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NCLEX
Arab American Culture
Touch Only When Same Gender
May Request Same Gender Healthcare Provider
Females Avoid Eye Contact with Males
Males Often Make Decisions
Muslims
Infertility Grounds for Divorce
No Organ Donation
2 mins
Asian American Culture
Avoids Direct Eye Contact
Conflict Avoidance
Soft Voice Tone
Males Make Most Decisions
Feet Considered Dirty
Hot-Cold Theory of Illness
Soups and Rice After Birth
2 mins
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
2 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)
1 min
Child and Elder Physical Abuse Assessment
Physical Abuse
Inconsistent Injuries
Delay in Treatment
Various Stages of Healing
Child Abuse
Symmetrical Burns
Sexually Transmitted Infection
Bloody/Torn Undergarments
Shaken Baby Syndrome
Elder Abuse
Poor Hygiene
Overmedication
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
2 mins
Glasgow Coma Scale
LOC Assessment
Score of 3 to 15
8 or Less = Coma
Eye Opening
Verbal Response
Motor Response
1 min
I-SBAR-R
Identify
Situation
Background
Assessment
Recommendation
Readback
1 min
Level of Consciousness: Descriptive guide for Glasgow Coma Scale
Conscious
Confused
Delirious
Somnolent
Obtunded
Stuporous
Comatose
3 mins
Lung Sounds - Crackles
Location
Lower Lobes
Description
Fine/Coarse
Sounds Like
Fine: Twisting Hair through Fingers
Coarse: Velcro
Cause
Collapsed Small Airways and Alveoli "Popping Open"
1 min
Lung Sounds - Wheezes
Location
Throughout Lung
Description
High Pitched
Sounds Like
Musical
Cause
Air Moving through Narrowed Airways
38 secs
Maslow's Hierarchy of Needs
Physiological Needs
Oxygen, Water, Nutrition
Body temperature, Elimination, Shelter, Sexual Expression
Safety and Security
Physical Safety
Physiological Safety
Love and Belonging
Affection and Companionship
Esteem
Self Respect and Respect for Others
Self Actualization
Fulfillment
2 mins
Mexican American Culture
May Avoid Eye Contact with Authoritative Figures
Family Involved in Decisions
Emotional Bereavement
No Organ Donation
Curandero (Curandera)
Hot-Cold Theory of Illness
Abdominal Binder after Pregnancy
2 mins
Native American Culture
No Direct Eye Contact
No Organ Donation
No Blood Donation
Strong Handshakes Offensive
Tribal Shaman
Navajo Mother Massage Newborn
2 mins
Neurovascular Assessment 6 P's
Pain
Paresthesia
Pulse
Pallor
Pressure
Paralysis
1 min
Pain Assessment
Types of Pain
Acute Pain
Chronic Pain
OPQRST Mnemonic
Onset
Provoking or Palliative
Quality
Radiation
Severity
Timing
Nursing Considerations
Subjective Findings
Objective Findings
Reassessment of Pain
2 mins
Patient Position Overview
Position Techniques
Trochanter Roll
Trapeze Bar
Ankle-Foot Orthotic (AFO) Devices
Positions
Fowlers Position
Supine Position
Trendelenburg
Side-Lying Position
Prone Position
Sims' Position
Nursing Considerations
Reposition q2 Hours/Prevent Skin Breakdown
Confirm Body Alignment
2 mins
Religion and Dietary Preferences Overview
Buddhism
Natural Foods of Earth
Hinduism
Cow is Sacred
Islam (Muslim)
Halal Foods
No Alcohol
Judaism
Kosher Meals
No Pork or Shellfish
Mormonism (Latter Day Saints)
The Word of Wisdom
1 min
The Nursing Process
ADPIE
Assessment
Diagnosis
Planning
Implementation
Evaluation
2 mins
Vital Signs - Adult
Temperature (96.8-100.4 Degrees F) (36-38 Degrees C)
Rectal
Tympanic
Oral
Axillary
Temporal
Respiration (12-20)
Oxygen Saturation (95%-100%)
Pulse (60-100)
Blood Pressure (<120/80)
Pain
2 mins
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