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From: "Colleen" <cpgmi@s.> Date: Sat Jan 31, 2004 10:37 pm Subject: NC6 Here are some areas to concentrate on for those of you studying for NC 6 from my saved emails. I took NC6 this am and passed with a B. I thought it was pretty hard. A lot of posts had said it was a lot from the Seth and Rue Study Guide, I didn't think so at all. I had only a few from the Seth. Things from my test to concentrate on: Gout(tx and meds), Myasthenia Gravis, Rheumatoid Arthritis, Rheumatic Fever, Increased ICP (position, meds, vitals), Burns(vitals, complications,care of grafts), Traction, Casts, Spinal Injuries. All I can say is to know your conditions inside and out, plus- go over some of your Electrolyte stuff, meds for each condition. Make sure you know your drugs. Drugs, drugs, drugs! I had a bunch of questions on diseases transmitted via respiratory secretions, and STD's. But mostly have your drugs down pat.Dilantin, Mannitol, tegretol, Gantrisin, Pilocarpine, Isoniazid, Nipride, Colchicine. How HIV/AIDs is transmitted How Gonorrhea causes sterility in females: obstuction of fallopian tubes Therapeutic action of zidovudine (AZT): inhibits or slows replication of virus Most common complication of HIV/AIDS: pneumocystis carinii pneumonia What STD can be tested for by blood: Syphilis A pt with Mononucleosis should avoid damage to what organ: Spleen How is Hep A & C transmitted: A - fecal/oral route, C - blood and body fluids Which healthcare worker is most at risk for contracting Hep C: phleobotomist What vaccine should you not give a 10 year old immunocompromised pt? What causes jaundice? Alot of questions on TB Know that warm compresses decreases muscle spasms and promotes healing and that cold increases muscle spasms and delays healing What is the first sign of Syphilis? painless chancre What is the hallmark sign of UTI: frequency What should you avoid during the acute phase of PID? Know the purpose of the Mantoux test: test large populations for exposure to TB Med to treat Strep: Penicillin, if allergic then erythromycin Side effects of Isonizid (INH) Know what a macule is Know what Koplik's spots are Know that fatigue is the most debilitating aspect of Mono Know that a sore throat is the most common symptom of a strep infection Know that glomerulonephritis is the complication to strep throat (acute pharyngitis) Know the site on an infant where you would give a HBV Know that you should have tracheostomy equip at the bedside for a pt. with epigottis Know the causitive organism for epigottitis, meningitis Know symptoms of meningitis: headache, nuchal rigidity, Kernig's sign Know that dilantin causes Hyperplasia of gingiva Know side effects of Penicillin Know that zoster vaccine is used to treat varicella Know that mumps is caused from inflammation of salivary glands Know why smoking predisposes a person to get otitis media Why is Vitamin K given to a pt with Hepatitis Who is most at risk for Nosocomial infections Know how you acquire Lyme disease Know that ESR will be elevated in an inflammatory disease such as rheumatoid arthritis or Lupus Know s/s of Lupus: butterfly rash Know s/s of septicemia & septic shock Know s/s of increased ICP What organism causes Rheumatic Fever and Rhematoid Arthritis Know to monitor for cardiac arrhymias in electrical burn pts Know s/s after pt takes corrosive chemical poison Know treatment for frostbite Know contusion & laceration Know the different types of fractures especially the one that is considered suspicious in abuse situations: In amputation pt, the reason the stump is wraped properly with elastic bandage to shape it in preparation for prosthesis For pts with allergies to insect stings inform them of things to avoid: wearing bright clothing, perfumes, walking barefoot In poison situations know when to have pt vomit and when not to Diets for crohn's disease, diverticulitis and ulcerative colitis Hallmark sign of ulcerative colitis Know what the pt can and can't do with C7 and C4 injury. Know that Buck's traction decreases muscle spasms Know the diet to promote wound healing: Vit C, protein, Iron Know the pathophysiology of Legg-Calve-Perthes Disease Know the s/s of Parkinson's and Huntington's and know how to distinguish between the 2 Know that Myasthenia Gravis is caused from a deficiency of acetylcholine Know the physiology of Myasthenia gravis Know what position the pt should be in when having a seizure: lateral Know that the most important way to prevent seizures is medication compliance Alot of questions on Gout Also, the Seth test and practice exams on this website were very helpful. There were alot of similar questions to the Seth test. I hope this helps you guys out. Love and Hugs~ Colleen STUFF TO KNOW NC6 Things from my test to concentrate on: Gout (tx and meds), Myasthenia Gravis, Rheumatoid Arthritis, Rheumatic Fever, Increased ICP (position, meds, vitals), Burns (vitals, complications, care of grafts), Traction, Casts, Spinal Injuries. Dilantin, Mannitol, tegretol, Gantrisin, Pilocarpine, Isoniazid, Nipride, Colchicine. How HIV/AIDs is transmitted How Gonorrhea causes sterility in females: obstruction of fallopian tubes Therapeutic action of zidovudine (AZT): inhibits or slows replication of virus Most common complication of HIV/AIDS: pneumocystis carinii pneumonia What STD can be tested for by blood: Syphilis A pt with Mononucleosis should avoid damage to what organ: Spleen How is Hep A & C transmitted: A - fecal/oral route, C - blood and body fluids Which healthcare worker is most at risk for contracting Hep C: Phlebotomist What vaccine should you not give a 10 year old immunocompromised pt? What causes jaundice? A lot of questions on TB Know that warm compresses decreases muscle spasms and promotes healing and that cold increases muscle spasms and delays healing What is the first sign of Syphilis? painless chancre What is the hallmark sign of UTI: frequency What should you avoid during the acute phase of PID? Know the purpose of the Mantoux test: test large populations for exposure to TB Med to treat Strep: Penicillin, if allergic then erythromycin Side effects of Isonizid (INH) Know what a macule is Know what Koplik's spots are Know that fatigue is the most debilitating aspect of Mono Know that a sore throat is the most common symptom of a strep infection Know that glomerulonephritis is the complication to strep throat (acute pharyngitis) Know the site on an infant where you would give a HBV Know that you should have tracheostomy equip at the bedside for a pt. with epiglottis Know the causative organism for epiglottitis, meningitis Know symptoms of meningitis: headache, nuchal rigidity, and Kernig’s sign Know that Dilantin causes Hyperplasia of gingiva Know side effects of Penicillin Know that zoster vaccine is used to treat varicella Know that mumps is caused from inflammation of salivary glands Know why smoking predisposes a person to get otitis media Why is Vitamin K given to a pt with Hepatitis? Who is most at risk for Nosocomial infections? Know how you acquire Lyme disease Know that ESR will be elevated in an inflammatory disease such as rheumatoid arthritis or Lupus Know s/s of Lupus: butterfly rash Know s/s of septicemia & septic shock Know s/s of increased ICP What organism causes Rheumatic Fever and Rheumatoid Arthritis? Know to monitor for cardiac arrhymias in electrical burn pts Know s/s after pt takes corrosive chemical poison Know treatment for frostbite Know contusion & laceration Know the different types of fractures especially the one that is considered suspicious in abuse situations: In amputation pt, the reason the stump is wrapped properly with elastic bandage to shape it in preparation for prosthesis For pts with allergies to insect stings inform them of things to avoid: wearing bright clothing, perfumes, walking barefoot In poison situations know when to have pt vomit and when not to Diets for Crohn’s disease, diverticulitis and ulcerative colitis Hallmark sign of ulcerative colitis? Know what the pt can and can't do with C7 and C4 injury. Know that Buck's traction decreases muscle spasms Know the diet to promote wound healing: Vit C, protein, Iron Know the pathophysiology of Legg-Calve-Perthes Disease Know the s/s of Parkinson's and Huntington's and know how to distinguish between the 2 Know that Myasthenia Gravis is caused from a deficiency of acetylcholine Know the physiology of Myasthenia gravis Know what position the pt should be in when having a seizure: lateral Know that the most important way to prevent seizures is medication compliance A lot of questions on Gout Know the difference between 2nd & 3rd degree burns: Complications r/t burns: Know all about the ABT's- esp. the side effects, Know active, passive immunity, etc., Know increased ICP- know everything about it, Know classic signs for comm. diseases as well as the meds, Know super-infections, Know the stages of the diff communicable diseases, Know diff types of spinal fx's and their implications, Know diff kinds of spine deformities- not just scoliosis, had a few on osteoporosis, osteomyelitis, and rheumatoid arth. Know Ms, and M. Gravis very well, Know Huntington's + chorea, Know spinal shock, Know epiglottitis and glomerulonephritis. Know the diff types of traumatic brain injury. Know the diff types of traction. Write out a couple care plans for each Medical Dx- Do peds care plans for the comm. diseases that affect kids the most. DIFF C NOTES THAT I REMEMBER FROM TEST 1) WHERE WOULD YOU NOT GIVE A HBG VACCINE IN INFANT?-vatus lateralis 2)WHAT CAUSES BRADYKINESIA IN PARKINSONS?-dopamine deficiency Drug of choice carbidopa-levodopa(Sinemet) Sx tremors, musle stiffness,rigidity,dementiaPt would have masklike face and shuffling gait. Congentin relieve muscle ridigity and tremors. Monitor for side effects of dry mouth, blurred vision, dizziness, urine retention and glaucoma. ****know the dyskinesias of parkinsons**** extrapyridal effect is caused by degeneration of the parts of basal ganglia. 3)LEGG CALVE PERTHES DISEASE - idiopathic vascular necrosis of the femoral head causing dislocation,flattened femoral head Tx spica body cast.Most common in boys 4-10yrs old . Provide cast care by petaling cast with tape.The joint most commonly affected is the hip. 4)RHINITIS-(cold) a parent needs further teaching if they say they should give antibiotic 5)DUMPING SYNDROME-sense of fullness,weakness,faitness,cramping,diarrhea nsg intervention-following the meal ,lie down for 20-30minutes,avoid fluids except during meals. 6)WHY IS TRACTION USED PREOP FOR A TOTAL HIP REPLACEMENT- to prevent dislocation. use abduction pillow What med is given post op?** What do you tell pt they can not do after hip sugery?? a)sleep with pillow between knees, keep knee together, keep legs internally rotated or semi fowlers? 7)WHAT WOULD MAKE A LUPUS PT FEEL BETTER ABOUT THEMSELVES? see a cosmetologist to cover face rash. pt has a defiency in acetycholine and also should get plenty of rest. Butterfly rash. Nursing Diagnosis-self care deficit. Pt sholud be told to restriict exposure to sunlight to prevent an acute onset of symptoms. 8)LUPUS IS SIMILIAR TO WHAT DISEASE? RA. This pt knows she should get plenty of rest. Lupys pt’s have a defiency in Acetylcholine. 9)WHAT VITALS INDICATE ICP? rising systolic B/P & slowing of pulse rate. You can tell that an infant has Icp by bulging fontanels 10)FAT EMBOLI-S/sx sudden respiratory distresss and restlessness.Common in femur fractures 11)PENDROSE DRAIN-EFFECTIVE APPLY GAUZE AROUND AND OVER DRAIN? 12)LYME DISEASE-looks like a rash, carried by tick S/sx include “bulls eye” rash. ESR increased in early disease.Tetracycline is treatment of choice.Pt’s should be taught to never take the medication with milk or dairy products or vitamins with iron. 13)HEP A **EARLY SYMPTOMS**, What causes jaundice in hep A? bile salts deposited on skin. -contracted through fecal oral route * are hep A pts placed on enteric isolation? likely to be found in whole blood, semen, potato salad. What symptoms are found in ictal phase but not in post itcal ? dark colored urine and clay colored stools. 14)MENIGITIS-PORTAL OF ENTRY OF -AN INFLAMATION OF THE MENINGES, CAUSED BY THE SPREAD OF DROPLETS; ORGANISMS ENTER THE BLOOD FROM THE NASOPHARYNX OR THE MIDDLE EAR. Can be a complication of severe pharyngitis. NOTE FOR sEIZURES,OPISTHOTONOS (SPASMODIC BODY POSTURING IN WHICH THE BACK ARCHES AND THE HEAD AND THE HEELS BEND BACK) NOTE THAT A LUMBAR PUNCTURE WILL SHOW INCREASED CSF PRESSURE. ISOLATE THE CHILD FOR AT LEAST 24HRS, PROVIDE A DARK ENVIRONMENT, KEEP THE CHILD FLAT IN BED,INSTITUTE SEIZURE PRECAUTIONS. The spinal fluid would show increased WBC’s, decrease glucose, increase protein.***what would you do in an accute attack? b)s/s aura? 15)POST OP HIP FX- WHAT KIND OF SPLINT IS USED?abduction pillow b)most common contracture after hipfx c)sign of dislocation? internally rotated - shorter or longer extremity 16)SOMANELLA-(typhoid fever) carried in the human feces and transmitted through sewage, flies, and shellfish. 17)MS- patho ?chronic , degenerative, progressive,disease of CNS with small patches of demyelination in the brain and the spianl cord. S/sx- weakness,loss of balance, visual disturbances,ataxia ,tremors- Diet high calorie, hi protein, hi vitamin, low fat 18)RISK FOR POST OP OBESE PT-overweight pt is at increased risk for complications because lack of blood supply common in adipose tissue impedes wound healing process. 19)SEIZURES-place pt in lateral side. dilantin used to control. Status epilepticus is defined as seizures which? 20)RHEUMATIC FEVER-usually follows strep throat, ( mediciation for strep is penicllin ) increases wbc’c,increased ESR, bedrest S/sx weakness,rapid muscle movements,,facial grimaces, the best activity for a child with rf is checkers because it will reduce the workload of the heart. Possible long term effects -heart valve damage 21)RUBEOLA MEASLES-most effective prevention is vaccination.S/sx fever, nasal discharge, cough,rash from head to toe, KOPLICKS SPOTS- grayish white forming on mucosa.The nursing diagnosi most appropriated is knowledge realated to compliance with the immuninization schedule. 22)OSTOMY MOST LIKELY CAUSE EXORIATION, ileostomy is an artificial opening in the small bowel wall. 23) ZOSTER IMMUNE GLOBULIN- used to stimulate an immunity to varicella. 24)WHY DO PTS EXPERIENCE PURITIS IN HEP BURNS*********** what do you watch for in a pt with electrical burn? cardiac arrhythmias. why do you use mannitol in electrical burns? 25)POSITION FOR BURN PT-arms extended WHAT IS 1ST DEGREE BURN? TX? WHAT IS 2ND DEGREE BURN AND TX? PT WITH SECOND DEGREE BURN PRIORITY IS VENTILATION Routine tx of 2nd degree burn (partial thickness) includes daily wound cleansing with debridement and sterile dressing FOLLOWING A FULL THICKNESS SKIN GRAFT THE IMMEDIATE POST OP CARE IS TO COVER THE SITE WITH BULKY OCCLUSIVE DRESING. WHAT IS A HOMOGRAFT and why is it used? CURLINGS ULCER IS BLACK TARRY STOOLS PT IN HYPOVOLEMIC PHASE FOLLOWING INJURY DUE TO HYPERKALEMIA 26)STEIMAN PIN WHATS NORMAL AND ABNORMAL? 27)PATHO FOR GULLAIN BARR SYNDROME watch for resp distress 28)WHY IS IT IMPORTANT TO GIVE PENICILLIN AT SCHEDULED TIME? 29)WHY DO SCHOOL CHILDREN GET UTI’S ? ENURESIS-incomplete emptying of the bladder 30)DIVERTICULOSIS?-increased bowel sounds,llq crampy pain,tx high fiber diet,high residue. Avoid nuts,corn and fruit w/seeds alternating diarrhea and constipation, flatus, and abdominal distention. 31)ANTICHOLINERGIC- (atropine) is given prior to surgery to dry up secretions in nose and respiratory track. and gastric secretions 32) Rubella - most at risk if exposed is the unborn fetus. German measles, mild, Variable rash begins on face spreads to entie body. 33)CEREBRAL ANGIOGRAM- PT FEELS NUMBNESS AND TINGLING. nurse would document vascular occlusion secondary to procedure. 34)SIDE EFFECTS OF CORTICOSTEROIDS 35)SPINAL INJURIES C5,C7,C6,C4 know bladder and bowel control. WHICH LEVEL LEADS TO AUTONOMIC DYSREFLEXIA? A)C4 IS QUAD OR PARAPLEGIC? b)pt with c7 injury can still move head and neck mucsle C)which would cause respiratory problems? 36)LOOK UP CVP-over 20 is overhydration 37)HOMONYMOUS HEMIANOPSIA WHERE DO YOU PLACE OBJECTS? on affected side 38)ERYTHROCYTE SEDIMENTATION RATE?-a non- specific test used to detect inflammatory,neoplastic,infectious,and necrotic processes. The test measure the distance in milliliters that RBC’s descend in normal saline in one hour.Pathologic conditoins increase the protein content of plasma. RBC”s have a tendency t o stack up on each other , increasing their weight and causing them to decsend faster. Therefore the ESR will be increased. Normal male findings are up to 15mm/hour and in females up to 20mm/hour. The ESR is fairly accurate regarding the presence of pathologic conditions when vague symptoms are present. what disease increase the ESR? 39)HAEMOPHILUS INFLUENZA- this shot would be contraindicated in the 16 year old patient on steroids b)notify doctor immediately if pt on steroids has . epigastric pain? 40)CHILD CHOREA-ACTIVITY-lower motor neuron disease may cause various abnormal movements. Discrete , jerky, ourposeless movements seen in the distal extremities and face.Diversional activity would be watching tv. 41)A SLOW INSIDIOUS PROGRESSIVE HEARING LOSS IS USUALLY CAUSED BY OSTOCLEROSIS 42)SS ULCERATIVE COLITIs - causes more blood loss than chron’s disease duodenal ulcer should heal by third intention *diet* what food would be ok? s&s”s 43)MUMPS-SWELLING OF PAROTID AND OTHER SALIVERY GLANDS-spread through fecal-oral route, usually by the ingestation of infected foods or liquids. 44)GLOMERULONEPHRITIS- AFTER A STREP INFECTION.A finding consistent with chronic glomerulonephritis is hypokalemia and pr has hypoalbuminemia. This pt should be encouraged to eat a low sodium,high calorie, low protein diet. what are sins and sypmtoms of strept? 45)SHINGLES-HERPES ZOSTER VIRUS- apply cool wet dressing is the most effective . This is manifested by lesions on one side of the neck and trunk.This is thought to be a reactivation of the organism causing chicken pox. 46)PIN WORMS-cellophane tape collects ova and worm. SIGNS AND SYMPTOMS 46)MALIGNANT HYPERTHERMIA- 47)WOUND HEALING 3 STAGES- 48) CHRONS-INFLAMMATORY BOWEL DISEASE. INCREASED BOWEL SOUNDS.DIET AVOID MILK,FATTY FOODS, AND SPICES. NO HIGH FIBER FOODS, CAFFIENE,OR CARBONATED BEV, The most definitivediagnostic test is a biopsy. RLQ PAIN, LOW RESIDUE DIET 49) CYSTITIS-MEDS WORKING IF. signs and symptoms =pyuria 50)SIDE EFFECTS OF CORTICORSTEROIDS 51)LOOK UP GLAUCOMA, DETACHED RETINA,CATARACTS- Cataracts is a common cause of gradual vision loss caused by opacity of the lens capsule of the eye. Cataracts commonly affect both eyes but each cataract progresses indendently. Surgery restores vision in about 95% but without surgery, eventually will result in complete visoin loss. Clinical Manifestations- Blinding glare from headlights when driving at night, poor reading vision, and glare in bright sunlight. Inspection reveals a milky area behind the pupil with advanced cataracts. Specific post op instructions include application of an eye shield or patch as oreder, instillation of eye drops, advise against activities that increase intraocular pressure, such as straing with cough, bowel movement or lifting: rubbing the affected eye: and bending at the waist, avoid laying on stomache, sneezing, and bedrest immediately post op.What woul be cause for concern after this surgery and would be something to call doctor for.? WHICH SIDE SHOULD POST OP LAY ON? bedrest and prone Detached Retina - retina tears or holes rarely heal spontaneously. Sx-floating spots, recurring light flashes, vision deteriorates to looking through a veil or curtain.**result of detached retina**?sensation of a veil in the line of sight. Glaucoma-- gradual loss of perpheral vision.open angle is asymptomatic: vision loss is major late sx.angel closure s/sx pain halo vision, blurred vision, redness, and change in eye appearance. Tx- decrease production of aqueous humor with timolol. Miotic dilates pupil which promotes aqueous humor output. a)WHAT IS THE ACTION OF nEO-SYNEPHRINE FOR EYE SURGERY? dilation 52)READ ABOUT CHICKENPOX-CAN BE FATAL IF WHAT MEDS ARE TAKEN?-ASA REYES SYNDOME CAN ALSO OCCUR. HIGHLY CONTAGIOUS FROM 2 DAYS BEFORE THE APPEARANCE OF A RASH TO 6 DAYS AFTER. THE INCUBATION PERIOD IS 21 DAYS. THE RASH BEGINS ON THE TRUNK. THE SCABS ARE NOT CONTAGIOUS AND THE CHILD MAY RETURN TO SCHOOL WHEN ALL OF THE LESIONS HAVE SCABBED. 53)Meniere’s Disease-limit head movements,ice pack to forehead s/sx hearing loss,n/v, pressure/fullness in the ear. *complaint of headache, verigo,tinnitus.Get up slowly and do not drive. Dizziness is expected. *pt is having an increase amount of?.* 54)MYASTHENIA GRAVIS-causes muscle weakness and fatigue, which may lead to decreases pulmonary ventilation. Ineffective breathing pattern is a priority nursing diagnosis since oxygenation is a basic vital function to survival. Complications from weakness and fatigue may lead too impaired physical mobility and skin integrity. Excessive muscular weakness, easy fatigabililty, diplopia and ptosis and a sleepy, masklike expression are symptoms. The most common medication is pyridostigmine steroids, mestinon, prostignin. WHAT IS THE DIAGNOSTIC TEST?tensilon test.Pt should be instructed to do physically demanding activities in the morning.DECREASED ACETYLOCHOLINE RECEPTORS IN MYASTHENIA GRAVIS. DISCHARGE TEACHING**** ???Why giveis it important to give Neostygmine bormide on time to this pt? 54)DUODENOL VS PEPTIC ULCERS peptic ulcer occur in pyloric area of the stomach UQ. duodenal ulcer-s/s, cause and diet duodenal ulcer wounds heal by third intention 55)PLUMBISM AFFECTS WHICH BODY SYSTEM? neurolic intellectual damage. Most common source is lead paint, soil,dust or drinking water with lead.**sypmtoms** 56) look up sepTIC SHOCK S/S , VS caused by gram negative bacterial.(Uti, Catheters) Low BP, warm skin. 58)MRI- magnetized patient tissue generates a weak electomagnetic signal that is mapped for visualization. Provides contrast between various tissues that is more detailed than CT scan or xray. Pt should be advised to remove jewelry .Motor function is affected Pt lie flat on a platform which moves through a magnetized tube. 59)-Electroencephalogram (EEG)- a graphic recording of the electrical activity of the brain. It is diagnostic for seizure disorders to determine the focus of the dysfunction and may also be helpful in the determining the size and location of cerebral infarts. 60)Xray- Shows the postion of normal structures and the displacement of and presence of abnormal shadows. Xray procedures may be combined with use of contrast media such as barium to provide better visualization of abnormal structure and function 61)Radionuclide Bone Scan: An intravevanous injection of radioistotope is administered. The scan visualizes bone in ways which normal radiographic studies cannot since areas of disease generally absorb greater amounts of the radioactive isotope. 62)Electomyograph (EMG)- a recording electrode is placed into a muscle to monitor electrical activity. EMG is used to detect primary muscular disooorders along withh muscular abnormalities caused by other system diseases such as nerve dysfunction. 63)Mononucleosis-the organsim thought to be responsible is Epstein- Barr virus. These Pt’s should avoid strenous activity because the spleen can easily suffer damage. 64)Otitis media- COMMON IN INFANTS BECAUSE THE EAR CANAL IS SHORTER AND LESS ANGELED. NOTE THAT INFANTS PULL ON THE EAR WHEN IN PAIN. ASSESSS FOR RED TYMPANIC MEMBRANE. REMEMBER TO PULL EAR DOWN AND BACK WHEN ADM EARDOPS TO INFANTS.OTTIS MEDIA CAN CAUSE CONDUCTION DEAFNESS B)HEARING LOSS/ CONDUCTIVE OR NEUROSENSORY C)OTOSCLEROSIS-CONDUCTIVE HEARING LOSS. sOUND INTERRUPTED AS IT TRAVELS FROM THE EXTERNAL CANAL TO THE INNER EAR. cAUSED BY SLOW FORMATION OF SPONGEY BONE IN THE AREA WHERE THE INNER EAR BONES CONDUCT SOUND WAVES. SX-SLOW PROGRESSIVE HEARING LOSS, TINNITUS, HEAR CONVERSATION BETTER IN NOISY ENVIRONMENT. 65)LABS TO INDICATE LOSS OF FLUIDS FROM BURNS-INCREASED K,DECREASED Na,INCREASED HEMOGLOBIN AND HEMATOCRIT,METABOLIC ACIDOSIS 66) ESCHAR IS BEST DESCRIBED AS NECROTIC SLOUGH 67)FOR A PT WITH CARBON MONOXIDE POISONING, WHAT SKIN COLOR WOULD YOU INITIALLY EXPECT TO FIND? CHERRY RED 68)FOLLOWING A 2ND DEGREE BURN, WHICH FOOD IS RECOMMENDED? MEAT,CITRUS, FRUIT,MILK 69)SX SPINAL SHOCK- 70)CAT SCAN-****look up. tell child before catscan to lay still while big machine takes picture. 71) ROCKY MOUNTAIN FEVER- CLASSIC SIGN- joint pain, muscle pain and a white covering on tounge. ASK PATIENT “HAVE YOU BEEN TO WOODS LATELY? 72)IMMUNIZATION CONTRAINDICATED 73)lUMBAR PUNTURE- MOST COMMON S/E IS HEADACHE, TO BE MANAGED WITH BEDREST, HYDRATION, ANALGESICS, AND DECREASED ENVIROMENTAL STIMULI. ANALYSIS OF CSF- WBC ARE ABNORMAL AND INDICATE INFECTION. 74)CVP OF 3 INDICATE? HYPOVOLEMIC SHOCK? 75)CVP OF 18 INDICATE OVERHYDRATION 76)Aceteminophen Poisoning- symptoms vomitting, decreased urinary output, pallor, weakness, slow weak pulse,sweating. Induce vomitting with ipecac syrup which is followed by water and adm antidote (acetlcysteine) ***1st intervention of overdose in ped pt**** 77)Salicylate toxicity and poisoning- ringing in the ears, dizziness, disturbances of hearing and vision, delirium. Theraputic interventions- activated charcoal and gastric lavage Never induce vomitting with corrosives or petroleum poisoning.(LYE) 78)Cholecystitis- inflammation of the gallbladder diet-low fat, low cal, high protein, high carb diet. gall bladder pain pain is commonly felt in the right quadrant, between the shoulder blades and trunk, and in the chest. cause stone in the duct. Pt is taking vit K to minimize bleeding, itching, and jaundice. Durning discharge instructions should be told to report immediately if there is leakage aroung the tube. 79) what is the best diagnosis for TB in AIDS pt ? b)how would you know if aids pt develop supra ifection? 80)Scoliosis - what are the physical findings? 81)HYPOVOLEMIA & HYPOVOLEMIC SHOCK 82)GASTROENTERITIS- 83)METHODS OF OBTAINING IMMUNE PROTECTION- 84)cause of thrush in 3 day old infant. 85)Ssx smoke inhalation? 86)Do sex partners of pt with candidiasis have to be treated? 87)post op amputation tx- do you treat phantom pain and wITHt statement indicates acceptance of amputation? 88)Gonorrhea- patho- what causes streility. Medication used is flagyl 89)tetracycline should never be taken with any mineral preparation such as vitamins with iron or with any dairy products. 90)pt with frostbite should have a bed cradle 91)what is the first thing you do when a pt has a heat stroke? 92) cyst- macule,papule ‘93)VACINATIONS*************** *MMR vacination- ask parent if child is allergic to eggs or chicken feathers *give MMR to a child via Z track technique. 94)what age do children get pertussus vaccine?- NEVER GIVE AFTER AGE 6 BECAUSE OF INCREASD RISK OF HYPERSENSITVITY AND ADVERSE REACTIONS. 95)natural immunity vs passive immunity*****defintly examples on exam b)unborn fetus is most at risk for exposure to Rubella c)a ten year old may be vaccinated with oral polio, rubella, mumps, except for PERTUSSIS. d)Three day old baby acquired IgG immunoglobin prior to birth. e)immunization contraindicated in immune suppressed person? (HIV) inactivated polio virus vaccine or trivalent polio vaccine? 96)how does herpes2 survive? spores r in the vaginia? 97)herpes zoster is caused by Varicella virus and in an adult is thought to be caused by reactivation of the organism that causes childhood disease chickenpox. 98)what is difference between herpes zoster, shingles & simplex? 99)what would you offer (not Rx) to your patient to help with symptomsss of diplopia? 100) postion after craniotomy- supine with head slightly up, place on affected side, away from affected side with head extended 101)how can a nurse protect herself in the collection of a sputum sample?. 102)what is the position after a craniotmony?? fowlers with a pillow under the sholuder. 103)Who has the best prognosis for healing? 6yr old in bucks traction or 26yr old complete leg cast? 104) Reye’s syndrome is caused by a virus, Reye’s syndrome can cause mental status changes due to an increase in Ammonia. 105) Lanoxin can cause yellow vision 106)HEMATOPETIC radiation would most likely to produce thromboctopenia. 107)isomestric ROM- 108)Malnourished pt going to surgery need to be on a high protein diet. 109) what test confirms joint disease? 110)know glasgow coma score 111)skeletal traction- read chapter-traction applied directly to the bone. How do you maintain the effectiveness of skeletal traction? 112)Newborn infnant with cocaine addicted mother would most likely show irritability , respeiratory alkalosis, HYPERCUSUA, rhinnorhea 113)pt with inadequate bowel length needs to have lifelong vitamin b12 114)Symtoms of hemmorohegic shock are restlessness, hypotension, decreased in hematocrit. 115)Anaphalactic shock: when given rubella vaccine because:allergy to eggs. If a child is restless and crying, or awke & somewhat cyanotic or awake alert & no cyanosis. 117) Alterations in magnesium can cause toxic shock syndrome. 118)complication of severe pharngitis? what signs would indicate worsening difficulty swallowing or hoarseness 119)TB AFB culture is used to confirm diagnosis inh and rampi 120)UTI’S - S&S”s-- enureis, oliguria, polyuria, anasarca what is the best med used? 121)autonomic dysreflexia- cause? plan of care, reduce environmental stimuli. S&S’s 122)pyelonephritis- S&S’s WHAT IS THE CHARACTERISITC OF URINE? FISHY 123)Huntinton’s disease- rare abnormal heriitary condition characterized by progressive chorea and mental deterioration. Usually sighns are shown between 35-45 and dies within 10-15 years. Pt’s usually die from heart failure, pneumonia, infection,or choking. Involuntary abnormal, nearly constant movement that involves the whole body accompanied by a decline in mentation . The primary goal is to maintain indepence as long as possible. 124)s 125)crutch teaching a)3 point gait b)2 point gait 126) increased urine specific gravity is most frequently caused by dehydration. 127) Sammonellosis- most likely caused from? nursing dx? 128)aphasia 129)apraxia 130)positions for transpheniod- 131)reason for ROM in pt with aka 132)Paget’s disease- disorder of localized rapid bone turnover usually skull, femur,tibia, pelvic bones and vertebrae. Disorganized pattern of bone develops that is structurally weak. Sx- bowing of legs, arthritis and pain. Xray. Glascow coma scale S/S superinfection of AIDS amt of immunization to give in preemie physio of infertility of gonorrhea spleen problems with mono Koplik spots with rubeola clinical manifest of rhuematic fever clinical manifest of epiglottitis proper tech for collection of sputum cx be prepared to trach or intubate with epiglottitis strep and glomerulonephritis spinal cord injuries Salmonella why bedrest for pnuemonia Hep A,B,C wound eviseration position for post op appy pt s/s cystitis Lyme disease menegitis s/s corrosive poisoning chemical burn and what to do Bucks traction follow ipecac with tepid water what does activated charcoal do safety for child with poorly controlled seizures mineres disease ALS MS and meds given s/s lead poisoning IBD Chrons and ulcerative colitis Lupus s/s low albumin don't give live vaccine to immunosupressed TB Kernigs sign singed nose hairs signs of inhalation burn compartment syndrome meds for peptic ulcer curlings ulcer wound healing by 3rd intention nutrition for burn patients signs paralytic ilius after abd surgery scolosis osteoporosis Legg-Calve-Perthes disease myasthenia Gravis Parkinsons s/s increased ICP and vs for s/s hydrocephalis Homans sign Guillain Barre syndrome post myelogram with contrast medium increase fluids Jackson Pratt drain s/s bacterial pharyngitis s/s autonomic dysreflexia Penrose drain left and right hemiparesis fat embolosim hypovolemic shock child with chorea diversional activity why does adipose tissue not heal well I passes Nc6 with a B, i dont know how. That was a very difficult test, i felt like i was guessing alot.Helpful tips: Know all about burns scoliosis osteoporsis Legg-calve-perthes disease Ms osteoarthritis Parkinsons MG- atropine antidote Huntingtons- S&S seizure precautions S&S- increase ICP adult- widening pulse pressure and children- vomiting Glosgow coma scale General anesthia wound healing- phase 2&3 wound debridement amputations poisoning with gasoline- use gastric lavage Diagnose aids with Elisa Herpes- wear cotton underwear How to properly get sputum sample Strep and glomerulonephritis polynephritis Kernigs sign varicella- zoster virus epiglottitis- intubation tray And S&S Hep A Shigellosis pinworms nosocomial inf meningitis Rheumatic fever Appendicitis Chrohns and diverticulitis alot on diets Lupus Hernias inguinal expect scrotal swelling peptic ulcer disease- diet Fat embolism scleroderma steroids Alot on nursing process and priority questions alot on teaching

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Journal of Geodetic Science Instructions for Authors 1. About Journal of Geodetic Science (JGS) is an international journal devoted to the rapid publication of works of wide significance, originality and relevance in all areas of Geodesy. JGS reflects the full breadth of research in theoretical and applied Geodesy, represented by diverse sections: Physical Geodesy, Mathematic

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The role and source of 5P-deoxyadenosyl radical in a carbon skeletonrearrangement catalyzed by a plant enzymeSandrine Ollagnier, Eric Kervio, Jaènos Reètey*Lehrstuhl fuër Biochemie, Institut fuër Organische Chemie, Universitaët Karlsruhe, Kaiserstr. 12, D-76128 Karlsruhe, GermanyReceived 15 August 1998; received in revised form 24 September 1998Abstract The last step in the biosynthesi

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