NCLEX-RN Study Guide Summary

Delegation Principles

• Do not delegate tasks that involve evaluation, assessment, teaching (EAT).

Addison's and Cushing's Disease

• Addison's:
  • Hyponatremia, hypotension, decreased blood volume, hyperkalemia, hypoglycemia.
• Cushing's:
  • Hypernatremia, hypertension, increased blood volume, hypokalemia, hyperglycemia.

Transmission-Based Precautions

• Airborne:
  • Measles, Chicken Pox/Varicella, Herpes Zoster (Shingles), TB.
  • MTV (Measles, TB, Varicella) mnemonic.
  • Private room, negative pressure.
• Droplet:
  • SPIDERMAN mnemonic for diseases (e.g., Scarlet fever, Pertussis, Mumps).
  • Private room or cohort, wear masks.
• Contact:
  • MRS.WEE mnemonic for conditions (e.g., MRSA, wound infections).
  • Skin infections: VCHIPS mnemonic (e.g., Varicella Zoster, Scabies).

Patient Positioning Techniques

1. Air Embolism: Left side, lower head of bed.
2. Un-reassuring FHR: Left side, give O2, stop Pitocin.
3. Tube Feeding: Right side with HOB elevated.
4. Epidural Puncture: Side-lying.
5. After Lumbar Puncture: Flat supine.
6. Heat Stroke: Flat, elevate legs.
7. Continuous Bladder Irrigation: Leg straight.
8. After Myringotomy: Side of affected ear.
9. After Cataract Surgery: Sleep on unaffected side.
10. After Thyroidectomy: Semi-Fowler’s, support head.
11. Infant with Spina Bifida: Prone position.
12. Buck's Traction: Elevate foot of bed.
13. After Total Hip Replacement: Avoid operated side, maintain abduction.

Mnemonics and Tips

• Eclampsia: Treat with Mag sulfate.
• Myasthenia Gravis: Worsens with exercise, improves with rest.
• Thyroid Storm: Increased temperature, pulse, and hypertension.
• Hypoparathyroid: CATS mnemonic (Convulsions, Arrhythmias, Tetany, Spasms).
• Hyperparathyroid: Fatigue, weakness, renal calculi.
• Addisonian Crisis: Nausea, vomiting, confusion.
• Pheochromocytoma: Persistent hypertension, headaches.

NCLEX Tips

• Assess before intervention unless in emergency.
• Avoid absolutes in answers (always, never).
• Prioritize patient-focused over equipment-focused answers.
• For medication administration, IV pushes should take 2 minutes.
• Elderly confusion often indicates pneumonia.
• Monitor for hypoglycemia symptoms when administering insulin or oral hypoglycemics.

Medication Notes

• Digoxin: Check pulse, hold if <60 bpm.
• Lithium: Monitor levels (0.5-1.5), maintain sodium intake.
• Ritalin: Monitor heart-related side effects.
• ACE Inhibitors: Preferred for CHF.
• Thyroid Medications: Administer on an empty stomach.

Important Assessments

• Head Injury: Elevate HOB 30 degrees.
• Autonomic Dysreflexia: Sit up first, check triggers.
• ICP vs. Shock: Opposite vital signs.
• Child Respiratory Distress: Elevated HOB, monitor for retractions.
• Hypoxia: First sign is restlessness.

Study and Review Strategies

• Use mnemonics to memorize procedures and conditions.
• Understand the rationale behind positioning techniques and precautions.
• Prioritize assessments over treatment unless it's an emergency.
• Review and practice pharmacology, especially antidotes and side effects.

This summary encompasses the key points and reminders for the NCLEX-RN, focusing on critical care scenarios, emergency interventions, and important mnemonics.