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Saunders Comprehensive Review For The NCLEX-RN Examination, 8 Ed. | Registered Nurse (RN) School Study Aid

IV Solutions

Hypotonic (< 280 mOsm/L)

1/4 Normal Saline (0.225% NaCl)

1/2 Normal Saline (0.45% NaCl)

Isotonic (280-300 mOsm)

Normal Saline (0.9% NaCl)

Lactated Ringer's (LR)

Dextrose 5% in Water (D5W)

Hypertonic (> 300 mOsm)

3% or 5% NaCl

Dextrose 5% in 0.45% NaCl

Dextrose 10% in Water (D10W)

3 mins

Cardiac Catheterization

Fluttering Sensation

Contrast Media

NPO 6-12 Hours

Bed Rest

Assess Circulation

Assess for Bleeding

Monitor Vital Signs

2 mins

Total Parenteral Nutrition (TPN)

Nutrition Given Outside GI

Hyperglycemia

Hyperlipidemia

Refeeding Syndrome

Nausea and Vomiting

Slow IV Infusion

Use Large Central Vein

No Added Meds to TPN Line

2 mins

Insulin

Rapid Acting

Insulin Lispro (Humalog)

Insulin Aspart (Novolog)

Insulin Glulisine (Apidra)

Short Acting

Regular Insulin (Humulin R)

Intermediate Acting

Isophane NPH (Humulin N)

Long Acting

Detemir (Levemir)

Glargine (Lantus)

2 mins

Blood Glucose Lab Value

70-100 mg/dL

25 secs

Calcium (Ca2+) Lab Value

8.5 to 10.5 mg/dL

26 secs

Magnesium (Mg2+) Lab Value

1.5 to 2.5 mEq/L

28 secs

Sodium (Na+) Lab Value

135-145 mEq/L

24 secs

Potassium (K+) Lab Value

3.5 to 5.0 mEq/L

20 secs

Chloride (Cl-) Lab Value

95-105 mEq/L

28 secs

Liver Enzyme Tests: AST and ALT

AST/ALT Ratio

AST: 8-20 U/L

ALT: 8-20 U/L

1 min

Platelet Lab Value

150,000-400,000 Micro L

40 secs

Hemoglobin (Hgb) Lab Values

Men: 13 - 17 g/dL

Women: 12 - 16 g/dL

47 secs

Blood Types and Compatibilities

No Antigens (Type O Blood)

Universal Donor

A Antigen (Type A Blood)

B Antigen (Type B Blood)

AB Antigen (Type AB Blood)

Universal Recipient

Rh (Rhesus) Antigen

Never Rh+ to Rh-

Blood Transfusion

Obstetric Patient

2 mins

Types of Blood Products

Whole Blood

Packed Red Blood Cells

Fresh Frozen Plasma

Immunoglobulins

Clotting Factors

Albumin

Platelets

Use within 24 Hours

Washing Removes Antibodies

Irradiation Destroys WBCs

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

Do Not Add Anything To Same IV Line

No Dextrose or Lactated Ringers

Jehovah's Witnesses, No Transfusions

3 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

Hyperkalemia

> 5.0 mEq/L K+

Abdominal Cramps

Muscle Weakness

Diarrhea

Arrhythmia

Tall, Peaked T Waves

IV Calcium

Infusion of Glucose and Insulin

Loop or Thiazide Diuretics

Kayexalate

Dialysis

Prevention Education

2 mins

Tracheostomy Care

Inner Cannula Removed and Cleaned

Clean Q8 Hours Around Stoma

One Finger Under Ties

Speak with Deflated Cuff

Can Eat with Tube in Place

Keep Replacement Tube Nearby

Immediately Replace if Dislodged

Physician Does First Tube Change

2 mins

Pneumothorax

Air Enters Pleural Space

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

High Fowler's Position With Oxygen

Prepare For Chest Tube Placement

Educate High Risk Patients

2 mins

Chest Tubes: Management and Care

Confirm suction order

Crepitus

Kinking

Shortness of Breath (SOB)

Infection

Excessive bubbling

If tube dislodges from patient, use petroleum gauze taped 3 ways

If drainage system is damaged, place disconnected drainage tube in sterile water

1 min

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

IV Fluid Replacement

Dry Sterile Dressing

Debridement

Elevate Burned Limbs

Analgesics

Silver Sulfadiazine

Escharotomy

2 mins

Rule of 9's for Burns

Total Body Surface Area (TBSA)

Head

Chest

Abdomen

Upper Back

Lower Back

Posterior Leg (each)

Anterior Leg (each)

Each Arm

Genitalia 1%

2 mins

Stages of Burn Care

Resuscitative/Emergent Phase

Injury to Return of Capillary Permeability

48-72 hours

IV Fluid Replacement

Acute Phase

Diuresis to Near Wound Closure

Wound Closure to Return of Optimal Level

2 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

Types of Wound Healing

Acute

Chronic

Primary Intention

Approximated Edges

Secondary Intention

Edges Not Approximated

Tertiary Intention

Delayed Closure due to Infection and Necrosis

2 mins

Wound Drainage Types and Devices

Serous

Serosanguineous

Sanguineous

Purulent

T-tube

Penrose

Jackson-Pratt (JP)

Hemovac

Record Drainage Amounts

Check Device Function

2 mins

Syndrome Of Inappropriate Antidiuretic Hormone (SIADH)

Hypersecretion of ADH

Increased Sensitivity to ADH

Serum Hypoosmolality

Coma and Seizure

Dilutional Hyponatremia

Cramps and Tremors

Euvolemia

Change in LOC

2 mins

Hypercalcemia Causes

Two CHIMPANZEES Acronym

Thyroid Disorders

Calcium Supplements

Hyperparathyroidism

Iatrogenic (Drugs, immobility)

Milk-Alkali Syndrome

Paget's Disease of Bone

Acromegaly or Addison's Disease

Neoplasms

Zollinger-Ellison Syndrome

Excessive Vitamin A

Excessive Vitamin D

Sarcoidosis

2 mins

Hypercalcemia

> 10.5 mg/dL Ca²⁺

Pathologic Fractures

Lethargy

Hypercoagulation

Constipation

ECG Changes

QT Shortening

No Calcium Intake

Chelating Drugs

Calcitonin

Bisphosphonates

Loop Diuretics instead of Thiazide Diuretics

Increased Risk for Renal Calculi

Increase Fluids

3 mins

Hypercalcemia Treatments

Treat Underlying Disorder

Hydration

Dialysis

Calcium Restriction

Bisphosphonates

Calcitonin

Cinacalcet

Glucocorticosteroids

Denosumab

2 mins

Hypocalcemia Causes

Hypoalbuminemia

Hypomagnesemia (Less Common Hypermagnesemia)

Hypovitaminosis D

Hypoparathyroidism

Medications

Hyperphosphatemia

Malnutrition

Acute Pancreatitis

Alkalosis

Sepsis

Chronic Kidney Disease

2 mins

Supine Hypotension (Vena Cava Syndrome)

Compression of the Vena Cava and Descending Aorta

Hypotension

Dizziness

Tachycardia

Decreased Renal Perfusion

Decreased Uteroplacental Perfusion

Side-lying Position

2 mins

Oxygen Delivery Methods

Nasal Cannula

Simple Face Mask

Non-Rebreather Mask

Venturi-Mask

Oxygen In Use Sign

No Electrical Sparks

Six Feet Away from Open Flames

Dry Nasal and Upper Airway Mucosa

Skin Irritation

Home Education

1 min

Acute Respiratory Distress Syndrome (ARDS) Assessment

Damaged Alveolar-Capillary Membrane

Restlessness

Dyspnea

Refractory Hypoxemia

Decreased PaO2

Diffuse Pulmonary Infiltrates

Atelectasis

Pulmonary Hypertension

2 mins

Acute Respiratory Distress Syndrome (ARDS) Interventions

Closely Monitor Patient

ABG's (Arterial Blood Gases)

Oxygen

Assess for O2 Toxicity

Mechanical Ventilation

PEEP

Assess for Pneumothorax

Permissive Hypercapnia

High Mortality Rate

2 mins

Types of Shock

Hypovolemic

Depleted Volume

Cardiogenic

Pump Failure

Obstructive

Indirect Pump Failure

Distributive

Lost Vascular Tone

Neurogenic

Anaphylactic

Septic

2 mins

Coronary Artery Bypass Grafting (CABG)

ST-Segment Elevation Myocardial Infarction (STEMI)

Cardiovascular Disease (CAD)

Uncontrolled Angina

Internal Mammary Artery

Saphenous (Leg) Vein

Transient Limb Edema

Closely Monitor Patients

Venous Thromboembolism (VTE) Prophylaxis

Incentive Spirometer

2 mins

Increased Intracranial Pressure (ICP) Assessment

Change in LOC

Headache

Cushings Triad

Irregular Respirations

Widening Pulse Pressure

Bradycardia

Projectile Vomiting

Abnormal Pupils

Papilledema

Posturing

2 mins

Increased Intracranial Pressure (ICP) Interventions

Elevate Head Of Bed

Foley Catheter

Mannitol (Osmitrol)

High Dose Barbiturates

Passive Hyperventilation

Dexamethasone (Neoplasm or Infection)

Neuro Assessment

Maintain Normal Temperature

Avoid Activities That Increase ICP

Intracranial Monitoring System

2 mins

Level of Consciousness: Descriptive guide for Glasgow Coma Scale

Conscious

Confused

Delirious

Somnolent

Obtunded

Stuporous

Comatose

3 mins

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