I feel your frustration.The feeling of failing after putting in hours of work is heartbreaking. I go for RN 4th attempt next week. I'm scared as hell. But i will not let this test win. I know i am capable 😌 💯 🙂
Frustration is a very positive sign. It means that the solution to your problem is within range, but what you're currently doing isn't working, and you need to change your approach in order to achieve your goal.
For question 11 why would you place the patient in a sitting position if they have a spinal cord injury? I thought leaving them supine and decreasing environmental stimuli would be best to decrease the ICP. I picked antihypertensive but honestly if that wasn't an option id go with calling the provider
In the case of autonomic dysreflexia in a patient with a spinal cord injury at T4, placing the patient in a sitting position is a critical first step despite general practices to keep spinal cord injury patients flat. Here’s why: Autonomic Dysreflexia Explanation: Autonomic dysreflexia (AD) is a potentially life-threatening condition that occurs in individuals with spinal cord injuries at or above the T6 level. It is characterized by sudden and severe hypertension, a severe headache, and other symptoms. It is triggered by a noxious stimulus below the level of the injury, such as bladder distension, bowel impaction, or skin irritation. Why Place the Patient in a Sitting Position: Immediate Reduction of Blood Pressure: Sitting the patient up helps to lower the blood pressure by promoting venous pooling in the lower extremities. This action helps prevent a hypertensive crisis and reduces the risk of complications such as stroke. Mitigation of Severe Hypertension: Autonomic dysreflexia leads to unopposed sympathetic outflow causing severe vasoconstriction and hypertension. Elevating the head reduces the blood pressure and helps manage the immediate hypertensive emergency. Safety and Prevention of Complications: While spinal precautions are essential to prevent further injury, the immediate danger posed by autonomic dysreflexia’s severe hypertension outweighs the risk of moving the patient. The goal is to stabilize the blood pressure quickly to prevent stroke or other serious complications. Next Steps: After positioning the patient, it is essential to identify and relieve the triggering cause, such as checking for bladder distension and catheterizing if necessary. Administer antihypertensive medication if blood pressure remains high despite initial interventions. Notify the healthcare provider for further management. Reference: "Autonomic Dysreflexia: Management should include immediate measures to lower blood pressure, such as sitting the patient up and removing tight clothing. Identifying and relieving the cause is essential to prevent recurrence." Source: Krassioukov A, Warburton DE, Teasell R, Eng JJ; Spinal Cord Injury Rehabilitation Evidence (SCIRE) Research Team. (2009). Autonomic Dysreflexia and Secondary Complications Following Spinal Cord Injury. Journal of Rehabilitation Research and Development, 46(1), 69-84. This guideline underscores the importance of prompt and appropriate management of autonomic dysreflexia in patients with spinal cord injuries. Also please see: www.ncbi.nlm.nih.gov/books/NBK482434/
While high-Fowler's position is helpful, it is a secondary measure compared to the immediate need for oxygen supplementation. Elevating the head of the bed helps with breathing mechanics but does not directly correct the hypoxemia. In summary, the immediate correction of hypoxemia with oxygen therapy takes precedence over positioning. Oxygen therapy provides a direct and rapid improvement in oxygen saturation, which is critical in stabilizing the patient in acute respiratory distress. Once oxygenation is initiated, placing the patient in a high-Fowler's position can be a supportive intervention to further ease breathing. Reference: "Immediate oxygen therapy is indicated for patients who have acute hypoxemia or signs of severe respiratory distress (e.g., cyanosis, confusion, tachypnea, accessory muscle use, paradoxical breathing). Oxygen therapy can help prevent further hypoxemia-related complications and should be administered as the first line of treatment." Source: American Thoracic Society. (2017). Oxygen Therapy for Adults in the Hospital: An Official American Thoracic Society Clinical Practice Guideline. American Journal of Respiratory and Critical Care Medicine, 195(4), 357-363.
In the case of autonomic dysreflexia in a patient with a spinal cord injury at T4, placing the patient in a sitting position is a critical first step despite general practices to keep spinal cord injury patients flat. Here’s why: Autonomic Dysreflexia Explanation: Autonomic dysreflexia (AD) is a potentially life-threatening condition that occurs in individuals with spinal cord injuries at or above the T6 level. It is characterized by sudden and severe hypertension, a severe headache, and other symptoms. It is triggered by a noxious stimulus below the level of the injury, such as bladder distension, bowel impaction, or skin irritation. Why Place the Patient in a Sitting Position: Immediate Reduction of Blood Pressure: Sitting the patient up helps to lower the blood pressure by promoting venous pooling in the lower extremities. This action helps prevent a hypertensive crisis and reduces the risk of complications such as stroke. Mitigation of Severe Hypertension: Autonomic dysreflexia leads to unopposed sympathetic outflow causing severe vasoconstriction and hypertension. Elevating the head reduces the blood pressure and helps manage the immediate hypertensive emergency. Safety and Prevention of Complications: While spinal precautions are essential to prevent further injury, the immediate danger posed by autonomic dysreflexia’s severe hypertension outweighs the risk of moving the patient. The goal is to stabilize the blood pressure quickly to prevent stroke or other serious complications. Next Steps: After positioning the patient, it is essential to identify and relieve the triggering cause, such as checking for bladder distension and catheterizing if necessary. Administer antihypertensive medication if blood pressure remains high despite initial interventions. Notify the healthcare provider for further management. Reference: "Autonomic Dysreflexia: Management should include immediate measures to lower blood pressure, such as sitting the patient up and removing tight clothing. Identifying and relieving the cause is essential to prevent recurrence." Source: Krassioukov A, Warburton DE, Teasell R, Eng JJ; Spinal Cord Injury Rehabilitation Evidence (SCIRE) Research Team. (2009). Autonomic Dysreflexia and Secondary Complications Following Spinal Cord Injury. Journal of Rehabilitation Research and Development, 46(1), 69-84. This guideline underscores the importance of prompt and appropriate management of autonomic dysreflexia in patients with spinal cord injuries. Also please see: www.ncbi.nlm.nih.gov/books/NBK482434/
Hello 🙂 Please see reference from The attached article from Cleveland Clinic for Neurogenic Shock: my.clevelandclinic.org/health/diseases/22175-neurogenic-shock
"Treatment for acute hyperkalemia involves stabilzing heart function, shifting potassium to the intracellular space [using a combination of IV insulin plus glucose (to offset hypoglycemia)..." Source: www.kidney.org/atoz/content/hyperkalemia/facts That being said, Yes, absolulutely Calcium Gluconate Reduces the risk of ventricular fibrillation caused by hyperkalemia. But, it does not take care of the initial issue of hyperkalemia. This will all be up to the ordering MD. @Geraldtrujillom You have great critical thinking skills and so happy you brought this up. 👍👍
![How to PASS the NCLEX [7 Day Training] Day #1 How to prepare for NCLEX Success](http://i.ytimg.com/vi/ljKgQaBW0io/mqdefault.jpg)
No .1
Should be high fowlers position followed by 02 therapy
I also failed on my 3rd attempt just last week. Its ridiculous, I've been studying and its all for nothing😢😭
I feel your frustration.The feeling of failing after putting in hours of work is heartbreaking. I go for RN 4th attempt next week. I'm scared as hell. But i will not let this test win. I know i am capable 😌 💯 🙂
Frustration is a very positive sign. It means that the solution to your problem is within range, but what you're currently doing isn't working, and you need to change your approach in order to achieve your goal.
Thank you.
Kindly include case study questions.
73/75... I'm ready
Thank you mam more useful...
For question 11 why would you place the patient in a sitting position if they have a spinal cord injury? I thought leaving them supine and decreasing environmental stimuli would be best to decrease the ICP. I picked antihypertensive but honestly if that wasn't an option id go with calling the provider
In the case of autonomic dysreflexia in a patient with a spinal cord injury at T4, placing the patient in a sitting position is a critical first step despite general practices to keep spinal cord injury patients flat. Here’s why:
Autonomic Dysreflexia Explanation:
Autonomic dysreflexia (AD) is a potentially life-threatening condition that occurs in individuals with spinal cord injuries at or above the T6 level. It is characterized by sudden and severe hypertension, a severe headache, and other symptoms. It is triggered by a noxious stimulus below the level of the injury, such as bladder distension, bowel impaction, or skin irritation.
Why Place the Patient in a Sitting Position:
Immediate Reduction of Blood Pressure: Sitting the patient up helps to lower the blood pressure by promoting venous pooling in the lower extremities. This action helps prevent a hypertensive crisis and reduces the risk of complications such as stroke.
Mitigation of Severe Hypertension: Autonomic dysreflexia leads to unopposed sympathetic outflow causing severe vasoconstriction and hypertension. Elevating the head reduces the blood pressure and helps manage the immediate hypertensive emergency.
Safety and Prevention of Complications: While spinal precautions are essential to prevent further injury, the immediate danger posed by autonomic dysreflexia’s severe hypertension outweighs the risk of moving the patient. The goal is to stabilize the blood pressure quickly to prevent stroke or other serious complications.
Next Steps:
After positioning the patient, it is essential to identify and relieve the triggering cause, such as checking for bladder distension and catheterizing if necessary.
Administer antihypertensive medication if blood pressure remains high despite initial interventions.
Notify the healthcare provider for further management.
Reference:
"Autonomic Dysreflexia: Management should include immediate measures to lower blood pressure, such as sitting the patient up and removing tight clothing. Identifying and relieving the cause is essential to prevent recurrence."
Source: Krassioukov A, Warburton DE, Teasell R, Eng JJ; Spinal Cord Injury Rehabilitation Evidence (SCIRE) Research Team. (2009). Autonomic Dysreflexia and Secondary Complications Following Spinal Cord Injury. Journal of Rehabilitation Research and Development, 46(1), 69-84.
This guideline underscores the importance of prompt and appropriate management of autonomic dysreflexia in patients with spinal cord injuries.
Also please see: www.ncbi.nlm.nih.gov/books/NBK482434/
@@nursestudynet8717 thank you. passed my NCLEX on the 2nd of July ❤️
@@chenillemorales5929congrats!! 👏🏻👏🏻
@@nursestudynet8717 well explained
The o2 saturation is very low
Maam @ no. 17. Would it be necessary to stop the cause to prevent further complication before we administer oxygen?
I feel so too
Yessss... I feel so too
That is definitely what I think too
@nursestudynet
I agree
Its really good. Thank you mam
In number 1 why can't you position the patient first before initiating o2 therapy?
That's what my answer is, D
While high-Fowler's position is helpful, it is a secondary measure compared to the immediate need for oxygen supplementation. Elevating the head of the bed helps with breathing mechanics but does not directly correct the hypoxemia.
In summary, the immediate correction of hypoxemia with oxygen therapy takes precedence over positioning. Oxygen therapy provides a direct and rapid improvement in oxygen saturation, which is critical in stabilizing the patient in acute respiratory distress. Once oxygenation is initiated, placing the patient in a high-Fowler's position can be a supportive intervention to further ease breathing.
Reference:
"Immediate oxygen therapy is indicated for patients who have acute hypoxemia or signs of severe respiratory distress (e.g., cyanosis, confusion, tachypnea, accessory muscle use, paradoxical breathing). Oxygen therapy can help prevent further hypoxemia-related complications and should be administered as the first line of treatment."
Source: American Thoracic Society. (2017). Oxygen Therapy for Adults in the Hospital: An Official American Thoracic Society Clinical Practice Guideline. American Journal of Respiratory and Critical Care Medicine, 195(4), 357-363.
Thanks for this 😊
We were told in school to sit the patient up first then apply o2, but I guess it’s o2 in this case because they came in having difficulty breathing.
If they came in with SoB, you can assume they're not laying down.
Thank you mam ‘m can you do a video on Maternity. ❤❤❤
Yes, soon
Thanks Alot nice section 👍🏻
Can you do a video for psych mental health and psych medication please
Thanks ma'am
Thku
Thanks
In number 11 is it okay for a patient with a thoracic spinal cord injury to put in a sitting position?
In the case of autonomic dysreflexia in a patient with a spinal cord injury at T4, placing the patient in a sitting position is a critical first step despite general practices to keep spinal cord injury patients flat. Here’s why:
Autonomic Dysreflexia Explanation:
Autonomic dysreflexia (AD) is a potentially life-threatening condition that occurs in individuals with spinal cord injuries at or above the T6 level. It is characterized by sudden and severe hypertension, a severe headache, and other symptoms. It is triggered by a noxious stimulus below the level of the injury, such as bladder distension, bowel impaction, or skin irritation.
Why Place the Patient in a Sitting Position:
Immediate Reduction of Blood Pressure: Sitting the patient up helps to lower the blood pressure by promoting venous pooling in the lower extremities. This action helps prevent a hypertensive crisis and reduces the risk of complications such as stroke.
Mitigation of Severe Hypertension: Autonomic dysreflexia leads to unopposed sympathetic outflow causing severe vasoconstriction and hypertension. Elevating the head reduces the blood pressure and helps manage the immediate hypertensive emergency.
Safety and Prevention of Complications: While spinal precautions are essential to prevent further injury, the immediate danger posed by autonomic dysreflexia’s severe hypertension outweighs the risk of moving the patient. The goal is to stabilize the blood pressure quickly to prevent stroke or other serious complications.
Next Steps:
After positioning the patient, it is essential to identify and relieve the triggering cause, such as checking for bladder distension and catheterizing if necessary.
Administer antihypertensive medication if blood pressure remains high despite initial interventions.
Notify the healthcare provider for further management.
Reference:
"Autonomic Dysreflexia: Management should include immediate measures to lower blood pressure, such as sitting the patient up and removing tight clothing. Identifying and relieving the cause is essential to prevent recurrence."
Source: Krassioukov A, Warburton DE, Teasell R, Eng JJ; Spinal Cord Injury Rehabilitation Evidence (SCIRE) Research Team. (2009). Autonomic Dysreflexia and Secondary Complications Following Spinal Cord Injury. Journal of Rehabilitation Research and Development, 46(1), 69-84.
This guideline underscores the importance of prompt and appropriate management of autonomic dysreflexia in patients with spinal cord injuries.
Also please see: www.ncbi.nlm.nih.gov/books/NBK482434/
Thanks mam 🎉
Number one should we not start with Theo oedema so give diuretics
The easiest way to remember IPSG
How can i want certifiy
Hi teacher,
For question 8:- if the patient is allergic to lactulose. What can be given instead .
Rifaximin Has been considered.
Mam. Can you please do a Saunders Capstone review please? I’m struggling.
Hernandez Margaret Clark Laura Thomas Charles
warm and flushed skin in neurogenic shock all shock have dry cold and clammy skin
Hello 🙂 Please see reference from The attached article from Cleveland Clinic for Neurogenic Shock: my.clevelandclinic.org/health/diseases/22175-neurogenic-shock
Pls my people, can we really only on thi or another ways to pass the exam pls
❤❤❤❤
Lopez Dorothy Lewis Anna Clark Helen
Lopez Michelle Hernandez Margaret Jones Edward
Question 9 , forst line is calcium gluconate
"Treatment for acute hyperkalemia involves stabilzing heart function, shifting potassium to the intracellular space [using a combination of IV insulin plus glucose (to offset hypoglycemia)..."
Source: www.kidney.org/atoz/content/hyperkalemia/facts
That being said, Yes, absolulutely Calcium Gluconate Reduces the risk of ventricular fibrillation caused by hyperkalemia. But, it does not take care of the initial issue of hyperkalemia.
This will all be up to the ordering MD.
@Geraldtrujillom You have great critical thinking skills and so happy you brought this up. 👍👍
Questions repeated after 50.
G!
b
Thanks