ABDOMINAL AORTIC ANEURISM

ABDOMINAL AORTIC ANEURISM

“4-A’s” Asymptomatic Abdominal mass Abdominal pulse Aches low back

ABDOMINAL DISTENSTION

"5-F's" Fat Fluid Feces Flatus Fetus

ACE INHIBITOR SIDE EFFECTS

"CAPTOPRIL" Cough Anaphylaxis Palpitations Taste Orthostatic -↓BP Potassium - ↑K+ Renal impairment Impotence Leukocytosis

ACID-BASE

"ROME" – Respiratory Opposite, Metabolic Equal

ACIDOSIS

» Respiratory (opposite): pH Pco2

» Metabolic (equal): pH HCO3

ALKALOSIS

» Respiratory (opposite): pH Pco2

» Metabolic (equal): pH HCO3

ACIDOSIS/ALKALOSIS

“ROME”

Respiratory Opposite:

pH↑ PCO2↓ = alkalosis pH↓ PCO2↑ = acidosis

Metabolic Equal:

pH↑ HCO3↑ = Alkalosis pH↓ HCO3↓ = Acidosis

ACIDOSIS/ALKALOSIS – COMPENSTATION

“RUB MUB”

Respiratory Uses Bicarb Metabolic Uses Breathing

ALKALOSIS AND ACIDOSIS

AlKalosis has “K” – it’s “K”icking pH up = PH↑ AciDosis has “D” – it’s “D”ropping pH Down = PH↓

ACUTE INFLAMMATION FEATURES

Think: "what a cute pair of SLIPpeRs" to tie acute

inflammation to “SLIPR”mnemonic).

“SLIPR”

Swelling Loss of function Increased heat Pain Redness

ADRENAL GLAND HORMONES

“SSS”

S-sugar (Glucocorticoids) S-salt (Mineralocorticoids) S-sex (Androgens) AIMS for improvement

“PETEES” AIMS

P - Patient centered care E - Efficient T - Timely E - Effective E - Equitable S - Safety

ALCOHOL WITHDRAWAL – CLINICAL FEATURES

"HITS" Hallucinations (visual, tactile) Increased vital signs & insomnia Tremens delirium tremens (potentially lethal) Shakes/Sweat/Seizures/Stomach pain (N/V)

ALCOHOLISM – BEHAVIORAL PROBLEMS

“5-D's” D- Denial D- Dependency D- Demanding D- Destructive D- Domineering

ALCOHOLISM OUTCOME

“BAD”

B- Brain Damage A- Alcoholic Hallucinosis D- Death

ALDOSTERONE IS REGULATED BY:

"RNA’S" Renin-angiotensin mechanism Na concentration in blood Anp (ANP – atrial natriuretic peptide) Stress ALZHEIMER – “5 A’s” to DIAGNOSIS “5-A's” Amnesia – loss of memories Anomia – unable to recall names of everyday objects

Apraxia – unable to perform tasks of movement Agnosia – inability to process sensory information Aphasia – disruption with ability to communicate

ANGINA – PRECIPITATING FACTORS

"4-E's" Eating Emotion Exertion (Exercise) Extreme Temperatures (Hot/Cold weather)

“ANOREXIA” – EATING DISORDER

A-menorrhea delayed N-o organic factors accounts for weight loss O-obviously thin but feels FAT R-refusal to maintain normal body weight E-epigastric discomfort is common X-symptoms (peculiar symptoms) I-intense fears of gaining weight A-always thinking of foods

ANOREXIA NERVOSA – CLINICAL FEATURES

"ANOREXIC" A-adolescent women/Amenorrhea N-GT alimentation (most severe cases) O-obsession w/ wt. loss/becoming fat though underweight R-refusal to eat (5% die) E-electrolyte abnormalities (e.g., K+, cardiac arrhythmia) X-exercise I-intelligence often above average/Induced vomiting C-cathartic use (and diuretic abuse)

ANTICHOLINERGIC CRISIS

Can't see (blurred vision) Can't spit (dry mouth) Can't pee (urinary retention) Can't shit (constipation)

ANTICHOLINERGIC CRISIS – SIGNS

"SLUD" Salivation Lacrimation Urination Defecation ANTI-TB DRUGS & SIDE EFFECTS

“RIPES”

Rifampicin – red-orange urine Isoniazid – peripheral neuritis Pyrazinamide – increase uric acid Ethambutol – eye problems Streptomycin – ototoxic (use a star as these drugs stain the teeth) – ???(H-eat, I-nduration) – ???

APGAR SCORING

"APGAR"

Appearance: cyanosis--peripheral, central, none

Pulse: pulse rate

Grimace: response to stimulation

Activity: movement of the baby (muscle tone)

Respiration: respiratory rate

APPENDICITIS - ASSESSMENT

“PAINS”

Pain (RLQ) - pain in RLQ of abdomen Anorexia - loss of appetite Increased temperature, WBC (15,000-20,000) Nausea Signs (McBurney's, Psoas)

ARTERIAL BLOOD GASES

1.look at pH:

Low pH = acidosis High pH = alkalosis 2.use “ROME” mnemonic (to determine if its

respiratory or metabolic):

Respiratory – Opposite Metabolic – Equal

ASSESSING CHANGES IN BEHAVIOR

"DEMENTIA" Drug and alcohol Eyes and ears Metabolic and endocrine disorders Emotional disorders Neurologic disorders Tumors and trauma Infection Arterial vascular disease

ASTHMA MANAGEMENT

"ASTHMA" Adrenergics (Albuterol) Steroids Theophylline Hydration (IV) Mask (Oxygen) Antibiotics

ASTHMA - MANAGEMENT

Asthma is a spasm of the airways, which causes difficulty breathing.

“ASTHMA”

Adrenergic (Albuterol) Steroids Theophylline

Hydration (IV) Mask (Oxygen) Antibiotics

ATRIAL FIBRILLATION – NEW ONSET CAUSES

“THE ATRIAL FIBS”

Thyroid Hypothermia Embolism (PE) Alcohol Trauma (cardiac contusion) Recent surgery (post CABG) Ischemia Atrial enlargement Lone or idiopathic Fever, anemia, high-output states Infarct Bad valves (mitral stenosis) Stimulants (cocaine, theo, amphet, caffeine)

ATRIOVENTRICULAR VALVES

"LAB RAT"

Left Atrium: Bicuspid

Right Atrium: Tricuspid

ATROPINE

"A goes with B" Atropine used to treat bradycardia.

BENNER'S MODEL

N - Nickerr's - easy to remember b/c it rhymes with Benner's Novice – strictly able to focus on learning the rules, onset of education A - and - "ad"vanced beginners – distinguish abnormal findings but cannot readily understand significance C - Comp - Competent – able to handle their pt.load and prioritize situation P - Planetary – big picture is the key word - Proficiency E - Experts – Leader/ role model not every nurse becomes one.

BETA 1 AND BETA 2

Beta 1 adrenergic receptors are mostly found in the heart. Beta 2 adrenergic receptors are found in lungs, GI tract, vascular smooth muscle, skeletal muscle, liver. Beta 1 beta blockers act primarily on the heart. Beta 2 beta blockers act primarily on the lungs.

Beta 1: heart

Beta 2: lungs - You have one heart and two lungs

BETA BLOCKERS

B1 Blocks the heart (only have ONE heart) B2 Blocks the lungs (have TWO lungs)

BETA BLOCKER CONTRAINDICATIONS

"ABCDE" Asthma Block (heart block) COPD Diabetes mellitus Electrolyte (hyperkalemia)

BETA BLOCKERS

"You have 1 heart and 2 lungs" Beta-1 act primarily on heart Beta-2 act primarily on lungs

BLEEDING PRECAUTIONS

“RANDI”

R- Razor Electric/Blades A- Aspirin N- No needles (esp. in small gauge) D- Do decrease in needle sticks) I - Injury (Protect from)

BLEEDING PRECAUTIONS

If a patient is taking an anticoagulant to prevent blood clots there is increased risk for bleeding. Be careful with blades when shaving. Do not take aspirin as it interferes with blood clotting and can magnify the effect of the medication. Avoid excess needle sticks and protect the patient from injury.

“RANDI”

Razor Electric/Blades Aspirin Needles- small gauge Decrease needle sticks Injury (Protect from)

BLOOD FLOW THROUGH HEART VALVES

"Tissue Paper My Ass" Tricuspid Pulmonic Mitral Aortic

BLOOD GLUCOSE

Symptom Implication (rhyme) Cold and clammy . . . give hard candy Hot and dry . . . glucose is high

BLOOD TYPES

Picture type O as a huge circle, like the universe, because they are the universal donor. They can give to everyone.However, also think of them as the “odd man out” because they can only receive type O as well. They

are universally odd, able to give to all but only receive from themselves!

BODY SYSTEMS

"MR DICE RUNS" Muscle Respiratory Digestive Integumentary Circulatory Endocrine Reproductive Urinary Nervous Skeletal BRADYCARDIA & LOW BP DRUGS

“IDEA”

I - Isoproterenol D - Dopamine E - Epinephrine A - Atropine Sulfate BRADYCARDIA & LOW BLOOD PRESSURE DRUGS This refers to symptomatic bradycardia and hypotension. Bradycardia and hypotension are not necessarily adverse clinical findings requirement treatment in and of themselves.

“IDEA”

Isoproterenol Dopamine Epinephrine Atropine Sulfate

BRADYCARDIA AND HYPOTENSION MEDS

"IDEA" Isoproterenol Dopamine Epinephrine Atropine Sulfate

BREASTFEEDING ASSESSMENT

"LATCH" Latch achieved by infant Audible swallow Type of nipple Comfort of mother Help given to mother with nursing

BRONCHODILATORS

"TO A SIS" Terbutaline Orciprenaline Adrenaline Salbutamol Isoprenaline Salmeterol

“BULIMIA” – EATING DISORDER

B-binge eating U-under strict dieting L-lacks control over-eating I-induced vomiting M-minimum of two binge eating episodes I-increased/Persistent concern of body size/shape A-abuse of diuretics & laxatives

BULIMIA CLIENT FINDINGS

“WASHED”

W-weight loss of 15% of original body weight A-amenorrhea S-social withdrawal H-history of high activity & achievement E-electrolyte Imbalance D-depression/ Distorted Body Image

CANCER ASSESSMENT

"CAUTION" Change in bowel or bladder habits A sore that doesn't heal Unusual bleeding or discharge Thickening or lump Indigestion or difficulty swallowing Obvious changes in a wart or mole Nagging cough or hoarseness

CANCER - EARLY WARNING SIGNS

Cancer can sometimes be difficult to identify, but the earlier it is detected the better chance treatment will be effective.

“CAUTION UP”

Change in bowel or bladder A lesion that does not heal Unusual bleeding or discharge Thickening or lump in breast or elsewhere Indigestion or difficulty swallowing Obvious changes in wart or mole Nagging cough or persistent hoarseness Unexplained weight loss Pernicious Anemia

CANCER - INTERVENTIONS

“CANCER”

Comfort Altered Body Image Nutrition Chemotherapy Evaluate response to meds Respite for caretakers