hesi gems(1)

7/23/2019 Hesi Gems(1)

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Normal Values

Hgb Hct RBC WBC

Platelets

• Males 14-18 42-52 4.7-.1 4.5-11 !

15" !-4"" !

• #emales 12-1 $7-47 4.2-5.4

P%&Couma'()* P%%&He+ar()* B,N Cr.

lucose

11-12.5 sec &/* "-7" sec &1.5-2.5 0s )orm* 1"-2"

".5-1.2 7"-11"

Colesterol B(l(rub() Pe)3la)()e (la)t() (t(um

62"" 1-12 6 2 bab3 6 a'ults 1"-2" ".5-1.5

Na+ 1$-145

K+ $.5-5

• H3+o9: . . . Prom()e)t , ;a<es= e+resse' >% segme)t= #lat % ;a<es

• H3+er9: . . . %all %-Wa<es= Prolo)ge' PR ()ter<al= ;('e ?R>

Ca+ @-11

• H3+ocalcem(a A muscle s+asms= co)<uls(o)s= cram+steta)3= : %rousseaus= :

C<oste!s= +rolo)ge' >% ()ter<al= +rolo)ge' ?% segme)t

Mg: Cl Pos lbum() >+ec ra<(t3 Hgb1c

1.5-2.5 @-1" $-4.5 $.5-5 1.""5-1."$" 4-67.5 o! &12" 'a3s*

PH CD2 HCD$ D2 D2 >at

7.$5-7.45 $5-45 H(gEc('os(s 21-28 H(gEl!alos(s 8"-1"" @5-

1""F

7/23/2019 Hesi Gems(1)


• Antidotes

(go0()

- (g(ba)' Couma'()

- V(tam() 9 &9ee+ P% a)' GNR 1-1.5 I )ormal* Be)Jo'(aJa+()es

- #lumJaem(l &%omaJ(co)* Mag)es(um >ulKate

- Calc(um luco)ate He+ar()

- Protam()e >ulKate &9ee+ P%% a)' P%% 1.5-2.5 I )ormal* %3le)ol

- Mucom(st &17 'oses : loa'()g 'ose* D+(ates &)arcot(c a)alges(cs= ero()= mor+()e*

- Narca) &Nalo0o)e* Col()erg(c Me's &M3este)(c Bra'3car'(a*

- tro+()e Metotre0ate

- euco<or()

• Delegation

RN Only

- Bloo' Pro'ucts &2 RNs must cec!*- Clott()g #actors- >ter(le 'ress()g ca)ges a)' +roce'ures

- ssessme)ts tat reLu(re cl()(cal u'gme)t- ,lt(matel3 res+o)s(ble Kor all 'elegate' 'ut(es Unlicensed Assistive Personnel

- No)-ster(le +roce'ures- Ca)t % &e<aluate= assess= teac*

VNs

- #ocuse' assessme)t- ND G<sOO

• Precautions & Room Assignments

,)(<ersal &>ta)'ar'* Precaut(o)s A HGV ()(t(ate'

- Was a)'s- Wear lo<es- o;)s Kor s+lases- Mas!s a)' 3e Protect(o) Kor s+lases a)' 'ro+lets- o)t reca+ )ee'les- Mout+(ece or mbu-bag Kor resusc(tat(o)- ReKra() Krom g(<()g care (K 3ou a<e s!() les(o)

Droplet (Respiratory) Precautions (ear !as")

7/23/2019 Hesi Gems(1)


- >e+s(s= >carlet #e<er= >tre+= #(Kt (sease &Par<o B1@*= Pertuss(s=

P)eumo)(a= G)ue)Ja= (+ter(a= +(glott(t(s= Rubella= Rubeola= Me)()g(t(s=

M3co+lasma= 'e)o<(rus= R()o<(rus- R>V &)ee's co)tact +recaut(o)s too*- %B A Res+(rator3 Gsolat(o)

Contact Precautions E ,)(<ersal : oggles= Mas! a)' o;)

o ND ()Kect(o) +at(e)ts ;(t (mmu)osu++resse' +at(e)tsOO

eird !iscellaneous #tu$ R(Kam+() &Kor %B*

- Rustora)gere' ur()e a)' bo'3 u('s P3r('(um &Kor bla''er ()Kect(o)*

- Dra)gere'+()! ur()e lasgo; Coma >cale

- 6 8 E coma

M3este)(a ra<(s- M3este)(c Cr(s(s E Wea!)ess ;(t ca)ge () <(tals &g(<e more me's*- Col()erg(c Cr(s(s E Wea!)ess ;(t )o ca)ge () <(tals &re'uce me's*

(abet(c Coma <s. G)sul() >oc!

- (<e glucose Qrst GK )o el+= g(<e ()sul() (abet(c 9etoac('os(s

- #ru(t3 breat c('-Base Bala)ce

- GK (t comes out oK 3our ass= (ts c('os(s.- Vom(t()g E l!alos(s

C3st(c #(bros(s

- >!() tastes salt3

(+(tor &stat()s*- () PMs o)l3- No gra+eKru(t u(ce

>tro!e

- %o)gue +o()ts to;ar' s('e oK les(o) &+aral3s(s*= ,<ula 'e<(ates a;a3 Krom

te s('e oK les(o) &+aral3s(s* Hol' (go0() (K HR 6 "

>ta3 () be' Kor $ ours aKter Qrst C G)(b(tor 'ose

<o(' ra+eKru(t u(ce ;(t Ca:: Ca))el Bloc!ers

)tra0 E Mult(-<ector b(oaJar'

Pulmo)ar3 a(r embol(sm +re<e)t(o)

- %re)'ele)burg &HDB 'o;)* : o) leKt s('e &to tra+ a(r () r(gt s('e oK eart* Hea' %rauma a)' >e(Jures

- Ma()ta() a(r;a3 E +r(mar3 co)cer) Pe+t(c ,lcers

- #ee' a uo'e)al ,lcer &+a() rel(e<e' b3 Koo'*- >tar<e a astr(c ulcer

cute Pa)creat(t(s

7/23/2019 Hesi Gems(1)


- #etal +os(t(o)= Blu(s '(scolorat(o) oK a)!s &%ur)ers >(g)*= Blu(s

'(scolorat(o) oK +er(cumbel(cal reg(o) &Culle)s >(g)*= Boar' l(!e ab'ome)

;(t guar'()g A >elK '(gest(o) oK +a)creas b3 tr3+s(). Hol' tube Kee'()g (K res('ual S 1""m

G) case oK #(re

- RC a)' P>> Cec! Restra()ts e<er3 $" m()utes

- 2 Q)gers room u)'er)eat ulla()-Barre >3)'rome

- Wea!)ess +rogresses Krom legs u+;ar' Res+ arrest %roug 'ra;

- T$" m() beKore sce'ule' a'm()(strat(o) Pea! ra;

- $"-" m() aKter me' a'm()(strat(o).

• !ental %ealt & Psyciatry

Most su(c('es occur aKter beg())()g oK (m+ro<eme)t ;(t ()crease () e)erg3

le<els MDGs

- H3+erte)s(<e Cr(s(s ;(t %3ram()e Koo's Nar'(l= Mar+la)= Par)ate

Nee' 2 ;! ga+ Krom >>RGs a)' %Cs to a'm() MDGs

(t(um %era+eut(c Ra)ge E ".5-1.5

Pe)ot(aJ()es &t3+(cal a)t(+s3cot(cs* P>= Potose)s(t(<(t3

t3+(cal )t(+s3cot(cs ;or! o) +os(t(<e a)' )egat(<e s3m+toms= less P>

Be)Jos &t(<a)= oraJe+am= etc*

- goo' Kor lcool ;(t'ra;al a)' >tatus +(le+t(cus )tabuse Kor lcool 'eterre)ce

- Ma!es 3ou s(c! ;(t DH ()ta!e lcool W(t'ra;al

- eler(um %reme)s %ac3car'(a= tac3+)ea= a)0(et3= )ausea= sa!es=

alluc()at(o)s= +ara)o(a A &%s start 12-$ rs aKter last 'r()!* D+(ate &Hero()= Mor+()e= etc.* W(t'ra;al

- Water3 e3es= ru))3 )ose= '(late' +u+(ls= NV= cram+s >t(mula)ts W(t'ra;al

- e+ress(o)= Kat(gue= a)0(et3= '(sturbe' slee+

• !edical'#urgical

H3+o<e)t(lat(o) E c('os(s &too muc CD2*

H3+er<e)t(lat(o) E l!alos(s &lo; CD2*

No BP or GV o) s('e oK Mastectom3

D+(ate D E P()+o()t Pu+(ls

7/23/2019 Hesi Gems(1)


es(o)s oK M('bra()

- ecerebrate Postur()g &0te)'e' elbo;s= ea' arce' bac!* es(o)s oK Corte0

- ecort(cate Postur()g &#le0(o) oK elbo;s= ;r(sts= Q)gers= stra(gt legs=

mumm3 +os(t(o)* ,r()e Dut+ut oK $" mr

- m()(mal com+ete)c3 oK eart a)' !(')e3 Ku)ct(o) 9(')e3 >to)e E Colel(t(as(s

#la)! +a()

- >to)e () !(')e3 or u++er ureter b'om()alscrotal +a()

- >to)e () m('lo;er ureter or bla''er Re)al #a(lure

- Restr(ct +rote() ()ta!e #lu(' a)' electrol3te +roblem

- Watc Kor H3+er9: &'(JJ3= ;!= )ausea= cram+s= ar3tm(as* Pre-re)al Problem

- G)terKere)ce ;(t re)al +erKus(o) G)tra-re)al Problem

- amage to re)al +are)c3ma Post-re)al Problem

- Dbstruct(o) () ,% a)3;ere Krom tubules to uretral meatus. ,suall3 $ +ases &Dl(gour(c= (uret(c= Reco<er3*

Mo)(tor Bo'3 Wt a)' GUDs

>tero(' ects

- Moo) Kace= 3+ergl3cem(a= ac)e= (rsut(sm= bualo um+= moo' s;()gs=

;e(gt ga() >+()'le sa+e= osteo+oros(s= a're)al su++ress(o) &'ela3e'

gro;t () !('s* . . . &Cus()gs >3)'rome s3m+toms*

''(so)s Cr(s(s- Me'(cal merge)c3OO &<ascular colla+se= 3+ogl3cem(a= tac3car'(a A

'm() GV glucose : cort(costero('s*- No PD cort(costero('s o) em+t3 stomac

Potass(um s+ar()g '(uret(c

- l'acto)e &>+(ro)olacto)e*- Watc Kor 3+er9: ;(t t(s a)' C G)(b(tors.

Car'(ac )J3mes

- %ro+o)() &1 r*- C9MB &2-4 r*- M3oglob() &1-4 r*- H1 &12-24 r*

MG %0- N(tro es- ND (go0()= Betabloc!ers= tro+()e

#(br()ol3t(cs

- >tre+to!()ase= %e)ecte+lase &%N9ase* CB E Coro)ar3 rter3 B3+ass raKt

P%C E Percuta)eous %ra)slum()al Coro)ar3 )g(o+last3

7/23/2019 Hesi Gems(1)


>e0 aKter MG o!a3 ;e) able to cl(mb 2 sl(gts oK sta(rs ;(tout e0ert(o) &%a!e

)(tro +ro+3lact(call3 beKore se0* BPH %0

- %,RP &%ra)suretral Resect(o) oK Prostate*- some bloo' Kor 4 'a3s= a)' bur)()g Kor 7 'a3s +ost-%,RP.

D)l3 (soto)(c ster(le sal()e Kor Bla''er Grr(gat(o)

Post %3ro('ectom3

- 9ee+ traceostom3 set b3 te be' ;(t D2= suct(o) a)' Calc(um gluco)ate Per(car'(t(s

- Per(car'(al #r(ct(o) Rub= Pa() rel(e<e' b3 lea)()g Kor;ar' Post >tre+ ,RG (seases a)' Co)'(t(o)s

- cute lomerulo)e+r(t(s- Reumat(c #e<er A Val<e (sease- >carlet #e<er

GK a cest-tube becomes '(sco))ecte'= D ND% clam+ A Put e)' () ster(le

;aterOO Cest %ube 'ra()age s3stem soul' so; bubbl()g a)' ;ater le<el

uctuat(o)s &t('al()g ;(t breat()g* %B

- %0 ;(t mult('rug reg(me) Kor @ mo)ts- R(Kam+() re'uces eect(<e)ess oK DCs a)' tur)s +ee ora)ge- Gso)(aJ('e &GNH* ()creases (la)t() bloo' le<els

,se bro)co'(lators B#DR stero('s Kor astma

- 0ale com+letel3= G)ale 'ee+l3= Hol' breat Kor 1" seco)'s Ve)t(lators

- Ma!e sure alarms are o) A Cec! e<er3 4 ours m()(mum >uct(o)()g

- Pre a)' Post o03ge)ate ;(t 1""F D2 A No more ta) $ +asses A No

lo)ger ta) 15 seco)'s A >uct(o) o) ;(t'ra;al ;(t rotat(o) CDP

- m+3sema E P()! Puer- Cro)(c Bro)c(t(s E Blue Bloater &C3a)os(s= Rt s('e' eart Ka(lure E

bloat()ge'ema* D2 'm()(strat(o)

- Ne<er more ta) m() b3 ca))ula- Must um('(K3 ;(t more ta) 4r- No more ta) 2m() ;(t CDP A &CD2 Narcos(s*- G) asce)'()g or'er oK 'el(<er3 +ote)c3 Nasal Ca))ula= >(m+le #ace Mas!=

No)rebreater Mas!= Part(al Rebreater Mas!= Ve)tur( Mas!- Restless)ess a)' Grr(tab(l(t3 E arl3 s(g)s oK cerebral 3+o0(aOO

s and *lood Product Administration

18-1@ gauge )ee'le Kor bloo' ;(t Qlter () tub()g

Ru) bloo' ;(t N> o)l3 a)' ;(t() $" m()utes oK a)g()g

V(tals a)' Breat >ou)'s

- BeKore= 'ur()g a)' aKter ()Kus(o) &15 m() aKter start= te) $" m() later=

te) ourl3 u+ to 1 r aKter*

7/23/2019 Hesi Gems(1)


Cec! Bloo'

- 0+ ate= clots= color= a(r bubbles= lea!s 2 RNs

- must cec! or'er= +t= bloo' +ro'uct- s! Pt about +re<(ous tra)sKus(o) H0

>ta3 ;(t Pt Kor Qrst 15 m()utes

- GK tra)sKus(o) react(o) A >to+ a)' 9VD ;(t N> Pre-me'(cate ;(t Be)a'r3l +r) Kor +re<(ous urt(car(a r0)s

Gsoto)(c >olut(o)s

- 5W- N> &".@F NaCl*- R()gers actate- N> o)l3 ;(t bloo' +ro'ucts a)' (la)t()

Diaetes and nsulin We) () 'oubt %reat Kor H3+ogl3cem(a Qrst

#(rst GV Kor 9

- N> #(rst= te) ()Kuse Regular ()sul() GV as R0'

H3+ogl3cem(a- co)Kus(o)= H= (rr(table= )ausea= s;eat()g= tremors= u)ger= slurr()g

H3+ergl3cem(a

- ;ea!)ess= s3)co+e= +ol3'(+s(a= +ol3ur(a= blurre' <(s(o)= Kru(t3 breat G)sul() ma3 be !e+t at room % Kor 28 'a3s

ra; Regular &Clear* ()sul() ()to s3r()ge #GR>% ;e) m(0()g ()sul()s

Rotate G)ect(o) >(tes &Rotate () 1 reg(o)= te) mo<e to )e; reg(o)*

Ra+(' ct()g G)sul()s

- (s+ro &Humalog* a)' s+art &No<olog* A D 5-15 m()= P .75-1.5 rs >ort ct()g G)sul()

- Regular &uma)* A D $"-" m()= P 2-$ rs &GV D!a3* G)terme'(ate ct()g G)sul()

- Gso+a)e G)sul() &NPH* A D 1-2 rs= P -12 rs o)g ct()g G)sul()

- larg()e &a)tus* A D 1.1 r= P 14-2" rs &o)t M(0* Dral H3+ogl3cem(cs

- 'ecrease glucose le<els b3 st(mulat()g ()sul() +ro'uct(o) b3 beta cells oK

+a)creas= ()creas()g ()sul() se)s(t(<(t3 a)' 'ecreas()g e+at(c glucose

+ro'uct(o)- l3bur('e= MetKorm() &luco+age*= <a)'(a= ctos- carbose blu)ts sugar le<els aKter meals

Oncology

eu!em(a- )em(a &re'uce' RBC +ro'uct(o)*- Gmmu)osu++ress(o) &)eutro+e)(a a)' (mmature WBCs*- Hemorrage a)' blee'()g te)'e)c(es &tromboc3to+e)(a*

cute 3m+oc3t(c E most commo) t3+e= !('s= best +rog)os(s

%est(cular Ca)cer A Pa()less lum+ or s;ell()g test(cle A >% () so;er S 14

3rs A 15-$5 E ge Prostate Ca)cer A S 4" E g

7/23/2019 Hesi Gems(1)


- P> ele<at(o)- Metast(s(s to s+()e= (+s= legs

le<ate' PP &+rostate ac(' +os+atase*

%R,> E %ra)suretral ,>

Post D+

- Mo)(tor oK emorrage a)' car'(o<ascular com+l(cat(o) Cer<(cal a)' ,ter()e Ca)cer

- aser= cr3otera+3= ra'(at(o)= co)(Jat(o)= 3sterectom3= e0e)terat(o)- Cemotera+3 E No el+

PP smears soul' start ;(t() $ 3ears oK ()tercourse or b3 age 21

D<ar(a) Ca)cer E lea'()g cause oK 'eat Krom g3)ecolog(cal ca)cer

Breast Ca)cer E ea'()g cause oK ca)cer () ;ome)

- ,++er outer Lua'ra)t= leKt S r(gt- Mo)tl3 >elK Breast 0ams

Mammogra+3

- Basel()e $5= ))uall3 aKter age 5"- Metast(s(s to l3m+ )o'es= te) lu)gs= l(<er= bra()= s+()e

Mastectom3- Ra'(cal Mastectom3 E 3m+ )o'es too &but )o mm resecte'*- <o(' BP measureme)ts= ()ect(o)s a)' <e)(+u)cture o) surg(cal s('e

)t(-emet(cs g(<e) ;(t Cemotera+3 ge)ts &C3to0a)= Metotre0ate=

G)terKero)= etc.*- Pe)erga) &PrometaJ()e HCl*- Com+aJ()e &Proclor+eraJ()e*- Regla) &Metocol+ram('e*- Be)a'r3l &(+e)3'ram()e*- XoKra) &D)'a)setro) HCl*- 93tr(l &ra)(setro)*

#,D-s >3+(l(s &%re+o)ema +all('um*

- Ca)cre : re' +a()less les(o) &Pr(mar3 >tage= @" 'a3s*- >eco)'ar3 >tage &u+ to mo* E Ras o) +alms a)' soles : #lu-l(!e

s3m+toms- %ert(ar3 >tage E Neurolog(c a)' Car'(ac 'estruct(o) &1"-$" 3rs*- %reate' ;(t Pe)(c(ll() GM.

o)orrea &Ne(sser(a o)orrea*

- ello; gree) uretral '(scarge &%e Cla+* Clam3'(a &Clam3'(a %racomat(s*

- M(l' <ag()al '(scarge or uretr(t(s

- o03c3cl()= %etrac3cl()e %r(como)(as(s &%r(como)as Vag()al(s*

- #rot3 Koul-smell()g <ag()al '(scarge- #lag3l

Ca)'('(as(s &Ca)'('a lb(ca)s*

- ello;= cees3 '(scarge ;(t (tc()g- M(co)aJole= N3stat()= Clom(traJole &3)e-otr(m()*

Her+es >(m+le0 2

- c3clo<(r

7/23/2019 Hesi Gems(1)


HPV &Huma) Pa++(lo<(rus*

- c('= aser= Cr3otera+3 HGV

- Coc!ta(ls

• Perioperative Care

Breat()g (s taugt () a'<a)ce &beKore or earl3 () +re-o+*

Remo<e )a(l +ol(s &)ee' to see ca+ reQll*

Pre D+

- Me's as or'ere'= NPD I 8 rs= G)ce)t(<e >+(rometr3 U Breat()g s taugt

() a'<a)ce= Vo('= No N>G> I 48 rs G)crease' cort(costero('s Kor surger3 &stress*

- Ma3 )ee' to ()crease ()sul() too Post D+ restless)ess ma3 ()'(cate

- emorrage= 3+o0(a Wou)' 'e(sce)ce or e0tra<(sat(o)

- Wet ster(le N> 'ress()g : Call r. Call r. +ost o+ (K

- 6 $" mr ur()e- >3s BP 6 @"- % S 1"" or 6 @

Post D+ Mo)(tor()g V> a)' B> A <er3 15 m()utes te Qrst our= <er3 $"

m() )e0t 2 ours= <er3 our te )e0t 4 ours= te) <er3 4 ours +r) 1-4 rs Post D+ E Gmme'(ate >tage A 2-24 rs Post D+ E G)terme'(ate >tage

A 1-4 'a3s Post D+ E 0te)'e' >tage Post D+ Pos(t(o)()g

%HR A No ''uct(o) +ast m('l()e= No (+ e0(o) +ast @" 'egrees

>u+rate)tor(al >0

- HDB $"-45 'egrees &>em(-#o;ler* G)Kra)te)tor(al >0

- #lat Pleb(t(s

- >u+()e= ele<ate ()<ol<e' leg Harr(s %ube

- Rtbac!t to a'<a)ce tube () G M(ller bbott %ube

- R(gt s('e Kor G a'<a)ceme)t ()to small ()test()e

%oracoce)tes(s- ,)aecte' s('e= HDB $"-45 'egrees

)em

- eKt >(ms &o; ()to s(gmo('* (<er B(o+s3

- R(gt s('e ;(t +(llo;to;el aga()st +u)cture s(te Cataract >0

- D++ s('e >em(-#o;ler

7/23/2019 Hesi Gems(1)


Car'(ac Cateter(Jat(o)

- #lat &HDB )o more ta) $" 'egrees*= eg stra(gt 4- rs= be' rest -12

rs Bur) utogra+

- le<ate' a)' Gmmob $-7 'a3s m+utat(o)

- >u+()e= ele<ate stum+ Kor 48 rs arge Bra() %umor Resect(o)

- D) )o)-o+erat(<e s('e G)ce)t(<e >+(rometr3

- G)ale slo;l3 a)' com+letel3 to !ee+ o; at ""-@""= Hol' breat 5

seco)'s= 1" t(mes +er r Post D+ Breat()g 0erc(ses A <er3 2 ours

- >(t u+ stra(gt- Breat () 'ee+l3 tru )ose a)' out slo;l3 tru +urse' l(+s- Hol' last breat $ seco)'s- %e) coug $ t(mes &u)less ab' ;ou)' re()Korces+l()t (K coug*

Watc Kor >tr('or aKter a)3 )ec!troat >0- 9ee+ %rac !(t at be' s('e

>ta+les a)' sutures remo<e' () 7-14 'a3s 9ee+ 'r3 u)t(l te)

No l(Kt()g o<er 1" lbs Kor ;ee!s &() ge)eral*

GK cest tube comes '(sco))ecte'

- +ut Kree e)' () co)ta()er oK ster(le ;ater Remo<()g Cest %ube

- Valsal<as= or ee+ breat a)' ol' GK cest tube 'ra() sto+s uctuat()g= te lu)g as re-()ate' &or tere (s a

+roblem* 9ee+ sc(ssors b3 be' (K +t as >. Bla!emore %ube &Kor eso+ <ar(ces*

- >u''e) res+(rator3 '(stress Cut ()at(o) tubes a)' remo<e %raceostom3 +at(e)ts

- 9ee+ 9ell3 clam+ a)' Dbturator &use' to ()sert ()to tracea te) remo<e'

lea<()g ca))ula* at be' s('e %ur) o N suct(o) Kor $" m() aKter PD me's

N %ube Remo<al A %a!e a 'ee+ breat a)' ol' (t

>tomac co)te)ts +H E 6 4 &gastr(c u(ces as+(rate'*

N %ube G)sert(o)

- GK coug a)' gag= bac! o a l(ttle= let calm= a'<a)ce aga() ;(t +t s(++()g

;ater Krom stra; N %ube e)gt

- )' oK )ose= to ear lobe= to 03+o(' &T22-2 ()ces* ecub(tus &+ressure* ,lcer >tag()g

- >tage 1 E r3tema o)l3- >tage 2 E Part(al t(c!)ess- >tage $ E #ull t(c!)ess to >?- >tage 4 E #ull t(c!)ess : ()<ol<()g mm bo)e

7/23/2019 Hesi Gems(1)


• Acute Care

CV A Hemorrag(c or mbol(c

-Qb a)' -utter E trombus Kormat(o)

3sartr(a &<erbal e)u)c(at(o)art(culat(o)*= +ra0(a &+erKorm +ur+oseKul

mo<eme)ts*= 3s+as(a &s+eec a)' <erbal com+ree)s(o)*= +as(a

&s+ea!()g*= gra+(a &;r(t()g*= le0(a &rea'()g*= 3s+ag(a &s;allo;()g* eKt Hem(s+ere es(o)

- a+as(a= agra+(a= slo;= caut(ous= a)0(ous= memor3 o!a3 R(gt Hem(s+ere es(o)

- ca)t recog)(Je Kaces= loss oK 'e+t +erce+t(o)= (m+uls(<e bea<(or=

co)Kabulates= +oor u'gme)t= co)sta)tl3 sm(les= 'e)(es (ll)ess= loss oK

to)al ear()g Hea' G)ur(es A

- <e) subtle ca)ges () moo'= bea<(or= restless)ess= (rr(tab(l(t3= co)Kus(o)

ma3 ()'(cate ()crease' GCP Ca)ge () le<el oK res+o)s(<e)ess

- Most (m+orta)t ()'(cator oK ()crease' GCP Watc Kor C># lea!s Krom )ose or ears

- ea!age ca) lea' to me)()g(t(s a)' mas! ()tracra)(al ()ur3 s()ce usual

()crease' GCP s3m+s ma3 be abse)t.

#pinal Cord n.uries Res+(rator3 status +aramou)t

- C$-C5 ())er<ates '(a+ragm 1 ;! to !)o; ult(mate +rog)os(s

>+()al >oc!

- Com+lete loss oK all ree0= motor= se)sor3 a)' auto)om(c act(<(t3 belo;

te les(o)- Me'(cal emerge)c3OO

Perma)e)t +aral3s(s (K s+()al cor' () com+resse' Kor 12-24 rs

H3+ote)s(o) a)' Bra'3car'(a ;(t a)3 ()ur3 abo<e %

Bla''er G)Kect(o)

- Commo) cause oK 'eat &tr3 to !ee+ ur()e ac('(c*

*urns G)Kect(o) E Pr(mar3 co)cer)

H3+er9: 'ue to cell 'amage a)' release oK ()tracellular 9:

(<e me's beKore 'ress()g ca)ges Pa()Kul

Mass(<e <olumes oK GV u(' g(<e)= 'ue to u(' s(Kt to ()terst(t(al s+aces a)'resulta)t soc!

#(rst egree

- +('erm(s &su+erQc(al +art(al t(c!)ess* >eco)' egree

- +('erm(s a)' erm(s &'ee+ +art(al t(c!)ess* %(r' egree

- +('erm(s= erm(s= a)' >? &Kull t(c!)ess*

7/23/2019 Hesi Gems(1)


Rule oK @s

- Hea' a)' )ec! E @F- , E @F eac- E 18F eac- #ro)t tru)! E 18F- Bac! %ru)! E 18F

>()ge' )asal a(r a)' c(rcumoral sootbur)s- >mo!e ()alat(o) bur)s

/ractures Re+ort ab)ormal assessme)t Q)'()gs +rom+tl3 A Com+artme)t >3)'rome

ma3 occur E Perma)e)t 'amage to )er<es a)' <essels 5 Ps oK )euro<ascular status &(m+orta)t ;(t Kractures*

- Pa()= Pallor= Pulse= Parestes(a= Paral3s(s Pro<('e age-a++ro+r(ate to3s Kor !('s () tract(o)

•#pecial ,ests and Patognomonic #igns

%e)s(lo) %est

- M3este)(a ra<(s &: () M3este)(c cr(s(s= - () Col()erg(c cr(s(s* G> a)' Wester) Blot

- HGV >;eat %est

- C3st(c #(bros(s Ce(los(s E >ores o) s('es oK mout

- R(boa<() 'eQc(e)c3 &B2* %rousseaus >(g) &Car+al s+asm ()'uce' b3 BP cu*

- H3+ocalcem(a &3+o+arat3ro('(sm*

C<oste!s >(g) &#ac(al s+asm aKter Kac(al )er<e ta+*- H3+ocalcem(a &3+o+arat3ro('(sm*

Bloo'3 (arrea

- ,lcerat(<e Col(t(s Dl(<e->a+e' Mass &e+(gastr(c* a)' Proect(le Vom(t()g

- P3lor(c >te)os(s Curre)t Yell3 >tool &bloo' a)' mucus* a)' >ausage->a+e' Mass () R,?

- G)tuss(ce+t(o) Ma)tou0 %est Kor %B (s : (K 1" mm ()'urat(o) 48 rs +ost a'm() &+re<(ous

BC <acc()e rec(+(e)ts ;(ll test :* Butter3 Ras E >

- <o(' '(rect su)l(gt 5 Ps oK NV Ku)ct(o)()g

- Pa()= +arestes(a= +ulse= +allor= +aral3s(s Culle)s >(g)

- +er(umbel(cal '(scolorat(o) E cute Pa)creat(t(s %ur)ers >(g)

- blue a)! E cute Pa)creat(t(s Mur+3s >(g) &Rt. costal marg() +a() o) +al+ ;(t ()s+(rat(o)*

- B or (<er '(sease

7/23/2019 Hesi Gems(1)


H more se<ere o) ;a!e)()g

- Bra() %umor &remo<e be)(g) a)' mal(g)a)t* Vom(t()g )ot assoc(ate' ;(t )ausea

- Bra() %umor le<ate' GCP

- G)crease' BP= ;('e)e' +ulse +ressure= ()crease' %em+ Par!()so)s

- P(ll-Roll()g %remor- e<o'o+a= Car'('o+a- #all +recaut(o)s= r(g('= stoo+e'= suZ()g

G Ba)'s o) lectro+ores(s

- M>- Wea!)ess starts () u++er e0trem(t(es bo;elbla''er aecte' () @"F- em3el()at(o) - %0 ;(t C%H= cort(costero('s= C3to0a) a)' oter

(mmu)osu++ressa)ts Ree'->ter)berg Cells

- Ho'g!()s

9o+l(! >+ots- Rubeola &Measles*

r3tema Marg()atum

- Ras oK Reumat(c #e<er o;ers >(g)

- Muscular 3stro+3 A (!e M()ors s(g) &;al!s u+ legs ;(t a)'s*

• Pediatrics

Be)c Mar!s

B(rt ;t 'oubles at mo)ts a)' tr(+les at 12 mo)ts

B(rt le)gt ()creases b3 5"F at 12 mo)ts Post Ko)ta)el closes b3 8 ;!s

)t Ko)ta)el closes b3 12-18 mo)ts

Moro ree0 '(sa++ears at 4 mo)ts

>tea'3 ea' co)trol ac(e<e' at 4 mo)ts

%ur)s o<er at 5- mo)ts

Ha)' to a)' tra)sKers at 7 mo)ts

>(ts u)su++orte' at 8 mo)ts

Cra;ls at 1" mo)ts

Wal!s at 1"-12 mo)ts

Coo()g at 2 mo)ts

Mo)os3llab(c Babbl()g at $- mo)ts= ()!s s3llables -@ mo

Mama= a'a : a Ke; ;or's at @-12 mo)ts

%ro;s a ball o<era)' at 18 mo)ts

a3t(me to(let tra()()g at 18 mo - 2 3ears

2-$ ;or' se)te)ces at 2 3ears

5"F oK a'ult Ht at 2 3ears

B(rt e)gt 'oubles at 4 3ears

,ses sc(ssors at 4 3ears

7/23/2019 Hesi Gems(1)


%(es soes at 5 3ears

(rls gro;t s+urt as earl3 at 1" 3ears

Bo3s catc u+ T ge 14

(rls Q)(s gro;()g at T15

Bo3s T 17

Autosomal Recessive Diseases

- C#= P9,= >(c!le Cell )em(a= %a3->acs= lb()(sm=- 25F ca)ce (K > &tra(t o)l3* I > &tra(t o)l3*- 5"F ca)ce (K > &tra(t o)l3* I >> &'(sease*

Autosomal Dominant Diseases

- Hu)t()gto)s= MarKa)s= Pol3'act3l= co)'ro+las(a= Pol3c3st(c 9(')e3

(sease- 5"F (K o)e +are)t as te '(seasetra(t &tra(t E '(sease () autosomal

'om()a)t*

0'1in"ed Recessive Diseases- Muscular 3stro+3= Hemo+(l(a - #emales are carr(ers &)e<er a<e te '(sease*- Males a<e te '(sease &but ca)t +ass (t o)*- 5"F ca)ce 'augters ;(ll be carr(ers &ca)t a<e '(sease*- 5"F ca)ce so)s ;(ll a<e te '(sease &)ot a carr(er E ca)t +ass (t o)*- %(s tra)slates to a) o<erall 25F ca)ce tat eac +reg)a)c3 ;(ll result ()

a c(l' tat as te '(sease

>col(os(s

- M(l;au!ee Brace 2$ rs'a3- og roll()g aKter >0

o;) >3)'rome

- %r(som3 21- >(m(a) creases o) +alms= 3+oto)(a= +rotru'()g to)gue= u+;ar' out;ar'

sla)t oK e3es Cerebral Pals3

- >c(ssor()g E legs e0te)'e'= crosse'= Keet +la)tar-e0e' P9,

- lea's to MR- utr(e %est- s+artame &Nutra>;eet* as +e)3lala)()e () (t a)' soul' )ot be g(<e)

to P9, +at(e)t

H3+ot3ro('(sm- ea's to MR

Pre<e)t Neural tube '(sor'ers ;(t #ol(c c(' 'ur()g P

M3elome)()gocele

- Co<er ;(t mo(st ster(le ;ater 'ress()g a)' !ee+ +ressure o H3'roce+alus

- >(g)s oK ()crease' GCP are o++os(te oK soc! A >oc!

7/23/2019 Hesi Gems(1)


- G)crease' +ulse a)' 'ecrease' BP GGCP

- ecrease' +ulse a)' ()crease' BP A &: ltere' DC E Most se)s(t(<e

s(g)* G)Ka)ts GGCP

- Bulg()g Ko)ta)els= (g +(tce' cr3= ()crease' ' c(rcum= su)set e3es=

;('e suture l()es= letarg3- %reat ;(t +er(to)eal su)t 'o)t +um+ su)t.

Dl'er !('s GGPC

- W('e)e' +ulse +ressure GGCP cause' b3 suct(o)()g= coug()g= stra()()g= a)' tur)()g %r3 to a<o('

Muscular 3stro+3

- I-l()!e' Recess(<e- ;a''l()g ga(t= 3+er lor'os(s= o;ers >(g) E '([cult3 r(s()g ;al!s u+ legs

&l(!e M()ors s(g)*= Kat +seu'o3+ertro+3 oK cal<es. >e(Jures

- Not()g () mout= tur) ' to s('e= ma()ta() a(r;a3= 'o)t restra()= !ee+

saKe- %reat ;(t Pe)obarb(tol &um()ol*= Pe)3to() &(la)t() %R E 1"-2" A

()g(<al H3+er+las(a*= #os+e)3to() &Cereb30*= Val+ro(c c(' &e+a!e)e*=

CarbamaJe+()e &%egr(tol* Me)()g(t(s &Bacter(al*

- umbar +u)cture so;s G)crease' WBC= +rote()= GGCP a)' 'ecrease'

glucose Ma3 lea' to >GH &%oo muc H* A Water rete)t(o)= u(' o<erloa'=

'(lut(o)al 3+o)atrem(a C# 9('s taste salt3 a)' )ee' e)J3mes s+r()!le' o) te(r Koo'

C(l're) ;(t Rubella

- treat to u)bor) s(bl()gs &ma3 reLu(re tem+orar3 (solat(o) Krom Mom'ur()g P*

Pa() () 3ou)g c(l're) measure' ;(t #aces +a() scale

No MMR Gmmu)(Jat(o) Kor !('s ;(t H0 oK allerg(c r0) to eggs or )eom3c()

Gmmu)(Jat(o) >('e ects

- % 6 1"2= re')ess a)' sore)ess at ()ect(o) s(te Kor $ 'a3s- g(<e %3le)ol a)' b(!e +e'al legs &+ass(<el3* Kor c(l'.

Call P3s(c(a) (K

- se(Jures= (g Ke<er= or (g-+(tce' cr3 aKter (mmu)(Jat(o) ll cases oK +o(so)()g

- Call Po(so) Co)trol Ce)ter

- No G+ecacO +(glott(t(s

- H. ()ue)Ja B- C(l' s(ts u+r(gt ;(t c() out a)' to)gue +rotru'()g &ma3be %r(+o'

+os(t(o)*= 'rool()g- Pre+are Kor ()tubat(o) or trac- D ND% +ut a)3t()g ()to !('s mout

Gsolate R>V +at(e)t ;(t Co)tact Precaut(o)s

- Pr(<ate room (s best

7/23/2019 Hesi Gems(1)


- ,se M(st %e)t to +ro<('e D2 a)' R(ba<(r() #loo' te)t ;(t D2 Qrst a)'

;(+e 'o;) ()s('e oK te)t +er(o'(call3 so 3ou ca) see +at(e)t cute lomerulo)e+r(t(s

- Kter B stre+ )t(ge)-)t(bo'3 com+le0es clog u+ glomerul( a)' re'uce

#R E ar! ur()e= +rote()ur(a

W(lms %umor- arge !(')e3 tumor A o)t +al+ate %# E %raceoeso+ageal tres(a

- $ Cs oK %# E Coug()g= Co!()g= C3a)os(s CleKt (+ a)' Palate

- Post-D+ Place o) s('e= ma()ta() oga) Bo;= elbo; restra()ts Co)ge)(tal Megacolo)

- H(rscs+ru)gs (sease- ac! oK +er(stals(s 'ue to abse)ce oK ga)gl(o)(c cells () colo)- >us+ect (K )o meco)(um ;() 24 rs or r(bbo)-l(!e Koul smell()g stools

Gro) eQc(e)c3 )em(a

- (<e Gro) o) em+t3 stomac ;(t c(trus u(ce &<(tam() C e)a)ces

absor+t(o)*- ,se stra; or 'ro++er to a<o(' sta()()g teet- %arr3 stools- l(m(t m(l! ()ta!e 6 $2 oJ'a3

>(c!le Cell (sease

- H3'rat(o) most (m+orta)t- >C Cr(s(s E Ke<er= ab' +a()= +a()Kul e'ematous a)'s a)' Keet &a)'-Koot

s3)'rome*= artralg(a- %0 : rest= 3'rat(o) A <o(' (g alt(tu'e a)' stre)uous act(<(t(es

%o)s(ll(t(s A usuall3 >tre+ A

- et P% a)' P%% Pre-D+ &as! about H0 oK blee'()g*- >us+ect Blee'()g Post-D+ (K KreLue)t s;allo;()g= <om(t()g bloo'= or

clear()g troat- No re' l(Lu('s= )o stra;s= (ce collar= soKt Koo's- H(gest r(s! oK emorrage E Qrst 24 rs a)' 5-1" 'a3s +ost-o+ &;(t

sloug()g oK scabs* Pr(mar3 me's Kor R Kor res+(rator3 '(stress

- >us-+r()e &+()e+r()e HCl* a)' %eo+3ll()e &%eo-'ur* A

Bro)co'(lators Must !)o; )ormal res+(rator3 rates Kor !('s A Res+(rator3 '(sor'ers E

Pr(mar3 reaso) Kor most me'(calR <(s(ts Kor !('s A

• Ne;bor)

- $"-"

• 1-11 mo

- 25-$5

• 1-$ 3ears

- 2"-$"

• $-5 3ears

- 2"-25

7/23/2019 Hesi Gems(1)


• -1" 3ears

- 18-22

• 11-1 3ears

- 1-2"

Cardiovascular Disorders Pedi

c3a)ot(c

- V>= >= P= Coarc oK orta= ort(c >te)os(s- )t(+rostagla)'()s cause closure oK P &aorta - +ulmo)ar3 arter3*

C3a)ot(c

- %etralog3 oK #allot= %ru)cus rter(os(s &o)e ma() <essel gets m(0e' bloo'*=

%V &%ra)s+os(t(o) oK reat Vessels* A Pol3c3tem(a commo) () C3a)ot(c

'(sor'ers $ %s oK C3a)ot(c Heart (sease &%etralog3= %ru)cus= %ra)s+os(t(o)*

%etralog3 oK #allot

- ,)o03ge)ate' bloo' +um+e' ()to aorta- Pulmo)ar3 >te)os(s- V>- D<er('()g orta- R(gt Ve)tr(cular H3+ertro+3

%% >+ells

- H3+o0(c e+(so'es tat are rel(e<e' b3 sLuatt()g or !)ee cest +os(t(o) CH# ca) result

- ,se (go0()- %R E ".8-2." Kor !('s

uctus Ve)osus- ,mbel(cal Ve() to G)Ker(or Ve)a Ca<a uctus rter(osus

- orta to Pulmo)ar3 rter3 Reumat(c #e<er

- cLu(re' Heart (sease- ects aort(c a)' m(tral <al<es- Prece'e' b3 beta emol3t(c stre+ ()Kect(o)- r3tema Marg()atum E Ras- le<ate' >D t(ter a)' >R- Cest +a()= sort)ess oK breat &Car'(t(s*= m(grator3 large o()t +a()=

tac3car'(a &e<e) 'ur()g slee+*

- %reat ;(t Pe)(c(ll() E Pro+3la0(s Kor recurre)ce oK R#

• !aternity

a3 1 oK c3cle E #(rst 'a3 oK me)ses &blee'()g*

D<ulat(o) o) a3 14 A 28 'a3s total

7/23/2019 Hesi Gems(1)


>+erm $-5 'a3s= ggs 24 rs

#ert(l(Jat(o) () #allo+(a) %ube

Ca';(c!s >(g)

- Blu()g oK Vag()a &earl3 as 4 ;ee!s* Hegars >(g)

- >oKte)()g oK (stmus oK cer<(0 &8 ;ee!s* oo'ells >(g)

- >oKte)()g oK Cer<(0 &8 ;ee!s* Preg)a)c3 %otal ;t ga() E 25-$" lbs &11-14 !g*

G)crease calor(e ()ta!e b3 $"" calor(es'a3 'ur()g P

G)crease +rote() $" g'a3

G)crease (ro)= Ca::= #ol(c c('= U C

a)gerous G)Kect(o)s ;(t P

- %DRCH E %o0o+lasmos(s= oter= Rubella= C3tomegalo<(rus= HPV Bra0to) H(c!s commo) trougout P

m)(ot(c u('

- 8""-12"" m

- 6 $"" m E Dl(go3'ram)(os E Ketal !(')e3 +roblems Pol33'ram)(os a)' Macrosom(a &large Ketus* ;(t (abetes

,mbel(cal cor'

- 2 arter(es= 1 <e()- Ve() carr(es o03ge)ate' bloo' to Ketus &o++os(te oK )ormal*

#HR E 12"-1"

#ol(c c(' eQc(e)c3 E Neural tube 'eKects

Pre-term

- 2"-$7 ;ee!s %erm

- $8-42 ;ee!s Post-term

- 42 ;ee!s: %P

- %erm b(rts= Pre-term b(rts= bort(o)s= (<()g c(l're) ra<('a

- \ oK Preg)a)c(es regar'less oK outcome Para

- \ oK el(<er(es &)ot !('s* aKter 2" ;!s gestat(o) Nagales Rule

- '' 7 'a3s to Qrst 'a3 oK last +er(o'- subtract $ mo)ts- a'' 12 mo)ts E C

Hgb a)' Hct a b(t lo;er 'ur()g P 'ue to 3+er3'rat(o) >('e-l3()g (s best +os(t(o) Kor utero+lace)tal +erKus(o) &e(ter s('e to leKt (s

tra'(t(o)al * 21 ec(t()>+()gom3el() Rat(o

- #etal lu)gs mature #P () am)(ot(c u('

- +oss(ble )eural tube 'eKect Nee' a Kull bla''er Kor m)(oce)tes(s earl3 () P &but )ot () later P*

7/23/2019 Hesi Gems(1)


(gte)()g

- #etus 'ro+s ()to true +el<(s Nest()g G)st()ct

- Burst oK )erg3 ust beKore labor %rue abor

- Regular co)tract(o)s tat ()te)s(K3 ;(t ambulat(o)= BP tat ra'(ates to

ab'ome)= +rogress(<e '(lat(o) a)' eaceme)t >tat(o)

- Negat(<e abo<e (sc(al s+()es- Pos(t(<e belo;

eo+ol' Ma)eu<er tr(es to re+os(t(o) Ketus Kor 'el(<er3

abor()g Mater)al V(tals

- Pulse 6 1"" &usuall3 a l(ttle (ger ta) )ormal ;(t P - BP (s u)ca)ge'

() P*- % 6 1"".4

NDN->tress %est

- React(<e E Healt3 &#HR goes u+ ;(t mo<eme)ts*

Co)tract(o) >tress %est &Dc3toc() Calle)ge %est*- ,)ealt3 E ate 'ecels )ote' &+os(t(<e result* ()'(cat(<e oK ,PG- Negat(<e/ result E No late 'ecels )ote' &goo' result*

Watc Kor 3+oree0(a ;(t Mag >ulKate a'm()

- (a+ragmat(c G)(b(t(o)- 9ee+ Calc(um gluco)ate b3 te be' &a)t('ote*

#(rsts

#etal HB

- 8-12 ;ee!s b3 o++ler- 15-2" ;ee!s b3 Ketosco+e

#etal mo<eme)t E ?u(c!e)()g

- 14-2" ;ee!s >o;()g

- 14 ;ee!s Bra0to) H(c!s

- 4 mo)ts a)' o);ar' arl3 ecels

- Hea' com+ress(o) E D9 Var(able ecels

- Cor' com+ress(o) E Not oo' ate ecels

- ,tero-+lace)tal ()su[c(e)c3 E BO GK Var(able or ate ecels

- Ca)ge mater)al +os(t(o)- >to+ P(toc()- 'm()(ster D2- Not(K3 P3s(c(a)

GC

- %0 (s ;(t He+ar() &saKe () P*- #etal em(se= bru+t(o Place)ta= G)Kect(o)

#u)'al He(gts

- 12-14 ;!s A t le<el oK s3m+3s(s

7/23/2019 Hesi Gems(1)


- 2" ;ee!s A 2" cm E e<el oK umb(l(cus- R(ses T 1 cm +er ;ee!

>tages oK abor

- >tage 1 E Beg())()g oK Regular co)tract(o) to Kull '(lat(o) a)' eaceme)t- >tage 2 E 1" cm '(lat(o) to 'el(<er3- >tage $ E el(<er3 oK Place)ta

- >tage 4 E 1-4 Hrs Kollo;()g 'el(<er3 Place)ta >e+arat(o)

- e)gte)()g oK cor' outs('e <ag()a= gus oK bloo'= Kull Keel()g () <ag()a- (<e o03toc() aKter +lace)ta (s out Not beKore.

>cultJ Prese)tat(o)

- >()3 s('e out &Ketal s('e oK +lace)ta* Post+artum V> >ce'ule

- <er3 15 m() I 1 r- <er3 $" m() I )e0t 2 ours- <er3 Hour I )e0t 2- ours- %e) e<er3 4 ours

Normal BM Kor mom ;(t() $ 'a3s E Normal

oc(a

- No more ta) 4-8 +a's'a3 a)' )o clots S 1 cm- #les3 smell (s )ormal- #oul smell E ()Kect(o)

Massage bogg3 uterus to e)courage ()<olut(o)

- m+t3 bla''er >P ma3 )ee' to cateter(Je- #ull bla''er ca) lea' to uter()e ato)3 a)' emorrage

%ears

- 1st egree E erm(s- 2)' egree E mmKasc(a- $r' egree E a)al s+()cter

- 4t egree E rectum PR

- HR= R= mm to)e= Ree0 (rr(tab(l(t3= Color- 1 a)' 5 m()utes A7-1" E oo'=- 4- E mo'erate resusc(tat(<e eorts=- 1-$ E mostl3 'ea'

3e care E -m3c() : >(l<er N(trate A Kor go)orrea

Pu'e)'al Bloc!

- 'ecreases +a() () +er()eum a)' <ag()a- No el+ ;(t co)tract(o) +a()

+('ural Bloc!

- %1"->5 A Bloc!s all +a() A #(rst s(g) E ;armt or t()gl()g () ball oK Koot

or b(g toe Reg(o)al Bloc!s oKte) result () Korce+s or <acuum ass(ste' b(rts because

te3 aect te moters ab(l(t3 to +us eect(<el3 WBC cou)ts are ele<ate' u+ to 25=""" Kor T1" 'a3s +ost +artum

Ro&* (mmu)e globul() &RoM*

- g(<e) to R- moters ;o 'el(<er R: !('- Not g(<e) (K mom as a :Coombs %est- >e alrea'3 as 'e<elo+e' a)t(bo'(es &too late*

7/23/2019 Hesi Gems(1)


Ca+ut >ucce'a)eum

-- e'ema u)'er scal+= crosses suture l()es

Ce+alematoma

- bloo' u)'er +er(osteum- 'oes )ot cross suture l()es

>uct(o) Mout Qrst te) )ostr(ls Moro Ree0

- >tartle ree0 &ab'uct(o) oK all e0trem(t(es* u+ to 4 mo)ts Root()g Ree0 A u+ to 4 mo)ts

Bab()s!( Ree0 A u+ to18 mo)ts

Palmar ras+ Ree0 Aesse)s b3 4 mo)ts

Ballar' >cale use' to est(mate gestat(o)al age

Heel >t(c! E lateral surKace oK eel

P3s(olog(c Yau)'(ce

- Normal at 2-$ 'a3s- b)ormal (K beKore 24 ours or last()g lo)ger ta) 7 'a3s

- ,)co)ugate' b(l(rub() (s te cul+r(t. V(tam() 9 g(<e) to el+ ;(t Kormat(o) oK clott()g Kactors 'ue to Kact tat te

)e;bor) gut lac!s te bacter(a )ecessar3 Kor <(tam() 9 s3)tes(s ()(t(all3- Vastus lateral(s mm GM

brut(o Place)ta

- ar! re' blee'()g- R(g(' boar' l(!e ab'ome)

Place)ta Pre<(a

- Pa()less br(gt re' blee'()g GC E (ssem()ate' G)tra<ascular Coagulat(o)

- Clott()g Kactors use' u+ b3 ()tra<ascular clott()g- Hemorrage a)' ()crease' blee'()g t(mes result- ssoc(ate' ;(t Ketal 'em(se= ()Kect(o) a)' abru+t(o +lace)ta.

Mag)es(um >ulKate

- use' to re'uce +reterm labor co)tract(o)s a)' +re<e)t se(Jures () Pre-

clam+s(a- Mg re+laces Ca:: () te smoot mm cells result()g rela0at(o)- Ca) lea' to 3+oree0(a a)' res+(rator3 'e+ress(o)- Must !ee+ Calc(um luco)ate b3 be' ;e) a'm()(ster()g 'ur()g labor E

)t('ote- Mo)(tor Kor

E bse)t %RsE Res+(rat(o)s 6 12

E ,r()ar3 Dut+ut 6 $"rE #etal Bra'3car'(a

P(toc() &D03toc()*

- use Kor 3stoc(a- GK uter()e teta)3 'e<elo+s= tur) o P(toc()= a'm() D2 b3 Kace mas!= tur) +t

o) s('e.- P(toc() ca) cause ;ater ()to0(cat(o) o;()g to H eects.

>us+ect uter()e ru+ture

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- (K ;oma) com+la()s oK a sar+ +a() Kollo;e' b3 cessat(o) oK co)tract(o)s Pre-clam+s(a E

- Ht) : 'ema : Prote()ur(a clam+s(a E

- Ht) : 'ema : Prote()ur(a : >e(Jures a)' Coma- >us+ect (K >e<ere H : <(sual '(sturba)ces

No Couma'() 'ur()g P &He+ar() (s D9* H3+eremes(s ra<('arum

- u)co)trollable )ausea a)' <om(t()g- Ma3 be relate' to H. +3lor(- Regla) &metaclo+rom('e*

G)sul() 'ema)'s 'ro+ +rec(+(tousl3 aKter 'el(<er3

No oral 3+ogl3cem(cs 'ur()g P %eratoge)(c

- G)sul() o)l3 Kor co)trol oK M Bab(es bor) ;(tout <ag()al sLueeJe more l(!el3 to a<e res+(rator3 '([cult3

()(t(all3 C->ect(o) ca) lea' to Paral3t(c Gleus

- arl3 ambulat(o) el+s Post+artum G)Kect(o) commo) () +roblem +reg)a)c(es &a)em(a= '(abetes=

traumat(c b(rt* Post+artum Hemorrage

- ea'()g cause oK mater)al 'eat- R(s! Kactors ()clu'e

E 3stoc(a= +rolo)ge' labor= o<er'(ste)'e' uterus= abrut(o +lace)ta=

()Kect(o)- %0 ()clu'es

E #u)'al massage= cou)t +a's= V>= GV u('s= D03toc()= )ot(K3 +3s(c(a) Y(tter()ess (s a s3m+tom oK 3+ogl3cem(a a)' 3+ocalcem(a () te )e;bor)

H3+ogl3cem(a

- tremors= (g +(tce' cr3= se(Jures H(g +(tce' cr3 : bulg()g Ko)ta)els E GGCP

H3+oterm(a

- ca) lea' to H3+o0(a a)' ac('o(s(s- 9ee+ ;arm- use b(carbo)ate +r) to treat ac('os(s () )e;bor).

a3 o) r(gt s('e aKter Kee'()g

- Mo<e stomac co)te)ts ()to small ()test()e Yau)'(ce a)' H(g b(l(rub() ca) cause e)ce+alo+at3

- 6 12 E )ormal- Pototera+3 'ecom+oses b(l(rub() <(a o0('at(o)

- Protect e3es= tur) e<er3 2 ours a)' ;atc Kor 'e3'rat(o)- %e 'a)gerous b(l(rub() (s te u)co)ugate' ()'(rect t3+e.

• Nutrition

9:

- Ba)a)as= 'r(e' Kru(ts= c(trus= +otatoes= legumes= tea= +ea)ut butter

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V(tam() C

- C(trus= +otatoes= ca)talou+e Ca::

- M(l!= ceese= gree) leaK3 <egg(es= legumes Na:

- >alt= +rocesse' Koo's= seaKoo' #ol(c c('

- ree) leaK3 <egg(es= l(<er= c(trus #e::

- ree) leaK3 <egg(es= re' meat= orga) meat= eggs= ;ole ;eat= carrots- ,se X-trac! Kor ()ect(o)s to a<o(' s!() sta()()g

Mg:

- Wole gra()s= gree) leaK3 <egg(es= )uts %(am()e &B1*

- Por!= beeK= l(<er= ;ole gra()s B12

- Drga) meats= gree) leaK3 <egg(es= 3east= m(l!= ceese= sellQs

- eQc(e)c3 E B(g re' beeK3 to)gue= )em(a V(tam() 9

- ree) leaK3 <egg(es= m(l!= meat= so3 V(tam()

- (<er= ora)ge a)' 'ar! gree) Kru(ts a)' <egg(es V(tam()

- a(r3= Qs o(l= su)l(gt V(tam()

- Vegg(e o(ls= a<oca'os= )uts= see's BMG

- 18.5-24.@ E Normal- H(ger E Dbese

• 2erontology

sse)t(all3 e<er3o)e goes to Hell () a +rogress(<el3 'ege)erat(<e a)'-

bas!et

• %() s!()= ba' slee+= mm ;ast()g= memor3 loss= bla''er sr()!s= ()co)t()e)ce=

'ela3e' gastr(c em+t3()g= CDP= H3+ot3ro('(sm= (abetes

Commo) (lme)ts

• eler(um a)' eme)t(a

• Car'(ac 3sr3tm(as

• Cataracts a)' laucoma

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• CV &usuall3 trombot(c= %Gs commo)*

• ecub(tus ,lcers

• H3+ot3ro('(sm

• %3roto0(cos(s &ra<es (sease*

• CDP &usuall3 comb()at(o) oK em+3sema a)' CB*

• ,%Gs a)' P)eumo)(a A Ca) cause co)Kus(o) a)' 'el(r(um

Memor3 loss starts ;(t rece)t +rogresses to Kull

eme)t(a

- Grre<ers(ble &lJe(mers*- e+ress(o)= >u)'o;)()g= oss oK Kam(l3 recog)(t(o)

eler(um

- >eco)'ar3 to a)oter +roblem

- Re<ers(ble &()Kect(o)s commo) cause* Me'(cat(o) lertO

- ue to 'ecrease' re)al Ku)ct(o)= me's metabol(Je' b3 te !(')e3s ma3

+ers(st to to0(c le<els We) () 'oubt o) NCI A )s;er soul' co)ta() somet()g about e0erc(se

a)' )utr(t(o).

• Advanced Clinical Concepts

3ric"son

' Psyco'#ocial Development "-1 3r &Ne;bor)*

- %rust <s. M(strust 1-$ 3rs &%o''ler*

- uto)om3 <s. oubt a)' >ame A #ear ()trus(<e +roce'ures - >ecur(t3

obects goo' &Bla)!(es= stue' a)(mals* $- 3rs &Pre-scool*

- G)(t(at(<e <s. u(lt A #ear mut(lat(o) Ba)'-('s goo' -12 3rs &>cool ge*

- G)'ustr3 <s. G)Ker(or(t3A ames goo'= Peers (m+orta)t A #ear loss oK

co)trol oK te(r bo'(es

12-1@ 3rs &'olesce)t*- G'e)t(t3 <s. Role Co)Kus(o) A #ear Bo'3 Gmage (stort(o)

2"-$5 3rs &arl3 'ultoo'*

- G)t(mac3 <s. Gsolat(o) $5-5 3rs &M(''le 'ultoo'*

- e)erat(<(t3 <s. >tag)at(o) D<er 5 &Dl'er 'ultoo'*

- G)tegr(t3 <s. es+a(r

7/23/2019 Hesi Gems(1)


o Piaget A Cognitive Development

>e)sor(motor >tage &"-2*

- ear)s about real(t3 a)' obect +erma)e)ce Preo+erat(o)al >tage &2-7*

- Co)crete t()!()g Co)crete D+erat(o)al >tage &7-11*

- bstract t()!()g #ormal D+erat(o)al >tage &11-a'ult*

- bstract a)' log(cal t()!()g

o /reud A Psyco'#e4ual Development

Dral >tage &B(rt -1 3ear*

- >elK grat(Qcat(o)= G' (s () co)trol a)' ru))()g ;(l' )al >tage &1-$*

- Co)trol a)' +leasure ;rt rete)t(o) a)' +oo+()g %o(let tra()()g () t(s

stage Pall(c >tage &$-*

- Pleasure ;(t ge)(tals= De'(+us com+le0= >u+ergo 'e<elo+s ate)c3 >tage &-12*

- >e0 urges ca))ele' to culturall3 acce+table le<el= ro;t oK go e)(tal >tage &12 u+*

- rat(Qcat(o) a)' sat(sK3()g se0ual relat(o)s= go rules 9olberg

- Moral e<elo+me)t- Moral 'e<elo+me)t (s seLue)t(al but +eo+le 'o )ot aromat(call3 go Krom

o)e stage to te )e0t as te3 mature

• e<el 1 E Pre-co)<e)t(o)al A Re;ar' <s. Pu)(sme)t Dr(e)tat(o)

• e<el 2 E Co)<e)t(o)al Moral(t3 A Co)Korms to rules to +lease oters

• e<el $ E Post- Co)<e)t(o)al A R(gts= Pr()c(+les a)' Co)sc(e)ce &Best Kor ll (s a

co)cer)*

• Calculations Rules & /ormulas

Rou)' Q)al a)s;er to te)ts +lace

Rou)' 'ro+s to )earest 'ro+ We) calculat()g mr= rou)' to )earest Kull m

Must ()clu'e " () Kro)t oK <alues 6 1

Pe'(atr(c 'oses rou)'e' to )earest 1""t. Rou)' 'o;) Kor +e's

Calculat()g GV #lo; Rates

- %otal m I ro+ #actor " I \Hrs E #lo; Rate () gttsm() Calculat()g G)Kus(o) %(mes

- %otal m I ro+ #actor #lo; Rate () gttsm() I " E Hrs to G)Kuse

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• Conversions

1 t E 5m

1 % E $ t E 15 m

1 oJ E $" cc E $" m E 2 %

1 gr E " mg

1 mg E 1""" ug &or mcg*

1 !g E 2.2 lbs

1 cu+ E 8 oJ E 24" m

1 +()t E 1 oJ

1 Luart E $2 oJ

egrees # E &1.8 I C* : $2

egrees C E &# $2* 1.8

• /all Precautions

Room close to )urses stat(o)

ssessme)t a)' or(e)tat(o) to room et el+ to sta)' &'a)gle Keet (K l(gt ea'e'*

Be' lo; ;(t s('e ra(ls u+

oo' l(gt()g a)' re'uce clutter () room

9ee+ co)s(ste)t to(let()g sce'ule

Wear +ro+er )o)-sl(+ Koot;ear

o t ome A

Pa()t e'ges oK sta(rs br(gt color

Bell o) cats a)' 'ogs

• Neutropenic (mmunosuppressed) Precautions

No +la)ts or o;ers () room

No Kres <egg(es A Coo!e' Koo's o)l3

<o(' cro;'s a)' ()Kect(ous +erso)s

Met(culous a)' ;as()g a)' 3g(e)e to +re<e)t ()Kect(o)

Re+ort Ke<er S 1"".5 &(mmu)osu++resse' +ts ma3 )ot ma)(Kest Ke<er ;(t

()Kect(o)*

• *leeding Precautions (Anticoagulants5 etc6)

>oKt br(stle' toot brus

lectr(c raJor o)l3 &)o saKet3 raJors*

Ha)'le ge)tl3= (m(t co)tact s+orts

Rotate ()ect(o) s(tes ;(t small bore )ee'les Kor bloo' t())ers

(m(t )ee'le st(c!s= ,se small bore )ee'les= Ma()ta() +ressure Kor 5 m()utes

o) <e)(+u)cture s(tes

7/23/2019 Hesi Gems(1)


No stra()()g at stool - Cec! stools Kor occult bloo' &>tool soKte)ers +r)*

No sal(c3lates= N>Gs= or su++os(tor(es

<o(' blo;()g or +(c!()g )ose

o )ot ca)ge V(tam() 9 ()ta!e (K o) Couma'()

hesi gems(1)

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