TABLE OF CONTENTS Fluids and Electrolytes…………………………………………………………… 3 Acid-Base Balance……………………………………………………………….. 13 Burns………………………………………………………………….………….. 16 Oncology………………………………………………………………..………… 22 Endocrine…………………………………………………………………..…….. 38 Cardiac…………………………………………………………………..……….. 52 Psychiatric Nursing……………………………………………………………..
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Gastrointestinal………………………………………………………………….. 92 Neuro……………………………………………………………………………... 104 Maternity Nursing………………………………………………………………. 114 Respiratory………………………………………………………………..……… 139 Orthopedics………………………………………………………………………. 144 Renal……………………………………………………………………………… 150 Questions…………………………………………………………………………. 158 Final Thoughts…………………………………………………………………… 178 Evaluations………………………………………………………………………… 186 Table of Contents for CD…………………………………………………………..188 Pediatric……………………………………………………………………………..189
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Hurst Review does not condone the discussion of the NCLEX-RN exam posttest. Thank you.
NOTICE TO FACULTY All materials used during any Hurst Review Services seminar are copyrighted and are not for use without the sole permission of Marlene Hurst in any form or fashion. This material is not intended for lecture use by any School of Nursing without permission. NOTICE TO STUDENTS If you are a student who has obtained this book from a past participant of my workshops . . . . .SHAME, SHAME, SHAME!!! Please understand that this book is written to accompany the live or video lectures presented in the class itself or my Internet Tutorials. This book is only an outline of what is needed to pass NCLEX. I hope you will join me in a live or video class or on the Internet to reap the full benefits of my materials. General Class Information - Please turn off ALL cell phones and pagers. -This class MAY NOT be recorded in any manner. (This included tape recording or videoing.) -Class Time: 8AM-4PM * Please note that each class is presented in a particular sequence if your instructor completes the material for that day, you may get out prior to 4 PM.
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FLUID VOLUME EXCESS: HYPERVOLEMIA Define: too much volume in the __________________ _________________ l. Causes: a. CHF: heart is__________, CO__________, decreased__________ perfusion, UO__________ *the volume stays in the _________________ _______________ b. RF: Kidneys aren't____________________ c. Alkaseltzer Fleets enemas
All 3 have a lot of_______________
IVF with Na d. Aldosterone (steroid, mineralocorticoid) Where does aldosterone live? -Normal action: when blood volume gets low (vomiting, blood loss, etc.) →aldosterone secretion increases→ retain Na/water→ blood volume ______ ** Diseases with too much aldosterone: -also seen with liver disease and heart disease 1._________________________ 2._________________________ **Disease with too little aldosterone: 1._________________________
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e. ADH (anti-diuretic hormone) Normally makes you retain or diurese? Retain? _________________________ 2 ADH problems Too Much
Not enough
Retain
Lose (diuese)
Fluid Volume _________
Fluid Volume __________
SIADH Syndrome of Inappropriate ADH Secretion
DI Diabetes Insipidus
Urine
Urine
Blood
Blood
*Concentrated makes #’s go up *Dilute makes #’s go down
specific gravity, Na
ADH lives in pituitary; key words to make you think potential ADH problem: craniotomy, head injury, sinus surgery, transphenoidal hypophysectomy *Another name for anti-diuretic hormone (ADH) is Vasopressin. The drug Vasopressin (Pitressin or DDAVP (Desmopressin acetate) may be utilized as an ADH replacement in Diabetes Insipidus.
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f. S/Sx of FVE: Distended neck veins/peripheral veins: vessels are_______________ Peripheral edema, third spacing: vessels can't hold anymore so they start to _______________ CVP: measured where? ____________________; number goes_________ More____________________....More____________________ Lung sounds: Polyuria: kidneys trying to help you_________________________ Pulse: _______________; your heart only wants fluid to go__________________ If the fluid doesn't go forward it's going to go______________into the_____________ BP: _______________
move volume.....more_______________
Weight: _______________
any acute gain or loss isn't fat-it’s fluid
g. Treatment: Low Na diet Diuretics Loop *Bumex® may be given when Lasix® doesn’t work. Thiazide (HCTZ)
* Watch lab work with all diuretics *Dehydration and electrolyte problems
K-sparing Bed rest induces____________________ *when you are supine you perfuse your kidneys more h. Interventions: Physical Assessment Give IVF’s slowly to elderly
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