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NCLEX-RN® Test Plan: Client Needs | Registered Nurse (RN) School Study Aid
Hemoglobin
- Hemoglobin Has Four Iron Hemes
- Lots Of Hemoglobin In Red Blood Cells
- High O2 Levels Increase O2 Binding
- High Temperature Reduces O2 Binding
- High CO2 Levels Reduce O2 Binding
- Low pH Reduces O2 Binding
- Myoglobin Binds Oxygen in Muscle
2 mins
ECG Interpretation
- Rate
- Rhythm
- P Waves
- Upright, Rounded, Before Every QRS
- PR Interval (< 0.20 seconds)
- Normal QRS (< 0.12 seconds)
2 mins
ECG: Sinus Bradycardia
- Rate
- < 60 bpm
- Rhythm
- Regular
- P Wave
- Present, Upright, Every QRS
- PR Interval
- < 0.20 seconds
- QRS Interval
- < 0.12 seconds
- Treatment
- Atropine
1 min
ECG: Sinus Tachycardia
- Rate
- > 100 bpm
- Rhythm
- Regular
- P Wave
- Present, Upright, Every QRS
- PR Interval
- < 0.20 seconds
- QRS Interval
- < 0.12 seconds
- Treatment
- Treat Underlying Cause
2 mins
ECG: Atrial Fibrillation
- Rate
- Variable Rate
- Rhythm
- Irregular Rhythm
- P Wave
- No P Wave
- PR Interval
- No PR Interval
- QRS Interval
- QRS < 0.12 Seconds
1 min
ECG: Atrial Flutter
- Rate
- Variable
- Rhythm
- Regular or Irregular
- P Wave
- Saw Tooth, Multiple Before Every QRS
- PR Interval
- Non-measurable
- QRS Interval
- < 0.12 seconds
2 mins
Whole Blood Composition
- Characteristics
- Plasma
- Electrolytes And Other Solutes
- Proteins
- Albumin
- Fibrinogen
- Globulins
- Water
- Formed Elements
- Buffy Coat
- White Blood Cells (WBC)
- Platelets
- Red Blood Cells (RBC)
2 mins
Blood Types and Compatibilities
- ABO Compatibility
- No Antigens (Type O Blood)
- Universal Donor
- A Antigen (Type A Blood)
- B Antigen (Type B Blood)
- AB Antigen (Type AB Blood)
- Universal Recipient
- Rhesus (Rh) Compatibility
- Rh (Rhesus) Antigen
- Never Rh+ to Rh-
- Considerations
- Blood Transfusion
- Obstetric Patient
2 mins
Coagulation Cascade Overview
- Secondary Hemostasis
- Intrinsic Pathway
- Partial Thromboplastin Time (PTT)
- Heparin
- Extrinsic Pathway
- Prothrombin Time (PT)
- Warfarin
- Common Pathway
- Thrombin
- Convert Fibrinogen to Fibrin
- Stabilizes the Platelet Plug
2 mins
Clotting Overview
- Characteristics
- Endothelial Cells are Damaged
- Platelets Respond to Exposed Collagen and Stick
- Platelets Release Recruiting Factors
- More Platelets are Attracted
- Soluble Fibrinogen Turns to Insoluble Fibrin
- Fibrin Seals the Clot
- Clot Dissolves
- Liver Produces Clotting Factors
2 mins
Bleeding Precautions
- Things to Avoid
- Hard Foods
- Aspirin Products
- Blowing Nose Forcefully
- Straining During BMs
- Enemas or Rectal Suppositories
- Pads and Monitor Menstruation
- Guidelines to Follow
- Soft-bristled Toothbrush
- Electric Razor
- Limit Needle Sticks
- Smaller Needle Size
3 mins
Warfarin Antidotes
- Antidotes
- Vitamin K
- Fresh Frozen Plasma
59 secs
Heparin Induced Thrombocytopenia (HIT)
- Pathophysiology
- 5-10 Days After Heparin Exposure
- Heparin-Platelet Factor 4 Complex
- Autoantibodies Form Against Complex
- Heparin-Platelet Factor 4-Antibody Complex Binds Platelets
- Platelet Aggregation
- Procoagulant Release
- Symptoms
- Thrombocytopenia
- Diagnosis
- Serotonin Release Assay (SRA)
- Treatment
- Stop Heparin, Start Direct Thrombin Inhibitor
2 mins
Sickle Cell Anemia Assessment
- Cause/Mechanism
- Hemoglobin S (Genetic Defect)
- Sickle Shaped RBCs
- Assessment
- Jaundice
- Vaso Occlusive Crisis
- Fever
- Priapism
- Severe Pain
- Considerations
- Prominent in African Americans
- May be Asymptomatic
- Increased Risk of Infection
2 mins
Sickle Cell Anemia Interventions
- Interventions
- Increase Hydration
- Analgesics
- Oxygen
- Warm Compress
- Bone Marrow Transplant
- Hydroxyurea
- Considerations
- Avoid High Altitudes
- Prophylactic Antibiotics
- Avoid Strenuous Exercise
- Vaccines
3 mins
Iron Deficiency Anemia
- Causes
- Malnutrition/Malabsorption
- Hemorrhage
- Signs
- Microcytic, Hypochromic Anemia
- Decreased Heme Synthesis
- Labs
- Decreased Reticulocytes
- Decreased Ferritin
- Increased Red Cell Distribution Width (RDW)
- Poikilocytosis
- Anisocytosis
- Increased Central Pallor
2 mins
Types of Blood Products
- Types
- Whole Blood
- Packed Red Blood Cells
- Fresh Frozen Plasma
- Immunoglobulins
- Clotting Factors
- Albumin
- Platelets
- Considerations
- 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
- Considerations
- Do Not Add Anything To Same IV Line
- No Dextrose or Lactated Ringers
- Jehovah's Witnesses, No Transfusions
3 mins
Types of Shock
- Hypovolemic
- Depleted Volume
- Cardiogenic
- Pump Failure
- Obstructive
- Indirect Pump Failure
- Distributive
- Lost Vascular Tone
- Neurogenic
- Anaphylactic
- Septic
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
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
Leukemia Assessment
- Cause
- Immature WBCs
- Assessment
- Recurrent Infections
- Easy Bruising
- Bleeding
- Anemia
- Fatigue
- Weight Loss
- Bone Pain
- Considerations
- May Have Normal or High WBC Count
2 mins
Leukemia Interventions
- Diagnosis
- Bone Marrow Aspiration
- X-Rays
- Interventions
- Chemotherapy
- Bleeding Precautions
- Neutropenic Precautions
- Strict Asepsis
- Bone Marrow Transplant
- Blood Transfusions
- Monitor Temperature Elevations
- Adequate Nutrition
- Imatinib (Gleevec) for Chronic Myelogenous Leukemia (CML)
3 mins
Hodgkin's Lymphoma Assessment
- Cause
- Lymph Node Cancer
- Contiguous Spread
- Assessment
- Painless Lymphadenopathy
- Constitutional B Signs
- Night Sweats
- Fever
- Weight Loss
- Considerations
- Bimodal Age Distribution
- Reed-Sternberg Cells
2 mins
Hodgkin's Lymphoma Interventions
- Diagnosis
- Biopsy
- Staging
- Interventions
- Radiation
- Chemotherapy
- Treat Side Effects of Therapy
- Considerations
- Secondary Cancer Screening
2 mins
Non-Hodgkin's Lymphoma Assessment
- Cause
- Lymphatic Cancer
- Non-Contiguous Spread
- B or T Cells
- Assessment
- Painless Lymphadenopathy
- Constitutional B Signs
- Night Sweats
- Fever
- Weight Loss
- Mediastinal or Abdominal Mass
- Considerations
- Older Adults
- > 60 Subtypes
2 mins
Primary Central Nervous System Lymphoma
- Associations
- EBV (Epstein Barr Virus)
- HIV/AIDS
- Elderly
- Immunocompromised
- Symptoms
- Confusion
- Memory Loss
- Seizures
- Blurry Vision
- Diagnosis
- MRI
- Single, Ring-Enhancing Lesion
- CSF Analysis
- Treatment
- Methotrexate
- Radiotherapy
2 mins
Disseminated Intravascular Coagulation (DIC) Interventions
- Complications
- Risk for Shock
- Renal Failure
- Interventions
- Treat Underlying Cause
- Manage Bleeding
- Maintain Fluid and Hemodynamic Balance
- Transfusion
- Oxygenation
- Heparin Drip
2 mins
Disseminated Intravascular Coagulation (DIC) Assessment
- Mechanism
- Improper Initiation of Clotting Cascade
- Signs and Symptoms
- Systemic Bleeding
- Petechiae, Purpura, Ecchymosis
- Change in LOC
- Increased PT and PTT
- Cyanosis
- Increased Fibrin Degradation Products (FDP)
- Decreased Platelets and Fibrinogen
2 mins
Polycythemia Vera Disease
- Pathophysiology
- JAK2 Mutation leading to increased red blood cells
- Tyrosine Kinase
- Symptoms
- Erythromelalgia
- Pruritus
- Often After Hot Shower
- Headache
- Treatment
- Phlebotomy
- Aspirin
1 min
Venous Thromboembolism (DVT) Assessment
- Mechanism
- Venous Wall Inflammation caused by Thrombus
- Assessment
- Tenderness
- Edema
- Warmth
- Asymmetry
- Considerations
- Could be Asymptomatic
- Monitor for Pulmonary Embolism
58 secs
Venous Thromboembolism (DVT) Interventions
- Anticoagulants
- Prevention Education
- Frequent Ambulation
- Leg Exercises
- Compression Stockings or SCD's
- Avoid Nicotine and Oral Contraceptives
- Surgery
1 min
Hemophilia
- Cause/Mechanism
- Genetic Mutation
- Assessment
- Prolonged Bleeding
- Pain
- Hemarthrosis
- Interventions
- Clotting Factor Replacement Therapy
- DDAVP (Desmopressin Acetate)
- Antifibrinolytic Therapy
- Analgesics
- Considerations
- Genetic Counseling
- Prevent Injury
3 mins
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