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HESI®-RN Comprehensive Review | Registered Nurse (RN) School Study Aid
Down Syndrome
- Pathophysiology
- Trisomy 21
- Meiotic Nondisjunction
- Signs and Symptoms
- Intellectual Disability (Mental Retardation)
- Single palmar crease
- Flat Facies
- Duodenal Atresia
- Hirschsprung's Disease
- Septum Primum Type ASD
- Endocardial Cushion Defects
- Prominent Epicanthal Folds
- Increased Risk of Acute Lymphoblastic Leukemia
- Alzheimer's Disease
3 mins
Airway, Breathing, Circulation (ABC's)
- Airway Assessment
- Changed Sound of Voice
- "See-saw" Respirations
- Stridor
- Breathing Assessment
- Normal Respiratory Rate: 12–20 Breaths/Min
- Use of Accessory Muscles in Respiration
- Cyanosis
- Circulation Assessment
- Color of Hands and Digits
- Normal Capillary Refill Time (CRT): 2 Seconds
- Decreased LOC
- Considerations
- Initial ‘Look, Listen and Feel” Assessment
- Emergency Treatment
- Prioritization in Exam Questions
5 mins
Cerebral Palsy (CP)
- Cause/Mechanism
- Maternal Infections
- Fetal Hypoxia
- Assessment
- Developmental Delay
- Neurological Dysfunction
- Spasticity
- Dysphagia
- Interventions
- Muscle Relaxants
- Muscle Exercises
- Assistive Devices
- Braces
2 mins
Phenytoin (Dilantin)
- Mechanism
- Blocks Na+ Channels
- Indications
- Tonic-clonic Seizures
- Side Effects
- Ataxia
- Nystagmus
- Sedation
- Gingival Hyperplasia
- Purple Glove Syndrome
- Hirsutism
- Rash
- Anemia
- Considerations
- Individualized Dosing
2 mins
Diazepam (Valium)
- Indications
- Anxiety
- Seizures and Status Epilepticus
- Muscle Spasms
- Alcohol Withdrawal
- Side Effect/Assessment
- Dizziness/Vision Changes
- Confusion/Amnesia
- Urinary Incontinence
- Behavioral Changes
- Respiratory Depression
- Antidote
- Flumazenil (Romazicon)
- Nursing Considerations
- Fall Precaution
- Do Not Stop Abruptly
2 mins
Phenobarbital (Barbiturates)
- Mechanism
- Barbiturate
- Indications
- Seizures
- Side Effects
- Ataxia
- Paradoxical Excitement
- Fatigue/Drowsiness
- Considerations
- Monitor Plasma Levels
- High Potential for Abuse
1 min
Valproic Acid (Depakote)
- Mechanism
- Blocks Na+ Channels
- Increases GABA Concentration
- Indications
- Tonic-clonic Seizures
- Bipolar Disorder
- Migraine Prophylaxis
- Side Effects
- Hepatotoxicity
- Blood Dyscrasias
- GI Distress
- Tremor
- Pancreatitis
1 min
Carbamazepine (Tegretol)
- Mechanism
- Inactivates Na+ Channels
- Indications
- Seizures
- Bipolar Disorder
- Trigeminal Neuralgia
- Side Effects
- Nystagmus
- Ataxia
- Hepatotoxicity
- Blood Dyscrasias
- Water Retention
- Stevens-Johnson Syndrome
- Considerations
- Avoid Grapefruit Juice
2 mins
Lamotrigine (Lamictal)
- Mechanism
- Blocks Na+ Channels
- Indications
- Seizures
- Bipolar Disorder
- Side Effects
- Diplopia
- Stevens-Johnson Syndrome
- Headache
- Aseptic Meningitis
- Nausea and Vomiting
- Considerations
- Screen for Suicide Risk
2 mins
Long-acting Benzodiazepines
- Drug Names
- Lorazepam
- Diazepam
- Clonazepam
- Chlordiazepoxide
- Indications
- Insomnia
- Anxiety
- Seizures
- Eclampsia
- Alcohol Withdrawal
- Considerations
- Half-life > 24 Hours
- Dependence
3 mins
Attention-Deficit Hyperactivity Disorder (ADHD) Assessment
- Assessment
- Inattention
- Incomplete Tasks
- Easily Distracted
- Hyperactivity
- Impulsiveness
- Disruptive
- Considerations
- Two Areas of Life
- Onset by Age 12
- Symptoms > 6 Months
3 mins
Attention-Deficit Hyperactivity Disorder (ADHD) Interventions
- Drug Therapy
- CNS Stimulants
- Amphetamine
- Methylphenidate
- Bupropion (Wellbutrin)
- Atomoxetine (Strattera)
- Guanfacine (Intuniv)
- Considerations
- Manage Disruptive Behavior
- Provide Simple Instructions
2 mins
Spina Bifida Assessment
- Cause
- Congenital Malformation of Vertebrae
- Assessment
- Dimple With or Without Hair Tuft
- Lumbar Sac
- Hydrocephalus
- Paralysis
- Considerations
- Identify Type
2 mins
Spina Bifida Interventions
- Surgery
- Prone Position
- Cover Sac with Moist (Sterile) Dressing
- Measure Head Circumference
- Bulging Fontanel
- Considerations
- Other Congenital Malformations Common
- Bowel Control
- Neurogenic Bladder
2 mins
Hydrocephalus
- Cause
- Increased CSF in Ventricles of Brain
- Assessment
- Signs of Increased ICP
- Infant Assessment
- High Pitched Cry
- Irritability
- Opisthotonus
- Increased Head Circumference
- Bulging Fontanel
- Setting Sun Sign
- Interventions
- Seizure Precautions
- Elevate HOB
- CSF Shunt
2 mins
Meningitis Assessment
- Assessment
- Nausea and Vomiting
- Fever
- Nuchal Rigidity
- Severe Headache
- Purpura
- Seizures
- Photophobia
- Infants and Young Children
- Opisthotonus Position
- High-Pitched Cry
- Bulging Fontanel
2 mins
Meningitis Interventions
- Drug Therapy
- IV Antibiotics
- Dexamethasone
- Analgesics
- Antipyretics
- Considerations
- Closely Monitor for Increased ICP
- Bed Rest
- Preventative Vaccinations
- Droplet-Airborne Precautions
2 mins
Common Causes of Meningitis: Newborn (0-6 Months)
- Group B Streptococci
- E. coli
- Listeria monocytogenes
1 min
Common Causes of Meningitis: Children (6 Months - 6 Years)
- Enteroviruses
- Neisseria meningitidis
- Haemophilus influenzae Type B
- Streptococcus pneumoniae
2 mins
Types of Seizures
- Tonic-Clonic
- Tonic
- Clonic
- Absence (Petit Mal)
- Myoclonic
- Atonic
- Partial (Focal) Seizure
- Focal Aware (Formerly Called Simple Partial)
- Focal Impaired Awareness (Formerly Called Complex Partial)
3 mins
Seizure Interventions
- Maintain Airway
- Side-lying Position
- Support Head
- Move to Floor
- Benzodiazepines
- Considerations
- Never Restrain
- No Objects in Mouth
- Document Details
2 mins
Seizure Precautions
- Reduce Environmental Stimuli
- Identify Triggers
- Aura
- Pad Side Rails
- Bed Lowest Position
- Oxygen and Suction Available
- Consideration
- Monitor Therapeutic Drug Levels
2 mins
Gabapentin
- Primary Indication
- Seizure Treatment
- Secondary Indications
- Peripheral Neuropathy
- Postherpetic Neuralgia
- Bipolar Disorder
- Migraine Prophylaxis
- Characteristics
- Inhibits Voltage-Gated Ca2+ channels
- Designed as a GABA Analog
- Side Effects
- Ataxia
- Sedation
2 mins
Topiramate
- Indications
- Seizure Treatment
- Migraine Prophylaxis
- Mechanism of Action
- Increase GABA Action
- Blocks Voltage-Gated Na+ Channels
- Side Effects
- Kidney Stones
- Weight Loss
- Sedation
1 min
Ethosuximide (Zarontin)
- Indications
- First Line Absence Seizure
- Mechanism of Action
- Blocks Thalamic T-Type Ca2+ Channels
- Side Effects
- Stevens-Johnson Syndrome
- Fatigue
- Diarrhea
- Blood Dyscrasias
- Considerations
- Do Not Stop Abruptly
2 mins
Streptococcus Pneumoniae Disease
- Signs and Symptoms
- Sickle Cell Anemia
- Sepsis in Patients with Splenectomy
- Rusty Sputum
- MOPS
- Meningitis
- Otitis Media
- Pneumonia
- Sinusitis
2 mins
Streptococcus Pneumoniae Characteristics
- Characteristics
- Gram-Positive
- Diplococci
- Lancet-Shaped
- Catalase-Negative
- Optochin-Sensitive
- Bile Soluble
- Alpha-Hemolytic
- Polysaccharide Capsule
- Positive Quellung Reaction
- IgA Protease
1 min
Neisseria Meningitidis
- Characteristics
- Gram-Negative
- Diplococci
- Chocolate Agar
- Thayer-Martin Media
- VPN
- Oxidase-Positive
- Maltose Fermentation
- Glucose Fermentation
- Endotoxin
- Lipooligosaccharide (LOS) in Membrane
- Polysaccharide Capsule
- IgA Protease
- Disease
- Waterhouse Friderichsen Syndrome
- Adrenal Insufficiency
- Petechial Rash
- Treatments
- Ceftriaxone
- Rifampin Prophylaxis
5 mins
Streptococcus agalactiae
- Characteristics
- Group B Streptococci
- Gram-Positive
- Cocci
- Beta-Hemolytic
- Bacitracin-Resistant
- Catalase-Negative
- Pyrrolidonyl Arylamidase (PYR) Negative
- Polysaccharide Capsule
- Hippurate Positive (+)
- Produces CAMP Factor
- Enlarges Area of Hemolysis by S. aureus
- Disease
- Mainly in Babies
- Meningitis
- Pneumonia
- Sepsis
- Colonizes Vagina
- Treatment
- Screen Pregnant Women at 35-37 Weeks
- Penicillin
3 mins
Haemophilus Influenzae Disease
- Disease
- Pneumonia
- Cherry Red Epiglottitis
- Meningitis
- Otitis Media
- COPD Exacerbation
- Thumbprint Sign (on X-ray)
- Treatment
- Rifampin Prophylaxis
- Ceftriaxone
2 mins
Haemophilus influenzae Characteristics
- Characteristics
- Gram-Negative
- Coccobacilli
- PRP Capsule in Type B
- Positive Quellung Reaction
- IgA Protease
- Chocolate Agar
- Factor V is NAD
- Factor X is Hematin
- Staph Aureus Provides Factor V
2 mins
Listeria Monocytogenes Disease
- Signs and Symptoms
- Soft Cheese
- Pregnant Women Have Flu-Like Symptoms
- Pregnant Women Have GI Symptoms
- Granulomatosis Infantiseptica
- Spontaneous Abortion
- Meningitis
- Monocytes in CSF
- Treatment
- Ampicillin
2 mins
Listeria Monocytogenes Characteristics
- Characteristics
- Gram Positive
- Bacillus
- Intracellular
- Survives in Cold Temperature
- Actin Rocket
- Tumbling Motility
- Catalase-Positive
- Beta-Hemolytic
- Only Gram-Positive with Endotoxin-Like Structure
2 mins
Common Causes of Meningitis: Adolescent and Adult (6 - 60 Years Old)
- Enteroviruses
- Herpes Simplex Virus (HSV)
- Neisseria meningitidis (#1 Cause in Teens)
- Streptococcus pneumoniae
1 min
Common Causes of Meningitis: Elderly (60+ Years Old)
- Streptococcus pneumoniae
- Gram-Negative Rods
- Listeria Monocytogenes
56 secs
Lumbar Puncture
- Indications
- CSF Sample
- CSF Pressure
- Considerations
- Empty Bladder
- Side-lying Position
- Between 3rd and 4th Lumbar Vertebrae
- Number Tubes
- Supine Position After Procedure
- Contraindications
- Increased ICP (Intracranial Pressure)
- Infection at Puncture Site
2 mins
Ampicillin and Amoxicillin
- Mechanism
- Aminopenicillin
- Broad Spectrum Penicillin
- Indications
- Gram-Positive and Some Gram-Negative Infections
- Side Effects
- Rash
- Diarrhea
- Considerations
- No Effect Against Staph Aureus
- Often combined with Beta Lactamase Inhibitor
- Allergic Reaction
2 mins
Reye's Syndrome
- Cause
- Aspirin (Salicylates) to Treat Viral Illness (In Children)
- Assessment
- Cerebral Edema
- Lethargy (Decreased LOC)
- Vomiting
- Liver Failure
- Interventions
- Monitor for Increased ICP
- Mannitol (Osmitrol)
- Considerations
- No Aspirin for Children
2 mins
Aspirin (Acetylsalicylic Acid)
- Mechanism
- Inhibits Platelet Aggregation
- NSAID
- Indications
- Thrombotic Event Prevention
- General Pain
- Inflammatory Conditions
- Fever
- Side Effects
- Pancytopenia
- GI Ulcers
- Bleeding
- Considerations
- Withhold Before Surgery 7-10 Days
- Reye's Syndrome
2 mins
Aspirin Poisoning (Salicylism) Assessment
- Early Symptoms
- Nausea and Vomiting
- Tinnitus
- Confusion
- Hyperventilation
- Respiratory Alkalosis
- Late Symptoms
- Metabolic Acidosis
- Coma
- Hyperthermia
1 min
Muscular Dystrophy
- Mechanism
- X-linked Recessive
- Signs and Symptoms
- Muscle Weakness
- Motor Problems
- Gower Sign
- Large Calves
- Waddling Gait
- Loss of Ambulation
- Consideration
- Cardiac and Respiratory Failure
2 mins
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