Study Tip: Thyrotoxicosis

Thyrotoxicosis (Thyroid Storm) – a form of severe hyperthyroidism that can be precipitated by stress, injury, or infection. It is a life-threatening emergency. Manifestations of thyroid storm include temperature above 102 degrees F (39 degrees C) – with this high temperature, all organ systems will be affected, tachycardia, abdominal pain, systolic hypertension, N/V, confusion, agitation, tremors, and possible seizures. Management of treatment requires careful follow-up by an endocrinologist. Medications include antithyroid medications and radioactive iodine.

Content area: Med-Surg | Endocrine

Study Tip: Status Asthmaticus

Status Asthmaticus – a severe, life-threatening acute exacerbation of asthma attack that is unresponsive to initial treatments and interventions for asthma attack with bronchodilators. Status Asthmaticus places the client at high risk for respiratory failure. The client has acidosis, hypoxemia, hypoxia, and hypercapnia; all of these together with effects of increase lung volume place the client at risk for pneumothorax and cardiac arrest. Status asthmaticus is considered a medical emergency.

Content Area: Med-Surg – Respiratory

Critical Thinking Question

Studying, planning and getting ready for your exams. Practice some critical thinking questions as you study; get yourself ready for success!

Complications of Cirrhosis

One of the complications of cirrhosis is Hepatic Encephalopathy. This is a neurological problem resulting from too much ammonia in the blood. Medications for the treatment of Hepatic Encephalopathy include Lactulose and Neomycin.

Question:

A client is undergoing treatment for Hepatic Encephalopathy. What are two main goals (objectives) of therapeutic management for this client?

Leave your answers in the comments

Answer is on Page 2 below

NCLEX Pharm: Heparin

Class: Anticoagulant

Indication:

  • Prevention of clotting in arterial and heart surgery
  • Disseminated Intravascular Coagulation (DIC)
  • Atrial fibrillation with embolization
  • DVT and Pulmonary embolism

Side effects:

  • Hematology: Thrombocytopenia, bleeding, bruising, injection-site reactions,
  • Skin: hair loss,
  • GI: liver enzyme changes

Nursing Tips:

  • Heparin is a High Alert Medication
  • Adjust dose based on lab results.
  • Dosage is considered adequate when the activated partial thromboplastin time (APTT) is 1.5 to 2 times normal
  • Give by deep subcutaneous injections; do not give IM.
  • Have protamine sulfate on hand as antidote.
  • Protect clients from injury, report bleeding gums, black or tarry stools, and severe headache.
  • Avoid intramuscular route of administration because of the frequent occurrence of hematoma at the injection site.
  • Always follow facility’s heparin protocol, whenever working with this medication.

Ref: Roach’s Introductory Clinical Pharmacology

To Your Success!

Rophem 🙂

Holiday Sales

‘Tis the season of giving 🙂 To bring out the special Christmas spirit and to usher in the new year, we have decided to host a new year sale.

FIRST – Continuing Education Courses are at 15% off for Nurses and Advanced Nurses in the following states: 

  • Florida
  • Georgia
  • South Carolina
  • District of Columbia
  • Arkansas
  • Licensed Midwives.
  • Alabama Nurses*

By using the code SAVE15, you can save when you get the course
package for your respective state, and you will be renewal ready.
Course credits post to CE Broker website within 24 hours.
(*Alabama Board of Nursing accepts CE courses that are approved by other BON within the US, see link for reference – http://www.alabamaadministrativecode.state.al.us/docs/nurs/610-X-10.pdf)

SECOND – Two for the price of One! Rophem NCLEX Review for graduate nurses.

Get your license this New Year 2019 with Rophem and what better way to stay accountable than with a friend. Get one NCLEX review and invite a friend for FREE, or simply split the bill for double the reward! Now you and a friend can do it together – #passNCLEX! Register Now on rophem.com! Seats are limited!
January 7, 8, 9, 10 (Mon to Thur).
January 14, 15, 16, 17 (Mon to Thur) – 9 am each day.

 

Rophem 🙂

Reye’s Syndrome

  • Reye’s syndrome is a rare illness, most common in children.
  • It is a serious illness that can be harmful to the brain and the liver.
  • Usually occurs in children who are recovering from a viral infection; which may include cold, flu, or chickenpox.
  • Reye’s syndrome is commonly associated with the use of aspirin in children.
    • To prevent Reye’s syndrome, aspirin (salicylates) should not be given to children.

Symptoms of Reye’s syndrome

  • Symptoms can be very mild and may not be easily noticed.
  • These symptoms can also can be very serious and may get worsen within few hours.
  • Symptoms of Reye’s Syndrome may lead to death.
    • Common symptoms include:
    • Changes in level of consciousness
    • Vomiting, Diarrhea
    • Irritability and aggressive behavior
    • Tachypnea (in children under 2 years old)
    • Confusion, Lethargy, Seizures & Coma

Causes of Reye’s Syndrome

  • The cause of Reye’s syndrome is not known yet.
  • The use of aspirin to treat children with viral illness increases the chances of developing Reye’s syndrome.

Diagnosis of Reye’s Syndrome

  • Diagnosis usually starts with blood and urine tests.
  • Doctors may also test for metabolic disorders that could affect the liver.
  • Sometimes more invasive tests are needed – lumbar puncture, liver biopsy, MRI, or CT.

Prevention of Reye’s syndrome

  • Education – nurses should teach parents to avoid giving children aspirin
  • Aspirin should not be given to any child under the age of 19
  • Prevent viral illnesses in children, teach parents to make sure the child’s vaccinations are up to date.

Treatment for Reye’s Syndrome

  • There is no cure for Reye’s syndrome.
  • Early diagnosis helps towards successful treatment.
  • A client with Reye’s Syndrome will be treated in the hospital, mostly in the intensive care unit (ICU).
  • Treatments include:
  • Corticosteroids
  • IV fluids and Diuretics
  • Medicines to prevent bleeding
  • Client may also need ventilator

Nursing Interventions – Prevent further complications

  • Monitor vital signs – BP, RR, HR, Temp. Administer oxygen. Maintain airway.
  • Monitor Intracranial Pressure and prevent seizures. Position to decrease ICP.
  • Monitor blood glucose levels closely
  • Intake and output, make sure to prevent fluid overload
  • Assess hemodynamic status; monitor cardiac, respiratory and neurologic status.
  • Administer medications per doctor’s orders, monitor for adverse effects, prevent injury and complications.
  • Provide skin and mouth care, provide range of motion exercise to promote joint mobility.
  • Provide supportive care for the client and the family members.

Reference: Wong’s Essentials of Pediatric Nursing 9th edition

Never Give Up

When there is a will, there is a way!!
You truly want to do something; and there are obstacles, you will always find a way to do it.

Set your eyes on the prize; always remember that nothing comes easy in life. If it were to be easy then everyone will have it and it wouldn’t worth that much.
What is the goal that you want to achieve at this time; stay focused, have the strong will and gently find available resources.

Other things will happen at the same time, life has to go on and these things may appear to stand in your way. Try not to pay too much attention to distractions. Stay focused. A person does not fail until they give up. Never give up!!!

With Love
Rophem 🙂