HESI/NCLEX Review
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| Sodium Normal | 135–145 mEq/L
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| Potassium Normal | 3.5–5.5 mEq/L
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| Calcium Normal | 8.5–10.9 mg/L
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| Chloride Normal | 95–105 mEq/L
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| Magnesium Normal | 1.5–2.5 mEq/L
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| Phosphorus Normal | 2.5–4.5 mg/dL
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| RBC Normal | 4.5–5.0 million
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| WBC Normal | 5,000–10,000
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| Plt Normal | 200,000–400,000
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| Hgb Normal | 12–16 gms women; 14–18 gms men
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| HCO3 Normal | 24–26 mEq/L
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| CO2 Normal | 35–45 mEq/L
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| PaO2 Normal | 80%–100%
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| SaO2 Normal | > 95%
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| Glucose Normal | 70–110 mg/dL
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| Specific gravity Normal | 1.010–1.030
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| BUN Normal | 7–22 mg/dL
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| Serum creatinine Normal | 0.6–1.35 mg/dL (< 2 in older adults)
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| LDH Normal | 100–190 U/L
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| CPK Normal | 21–232 U/L
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| Uric acid Normal | 3.5–7.5 mg/dL
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| Triglyceride Normal | 40–50 mg/dL
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| Total cholesterol Normal | 130–200 mg/dL
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| Bilirubin Normal | < 1.0 mg/dL
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| Protein Normal | 6.2–8.1 g/dL
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| Albumin Normal | 3.4–5.0 g/dL
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| Digoxin Therapeutic level | 0.5–2.0 ng/ml
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| Lithium Therapeutic level | 0.8–1.5 mEq/L
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| Dilantin Therapeutic level | 10–20 mcg/dL
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| Theophylline Therapeutic level | 10–20 mcg/dL
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| Heart rate Normal (adult) | 80–100
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| Respiratory rate Normal (adult) | 12–20
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| Blood pressure Normal (adult) | 110–120 (systolic); 60–90 (diastolic)
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| Temperature Normal (adult) | 98.6° ?/–1
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| FHR Normal | 120–160 BPM.
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| Variability Normal | 6–10 BPM.
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| Contractions Normal | normal frequency 2–5 minutes apart; normal duration < 90 sec.; intensity < 100 mm/hg.
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| Amniotic fluid Normal | 500–1200 ml (nitrozine urine-litmus paper green/amniotic fluid-litmus paper blue).
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| Apgar scoring | A: appearance, P: pulses, G: grimace, A: activity, R: reflexes (Done at 1 and 5 minutes with a score of 0 for absent, 1 for decreased, and 2 for strongly positive.)
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| AVA | The umbilical cord has two arteries and one vein. (Arteries carry deoxygenated blood. The vein carries oxygenated blood.)
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| FAB 9 | Folic acid/B9. Hint: B stands for brain (decreases the incidence of neural tube defects); the client should begin taking B9 three months prior to becoming pregnant.
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| Early decelerations | Begin prior to the peak of the contraction and end by the end of the contraction. Caused by head compression. No need for intervention if the variability is within normal range (rapid return to the baseline FHR) and the FHR is within normal range.
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| Variable decelerations | V-shaped on the monitoring strip. Can occur anytime. Caused by cord compression. Intervention: change position; if pitocin is infusing, stop the infusion; apply oxygen; and increase the rate of IV fluids. Contact the doctor if the problem persists.
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| Late decelerations | Occur after peak of the contraction and mirror the contraction in length and intensity. Caused by uteroplacental insuffiency. Intervention: change position; if pitocin is infusing, stop it; apply O2; and increase rate of IVF. Contact doctor if persists.
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| TORCHS syndrome in the neonate | This is a combination of diseases. These include toxoplasmosis, rubella (German measles), cytomegalovirus, herpes, and syphyllis. Pregnant nurses should not be assigned to care for the client with toxoplasmosis or cytomegalovirus.
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| STOP (treatment for maternal hypotension after an epidural anesthesia) | Stop pitocin if infusing; Turn the client on the left side; Administer oxygen; If hypovolemia is present, push IV fluids.
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| Warfarin (Coumadin) monitoring | therapeutic goal is PT 1.5 to 2.5 times greater than the control (normal: 10-12 sec), or INR of 2 to 3 (normal 0.75-1.25)
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| Warfarin (Coumadin) antidote | Vitamin K
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| Heparin/Lovenox/Dalteparin monitoring | APTT (activated partial thromboplastin time) 1.5-2 times the control, normally 46-70 seconds (1.5-2 times normal value of 25-35)
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| Heparin/Lovenox/Dalteparin antidote | protamine sulfate
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| Rule of nines for calculating TBSA for burns | Head: 9%; Arms: 18% (9% each); Torso: 36% (18% each front/back); Legs; 36% (18% each); Genitalia: 1%
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| Arab American cultural attributes | Females avoid eye contact with males; touch accepted if by same-sex; most decisions made by males; Muslims (Sunni) refuse organ donation; most do not eat pork; avoid icy drinks when sick or hot/cold drinks together; colostrum considered harmful to newborn
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| Asian American cultural attributes | Avoid direct eye contact; feet considered dirty (should be touched last); males make most decisions; usually refuse organ donation; generally do not prefer cold drinks, believe in the “hot-cold” theory of illness.
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| Native American cultural attributes | They sustain eye contact; blood and organ donation is generally refused; they might refuse circumcision; may prefer care from the tribal shaman rather than using western medicine.
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| Mexican American cultural attributes | They might avoid direct eye contact with authorities; they might refuse organ donation; most are very emotional during bereavement; believe in the “hot-cold” theory of illness.
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| Jehovah’s Witness religious beliefs | No blood products should be used
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| Hindu religious beliefs | No beef or items containing gelatin
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| Jewish religious beliefs | Special dietary restrictions, use of kosher foods
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| Renal diet | High calorie, high carbohydrate, low protein, low potassium, low sodium, and fluid restricted to intake equal to output + 500 ml
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| Gout diet | Low purine; omit poultry (“cold chicken”); medication for acute episodes: Colchicine; maintenance medication: Zyloprim
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| Spironolactone (Aldactone) diet | a potassium-sparing diuretic, so diet high in potassium should be avoided, including potassium salt substitutes, which can lead hyperkalemia
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| Warfarin (Coumadin) diet | avoid foods and substances containing vitamin K such as green leafy vegetables (spinach, broccoli, brussel sprouts)
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| MAO inhibitor diet | tyramine consumption can cause a hypertensive crisis (explosive headache, palpitations, sudden elevation of BP, chest pain, nausea, and vomiting); avoid cheese, aged meats, and imported beers
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| Heart healthy diet | Low fat (less than 30% of calories should be from fat)
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| Acid/base balance when pH down, CO2 up, and HCO3 up | respiratory acidosis
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| Acid/base balance when pH down, CO2 down, and HCO3 down | metabolic acidosis
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| Acid/base balance when pH up, CO2 down, and HCO3 down | respiratory alkalosis
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| Acid/base balance when pH up, CO2 up, and HCO3 up | metabolic alkalosis
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| Addison’s vs. Cushing’s | diseases involving either overproduction or inadequate production of cortisol; Addison’s Treatment: increase sodium intake, cortisone preparations vs Cushing’s Treatment: restrict sodium; observe for signs of infection.
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| Treatment for spider bites/bleeding | RICE (rest, ice, compression, and elevate extremity)
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| Treatment for sickle cell crises | HHOP (heat, hydration, oxygen, pain medications)
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| Five Ps of fractures and compartment syndrome | Pain, Pallor, Pulselessness, Paresthesia, Polar (cold)
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| Hip vs. Femur fractures | Hip fractures commonly hemorrhage, whereas femur fractures are at risk for fat emboli.
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| Profile of gallbladder disease | Fair, fat, forty, five pregnancies, flatulent (can occur in all ages and both sexes).
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| Autonomy | An individual's right of self-determination and freedom of decision making.
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| Beneficence | Doing good for clients and providing benefit balanced against risk.
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| Nonmaleficence | Doing no harm to clients.
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| Justice | Being fair to all and giving equal treatment, including distributing benefits, risks, and costs equally.
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| Fidelity | Being loyal and faithful to commitments and accountable for responsibilities.
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| Veracity | Telling the truth and not intentionally deceiving or misleading clients.
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| Daily fluid requirements | 0-10 kg: 100 ml/kg/day; 10-20 kg: 1000 ml for first 10 kg plus 50 ml/kg/day for each kg between 10-20; 1500mL for first 20 kg + 20mL/kg for each additional kg over 20 kg
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| Normal urine output | 1 mg/kg/hr
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| DKA vs. HHNS | onset: DKA sudden vs. HHNS gradual; precipitating factor: DKA inadequate insulin vs. HHSN poor fluid intake; manifestations: DKA ketosis, Kussmaul resp, “fruity” breath, nausea, abdominal pain vs. HHNS altered CNS function; glucose: DKA >300 vs. HHNS >600
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| Right-sided vs. left-sided HF manifestations | Right-sided: edema, JVD, an enlarged liver, abdominal ascites, and weight gain vs. Left-sided: dyspnea, lung crackles, tachycardia, fatigue, and anxiety
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| Left-sided brain attack manifestations | aphasia, agraphia, alexia; memory deficit; inability to discriminate words and letters, reading problems, deficits in right visual field; slowness, cautiousness, anxiety with new tasks, depression, guilt, worries, quick anger, intellectual impairment
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| Right-sided brain attack manifestations | impaired sense of humor; disorientation to time, place, person, inability to recognize faces; visual spatial deficits, left-side neglect, loss of depth perception; impulsiveness, denial, confabulation, euphoria, poor judgment, overestimation of abilities
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| Residual in feeding tube that indicates next feeding should be held | > 60 mL
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| Virchow’s triad | three major factors involved in the development of DVT: stasis of blood, vessel wall injury, altered blood coagulation
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| GTPAL | Gravida (number of pregnancies including current); Term (number pregnancies at least 38wks); Preterm (number of pregnancies 20-37 wks); Abortion (pregnancies with fetal loss up to 20 weeks); Living (number of living children)
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| HELLP | hemolysis (H), evidenced by burr cells or elevated bilirubin level; elevated liver enzymes (EL), evidenced by elevated AST and ALT; and low platelets (LP), evidenced by a platelet count of < 100,000 mm3
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| Preeclampsia vs. HELLP syndrome | HELLP syndrome occurs in 2-12% of those with severe preeclampsia. Pts with HELLP syndrome may complain of malaise over several days, epigastric or upper abdominal pain, and n/v. BP may be only slightly elevated or normal and proteinuria may be absent.
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| DSM-IV-TR axis | Axis I: Clinical syndromes; Axis II: Personality disorders; Axis III: General medical conditions; Axis IV: Psychosocial and environmental problems; Axis V: Global assessment of functioning
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| Psychosis vs. schizophrenia | negative symptoms are characteristic of schizophrenia and include behaviors such as minimal eye contact, poor grooming and hygiene, apathy, flat affect, and social inattentiveness (spaciness)
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| Piaget's Period for Infancy | Sensorimotor: Reflexive behavior is used to adapt to the environment; egocentric view of the world; development of object permanence.
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| Erikson's Stage for Infancy | Trust vs. Mistrust (0-18 months): Development of a sense that the self is good and the world is good when consistent, predictable, reliable care is received; characterized by hope.
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| Piaget's Period fo Toddlers & Preschoolers | Preoperational Thought: Thinking remains egocentric, becomes magical, and is dominated by perception.
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| Erikson's Stage for Toddlers | Autonomy vs. Shame and Doubt (2-3 yr): Development of sense of control over the self and body functions; exerts self; characterized by will.
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| Erikson's Stage for Preschoolers | Initiative vs. Guilt (3-5 yr): Development of a can-do attitude about the self; behavior becomes goal-directed, competitive, and imaginative; initiation into gender role; characterized by purpose.
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| Piaget's Period for School Age | Concrete Operations: Thinking becomes more systematic and logical, but concrete objects and activities are needed.
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| Erikson's Stage for School Age | Industry vs. Inferiority (6-11 yr): Mastering of useful skills and tools of the culture; learning how to play and work with peers; characterized by competence.
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| Piaget's Period for Adolescence | Formal Operations: New ideas can be created; situations can be analyzed; use of abstract and futuristic thinking; understands logical consequences of behavior.
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| Erikson's Stage for Adolescence | Identitity vs. Role Confusion (12-18 yr): Begins to develop a sense of “I”; this process is lifelong; peers become of paramount importance; child gains independence from parents; characterized by faith in self.
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| Erikson's Stage for Young Adulthood | Intimacy vs. Isolation (19-40 yr): Development of the ability to lose the self in genuine mutuality with another; characterized by love.
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| Erikson's Stage for Middle Adulthood | generativity vs. stagnation (40-65 yr): Production of ideas and materials through work; creation of children; characterized by care.
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| Erikson's Stage for Mature Adults | Ego Integrity vs. Despair (> 65 yr): Realization that there is order and purpose to life; characterized by wisdom.
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| Age posterior fontanel closes | 2-3 months
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| Age Anterior fontanel closes | 18 months
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| Age infant raises head and holds position | 2 wk-2 mo
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| Age infant sits alone, using hands for support | 3-6 months
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| Age infant smiles in response to stimuli | 6-8 weeks
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| Age Moro, tonic neck, and rooting reflexes disappear | 4-5 months
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| Age infant turns from abdomen to back and back to abdomen | 6-7 months
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| Age infantcan crawl | 6-9 months
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| Age infant begins to pull up | by 11 months
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| Age pincer grasp develops | 8-9 months; complete by 12 months
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| Age Babinski reflex disappears | 10-12 months
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| Age grasp reflex disappears | 2-3 months
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| Age children cruise (walk with support) | by 12 months
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| Age children can sit from a standing posture | by 12 months
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| Age children can walk alone | 15 months
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| Age handedness begins to emerge | about 3 years; clearly established by 4 years
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| Age children can jump and climb well | 4 years
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| Stages of dying | denial, anger, bargaining, depression, and acceptance
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| Immunization contraindications for children with immunodeficiency | can’t have any live vaccines (chickenpox [varicella], MMR [measles-mumps-rubella], intranasal influenza)
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| Hepatitis B vaccine minimum age, maximum age, and minimum dose intervals | Min: Birth (in hospital); Max: none; Dose intervals: 4 wks, 8 wks (and 16 wks from fist dose with minimum age for final dose 24 wks)
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| Rotavirus vaccine minimum age, maximum age, and minimum dose intervals | Min: 6 wks; Max: <15 wks; Dose interval: 4 wks, 4 wks (with max age 8 mos)
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| DTaP (diphtheria, tetanus, pertussis) vaccine minimum age, maximum age, and minimum dose intervals | Min: 6 wks; Max: none; Dose intervals: 4 wks, 4 wks, 6 mos, 6 mos
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| Hoemophilus influenza type b (Hib) vaccine minimum age, maximum age, and minimum dose intervals | Min: 6 wks; Max: none; Dose Intervals: 4wks (if < 12 mos), 8 wks (final dose if 12-14 mos), no further doses needed (>14 mos)
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| Pneumococcal (PCV) vaccine minimum age, maximum age, and minimum dose intervals | Min: 6 wks; Max: 24 mos; Dose Intervals: 4 wks (if < 12 mos), 8 wks (final dose if 12-24 mos)
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| Inactivated poliovirus (IPV) vaccine minimum age, maximum age, and minimum dose intervals | Min: 6 wks; Max: 18 years; Dose Intervals: 4 wks, 4 wks, 6 mos (min age 4 yrs for final dose)
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| Varicella vaccine minimum age, maximum age, and minimum dose intervals | Min: 12 mos; Max: 18 years; Dose Intervals: 3 mos
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| Measles, Mumps, and Rubella (MMR) vaccine minimum age, maximum age, and minimum dose intervals | Min: 12 mos; Max: none ; Dose Intervals: 3 mos
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| Hepatitis A vaccine minimum age, maximum age, and minimum dose intervals | Min: 12 mos; Max: none; Dose Intervals: 6 mos
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| Vaccines not given to older children with no immunizations | Rotavirus (not given after 14 wks) and Pneumococcal (not given after 24 mos).
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| Vaccines that contain Neomycin | Inactivated poliovirus (IPV) and Measles, Mumps, and Rubella (MMR)
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| Vaccine associated with egg or chicken allergic reactions | influenza, MMR
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| Vaccine that contains baker’s yeast | HPV4
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| Vaccines given SQ | Varicella, MMR, IPV
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| Vaccines given IM | DTaP, Hib, Hep A, Hep B, Influenza (also nasal mist), Pertussis, PCV
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| Vaccines given PO | Rotavirus
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| Vaccine given to newborn before discharge | Hep B
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| high-iron foods | Breads, Cereals, and Grain Products; Meat, Poultry, Fish, and Alternatives
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| high-fiber foods | Vegetables, Fruits, and Grain Products
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| high-sodium foods | cured meats, pickled foods, canned soups and stews, frankfurters, cold cuts, soy sauce, and salad dressings
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| high-potassium foods | salt substitutes, oranges, bananas, melons, tomatoes, prunes, raisins, deep green and yellow vegetables, beans, and legumes
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| high-phosphate foods | dairy products (e.g., meat, milk, ice cream, cheese, yogurt) and foods containing dairy products (e.g., pudding)
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| high-calcium foods | Milk, cheese, ice cream, yogurt, sauces containing milk; all beans (except green beans), lentils; fish with fine bones (e.g., sardines, kippers, herring, salmon); dried fruits, nuts; Ovaltine, chocolate, cocoa
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| high-purine foods | Sardines, herring, mussels, liver, kidney, goose, venison, meat soups, sweetbreads
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| high-oxalate foods | Dark roughage, spinach, rhubarb, asparagus, cabbage, tomatoes, beets, nuts, celery, parsley, runner beans; chocolate, cocoa, instant coffee, Ovaltine, tea; Worcestershire sauce
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| high-folate foods | Liver, legumes, vegetables, Papaya, Breakfast cereal, wheat germ
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| Urinary tract calculi diet | low-purine, low-calcium, low-oxalate
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| Chemotherapy diet | low-fiber; To prevent diarrhea, other foods that may be avoided include fried or highly seasoned foods, or other foods that are gas producing; hydration and electrolyte supplementation
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| First trimester pregnancy diet | same kcal & protein as nonpregnant
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| Second trimester pregnancy diet | nonpregnant kcal + 340; nonpregnant protein + 25g
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| Third trimester pregnancy diet | nonpregnant kcal + 452; nonpregnant protein + 25g
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| Lactation diet | nonpregnant kcal 330-400
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| CKD Diet | low-normal protein (greater during PD to compensate for losses); fluid restriction based on daily urine output and weight gain; Sodium & Potassium Restriction; Phosphate Restriction
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| CKD foods to avoid | high-sodium foods; high-potassium foods; high-phosphate foods
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| Parkland (Baxter) formula for estimating fluid replacement | 4 mL lactated Ringer's solution per kilogram (kg) of body weight per percent of total body surface area (% TBSA) burned = total fluid requirements for first 24 hr after burn; 1/2 given in first 8hr
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| Burn Diet | high-calorie, high-protein, supplemental vitamins (especially iron)
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