NCLEX buzzer round

NCLEX BUZZER....SATA TYPE QUESTION ON DIGOXIN TOXICITY

The answer for the above SATA type question is

2, 4, & 5

Areas to brainstorm…

Early Signs of Toxicity

GI manifestations such as anorexia, nausea, vomiting and diarrhea.

Subsequent Manifestations

Head ache

Visual disturbances such as. Diplopia, Blurred vision, Yellow-green halos and Photophobia

Other Manifestations

Drowsiness, fatigue, and weaknesses

Cardiac Rhythm abnormalities

 Any questions feel free to ask in comments.

HAVE A HEALTHY AND HAPPY TIME

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HOW GOOD ARE YOU AT MED SURG – 2

Today I am here  with some abdominal signs that can be elicited on abdominal examination. Do you know the disease conditions where these signs are seen???

Remember the answers for these?? Plz, share your answers…

Here is the answer…

A smiling umbilicus is seen in ascitis

The normal umbilicus is inverted and situated centrally in the mid abdomen. In ascitis umbilicus is transversely stretched giving it a look,  like that of a smile. Hence the name smiling  umbilicus.

It’s not the only case where a smiling umbilicus is seen

Yes, a Smiling umbilicus can be seen in obese patients and also in pregnant women 

2) Cullen sign : 

It is the bluish discoloration of the periumbilical area.It is seen in either,hemorrhagic pancreatitis or ruptured ectopic pregnancy.

3) crying umbilicus is seen in  Ascitis

In this the umbilicus may exude fluid,( ascitis fluid) which is seen as a cry.

Crying can occur in some other diseases too.

Eg: Enteric Fistulae,where the umbilicus excuds feculant material.

Clear fluid exudate in patent urachus.

All these for today…

Have a healthy and happy time…

Buzzer Round for NCLEX…

Today I am introducing a brand new area which will help you in your studies for nursing competitive exams. I like to call it as the BUZZER ROUND FOR NCLEX…

Continue reading Buzzer Round for NCLEX…

TAMIFLU

The year 2018 is more of a bitter one except for one or two sweet memories. After the devastating flood, which drained me out physically and mentally, it’s the turn of H1N1 flu to attack my health.

Continue reading TAMIFLU

HOW GOOD ARE YOU AT MED SURG?

Thought to share some reminders in med surg, which are very minor but much useful information. A free printable of the Q card is there at the end of this topic,  with answers. Continue reading HOW GOOD ARE YOU AT MED SURG?

ACCEPTING THE UNAVOIDABLE… MY PERSONAL EXPERIENCES DURING KERALA FLOOD 2018

Let me say SORRY to all my dear readers…This very gap in my posts was really unexpected. Firstly, even though in vacation my plans to continue to write was a big fail, as we were stuck in the Flood that hit my homeland…our gods own country…Kerala.

Kerala is a calm and serene destination in south India. We the people of Kerala are always blessed with the finest climates, and the rainy season – the monsoon- on which agricultural Kerala relays on, is a time of blend emotions, that Keralites always cherish. The school reopenings, all the busy rainy mornings, playful kids at the roadside puddles, that patting sounds of rain at the window sills…

But, the rainy season of 2018, was not like the previous years. It was as if GOD had plans, not a single, but many many plans to each individual Keralites…and that’s why each one of us have our own stories to share, stories of horror, and sleepless nights, prayers and religious harmony, cooperation and compassion, moreover the stories of acceptance of the unavoidable, acceptance of the supernatural power above .

Here is the front view of my house during the flood. A picture captured by my relative who took shelter on the first floor of our house. Later they were rescued by the helicopter rescue team.

My House

The aftermath of the devastating flood…

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Days of cleaning and chlorination followed and still some more electrical and plumbing works pending.

All those flood days taught many valuable lessons.

Firstly, only a neighbor worth more than a distant relative.

Then, we understood the warmth of family bonds, as many of us took shelter in those relatives house, we haven’t been in touch for long.

We came to understand, how to live with minimal resources.

We learned to be in harmony irrespective of religion, financial or social status.

Now, after three months, our Kerala is almost back on track. And once again is open to the world with her natural beauty…..

Bonus: You could watch a documentary on 12th Nov 2018 on Discovery Channel at  9 pm (IST ) ‘KERALA FLOODS – THE HUMAN STORY’

ANTIANGINALS

 

A case of chest pain in the emergency department always go for the protocol of angina and/or MI. The MI protocol primarily focuses on relief of pain with antianginal medications.

What are Antianginal Medications?

Those medicines which reduce the oxygen demand of the myocardium or increases the oxygen supply to the heart are known as The Antianginal Drugs.

Examples

Here I will discuss the details of Nitrates

NITRATES

Classification

Screenshot_20180720-091006_1.jpg

Indications of NITRATES

  • Acute Angina – Prophylaxis and Treatment
  • Chronic Angina treatment
  • Hypertension associated with MI or CHF
  • Raynaud’s disease (NTG ointment)

Mechanism of Action

Antianginals mainly work either by decreasing the Oxygen demand or by increasing oxygen supply.

PHARMACOKINETICS

  • ONSET – 2min (S/L); 3min (PO); 30min (Topical)
  • HALF LIFE – 5-7min
  • METABOLISM – In Liver

Contraindications

  • Sensitivity to Nitrates
  • Severe Anemia
  • Hepatic or Renal dysfunction
  • Hypotension
  • Head Trauma
  • Cerebral Haemorrhage

Side Effects

  • Dizziness (especially at the beginning of the treatment)
  • Orthostatic Hypotension
  • Topical application may lead to dermatitis
  • A throbbing Headache
  • Flushing of face
  • Reflex tachycardia

Drug Interaction

Additive hypotension with other ANTIHYPERTENSIVES

SILDENAFIL (Viagra) can cause additive hypotension

Intake of ALCOHOL along with NTG also cause hypotension

NURSING CONSIDERATIONS WHILE ADMINISTERING NITRATES

About the nurse’s responsibility, there is a lot to discusses. So I am dealing with it as a separate post. You can read it  NURSING CONSIDERATIONS WHILE ADMINISTERING NITRATES