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Registered Nurse (RN)
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NCLEX®
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NCLEX-RN® Test Plan: Client Needs
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Alterations in Body Systems

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NCLEX-RN® Test Plan: Client Needs | Registered Nurse (RN) School Study Aid

Alterations in Body Systems
37 Picmonics to Learn | 1 hr 15 mins
Care for the Visually Impaired
Assessment
Decreased Visual Acuity
Snellen Chart
Status of Corrective Lenses
Nursing Considerations
Sighted-Guide Technique
Communication
Safe Environment
Medications
Clock Technique for Food
Activities of Daily Living (ADL)
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1 min
Care for the Hard of Hearing
Assessment
Normal: 0-15 dB
Rinne's Test
Weber's Test
Tinnitus
Difficulty Following Conversations
Nursing Considerations
Face Patient/Speak Clearly
Rephrase Misunderstood Statements
Repeat Statements Back
Hearing Aids
Sign Language
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2 mins
Wound Drainage Types and Devices
Drainage Types
Serous
Serosanguineous
Sanguineous
Purulent
Drainage Devices
T-tube
Penrose
Jackson-Pratt (JP)
Hemovac
Considerations
Record Drainage Amounts
Check Device Function
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2 mins
Prenatal Care
Prenatal Visits
Vital Signs, FHR
Fundal Height
Urine Dipstick
Weight
Prenatal Screening
Laboratory Testing
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2 mins
Pregnant Cardiac Patient Assessment
Mechanism
Cardiac Decompensation
Signs and Symptoms
Frequent Cough
Dyspnea
Palpitations
Excessive Fatigue
Pulse > 100 bpm
Crackles
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2 mins
Pregnant Cardiac Patient Interventions
Prenatal
Monitor for Cardiac Decompensation
Stool Softener
Calcium Channel Blockers
Labor
ECG Monitor
Open Glottis Pushing
Pulmonary Artery Catheter
No Beta-Adrenergic Medications
Penicillin Prophylaxis
Postpartum
Stress on Heart
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2 mins
Pregnant Diabetic Patient Interventions
First Trimester
Increase Insulin then Decrease
Metformin
Nutrition
Exercise
Second Trimester
Increase Insulin
More Likely to Develop Hypoglycemia than Hyperglycemia
Third Trimester
Double or Quadruple Insulin
Early Delivery
Postpartum
Drastically Decrease Insulin
Monitor Neonate for Hypoglycemia
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3 mins
Placental Implantation Abnormalities
Mechanism
Placenta Adheres Directly to Myometrium
Placenta Accreta
Placenta Increta
Placenta Percreta
Caused by Scar Tissue
Hemorrhage
Diagnosis
Ultrasound is First-line, then MRI
Treatment
C-section Delivery
Artery Ligation or Embolization
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2 mins
Abruptio Placentae
Mechanism
Premature Separation of Placenta
Assessment
Tearing Pain
Bleeding (Often Concealed)
Rigid Uterus
Contractions
Interventions
Corticosteroids as Needed
Emergent Delivery
Considerations
Increased Risks for Neonate
Rh (Rhesus) Incompatibilities
Increased Risk for Shock
Monitor Fetal Heart Rate
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3 mins
Placenta Previa
Mechanism
Placenta Covers Cervical Os
Assessment
Painless
Bright Red Vaginal Bleeding
Interventions
Stable Fetus
Bed Rest
Observation
Unstable Fetus
C-section Delivery
Considerations
Risk for Shock
Magnesium Sulfate
Tocolysis
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3 mins
Preeclampsia Assessment
After 20 Weeks of Pregnancy
Mild
Hypertension > 140/90
Proteinuria or End-Organ Dysfunction
Severe
Hypertension > 160/110
Progressive Renal Insufficiency
Vision Changes
HELLP Syndrome
Pulmonary Edema
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2 mins
Preeclampsia Interventions
Side Lying Position and Bedrest
Antihypertensives
Magnesium Sulfate
Labor Induction
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1 min
Severe Preeclampsia
Mechanism of Action
Vasospasm and Decreased Organ Perfusion
Intravascular Coagulation
Increased Permeability and Capillary Leakage
Signs and Symptoms
Hypertension
Proteinuria or End-Organ Dysfunction
HELLP Syndrome
Hepatic Dysfunction and Hemolysis
Elevated Liver Enzymes
Low Platelet Counts
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3 mins
Eclampsia
Mechanism of Action
Increased Central Nervous System Irritability
Signs and Symptoms
Hyperreflexia
Positive Ankle Clonus
Headaches
Visual Disturbances
Epigastric or RUQ Pain
Seizures
Coma
Considerations
Don't Leave Bedside
Magnesium Sulfate
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2 mins
Hyperemesis Gravidarum
Signs and Symptoms
Excessive Vomiting
Significant Weight Loss
Dehydration
Hypotension
Electrolyte Imbalance
Interventions
Antiemetics
Frequent Small Meals
IV Therapy
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2 mins
Prolactinoma
Pituitary Adenoma
Galactorrhea
Prolactin Inhibits Gonadotropin Releasing Hormone
Impotence
Amenorrhea
Bitemporal Hemianopsia
Treat with Dopamine
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2 mins
Asthma Implementation and Education
Medication
Oxygen
Corticosteroids
Ipratropium (Anticholinergic)
Albuterol
Implementation
Inhaler/nebulizer
Pulse Oximetry
Pursed Lip Breathing
Education
Carry Inhaler
Rinse Mouth after Inhaler
Identify Trigger (Cold Air, Dander, Dust, Infection, Mold, Pollen, Smoke)
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2 mins
Diabetes Education
Self-Monitoring (Blood Glucose)
SubQ Injection Technique
Lifestyle Changes
Symptoms of Hyperglycemia and Hypoglycemia
Sick Day Care
Foot Care
Exercise Therapy
Medication
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1 min
Tracheostomy Care
Inner Cannula Removed and Cleaned
Clean Q8 Hours Around Stoma
One Finger Under Ties
Considerations
Speak with Deflated Cuff
Can Eat with Tube in Place
Keep Replacement Tube Nearby
Immediately Replace if Dislodged
Physician Does First Tube Change
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2 mins
Fever
Flushed skin, warm to touch
Chills
Sweating
Change in LOC
Provide adequate fluids
Monitor Electrolytes and Fluid
Monitor vital signs, esp temperature
Remove excess clothing and blankets
Sponge bath with tepid water
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2 mins
Types of Wound Healing
Types of Wounds
Acute
Chronic
Healing Process
Primary Intention
Approximated Edges
Secondary Intention
Edges Not Approximated
Tertiary Intention
Delayed Closure due to Infection and Necrosis
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2 mins
Dialysis
Hemodialysis
Rapid Shifts of Fluid and Electrolytes
Disequilibrium Syndrome
Hypotension
NO BP IN ARM with Shunt or Fistula
Assess for Thrill and Bruit
Peritoneal Dialysis
Slow Process
Peritonitis
Loss of Protein
Hyperglycemia
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3 mins
Ileostomy Care
Antibiotics
Monitor Skin Breakdown
Drains Continuously
Fluid and Electrolyte Imbalance
Low Fiber Diet
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2 mins
Seizure Interventions
Maintain Airway
Side-lying Position
Support Head
Move to Floor
Benzodiazepines
Considerations
Never Restrain
No Objects in Mouth
Document Details
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2 mins
Chest Tubes: Management and Care
Confirm suction order
Assessment
Crepitus
Kinking
Shortness of Breath (SOB)
Infection
Excessive bubbling
Quick Interventions
If tube dislodges from patient, use petroleum gauze taped 3 ways
If drainage system is damaged, place disconnected drainage tube in sterile water
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1 min
Postpartum Infection
Diagnosis
Fever > 100.4F After 24 Hours (38 C)
Risk Factors
Multiple Vaginal Examinations
Vaginal Trauma
Prolonged Rupture of Membranes
Cesarean Birth
Anemia of Pregnancy
Retained Placental Fragments
Poor Health Status
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3 mins
Postpartum Hemorrhage
Mechanism
Uterine Atony
Lacerations
Retained Placenta
Signs and Symptoms
Bleeding
Hypotension
Boggy Uterus
Considerations
Oxytocin
Bimanual Compression of Uterus
Surgery
Blood Transfusion
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2 mins
Postpartum Nursing Assessment
BUBBLE - LE
Breasts
Uterus
Bladder
Bowels
Lochia
Episiotomy (Laceration)
Lower Extremities
Emotions
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3 mins
Increased Intracranial Pressure (ICP) Assessment
Change in LOC
Headache
Cushings Triad
Irregular Respirations
Widening Pulse Pressure
Bradycardia
Projectile Vomiting
Abnormal Pupils
Papilledema
Posturing
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2 mins
Postoperative Care
Head to Toe Assessment
Complications
Hemorrhage
Clotting
Pain
Dehiscence or Evisceration
Respiratory Complications
Paralytic Ileus
Infection
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2 mins
Postoperative Fever
5 W's
Wind (Days 1-3)
Atelectasis
Pneumonia
Water (Days 3-5)
Urinary Tract Infection from Catheter
Walking (Days 4-6)
Deep Vein Thrombosis (DVT)
Pulmonary Embolism
Wound (Days 5-7)
Infection
Wonder Drugs (Days 7+)
Drugs
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2 mins
Human Immunodeficiency Virus (HIV) Assessment
Assessment
RNA Retrovirus
CD4+ Helper T Cells
Primary Infection
Flu-like Symptoms
Lymphadenopathy
Symptomatic Stage
Fatigue
Diarrhea
Unexplained Weight Loss
White Spots on Tongue
Persistent Fever
Night Sweats
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2 mins
Human Immunodeficiency Virus (HIV) Diagnosis
HIV-1/2 Antigen/Antibody Immunoassay
HIV-1/2 Antibody Differentiation Immunoassay
Nucleic Acid Testing (NAT)
Viral Load
Polymerase Chain Reaction (PCR) in Neonates
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3 mins
Human Immunodeficiency Virus (HIV) Stages
Primary Infection
Within 3 Weeks
Flu-like Symptoms
Asymptomatic Stage
Years
Symptomatic Stage
CD4+ < 500
AIDS
Opportunistic Infections
CD4+ < 200
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2 mins
Human Immunodeficiency Virus (HIV) Interventions
Interventions
Adequate Nutrition
Small Frequent Meals
IV Hydration
Emotional Support
HIV Medications
HAART
Considerations
Transmission Education
Strict Asepsis for Invasive Procedures
Treat Opportunistic Infections
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2 mins
Tuberculosis Assessment
Etiology
Airborne Droplet
Assessment
3 Week Productive Cough
Night Sweats
Chest Pain
Fever
Weight Loss
Fatigue
Diagnosis
Chest X-Ray
Blood Tests
Mantoux Skin Test
3 Positive Sputum Tests
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1 min
Tuberculosis Intervention
Hospital Care
Airborne Isolation
Drug Therapy
Combination Drug Therapy (RIPE)
6-12 Months
Considerations
DOT
BCG Vaccination
Medication Education
3 Negative Sputum Specimens
Infection Control
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2 mins

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