Nursing Path

CARING is the essence of NURSING. -Jean Watson

Nursing Path

Knowing is not enough, we must APPLY. Willing is not enough, we must DO. -Bruce Lee

Nursing Path

Treat the patient as a whole, not just the hole in the patient.

Nursing Path

Success is not final. Failure is not fatal. It is the courage to continue that counts. -Winston Churchill

Nursing Path

A problem is a chance for you to do your best. -Duke Ellington

Nursing Research Quiz Series - 8

Pharmacology Quiz Series - 7

Medical-surgical Nursing Quiz Series - 7

Fundamental of Nursing Quiz Series - 7

Nutrition and Biochemistry Quiz Series - 5

Microbiology Quiz Series - 5

Anatomy and Physiology Quiz Series - 5




  

NCLEX Quiz Series

Anatomy and Physiology

Blood  C        Components of blood Red Blood Cell (RBC)   White Blood Cell (WBC)            Immunoglobulin (Ig) & Immunity      Platelets          Bleeding profile            Blood group

Cardiovascular SystemC Heart                    Chamber of hear                    Heart valve & Heart sound            Conduct system          ECG     Blood Pressure           Blood vessels

Endocrine SystemC Concept of Endocrine system  Pituitary gland Thyroid gland            Parathyroid gland       Pancreatic Islets         Adrenalin gland

Urinary SystemC       Concept of urinary system     Bladder

Male Reproductive System   Skin     Eye

Nervous SystemC     Structure        Meninges        Parts of Brain  Spinal Cord            Cranial Nerves

Respiratory SystemC Basic Structure           Lungs   Respiratory Process    Lung Function Test

Digestive SystemC    Basic Structure           Mouth or Oral Cavity  Oesophagus and Stomach          Intestine         Pancreas         Liver    Miscellaneous Term

Skeleton SystemC     Basic Structure           Vertebral Column       Skull            Appendicular Skeleton           Joint

Cell and TissueC        Cell      Tissue              Muscle Tissue DNA and Chromosome            Miscellaneous

Fundamental of Nursing

Fluid Balance & Imbalance     Acid-base Balance and Imbalance     Electrolytes Balance & Imbalance  Blood Transfusion      Oxygen Administration          IV Infusion            Administration of Medication Lab Specimen Positions         Diagnostic Tools

Vital SignsC    Temperature Pulse   Respiration     Blood Pressure           Heat & Cold Application         Diarrhoea and Constipation   Enema Body Mechanism            Unconscious (GCS) & Dying Patient   Pre & Post Operative Nursing Barrier Nursing           Nursing Process          Tracheostomy, ET Intubation Nasogastric Lavage & Gavage        Orthopaedic Procedure like Traction or        Bandages etc.            Lumber Puncture        Paracentesis & Chest Drainage System          Urinary Catheterization & Irrigation   Bed Sore & Wound Care        Wound Care               Other Miscellaneous Procedure                    Nursing Theory, Ethics & As a Profession       Hospital Set up

Medical – Surgical Nursing

Blood  C Anaemia     Haemophilia   Leukemia        Hodgkin’s Disease

Cardiovascular SystemC Hypertension       Myocardial Infarction (Cardiac Indicator of MI)  ECG changes in MI                  Medical Management of MI   Risk factor of MI & CAD     Angina Heart failure   Shock              Cardiac arrest & Heart Block  Ventricular Flutter, Fibrillation, Tachycardia        Valvular Defect           Venous Insufficiency            Vascular Disorder       Embolism,       Thromboembolism, DIC & DVT            Carditis

Endocrine SystemC  Hypo & Hyperthyroidism       Cushing’s Syndrome & Addison’s Disease           Pheochromocytoma   Diabetes Inspidus       Diabetes Mellitus (DM)            DKA (Diabetic Ketoacidosis)

Urinary SystemC       Renal calculi                Renal failure   Nephrotic Syndrome            Glomerulonephritis    BPH     UTI      Miscellaneous

SkinC Burn    Other Skin disorder

EyeC  Cataract & Glaucoma

Nervous SystemC                 Meningitis      Epilepsy          Guillain-Barre Syndrome (GBS)   CVA or Stroke Parkinsonism  Bell’s Palsy      Myasthenia Gravis                 Trigeminal Neuralgia  Head Injury     Spinal Injury                Brain Tumour            Miscellaneous

Respiratory SystemC COPD               Epistaxis                     Pneumonia     ARDS            Pneumothorax           Other Miscellaneous Disorder

Digestive SystemC    Liver Disorder Hepatitis         Pancreatic Disorder    Disorder of Biliary System Gastroenteritis, Gastritis and Peptic & Duodenal Ulcer            Inflammatory Bowel Disorder (Ulcerative Colitis and Crohn’s Disease)            Haemorrhoids Appendicitis               Other Intestinal Disorder                   Other Miscellaneous  Metabolism

Skeleton SystemC     Fracture          Osteoporosis  Osteomyelitis Arthritis

Oncology

Growth & Development

Concept of growth and development             Play     Common Health Problem of new born    Respiratory Distress   KMC in Hypothermia  Fontanel Breast feeding            APGAR Score   Physiological and Pathological Jaundice        Preterm and Post Term New Born          Developmental Milestone     Reflex

Child Health Nursing

Introduction to Child Health Nursing Chromosomal & Other Congenital Disorder            Central Nervous System

Cardiovascular DisorderC    Tetralogy of Fallot      Rheumatic Fever

Gastrointestinal DisorderC  Pyloric Stenosis          Celiac Disease Intussusception            Diarrhea          Megacolon      Phenylketonuria         Cleft Lip & Palate                    Respiratory Disorder Genito-Urinary Disorder

Mental Health Nursing

Introduction to Mental Health          Psychopathology        Models of Care (ECT)

PsychopharmacologyC        Anti-Psychotic Mood Stabilizer (Lithium)                  Antidepressant           Sedative-Hypnotic Drug         Other Miscellaneous Drugs

Psychotherapy            Therapeutic communication

Psychiatric DisordersC         Schizophrenia BPD or Affective Disorder (Mania or Depression)    Phobia Eating Disorder           Substance Abuse        Personality Disorder          Dementia & Delirium (Organic Disorder)                   Grief    Attention-Deficit/Hyperactivity Disorder (ADH) or any Other Childhood Developmental Disorder          Obsessive Compulsive Disorder (OCD)           Anxiety Disorder            Other Miscellaneous Disorders

Community Health Nursing

Vaccination     Cold chain       BCG     Polio Vaccine  MMR   Vitamin           Other Miscellaneous Vaccine           Level of Prevention    Health promotion      Mother Child Health (MCH)    Health Communication          Contraceptives            Demography and Epidemiology                     Mortality and Morbidity            Indicator of health     Epidemiological Term Bio-Medical Waste     HFA, Health Delivery System and PHC        Health Planning in India Including National, International Health Agencies & Professional Bodies           National Health Programme     Environmental Hygiene          Occupational Health  Disaster Management  Vital Health Statistics Home visit      Miscellaneous

Communicable Diseases

Measles          Chickenpox     AIDS    Typhoid          Diphtheria and Shick Test            Tuberculosis               Malaria           Polio    Cholera           Mumps            Dengue           Rabies Leprosy           Whooping Cough (Pertusis)   STD            Plague Kala azar         Other Communicable diseases          Nutrition

Introduction to Nutrition                   Lipids              Protein Carbohydrate Vitamins            Vitamin A        Vitamin B Complex                 Vitamin C        Vitamin D            Vitamin E        Vitamin K        Minerals         National Nutritional Programme            PEM     Miscellaneous

Maternal Nursing

Female Reproductive System Gynaecology   Pelvis               Fetal Head      Position, Presentation, Lie, Attitude and Embryonic Development     Placenta, Amniotic Fluid, Umbilical Cord and Fetal Circulation Normal Pregnancy                  Complication related to Pregnancy, DM During Pregnancy APH (Placenta Previa & Placenta Abruptia)        Abortion         Ectopic Pregnancy      Molar Pregnancy or Hydatidiform Mole   Rh Incompatibility      Twin Pregnancy         Labour Puerperium and its Complication (PPH)    Lochia Surgical Obstetric

Psychology and Sociology

Introduction to Psychology    Ego Defence Mechanism        Maslow’s Hierarchy of Need   Intelligence and their Test      Personality     Emotion          Learning            Miscellaneous

SociologyC    Introduction to sociology                   Marriage         Family

Microbiology

Sterilization    Infection         Microorganism

Pharmacology

Introduction to Pharmacology           NSAID              Opiates           Antibiotic            Poisoning, Antidote & Anaphylactic Reaction           Emergency Drugs            Body Mass Index (BMI)           Diuretic           Miscellaneous

Nursing Education

Introduction to Education & Philosophy       Teaching-Learning Process     Method of Teaching         Instructional Media (AV Aids) Measurement and Evaluation Other Miscellaneous Issue

Nursing Management & Administration

Introduction to Management & Administration       Quality Assurance & Audit            Delegation      Leadership      Span of Control          Supervision     Material Management (Inventory)       Financial Management (Budgeting)   Human Resource Management  Job Description           Record and Report     Ward Management            Other Miscellaneous Issue

Nursing Research and Statistics

Introduction to Nursing Research      Hypothesis     Types of Research Approach/Design       Research Variables     Sampling         Research Tools            Review of Literature   Other Miscellaneous Issue of Research Process            Statistics         Reliability and Validity           Scales of Measurement            Other Issues of Statistics

Anxiety Disorders

Nursing Management Quiz Series - 7

Clozapine


Generic Name : clozapine
Brand Name: Clozaril, FazaClo, Gen-Clozapine (CAN)
Classification: Antipsychotic (Dopaminergic blocker)
Pregnancy Category B

Dosage & Route
Adults
§  Initial therapy: 12.5 mg PO once or twice daily. If using orally disintegrating tablets, begin with 1/2 (12.5 mg) of a 25-mg tablet and destroy the remaining half. Continue to 25 mg PO daily or bid; then gradually increase with daily increments of 25–50 mg/day, if tolerated, to a dose of 300–450 mg/day by the end of second week. Adjust later dosage no more often than twice weekly in increments < 100 mg. Do not exceed 900 mg/day.
§  Maintenance: Maintain at the lowest effective dose for remission of symptoms.
§  Discontinuation of therapy: Gradual reduction over a 2-wk period is preferred. If abrupt discontinuation is required, carefully monitor patient for signs of acute psychotic symptoms.
§  Reinitiation of treatment: Follow initial dosage guidelines, use extreme care; increased risk of severe adverse effects with re-exposure.

Pediatric Patients 
§  Safety and efficacy in patients < 16 yr not established.

Therapeutic actions 
§  Clozapine has relatively weak dopamine receptor-blocking activity at D1, D2, D3 and D5receptors but has high affinity for the D4 receptor. It has also blocking effects on serotonin, α-adrenergic histamine H1 and cholinergic receptors.

Indications 
§  Management of severely ill schizophrenics who are unresponsive to standard antipsychotic drugs
§  Reduction of the risk of recurrent suicidal behavior in patients with schizophrenia or schizoaffective disorder (not orally disintegrating tablet)

Adverse effects 
§  Drowsiness, dizziness, headache; nausea, vomiting, constipation; anxiety, confusion, fatigue, transient fever. Rarely, dysphagia, acute pancreatitis, cholestatic jaundice; orthostatic hypotension, tachycardia; seizures; hypersalivation.
§  Potentially Fatal: Rarely, thromboembolism. Reversible neutropenia which may progress to a potentially fatal agranulocytosis. Fatal myocarditis.

Contraindications 
§  History of bone marrow disorders including agranulocytosis, circulatory collapse, alcoholic or toxic psychosis, drug intoxication, uncontrolled epilepsy, severe renal, hepatic or cardiac disease; paralytic ileus. Pregnancy and lactation.

Nursing considerations
CLINICAL ALERT! Name confusion has occurred between Colazal (balsalazide); dangerous effects could occur. Use caution.

Assessment 
§  History: Allergy to clozapine, myeloproliferative disorders, history of clozapine-induced agranulocytosis or severe granulocytopenia, severe CNS depression, comatose states, history of seizure disorders, CV disease, narrow-angle glaucoma, lactation, pregnancy
§  Physical: T, weight; reflexes, orientation, IOP, ophthalmologic examination; P, BP, orthostatic BP, ECG; R, adventitious sounds; bowel sounds, normal output, liver evaluation; prostate palpation, normal urine output; CBC, urinalysis, LFTs, renal function tests, EEG

Interventions
§  BLACK BOX WARNING: Use only when unresponsive to conventional antipsychotic drugs; risk of serious CV and respiratory effects.
§  Obtain clozapine through the Clozaril Patient Assistance Program. For more information, call 1-800-448-5938.
§  Dispense only 1 wk supply at a time.
§  Monitor WBC carefully prior to first dose.
§  BLACK BOX WARNING: Weekly monitoring of WBC during treatment and for 4 wk thereafter. Dosage may be adjusted based on WBC count. Potentially fatal agranulocytosis has been reported.
§  Monitor T. If fever occurs, rule out underlying infection, and consult physician for comfort measures.
§  BLACK BOX WARNING: Monitor for seizures; with history of seizures, risk increases as dose increases.
§  Monitor elderly patients for dehydration. Institute remedial measures promptly; sedation and decreased thirst related to CNS effects can lead to dehydration.
§  Monitor patient regularly for signs and symptoms of diabetes mellitus.
§  Encourage voiding before taking drug to decrease anticholinergic effects of urinary retention.
§  Follow guidelines for discontinuation or reinstitution of the drug.
§  Educate patient on seriousness of potential agranulocytosis.

Teaching points 
§  Weekly blood tests will be taken to determine safe dosage; dosage will be increased gradually to achieve most effective dose. Only 1 week of medication can be dispensed at a time and will depend on your white blood cell count. Do not take more than your prescribed dosage. Do not make up missed doses, instead contact your health care provider. Do not stop taking this drug suddenly; gradual reduction of dosage is needed to prevent side effects.
§  If you think you are pregnant or wish to become pregnant, contact your health care provider.
§  You may experience these side effects: Drowsiness, dizziness, sedation, seizures (avoid driving or performing tasks that require concentration); dizziness, faintness on arising (change positions slowly); increased salivation (reversible); constipation (consult your health care provider for correctives); fast heart rate (rest, take your time).
§  Report lethargy, weakness, fever, sore throat, malaise, mouth ulcers, and flulike symptoms.