Naxlex RAT 12

1. gender dysphoria 성적 불쾌감 : 출생시의 성별과 다른 것에 스트레스 받음. 

(중재)

: Use the client's preferred name and pronouns during interaction

: Facilitate a referral to a mental health specialist

: Validate the client's feeling about their gender identify 

 

 

2. Alcohol withdrawal 알코올 금단증상

★ Tachycardia 100회 초과 

★ HTN (SBP>140)

★ Tremor / agitation / Sz 

* Benzodiazepine : first prevent Sz and Delirium tremors

 

3. Parenteral nutrition (PN) 비경구영양 = 최후의 수단

 

4. Quality improvement 단계 

- Identify problem -> Form team -> set goal -> Collect data -> implement -> Evaluate

 

5. Severe acute repiratory syndrome (SARS) : Airborne precaution

-> N95mask / eyewear

 

6. Sleep hygiene

-> 30분이상 잠들지 못하면 침대밖으로 나오기. Getting out of bed

 

7. Ethambutol : TB medication

-> Ocular toxicity 시신경 

-> Vision loss

 

8. Pyrazinamide : Hepatotoxicity 간독성

 

9. Hepatic encephalopathy : Lactulose effect

-> Watery diarrhea / Sunden eyes 움푹꺼진 눈 

Lactulos : Ammonia level낮추는데 사용 됨. 

 

10. Atopic dermatitis 아토피 피부염

-> Pruritus

-> Lechenified lesions 피부가 두꺼워지고 가죽처럼 변화 

-> Dry skin

 

11. Epiglottitis 후두개염

증상 : Severe sore throat / Difficulty Swallowing / Drooling / Hoarseness / Fever 

-> Airway obstruction : Tripod position -> Notify 

 

12. Methadone = Opioid use disorder

부작용 : Respiratory depression / QT prolong

 

13. Montelukast

- Reduce inflammation by inhibiting Leukotriene receptors in the airway

-> Reduce airway inflammation

-> Evening에 섭취 

-> Preventing bronchoconstriction

 

14. Potential Pediculosis capitis (Head lice)

-> direct head-to-head contact

-> Nape of the neck and behind the ears

-> Small white sacs attached to the hair shafts

-> Small white Sacs

 

15. Lyme disease

-> Antibiotic treatment가 가장 먼저!!!!

 

16. Anaphylaxis -> Epinephrine이 First-line

-> Epinephrine IM이 언제나 First!!!! intervention

 

17. Colorectal Cancer

=> Neutropenia 호중구감소증 

 

18. Lithium toxicity 리튬독성

-> 치료용량 : 0.6~1.2

-> Kidney function monitoring

★ Early sign : Fine tremors / Polyuria 

★ Severe sign : Impaired coordination / Ataxia 운동실조증 / Sz

 

19. Measles = Airborne precaution 

★ Koplik spots / High fever / cough / conjunctivitis

★ N95 mask

 

20. Airborne precuation

★ measles / Varicella / SARS-CoV / Pulmonary TB

 

21. Droplet : Bacterial Pneumonia / Epiglottitis

 

22. COPD 간호중재

-> Encourage the client to increase fluid intake

 

23. Manic episodes = Reduce external stimulation

 

24. Colchicine -> Gout

reduce the inflammatory response 

 

25. Allopurinol => Lower uric acid level 

 

26. Lithium 금기 환자 = Diabetes insipidus 

 

27. Disulfiram 알코올환자 치료(혐오요법)

-> Disulfiram 중단 14일 까지도 알코올 피해야됨. 

-> 부작용 : Hypotension (Vasodilation) 

 

28. Levodopa-carbidopa = Parkinson's disease 

(부작용) : Orthostatic hypotension 갑자기 일어나지 마세요. 

             : Reddish-brown urine (유해하지는 않음.) 

 

29. HUO >30cc/hr가 적어도 나와야함. 

 

30. 우선순위

1st. Airway

2nd Breathing

3rd Circulation

 

31. Anti-infective therapy 

-> 감염치료중의 Diarrhea와 Fever는 notify해야함.

 

32. Maternal substance abuse가 신생아에게 미치는 영향

- Neonatal abstinence syndrome 신생아 금단 증후군 (Irritability / feeding difficulty)

-> Low birth weight (2,500g미만) 

-> Respiratory distress syndrome

-> Premature closure of the ductus arteriosus 동맥관의 조기폐쇄

 

 

33. Non-breastfeeding Breast engorgement 모유수유하지 않는 산모의 유방울혈 중재

-> applying cold cabbage leaves and wearing a supportive bra

-> Apply Cold 차가운거!!!

-> Avoid warm compress 따뜻한 마사지는 피하기 

 

34. Newborn HR (정상=110~160bpm)

     Newborn 정상 RR (30~60)

 

35. AKI

(1) Pre-renal AKI : decreased renal perfusion / HF / Hypovolemia / Shock

 

(2) Intrinsic renal causes : NSAID toxicity / Acute tubular necrosis

 

(3) Post-renal AKI : obstruction to urine flow

 

36. Breast cancer 예방

-> 알코올 소비 줄이기

-> Taking anti estrogen chemo-preventive drugs

-> Screening with MRI is recommended 

 

37. Hepatic cirrhosis -> Serum ammonia level 

 

38. Addison disease : Adrenal insufficiency 

위험 : Adrenal crisis (Shock d/t severe hypotension, e' imbalances) 

간호중재 : Observe the client for shock 

 

39. Preschool-aged children (3~5세) 

-> focus on structured routines / discipline

-> Structured environments with clear rules and consistent expectations 

 

40. Hemophilia 혈우병 

-> IM inject 금기!!! -> Muscle hematoma 유발함. 

-> PO나 IV로 약 줘야함. 

-> Factor 8 IV 주기 

 

41. Newborn Hyperbilirubinemia 

신생아 고빌리루빈  Bilirubin >17mg/dL

(증상) : Jaundice / Lethargy / poor feeding

(합병증) : Kernicterus 핵황달 

(간호중재) : Early breastfeeding -> Supports bilirubin excretion via stool 

                 : Frequent feeding -> Stimulates gastrointestinal moility

 

42. 소변색 변화 시키는 약

-> Rifampicin (TB약) 

-> Nitrofurantoin (UTI 약) :Brown urine

-> Levodopa-cabedopa : Brown

 

43. Rights of delegation

-> Right Tast

-> Right circumstance

-> Right Person

-> Right Direction/communication

-> Right supervision / Evaluation

 

44. Mycoplasma pneumonia- Droplet precaution

 

45. Sterile field 멸균영역 

-> Pouring sterile solution from 6inchs(10~15cm) height

-> Cap은 upright

 

46. contact precautions. 

-> Limit movement of the client outside of the client's room 

-> Gloves / gown / hand hygiene

 

47. Hypoxic-ischemic encephalopathy (HIE)

-> Decreased muscle tone

-> Elevated lactate level

-> Sz activity

-> positive blood cultures

-> Poor feeding'

 

48. Cellulitis 봉소염 (피부의 세균질환)

★ 증상 : Redness / Swelling / warmth

-> elevated white blood cell count

★ 중재 : Administer IV antibiotics / Elevate the affected limb

★ monitor : Size of erythema / 홍반의 크기  / Pain level 

 

49. Cystic fibrosis (CF)

★ 증상 : thick / sticky mucus production

★ 중재 : Perform bronchial postural drainage before meal

          : physical exercise to increase clearance of secertion

          : Routine chest physiotherapy at least twice a day. 

 

50. Immune thrombocytopenia (ITP) 면역 혈소판감소증

★ 증상 : Easy bruising / bleeding

★ 중재 : IM 주사는 피하기-> Intramuscular hematoma 유발

            : Neutropenic precaution 호중구감소예방조치

 

51. Prenatal warning signs (임신 중 notify 해야되는 증상)

-> Severe headache

-> visual disturbances

-> Swelling of the face or hands

-> vaginal bleeding & fever(36.5~37.5가 정상) 

 

52. Foramen ovale 난원공 (Fetal circulation) 

-> Allows oxygenated blood to bypass the lungs

* 태아의 폐는 기능이 없기 때문에 난원공을 통해 폐를 우회하면 산소가 좌심방과 전신으로 흐름. 

-> Promotes circulation to the systemic body tissues

-> Shunts blood between the right atrium and left atrium 우심방과 좌심방 사이 혈액 공급 

-> 출생 후 , 심장 압력 변화로 난원공이 닫힘. 

 

53. Fetal Heart rate abnormality ( = Fetal hypoxia 유발) 

-> 정상 태아 심박수(110~160bpm) 

 

54. 윤리원칙 

Veracity : 정확성 = 약물의 부작용을 솔직하게 말함.

 

55. Prostatitis

★ 증상 : Urinary frequency / Urgency / rectal discomfort / Fever / chills / back pain 

 

56. Speech therapist

-> Evaluate Swallowing

-> Reduce aspiration risk

-> Impaired cough / Swallowing reflexes

 

57. Open reduction internal fixation (ORIF)

-> Avoid positioning your left leg outward

 

58. Methylphenidate - ADHD 약

- common side effects : Insomnia / appetite loss / Weight loss 

-> 아침에 투약 / In the morning -> 부작용인 Insomnia 최소화 

 

59. Diphenhydramine = Antihistamine 

부작용 : Anticholinergic (Palpitation)

          :  Drowsiness / Dry mouth / Blurred vision / Urinary retention

 

60. 조영제 부작용 예, Iodized salt에 알러지 있는사람

-> Corticosteroids