YOUR WEEKEND NCLEX TIP

After hip replacement surgery, the patient should avoid these three positions until fully recovered:

• Bending more than 90 degrees at the waist (for example, bending over to pick something up)
• Internally rotating the leg
• Adducting the legs (including crossing one’s legs)

The device seen above helps to prevent the latter two positions from occurring during sleep

YOUR WEEKEND NCLEX TIP 

RNs can delegate tasks to other RNs and LPNs - CNAs are assigned tasks to do. The language is very subtle yet important here. In addition, tasks that you cannot delegate include: assessments, judgements and patient education. 

YOUR WEEKEND NCLEX TIP 

Chronic is more stable than acute. This gets tricky when you’re trying to prioritize your care and there’s a chronically ill patient involved. For example, even though COPD is an airway issue, it’s a chronic one - therefore it’s lower on the priority list than caring for any acutely sick patients. 

YOUR WEEKEND NCLEX TIP

If the question lists vital signs, it’s usually for a reason. For example, wide pulse pressure (the difference between systolic and diastolic blood pressure readings) usually indicates an increased intracranial pressure. 

MED REVIEW MONDAY

Penicillin is a very popular antimicrobial which works by interfering with the synthesis of bacteria cell walls. It was first made available to the public in the early 1940’s and was sort of a “silver bullet” drug - it worked on most gram positive infections. Unfortunately, there can be severe side effects, ranging from a rash or GI upset to a full anaphylactic reaction. Over 10% of the population is allergic to the drug! Penicillin has been used so widely for the past seven decades that many bacteria have developed resistance, so scientists went right on ahead and started producing combination therapies that included resistance inhibitors in the same dosage (haha, evolution - take that!) NCLEX tip: Penicillin should be taken on an empty stomach (one hour before meals or two hours after) because it is destroyed by gastric acid. 

YOUR WEEKEND NCLEX TIP

When a patient is exhibiting any sort of respiratory difficulty, your first priority is always to raise the head of the bed. 

MED REVIEW MONDAY: Acetylcysteine aka Mucomyst

• Classified as mucolytic (muco = mucus, lytic = breaks up)
• Used to break up mucus in respiratory conditions such as cystic fibrosis, pneumonia, TB and COPD
• Administered through a nebulizer
• Distinct rotten egg smell
• In the oral form, it acts as an antidote for acetaminophen overdose

Those of you who have been following my blog for a while are probably familiar with “Celebrity Saturday” - I had originally chosen to analyze diseases that could be linked with celebrities because I find that relating nursing to pop culture helps me remember things better. Unfortunately for blogging purposes (but fortunately for celebrities!), this is a limited subject and I’ve run out of celebrities. I will now designate Saturdays for tips for taking the nursing boards (or, “NCLEX” as it’s called in the US). The content will consist of little reminders of things I didn’t pick up until I took a review course. 

YOUR WEEKEND NCLEX TIP

Patients with small-cell lung cancer are always at risk for developing SIADH (syndrome of inappropriate anti-diuretic hormone hypersecretion).

CELEBRITY SATURDAY

Impetigo is a skin infection usually seen in pre-schoolers and athletes who participate in skin-to-skin contact such as wrestlers. Symptoms include red sores that erupt and ooze, resulting in honey-colored crusts. The infection is very contagious, so patients should cover their sores with gauze or bandages and avoid allowing the infected area to come into contact with others, especially those with pre-existing skin conditions such as eczema. They should wash their hands often and linens should be washed separately. Itching will spread the infection. There are two types of impetigo: less-severe Bullous impetigo which is caused by the Staph bacteria, and Ecthyma, caused by the Strep bacteria with sores penetrating into the dermis layer of the skin. Mild cases of impetigo can be treated with bactericidal ointment such as neosporin, more serious cases should be treated with an oral antibiotic such as erythromycin. Children should be kept home from school until deemed non-contagious, usually after 24 hours of starting antibiotics. 

In Spring 2008, the late Amy Winehouse was diagnosed with an Impetigo infection.