These tips sound very random, but they can get overlooked. If you look at NCLEX questions or questions for your nursing exams, you could end up overthinking the multiple choices in front of you. If you have select all that applies, then you could very well be digging your own grave.

1. Hypoparathyroidism

If your patient complains of a “pins and needles” feeling after parathyroid gland removal, you automatically assume it is a neurology problem because pins and needles mean paresthesia. You need to expect the patient’s CALCIUM level to be abnormal. After surgery of parathyroid gland removal, the patient would be at risk for hypocalcemia, which is an indication of hypoparathyroidism.

Hypoparathyroidism is when the parathyroid gland is not able to produce enough parathyroid (PTH). Watch out for signs of dysphagia and paresthesia.

2. Medications contraindications for a pregnant client

I bet you focus hard on what a client can and cannot have that you forget about the pregnant woman. Know the big antibiotic drugs that a PREGNANT woman cannot have. Always question the doctor’s orders with tetracyclines and fluoroquinolones. Cephalosporin can be given to a pregnant client.

3. Addison’s Disease

What is the opposite of Addison’s Disease? Cushing’s Syndrome!

If you have a patient with Addison’s Disease, you will not expect weight gain. In fact, it would be the opposite. The patient would have weight loss. Weight gain is seen in patients with Cushing’s Syndrome.

If a patient has yellow skin, you would not be thinking of Addison’s Disease. You would think of jaundice. With jaundice, the mucus membranes or the whites of your eyes would also turn yellow due to an abnormally high amount of bilirubin.

4. Measuring the amount of drug in the patient’s bloodstream

Are you getting confused between trough and peak levels? Before the scheduled daily dose of the drug given to the patient, measure the amount of drug circulating in the patient’s bloodstream.

When to draw trough levels: when the dose is at its lowest, before administering the next drug. When to draw peak levels: When dose is at its highest, after 30 minutes of administering the drug.

If the levels are abnormal, just document the levels and carry on. Just kidding. Please tell the physician as soon as possible.

5. Paralytic ileus

If you are assigned to a patient with paralytic ileum, you would expect severe abdominal distention. Know that few to no bowel sounds can be heard. After all, the bowel is inactive. The patient may also vomit or have constipation due to bowel obstruction. You would not expect diarrhea.