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 Schizophrenia: primary symptoms"4A's" Affect Ambivalence Associative looseness Autism Psychotropic medications: common antidepressives (tricyclics)"VENT" Vivactil Elavil Norpramin Tofranil Mental retardation: nursing care plan"3R's" Regularity (provide routine and structure) Reward (positive reinforcement) Redundancy (repeat) Cognitive disorders: assessment of difficulties"JOCAM"

Judgment Orientation Confabulation Affect Memory 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)

Systems of the Body MR DICE RUNS M= Muscle R= Respiratory D=Digestive I= Integumentary C= Circulatory E= Endocrine R= Reproductive U= Urinary N= Nervous S= Skeletal Oh, Oh, Oh, To TouchAnd Feel Virgin GirlsVagina, AndHymen/Hooters I - Olfactory nerve II - Optic nerve III - Oculomotor nerve IV - Trochlear nerve/pathic nerve V - Trigeminal nerve/dentist nerve VI - Abducens nerve VII - Facial nerve VIII - Vestibulocochlear nerve/Auditory nerve IX - Glossopharyngeal nerve X - Vagus nerve XI - Accessory nerve/Spinal accessory nerve XII - Hypoglossal nerve Patients are predisposed to Cholelithiasis (aka Gallstones) by the: 4 F's (Fat, Forty, Female, and Fertile).

use the abcd rule to assess a moles malignant potential: a: asymmetry--is the mole irregular in shape? b: border--is the border irregular, notched, or poorly defined? c: color--does the color vary (for example, between shades of brown, red, white, blue, or black)? d: diameter--is the diameter more than 6 mm? having difficulty distinguishinghypoplasia from hyperplasia? when you see plasia in any word, think of "plastic." plastic, in turn, means forming or developing. as for hypo and hyper, thats the easy part. hypo means under, or below normal. hyper means excessive, or above normal. thus, hypoplasia means underdevelopment, and hyperplasia means overdevelopment. to remember which blood types are compatible, visualize the letter o as an orb representing the universe, because type o blood is the universal donor blood. patients with any blood type can receive it. but o also means odd man out: patients with type o blood can receive only type o blood. think beep to remember the signs of minor bleeding: b: bleeding gums e: ecchymoses (bruises) e: epistaxis (nosebleed) p: petechiae (tiny purplish spots) PREGNANCY INDUCED HYPERTENSION- HELP HEMOLYSIS ELEVATED LIVER ENZYMES LOW PLATELETS SICKLE CELL DISEASE-HOPIA HYDRATION OXYGENATION PAIN INFECTION AVOID HIGH PLACES MG SO4 TOXICITY- BURP

BP DECREASE URINE OUTPUT DECREASE RESPIRATORY RATE DECREASE PATELLAR REFLEX ABSENT CONGESTIVE HEART FAILURE- D MAD DOG

DIGOXIN MORPHINE AMINOPHYLLINE DOPAMINE DIURETICS O2 GASSES MONITOR (ABG) EARLY SIGNS OF HYPOXIA RESTLESSNESS AGITATION TACHYCARDIA LATE SIGNS OF HYPOXIA BRADYCARDIA EXTREME RESTLESSNESS DYSPNEA CYANOSIS INCREASE ICP HYPERBRADYBRADY CUSHINGS TRIAD: HYPERTENSION (WIDE PULSE PRESSURE) BRADYCARDIA BRADYPNEA Days of appearance of rashesVaricella(chickenpox) "Very Sick PatientsMust Take DoubleExercise" 1st dayScarlet fever 2nd dayPox(smallpox) 3rd dayMumps

4th dayTyphus 5th dayDengue 6th dayEnteric fever(typhoid) Cardinal Symptoms of Parkinson's Disease - "TRAP" Tremor Rigidity Akinesia and bradykinesia Postural Instability Causes of huge spleen - "3M's" Myelofibrosis Malaria Myelogenous leukemia Signs of anti-cholinergic crisis - "SLUD" Salivation Lacrimation Urination Defecation Six "S" in Scarlet Fever Streptococci causal organism Sorethroat Swollen tonsils Strawberry tongue Sandpaper rash

miliary Sudamina vesicles over hands, feet, abdomen Signs of cor pulmonale - "Please Read His Text" Peripheral edema Raised JVP Hepatomegaly Tricuspid incompetence 10 essential amino acids - "PVT. TIM HALL" Phenylalanine Valine Tryptophan Threonine Isoleucine Metheonine Histidine(semi-essential) Arginine(semi-essential) Leucine Lysine Order of prevalence of White Blood Cells, most prevalent to least "NeverLet Monkeys Eat Bananas" Neutrophils Lymphocytes Monocytes Eosinophils Basophils Stages of mitosis/meiosis including interphase as a phase - "In Philippines,Men Are Talented" Interphase Prophase

Metaphase Anaphase Telophase Viruses causing diarrhea - "ACNE CAR" Adeno virus Corana virus Norwak virus Entero virus Calci virus Astro virus Rota virus Carpal bones of the hand (lateral to medial) - "She LooksToo Proud, Try ToChase Her" Proximal row: Scaphoid Lunate Triquetrum Pisiform Distal row: Trapezium Trapezoid Capitate Hamate Layers of the scalp - "SCALP" Skin Connective tissue Aponeurosis Loose areolar tissue Pericranium 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 Types of Joint movements - "FEEDPIPE CARDSHARP" Flexion Extension Eversion Dorsiflexion Pronation Inversion Plantarflexion Elevation Circumduction Abduction Rotation Depression Supination

Hyperextension Adduction Retraction Protraction "Cut C4, breathe no more" The 3rd, 4th and 5th cervical spinal nerves innervate the diaphragm. "Point and Shoot!" For remembering thatParasympathetics are involved with erection and Sympatheticswith ejaculation. Location of the heart valve from right to left - "A PermanentlyTemperamental Man" Aortic Pulmonary Tricuspid Mitral SIGNS OF CANCER-"CAUTION US" Change in bowel /bladder habits A sore that doesnt 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) 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 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 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 SUBARACHNOID HEMORRHAGE (SAH) CAUSES BATS: Berry aneurysm Arteriovenous malformation/ Adult polycystic kidney disease Trauma (eg being struck with baseball bat) Stroke SHOCK: SIGNS AND SYMPTOMS TV SPARC CUBE: Thirst Vomiting Sweating Pulse weak Anxious Respirations shallow/rapid Cool Cyanotic Unconscious BP low Eyes blank

SHOCK HYPOTACHYTACHY HYPOTENSION TACHYPNEA TACHYCARDIA "TRY PULLING MYAORTA": Tricuspid Pulmonary Mitral Aorta FEMORAL HERNIA FEMoral hernias are more common in FEMales. 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. CROUP - Signs and Symptoms SSS S - Stridor S - Subglottic swelling S - Seal-bark cough PNEUMONIA - risk factors INSPIRATION I - Immunosuppression N - Neoplasia S - Secretion retention P - Pulmonary oedema I - Impaired alveolar macrophages R - RTI (prior) A - Antibiotics & cytotoxics T - Tracheal instrumentation I - IV dug abuse O - Other (general debility, immobility) N - Neurologic impairment of cough reflex, (eg NMJ disorders) PNEUMOTHORAX Signs and Symptoms P-THORAX

P - Pleuritic pain T - Trachea deviation H - Hyper resonance O - Onset sudden R - Reduced breath sounds (& dypsnea) A - Absent fremitus X - X-ray shows collapse inducing drugs for Respiratory Depression STOP breathing S - Sedatives and hypnotics T - Trimethoprim O - Opiates P - Polymyxins BLEEDING - S/Sx BEEP B - Bleeding gums E - Ecchymoses (bruises) E - Epistaxis (nosebleed) P - Petechiae (tiny purplish spots) 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) Transient ischemic attacks: assessment"3Ts" Temporary unilateral visual impairment Transient paralysis (one-sided) Tinnitus = vertigo 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) Tracheoesophageal fistula: assessment"3Cs" Coughing Choking Cyanosis Sprain: nursing care plan"RICE" Rest Ice Compression Elevation Postoperative complications: order"4W's" Wind (pulmonary) Wound Water (urinary tract infection) Walk (thrombophlebitis) Myocardial infarction: treatment"MONA" Monitor/ Morphine Oxygen Nitroglycerin Aspirin Basic MI management - "BOOMAR" Bed rest Oxygen Opiate Monitoring

Anticoagulation Reduce clot size Melanoma characteristics"ABCD" Asymmetry Border Color Diameter Hypoglycemia: signs and symptoms"DIRE"

Diaphoresis Increased pulse Restless Extra hungry 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 Portal hypertension features - "ABCDE" Ascites Bleeding (hematemesis, piles) Caput medusae Diminished liver

Enlarged spleen Diabetes: signs and symptoms"3P's,"

Polydipsia (very thirsty) Polyphagia (very hungry) Polyuria (urinary frequency) Cushing's syndrome: symptoms"3S's"

Sugar (hyperglycemia) Salt (hypernatremia) Sex (excess androgens) 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 COMA: CONDITIONS TO EXCLUDE AS CAUSE MIDAS: Meningitis Intoxication Diabetes Air (respiratory failure) Subdural/ Subarachnoid hemorrhage 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) Positionnever on abdomen Cholecystitis: risk factors"5F's"

Female Fat Forty Fertile Fair Blood glucose (rhyme)

Symptom Implication

Cold and clammy . . . give hard candy Hot and dry . . . glucose is high Neurovascular Occlusion: symptoms "6 P's"

Pain Pale Pulseless Paresthesia Poikilothermic Paralysis

Appendicitis: assessment"PAINS"

Pain (RLQ) Anorexia Increased temperature, WBC (15,00020,000) Nausea Signs (McBurney's, Psoas) 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) Angina: precipitating factors"4E's"

Eating Emotion Exertion (Exercise) Extreme Temperatures (Hot or Cold weather) 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 "cats" of "hypocalcemia" c - convulsions a- arrhythmias t - tetany s - spasms and stridor hypernatremia signs and symptoms "you are fried" f - fever (low grade), flushed skin r - restless (irritable) i - increased fluid retention and increased bp e - edema (peripheral and pitting) d - decreased urinary output, dry mouth can also use this one: salt s = skin flushed a = agitation l = low-grade fever t = thirst The HYPERKALEMIA "Machine" - Causes of Increased Serum K+ M - Medications - ACE inhibitors, NSAIDS A - Acidosis - Metabolic and respiratory C - Cellular destruction - Burns, traumatic injury H - Hypoaldosteronism, hemolysis I - Intake - Excesssive N - Nephrons, renal failure E - Excretion - Impaired

murder signs and symptoms of increased serum k+ m - muscle weakness u - urine, oliguria, anuria r- respiratory distress d - decreased cardiac contractility e - ecg changes r - reflexes, hyperreflexia, or areflexia (flaccid) Trouble figuring out which eye is which? OS is left eye OD is the right eye You can remember which one is the right eye (OD), because you can make the D into an R You just have to draw to stick legs on the bottom of the D. Write it down on paper, you'll see what I mean (it's hard to show you when all I can do is type) A NiceDeliciousPIE A= Assessment ND = Nursing diagnosis P= Plan I= Interventions E= Evaluation APE TO MAN Atrial, Pulmonic,Erb's point, Tricuspid,Matrial Key questions needed in an emergency history taking situation - "AMPLE" Allergies Medication Past medical history Last meal Events and environment related to injury 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 Eyes Physical Assessment PERRLA PupilsEquallyRound andReactive toLight andAccommodation RESUSCITATION: BASIC STEPS ABCDE: Airway Breathing Circulation Drugs Environment MALIGNANT HYPERTHERMIA TREATMENT "Some Hot DudeBetter Give IcedFluids 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] 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) Stool assessment"ACCT" Amount Color Consistency Timing

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 Choiceslet clients know their choices Deliver what you can, when you said you would Empower/Enable clients' control over pain 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) Manipulation: nursing planpromote the "3C's" Cooperation Compromise

Collaboration Diet: low cholesterolavoid the "3C's" Cake Cookies Cream (dairy, e.g., milk, ice cream) PLACENTA-CROSSING SUBSTANCES "Want My HotDog": Wastes Antibodies Nutrients Teratogens Microorganisms Hormones/ HIV Drugs 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]) Obstetric (maternity) history"GTPAL" Gravida Term Preterm Abortions (SAB, TAB) Living children Newborn assessment components"APGAR" Appearance Pulse

Grimace Activity Respiratory effort 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 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) Infections during pregnancy"TORCH" Toxoplasmosis Other (hepatitis B, syphilis, group B beta strep) Rubella Cytomegalovirus Herpes simplex virus Episiotomy assessment"REEDA"

Redness Edema Ecchymosis Discharge Approximation of skin Dystocia: etiology"3P's"

Power Passageway Passenger Dystocia: general aspects (maternal)"3P's"

Psych Placenta Position Complication of severe preeclampsia"HELLP" syndrome Hemolysis ElevatedLiver enzymes Low Platelet count Blood vessels in umbilical cord"AVA" (2 arteries and 1 vein) Artery Vein Artery Side effects of steroids. The 5 S's. Sick- easier to get sick Sad-causes depression Sex-increases libido Salt-retains more and causes weight gain Sugar-raises blood sugar Bronchodilators - "TO A SIS" Terbutaline Orciprenaline Adrenaline Salbutamol Isoprenaline Salmeterol Medication administration"six rights"

RIGHT medication RIGHT dosage RIGHT route RIGHT time RIGHT client RIGHT technique VFIB/VTACH DRUGS USED ACCORDING TO ACLS "Every LittleBoy MustPray": Epinephrine Lidocaine Bretylium Magsulfate Procainamide To Remember Immunoglobulins - "GAMED" IgG IgA IgM IgE IgD Uses of Chloroquine (other than malaria) - "RED LIP" Rheumatoid arthritis Extra intestinal amoebiasis Discoid lupus erythematosus Lepra reaction Infectious mononucleosis Photogenic reactions The Krebs cycle - "Can I ActuallySee SomeFilipina Mothers"

Citrate Isocitrate alpha Ketoglutarate Succinyl CoA Succinate Fumarate Malate Oxaloacetate ENDOTRACHEAL TUBE DELIVERABLE DRUGS O NAVEL Oxygen Naloxone Atropine Ventolin (albuterol) Epinephrine Lidocaine IPECAC: CONTRAINDICATIONS 4 C's: Comatose Convulsing Corrosive hydroCarbon ACTIVATED CHARCOAL: CONTRAINDICATIONS CHEMICALCamP: Cyanide Hydrocarbons Ethanol Metals Iron

Caustics Airway unprotected Lithium CAMphor Potassium Eye Medications

Mydriatic = dilated pupils Miotic = tiny (constricted) pupils MALARIA: COMPLICATIONS OF FALCIPARUM MALARIA CHAPLIN: Cerebral malaria/ Coma Hypoglycemia Anaemia Pulmonary edema Lactic acidosis Infections Necrois of renal tubules (ATN)