Вы находитесь на странице: 1из 31

CARDIAC VALVES

"TRI before you BI":

Tricuspid valve is located in left heart and Bicuspid valve is located in right heart. Blood flows
through the tricuspid before bicuspid.

FEMORAL HERNIA

FEMoral hernias are more common in FEMales.

"TRY PULLING MY AORTA":

Tricuspid

Pulmonary

Mitral

Aorta

PLACENTA-CROSSING SUBSTANCES

"Want My Hot Dog":

Wastes

Antibodies

Nutrients

Teratogens

Microorganisms

Hormones/ HIV

Drugs

EMERGENCY MEDICINE
ACTIVATED CHARCOAL: CONTRAINDICATIONS
CHEMICAL CamP:
Cyanide

Hydrocarbons

Ethanol

Metals

Iron
Caustics

Airway unprotected

Lithium

CAMphor

Potassium

IPECAC: CONTRAINDICATIONS

4 C's:

Comatose

Convulsing

Corrosive

hydroCarbon

ATRIAL FIBRILLATION: CAUSES OF NEW ONSET

THE ATRIAL FIBS:

Thyroid

Hypothermia

Embolism (P.E.)

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)

ENDOTRACHEAL TUBE DELIVERABLE DRUGS


O NAVEL:

Oxygen

Naloxone

Atropine

Ventolin (albuterol)

Epinephrine

Lidocaine

MALARIA: COMPLICATIONS OF FALCIPARUM MALARIA

CHAPLIN:

Cerebral malaria/ Coma

Hypoglycemia

Anaemia

Pulmonary edema

Lactic acidosis

Infections

Necrois of renal tubules (ATN)

MI: IMMEDIATE TREATMENT

DOGASH:

Diamorphine

Oxygen

GTN spray

Asprin 300mg

Streptokinase

Heparin

PAIN HISTORY CHECKLIST

OLDER SAAB:
Onset

Location

Description (what does it feel like)

Exacerbating factors

Radiation

Severity

Associated symptoms

Alleviating factors

Before (ever experience this before)

SHOCK: SIGNS AND SYMPTOMS

TV SPARC CUBE:

Thirst

Vomiting

Sweating

Pulse weak

Anxious

Respirations shallow/rapid

Cool

Cyanotic

Unconscious

BP low

Eyes blank

SUBARACHNOID HEMORRHAGE (SAH) CAUSES

BATS:

Berry aneurysm

Arteriovenous malformation/ Adult polycystic kidney disease

Trauma (eg being struck with baseball bat)


Stroke

VENTRICULAR FIBRILLATION: TREATMENT

"Shock, Shock, Shock, Everybody Shock, Little Shock, Big Shock, Momma Shock, Poppa
Shock":

Shock= Defibrillate

Everybody= Epinephine

Little= Lidocaine

Big= Bretylium

Momma= MgSO4

Poppa= Pocainamide

VFIB/VTACH DRUGS USED ACCORDING TO ACLS

"Every Little Boy Must Pray":

Epinephrine

Lidocaine

Bretylium

Magsulfate

Procainamide

DIABETIC KETOACIDOSIS MANAGEMENT

KING UFC:

K+ (potassium)

Insulin (5u/hour. Note: sliding scale no longer recommended in the UK)

Nasogastic tube (if patient comatose)

Glucose (once serum levels drop to 12)

Urea (check it)

Fluids (crytalloids)

Creatinine (check it)/ Catheterize

NEUROLOGICAL FOCAL DEFICITS


10 S's:

Sugar (hypo, hyper)

Stroke

Seizure (Todd's paralysis)

Subdural hematoma

Subarachnoid hemorrhage

Space occupying lesion (tumor, avm, aneurysm, abscess)

Spinal cord syndromes

Somatoform (conversion reaction)

Sclerosis (MS)

Some migraines

COMA: CONDITIONS TO EXCLUDE AS CAUSE

MIDAS:

Meningitis

Intoxication

Diabetes

Air (respiratory failure)

Subdural/ Subarachnoid hemorrhage

MALIGNANT HYPERTHERMIA TREATMENT

"Some Hot Dude Better Give Iced Fluids Fast!" (Hot dude = hypothermia):

Stop triggering agents

Hyperventilate/ Hundred percent oxygen

Dantrolene (2.5mg/kg)

Bicarbonate

Glucose and insulin

IV Fluids and cooling blanket

Fluid output monitoring/ Furosemide/ Fast heart [tachycardia]


RESUSCITATION: BASIC STEPS

ABCDE:

Airway

Breathing

Circulation

Drugs

Environment

RLQ PAIN: DIFFERENTIAL

APPENDICITIS:

Appendicitis/ Abscess

PID/ Period

Pancreatitis

Ectopic/ Endometriosis

Neoplasia

Diverticulitis

Intussusception

Crohns Disease/ Cyst (ovarian)

IBD

Torsion (ovary)

Irritable Bowel Syndrome

Stones

Posted by Admin at Friday, February 16, 2007

Feb
15
MNEMONICS CORNER 05
Labels: MNEMONICS | 0 comments

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

Alcohol withdrawal: clinical features—"HITS"

Hallucinations (visual, tactile)

Increased vital signs and insomnia

Tremens delirium tremens (potentially lethal)

Shakes/ Sweats/ Seizures/ Stomach pains (nausea, vomiting)

Angina: precipitating factors—"4E's"

Eating

Emotion

Exertion (Exercise)

Extreme Temperatures (Hot or Cold weather)

Anorexia nervosa: clinical features—"ANOREXIC"

Adolescent women/ Amenorrhea

NGT alimentation (most severe cases)

Obsession with losing weight/ becoming fat though underweight

Refusal to eat (5% die)

Electrolyte abnormalities (e.g., K+, cardiac arrhythmia)

X - ercise

Intelligence often above average/ Induced vomiting

Cathartic use (and diuretic abuse)

Appendicitis: assessment—"PAINS"

Pain (RLQ)
Anorexia

Increased temperature, WBC (15,000–20,000)

Nausea

Signs (McBurney's, Psoas)

Neurovascular Occlusion: symptoms— "6 P's"

Pain

Pale

Pulseless

Paresthesia

Poikilothermic

Paralysis

Blood glucose (rhyme)

Symptom Implication

Cold and clammy . . . give hard candy

Hot and dry . . . glucose is high

Blood vessels in umbilical cord—"AVA" (2 arteries and 1 vein)

Artery

Vein

Artery

Cholecystitis: risk factors—"5F's"

Female

Fat

Forty

Fertile

Fair

Cleft lip: nursing care plan (postoperative)—"CLEFT LIP"


Crying, minimize

Logan bow

Elbow restraints

Feed with Brecht feeder

Teach feeding techniques; two months of age (average age at repair)

Liquid (sterile water), rinse after feeding

Impaired feeding (no sucking)

Position—never on abdomen

Cognitive disorders: assessment of difficulties—"JOCAM"

Judgment

Orientation

Confabulation

Affect

Memory

Coma: causes—"A-E-I-O-U TIPS"

Alcohol, acidosis (hyperglycemic coma)

Epilepsy (also electrolyte abnormality, endocrine problem)

Insulin (hypoglycemic shock)

Overdose (or poisoning)

Uremia and other renal problems

Trauma; temperature abnormalities (hypothermia, heat stroke)

Infection (e.g., meningitis)

Psychogenic ("hysterical coma")

Stroke or space-occupying lesions in the cranium

Complication of severe preeclampsia—"HELLP" syndrome

Hemolysis
Elevated Liver enzymes

Low Platelet count

Cushing's syndrome: symptoms—"3S's"

Sugar (hyperglycemia)

Salt (hypernatremia)

Sex (excess androgens)

Diabetes: signs and symptoms—"3P's,"

Polydipsia (very thirsty)

Polyphagia (very hungry)

Polyuria (urinary frequency)

Diet: low cholesterol—avoid the "3C's"

Cake

Cookies

Cream (dairy, e.g., milk, ice cream)

Dystocia: etiology—"3P's"

Power

Passageway

Passenger

Dystocia: general aspects (maternal)—"3P's"

Psych

Placenta

Position

Episiotomy assessment—"REEDA"

Redness

Edema
Ecchymosis

Discharge

Approximation of skin

Eye medications

Mydriatic = dilated pupils

Miotic = tiny (constricted) pupils

Hypertension: complications—"4 C's"

CAD (coronary artery disease)

CHF (congestive heart failure)

CRF (chronic renal failure)

CVA (cardiovascular accident; now called brain attack or stroke)

Hypertension: nursing care plan— "I-TIRED"

Intake and output (urine)

Take blood pressure

Ischemia attack, transient (watch for TIAs)

Respiration, pulse

Electrolytes

Daily weight

Hypoglycemia: signs and symptoms—"DIRE"

Diaphoresis

Increased pulse

Restless

Extra hungry

Infections during pregnancy—"TORCH"

Toxoplasmosis

Other (hepatitis B, syphilis, group B beta strep)


Rubella

Cytomegalovirus

Herpes simplex virus

IUD: potential problems with use—"PAINS"

Period (menstrual: late, spotting, bleeding)

Abdominal pain, dyspareunia

Infection (abnormal vaginal discharge)

Not feeling well, fever or chills

String missing

Manipulation: nursing plan—promote the "3C's"

Cooperation

Compromise

Collaboration

Medication administration—"six rights"

RIGHT medication

RIGHT dosage

RIGHT route

RIGHT time

RIGHT client

RIGHT technique

Melanoma characteristics—"ABCD"

Asymmetry

Border

Color

Diameter
Mental retardation: nursing care plan—"3R's"

Regularity (provide routine and structure)

Reward (positive reinforcement)

Redundancy (repeat)

Myocardial infarction: treatment—"MONA"

Monitor/ Morphine

Oxygen

Nitroglycerin

Aspirin

Newborn assessment components—"APGAR"

Appearance

Pulse

Grimace

Activity

Respiratory effort

Obstetric (maternity) history—"GTPAL"

Gravida

Term

Preterm

Abortions (SAB, TAB)

Living children

Oral contraceptives: signs of potential problems—"ACHES"

Abdominal pain (possible liver or gallbladder problem)

Chest pain or shortness of breath (possible pulmonary embolus)

Headache (possible hypertension, brain attack)

Eye problems (possible hypertension or vascular accident)


Severe leg pain (possible thromboembolic process)

Pain: assessment—"PQRST"

What Provokes the pain?

What is the Quality of the pain?

Does the pain Radiate?

What is the Severity of the pain?

What is the Timing of the pain?

Pain: management—"ABCs"

Ask about the pain

Believe when clients say they have pain

Choices—let clients know their choices

Deliver what you can, when you said you would

Empower/Enable clients' control over pain

Postoperative complications: order—"4W's"

Wind (pulmonary)

Wound

Water (urinary tract infection)

Walk (thrombophlebitis)

Preterm infant: anticipated problems—"TRIES"

Temperature regulation (poor)

Resistance to infections (poor)

Immature liver

Elimination problems (necrotizing enterocolitis [NEC])

Sensory-perceptual functions (retinopathy of prematurity [ROP])

Psychotropic medications: common antidepressives (tricyclics)—"VENT"

Vivactil
Elavil

Norpramin

Tofranil

Schizophrenia: primary symptoms—"4A's"

Affect

Ambivalence

Associative looseness

Autism

Sprain: nursing care plan—"RICE"

Rest

Ice

Compression

Elevation

Stool assessment—"ACCT"

Amount

Color

Consistency

Timing

Tracheoesophageal fistula: assessment—"3Cs"

Coughing

Choking

Cyanosis

Traction: nursing care plan—"TRACTION"

Trapeze bar overhead to raise and lower upper body

Requires free-hanging weights; body alignment


Analgesia for pain, prn

Circulation (check color and pulse)

Temperature (check extremity)

Infection prevention

Output (monitor)

Nutrition (alteration related to immobility)

Transient ischemic attacks: assessment—"3Ts"

Temporary unilateral visual impairment

Transient paralysis (one-sided)

Tinnitus = vertigo

Trauma care: complications—"TRAUMA"

Thromboembolism; Tissue perfusion, altered

Respiration, altered

Anxiety related to pain and prognosis

Urinary elimination, altered

Mobility impaired

Alterations in sensory-perceptual functions and skin integrity (infections)

Wernicke-Korsakoff syndrome (alcohol-associated neurological disorder)—"COAT RACK"

Wernicke's encephalopathy (acute phase)

clinical features:

Confusion

Ophthalmoplegia

Ataxia

Thiamine is an important aspect of Tx

Korsakoff's psychosis (chronic phase)

characteristic findings:
Retrograde amnesia (recall of some old memories)

Anterograde amnesia (ability to form new memories)

Confabulation

Korsakoff's psychosis

Posted by Admin at Thursday, February 15, 2007

Feb
14
MNEMONICS CORNER 04
Labels: CANCER, MNEMONICS | 0 comments

SIGNS OF CANCER

Change in bowel /bladder habits

A sore that doesn’t heal

Unusual bleeding/ Discharge

Thickening of lump – breast or elsewhere

Indigestion/ Dysphagia

Obvious change in wart/ mole

Nagging cough/ hoarseness

Unexplained anemia

Sudden weight loss

FOCUS OF PATIENT CARE IN CLIENTS WITH CANCER

Chemotherapy

Assess body image disturbance (related to alopecia)

Nutritional needs when N/V present

Comfort from pain

Effective response to Tx? (Evaluate)

Rest (for patient and family)

Posted by Admin at Wednesday, February 14, 2007

Feb
13
MNEMONICS CORNER 03
Labels: MNEMONICS | 0 comments

Basic MI management - "BOOMAR"

Bed rest

Oxygen

Opiate

Monitoring

Anticoagulation

Reduce clot size

To Remember Immunoglobulins - "GAMED"

IgG

IgA

IgM

IgE

IgD

Location of the heart valve from right to left - "A Permanently Temperamental Man"

Aortic

Pulmonary

Tricuspid

Mitral

"Cut C4, breathe no more"

The 3rd, 4th and 5th cervical spinal nerves innervate the diaphragm.

Types of Joint movements - "FEEDPIPE CARDSHARP"

Flexion

Extension
Eversion

Dorsiflexion

Pronation

Inversion

Plantarflexion

Elevation

Circumduction

Abduction

Rotation

Depression

Supination

Hyperextension

Adduction

Retraction

Protraction

Cranial Nerves - "Oh Ohh Ohhh To Try And Fit A Gold Velvet So Heavenly"

Olfactory CN I

Optic CN II

Occulomotor CN III

Trochlear CN IV

Trigeminal CN V

Abducens CN VI

Facial CN VII

Auditory CN VIII

Glasopharyngeal CN IX

Vagus CN X

Spinal/Accessory CN XI
Hypoglossal CN XII

"Point and Shoot!"

For remembering that Parasympathetics are involved with erection and Sympathetics with
ejaculation.

Layers of the scalp - "SCALP"

Skin

Connective tissue

Aponeurosis

Loose areolar tissue

Pericranium

Carpal bones of the hand (lateral to medial) - "She Looks Too Proud, Try To Chase Her"

Proximal row:

Scaphoid

Lunate

Triquetrum

Pisiform

Distal row:

Trapezium

Trapezoid

Capitate

Hamate

Viruses causing diarrhea - "ACNE CAR"

Adeno virus

Corana virus

Norwak virus
Entero virus

Calci virus

Astro virus

Rota virus

The Krebs cycle - "Can I Actually See Some Filipina Mothers"

Citrate

Isocitrate

alpha Ketoglutarate

Succinyl CoA

Succinate

Fumarate

Malate

Oxaloacetate

Stages of mitosis/meiosis including interphase as a phase - "In Philippines, Men Are Talented"

Interphase

Prophase

Metaphase

Anaphase

Telophase

Order of prevalence of White Blood Cells, most prevalent to least - "Never Let Monkeys Eat
Bananas"

Neutrophils

Lymphocytes

Monocytes

Eosinophils
Basophils

10 essential amino acids - "PVT. TIM HALL"

Phenylalanine

Valine

Tryptophan

Threonine

Isoleucine

Metheonine

Histidine(semi-essential)

Arginine(semi-essential)

Leucine

Lysine

Uses of Chloroquine (other than malaria) - "RED LIP"

Rheumatoid arthritis

Extra intestinal amoebiasis

Discoid lupus erythematosus

Lepra reaction

Infectious mononucleosis

Photogenic reactions

Bronchodilators - "TO A SIS"

Terbutaline

Orciprenaline

Adrenaline

Salbutamol

Isoprenaline
Salmeterol

Signs of cor pulmonale - "Please Read His Text"

Peripheral edema

Raised JVP

Hepatomegaly

Tricuspid incompetence

Portal hypertension features - "ABCDE"

Ascites

Bleeding (hematemesis, piles)

Caput medusae

Diminished liver

Enlarged spleen

Key questions needed in an emergency history taking situation - "AMPLE"

Allergies

Medication

Past medical history

Last meal

Events and environment related to injury

Malignancies that metastisize to bone - "Laging Panalo Kung Taga Bulacan"

Lung

Prostat

Kidney

Thyroid

Breast
Six "S" in Scarlet Fever

Streptococci causal organism

Sorethroat

Swollen tonsils

Strawberry tongue

Sandpaper rash

miliarySudamina vesicles over hands, feet, abdomen

Signs of anti-cholinergic crisis - "SLUD"

Salivation

Lacrimation

Urination

Defecation

Causes of huge spleen - "3M's"

Myelofibrosis

Malaria

Myelogenous leukemia

Cardinal Symptoms of Parkinson's Disease - "TRAP"

Tremor

Rigidity

Akinesia and bradykinesia

Postural Instability

Days of appearance of rashesVaricella(chickenpox) - "Very Sick Patients Must Take Double


Exercise"

1st dayScarlet fever


2nd dayPox(smallpox)

3rd dayMumps

4th dayTyphus

5th dayDengue

6th dayEnteric fever(typhoid)

Posted by Admin at Tuesday, February 13, 2007

Feb
12
MNEMONICS CORNER 02
Labels: MNEMONICS | 0 comments

SHOCK – HYPOTACHYTACHY

HYPOTENSION

TACHYPNEA

TACHYCARDIA

INCREASE ICP – HYPERBRADYBRADY

CUSHINGS TRIAD:

HYPERTENSION (WIDE PULSE PRESSURE)

BRADYCARDIA

BRADYPNEA

HYPOGLYCEMIA

TREMORS, TACHYCARDIA

IRRITABILITY

RESTLESSNESS

EXTREME

DIAPHORESIS
EARLY SIGNS OF HYPOXIA

RESTLESSNESS

AGITATION

TACHYCARDIA

LATE SIGNS OF HYPOXIA

BRADYCARDIA

EXTREME RESTLESSNESS

DYSPNEA

CYANOSIS

CONGESTIVE HEART FAILURE

DIGOXIN

MORPHINE

AMINOPHYLLINE

DOPAMINE

DIURETICS

O2

GASSES – MONITOR (ABG)

MG SO4 TOXICITY

BP DECREASE

URINE OUTPUT DECREASE

RESPIRATORY RATE DECREASE


PATELLAR REFLEX ABSENT

SICKLE CELL DISEASE

HYDRATION

OXYGENATION

PAIN

INFECTION

AVOID HIGH PLACES

PREGNANCY INDUCED HYPERTENSION

HEMOLYSIS

ELEVATED LIVER ENZYMES

LOW

PLATELETS

GI SYMPTOMS AND TOXICITY TO DIGOXIN

VOMITTING

ANOREXIA

NAUSEA

DIARRHEA

ABDOMINAL PAIN

FRACTURE

PRESSURE

REST
ICE

COMPRESSION

ELEVATION

TETRALOGY OF FALLOT

DISPLACED AORTA

RIGHT VENTRICULAR HYPERTROPHY

OPENING INTO THE SEPTUM (VSD)

PULMONARY STENOSIS

HYPOKALEMIA

SKELETAL MUSCLE WEAKNESS

U-WAVE ON ECG

CONSTIPATION

TOXICITY TO DIGOXIN

IRREGULAR WEAK PULSE

OTOSTASIS

NUMBNESS PARESTHESIA

PAIN ASSESSMENT

PROVOCATION

QUALITY

RADIATION, RELIEF

SEVERITY

TIME
NEUROVASCULAR CHECK

PAIN

PULSELESSNESS

PARESTHESIA

PARALYSIS

PALLOR

VIRCHOW’S TRIAD IN DVT

VENUS STASIS

DAMAGE TO VESSELS

HYPERCOAGUABILITY

ABDOMINAL AORTIC ANEURISM (4A)

ASSYMPTOMATIC

ABDOMINAL MASS

ABDOMINAL PULSE

ACHES LOW BACK

ANTI TB DRUGS AND SIDE EFFECTS

RIFAMPICIN – RED-ORANGE URINE

ISONIAZID – PERIPHERAL NEURITIS

PYRAZINAMIDE – INCREASE URIC ACID

ETHAMBUTOL – EYE PROBLEMS

STREPTOMYCIN – OTOTOXIC

Posted by Admin at Monday, February 12, 2007

Feb
11
MNEMONICS CORNER 01
Labels: MNEMONICS | 0 comments

USE STRAW BECAUSE THESE DRUGS STAIN THE TEETH

L - LUGOL'S SOLUTION

I - IRON

N - NITROFURANTOIN

T - TETRACYCLINE

LR6 - LATERAL RECTUS : CN6

SO4 - SUPERIOR OBLIQUE : CN4

ALL3 - ALL THE REST : CN3

RADIATION TX VIA:

MUSTARD

ESTROGEN

NITROGEN

STEROIDS

ANTIBIOTICS