APPENDIX B

Memory Aids
Acid-baseRAMS (Respiratory Alternate, Metabolic
Same)
Respiratory (Alternate)

Metabolic (Same)

Acidosis

pH

PCO2

pH

HCO3

Alkalosis

pH

PCO2

pH

HCO3

Arterial occlusion: symptomssix Ps

Pain
Pale
Pulseless
Paresthesia
Poikilothermic
Paralysis
Blood glucose (rhyme)

Alcohol withdrawal: clinical featuresHITSa

Hallucinations (visual, tactile)
Increased vital signs and insomnia
Tremens delirium tremens (potentially lethal)
Shakes/Sweats/Seizures/Stomach pains (nausea, vomiting)
Angina: precipitating factorsthree Es
Eating
Emotion
Exertion (Exercise)
Anorexia nervosa: clinical featuresA 2NOREXI 2C a
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)
eXercise
Intelligence often above average/Induced vomiting
Cathartic use (and diuretic abuse)
Appendicitis: assessmentPAINS
Pain (RLQ)
Anorexia
Increased temperature, WBC (15,00020,000)
Nausea
Signs (McBurneys, psoas)

Symptom

Implication

Cold and clammy . . .

give hard candy

Hot and dry . . .

glucose is high

Blood vessels in umbilical cordAVA

Artery
Vein
Artery
Cancer: early signsCAUTION
Change in bowel or bladder habits
A persistant sore throat
Unusual bleeding or discharge
Thickening or lump
Indigestion: dysphagia
Obvious change in a wart/mole
Nagging cough or hoarseness
Cancer: focus of patient careCANCER
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)

aModified

from Rogers, PT: The Medical Students Guide to Top Board Scores. Little, Brown,
Boston (out of print).

915

916

appendix B Memory Aids

Cholecystitis: risk factorsfive Fs

Female
Fat
Forty
Fertile
Fair
Cleft lip: nursing care plan (postoperative)CLEFT 2
LIP
Crying, minimize
Logan bow
Elbow restraints
Feed with Breck 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
Cognitive disorders: assessment of difficulties
JOCAM
Judgment
Orientation
Confabulation
Affect
Memory

APPENDIX B

Coma: causesA2-E3-I-O-U T2IPS2 b

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 preeclampsiaHELLP
syndrome
Hemolysis
Elevated Liver enzymes
Low Platelet count
Cushings syndrome: symptomsthree Ss
Sugar (hyperglycemia)
Salt (hypernatremia)
Sex (excess androgens)
Diabetes: signs and symptomsthree Ps, three polys
Polydipsia (very thirsty)
Polyphagia (very hungry)
Polyuria (urinary frequency)

bAdapted

from Caroline, NL: Emergency Care in the Streets, ed 5. Little, Brown, Boston
(out of print)

Diet: low cholesterolavoid the three Cs:

Cake
Cookies
Cream (dairy, e.g., milk, ice cream)
Dystocia: etiologythree Ps
Power
Passageway
Passenger
Dystocia: general aspects (maternal)three Ps
Psych
Placenta
Position
Episiotomy assessmentREEDA
Redness
Edema
Ecchymosis
Discharge
Approximation of skin
Eye medications
Mydriatic = dilated pupils
Miotic = tiny (constricted) pupils
Hypertension: complicationsfour Cs
CAD (coronary artery disease)
CHF (congestive heart failure)
CRF (chronic renal failure)
CVA (cardiovascular accident; now called brain attack
or stroke)
Hypertension: nursing care planI TIRED
Intake and output (urine)
Take blood pressure
Ischemia attack, transient (watch for TIAs)
Respiration, pulse
Electrolytes
Daily weight
Hypoglycemia: signs and symptomsDIRE
Diaphoresis
Increased pulse
Restless
Extra hungry
Infections during pregnancyTORCH
Toxoplasmosis
Other (hepatitis B, syphilis, group B beta strep)
Rubella
Cytomegalovirus
Herpes simplex virus
Infections: signsINFE3CT
Increasedpulse, respiration, WBC
Nodesenlarged
Functionimpaired
E3: Erythema, Edema, Exudate
Complaintsdiscomfort, pain
Temperaturelocal or systemic

Memory Aids

Manipulation: nursing planpromote the three Cs

Cooperation
Compromise
Collaboration
Medication administrationsix rights
RIGHT medication
RIGHT dosage
RIGHT route
RIGHT time
RIGHT client
RIGHT technique
Melanoma characteristicsABCD
Asymmetry
Border
Color
Diameter
Mental retardation: nursing care planthree Rs
Regularity (provide routine and structure)
Reward (positive reinforcement)
Redundancy (repeat)
Myocardial infarction: treatmentM2ONA
MONA greets every M.I.:
Monitor/Morphine
Oxygen
Nitroglycerin
Aspirin
Newborn assessment componentsAPGAR
Appearance
Pulse
Grimace
Activity
Respiratory effort

Headache (possible hypertension, brain attack)

Eye problems (possible hypertension or vascular
accident)
Severe leg pain (possible thromboembolic process)
Pain: assessmentPQRST
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: managementABCDE
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
Postoperative complications: orderfour Ws
Wind (pulmonary)
Wound
Water (urinary tract infection)
Walk (thrombophlebitis)
Preterm infant: anticipated problemsTRIES
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 symptomsfour As
Affect
Ambivalence
Associative looseness
Autism

Obstetric (maternity) historyGTPAL

Gravida
Term
Preterm
Abortions (SAB, TAB)
Living children

Sprain: nursing care planRICE

Rest
Ice
Compression
Elevation

Oral contraceptives: signs of potential problems

ACHES c
Abdominal pain (possible liver or gallbladder problem)
Chest pain or shortness of breath (possible pulmonary
embolus)

Stool assessmentACCT
Amount
Color
Consistency
Timing

cFrom

Hatcher, RA, et al: Contraceptive Technology, ed 16. Irving, New York.

APPENDIX B

IUD: potential problems with usePAINS c

Period (menstrual: late, spotting, bleeding)
Abdominal pain, dyspareunia
Infection (abnormal vaginal discharge)
Not feeling well, fever or chills
String missing

917

918

appendix B Memory Aids

Tracheoesophageal fistula: assessmentthree Cs

Coughing
Choking
Cyanosis
Traction: nursing care planTRACTION
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: assessmentthree Ts
Temporary unilateral visual impairment
Transient paralysis (one-sided)
Tinnitus = vertigo
Trauma care: complicationsT2RAUMA
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 d
Wernickes encephalopathy (acute phase): clinical features:
Confusion
Ophthalmoplegia
Ataxia
Thiamine is an important aspect of Tx
Korsakoffs psychosis (chronic phase): characteristic findings:
Retrograde amnesia ( recall of some old memories)
Anterograde amnesia ( ability to form new
memories)
Confabulation
Korsakoff s psychosis
dAdapted

from Rogers, PT: The Medical Students Guide to Top Board Scores. Little, Brown,
Boston (out of print).

APPENDIX B