath, tachycardia and pallor.

To cure this illness, doctors usually prescribe Epogen. As such, this medication is commonly found in the NCLEX.

Indications for Use

Generically known as Epoietin Alfa, Epogen is categorized as a recombinant human erythropoietin. It boosts the production of glycoproteins in the kidneys, which then increases the synthesis of red blood cells in the bone marrow.

Epogen is prescribed in patients with anemia related to the following:

  • Chronic renal failure, especially those on dialysis
  • Renal failure in ages 1-16 years old, requiring dialysis
  • Zidovudine therapy for HIV-AIDS
  • Chemotherapy

Apart from anemia treatment, Epogen is also used to reduce allogenic blood transfusions in patients undergoing surgery. Other indications included pruritus secondary to renal failure, myelodysplastic syndrome and chronic inflammation due to rheumatoid arthritis.

symptoms of anemiaNursing Considerations

Assessment is an integral part of Epogen therapy. As such, make sure to take the patient’s history and note for hypersensitivity to mammalian cell-derived products/human albumin, uncontrolled hypertension and lactation.

As for physical examination, obtain pertinent information such as the patient’s vital signs, affect, reflexes and urinary output prior to administration. Ensure that lab exams such as CBC, Hematocrit, Serum iron, electrolytes and renal function tests are extracted accordingly.

NCLEX Nursing Interventions

When preparing Epogen, remember to gently mix the solution. Do not shake the vial, as it might denature the glycoprotein. Additionally, use only one dose per vial and avoid re-entering it. Discard the vial after use, even if there is still something remaining in the container.

Avoid giving Epogen with any other drug or medication.

Epogen should be administered thrice weekly. Intravenous or subcutaneous are the preferred routes, though it can be given directly to the venous access line of dialysis patients. Prior and after administration, evaluate the access line for signs of clotting.

Make sure that the patient’s Hematocrit is checked prior to Epogen therapy. This will determine the accurate dosage for the client. Additionally, check the patient’s serum iron to evaluate if supplemental iron is needed.

Remember to place patients receiving Epogen on seizure precaution, as it can occur with the drug.

Important NCLEX Teaching Points

As Epogen needs to be given three times a week, create an administration schedule for the patient so that he can comply. Additionally, create a schedule of blood extraction tests handy, so the appropriate dosage can be determined.

As for side effects, inform the patient that these are normal:

  • Headache
  • Dizziness
  • Joint pain
  • Fatigue
  • Nausea and vomiting
  • Diarrhea

The following, however, are warning signs that should be reported to the doctor or the nurse:

  • Difficulty of breathing
  • Tingling/numbness
  • Chest pain
  • Severe headache
  • Seizures

Knowing the following facts will definitely make you an effective nurse. Ensure your patient’s health and safety by studying the practice NCLEX questions at nclexpreceptor.com.

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References:

http://www.mayoclinic.org/drugs-supplements/epoetin-alfa-injection-route/description/drg-20068065

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

http://www.mayoclinic.org/diseases-conditions/anemia/basics/definition/con-20026209

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Help Patients with Substance Abuse Problems with Alcoholism Core Measures

Alcoholism Core Measures

Alcoholism is a prevalent problem, causing approximately 1 out of 4 deaths in the United States. Not only does it lead to medical problems, it puts a strain on the society as well. In fact, alcoholism has cost the a whopping $185 billion in expenditures.

Apart from causing dependence, constant alcohol use can lead to stroke, cirrhosis, cancer and arrhythmias, to name a few. Since dependence and addiction to this substance can be easily prevented, the Joint Commission has come up with proven-effective core measures.

Alcohol Use Screening

Patients admitted in the hospital – with an alcohol test indicative of acute intoxication – are subjected to screening. These individuals should be 18 years of age. They should have been hospitalized anywhere from a day to 120 days.  Data elements that should be included in the process are the following:

  • Admission date
  • Birthdate
  • Cognitive impairment
  • Discharge date

As a registered nurse, you have to ensure that the screening process is done and documented – or why it has been refused by certain individuals.

Alcoholism

Alcohol Use Brief Intervention Provided or Offered

An estimated 22.6 million people meet the criteria for alcoholism and substance use disorder. Fortunately, Obama care has expanded benefits for alcoholism treatment. Consequently, more and more individuals can receive the proper therapy they need.

Acknowledging the impact of alcohol use, several clinical trials were held to determine the best health care solution for these individuals. According to the studies, brief interventions, especially those given before the onset of addiction, can markedly reduce alcohol-related expenses. Treatment referral is also deemed beneficial in clients diagnosed with alcoholism.

As a nurse, you should know your facility’s policies regarding brief treatment. Make sure to initiate and document this process as indicated.

Alcoholism Treatment Provided or Offered at Discharge

While a stint in an urgent care facility can reduce alcoholism tendencies, the will to stay sober can immediately go away upon discharge. To prevent a relapse, the Joint Commission recommends medical and nursing personnel to provide/offer treatment upon discharge.

Such therapies that may be suggested after discharge include detoxification, rehabilitation and maintenance of sobriety. Medications that can be prescribed include Vivitrol, Disulfiram (Antabuse) and Naltrexone (Revia.)

Alcoholism: Assessing Status after Discharge

After discharge, the alcoholic patient is contacted 7 to 30 days after hospitalization. Information such as counseling, use of prescribed meds and quit status are established during this follow-up call.

While the nurse does not play a role in the follow-up process, he can ensure the compliance of the patient by educating him in the urgent care facility. He can foster follow-up by encouraging the patient to live a healthy, alcohol-free life.

Alcoholism can cause a variety of diseases. You, as a nurse, can help in the reduction of relapse and confinement by following these core measures. To learn more about these evidence-based practices, visit nclexpreceptor.com.

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References:

http://www.jointcommission.org/assets/1/6/Substance_Use_Measures_List.doc.pdf

http://hospitalsbirt.webs.com/SBIRT%20Measures%20SUB1.pdf

http://www.rn.com/getpdf.php/1859.pdf?Main_Session=4c1ab3e6289683a53c9ce44479f6a95d

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Know the Important Details of Oxytocin

Oxytocin Important Details

Obstetrics and Gynecology is considered difficult by many NCLEX takers. But since it is a major subject, questions about this field are sure to appear in your forthcoming test. Increase your chances of passing the exam by familiarizing yourself with one of Ob-Gyne’s most common medications: Oxytocin.

under-the-molecule-oxytocin-banner

Indications for Use

Also known by the brand name Pitocin, it is a synthetic hormone similar to the substance produced by the hypothalamus. Oxytocin works by stimulating the uterus, as such it is used to jumpstart labor – and continue it along the way.

Apart from stimulating labor, Oxytocin is used to control post-partum bleeding. It is also indicated in the management of incomplete or inevitable abortion.

Pitocin also causes the contraction of lacteal glands. As such, it is used to improve milk secretion in breastfeeding mothers.

Nursing Considerations

While Oxytocin can help stimulate labor, an aspiring nurse like you should be mindful about assessing the patient receiving the said drug. History-taking is vital, as cephalopelvic disproportion, unfavorable fetal presentation/position, previous Caesarian section and toxemia are contraindications to the use of Pitocin.

As a nurse, it is also important to monitor the patient’s uterine contraction and uterine tone. Other aspects that should be included in the assessment are the patient’s vital signs, reflexes, breath sounds and urinary output. Lab tests such as CBC and coagulation studies should be evaluated in patients receiving Oxytocin as well.

NCLEX Nursing Interventions

Since Oxytocin works by stimulating the uterus, the nurse should be vigilant in monitoring uterine tone and uterine contraction. Maternal BP should be checked periodically as well. As a nurse, it is your responsibility to discontinue the drug and alert the physician if you notice signs of uterine spasm/hyperactivity or an impending hypertensive emergency (characterized by sudden headache, elevated BP and stiff neck, to name a few.)

Apart from the mother, the fetus (specifically his heart rate) should be monitored while the patient undergoes Oxytocin therapy. In case of rapid changes in FHT, the solution should be discontinued and the patient should be placed on her side to avoid fetal anoxia.

Oxytocin also has marked effects on the baby. After delivery, the nurse should check the neonate for the onset of jaundice or retinal hemorrhage.

Important NCLEX Teaching Points

Although patients on Oxytocin are usually in hospitals and can be monitored regularly, it is your duty as a nurse to inform the client about the actions and effects of Oxytocin.

Severe and sudden headache is an adverse side effect of Oxytocin. Instruct patient to report such onset to you or other healthcare providers, ASAP.

tension_headache

Ob-Gyne NCLEX questions might be hard, but you can ace them all simply by reviewing this study guide about Oxytocin. Learn more about other commonly asked drugs by going through the practice NCLEX questions at nclexpreceptor.com.

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Resources:

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

http://www.mayoclinic.org/drugs-supplements/oxytocin-intravenous-route-intramuscular-route/description/drg-20065254

 

 

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Acyclovir Pointers: What You Need to Pass Your NCLEX Quickly

Vital Acyclovir Pointers

The first anti-viral medications were created in the 1960’s, and they were all focused on curing the herpes virus family. Fortunately, through tireless effort and monitoring – Acyclovir – one of the common NCLEX medications – was invented.

Indications for Use

Known with the brand name of Zovirax, Acyclovir is an anti-viral agent that works by inhibiting DNA replication.

Whereas antibiotics are for bacterial infections, anti-virals such as Acyclovir are prescribed for certain viral illnesses. Compared to antibiotics, anti-virals can only inhibit the development of pathogens, and not destroy them.

Acyclovir is primarily prescribed in patients suffering from a Herpes infection. They include:

  • Genital herpes
  • Herpes zoster/ Herpes simplex
  • Herpes simplex encephalitis in babies 6 months and younger
  • Mucosal/cutaneous Herpes Simplex (HSV) 1 or 2 in Immunocompromised patients
  • HSV infection following transplant
  • Disseminated eczema herpeticum

herpes zosterOther indications include Cytomegalovirus infection, infectious mononucleosis and varicella pneumonia.

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Nursing Considerations

As it has been emphasized in nursing school, assessment is the first vital step to the nursing process. Before administering Acyclovir, make sure to evaluate the patient for the presence of allergies, congestive heart failure, seizures, renal disorder and lactation.

Additionally, perform a thorough physical examination of the patient. Check the client’s vital signs, orientation, lung sounds, urinary output, skin color and presence of skin lesions. Lab exams that should be requested are kidney function tests (BUN and Creatinine.)

NCLEX Nursing Interventions

When administering systemic Acyclovir, ensure that the patient is hydrated throughout the course of the therapy. Remember that this drug is nephrotoxic, which means it can have a negative effect on the kidneys.

If administering Acyclovir topically, institute treatment as soon as the first infectious signs and symptoms appear. Additionally, don a finger cot when applying the medication.

Important NCLEX Teaching Points

For patients receiving Acyclovir therapy, instruct them to complete the prescribed dose. Emphasize that they should not go beyond the recommended dose.

Additionally, remind them that it will NOT cure the disease, but it can lessen the severity signs/symptoms. Note that even with the application of the drug during symptom-free periods, prevention of recurrence is not ensured. As such, instruct the patient to wear a rubber glove/finger cot upon topical application to prevent transmission or self-inoculation.

Remember to teach the patient about the expected side effects of the drug (systemic), which include diarrhea, headache, dizziness, loss of appetite, vomiting and nausea.

Side effects for topical Acyclovir, on the other hand, are stinging, burning, itching and rashes. If these signs become more pronounced, inform the nurse/doctor right away.

Apart from the severity of the following signs, the onset of skin rashes, urination difficulty and recurrence also warrant the notification of healthcare personnel right away.

Those receiving Acyclovir therapy (both systemic and topical) should also be reminded to abstain from sexual intercourse especially if lesions are visibly present.

Anti-virals are commonly used in hospital and home settings, so it is best if you know about this medication. Master this drug – and many other therapeutic agents – with the practice NCLEX questions 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/acyclovir.htm

http://www.robholland.com/Nursing/Drug_Guide/data/monographframes/V002.html

http://www.mayoclinic.org/drugs-supplements/acyclovir-oral-route-intravenous-route/description/drg-20068393

 

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Narcan Facts You Need to Master

Narcan NCLEX Pointers

Administering medications is the daily bread of nurses. As such, the NCLEX aims to prepare aspiring nurses for the big task that lies ahead. While the exam deals with a bevy of drugs, most questions focus on commonly-used drugs in the floor, such as Narcan.

0507_heroin-overdose

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Indications for Use

Narcan, generically known as Naloxone Hydrochloride, is a central nervous system agent and a narcotic antagonist. It works by reversing the effects of opioids on the body, with signs that include sedation, respiratory depression and hypotension.

Because of these effects, Narcan is used to overturn respiratory depression caused by opioids such as Nalbuphine, Butorphanol, Propoxyphene and Pentazocine, to name a few. It is also used to diagnose suspected cases of opioid overdose.

Narcan is also used in reversing alcohol coma, enhancing circulation in refractory shock and treating schizophrenic/Alzheimer’s dementia.

Nursing Considerations

A good history is the foundation of effective medication administration. As such, prior to giving Narcan, make sure to perform a comprehensive history in order to detect allergy to narcotic antagonists and presence of narcotics addiction. Cardiovascular problems and lactation should be assessed in patients who you have to medicate as well.

A thorough physical examination should also be done prior to the administration of Naloxone Hydrochloride. Things you need to check are the following: vital signs, lung sounds, reflexes, pupil size and sweating.

For best results, store the drug at temperatures ranging from 59 to 86 degrees Fahrenheit. Avoid exposing it to excessive light. Additionally, make sure to use Narcan within 24 hours of opening.

NCLEX Nursing Interventions

Continuous monitoring is important in all patients taking medications, especially those prescribed with Narcan. The most important thing to remember is to ensure that the patient has an open airway. Provide artificial ventilation and vasopressor agents, and administer vasopressor agents as needed to combat narcotic overdose.

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Also know that those receiving this drug might warrant repeated doses, depending on the time of the last drug administration, and the lifespan of the narcotic in the body. However, be careful in administering this drug with other medications especially if you use a Y-site. Note that it is highly incompatible with Amphotericin B Cholesteryl Complex.

If you have a patient receiving Narcan who has recently undergone a surgical or obstetrical procedure, monitor him/her for signs of profuse bleeding. Remember, use of Naloxone Hydrochloride has been associated with deranged bleeding times.

Important NCLEX Teaching Points

Health teaching is a vital role of nurses, as it helps the patient optimize the medication – and avoid any untoward adverse effects associated with it.

When administering Narcan, it is important that you tell the patient to immediately report feelings of tremulousness and profuse sweating.

 

NCLEX drugs might be overwhelming, but you can master them efficiently! Be able to do so by going through the NCLEX practice questions at nclexpreceptor.com.

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References:

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

http://robholland.com/Nursing/Drug_Guide/data/monographframes/N009.html

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Tegretol Info You Need to Memorize

Important Tegretol Info

Psychiatric Nursing is an interesting branch of practice that deals with patients diagnosed with mental distress and illnesses. The nurse’s therapeutic approach is key for these patients, just like the medications that help the clients overcome their disorders. As such, if you want to be a good psychiatric nurse, you need to master a handful of drugs, such as Tegretol.

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Indications for Use

Tegretol, which is the brand name of the drug Carbamazepine, is an anti-epileptic agent. Also known as Carbatrol, Atretol and Epitol, it works by inhibiting poly-synaptic responses and hindering post-tetanic potentiation.

Tegretol is mainly used in patients with refractory seizure disorders, including grand mal and generalized seizures. Apart from these, Carbamazepine is also used in the treatment of bipolar disorder, resistant schizophrenia and other psychiatric maladies.

Pain

While it is widely used in mental illnesses, Tegretol is also utilized in other health conditions. For one, it is prescribed as a pain reliever in individuals suffering from Trigeminal Neuralgia. Other unlabeled uses include treatment for Diabetes Insipidus, Restless Leg Syndrome, Chorea and Non-Neuritic Pain Syndrome.

Nursing Considerations

Prior to administering Tegretol, you need to check the patient’s history. Note the presence of carbamazepine/tricyclic anti-depressant allergy and the history of adverse reactions to other drugs. Check if the patient takes MAOIs, or had a history of bone marrow depression. The presence of increased intraocular pressure, renal/cardiac/hepatic damage should be recorded as well.

Physical examination is also important, so make sure to check the patient’s vital signs, as well as his affect, orientation and reflexes. Auscultate the lungs and check the patient’s urinary output and bowel sounds.

Ensure that lab exams such as CBC with platelet and reticulocyte count, Urinalysis, BUN/Creatinine, Serum Iron, Thyroid and Hepatic function tests, as well as ECG, are obtained prior/during the course of Tegretol therapy.

NCLEX Nursing Interventions

Prior to dispensing Tegretol, make sure that the patient has eaten already to prevent GI upset.  If you will give ER tablets, advise patient not to crush, chew or cut the drug. Instead, he should take it wholly.

When preparing Tegretol suspension, do not mix it with other drugs or substances as it might precipitate. Additionally, it offers a higher peak level – that is why lower doses should be given at first.

Perhaps the most important nursing intervention is memorizing the therapeutic serum levels of Tegretol, which range from 4 to 12 mcg/ml.

Important NCLEX Teaching Points

The nurse should advise the patient to take Tegretol with food to avoid GI upset. Whole swallowing should also be reinforced, especially in those who are prescribed with ER tablets.

Advise the client to avoid over-the-counter drugs, sleep aids and alcohol, as it might result to adverse side effects. Such signs that warrant the notification of the healthcare provider include abdominal pain, unusual bleeding, pale feces, darkened urine, yellowing of the skin or the eyes, edema and CNS disturbances.

Additionally, educate the patient about the normal side effects of Tegretol, which are blurred vision, drowsiness, dizziness and GI upset.

Most importantly, remind patient not to discontinue or substitute Tegretol abruptly, as it can result to status epilepticus, or a state of persistent seizure.

 

Memorizing medications is not so hard! Combat your NCLEX woes by parsing through the practice NCLEX questions posted here at nclexpreceptor.com.

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References:

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

http://robholland.com/Nursing/Drug_Guide/data/monographframes/C020.html

http://www.mayoclinic.org/drugs-supplements/carbamazepine-oral-route/description/drg-20062739

 

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Provide Superior Respiratory Care with Pneumonia Core Measures

Pneumonia Core Measures

Pneumonia, an acute respiratory disorder, is the leading cause of death amongst children. Caused by bacteria, viruses and fungi, it accounts for 1.1 million annual deaths in kids under 5 years old.

Although common in children, pneumonia affects young and older adults as well. Causing an average of 5.2 days in confinement, the registered nurse can help lessen its medical and financial burdens by following these pneumonia core measures:

Blood CulturesPneumonia in lower lobe of lung

As it has been mentioned, pneumonia can be caused by bacteria, viruses or fungi. Depending on the culprit, the doctor will prescribe the appropriate antibiotic, anti-viral or anti-fungal agent.

Because of the various microorganisms that can cause pneumonia, it is important that the nurse facilitates blood cultures. Know that they should be done within 24 hours upon admission, especially if the patient is transferred to the ICU. Since it helps determine the organism and the subtype that can cause the disease, blood cultures pave the way for better and immediate pneumonia hospital treatment.

Appropriate Antibiotics

Since pneumonia can be caused by a variety of organisms, the foremost health care is to give appropriate antibiotics. The treatment will of course, depend on the blood cultures, as well as the patient’s condition.

For non-ICU pneumonia patients, the treatment options are:

  • Beta-lactams (IV or IM) with Macrolide (IV or PO)
  • Beta-lactams (IV or IM) with Doxycycline (IV or PO)
  • Macrolide Monotherapy (IV or PO)

ICU patients with pneumonia, on the other hand, are given the following antibiotics for urgent care:

  • Macrolide (IV) with Beta-lactams (IV) OR Antipneumococcal/ Antipseudomonal Beta-lactam (IV)
  • Antipneumococcal/ Antipseudomonal Quinolone (IV) with Beta-lactam (IV) OR  Antipneumococcal/ Antipseudomonal Beta-lactam (IV)
  • Antipneumococcal/ Antipseudomonal Beta-lactam (IV) with Aminoglycoside (IV) with Antipneumococcal Quinolone (IV) OR Macrolide (IV)

Non-ICU patients with pneumococcal risk are prescribed the following medications:

  • Antipneumococcal/ Antipseudomonal Beta-lactam (IV) with Antipseudomonal Quinolone (IV or PO)
  • Antipseudomonal Beta-lactam (IV) with Aminoglycoside (IV) with Antipneumococcal Quinolone (IV or PO) OR Macrolide (IV or PO)
  • Aztreonam (IV or IM) with Antipneumococcal Quinolone (IV or PO) with Aminoglycoside (IV)
  • Aztreonam 2 (IV or IM) with Levofloxacin (IV or PO)

Depending on the medications prescribed to your patient, you should observe the appropriate nursing interventions per drug. For example:

  • Beta-Lactams: Monitor for signs of opportunistic infections. Discontinue at the first sign of colitis.
  • Aminoglycosides: Watch for signs of neurotoxicity, renal impairment or ototoxicity. Ensure patient is well-hydrated.
  • Quinolones: Ensure that pneumonia patient is well-hydrated. Provide antacids 2 hours after administration.
  • Macrolides: If taking Azithromycin or Erythromycin, advise patient to take the meds 1 hour before/2 hours after meals. Monitor for hepatic dysfunction.
  • Levofloxacin: Advise patient to take the meds 1 hour before/2 hours after meals. Ensure patient is well-hydrated. Discontinue at first sign of hypersensitivity.
  • Aztreonam: Inform pneumonia patient that IV Aztreonam may cause taste changes.

Proper nursing care can help reduce the cases of pneumonia, a very prevalent disease. Make Obama care successful by learning more about the various core measures here at nclexpreceptor.com.

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References:

http://www.who.int/mediacentre/factsheets/fs331/en/

http://www.jointcommission.org/assets/1/6/Pneumonia.pdf

https://www.cedars-sinai.edu/Patients/Quality-Measures/External-Rankings/The-Joint-Commission/Pneumonia-Care-Measures/

https://www.bannerhealth.com/NR/rdonlyres/5FBF096A-3131-418C-9F67-8939C380347C/0/PNCMSCoreMeasures2011.pdf

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Be an Excellent Cardiac Nurse with these Heart Failure Core Measures

Heart Failure Core Measures

Heart Failure is caused by the inability of the heart to supply the needed blood and oxygen to various body organs. It is sad that heart failure is a prevalent disease.  It affects as many as 5.1 million Americans.  Once diagnosed, heart failure patients usually die within 5 years.
Early diagnosis and treatment are pivotal in lengthening and improving the quality of life of the said individuals. Joint Commission drafted core measures that will help medical personnel provide quality health care. Here are some pointers that should help you provide effective heart failure nursing care:

Normal vs Congestive Heart

Discharge Instructions

Since heart failure can be complicated by unhealthy lifestyle choices, it is your role as a registered nurse to provide comprehensive health instructions prior to the patient’s discharge. Guidelines that you should include in your discharge teaching are the following:

  • Healthy diet – low in salt and low in fat
  • Weight monitoring
  • Healthy levels of activity
  • Medication compliance
  • Signs of worsening symptoms: DANGER!

o   Dyspnea
o   Anxiety
o   Nocturnal Paroxysmal Dyspnea
o   Gain in weight – 2 pounds/day, or 5 pound-change from baseline weight
o   Edema of the lower extremities
o   Respiratory distress – nasal flaring and use of accessory respiratory muscles

  • Importance of follow-up treatments

Assessment of Left Ventricular Systolic Function

Left ventricular systolic (LVS) function is a measure of the pumping ability of the left ventricle (lower left heart chamber.) It also shows how well the ventricle can deliver blood to other parts of the body. This diagnostic test is an urgent care measure, as it is a foremost sign of heart failure. The goal of Joint Commission is for all hospitals to carry out this exam and deliver a higher level of patient care.

Apart from LVS function, the doctor or nurse should obtain the patient’s medical history and physical exam. Other exams that should be obtained include blood tests, chest x-ray, ECG and echocardiogram. As a nurse, you should ensure that the LVS function test and other exams are undertaken. At the same time, you should facilitate the needed heart failure procedure/s in a timely manner.

ACE Inhibitors and ARBs at Discharge

Since high blood pressure can lead to worsening heart failure, Obama care core measures emphasize the importance of prescribing ACE inhibitors and Angiotensin Receptor Blockers (ARB) at discharge. These medications block hormones that can lead to blood vessel constriction, which then leads to hypertension.

As a nurse, you need to make sure that your patient receives the appropriate medications upon discharge. Clients with decreased heart functions should receive ARBs at discharge. Those with heart failure/heart attack, on the other hand, should be prescribed with ACE inhibitors.

Heart failure might be fatal, but the patient can live a longer, better life with these core measures. Learn more about these care standards at nclexpreceptor.com.

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Resources:

http://www.jointcommission.org/heart_failure/

http://www.cdc.gov/dhdsp/data_statistics/fact_sheets/fs_heart_failure.htm

http://www.rn.com/getpdf.php/1859.pdf?Main_Session=4c1ab3e6289683a53c9ce44479f6a95d

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Become a Better Nurse Advocate with these Smoking Core Measures

Smoking Core Measures

Smoking or tobacco use, hands down, is the greatest cause of disease in the United States – even the whole world. Annually, it causes about 435,000 deaths.

Apart from causing heart disease, stroke, cancer and chronic obstructive pulmonary disease (among many others,) it puts a heavy burden to the individuals. A staggering $96 billion is lost due to smoking-related urgent care expenses, while $97 billion are lost in productivity gains because of tobacco use.

Because of its huge impact to the society, the Joint Commission has drafted a core measure set that addresses the perils of tobacco use. The statutes are:

Tobacco Use: Screening

Generally, patients aged 18 years and above are candidates for the screening process. As part of your nursing history, you need to calculate the patient age, which is the admission date minus the birthdate. If the patient is aged 18 years or older, proceed with the calculation of the length of hospital stay. If the length of stay exceeds one day, proceed with checking the patient’s cognitive impairment. If the patient demonstrates cognitive impairment, go ahead and check the patient’s smoking/tobacco use status.

NCLEX Nursing Smoking Facts

Tobacco Use: Treatment Provided or Offered

Once you have established the patient’s smoking history (use of cigarettes, smokeless tobacco, cigars or pipes within the last 30 days,) the registered nurse’s responsibility is to discuss tobacco treatment, or at least make a referral for the patient’s treatment.

At the same time, you should encourage the patient regarding the many benefits of smoking cessation. Should the client refuse the treatment options, make sure to document the reason behind his non-acceptance.

Tobacco Use: Treatment Provided or Offered at Discharge

Patients can be addicted to smoking, that is why it is important to provide or offer treatment upon discharge. Before the patient is sent home from the medical center, the nurse should make sure that the client receives a prescription for a FDA-approved medication. Examples include:

  • Varenicline (Chantix). Blocks the effects of nicotine and reduces withdrawal symptoms.
  • Bupropion (Wellbutrin or Zyban). A prescription pill that reduces smoking nicotine cravings.
  • Nicotine Replacement Therapies. Available in patches, gums, inhalers, nasal sprays and lozenges.

A referral to an outpatient counseling center should be sent as well.

Apart from documenting the nursing process, the nurse should educate the client regarding the benefits of smoking cessation.

Tobacco Use: Assessing Status after Discharge

Even after discharge, the nurse should help monitor the patient’s status. The officer in-charge should contact the client 15 to 30 days after release. Follow-up information should be gathered throughout the call. Questions that need to be asked include:

  • Whether smoking counseling was received
  • If medication was received
  • If he has quit smoking or using other tobacco products

Although the nurse has no role in follow-up, he can help improve follow-up rates. He can do so by encouraging the patient to attend counseling, as well as telling him about the evils of smoking.

Fact: Obama Care levies an additional 50% to smokers because of “tobacco surcharge.” Do your part in eradicating this health care burden by learning more about the smoking core measures – available here at nclexpreceptor.com.

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References:

http://www.jointcommission.org/assets/1/6/Tobacco_Treatment_Measures_List.doc.pdf

http://www.ctri.wisc.edu/joint.pdf

http://www.rn.com/getpdf.php/1859.pdf?Main_Session=4c1ab3e6289683a53c9ce44479f6a95d

http://www.ctri.wisc.edu/Smokers/smokers_FDA.Approved.Medications.htm

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Optimize your Pediatric Nursing Practice with these Childhood Asthma Core Measures

Childhood Asthma Core Measures

Childhood Asthma is the most common chronic condition in kids. It is one of the biggest reasons why children are sent to the hospital, with confinement cases amounting to 200,000 yearly.

With childhood asthma racking up to $3 billion in medical costs every year, the Joint Commission has released a core measure set to lessen such cases. These are proven-effective interventions which can decrease lost school time for children. At the same time, it can reduce Obama care hospitalization bills.

Use of Relievers for Inpatient Childhood Asthma

According to numerous studies, bronchodilators and short-acting beta agonists (SABA) are the best medications for patients. They bring about acute, urgent care relief of childhood asthma symptoms. Examples of such medications are Albuterol, Albuterol Sulfate, Albuterol/Ipratropium, Epinephrine, Ipratropium Bromide, Levabuterol Hydrochloride, Metaproterenol, Pirbuterol Acetate and Terbutaline.

As a nurse, it is your duty to educate the child or the parent/caregiver regarding the proper use of these inhaler medications. Ask the child or parent/caregiver to demonstrate the use of the inhaler. Let them ask questions as needed.

Asthma Triggers

Your foremost nursing consideration for this measure is to ask the patient/parent to report any of these symptoms:

  • Allergic reactions
  • Difficulty breathing
  • Dizziness or severe headache
  • Fast/irregular heartbeat
  • Chest pain
  • Pounding in the chest
  • Ear pain
  • Hoarseness
  • Blistered, swollen, reddened or peeling skin

Use of Systemic Corticosteroids for Inpatient Childhood Asthma

Many studies also suggest the use of systemic corticosteroids, as they can control acute childhood asthma exacerbation. At the same time, they can reduce the severity of symptoms in kids with mild, moderate or severe childhood asthma. These meds bring immediate relief by decreasing bronchoconstriction activities.

Systemic corticosteroids that the registered nurse might administer to childhood asthma patients include Dexamethasone, Hydrocortisone, Methylprednisolone, Prednisolone and Prednisone.

While systemic corticosteroids have fewer side effects, they are used for a short time only. Prolonged use can lead to impaired growth, hyperglycemia, osteoporosis and immunosuppression.Asthma Triggers for children

Home Management Plan of Given to Parent/Caregiver

Health care education is an essential component for both parents and caregivers of kids with childhood asthma. Accordingly, this is considered the most challenging of the three measures. In order to meet the requirements of the Joint Commission, the patient’s home management plan should contain all of the following:

  • A copy of the Home Management Plan, which should be attached to the chart.
  • Parent/caregiver acknowledgement which proves that the plan was received.
  • Follow-up arrangements and schedules.
  • Triggers (environmental or other) that need to be addressed.
  • The childhood asthma controllers that need to be used.
  • The childhood asthma relievers that need to be used.
  • The Home Management Plan that states the time and methods of rescue interventions.

Although chronic, exacerbation of childhood asthma can be controlled with medication compliance and the elimination of environmental triggers, to name a few. Learn more about life-changing core measures at nclexpreceptor.com.

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References:

http://www.jointcommission.org/assets/1/6/CAC-Measures.pdf

http://www.rn.com/getpdf.php/1859.pdf?Main_Session=4c1ab3e6289683a53c9ce44479f6a95d

https://www.bannerhealth.com/NR/rdonlyres/856CF8DE-7912-4BCB-85AF-FFFBFDF3280D/0/PediatricAsthmaCMSCoreMeasures2011.pdf

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Top Meds on NCLEX Press Release

Top Meds on NCLEX Press Release

MEDIA CONTACT                                                                                            

CONTACT: Chief Editor, Barbara Brown–barbara.brown@nclexpreceptor.com

Company: NCLEX Preceptor–info@nclexpreceptor.com

For Immediate Release: January 1, 2015

http://www.amazon.com/dp/B00EMLFF0S/ref=rdr_kindle_ext_tmb to get the Top Medications on NCLEX RN exam

Nursing Students Surpassing NCLEX Exam—99% Pass Rate

Atlanta, Georgia – Nursing students are utilizing NCLEX Questions: Top Meds on NCLEX RN 3rd Edition to help them ace the nursing NCLEX exam with a 99% pass rate. This book has drastically increased nursing students’ pass rates on an exam that, historically, many have failed theirfirst time taking.

Nursing students have to pass a test called NCLEX before becoming a Registered Nurse, and many will fail when not properly prepared. NCLEX Questions: Top Meds on NCLEX RN 3rd Edition prepares nursing students by providing the top medications they may find on the NCLEX exam.

Nursing professor Leslie Jennings has over 17 years of experience as a registered nurse and works in Houston, TX. She states, “I highly endorse this book. I found the content straight to the point and easy to remember. My students that use this book do very well on NCLEX.”

The book has found many favorable reviews with nursing students. Nancy B. Bell, a registered nurse in Chicago, IL, says, “I wish I found this book earlier. It has saved me a lot of time studying medications. It is well-written and has a lot of review questions.”

NCLEX Questions: Top Meds on NCLEX RN 3rd Edition has managed to find its way to the top of two categories on Amazon. The book was listed on Amazon as the #1 seller for nursing pharmacology and #1 seller for nursing test prep material. Nursing schools have also supported this book as a way to increase their NCLEX pass rates.

Writer Jonathan Small is a certified nursing instructor and author of NCLEX Questions: Top Meds on NCLEX RN 3rd Edition. He has over 13 years of healthcare experience. “Medications are one of the difficult parts of nursing school and the NCLEX exam. This book focuses on the important medications and how to pass NCLEX,” said Small.

It is worth mentioning that there are other larger, well-known publishers that have published books to help nursing students. Publishers such as McGraw Hill, Kaplan, and Mosby’s are recognized for their test preparation material.

Noting that students who have already used NCLEX Questions: Top Meds on NCLEX RN 3rd Edition have a reported 99% NCLEX pass rate, it would be of value for nursing students to consider this resource.

For further information about NCLEX Questions: Top Meds on NCLEX RN 3rd Edition, please visit Amazon.com or www.nclexpreceptor.com.

Small, Jonathan. NCLEX Questions: Top Meds on NCLEX RN. 3 ed. Atlanta: 2014.

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Surefire Tips on Acing the Exam in Just 75 NCLEX Questions

Join Our Private NCLEX Group

Want to make your dreams of becoming a nurse come true? Apart from nursing school, there is one obstacle you need to overcome in order to get that prized plum: the NCLEX. Known as the the National Council Licensure Examination, the NCLEX is a test that checks your proficiency and critical knowledge as a nurse.

During the exam, you can receive anywhere from 75 to 265 NCLEX questions. While the average number of questions that an individual receives is anywhere around 120, there are an elite few who pass the exam in as little as 75 NCLEX questions.

Want to be part of the distinguished 75 club? Then make sure to follow these tips on how to pass the exam in 75 NCLEX questions.

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Take it ASAP

In order to increase your chances of acing the test in as short as 75 NCLEX questions, it will help if you take the exam at the soonest possible time. It is best if you take it after graduation, while the facts are still fresh in your mind. The authorization letter usually comes after 2 to 3 weeks; so make the most out of this time by preparing yourself mentally and emotionally for the challenge that lies ahead.

Choose the Best Time for your Mind

When do you function best? Morning or afternoon? If you dislike waking up early, you do not have to force yourself to do so just to take the NCLEX. There are afternoon slots available (2 pm) and if you function better in the afternoon, then by all means, take this shift. If you are much awake and energetic after lunch, you will have better chances of finishing the test in only 75 NCLEX questions.

Practice Answering NCLEX Questions

According to Maryam Syed, a nurse who got into the mythical 75 club last 2012, the key to passing the test efficiently is to practice NCLEX questions as often as possible. If you can, answer 150 to 200 questions a day in order to exercise your mental faculties.

Instead of just going over your books, go through questions as if you were already taking the NCLEX. After all, this is what you need to do come your most-anticipated exam date.

Be Ready for SATA

SATA means “Select all that apply.” This is a new format found in most NCLEX questions. Remember that this is all or nothing, meaning you have to choose all the applicable data in order to get the question right. There are many available NCLEX questions that deal with SATA, so make sure to include this in the mix.

Research More About the Rationale

If ever you get some of the practice NCLEX questions wrong, do not just be contented by reading the rationale of the answer. Instead, read more about the case. Search your nursing books – or the internet if you want to get the answers right away. Reading more about the answers you got wrong will better facilitate the learning process.

The prospect of NCLEX might give you butterflies at first, but as long as you are confident – and as long as you follow the aforementioned tips – you can make yourself a member of the prestigious 75 club!

Good Luck!

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Improve Your Nursing Practice with Heart Attack Core Measures

Heart Attack Core Measures

Heart attack – also known as Acute Myocardial Infarction (AMI) – is the leading cause of death in the United States. It occurs when the blood supply to the heart muscles is stopped or slowed down. Without the adequate oxygen and nutrient that it needs, the affected heart tissue will die. Because of the prevalence of heart attack, registered nurses – with the entire health team – should provide urgent care measures to AMI patients. In order to further improve the quality of life of these individuals, the Joint Commission has drafted several life-saving core measures.

Artery plaque build up

Administering Aspirin Upon Hospital Arrival

Throughout years of research, Aspirin has shown the most benefits with regards to reducing heart attack-caused mortality. The effects manifest quickly, and persist throughout therapy. In order to actualize the benefits of the drug, Aspirin 325 milligrams should be given immediately to the patient. The nurse should administer the drug once the signs and symptoms of heart attack have been recognized. He should document the time it was given, or why it was contraindicated/not given.

Aspirin Prescribed at Hospital Discharge

As it has been said, Aspirin is efficient in reducing heart attack mortality. It remains effective with long-term use, even at doses of 75 milligrams per day. In order to prevent heart attack re-occurrence, the medical doctor should prescribe Aspirin upon the patient’s discharge. The nurse should then ensure that this is included in the patient’s take-home medication list. He should also educate the client about the importance of compliance. Other important nursing teaching points for post-heart attack patients include:

  • Taking the drug with food if stomach upset occurs.
  • Avoiding the intake of other over-the-counter meds, unless prescribed by the doctor.
  • Knowing the side effects of Aspirin, which are stomach upset, nausea, heartburn, gum bleeding and easy bruising.
  • Not crushing, chewing or cutting SR products.

Appropriate Usage of ACE Inhibitors/ ARBs

Studies show that the survival and quality of life of heart attack patients are enhanced with certain blood pressure-lowering drugs. These meds, in particular, are ACE Inhibitors and Angiotensin-Receptor Blockers. They can prevent future heart attack problems by blocking hormones that lead to blood vessel constriction, which then results to hypertension.

Beta Blocking Medications Prescribed at Hospital Discharge

Another blood pressure-lowering medication – the Beta-Blocker– has been proven effective in decreasing mortality during and after a heart attack. It does so by slowing the heart rate, decreasing heart stress and lowering the risk of abnormal heart rhythms. The nurse’s responsibility for this health care measure is to ensure that the medication is included in the list. Additionally, he should educate the client regarding the proper intake of the drug, as well as its side effects.

PCI Within 90 Minutes of Hospital ArrivalHeart Attack Signs

Percutaneous coronary intervention or PCI should be administered to the heart attack patient within 90 minutes of his arrival. In this procedure, the interventional cardiologist inserts a balloon, which is inflated at the blocked artery. A stent is then placed to permanently open the vessel, establishing normal blood flow. Apart from ensuring that this procedure is done, the nurse should place the patient on complete bed rest right after. The nurse should also place the patient on a cardiac monitor. He should check the vital signs frequently as well. The limb used for PCI should also be monitored for signs of poor circulation.

In order to meet the goals of Obama care, the nurse should make sure that the heart attack core measures are followed. Know more about other nursing best practices by parsing through nclexpreceptor.com.

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References:

http://www.theheartfoundation.org/heart-disease-facts/heart-disease-statistics/

http://www.huntingtonhospital.com/Main/HeartAttackCare.aspx

http://www.clevelandclinicmeded.com/medicalpubs/diseasemanagement/cardiology/acute-myocardial-infarction/

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

http://www.nursetogether.com/core-measures-in-nursing-handling-acute-myocardial-infarction

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Tips on how to Enhance Your Nursing Knowledge with NCLEX Review Questions

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Are you ready to take your NCLEX? While scanning through your old books is an advisable method of reviewing, practicing NCLEX review questions is a better way to help you pass the exam.

As an entry-level nurse, you need to prove your worth and ability to practice by passing the NCLEX. This test, crafted by the National Council of State Boards of Nursing, is designed to evaluate the essential knowledge, abilities and skills that a nurse like you should possess.

Become a stellar nurse by following these tips on practicing NCLEX review questions:

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Learn More About the Key Sections of the Test

With a wide collection of NCLEX review questions out there, you can easily be overwhelmed with the choices that lie in front of you. But if you only have limited study time, the best way to make the most out of NCLEX review questions is to familiarize yourself with the key sections of the test. This gives you a preview of what the exam would generally include, so you can prepare yourself for the test that lies ahead.

Hear are the four categories and six sub-categories that you should focus on, as well as the percentile of questions that will appear on your NCLEX test:

  1. Safe and Effective Care Environment
    1. Management of Care – 13-19%
    2. Safety and Infection Control – 8-14%
  2. Health Promotion and Maintenance – 6-12%
  3. Psychosocial Integrity – 6-12%
  4. Physiological Integrity
    1. Basic Care and Comfort – 6-12%
    2. Pharmacological and Parenteral Therapies – 13-19%
    3. Reduction of Risk Potential – 13-19%
    4. Physiological Adaptation – 11-17%

Create a Study Schedule

How long or limited is your study time prior to the NCLEX? Make the most out of your free days by creating a study schedule. Divide your days accordingly, keeping in mind the categories mentioned above. Efficiently chunking your schedule will give you ample time to study all aspects of important NCLEX Review Questions.

Take Advantage of the Wealth of NCLEX Review Questions Available

In this modern day and age, you will not find it hard to stumble upon NCLEX review questions that can help you in your review. Most of these resources are free of charge (such as this blog site, nclexpreceptor.com) so make the most out of them and answer as many NCLEX review questions as you can!

Read the Rationales

While NCLEX review questions might help you hone your knowledge and skills, of course you cannot avoid some mistakes along the way. And in case you encounter some errors, the best way to rectify your blunders is to read through the rationales. These justifications can enlighten your thought process, and provide you with an idea on where you went wrong. If the rationales are not that clear to you, log on to the internet and search for further explanations online.

Remember: the NCLEX is your ticket to your dreams. Pass this exam with flying colors by making the most out of nclexpreceptor.com’s NCLEX review questions.

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Enhance your Nursing Skills with Stroke Core Measures

Stroke Core Measures

Stroke or Brain Attack is the primary cause of adult disability in the United States. To curb the skyrocketing rates of this debilitating disease, the Joint Commission has developed proven-effective core measures. The goal of these health care guidelines is to lessen disability, prevent mortality and minimize stroke recurrence. In order to meet these objectives, it is your responsibility as a registered nurse to follow these proven-effective core measures:

Stroke FAST

Venous Thromboembolism (VTE) Prophylaxis

Brain attack patients are at risk of developing VTE. In clinical practice guidelines, prophylaxis is recommended to prevent morbidity and mortality. Prophylaxis for VTE comes in two forms: mechanical and pharmacological. Mechanical measures include the use of graduated compression stockings (GCS) and intermittent pneumatic compression devices. The nursing considerations for GCS are:

  • Teach the patient how to wear the GCS.
  • Monitor the use of GCS.
  • Ensure that stockings are worn from admission until the patient regains normal mobility.

Several pharmacological prophylactic agents for VTE are also available. Depending on the patient’s medical history, the physician might prescribe:

  • Fondaparinux Sodium
  • Low Molecular Weight Heparin
  • Unfractionated Heparin, for patients with kidney disease

Prophylaxis should be given immediately after risk assessment. If the patient is not able to receive VTE prophylaxis, the nurse should document why it was not done.

Discharged on Anti-Thrombotic Therapy

Studies show that anti-thrombotic agents can reduce stroke-related morbidities, mortality and recurrence. As such, Obama care statutes recommend the prescription of anti-thrombotic therapy right after discharge.  According to clinical practice guidelines, Warfarin should be prescribed, unless otherwise contraindicated.

Anticoagulation Therapy for Atrial Fibrillation/Flutter

Nonvalvular atrial fibrillation (NVAF) is a known risk factor for brain attack. It is common in advanced age, and affects about 2 million Americans. To prevent first/recurrent stroke in these individuals, anticoagulation therapy is integrated in the health care plan. Since warfarin therapy can decrease brain attack risk in patients with atrial fibrillation, they should be given to this high-risk population – unless contraindicated.

Ischaemic stroke

Thrombolytic Therapy

IV Tissue Plasminogen Activator (IV t-PA) is a drug that dissolves blood clots quickly. As an urgent care medication, it should be given within three hours of symptom onset. The reason why it was not given – or why it was contraindicated – should be documented by the doctor and the nurse.

Antithrombotic Therapy by End of Hospital Day 2

As it has been established, antithrombotic agents can reduce brain attack mortality, morbidity and recurrence. To make these happen, these drugs should be given within 2 days/48 hours of symptom onset. In acute therapy, Aspirin 325 milligrams is recommended. Other options include Clopidogrel and Aspirin 50-325 milligrams combined with extended-release dipyridamole.

Discharged on Statin Medication

Statins (cholesterol-lowering meds) should be prescribed in ischemic stroke patients, especially to those with the following specifications:

  • LDL > 100 mg/dl
  • LDL not measured
  • Have taken cholesterol-lowering meds prior to hospitalization

Why? Studies show that statins can help reduce the rate of ischemic stroke and major coronary problems. Following this guideline, the nurse should also make sure that the patient’s LDL should be checked within 48 hours of admission.

Stroke Education

The nurse should give educational materials to hemorrhagic/ischemic stroke patients as soon as they are admitted. The resources should cover the following bases:

  • How to activate the emergency medical system
  • The importance of follow-up after discharge
  • Medications prescribed after discharge
  • Stroke risk factors
  • Brain attack warning signs and symptoms

Assessed for Rehabilitation

Only 2/3 of all stroke sufferers survive. Most of these people would live with a moderate functional impairment, which often requires rehabilitation. With the entire medical team, the nurse should help in the rehabilitation of the patient – which should be enacted as soon as the diagnosis has been made. With early rehab, recovery can be hastened and functional disability can be minimized.

Caring for a stroke patient can be challenging. Improve patient outcomes by learning more about core measures here at nclexpreceptor.com.

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References:

http://www.heart.org/idc/groups/heart-public/@wcm/@private/@hcm/@gwtg/documents/downloadable/ucm_310976.pdf

http://www.cdc.gov/dhdsp/docs/pcnasr_performance_measures.pdf

http://www.jointcommission.org/assets/1/6/Stroke.pdf

http://www.jhsmh.org/LinkClick.aspx?fileticket=voYA41z-SP8%3D&tabid=84

https://www.fhcme.com/sites/default/files/STROKE%20Core%20Measure%20for%20physcians.pdf

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Boost your Psychiatric Nursing Skills with Mental Illness Core Measures

Mental Illness Core Measures

Mental illness is a common medical condition, affecting 1 out of 4 Americans every year. Out of these 61.5 million people, more than 13 million live with a serious condition, such as major depression, schizophrenia and bipolar disorder.

In response to these staggering numbers, the Joint Commission, together with various entities and facilities, has formulated the Hospital Based Inpatient Psychiatric Services core measure set. Also known as HBIPS, these urgent care measures are derived from evidence-based practice and researches. They have been developed to curb the number of mental illness patients – as well as the consequences that come with these disorders.

Admission Screening

NCLEX Mental Health Core Measures for Registered Nurses

Upon admission to the hospital, the nurse should see to it that the patient is screened within the first 3 days of confinement. He should be evaluated for the following:

  • Risk of violence (to self or to others)
  • Use of substances
  • History of psychological trauma
  • Patient strengths

Screening is important upon admission as there is a strong connection between substance use/trauma history and health care confinement. Risk of violence, on the other hand, should be checked to establish safety. Patient’s strengths are important as they can be utilized for immediate recovery. In order to determine the best type of treatment, these factors should be screened immediately.

Physical Restraint

The registered nurse should document the total number of hours of that the mental illness patient spent in restraint. While restraint is used only in cases of imminent danger, the length of time it was used can be analyzed to determine how much it should be used in a future outburst. Efficacy of this core measure is of course, demonstrated by a decreased number of restraining hours.

Seclusion

Seclusion is the supervised confinement of a client in a room which may be locked. Used as a last resort, it aims to control behavior that can inflict injury to others. Like restraint, seclusion is thoroughly monitored. After all, the hours spent by the patient in seclusion can be used in future treatment. With that being said, the nurse should monitor and document seclusion practices carefully.

DepressionMultiple Antipsychotic Medications at Discharge

Studies show that patients are discharged from medical facilities with 2-3 antipsychotic medications. Unfortunately, the use of multiple drugs does not improve outcomes, and can even worsen side effects in mental illness patients.

To prevent these events, experts are advising practitioners to prescribe one drug only. A second antipsychotic should only be given if the drug is inadequate, or if the patient is treatment-resistant.

Certain events, such as a shorter hospitalization stay, might warrant the need for multiple antipsychotic treatments. However, the doctor and nurse should ensure that the mental illness client is given an aftercare plan. This plan should help ease the transition to using only one antipsychotic drug.

Most importantly, to ensure sound therapy, effective nursing communication should be observed in patients with mental illness.

Multiple Antipsychotic Medications at Discharge with Appropriate Justification

As it has been said, multiple antipsychotic drugs can lead to worsened side effects. However, there are cases that require multiple antipsychotic drugs. For these mental illness cases (short treatment duration, inadequate drug effect or treatment resistance,) multiple drugs can be prescribed, given that it comes with appropriate justification.

Post-Discharge Continuing Care Plan

Effective health teaching can help prevent mental illness relapse. Upon discharge, the patient should be given after-care instructions, including medication compliance, follow-up, laboratory exams, etc.

Post-Discharge Continuing Care Plan Transmitted to Next Level of Care Provider

The next level of care provider can help the mental illness patient  live a better life. As such, it is important that the discharging nurse creates a post-discharge continuing care plan. The document should include the events that led to admission, as well as the therapy during the confinement. Discharge medications and recommendations should also be included.

Mental illness treatment is one of the key inclusions in the Obama care platform. In order to maximize this program, make sure to follow the mental illness core measures, as mentioned here at nclexpreceptor.com.

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References:

http://www.nami.org/factsheets/mentalillness_factsheet.pdf

http://www.jointcommission.org/assets/1/6/HBIPS.pdf

https://manual.jointcommission.org/releases/TJC2013A/HospitalBasedInpatientPsychiatricServices.html

http://www.iom.edu/~/media/Files/Activity%20Files/MentalHealth/TRICAREMentalHealth/Ghinassi.pdf

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Helpful Study Tips: NCLEX Review Questions on Cranial Nerves

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Cranial nerves are pathways that originate from the brain. In humans, there are 12 nerves that are classified as members of the peripheral nervous system.

NCLEX Review Questions on Cranial Nerves: How to Avoid Confusion

The names and functions of cranial nerves might be confusing, especially in situational NCLEX review questions. As such, it is important that you learn more about the 12 cranial nerves (CN), which are:

CN 1: Olfactory (Sensory) – deals with the sense of smell

CN 2: Optic (Sensory) – deals with the sense of sight

CN 3: Oculomotor (Motor) – governs eye movement

CN 4: Trochlear (Motor) – enables the eyes to move inward or downward

CN 5: Trigeminal (Both) – responsible for chewing and jaw movement; also governs sense of touch in the face

CN 6: Abducens (Motor) – enables lateral or outward eye movement

CN 7: Facial (Both) – regulates facial expression and movements; also responsible for neck muscle movement

CN 8: Acoustic / Vestibulococchlear (Sensory) – deals with the sense of hearing

CN 9: Glossopharyngeal (Both) – responsible for speech and swallowing; governs sensation in a small part of the ear

CN 10: Vagus (Both) – in charge of the gag reflex

CN 11: Spinal Accessory (Motor) – moves the sternocleidomastoid and trapezius muscles; responsible for head and shoulder movement

CN 12: Hypoglossal (Motor) – responsible for tongue movement

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Mnemonics

The 12 cranial nerves might appear in NCLEX review questions. If you want to perfect your NCLEX review questions, it will help if you memorize the nerves by keeping in mind the following mnemonics:

On old Olympus towering tops, a Finn and German viewed some hops.” (CN 11 as Spinal Accessory)

Oh, oh, oh, to touch and feel very good velvet…ah, heaven.” (CN 11 as Accessory)

Old Opie occasionally tries trigonometry and feels very gloomy, vague and hypoactive.”

Sensory or Motor?

The cranial nerves are responsible for either sensory (S) or motor (M) functions, sometimes both (B.) Answer NCLEX review questions regarding such nature by memorizing this:

Some Say Marry Money But My Brother Says Big Brains Matter More.”

Cranial Nerve Examination

Aside from identification, cranial nerve examination is usually included in NCLEX review questions. Be sure to answer these items by familiarizing yourself with the following evaluation tests:

CN 1, Olfactory: Check by placing an identifiable, non-irritating stimulus under one nostril while occluding the other.

CN 2, Optic: Check for visual acuity with the use of the Snellen chart/near card. Check for color vision with the Ishihara chart. Check visual field and pupillary light reflex as well. Do fundoscopy.

CN 3, Oculomotor; CN 4, Trochlear and CN 6, Abducens: For NCLEX review questions on these, ask patient to follow your fingers with their eyes. Also ask if patient has double vision.

CN 5, Trigeminal: Lightly touch the patient’s forehead, cheek and jawline with cotton and a blunt pin. Also check for corneal reflex and jaw clenching.

CN 7, Facial: Ask patient to crease forehead, keep eyes closed even with resistance, puff cheeks and show teeth.

CN 8, Acoustic: Perform Rinne and Weber tests (hearing exams often found in NCLEX review questions.)

CN 9, Glossopharyngeal: Check for gag reflex or touch the pharyngeal arches.

CN 10, Vagus: Check uvula while patient says “aaah.”

CN 11, Accessory: Ask patient to shrug and turn his head despite resistance.

CN 12, Hypoglossal: Check patient’s tongue for signs of fasciculations or weakness.

NCLEX review questions dealing with cranial nerves might be difficult at first, but you can eventually perfect them! Test your knowledge by answering NCLEX review questions here at nclexpreceptor.com.

 

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NCLEX Questions: Top Meds on NCLEX RN, 3rd Edition – A Review

 

Pharmacology, without a doubt, is one of the hardest chapters in the NCLEX. Although drug names, effects and functions might be confusing, you can answer medication NCLEX questions correctly with the help of a good guide book, such as the NCLEX Questions: Top Meds on NCLEX RN, 3rd Edition.

About the Book

The NCLEX Questions: Top Meds on NCLEX RN, 3rd Edition is a 144-page e-book published Jonathan Small, edited by Maria Gonzales and illustrated by Md Asifullah. Developed by experienced educators and a registered pharmacist, this book features comprehensive medication NCLEX questions that can prepare you for the test that lies ahead.

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Top Meds on NCLEX

Features

With NCLEX Questions: Top Meds on NCLEX RN, 3rd Edition, you can answer medication NCLEX questions of all kinds with the help of the book’s features:

  • Covers 28 drug classes. From anti-hypertensives to antibiotics, this book includes all kinds of medication NCLEX questions that you might encounter.
  • Comprehensive chapters. Know more about the most important facets of the drug with the book’s drug FAQs, side effects, indications and nursing considerations.
  • Medication NCLEX questions at the end of each chapter. Be able to check your drug knowledge with the help of challenging medication NCLEX questions, found at the terminus of each chapter.

Pros

While there are many other guides featuring medication NCLEX questions, NCLEX Questions: Top Meds on NCLEX RN, 3rd Edition proves to be one of the best choices because of the following pluses:

  • Clear and concise chapters. No need to scan through layers and layers of notes, the book goes straight to the point. In short, it lets you in on the most important details of the drugs, so you do not have to juggle your mind with other unnecessary information.
  • E-book feature, which means a lesser load on your back. Gone are the days when you need to carry a crazy-heavy book just to study medication NCLEX questions. With the NCLEX Questions: Top Meds on NCLEX RN, 3rd Edition, you can improve your drug knowledge simply by using your Kindle, Android or iOS device.
  • Affordable price.NCLEX Questions: Top Meds on NCLEX RN, 3rd Edition only costs $10 – a small price to pay for mastering the medication NCLEX questions that will help you ace the exam.

Medication NCLEX Questions In a Nutshell

If you find medication NCLEX questions to be particularly hard, then a copy of the NCLEX Questions: Top Meds on NCLEX RN, 3rd Edition is what you need. Comprehensive yet affordable, this gives you the medication knowledge that you need, especially because as much as 19% of the NCLEX exam deals with Pharmacology questions.

With its straight-to-the-point chapters, mind-juicing medication NCLEX questions and interactive feature, the NCLEX Questions: Top Meds on NCLEX RN, 3rd Edition is a beneficial investment for any individual who wishes to pass the NCLEX RN exam.

 

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Practice NCLEX Questions While On the Go: A Review of the NCLEX Questions App

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Mobile phones and tablets have greatly simplified the way we live. Apart from enabling easy communication and easy entertainment, these devices can also help you practice NCLEX questions – whenever, wherever.

An example of such an app is NCLEX Questions, an educational program launched by NCLEX Preceptor just this December 2013.

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What’s it All About?

NCLEX Questions” is a program designed with the NCLEX test-taker in mind. This portable program enables the user to practice NCLEX questions with the help of the following features:

  • Abundant practice NCLEX questions that can help you prepare for the exam
  • Includes lab values, pharmacology questions, study flashcards and NCLEX tips, aside from the traditional practice NCLEX questions
  • Practice NCLEX questions that can improve your test-taking strategies and techniques
  • Practice NCLEX questions that you can customize according to your preference
  • Reports that assess your test-taking strengths and weaknesses

Why Use NCLEX Questions?

There are many apps that can help you practice NCLEX questions, but why should you go with this one? Here are several of the advantages that come with the NCLEX Questions App:

  • Rationales are given after you practice NCLEX questions. Not only will you know the right answer to the question, you will get the essential information that can help you later on in life.
  • Updated set of questions. You can expect additional questions – and not the usual ones – so you can learn more and more every day.
  • Made by experienced professionals. NCLEX Questions was developed by veteran nursing instructors and a pharmacist – all experts in their own respected fields.
  • Affordable. You do not have to shell out a huge fee just to practice NCLEX questions.
  • Advertisement-free. No need to close unwelcome dialogues every time you practice NCLEX questions.

The Downside

While NCLEX Questions is a great addition to any mobile device, downloading takes some time. But after you are done with waiting, you can expect to load the NCLEX Questions App with relative ease and efficiency.

Practice NCLEX Questions Anytime, Anywhere

 

If you are always on the go – and cannot seem to get hold of your books for an extended period of time – then the mobile app NCLEX Questions is what you are looking for. This portable program – which you can access through your Android phone or tablet – gives you the freedom and convenience to study while you are commuting from work, watching TV or dining with friends.

And because it was voted as the 5-star NCLEX practice mobile app of the year, this app can truly help you practice NCLEX questions easily – and pass the exam with great confidence. With its great features and affordable price, there is no reason why you should not have NCLEX Questions in your Android device!

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Practice NCLEX Questions with Essential OB Gyne Mnemonics

 

OB Gyne Nursing is a branch of care that deals with all aspects of the female reproductive system, from the onset of menstruation through menopause and beyond. OB Gyne Nurses are often found in labor and delivery units, as well as birthing centers, postpartum wards and maternity clinics.

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Practice NCLEX Questions Perfectly with Mnemonics

OB Gyne is one of the major scopes of Nursing, and as such, you can expect OB Gyne-related questions once you take the exam. Practice NCLEX questions – and perfect them – with the help of these essential OB Gyne Mnemonics:

Every Darn Fool in Egypt Eats Raw Eggs

When dealing with practice NCLEX questions pertaining to the 7 cardinal movements of the fetus, just recall this mnemonic: Every Darn Fool in Egypt Eats Raw Eggs. Remember:

Every = Engagement of the fetus into the pelvis

Darn = Descent

Fool = Flexion, to allow presentation through the pelvis

In = Internal Rotation, or turning of the fetus to facilitate pelvic passage

Egypt = Extension, wherein the neck extends to facilitate childbirth

Eats Raw = External Rotation, or the realignment of the head with the torso

Eggs = Expulsion, or the complete delivery of the fetus

BUBBLE-HE

When dealing with practice NCLEX questions that pertain to postpartum care, a helpful mnemonic is BUBBLE-HE, or:

Breast – Check for symmetry, size, pain, swelling, wounds, presence of colostrum.

Uterus – Check for bogginess or firmness, as well as the location of the fundus.

Bowel – Ask about flatus and last bowel movement; check for pain or abdominal distention.

Bladder – Note the amount of urine; check for incontinence, retention, distention or infection.

Lochia – Note color, amount and odor.

Episiotomy – Check the laceration, and presence of discharge, bruises, redness or edema

Homan’s Sign – Pain with dorsiflexion; a symptom of deep vein thrombosis.

Emotional State – Assess for maternal-infant bonding, as well as signs of postpartum depression.

To Peace and Love

Some practice NCLEX questions ask about Obstetrical Scoring. Get the right OB Score by keeping the mnemonic “To Peace and Love” in mind:

T: Term Pregnancies

P: Premature Births

A: Abortions, whether elective or spontaneous

L: Live Births

CABS

As a budding nurse, it is important that you recognize the danger signs of pregnancy. Answer practice NCLEX questions correctly by keeping the acronym CABS in mind:

C: Chills and fever, cerebral disturbances

A: Abdominal pain

B: Blood pressure (elevated), bleeding or blurred vision

S: Sudden rush of fluid or swelling

4 T’S

Postpartum hemorrhage is a life-threatening condition. Ace practice NCLEX questions dealing with this phase by memorizing the 4 T’s:

Tissue, or retained placental fragments

Tone (poor), signifying uterine atony

Trauma, including episiotomy or a traumatic delivery

Thrombin, blood coagulation disorders, such as Disseminated Intravascular Coagulation

Practice NCLEX questions dealing with OB can be confusing, but you can overcome them by keeping these OB mnemonics in mind.

Remember:

  • When reviewing, read and understand practice NCLEX questions thoroughly.
  • Consider the nursing process when answering practice NCLEX questions.

Put your mind to the test! Challenge yourself and practice NCLEX questions in OB at nclexpreceptor.com.

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NCLEX RN Priority Questions: Strategies for Mastery

 

The NCLEX is an exam that any wannabe RN has to pass in order to practice the profession. If you are in the throes of taking this life-changing test, then you know how important it is to practice NCLEX RN questions.

One type of question you can expect throughout the NCLEX RN test is the “priority question,” which asks the nurse’s best, first, or most important action. While all the answers might look correct (oftentimes, all of the answers are actually correct,) you need to determine the first step you need to undertake in the scenario.

Strategies for NCLEX RN Priority Questions

If NCLEX RN priority questions continue to puzzle you, here are several strategies that can help you determine the best answer:

Maslow Strategy

When answering NCLEX RN priority questions, one factor you should keep in mind is Maslow’s hierarchy of needs. It tells about the five levels of human needs – physiological needs, safety and security, love and belonging, self-esteem and self-actualization (ranked from the most important to the least important.)

If you are faced with a difficult NCLEX RN exam question, just recall Maslow’s hierarchy. Prioritize the answer that caters to physiological needs, as they are necessary for survival. Answers like these usually tackle oxygenation, nutrition, fluid intake, rest, temperature, elimination and rest.

If an answer pertaining to physiological needs is not present in the selection, work your way through the other levels:

  • Safety and security – both physical and psychosocial
  • Love and belonging – love and acceptance by individuals surrounding the client
  • Self-esteem – the person’s self-confidence and usefulness
  • Self-actualization – fulfillment and recognition of one’s potential

Nursing Process Strategy

Another technique that can help you answer NCLEX RN priority questions correctly is the Nursing Process Strategy. Before you select the answer, you need to recall the chronology of the nursing processes. Remember, it starts with assessment, followed by analysis, planning, implementation, and finally, evaluation.

Assessment, or the process of appraising a client’s condition or needs, is the first step of the nursing process. As such, activities that deal with assessment should be your answer in priority questions. Remember, in the real world, you need to assess first before you implement! Otherwise, there could be fatal consequences that you’ll have to deal with.

Safety Strategy

Another technique that can help you get correct answers to NCLEX RN questions is the “Safety Strategy.” As a budding nurse, it is your foremost responsibility to ensure the safety of your clients. Keeping your patients protected includes making sure that their basic needs are met, that hazards that pose injury are prevented, and that the transmission of pathogens are avoided.

The NCLEX RN test is designed to ensure that you know how to provide safe nursing care, so it is a must that you consider the patient’s safety when answering priority questions. This is especially true when all the answers are implementing activities – you need to choose the NCLEX RN intervention that will keep the patient safe and unharmed.

Priority questions might be tricky, but if you apply these three strategies, you will be able to answer the NCLEX RN exam correctly! Practice your newfound knowledge by answering sample NCLEX RN questions at nclexpreceptor.com.

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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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