ABDOMINAL AORTIC ANEURISM Think: "what a cute pair of SLIPpeRs" to tie acute
“4-A’s” inflammation to “SLIPR”mnemonic).
Asymptomatic “SLIPR”
Abdominal mass Swelling
Abdominal pulse Loss of function
Aches low back Increased heat
ABDOMINAL DISTENSTION Pain
"5-F's" Redness
Fat ADRENAL GLAND HORMONES
Fluid “SSS”
Feces S-sugar (Glucocorticoids)
Flatus S-salt (Mineralocorticoids)
Fetus S-sex (Androgens)
ACE INHIBITOR SIDE EFFECTS AIMS for improvement
"CAPTOPRIL" “PETEES” AIMS
Cough P - Patient centered care
Anaphylaxis E - Efficient
Palpitations T - Timely
Taste E - Effective
Orthostatic -↓BP E - Equitable
Potassium - ↑K+ S - Safety
Renal impairment ALCOHOL WITHDRAWAL – CLINICAL FEATURES
Impotence "HITS"
Leukocytosis Hallucinations (visual, tactile)
ACID-BASE Increased vital signs & insomnia
"ROME" – Respiratory Opposite, Metabolic Equal Tremens delirium tremens (potentially lethal)
ACIDOSIS Shakes/Sweat/Seizures/Stomach pain (N/V)
» Respiratory (opposite): pH Pco2 ALCOHOLISM – BEHAVIORAL PROBLEMS
» Metabolic (equal): pH HCO3 “5-D's”
ALKALOSIS D- Denial
» Respiratory (opposite): pH Pco2 D- Dependency
» Metabolic (equal): pH HCO3 D- Demanding
ACIDOSIS/ALKALOSIS D- Destructive
“ROME” D- Domineering
Respiratory Opposite: ALCOHOLISM OUTCOME
pH↑ PCO2↓ = alkalosis “BAD”
pH↓ PCO2↑ = acidosis B- Brain Damage
Metabolic Equal: A- Alcoholic Hallucinosis
pH↑ HCO3↑ = Alkalosis D- Death
pH↓ HCO3↓ = Acidosis ALDOSTERONE IS REGULATED BY:
ACIDOSIS/ALKALOSIS – COMPENSTATION "RNA’S"
“RUB MUB” Renin-angiotensin mechanism
Respiratory Uses Bicarb Na concentration in blood
Metabolic Uses Breathing Anp (ANP – atrial natriuretic peptide)
ALKALOSIS AND ACIDOSIS Stress
AlKalosis has “K” – it’s “K”icking pH up = PH↑ ALZHEIMER – “5 A’s” to DIAGNOSIS
AciDosis has “D” – it’s “D”ropping pH Down = PH↓ “5-A's”
ACUTE INFLAMMATION FEATURES Amnesia – loss of memories
Anomia – unable to recall names of everyday objects
,Apraxia – unable to perform tasks of movement (use a star as these drugs stain the teeth) – ???
Agnosia – inability to process sensory information (H-eat, I-nduration) – ???
Aphasia – disruption with ability to communicate APGAR SCORING
ANGINA – PRECIPITATING FACTORS "APGAR"
"4-E's" Appearance: cyanosis--peripheral, central, none
Eating Pulse: pulse rate
Emotion Grimace: response to stimulation
Exertion (Exercise) Activity: movement of the baby (muscle tone)
Extreme Temperatures (Hot/Cold weather) Respiration: respiratory rate
“ANOREXIA” – EATING DISORDER APPENDICITIS - ASSESSMENT
A-menorrhea delayed “PAINS”
N-o organic factors accounts for weight loss Pain (RLQ) - pain in RLQ of abdomen
O-obviously thin but feels FAT Anorexia - loss of appetite
R-refusal to maintain normal body weight Increased temperature, WBC (15,000-20,000)
E-epigastric discomfort is common Nausea
X-symptoms (peculiar symptoms) Signs (McBurney's, Psoas)
I-intense fears of gaining weight ARTERIAL BLOOD GASES
A-always thinking of foods 1. look at pH:
ANOREXIA NERVOSA – CLINICAL FEATURES Low pH = acidosis
"ANOREXIC" High pH = alkalosis
A-adolescent women/Amenorrhea 2. use “ROME” mnemonic (to determine if its
N-GT alimentation (most severe cases) respiratory or metabolic):
O-obsession w/ wt. loss/becoming fat though Respiratory – Opposite
underweight Metabolic – Equal
R-refusal to eat (5% die) ASSESSING CHANGES IN BEHAVIOR
E-electrolyte abnormalities (e.g., K+, cardiac "DEMENTIA"
arrhythmia) Drug and alcohol
X-exercise Eyes and ears
I-intelligence often above average/Induced Metabolic and endocrine disorders
vomiting Emotional disorders
C-cathartic use (and diuretic abuse) Neurologic disorders
ANTICHOLINERGIC CRISIS Tumors and trauma
Can't see (blurred vision) Infection
Can't spit (dry mouth) Arterial vascular disease
Can't pee (urinary retention) ASTHMA MANAGEMENT
Can't shit (constipation) "ASTHMA"
ANTICHOLINERGIC CRISIS – SIGNS Adrenergics (Albuterol)
"SLUD" Steroids
Salivation Theophylline
Lacrimation Hydration (IV)
Urination Mask (Oxygen)
Defecation Antibiotics
ANTI-TB DRUGS & SIDE EFFECTS ASTHMA - MANAGEMENT
“RIPES” Asthma is a spasm of the airways, which causes
Rifampicin – red-orange urine difficulty breathing.
Isoniazid – peripheral neuritis “ASTHMA”
Pyrazinamide – increase uric acid Adrenergic (Albuterol)
Ethambutol – eye problems Steroids
Streptomycin – ototoxic Theophylline
,Hydration (IV) B1 Blocks the heart (only have ONE heart)
Mask (Oxygen) B2 Blocks the lungs (have TWO lungs)
Antibiotics BETA BLOCKER CONTRAINDICATIONS
ATRIAL FIBRILLATION – NEW ONSET CAUSES "ABCDE"
“THE ATRIAL FIBS” Asthma
Thyroid Block (heart block)
Hypothermia COPD
Embolism (PE) Diabetes mellitus
Alcohol Electrolyte (hyperkalemia)
Trauma (cardiac contusion) BETA BLOCKERS
Recent surgery (post CABG) "You have 1 heart and 2 lungs"
Ischemia Beta-1 act primarily on heart
Atrial enlargement Beta-2 act primarily on lungs
Lone or idiopathic BLEEDING PRECAUTIONS
Fever, anemia, high-output states “RANDI”
Infarct R- Razor Electric/Blades
Bad valves (mitral stenosis) A- Aspirin
Stimulants (cocaine, theo, amphet, caffeine) N- No needles (esp. in small gauge)
ATRIOVENTRICULAR VALVES D- Do decrease in needle sticks)
"LAB RAT" I - Injury (Protect from)
Left Atrium: Bicuspid BLEEDING PRECAUTIONS
Right Atrium: Tricuspid If a patient is taking an anticoagulant to prevent
ATROPINE blood clots there is increased risk for bleeding. Be
"A goes with B" careful with blades when shaving. Do not take
Atropine used to treat bradycardia. aspirin as it interferes with blood clotting and can
magnify the effect of the medication. Avoid excess
BENNER'S MODEL needle sticks and protect the patient from injury.
N - Nickerr's - easy to remember b/c it rhymes with “RANDI”
Benner's Novice – strictly able to focus on learning Razor Electric/Blades
the rules, onset of education Aspirin
A - and - "ad"vanced beginners – distinguish Needles- small gauge
abnormal findings but cannot readily understand Decrease needle sticks
significance Injury (Protect from)
C - Comp - Competent – able to handle their pt. BLOOD FLOW THROUGH HEART VALVES
load and prioritize situation "Tissue Paper My Ass"
P - Planetary – big picture is the key word - Tricuspid
Proficiency Pulmonic
E - Experts – Leader/ role model not every nurse Mitral
becomes one. Aortic
BETA 1 AND BETA 2 BLOOD GLUCOSE
Beta 1 adrenergic receptors are mostly found in the Symptom Implication (rhyme)
heart. Beta 2 adrenergic receptors are found in Cold and clammy . . . give hard candy
lungs, GI tract, vascular smooth muscle, skeletal Hot and dry . . . glucose is high
muscle, liver. Beta 1 beta blockers act primarily on BLOOD TYPES
the heart. Beta 2 beta blockers act primarily on the Picture type O as a huge circle, like the universe,
lungs. because they are the universal donor. They can give
Beta 1: heart to everyone.
Beta 2: lungs - You have one heart and two lungs However, also think of them as the “odd man out”
BETA BLOCKERS because they can only receive type O as well. They
, are universally odd, able to give to all but only Isoprenaline
receive from themselves! Salmeterol
BODY SYSTEMS “BULIMIA” – EATING DISORDER
"MR DICE RUNS" B-binge eating
Muscle U-under strict dieting
Respiratory L-lacks control over-eating
Digestive I-induced vomiting
Integumentary M-minimum of two binge eating episodes
Circulatory I-increased/Persistent concern of body size/shape
Endocrine A-abuse of diuretics & laxatives
Reproductive BULIMIA CLIENT FINDINGS
Urinary “WASHED”
Nervous W-weight loss of 15% of original body weight
Skeletal A-amenorrhea
BRADYCARDIA & LOW BP DRUGS S-social withdrawal
“IDEA” H-history of high activity & achievement
I - Isoproterenol E-electrolyte Imbalance
D - Dopamine D-depression/ Distorted Body Image
E - Epinephrine CANCER ASSESSMENT
A - Atropine Sulfate "CAUTION"
BRADYCARDIA & LOW BLOOD PRESSURE DRUGS Change in bowel or bladder habits
This refers to symptomatic bradycardia and A sore that doesn't heal
hypotension. Bradycardia and hypotension are not Unusual bleeding or discharge
necessarily adverse clinical findings requirement Thickening or lump
treatment in and of themselves. Indigestion or difficulty swallowing
“IDEA” Obvious changes in a wart or mole
Isoproterenol Nagging cough or hoarseness
Dopamine CANCER - EARLY WARNING SIGNS
Epinephrine Cancer can sometimes be difficult to identify, but
Atropine Sulfate the earlier it is detected the better chance
BRADYCARDIA AND HYPOTENSION MEDS treatment will be effective.
"IDEA" “CAUTION UP”
Isoproterenol Change in bowel or bladder
Dopamine A lesion that does not heal
Epinephrine Unusual bleeding or discharge
Atropine Sulfate Thickening or lump in breast or elsewhere
BREASTFEEDING ASSESSMENT Indigestion or difficulty swallowing
"LATCH" Obvious changes in wart or mole
Latch achieved by infant Nagging cough or persistent hoarseness
Audible swallow Unexplained weight loss
Type of nipple Pernicious Anemia
Comfort of mother CANCER - INTERVENTIONS
Help given to mother with nursing “CANCER”
BRONCHODILATORS Comfort
"TO A SIS" Altered Body Image
Terbutaline Nutrition
Orciprenaline Chemotherapy
Adrenaline Evaluate response to meds
Salbutamol Respite for caretakers
“4-A’s” inflammation to “SLIPR”mnemonic).
Asymptomatic “SLIPR”
Abdominal mass Swelling
Abdominal pulse Loss of function
Aches low back Increased heat
ABDOMINAL DISTENSTION Pain
"5-F's" Redness
Fat ADRENAL GLAND HORMONES
Fluid “SSS”
Feces S-sugar (Glucocorticoids)
Flatus S-salt (Mineralocorticoids)
Fetus S-sex (Androgens)
ACE INHIBITOR SIDE EFFECTS AIMS for improvement
"CAPTOPRIL" “PETEES” AIMS
Cough P - Patient centered care
Anaphylaxis E - Efficient
Palpitations T - Timely
Taste E - Effective
Orthostatic -↓BP E - Equitable
Potassium - ↑K+ S - Safety
Renal impairment ALCOHOL WITHDRAWAL – CLINICAL FEATURES
Impotence "HITS"
Leukocytosis Hallucinations (visual, tactile)
ACID-BASE Increased vital signs & insomnia
"ROME" – Respiratory Opposite, Metabolic Equal Tremens delirium tremens (potentially lethal)
ACIDOSIS Shakes/Sweat/Seizures/Stomach pain (N/V)
» Respiratory (opposite): pH Pco2 ALCOHOLISM – BEHAVIORAL PROBLEMS
» Metabolic (equal): pH HCO3 “5-D's”
ALKALOSIS D- Denial
» Respiratory (opposite): pH Pco2 D- Dependency
» Metabolic (equal): pH HCO3 D- Demanding
ACIDOSIS/ALKALOSIS D- Destructive
“ROME” D- Domineering
Respiratory Opposite: ALCOHOLISM OUTCOME
pH↑ PCO2↓ = alkalosis “BAD”
pH↓ PCO2↑ = acidosis B- Brain Damage
Metabolic Equal: A- Alcoholic Hallucinosis
pH↑ HCO3↑ = Alkalosis D- Death
pH↓ HCO3↓ = Acidosis ALDOSTERONE IS REGULATED BY:
ACIDOSIS/ALKALOSIS – COMPENSTATION "RNA’S"
“RUB MUB” Renin-angiotensin mechanism
Respiratory Uses Bicarb Na concentration in blood
Metabolic Uses Breathing Anp (ANP – atrial natriuretic peptide)
ALKALOSIS AND ACIDOSIS Stress
AlKalosis has “K” – it’s “K”icking pH up = PH↑ ALZHEIMER – “5 A’s” to DIAGNOSIS
AciDosis has “D” – it’s “D”ropping pH Down = PH↓ “5-A's”
ACUTE INFLAMMATION FEATURES Amnesia – loss of memories
Anomia – unable to recall names of everyday objects
,Apraxia – unable to perform tasks of movement (use a star as these drugs stain the teeth) – ???
Agnosia – inability to process sensory information (H-eat, I-nduration) – ???
Aphasia – disruption with ability to communicate APGAR SCORING
ANGINA – PRECIPITATING FACTORS "APGAR"
"4-E's" Appearance: cyanosis--peripheral, central, none
Eating Pulse: pulse rate
Emotion Grimace: response to stimulation
Exertion (Exercise) Activity: movement of the baby (muscle tone)
Extreme Temperatures (Hot/Cold weather) Respiration: respiratory rate
“ANOREXIA” – EATING DISORDER APPENDICITIS - ASSESSMENT
A-menorrhea delayed “PAINS”
N-o organic factors accounts for weight loss Pain (RLQ) - pain in RLQ of abdomen
O-obviously thin but feels FAT Anorexia - loss of appetite
R-refusal to maintain normal body weight Increased temperature, WBC (15,000-20,000)
E-epigastric discomfort is common Nausea
X-symptoms (peculiar symptoms) Signs (McBurney's, Psoas)
I-intense fears of gaining weight ARTERIAL BLOOD GASES
A-always thinking of foods 1. look at pH:
ANOREXIA NERVOSA – CLINICAL FEATURES Low pH = acidosis
"ANOREXIC" High pH = alkalosis
A-adolescent women/Amenorrhea 2. use “ROME” mnemonic (to determine if its
N-GT alimentation (most severe cases) respiratory or metabolic):
O-obsession w/ wt. loss/becoming fat though Respiratory – Opposite
underweight Metabolic – Equal
R-refusal to eat (5% die) ASSESSING CHANGES IN BEHAVIOR
E-electrolyte abnormalities (e.g., K+, cardiac "DEMENTIA"
arrhythmia) Drug and alcohol
X-exercise Eyes and ears
I-intelligence often above average/Induced Metabolic and endocrine disorders
vomiting Emotional disorders
C-cathartic use (and diuretic abuse) Neurologic disorders
ANTICHOLINERGIC CRISIS Tumors and trauma
Can't see (blurred vision) Infection
Can't spit (dry mouth) Arterial vascular disease
Can't pee (urinary retention) ASTHMA MANAGEMENT
Can't shit (constipation) "ASTHMA"
ANTICHOLINERGIC CRISIS – SIGNS Adrenergics (Albuterol)
"SLUD" Steroids
Salivation Theophylline
Lacrimation Hydration (IV)
Urination Mask (Oxygen)
Defecation Antibiotics
ANTI-TB DRUGS & SIDE EFFECTS ASTHMA - MANAGEMENT
“RIPES” Asthma is a spasm of the airways, which causes
Rifampicin – red-orange urine difficulty breathing.
Isoniazid – peripheral neuritis “ASTHMA”
Pyrazinamide – increase uric acid Adrenergic (Albuterol)
Ethambutol – eye problems Steroids
Streptomycin – ototoxic Theophylline
,Hydration (IV) B1 Blocks the heart (only have ONE heart)
Mask (Oxygen) B2 Blocks the lungs (have TWO lungs)
Antibiotics BETA BLOCKER CONTRAINDICATIONS
ATRIAL FIBRILLATION – NEW ONSET CAUSES "ABCDE"
“THE ATRIAL FIBS” Asthma
Thyroid Block (heart block)
Hypothermia COPD
Embolism (PE) Diabetes mellitus
Alcohol Electrolyte (hyperkalemia)
Trauma (cardiac contusion) BETA BLOCKERS
Recent surgery (post CABG) "You have 1 heart and 2 lungs"
Ischemia Beta-1 act primarily on heart
Atrial enlargement Beta-2 act primarily on lungs
Lone or idiopathic BLEEDING PRECAUTIONS
Fever, anemia, high-output states “RANDI”
Infarct R- Razor Electric/Blades
Bad valves (mitral stenosis) A- Aspirin
Stimulants (cocaine, theo, amphet, caffeine) N- No needles (esp. in small gauge)
ATRIOVENTRICULAR VALVES D- Do decrease in needle sticks)
"LAB RAT" I - Injury (Protect from)
Left Atrium: Bicuspid BLEEDING PRECAUTIONS
Right Atrium: Tricuspid If a patient is taking an anticoagulant to prevent
ATROPINE blood clots there is increased risk for bleeding. Be
"A goes with B" careful with blades when shaving. Do not take
Atropine used to treat bradycardia. aspirin as it interferes with blood clotting and can
magnify the effect of the medication. Avoid excess
BENNER'S MODEL needle sticks and protect the patient from injury.
N - Nickerr's - easy to remember b/c it rhymes with “RANDI”
Benner's Novice – strictly able to focus on learning Razor Electric/Blades
the rules, onset of education Aspirin
A - and - "ad"vanced beginners – distinguish Needles- small gauge
abnormal findings but cannot readily understand Decrease needle sticks
significance Injury (Protect from)
C - Comp - Competent – able to handle their pt. BLOOD FLOW THROUGH HEART VALVES
load and prioritize situation "Tissue Paper My Ass"
P - Planetary – big picture is the key word - Tricuspid
Proficiency Pulmonic
E - Experts – Leader/ role model not every nurse Mitral
becomes one. Aortic
BETA 1 AND BETA 2 BLOOD GLUCOSE
Beta 1 adrenergic receptors are mostly found in the Symptom Implication (rhyme)
heart. Beta 2 adrenergic receptors are found in Cold and clammy . . . give hard candy
lungs, GI tract, vascular smooth muscle, skeletal Hot and dry . . . glucose is high
muscle, liver. Beta 1 beta blockers act primarily on BLOOD TYPES
the heart. Beta 2 beta blockers act primarily on the Picture type O as a huge circle, like the universe,
lungs. because they are the universal donor. They can give
Beta 1: heart to everyone.
Beta 2: lungs - You have one heart and two lungs However, also think of them as the “odd man out”
BETA BLOCKERS because they can only receive type O as well. They
, are universally odd, able to give to all but only Isoprenaline
receive from themselves! Salmeterol
BODY SYSTEMS “BULIMIA” – EATING DISORDER
"MR DICE RUNS" B-binge eating
Muscle U-under strict dieting
Respiratory L-lacks control over-eating
Digestive I-induced vomiting
Integumentary M-minimum of two binge eating episodes
Circulatory I-increased/Persistent concern of body size/shape
Endocrine A-abuse of diuretics & laxatives
Reproductive BULIMIA CLIENT FINDINGS
Urinary “WASHED”
Nervous W-weight loss of 15% of original body weight
Skeletal A-amenorrhea
BRADYCARDIA & LOW BP DRUGS S-social withdrawal
“IDEA” H-history of high activity & achievement
I - Isoproterenol E-electrolyte Imbalance
D - Dopamine D-depression/ Distorted Body Image
E - Epinephrine CANCER ASSESSMENT
A - Atropine Sulfate "CAUTION"
BRADYCARDIA & LOW BLOOD PRESSURE DRUGS Change in bowel or bladder habits
This refers to symptomatic bradycardia and A sore that doesn't heal
hypotension. Bradycardia and hypotension are not Unusual bleeding or discharge
necessarily adverse clinical findings requirement Thickening or lump
treatment in and of themselves. Indigestion or difficulty swallowing
“IDEA” Obvious changes in a wart or mole
Isoproterenol Nagging cough or hoarseness
Dopamine CANCER - EARLY WARNING SIGNS
Epinephrine Cancer can sometimes be difficult to identify, but
Atropine Sulfate the earlier it is detected the better chance
BRADYCARDIA AND HYPOTENSION MEDS treatment will be effective.
"IDEA" “CAUTION UP”
Isoproterenol Change in bowel or bladder
Dopamine A lesion that does not heal
Epinephrine Unusual bleeding or discharge
Atropine Sulfate Thickening or lump in breast or elsewhere
BREASTFEEDING ASSESSMENT Indigestion or difficulty swallowing
"LATCH" Obvious changes in wart or mole
Latch achieved by infant Nagging cough or persistent hoarseness
Audible swallow Unexplained weight loss
Type of nipple Pernicious Anemia
Comfort of mother CANCER - INTERVENTIONS
Help given to mother with nursing “CANCER”
BRONCHODILATORS Comfort
"TO A SIS" Altered Body Image
Terbutaline Nutrition
Orciprenaline Chemotherapy
Adrenaline Evaluate response to meds
Salbutamol Respite for caretakers
