Nursing NCLEX Review Lecture

Introduction

• Lecture by Amanda from beautifulnursing.com
• Created to help nursing graduates prepare for the NCLEX exam.
• Focus on making nursing concepts accessible.

Agenda

• Topics: Lab values, ABGs, Electrolytes, Safety Precautions, Mobility Aids, Restraints, Diabetes, OB Maternity, Psych, Pediatrics, Pharmacology, Blood Therapy, IV Fluid Types, Anaphylaxis, EKGs, Delegation, and Prioritization.

Lab Values

• Common lab values and mnemonics to remember them:
  • Potassium: 3.5 to 5
  • Chloride: 95 to 105
  • Hemoglobin: Males 13-18, Females 12-16
  • Magnesium: 1.5 to 2.5
  • BUN: 10 to 20
  • Calcium: 9 to 11
  • Phosphate: 2.5 to 4.5
  • Creatinine: 0.5 to 1.5
  • Sodium: 135 to 145
• Critical values to watch:
  • pH: Less than 6
  • Potassium: Greater than 6
  • CO2: Greater than 60
  • O2: Less than 60
  • Platelets: Less than 40,000

Neutropenic Precautions

• For patients with WBC < 1000 or neutrophils < 500.
• Strict hand hygiene, no fresh produce, limit visitors.

Arterial Blood Gases (ABGs)

• HCO3 (bicarbonate): 22 to 26
• PaCO2: 35 to 45
• pH: 7.35 to 7.45
• Relationship between pH, CO2, and bicarbonate.

Safety Precautions

• Standard: Hand hygiene, gloves, gown, mask.
• Droplet: Surgical mask, private room.
• Airborne: N95 mask, negative pressure room.
• Contact: Hand hygiene, gloves, gown.

Mobility Aids

• Proper use of crutches, canes, and walkers.
• Crutch gait types: 2-point, 3-point, 4-point, swing through.

Restraints

• Types: Chemical, mechanical.
• Informed consent required, MD order needed within an hour.
• Time restrictions based on age.

Diabetes

• Type 1: Insulin-dependent, usually diagnosed in children.
  • Signs: Polyuria, polyphagia, polydipsia.
• Type 2: Often associated with lifestyle factors.
  • Treatment: Diet, oral hypoglycemics, activity.
• Diabetes Insipidus: Decrease in ADH, excessive urination and thirst.

Complications of Diabetes

• DKA: Blood glucose > 250, dehydration, ketones, acidotic state.
• Hypoglycemia: Blood glucose < 70, treat with orange juice or glucagon.
• HHS: Blood glucose > 600, dehydration.

Insulin Types

• Rapid: Lispro, Aspart (Onset 15 min, Peak 30 min, Duration 3 hrs)
• Short: Regular (Onset 1 hr, Peak 2 hrs, Duration 4 hrs)
• Intermediate: NPH (Onset 6 hrs, Peak 8 hrs, Duration 12 hrs)
• Long: Lantus (No peak, Duration 24 hrs)

OB Maternity

• Probable signs: Goodell's sign, Chadwick's sign.
• Stages of labor and important contractions signs.
• Common OB medications and complications (placenta previa, abruptio placenta).

Psychiatric Disorders

• Major depression, schizophrenia, bipolar disorder.
• Therapeutic communication techniques.

Pediatrics

• Tetralogy of Fallot and other pediatric heart defects.
• Pediatric milestones and nutrition.

Pharmacology

• Toxic drug levels to know: Lithium, Digoxin, Theophylline, Phenytoin.
• Anti-hypertensive, psychiatric, and antimicrobial drugs.
• Antidotes for various drugs.

Blood Administration and IV Fluids

• Verify blood compatibility and administer within time limits.
• Types of IV fluids: Isotonic, Hypotonic, Hypertonic.

EKG and Cardiac Rhythms

• Basic understanding of EKG waves and common arrhythmias.
• Sinus rhythms, atrial flutter, fibrillation, ventricular tachycardia.

Delegation and Prioritization

• Know the rights of delegation and tasks appropriate for LPNs and UAPs.
• Prioritize patients based on stability and unexpected events.

NCLEX Tips

• Answer strategies for selecting the right options.
• Focus on safety and delegation as key themes.

This lecture provides a comprehensive overview of essential topics for the NCLEX exam, focusing on safety, critical thinking, and practical nursing knowledge.