Measles TB
Varicella-Chicken Pox/Herpes Zoster-Shingles
Private Room: Negative pressure with 6-12 air exchanges/hr
Mask: N95 for TB
Sepsis
... [Show More] Scarlet fever
Streptococcal Pharyngitis (Streptococcus group A/ Strep Throat): Can Lead to Glomerulonephritis & Rheumatic
Fever.
Pneumonia
Influenza/ Haemophilus influenza type B
Diphtheria (Pharyngeal): Serious bacterial infection.
Epiglottitis: Medial Emergency! No Throat Inspection.
2 NCLEX RN STUDY GUIDE
Rubella/ German measles
Mumps
Meningitis/ Neisseria Meningitidis Mycoplasma/ Meningeal Pneumonia An - Adenovirus
Private Room or Cohort Surgical mask PRN for Procedures Mask 3ft Distance
Multidrug resistant organism/ MRSA/ VRE
Respiratory infection Skin infections Wound infection
Enteric infection - Clostridium Difficile
Eye infection – Conjunctivitis
*MRSA - Contact precaution ONLY. Use Chlorhexidine Wipe!
*VRSA - Contact & Airborne precaution (Private room, door closed, negative pressure)
*SARS (Severe Acute Resp Syndrome) Airborne & Contact (just like Varicella)
Varicella Zoster
Cutaneous Diphtheria (Bacteria Infection in the Wound)
Herpes Simplex
Impetigo (Bacterial Skin Infection)
Pediculosis (Lice)
Scabies (Itchy Skin condition. Burrowing Trail of the Scabies Mite)
3 NCLEX RN STUDY GUIDE
Middle East Respiratory Syndrome (MERS): Viral respiratory illness caused by Coronavirus (MERS-CoV). S/S: Fever, Cough, SOB, and Death. The Incubation Period is 5-6 days but can range from 2-14 days.
CDC: Standard (Gloves), Contact (Gown), Eye Protection (Goggles), Airborne Precautions (N95)
room: Negative disease (TB, Disseminated Herpes Zoster) room: Protect the Patient (HIV, Cancer)
Addison’s= hyponatremia, hypotension, decreased blood vol, hypoglycemia, hyperKalemia, HyperCalcemia.
Cushing’s= HyperNatremia, HyperTension, Incr. Blood Vol, HyperGlycemia, hypokalemia, hypocalcemia.
Managing Stress in a patient with Adrenal Insufficiency (Addison’s) is paramount, because if the Adrenal glands are stressed further it could result in Addisonian Crisis.
Addison’s: Remember BP is the most Important assessment parameter, as it causes Severe Hypotension.
Addison’s: (need to "add" hormone): Hypoglycemia, Dark pigmentation, Decr. Resistance to Stress, fractures, Alopecia, Weight Loss, GI distress. Vitiligo. Mood swings (Normal)
Need to Report S/S of Infection/ Fever (Addisonian Crisis) Tx: Mineral Corticoids.
Addisonian Crisis: Hypoglycemia, Confusion, n/v, Abd Pain, Extreme Weakness, Dehydration, Decr. BP.
Cushings: (have extra "Cushion" of Hormones): Hyperglycemia, prone to Infection, Muscle Wasting, Weakness, Edema, HTN, Hirsutism, Moonfaced/Buffalo Hump
Cause: Excessive production of Corticotropin (Hyperplasia of the Adrenal Cortex) & Cortisol-secreting Adrenal Tumor.
Prednisone Toxicity: Cushing’s syndrome- Buffalo Hump, Moon face, Hyperglycemia, Hypertension.
Acetaminophen: 10-20. Max 4000mg per day.
4 NCLEX RN STUDY GUIDE
Acetaminophen Poisoning: Possible Liver Failure for about 4 days. Close observation required. Tx: (Antidote) n-AcetylCysteine/Mucomyst
AcetylSalicyclic Acid (ASA): Metabolic Acidosis.
S/S: Tinnitus, Coffee Ground Emesis (Old Blood), Black tarry stools (Melena), Bruising, Tachycardia, Hypotension, GI Ulcers.
Tx: Activated Charcoal, then IV Na+ Carbonate.
Acromegaly: Coarse Facial feature. Assess Cardiac Problems (eg. S3, S4).
Acute Respiratory Distress Syndrome (ARDS):
The 1st Sign is Incr. Respirations. Later comes Dyspnea, Retractions, Air Hunger, Cyanosis. Cardinal sign is Hypoxemia (Low O2 level in tissues).
Refractory Hypoxemia is the hallmark of ARDS, a progressive form of acute respiratory failure that has a high Mortality rate. It can develop following a Pulmonary Insult (eg, aspiration, pneumonia, toxic inhalation) or nonpulmonary insult (eg, sepsis, multiple blood transfusions, trauma) to the Lung.
The Inability to improve Oxygenation With Incr. in O2 concentration.
The insult triggers a Massive Inflammatory response that causes the lung tissue to release inflammatory mediators (leukotrienes, proteases) that cause damage to the alveolar-capillary (A-C) membrane. As a result of the damage, the A-C membrane becomes more permeable, and intravascular fluid then leaks into the alveolar space, resulting in a Noncardiogenic Pulmonary Edema.
The lungs become Stiff and Noncompliant, which makes Ventilation and Oxygenation less than optimal and results in increased work of breathing, tachypnea and alkalosis, atelectasis, and refractory hypoxemia.
ARDS (fluids in alveoli), DIC (Disseminated Intravascular Coagulation) are always Secondary to something else (another disease process). – Impaired Gas Exchange.
5 NCLEX RN STUDY GUIDE
PreOxygenated with 100% O2, and Suction should be applied for no more than 10 seconds to prevent hypoxia. The nurse must wait 1-2 minutes between passes to ventilate to prevent hypoxia.
Deep reBreathing should be encouraged.
The Suction catheter should be No more than half the width of the artificial airway and inserted without suction. Don Sterile gloves if it is not have a closed suction system.
Suction should be set at Medium Pressure (100-120 mm Hg for adults, 50-75 mm Hg for children) as Excess pressure will traumatize the mucosa and can cause hypoxia.
Clients usually Cough as the catheter enters the trachea, and this helps loosen secretions. The catheter should be advanced until resistance is felt and then, to prevent mucosal damage, Retracted 1 cm before applying suction.
You will ask every New Admission if he has an Advance Directive, and if not you will explain it, and he will have the option to sign or not.
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