HESI Exit Exam Preparation Lecture Notes

Key Topics and Questions

Medication Management

• Digoxin and Hypokalemia
  • Serum potassium level of 3:
    • Prioritize withholding digoxin due to risk of toxicity.
• Post-Thyroidectomy Complication
  • Tingling around mouth/fingers:
    • Administer calcium gluconate for potential hypocalcemia.
• Sertraline for Major Depressive Disorder
  • Avoid concurrent use of other antidepressants to prevent serotonin syndrome.
• Metoprolol for Hypertension
  • Monitor for bradycardia as a potential adverse effect.
• Clozapine for Schizophrenia
  • Monitor for agranulocytosis, a serious side effect.

Clinical Assessments and Interventions

• Severe Preeclampsia
  • Indicative sign: Epigastric pain.
• Moderate Dehydration in Toddlers
  • Sign: Sunken fontanels.
• COPD and Oxygen Therapy
  • Monitor for increased respiratory rate.
• Schizophrenia Auditory Hallucinations
  • Administer antipsychotic medication as prescribed.

Nursing Priorities and Actions

• Blood Transfusion Reaction
  • Signs: Chills, fever, back pain.
    • Immediate action: Stop the transfusion.
• Gestational Diabetes (GDM)
  • Potential need for insulin therapy.
• Heart Failure and Lasix
  • Monitor for hypokalemia.
• Pulmonary Embolism
  • Common manifestation: Hemoptysis (coughing up blood).

Client Education

• Warfarin and Ciprofloxacin
  • Monitor for increased bleeding risk.
• Levothyroxine for Hypothyroidism
  • Take on an empty stomach in the morning for optimal absorption.
• Proper Hand Hygiene
  • Crucial in preventing the spread of infectious diseases.

Emergency and Critical Care

• Ventricular Fibrillation
  • Immediate action: Begin chest compressions.
• Increased Intracranial Pressure
  • Priority intervention: Administer hypertonic saline.

Special Considerations

• Rheumatoid Arthritis and Methotrexate
  • Monitor for liver toxicity.
• Heparin Therapy for DVT Prophylaxis
  • Monitor APTT levels.
• Acute Pancreatitis
  • Classic sign: Jaundice.

Lifestyle and Health Promotion

• Preventing Cardiovascular Disease
  • Emphasis on regular physical activity.
• Smoking Cessation
  • Recommend nicotine patches as a first-line option.
• Community Health Education
  • Prioritize use of barrier methods to prevent STIs.

Conclusion

• Ensure consistent and thorough knowledge of medications, clinical signs, nursing interventions, and patient education to effectively prepare for the HESI exit exam.

These notes summarize the content of the HESI exit exam preparation lecture, highlighting key points and nursing priorities to aid in studying and exam success.