HYPERNATREMIA FRIED SALT F - Fever (low), flushed skin R - Restless (irritable) I - Increased fluid retention & increased BP E - Edema

(peripheral and pitting) D - Decreased urinary output, dry mouth SALT S - Skin flushed A - Agitation L - Low-grade fever T - Thirst HYPERKALEMIA - Signs & Symptoms MURDER M - Muscle weakness U - Urine, oliguria, anuria R - Respiratory distress D - Decreased cardiac contractility E - ECG changes R - Reflexes, hyperreflexia, or areflexia (flaccid) HYPERKALEMIA - Causes MACHINE M - Medications - ACE inhibitors, NSAIDS A - Acidosis - Metabolic and respiratory C - Cellular destruction - Burns, traumatic injury H - Hypoaldosteronism/ hemolysis I - Intake - Excessive N - Nephrons, renal failure E - Excretion - Impaired HYPOCALCEMIA CATS C - Convulsions A - Arrhythmias T - Tetany S - Spasms and stridor BLEEDING - S/Sx BEEP B - Bleeding gums E - Ecchymoses (bruises) E - Epistaxis (nosebleed) P - Petechiae (tiny purplish spots) RESPIRATORY DEPRESSION - inducing drugs STOP breathing S - Sedatives and hypnotics T - Trimethoprim O - Opiates P - Polymyxins PNEUMOTHORAX - S/Sx P-THORAX P - Pleuretic pain T - Trachea deviation H - Hyperresonance O - Onset sudden R - Reduced breath sounds (& dypsnea) A - Absent fremitus X - X-ray shows collapse 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) CROUP - S/Sx SSS S - Stridor S - Subglottic swelling S - Seal-bark cough SHORTNESS OF BREATH - Causes AAAA PPPP A - Airway obstruction A - Angina A - Anxiety A - Asthma P - Pneumonia P - Pneumothorax P - Pulmonary Edema P - Pulmonary Embolus 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 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 (15,00020,000)

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)

Positionnever 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 cholesterolavoid the "3C's"

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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

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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 planpromote the "3C's" Cooperation Compromise Collaboration Medication administration"six rights" RIGHT medication RIGHT dosage RIGHT route RIGHT time RIGHT client RIGHT technique

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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)

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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 Choiceslet 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

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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

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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 Basic MI management - "BOOMAR"

Bed rest

Oxygen

Opiate

Monitoring

Anticoagulation

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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

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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

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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

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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

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

Neutrophils

Lymphocytes

Monocytes

Eosinophils

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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

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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"

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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"

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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

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6th dayEnteric fever(typhoid) 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

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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

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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

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RADIATION, RELIEF SEVERITY TIME

NEUROVASCULAR CHECK PAIN PULSELESSNESS PARESTHESIA PARALYSIS PALLOR

VIRCHOWS 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 USE STRAW BECAUSE THESE DRUGS STAIN THE TEETH L - LUGOL'S SOLUTION I - IRON N - NITROFURANTOIN T - TETRACYCLINE

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RADIATION TX VIA: MUSTARD ESTROGEN NITROGEN STEROIDS ANTIBIOTICS

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