Cambodia Nursing Exit Exam flashcards

32 cards. Read the term and the definition here. The deck at the top of this page is optional.

Normal adult vital signs

Temperature 36.5-37.5 C, pulse 60-100 beats per minute, respirations 12-20 per minute, blood pressure below 120/80 mmHg, and oxygen saturation 95-100% on room air.

Left versus right heart failure

Left heart failure causes pulmonary congestion with dyspnea, orthopnea, and crackles. Right heart failure causes jugular venous distension, hepatomegaly, and dependent peripheral edema.

Hypoglycemia treatment rule

Blood glucose below 70 mg/dL with sweating, tremor, and confusion is treated with 15 grams of fast carbohydrate, then recheck in 15 minutes.

Stroke thrombolysis window

Intravenous thrombolysis may be given up to 4.5 hours after symptom onset. Check blood glucose first, because hypoglycemia can mimic stroke.

Naegele rule

Estimated date of delivery equals the first day of the last menstrual period minus 3 months, plus 7 days, plus 1 year.

Fetal heart rate decelerations

Baseline is 110-160 per minute. Late decelerations reflect uteroplacental insufficiency; variable decelerations reflect cord compression; both require repositioning and oxygen.

Postpartum hemorrhage definition

Blood loss over 500 mL after vaginal birth or over 1000 mL after cesarean. Uterine atony is the most common cause; treat with fundal massage and oxytocin.

Magnesium sulfate monitoring

Given for preeclampsia seizure prevention; monitor respiratory rate, deep tendon reflexes, and urine output. Loss of reflexes or slow breathing suggests toxicity; antidote is calcium gluconate.

Apgar score components

Scored at 1 and 5 minutes on heart rate, respiratory effort, muscle tone, reflex irritability, and color; each 0-2 points, maximum total 10.

Holliday-Segar fluid rule

Pediatric maintenance fluids: 100 mL/kg for the first 10 kg, 50 mL/kg for the next 10 kg, and 20 mL/kg for each kilogram above 20.

Infant developmental milestones

Head control at 3-4 months, sitting unsupported at 6-8 months, pincer grasp at 9 months, and independent walking at 12-15 months.

Kawasaki disease features

Fever over 5 days with conjunctivitis, rash, cervical lymphadenopathy, cracked lips, and peeling extremities. Main risk is coronary aneurysm; treat with IV immunoglobulin and aspirin.

Pediatric dehydration signs

Sunken fontanel, absent tears, dry mucous membranes, poor skin turgor, and urine output below 1 mL/kg per hour indicate dehydration requiring fluid replacement.

Levels of prevention

Primary prevents disease through immunization and sanitation; secondary detects disease early through screening; tertiary limits disability through treatment and rehabilitation.

Incidence versus prevalence

Incidence is the number of new cases in a period divided by the population at risk. Prevalence is all existing cases at a point in time.

Cold chain requirements

BCG and measles vaccines are kept at 2-8 C; oral polio vaccine is stored frozen. Do not freeze DPT, hepatitis B, or tetanus toxoid.

Epidemiological triad

Disease results from interaction among host, agent, and environment. Breaking any one link interrupts transmission and prevents disease.

Pressure injury staging

Stage 1 is non-blanchable redness; stage 2 is partial-thickness loss; stage 3 extends to fascia; stage 4 reaches bone or tendon; unstageable has slough or eschar.

Five moments of hand hygiene

Before patient contact, before an aseptic task, after body fluid exposure, after patient contact, and after contact with patient surroundings.

Minimum urine output

Adequate adult urine output is at least 0.5 mL/kg per hour. A 1 kg weight change equals approximately 1 liter of fluid.

Digoxin administration safety

Check the apical pulse for one full minute and withhold if below 60 per minute in adults. Therapeutic range is 0.5-2 ng/mL; toxicity causes nausea, visual changes, and bradycardia.

Warfarin and heparin antidotes

Warfarin is monitored by INR with target 2-3; antidote is vitamin K. Heparin is monitored by aPTT; antidote is protamine sulfate.

IV drip rate formula

Drops per minute equals volume in milliliters multiplied by drop factor in drops per milliliter, divided by time in minutes.

Paracetamol overdose antidote

Maximum adult dose is 4 grams daily. Overdose causes liver injury; the antidote is N-acetylcysteine, given as early as possible.

Airborne precautions

Used for tuberculosis, measles, and varicella; requires a negative-pressure room, an N95 respirator, and a closed door.

Clostridioides difficile hand hygiene

Wash hands with soap and water because alcohol-based rub does not kill spores. Use contact precautions and clean with a sporicidal agent.

Adult CPR compression ratio

Give chest compressions at 100-120 per minute, depth 5-6 cm, with full recoil, at a ratio of 30 compressions to 2 breaths.

Anaphylaxis first-line drug

Give adrenaline intramuscularly into the anterolateral thigh, 0.5 mg of 1:1000 for adults, repeated every 5-15 minutes as needed, then support airway and circulation.

Glasgow Coma Scale scoring

Eye opening 1-4, verbal response 1-5, motor response 1-6; total ranges 3-15. A score of 8 or below indicates need for airway protection.

Serotonin syndrome signs

Agitation, hyperthermia, tremor, clonus, and diarrhea after serotonergic drugs. Stop the offending drug and provide urgent supportive care.

Therapeutic communication techniques

Use open-ended questions, reflection, silence, and clarification. Avoid false reassurance, giving advice, and asking why questions.

Informed consent elements

Requires patient capacity, disclosure of risks and benefits, voluntary choice, and comprehension. The provider obtains consent; the nurse witnesses and clarifies.