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NCLEX-RN® Test Plan: Client Needs | Registered Nurse (RN) School Study Aid
Stages of Hypothermia
- Mild
- 32 to 35°C (90 to 95°F)
- Shivering
- Moderate
- 28 to 32°C (82 to 90°F)
- Obvious Motor Impairment
- Slowed Thinking
- Severe
- < 28°C (< 82°F)
- Shivering Stops
- Paradoxical Undressing
- Arrhythmias
3 mins
Hypothermia Interventions
- Remove From Environment
- Remove Wet Clothing
- Passive Rewarming
- Warm Clothing
- Active Rewarming
- Heated Blankets
- Warm IV Solutions
- Heated Oxygen
- Warm Gastric Lavage
- Considerations
- Warm Trunk BEFORE Extremities
2 mins
Types of Head Injuries
- Open Head Injury
- Linear Fracture
- Comminuted Fracture
- Depressed Fracture
- Open Fracture
- Basilar Skull Fracture
- Closed Head Injury
- Coup and Contrecoup
- Brain Contusion
- Concussion
2 mins
Traumatic Brain Injury Assessment
- Assessment
- Change in LOC
- Personality Changes
- Amnesia
- Increased Intracranial Pressure
- Diplopia
- Posturing
- Location of Injury
- Basilar Skull Fracture
- Halo or Ring Sign
- Considerations
- Intracranial Bleeding
2 mins
Disseminated Intravascular Coagulation (DIC)
- Pathophysiology
- Bleeding State
- Activation of Clotting Factors
- Deficiency of Clotting Factors
- Causes
- Sepsis
- Trauma
- Obstetric Complications
- Acute Pancreatitis
- Malignancy
- Nephrotic Syndrome
- Transfusion
2 mins
Compartment Syndrome Assessment
- Mechanism
- Trauma
- Increased Pressure
- Compressed Nerves and Blood Vessels
- Assessment
- 1 or more of 6 P's
- Ankle-Brachial Index (ABI)
- Considerations
- May take Days to develop
- Early Detection
- Ischemia
- Damage often Irreversible
2 mins
Flail Chest
- Cause/Mechanism
- Trauma
- Assessment
- Shallow Respirations
- Chest Pain
- Paradoxical Chest Movement
- Interventions
- Mechanical Ventilation
- Analgesics
- Intercostal Nerve Blocks
- Considerations
- Surgical Rib Fixation
- Monitor Pulmonary Contusion
2 mins
Cauda Equina Syndrome
- Acute Loss of Lumbar Plexus Function
- Surgical Emergency
- Saddle Anesthesia
- Causes
- Inflammatory Disorders
- Spinal Stenosis
- Trauma
- Lesions
- Symptoms
- Urinary and Fecal Incontinence
- Sciatica
- Diagnosis
- Magnetic Resonance Imaging (MRI)
- Clinical
1 min
Anterior Shoulder Dislocation
- Axillary Nerve Damage
- Axillary Artery
- Rotator Cuff Injury
- Supraspinatus Tendon
- Anterior Glenohumeral Ligament
- Anatomic Lesions
- Bankart's Lesion
- Hill-Sachs Lesion
1 min
Abusive Head Trauma (Shaken Baby Syndrome)
- Presentation
- Subdural Hemorrhage
- Retinal Hemorrhages
- Bruising and Fractures
- Diagnosis
- CT of Head
- Skeletal Survey
- Treatment
- Document Injuries
- Notify Child Protective Services
1 min
Epidural Hematoma
- Mechanism
- Middle Meningeal Artery Rupture
- Temporal Bone Fracture
- Hematoma Between Skull And Dura Mater
- Transtentorial Herniation
- Lucid Interval
- Imaging
- Lens-shaped on CT
- Does Not Cross Suture Lines
- Treatment
- Craniotomy
1 min
Subarachnoid Hemorrhage
- Bleeding into Subarachnoid Space
- Mechanisms
- Trauma
- Aneurysm Rupture
- AVM Rupture
- Vasospasm causes Ischemia
- Signs & Symptoms
- "Worst Headache Of My Life"
- Diagnosis
- Noncontrast Head CT
- Lumbar Puncture
- Angiography
- Considerations
- Surgery
- Blood Pressure Control
- Intracranial Pressure Control
- Nimodipine for Vasospasm Prophylaxis
3 mins
Subdural Hematoma
- Mechanism
- Tear of Bridging Veins
- Slow Bleeding, Over Time
- Imaging
- Subdural Space
- Crescent-shaped on CT
- Crosses Suture Lines
- Midline Shift
- Causes
- Elderly
- Whiplash
- Abusive Head Trauma (Shaken Baby Syndrome)
2 mins
Cardiac Tamponade
- Mechanism
- Fluid in the Pericardial Sac
- Pericarditis
- Decreased Cardiac Output
- Signs/Symptoms
- Beck's Triad
- Hypotension
- Jugular Venous Distention (JVD)
- Distant Heart Sounds
- Pulsus Paradoxus
- Electrical Alternans
- Treatment
- Pericardiocentesis
1 min
Traumatic Aortic Rupture
- ETIOLOGY
- Blunt Thoracic Trauma
- Presentation
- Hemorrhagic Shock
- Diagnosis
- Chest X-Ray
- Ultrasound
- CT Angiography
- Management
- Fluid Resuscitation
- Blood Pressure Control
- Surgery
- Considerations
- Grave Prognosis
3 mins
Abdominal Aortic Aneurysm Rupture
- Clinical Features
- Acute Tearing Pain
- Pulsatile Abdominal Mass
- Grey Turner Sign
- Cullen Sign
- Hypovolemic Shock
- Diagnosis
- Diagnosis by Clinical Impression
- Treatment
- Emergent Surgical Intervention
- Considerations
- Poor Prognosis
3 mins
Types of Fractures
- Nondisplaced
- Displaced
- Incomplete
- Complete
- Closed
- Open
- Direction of Fracture Line
2 mins
Cardiopulmonary Resuscitation (CPR) for Adults
- Steps Before CPR
- Scan Scene
- Activate Emergency Response System
- Check For Breathing (Max 10 Seconds)
- Open Airway
- Compressions, Airway, Breathing (CAB)
- Compressions: 2 Inches Deep (100-120 Compressions/Min)
- Airway: Ensure Airway is Still Open
- Breathing: Administer 2 Rescue Breaths
- Considerations
- Repeat C-A-B Sequence (30:2) Until Help Arrives
3 mins
Pneumothorax
- Mechanism
- Air Enters Pleural Space
- Assessment
- Sudden Dyspnea
- Absent or Restricted Movement on Affected Side
- Decreased or Absent Breath Sounds on Affected Side
- Chest Pain
- Tracheal Deviation
- Vital Sign Changes
- Crepitus
- Considerations
- High Fowler's Position With Oxygen
- Prepare For Chest Tube Placement
- Educate High Risk Patients
2 mins
Compartment Syndrome Interventions
- Interventions
- Frequent Neurovascular Assessments
- Evaluate Pain
- Do Not Elevate Extremity
- Remove or Loosen Restrictive Items
- Fasciotomy
- Amputation
- Considerations
- Infection
- Monitor Urine Output
2 mins
Snake Bite Injury
- Local Findings
- Edema
- Erythema
- Tissue Necrosis
- Systemic Findings
- Neurotoxicity
- Distributive Shock
- Disseminated Intravascular Coagulation (DIC)
- Diagnosis
- Diagnosis by Clinical Impression
- Management
- Antivenom
- Closely Monitor Patient
2 mins
Acquired Diaphragmatic Hernia
- Etiology
- Trauma
- Clinical Features
- Bowel in the Chest
- Respiratory Distress
- Abdominal Pain
- Diagnosis
- Chest X-ray
- CT Scan
- Management
- Surgery
- Considerations
- Bowel Incarceration or Perforation
- Avoid Chest Tube
4 mins
Types of Burns
- Superficial Thickness
- Sunburn
- Superficial Partial Thickness
- Blisters
- Blanching
- Deep Partial Thickness
- Little or Non-blanching
- Full Thickness
- Waxy White, Yellow or Black
- Decreased Pain
2 mins
Burns Assessment
- Stage and Extent of Burn
- Dyspnea
- Singed Nasal Hairs
- Pain
- Initial Decrease Urinary Output
- Paralytic Ileus
- Signs of Inadequate Hydration
- Shock
- Hypothermia
- Hyperkalemia
2 mins
Burns Interventions
- Ensure Airway Patency
- O2
- IV Fluid Replacement
- Dry Sterile Dressing
- Debridement
- Elevate Burned Limbs
- Analgesics
- Silver Sulfadiazine
- Escharotomy
2 mins
Burns Considerations
- Maintain Body Temperature
- Increased Risk of Infection
- Venous Thromboembolism (VTE) Prophylaxis
- Curling's Ulcer
- Excision and Grafting
- Adequate Nutrition
- Contractures
2 mins
Stages of Burn Care
- Phase / Stage 1
- Resuscitative/Emergent Phase
- Injury to Return of Capillary Permeability
- 48-72 hours
- IV Fluid Replacement
- Phase / Stage 2
- Acute Phase
- Diuresis to Near Wound Closure
- Phase / Stage 3
- Wound Closure to Return of Optimal Level
2 mins
Rule of 9's for Burns
- Total Body Surface Area (TBSA)
- Head
- Anterior Torso (18%)
- Chest
- Abdomen
- Posterior Torso (18%)
- Upper Back
- Lower Back
- Extremities
- Posterior Leg (each)
- Anterior Leg (each)
- Each Arm
- Genitalia 1%
2 mins
Parkland Formula
- Burn victims
- 24 hours
- TBSA% x Weight x 4 = Fluids
- TBSA %
- x Weight (kg)
- x 4
- = Fluid Requirement (in first 24 hrs)
- Fluids in first 8 hours
- 1/2 of fluid given in first 8 hours
1 min
Types of Shock
- Hypovolemic
- Depleted Volume
- Cardiogenic
- Pump Failure
- Obstructive
- Indirect Pump Failure
- Distributive
- Lost Vascular Tone
- Neurogenic
- Anaphylactic
- Septic
2 mins
Sepsis Assessment
- Signs and Symptoms
- Systemic Infectious Process
- Fever
- Hypotension
- Change in LOC
- Increased WBC
- Shift to the Left
- Tachycardia
- Tachypnea
- Hyperglycemia
- Edema
2 mins
Severe Sepsis and Septic Shock Assessment
- Microthrombi
- DIC
- Decreased Oxygen Saturation
- Decreased WBC
- Oliguria
- High Output Heart Failure
- Multiple Organ Failure
2 mins
Systemic Inflammatory Response Syndrome (SIRS) Criteria
- Must have 2 or more of the following:
- Temperature < 36C or > 38C
- Pulse > 90 beats per minute
- Respirations > 20/min or PCO2 < 32
- WBC < 4,000 or > 12,000 or 10% bands
- Mechanism
- Subset of Cytokine Storm and Related to Sepsis
2 mins
Transfusion Reactions
- Acute Hemolytic
- Febrile, Non-Hemolytic
- Mild Allergic
- Anaphylactic
- Circulatory Overload
- Sepsis Reaction
- Transfusion-Related Acute Lung Injury (TRALI)
- Massive Blood Transfusion
2 mins
Blood Transfusion Administration
- Proper Patient Identification
- Large Bore Needle
- Y Tubing
- Baseline Vital Signs
- Slow IV Infusion
- Monitor During First 15 Minutes or 50 mL of Blood
- Monitor for Reactions
- Considerations
- Do Not Add Anything To Same IV Line
- No Dextrose or Lactated Ringers
- Jehovah's Witnesses, No Transfusions
3 mins
Malignant Hyperthermia vs. Neuroleptic Malignant Syndrome vs. Serotonin Syndrome
- Autonomic Instability
- Muscle Rigidity
- Malignant Hyperthermia
- Ryanodine Receptor 1 Mutation
- Inhaled Anesthetics
- Succinylcholine
- Dantrolene
- Neuroleptic Malignant Syndrome
- Antidopaminergic Medications
- Hyporeflexia
- Myoglobinuria
- Dantrolene
- Serotonin Syndrome
- Serotonergic Medications
- Hyperreflexia
- Clonus
- Cyproheptadine
3 mins
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