Medical-Surgical Nursing

1. Respiratory Patterns
There are five abnormal breathing patterns that you can observe as symptoms in many diseases.
The Kussmaul pattern is characterized by deep and labored breathing commonly associated with
diabetic ketoacidosis and metabolic acidosis. The Cheyne-Stokes breathing, which is present in
severe neurological and cardiac diseases, is characterized by periods of hyperventilation and apnea.
Biots respiration, on the other hand, describes the quick and shallow respirations followed by periods
of apnea.
Standard abnormal breathing patterns include tachypnea which is a rapid breathing pattern and
bradypnea which is a slow breathing pattern.

Study Guides:
Nursing Mnemonics & Tips nursingmnemonics.blogspot.com
Cheyne-Stokes and Abnormal Patterns of Respiration Patient.co.uk
Abnormal Breathing Patterns Breathsounds.org

2. Cardiac Blood Flow

Remembering the flow of blood through cardiac valves is easy with the mnemonic Tissue Paper My
Assets.
First, the blood flows from the bodys circulatory system through the tricuspid valve. It then goes to
the lungs for the blood oxygenation process through the pulmonic valve. From the lungs the
oxygenated blood goes back to the heart through the mitral valve and the blood circulates back to
the body through the aorta.

Study Guides:
Your Heart Valves Cleveland Clinic
Heart Contraction & Blood Flow National Heart, Lung, and Blood Institute

3. Hypoglycemia
Hypoglycemia is a condition characterized by abnormally low blood glucose levels in the blood. It
usually results from insufficient intake of food, too much exercise and excessive insulin
administration.
Immediate symptoms of hypoglycemia include cool clammy skin, anxiousness, excessive sweating,
confusion, blurred or double vision and irritability. Onset of hypoglycemia is rapid at around 1-3
hours.

Study Guides:
Hypoglycemia (Low Blood Glucose) American Diabetes Association
Hypoglycemia Definition Mayo Clinic

4. Abnormal Posturing
Decorticate posturing is the abnormal flexion posture of the body when there are problems in the
cervical spinal tract or in the cerebral hemisphere part of the brain. The decorticate posture can be
easily remembered by the Flexor keyword as the arms in this posture will bend inward into the
chest.
Decerebrate posture, on the other hand, is the abnormal extension of the upper extremities usually
in response to external stimuli. It is often associated with problems within the midbrain or pons. It is
characterized by the extension of the arms and legs while the head is arched backwards.

Study Guides:
What Causes Posture Abnormal? 12 Possible Conditions Healthline
Abnormal Posturing and Potential Causes Disabled World

5. Myocardial Infarction
Myocardial infarction, simply known as heart attack, needs immediate medical attention to prevent
irreversible damage to the heart.
Immediate treatment for myocardial infarction can be easily remembered with the acronym MONA
Morphine, Oxygen, Nitroglycerin and ASA or aspirin.
Morphine is used to relieve chest pain associated with heart attack. Because there will be an
inadequate oxygen supply to the heart during myocardial infarction, continuous oxygen supply is
beneficial in preventing hypoxia. Nitroglycerin is used to lower blood pressure and reduce the hearts
demand for oxygen. ASA or aspirin is helpful in dissolving the blood clot that caused the attack.

Study Guides:
Myocardial Infarction (Heart Attack) Johns Hopkins Medicine
Myocardial Infarction (Heart Attack) Patient.co.uk

6. Congestive Heart Failure

Congestive Heart Failure happens when the heart cant handle a high output of blood volume in the
circulatory system. Its a life-threatening condition that needs immediate treatment and initial
management can be easily remembered with the acronym UNLOAD FAST.
The patient should be kept in an upright position and nitrates will be given to reduce hearts oxygen
demand. Lasix is needed to expel excess fluid volume in the blood through diuresis and oxygen will
support oxygen supply in the body during heart failure.
Chronic management includes usage of ACE inhibitors to control blood pressure through
vasodilatation and digoxin to reduce ventricular rate. Fluid limitation is necessary to decrease
afterload of the heart. Sodium, which may cause fluid retention to the body, should be restricted.
Diagnostic tests should be routinely done like testing for digoxin levels to prevent digoxin toxicity,
obtaining ABGs to determine adequacy of oxygen level in the blood and testing for serum potassium
as hypokalemia may happen when inducing diuresis to prevent fluid volume excess.

Study Guides:
Congestive Heart Failure (CHF) CHealth
Heart Failure Definition Mayo Clinic

7. Paralysis
Quadriplegia, also known as tetraplegia, is the loss of movement in all limbs. It occurs when injury
happens above the first thoracic vertebrae or in the cervical vertebrae.
Paraplegia, on the other hand, is the loss of movement in the lower limbs. It happens when the injury
occurs below the first thoracic vertebrae.
Hemiplegia is different as loss of movement happens in one side of the body. It can be caused by a
traumatic brain injury and incomplete spinal cord injuries.

Study Guides:
Types of Paralysis Quadriplegia (Tetraplegia) and Paraplegia Apparelyzed
Types of Paralysis Step Ahead Australia

8. Stroke
There are three simple steps in recognizing stroke. First, ask the person to smile and stick out his or
her tongue to determine symmetry. Then, ask the person to make a complete sentence to determine
if there is slurred speech. Lastly, ask the person to raise both arms. If there are problems in
completing these three tasks, you should consider stroke and seek for immediate medical attention.

Study Guide:
Stroke Definition Mayo Clinic

9. Blood Transfusion Reactions

Blood transfusion reactions usually happen in the first ten to fifteen minutes of blood transfusion or in
the first 50cc of blood transfused. Symptoms include facial flushing, rashes, restlessness and
wheezing. The person might be febrile and symptoms associated with it include chills, headache,
tachycardia and tachypnea.
Hemolytic-related reactions also include chest pain, low back pain, blood in the urine and decreased
blood pressure. When transfusion reactions happen, blood transfusion should be immediately stopped
and keep the IV line open with plain saline solution.

Study Guides:
7 Adverse Reactions to Transfusion
Transfusion Reactions Medscape
Blood Transfusion Reactions Patient.co.uk

Transfusion Reactions www.bbguy.org

10. Head Injury

In the first 24 hours after a head injury, a person should be closely observed for signs and symptoms
of worsening condition that may indicate severe brain injury.
The level of consciousness should be assessed first determine if there is drowsiness, confusion or
difficulty in arousing patient. Seizures, visual problems and unequal dilation or constriction of pupils
during examination should also be noted.
Bleeding or water drainage from the nose or ears and projectile vomiting are also classic symptoms
of serious brain injury. Symptoms related to paralysis like slurred speech and loss of sensation in
certain extremity should also be observed.