Psyche Nursing

For Withdrawn clients Allow client to set pace Encourage social activities or games For Depressed client Assess suicide potential Let client talk about personal problems Do not leave alone For Suicidal clients Crisis intervention to assess suicide protential. Communicate intent are you tired of living? Previous attempts Specific plan Social support system DO NOT make suicide contract! For Anxious clients Convey interest and care Dont force client Help client identify source of anxiety Suggest relaxation techniques For Violent clients Remain calm and in control of the situation Give client space, avoid sudden movements Encourage verbal expression of anger Restrain or seclude if necessary For Compulsive clients Allow client to engage in rituals (these are used to cover up anxiety)

 Gradually limit length of time for rituals. For Manipulative clients Set clear limits Hold client responsible for behavior For Dependent clients Dont reward dependent behavior Client should share responsibility for treatment For Paranoid clients Dont argue with client (simply state that you dont share his beliefs) Be reliable and consistent For Delusional clients Stay with client Dont argue about the reality of delusions Orient frequently to reality (place, situation) Assess potential for self harm For Somatization clients Respect client and his problems (client is not faking) Rule out physical basis for symptoms Help client express anxiety

DEFENSE MECHANISMS: 1. Conversion: A college student develops diarrhea on day of exam 2. Regression: Returning to immature ways of dealing with stress: crying, tantrums 3. Repression: Blocking of unacceptable urges and feelings

from awareness. 4. Denial: Blocking of unacceptable information or perceptions from awarness. 5. Dissociation of affect: A girl laughs when telling about her failed exam 6. Rationalization: Substituting an acceptable motive for attitudes or behavior for an unacceptable motive 7. Reaction formation: you want to kick your bosses ass but end up kissing it. 8. Identification: A teenager dresses like Madonna and mimics her behavior. 9. Projection: you are acting like a teenager, not I 10. Introjection: A boy yells at his dog like his father does him 11. Displacement: Client is upset about disease and yells at nurse. Nurse gets upset and yells at nursing assistant 12. Undoing: magic, SIGNS AND SYMPTOMS Aphasia Receptive (Wernicke =difficulty to comprehend language) or expressive (Broca = difficulty to find the right word language disorder Apraxia Failure to do, despite intact motor function Agnosia Failure to recognize Dementia Gradual impairment of cognitive functions, memory

 Alzheimer dementia: early memory loss Multi infarct dementia: step like decline Delirium Acute, organic, short lasting Clouded consciousness Confusion, disorientation, anxiety Sometimes hallucinations Delusions Persistent false belief despite invalidating evidence Grandeur Paranoia Somatic delusions illusions Misperception of external stimuli Hallucinations Perception without external stimuli

TERMS: 1. Neologisms: invents new words: Schizophrenia 2. Echolalia: echoes words or sentences: Schizophrenia 3. Word Salad: jumble of words without meaning: Schizophrenia 4. Flight of ideas: rapid switching from topic to topic: Mania 5. Confabulation: invents stories to fill memory gaps: Korsakoff encephalopathy. DELIRIUM Acute onset

 Fluctuating consciousness Disorientation Optical hallucinations DEMENTIA Gradual onset No impairment of consciousness Loss of intellectual functions: memory, orientation, language.

ALZHEIMERS ASSESSMENT: Progressive memory loss Declining mental, social, and self care abilities ANALYSIS: Risk of injury due to cognitive deficits Family/caregiver burnout IMPLEMENTATION: Support family caregivers Provide safe and familiar environment Support clients attempts at independence Continually orient client to time, date and person Advance directive should be drafted as early as possible

GRIEF

DEPRESSION

Initial: shock/ denial Illusions/hallucinations may occur

Feeling of hopelessness Feeling of worthlessness

Low risk of suicide PERSONALITY DISORDERS:

High risk of suicide

Behavior is inflexible across a broad range of situations Behavior is markedly deviant from cultural norms Significant distress and impairment of functioning
DEPENDENT Afraid of being helpless Need to be cared for COMPULSIVE Fear of loss of control Tries to control physician PASSIVE-AGGRESSIVE HISTRIONIC Appears willing but is not compliant Dramatic, emotional May display inappropriate sexual behavior NARCISSISTIC Feels better than others Perfect self image is threatened by disease PARANOID SCHIZOID May blame nurse or others for disease Anxious, withdrawn (doesnt want close relationships) BORDERLINE Severe disorder! Intense unstable relationships Paranoia and suicidal behavior Features of psychoses

ANXIETY DISORDERS:

 Clients are distressed and know that their symptoms are irrational.
PHOBIA Persistent excessive of specific objects or situations. Patient knows that his fear is unrealistic PANIC ATTACK Abrupt onset, peak within 10 min. Palpitations, tachycardia Sweating, trembling, shaking Fear of dying Derealization: feeling of unreality of the external world. Depersonalization: feeling of being detached from oneself AGORAPHOBIA Hx of panic attacks Patient avoids places where panic attack might occur (especially public places) OBSESSSIVE COMPULSIVE Obsessions: recurrent thoughts Compulsions: repetitive behavior POSTRAUMATIC STRESS DISORDER Traumatic event in clients history May occur any time after event Persists for > 1 month

HYPOCHONDRIASIS & MALINGERING:

HYPOCHONDRIASIS Unrealistic interpretation of body signs Client believes to have serious disease that

is unrecognized by family and physicians FACTITIOUS DISORDER Intentional feigning of symptoms Motivation: to assume the sick role: external incentives such as economic gain or avoiding legal responsibilities are absent MALINGERING Intentional feigning of symptoms Motivation: economic gain Avoiding leagal responsibilities

MAJOR DEPRESSION ASSESSMENT:

Feeling of worthlessness Thoughts of death or suicide Lethargy Slow, muted speech Anorexia, weight loss Early morning awakening

ANALYSIS:

Risk of suicide

IMPLEMENTATION:

Assess suicidal risk ( ask client directly) Remove potentially harmful objects Encourage verbal expression of feelings Encourage participation in group activities

MEDICATIONS:

Antidepressants (require several weeks for full effect) Watch for anticholinergic side effects:
Blurred vision Dry mouth Constipation Urinary retention

BIPOLAR DISORDER: Manic episodes alternate with episodes of major depression. Some clients have only manic episodes, no depressive episodes.
ASSESSMENT:

Euphoria Grandiose ideas Uninhibited sexuality Buying sprees Psychomotor agitation

IMPLEMENTATION:

Low stimulus environment Provide frequent small meals, snacks Encourage physical activity as a means to act out

MEDICATION:

Lithium Watch for signs of toxicity

 Abdominal pain, nausea Hand tremor Ataxia, nystagmus Slurred speech

Monitor serum levels closely

Not to exceed 1 mEq/L

SCHIZOPHRENIA:
ASSESSMENT:

Defect in reality testing Affect incongruent ( does not match thoughts) Thought form: tangential, circumstantial, loose associations

POSITIVE SYMPTOMS Delusions Hallucinations NEGATIVE SYMPTOMS Flat affect Loss of interest Ambivalence Autism CATATONIA:

 Waxy rigidity of muscles Client maintains bizarre positions IMPLEMENTAION: Establish trusting, honest relationship Maintain calm, consistent manner Dont challenge clients thought content Decrease environmental stimuli MEDICATION:

Neuroleptics: monitor for signs of tardive dyskinesia

Choreoathetosis Lateral movements of jaw Tongue protrusion

CLIENT EDUCATION: Stress importance to comply with follow up visits Encourage family support

DRUG ABUSE: Abuse: recurrent use of drugs resulting in social failures at home, school or work, legal problems or hazardous situations. Dependence: Tolerance (needs larger doses to achieve effect). Withdrawal symptoms.
INTOXICAITON WITHDRAWAL

ALCOHOL

Euphoria Disorientaion Unsteady gait

Nausea Delusions, hallucinations Delirium Tremor, seizures

BARBITURATES

Sedation

Delirium Epilepsy Coma, death

BENZODIAZEPINES

Antianxiety Sedation

Anxiety Irritability insomnia

AMPHETAMINES, COCAINE OPIOIDS

Arousal Euphoria Euphoria Apathy

Fatigue Dysphoria Nausea, vomiting Sweating, fever Muscle aches

LSD

Hallucinations Anxiety Paranoid ideas

NONE

Medical Mnemonics Part 1

ANATOMY

Bowel components "Dow Jones Industrial AverageClosing Stock Report": From proximal to distal: Duodenum Jejunum Ileum Appendix Colon Sigmoid Rectum Alternatively: to include the cecum, "Dow Jones Industrial Climbing Average Closing Stock Report". Knowledge Level 1, System: Alimentary Anonymous Contributor

Diaphragm apertures: spinal levels Aortic hiatus = 12 letters = T12 Oesophagus = 10 letters = T10 Vena cava = 8 letters = T8 Knowledge Level 1, System: Alimentary Oriade Adeoye Dept. of Medicine, College of Health Sciences, OAU, Ile-Ife

Duodenum: lengths of parts "Counting 1 to 4 but staggered": 1st part: 2 inches 2nd part: 3 inches 3rd part: 4 inches 4th part: 1 inch Knowledge Level 5, System: Alimentary Anonymous Contributor

Liver inferior markings showing right/left lobe vs. vascular divisions There's a Hepatic "H" on inferior of liver. One vertical stick of the H is the dividing line for anatomical right/left lobe and the other vertical stick is the divider for vascular halves. Stick that divides the liver into vascular halves is the one with vena cava impression (since vena cava carries blood, it's fortunate that it's the divider for blood halves). Knowledge Level 5, System: Alimentary Robert O'Connor University College Dublin

Meckel's diverticulum details 2 inches long. 2 feet from end of ileum. 2 times more common in men. 2% occurrence in population. 2 types of tissues may be present.

Note: "di-" means "two", so diverticulum is the thing with all the twos. Knowledge Level 2, System: Alimentary Robert O'Connor University College Dublin

Aorta vs. vena cava: right vs. left Aorta and right each have 5 letters, so aorta is on the right. Vena and cava and left each have 4 letters, so vena cava is on the left. Knowledge Level 1, System: Cardiovascular Robert O'Connor University College Dublin

Aortic arch: major branch order - "Know your ABC'S": Aortic arch gives rise to: Brachiocephalic trunk left Common Carotid left Subclavian Beware though trick question of 'What is first branch of aorta?' Technically, it's the coronary arteries. Knowledge Level 1, System: Cardiovascular Anonymous Contributor

Atrioventricular valves - "LAB RAT":

Left Atrium: Bicuspid Right Atrium: Tricuspid Knowledge Level 1, System: Cardiovascular Amir A. Ghaferi Johns Hopkins School of Medicine Axillary artery branches "Screw The Lawyer Save APatient": Superior thoracic Thoracoacromiol Lateral thoracic Subscapular Anterior circumflex humeral Posterior circumflex humeral Alternatively: "Some Times Life Seems A Pain". Knowledge Level 2, System: Cardiovascular Anonymous contributor and Joe Azzopardi Not specified and Xarabank

Brachial artery: recurrent and collateral branches "IAm Pretty Sexy" Inferior ulnar collateral artery goes with Anterior ulnar recurrent artery. Posterior ulnar recurrent artery goes with Superior ulnar collateral artery. Alternatively: "I Am Pretty Smart". Knowledge Level 5, System: Cardiovascular

Paul's Boutique Western University College of Osteopathic Medicine of the Pacific

Carotid sheath contents - "I See 10 CC's in the IV" I See (I.C.) = Internal Carotid artery 10 = CN 10 (Vagus nerve) CC = Common Carotid artery IV = Internal Jugular Vein Knowledge Level 1, System: Cardiovascular Anonymous Contributor

Cavernous sinus contents - O TOM CAT O TOM are lateral wall components, in order from superior to inferior. CA are the components within the sinus, from medial to lateral. CA ends at the level of T from O TOM. See diagram. Occulomotor nerve (III) Trochlear nerve (IV) Ophthalmic nerve (V1) Maxillary nerve (V2) Carotid artery Abducent nerve (VI) T: When written, connects to the T of OTOM. Knowledge Level 4, System: Cardiovascular

Jonathan Vafai New York University School of Medicine

Coelic trunk: branches - Left Hand Side (LHS): Left gastric artery Hepatic artery Splenic artery Knowledge Level 1, System: Cardiovascular Dr. Harsh Sharma Descending abdominal aorta branches from diaphragm to iliacs - "Prostitutes Cause Sagging Swollen RedTesticles [in men] Living In Sin": Phrenic [inferior] Celiac Superior mesenteric Suprarenal [middle] Renal Testicular ["in men" only] Lumbars Inferior mesenteric Sacral Knowledge Level 2, System: Cardiovascular Josser Mt. Sinai Medical School

External carotid artery branches -

"Some AnatomistsLike F*#king, Others Prefer S & M": Superior thyroid Ascending pharyngeal Lingual Facial Occipital Posterior auricular Superficial temporal Maxillary Knowledge Level 2, System: Cardiovascular Anonymous Contributor

Femoral triangle: arrangement of contents NAVEL: From lateral hip towards medial navel: Nerve (directly behind sheath) Artery (within sheath) Vein (within sheath) Empty space (between vein and lymph) Lymphatics (with deep inguinal node) Nerve/Artery/Vein are all called Femoral. Knowledge Level 1, System: Cardiovascular Andrew J. Vasil UMD School of Medicine, Duluth, MN

Heart valve sequence - "Try Pulling My Aorta": Tricuspid Pulmonary Mitral Aorta Knowledge Level 1, System: Cardiovascular Michael Franco Melbourne University, Australia

Inferior vena cava tributaries - "I Like To Rise SoHigh": Illiacs Lumbar Testicular Renal Suprarenal Hepatic vein. Think of the IVC wanting to rise high up to the heart. Knowledge Level 3, System: Cardiovascular Usman Ahmad KMC

Internal iliac artery: anterior branches What Bill admitted to Hilary: "I Milked Our InsatiableIntern's Udders Under the Desk":

Inferior gluteal Middle rectal Obturator Inferior vesical artery Internal pudendal artery Umbilical U/D=Uterine artery (female)/ Deferential artery (male) Knowledge Level 4, System: Cardiovascular Anonymous Contributor

Internal jugular vein: tributaries "Medical Schools LetConfident People In": From inferior to superior: Middle thyroid Superior thyroid Lingual Common facial Pharyngeal Inferior petrosal sinus Knowledge Level 6, System: Cardiovascular LaShawn A. Weaver Medical University of South Carolina Liver: side with ligamentum venosum/ caudate lobe vs. side with quadrate lobe/ ligamentum teres "VCgoes with VC": The Venosum and Caudate is on same side as Vena Cava [posterior]. Therefore, quadrate and teres must

be on anterior by default. Knowledge Level 4, System: Cardiovascular Robert O'Connor University College Dublin

Lung lobe numbers: right vs. left Hi Yield [ID 79] Tricuspid heart valve and tri-lobed lung both on the right side. Bicuspid and bi-lobed lung both on the left side. Knowledge Level 1, System: Cardiovascular Robert O'Connor University College Dublin

Common Signs And Symptoms

01. PTB low-grade afternoon fever. 02. PNEUMONIA rusty sputum. 03. ASTHMA wheezing on expiration. 04. EMPHYSEMA barrel chest. 05. KAWASAKI SYNDROME strawberry tongue. 06. PERNICIOUS ANEMIA red beefy tongue. 07. DOWN SYNDROME protruding tongue. 08. CHOLERA rice watery stool. 09. MALARIA stepladder like fever with chills. 10. TYPHOID rose spots in abdomen. 11. DIPTHERIA pseudo membrane formation 12. MEASLES kopliks spots. 13. SLE butterfly rashes.

14. LIVER CIRRHOSIS spider like varices. 15. LEPROSY lioning face. 16. BULIMIA chipmunk face. 17. APPENDICITIS rebound tenderness. 18. DENGUE petechiae or (+) Hermans sign. 19. MENINGITIS Kernigs sign (leg flex then leg pain on extension), Brudzinski sign (neck flex = lower leg flex). 20. TETANY hypocalcemia (+) Trousseaus sign/carpopedal spasm; Chvostek sign (facial spasm). 21. TETANUS risus sardonicus. 22. PANCREATITIS Cullens sign (ecchymosis of umbilicus); (+) Grey turners spots. 23. PYLORIC STENOSIS olive like mass. 24. PDA machine like murmur. 25. ADDISONS DISEASE bronze like skin pigmentation. 26. CUSHINGS SYNDROME moon face appearance and buffalo hump. 27. HYPERTHYROIDISM/GRAVES DISEASE exopthalmus. 28. INTUSSUSCEPTION sausage shaped mass, Dance Sign (empty portion of RLQ) 29. MS Charcots Triad (IAN) 30. MG descending muscle weakness 31. Guillain Barre Syndrome ascending muscle weakness 32. DVT Homans Sign 33. CHICKEN POX Vesicular Rash (central to distal) dew drop on rose petal

34. ANGINA Crushing stubbing pain relieved by NTG 35. MI Crushing stubbing pain which radiates to left shoulder, neck, arms, unrelieved by NTG 36. LTB inspiratory stridor 37. TEF 4Cs Coughing, Choking, Cyanosis, Continous Drooling 38. EPIGLOTITIS 3Ds Drooling, Dysphonia, Dysphagia 39. HODGEKINS DSE/LYMPHOMA painless, progressive enlargement of spleen & lymph tissues, Reedstenberg Cells 40. INFECTIOUS MONONUCLEOSIS Hallmark: sore throat, cervical lymph adenopathy, fever 41. PARKINSONS Pill-rolling tremors 42. FIBRIN HYALIN Expiratory Grunt 43. CYSTIC FIBROSIS Salty skin 44. DM polyuria, polydypsia, polyphagia 45. DKA Kussmauls breathing (Deep Rapid RR) 46. BLADDER CA painless hematuria 47. BPH reduced size & force of urine 48. PEMPHIGUS VULGARIS Nikolskys sign (separation of epidermis caused by rubbing of the skin) 49. RETINAL DETACHMENT Visual Floaters, flashes of light, curtain vision 50. GLAUCOMA Painfull vision loss, tunnel/gun barrel/halo vision (Peripheral Vision Loss) 51. CATARACT Painless vision loss, Opacity of the lens, blurring of vision 52. RETINO BLASTOMA Cats eye reflex (grayish discoloration of pupils)

53. ACROMEGALY Coarse facial feature 54. DUCHENNES MUSCULAR DYSTROPHY Gowers sign (use of hands to push ones self from the floor) 55. GERD Barretts esophagus (erosion of the lower portion of the esophageal mucosa) 56. HEPATIC ENCEPHALOPATHY Flapping tremors 57. HYDROCEPHALUS Bossing sign (prominent forehead) 58. INCREASE ICP HYPERtension BRADYpnea BRADYcardia (Cushings Triad) 59. SHOCK HYPOtension TACHYpnea TACHYcardia 60. MENIERES DSE Vertigo, Tinnitus 61. CYSTITIS burning on urination 62. HYPOCALCEMIA Chvostek & Trosseaus sign 63. ULCERATIVE COLITIS recurrent bloody diarrhea 64. LYMES DSE Bulls eye rash

Nurse Abbreviation Guide

ABG arterial blood gases ACE angiotensin converting enzyme ACL anterior cruciate ligament ACTH adrenocorticotropic hormone ADA American Diabetes Association ADH antidiuretic hormone ADL activities of daily living AFB acid-fast bacilli AFP alpha-fetoprotein AGA appropriate for gestational age AIDS acquired immune deficiency syndrome AKA above knee amputation

ALP alkaline phosphatase ALT alanine transaminase, alanine aminotransferase AMA against medical advice AMI acute myocardial infarction AODM adult onset diabetes mellitus AP apical pulse APSGN acute poststreptococcal glomerulonephritis ARF acute renal failure ASD atrial septal defect AST aspartate aminotransferase ATN acute tubular necrosis AU both ears AVB atrio-ventricular block A.A. Associate of Arts A.A.S. Associate in Applied Science A.D. Associate Degree A.D.N. Associate Degree in Nursing A.S. Associate of Science BBS bilateral breath sounds BE barium enema BG blood glucose BI brain injury BID twice a day BILAT bilateral B/K below knee BM bowel movement or breast milk BP blood pressure BPH benign prostatic hypertrophy BRM biologic response modifiers

BRP bathroom privileges BS bowel sounds BSA body surface area BSE breast self examination BT bowel tones BUN blood urea nitrogen B.A. Bachelor of Arts B.S. Bachelor of Science B.S.N. Bachelor of Science in Nursing

C&S culture and sensitivity CA calcium, cancer, carcinoma CABG coronary artery bypass graft CAD coronary artery disease CAPD continuous ambulatory peritoneal dialysis CAT computerized tomography scan CBC complete blood count CBD common bile duct CBE clinical breast examination CBG capillary blood glucose CBI continuous bladder irrigation CBS capillary blood sugar CC chief complaint CCK cholecystokinin CCPD continuous cyclic peritoneal dialysis CEA cultured epithelial autograft CFT complement-fixation test CIN cervical intraepithelial neoplasm CL cleft lip

CMS circulation, motion, sensation CO cardiac output COPD chronic obstructive pulmonary disease CP chest pain, cleft palate CPAP continuous positive airway pressure CPD cephalo-pelvic disproportion CPP cerebral perfusion pressure CPPD chest percussion and post drainage CRF chronic renal failure CRRT continuous renal replacement therapy CRT capillary refill time CSF cerebrospinal fluid, colony stimulating factors CT chest tube, computed tomography CVA cerebral vascular accident, costovertebral angle CVP central venous pressure CX cancel, cervix CXR chest x-ray CDA Certified Dental Assistant CLS Clinical Laboratory Scientist CLT Clinical Laboratory Technician CMA Certified Medical Assistant CNMT Certified Nuclear Medical Technologist COTA Certified Occupational Therapy Assistant CRTT Certified Respiratory Therapy Technician

DAT diet as tolerated DC (dc) discontinue DCCT Diabetes Control and Complication Trials DEX (DXT) blood sugar

DIC disseminated intravascular coagulation DKA diabetic ketoacidosis DNA deoxyribonucleic acid DNR do not resuscitate DTR deep tendon reflex DVT deep vein thrombosis DX diagnosis D.M.D Doctor of Dental Medicine DDS Doctor of Dental Surgery DVM Doctor of Veterinary Medicine

EBV Epstein-Barr Virus ECF extracellular fluid, extended care facility EENT eye, ear, nose and throat EMC ensephalomyocarditis EMG electromyogram ERCP endoscopic retrograde cholangiopancreatography ESRD end stage renal disease ET endotracheal tube EMT-B Emergency Medical Technician-Basic EMT-I Emergency Medical Technician-Intermediate EMT-P Emergency Medical Technician-Paramedic

F & R force and rhythm FA fatty acid FBS fasting blood sugar FD fatal dose, focal distance FDA Food & Drug Administration

FX fracture FUO fever of unknown origin FVD fluid volume deficit FNP Family Nurse Practitioner

GB gallbladder GERD gastroesophageal reflux disease GFR glomerular filtration rate GGT gamma-glutamyl transferase GI gastrointestinal GOT glutamic oxalic transaminase GU genitourinary GVHD graft-versus-host-disease

HA headache HB hemoglobin HCG human chorionic gonadotropin HCO3 bicarbonate HCT hematocrit HD hemodialysis HDL high density lipoprotein HEENT head, eye, ear, nose and throat HGB hemoglobin HIV human immunodeficiency virus HRT hormone replacement therapy HS bedtime HX history

IBC iron binding capacity IBD inflammatory bowel disease IBS irritable bowel syndrome IBW ideal body weight ICCE intracapsular cataract extraction ICF imtermediate care facility ICP intracranial pressure ICS intercostal space ICT inflammation of connective tissue ICU intensive care unit IDM infant of diabetic mother IDDM insulin dependent diabetes mellitus IE inspiratory exerciser IH infectious hepatitis IHD ischemic heart disease IIP implantable insulin pump IM intramuscular IMV intermittent mandatory ventilation INR international normalization ratio IPD intermittent peritoneal dialysis IPPB intermittent positive pressure breathing ITP immune thrombocytopenic purpura IV intravenous IVF in vitro fertilization IVP intravenous pyelography

JAMA Journal of the American Medical Association JVP jugular venous pressure

K potassium KCl potassium chloride KI potassium iodide KUB kidney, ureter, bladder KVO keep vein open

L & A light and accommodation LAD left anterior descending artery LB large bowel LDL low density lipoprotein LE lupus erythematosus LFTs liver function tests LIJ left internal jugular LLQ left lower quadrant LMP last menstrual period LP lumbar puncture LSC left subclavian LUQ left upper quadrant LPN Licensed Practical Nurse

MAP mean arterial pressure MAR medication administration record MCL modified chest lead MDI multiple daily vitamin MI myocardial infarction MLC midline catheter

MM mucous membrane MOABS monoclonal antibodies MOM Milk of Magnesia MRDD mental retarded/developmentally disabled MRI magnetic resonance imaging MRM modified radical mastectomy MS multiple sclerosis, morphine sulfate M.B.A. Master of Business Administration M.D. Doctor of Medicine M.H.E. Master of Health Education M.N. Master of Nursing M.P.A. Master of Public Administration M.P.H. Master of Public Health M.P.T. Master of Physical Therapy M.S. Master of Science M.S.N. Master of Science in Nursing M.S.W. Master of Social Work MD Medical Doctor MLT Medical Laboratory Technician MT Medical Technologist

NA sodium NACL sodium chloride NED no evidence of disease NICU neonatal intensive care unit NIDDM noninsulin dependent diabetes mellitus NKA no known allergies NKDA non-ketotic diabetic acidosis NKMA no known medcation allergies

NPD nightly peritoneal dialysis NPO nothing by mouth NSAID nonsteroidal anti-inflammatory drug NTD neural tube defect NV nausea & vomiting NYD not yet diagnosed

OD right eye OGTT oral glucose tolerance test ORIF open reduction internal fixation OS left eye OU both eyes OTR Occupational Therapist-Registered

PABA para-aminobenzoic acid PC after meals PCA patient controlled analgesia, posterior communicating artery PCN penicillin, primary care nurse PCV packed cell volume PD peritoneal dialysis PDA patent ductus arteriosus, posterior descending artery PDD pervasive development disorder PDR physicians desk reference PEG percutaneous endoscopic gastrostomy PEJ percutaneous endoscopic jejunostomy PERL pupils equal, react to light PERRLA pupils equal, round, react to light, accommodation

PET positron emission tomography PFT pulmonary function test PG prostaglandin PH past history PI present illness PICC peripherally inserted central venous catheter PID pelvic inflammatory disease PMI point of maximal impulse PNH paroxysmal nocturnal hemoglobinuria PO by mouth PRBC packed red blood cells PS pyloric stenosis PSA prostate specific antigen PT prothrombin time PTT partial thromboplastin time PUD peptic ulcer disease PVD peripheral vascular disease PX pneumothorax Ph.D. Doctor of Philosophy Pharm.D. Doctor of Pharmacy PT Physical Therapist PTA Physical Therapy Assistant

QD everyday QID four times a day QNS quantity not sufficient QOD every other day QS quantity sufficient, quantity required

RA rheumatoid arthritis RAD reactive airway disease RAI radioactive iodine RAIU radioactive iodine uptake RCA right coronary artery RDW red cell distribution width REEDA redness, edema, ecchymosis, drainage, approximation RHD rheumatic heart disease, relative hepatic dullness RIJ right internal jugular RLQ right lower quadrant RM respiratory movement ROM range of motion ROS review of systems RSC right subclavian RUQ right upper quadrant RX prescription, pharmacy RD Registered Dietician Registration Abbreviations RHIA Registered Health Information Administrator RHIT Registered Health Information Technician RN Registered Nurse RRA Registered Record Administrator RRT Registered Respiratory Therapist RT Radiologic Technologist RTN Registered Technician of Nuclear Medicine

S/S signs & symptoms

SAB spontaneous abortion SAST serum aspartate aminotransferase SB spina bifida SBO small bowel obstruction SGPT serum glutamic-pyruvic transaminase SLE systemic lupus erythematosus SNF skilled nursing facility SOB short of breath SR sedimentation rate SS social services STD sexually transmitted disease STH somatotropic hormone STM short term memory SUI stress urinary incontinence SVR systemic vascular resistance

T3 triiodothyronine T4 thyroxine TBSA total body surface area TCDB turn, cough, deep breathe TED (hose) thrombo-embolism deterrent TEP transesophageal puncture THR total hip replacement TIA transient ischemic attack TIBC total iron binding capacity TID three times a day TIL tumor infiltrating lymphocytes TKR total knee replacement TNF tumor necrosis factor

TNM tumor, node, metastases TNTC too numerous to mention TP tuberculin precipitation TPN total parenteral nutrition TTN transient tachypnea of the newborn TTP thrombotic thrombocytopenia purpura TUPR trans-urethral prostatic resection TUR (or TURP) trans-urethral resection of the prostate TWB touch weight bear TWE tap water enema TX treatment, traction

UA urinalysis UAO upper airway obstruction UBW usual body weight UGI upper gastrointestinal UPJ ureteropelvic junction URI upper respiratory infection US ultrasonic UTI urinary tract infection UVJ ureterovesical junction

VA visual acuity VBAC vaginal birth after caeserean VF ventricular fibrillation VLDL very low density lipoprotein VMA vanillylmandelic acid VSD ventricular septal defect

VT ventricular tachycardia VW vessel wall

W/C wheelchair WBC white blood cell WD well developed WHO World Health Organization WN well nourished WNL within normal limits

XR x-ray

YO years old

Z zero

Arterial Blood Gas Analysis Made Easy

PH 7.34-7.45 PaCO2 35 to 45mm Hq HCO3

22-26mEq/L Step 1: Look at the PH firse. Draw an arrow if it is alow or high.An arrpw indocating low means acidosis. An arrow indicating high means alkalosis. Next, loook at the resporatory indicator (PaCO2). Draw an arrowif it is low or high. Step 2: If the arrows are in the opposite direction, the problem is respiratory in nature-either resp.acidosis or resp.alkalosis. Next, look at the metabolic indicator (HCO3). Draw an arrow if it is low or high. Step 3: If the pH arrow and the metabolic arrow are in the same direction, the problem is of metabolic in nature-either metab.acidosis or metab alkalosis. Step 4: Compensation is present if the arrows of PaCO2 and HCO3 are opposite.Partial compensation is present if the arrows of PaCO2 and HCO3 point in the same direction.

Glasgow Coma Scale

A neurologic assessment scale that provides objective measurement of level of consciousness, pupil reaction,and motor activity. The total of the three scores can range from 3 to 15. A client who is oriented, opens the eyes

spontaneously, and follows commands scores a 15. A client in a deep coma would score a 3. The first GCS score becomes the baselin. Future scores indicate trends or changes in nureologic status.

Eye response
*opens *opens *opens *opens spontaneously -----------------------------------4 to verbal command ------------------------------ 3 to pain ------------------------------------------ 2 response ---------------------------------------- 1

Motor response
*react to verbal command ------------------------------ 6 *reacts to painful stimuli -------------------------------- 5 *flexes and withdraws --------------------------------- 4 *assumes flexor posture -------------------------------- 3 *assumes extensor posture ----------------------------- 2 *no response ------------------------------------------- 1

Verbal response *is oriented and converses ------------------------------ 5

*isdisoriented but converses ---------------------------- 4 *uses inappropriate words ------------------------------ 3 *makes unintelligible sounds ---------------------------- 2 *no response ------------------------------------------- 1

Adventitious Lung Sounds

Crackles Characteristics: popping,crackling,bubbling, moist sound on insporation LUNG PROBLEM: pneumoina,pulmonary edema, pulmonary fibrosis ----------------------------------------------------------Rhonchi Characteristics: rumbling sound on expiration LUNG PROBLEM: pneumonia,emphysema,bronchitis, bronchiectasis ----------------------------------------------------------Wheezes Characteristics: high-pitched musical sound during both inspiration ans expiration (lounder) LUNG PROBLEM: emphysema,asthma,

foreign bodies ----------------------------------------------------------Pleural Friction Rub Characteristics: dry,grationg sound on both inspiration and expiration LUNG PROBLEM: pleurisy,pneumonia, pleural infarct