abdominal aortic aneurism “4 a’s” asymptomatic abdominal mass abdominal pulse aches low back abdominal distenstion 5 fs fat fluid feces flatus fetus ace inhibitor side effects captopri
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ABDOMINAL AORTIC ANEURISM ALKALOSIS AND ACIDOSIS
“4-A’s” AlKalosis has “K” – it’s “K”icking pH up = PH↑
Asymptomatic AciDosis has “D” – it’s “D”ropping pH Down = PH↓
Abdominal mass ACUTE INFLAMMATION FEATURES
Abdominal pulse Think: "what a cute pair of SLIPpeRs" to tie acute
Aches low back inflammation to “SLIPR”mnemonic).
ABDOMINAL DISTENSTION “SLIPR”
"5-F's" Swelling
Fat Loss of function
Fluid Increased heat
Feces Pain
Flatus Redness
Fetus ADRENAL GLAND HORMONES
ACE INHIBITOR SIDE EFFECTS “SSS”
"CAPTOPRIL" S-sugar (Glucocorticoids)
Cough S-salt (Mineralocorticoids)
Anaphylaxis S-sex (Androgens)
Palpitations AIMS for improvement
Taste “PETEES” AIMS
Orthostatic -↓BP P - Patient centered care
Potassium - ↑K+ E - Efficient
Renal impairment T - Timely
Impotence E - Effective
Leukocytosis E - Equitable
ACID-BASE S - Safety
"ROME" – Respiratory Opposite, Metabolic Equal ALCOHOL WITHDRAWAL – CLINICAL FEATURES
ACIDOSIS "HITS"
» Respiratory (opposite): pH Pco2 Hallucinations (visual, tactile)
» Metabolic (equal): pH HCO3 Increased vital signs & insomnia
ALKALOSIS Tremens delirium tremens (potentially lethal)
» Respiratory (opposite): pH Pco2 Shakes/Sweat/Seizures/Stomach pain (N/V)
» Metabolic (equal): pH HCO3 ALCOHOLISM – BEHAVIORAL PROBLEMS
ACIDOSIS/ALKALOSIS “5-D's”
“ROME” D- Denial
Respiratory Opposite: pH↑ PCO2↓ = D- Dependency
alkalosis pH↓ PCO2↑ = acidosis D- Demanding
Metabolic Equal: pH↑ HCO3↑ = D- Destructive
Alkalosis pH↓ HCO3↓ = Acidosis D- Domineering
ACIDOSIS/ALKALOSIS – ALCOHOLISM OUTCOME
COMPENSTATION “BAD”
“RUB MUB” B- Brain Damage
Respiratory Uses Bicarb A- Alcoholic Hallucinosis
Metabolic Uses Breathing D- Death
,ALDOSTERONE IS REGULATED BY: Can't shit (constipation)
"RNA’S" ANTICHOLINERGIC CRISIS – SIGNS
Renin-angiotensin mechanism "SLUD"
Na concentration in blood Salivation
Anp (ANP – atrial natriuretic peptide) Lacrimation
Stress Urination
ALZHEIMER – “5 A’s” to DIAGNOSIS Defecation
“5-A's” ANTI-TB DRUGS & SIDE EFFECTS
Amnesia – loss of memories “RIPES”
Anomia – unable to recall names of everyday Rifampicin – red-orange urine
objects Apraxia – unable to perform tasks of Isoniazid – peripheral neuritis
movement Pyrazinamide – increase uric acid
Agnosia – inability to process sensory information Ethambutol – eye problems
Aphasia – disruption with ability to communicate Streptomycin – ototoxic
ANGINA – PRECIPITATING FACTORS (use a star as these drugs stain the teeth) – ???
"4-E's" (H-eat, I-nduration) – ???
Eating APGAR SCORING
Emotion "APGAR"
Exertion (Exercise) Appearance: cyanosis--peripheral, central, none
Extreme Temperatures (Hot/Cold weather) Pulse: pulse rate
“ANOREXIA” – EATING DISORDER Grimace: response to stimulation
A-menorrhea delayed Activity: movement of the baby (muscle tone)
N-o organic factors accounts for weight loss Respiration: respiratory rate
O-obviously thin but feels FAT APPENDICITIS - ASSESSMENT
R-refusal to maintain normal body weight “PAINS”
E-epigastric discomfort is common Pain (RLQ) - pain in RLQ of abdomen
X-symptoms (peculiar symptoms) Anorexia - loss of appetite
I-intense fears of gaining weight Increased temperature, WBC (15,000-20,000)
A-always thinking of foods Nausea
ANOREXIA NERVOSA – CLINICAL FEATURES Signs (McBurney's, Psoas)
"ANOREXIC" ARTERIAL BLOOD GASES
A-adolescent women/Amenorrhea 1. look at pH: Low
N-GT alimentation (most severe cases) O- pH = acidosis
obsession w/ wt. loss/becoming fat though High pH = alkalosis
underweight 2. use “ROME” mnemonic (to determine if its
R-refusal to eat (5% die) respiratory or metabolic):
E-electrolyte abnormalities (e.g., K+, cardiac Respiratory – Opposite
arrhythmia) Metabolic – Equal
X-exercise ASSESSING CHANGES IN BEHAVIOR
I-intelligence often above average/Induced "DEMENTIA"
vomiting Drug and alcohol
C-cathartic use (and diuretic abuse) Eyes and ears
ANTICHOLINERGIC CRISIS Metabolic and endocrine disorders
Can't see (blurred vision) Emotional disorders
Can't spit (dry mouth) Neurologic disorders
Can't pee (urinary retention) Tumors and trauma
,Infection learning the rules, onset of education A - and -
Arterial vascular disease "ad"vanced beginners – distinguish abnormal
ASTHMA MANAGEMENT findings but cannot readily understand significance
"ASTHMA" C - Comp - Competent – able to handle their pt.
Adrenergics (Albuterol) load and prioritize situation P - Planetary – big
Steroids picture is the key word -
Theophylline Proficiency
Hydration (IV) E - Experts – Leader/ role model not every nurse
Mask (Oxygen) becomes one. BETA 1 AND BETA 2
Antibiotics Beta 1 adrenergic receptors are mostly found in the
ASTHMA - MANAGEMENT heart. Beta 2 adrenergic receptors are found in
Asthma is a spasm of the airways, which causes lungs, GI tract, vascular smooth muscle, skeletal
difficulty breathing. muscle, liver. Beta 1 beta blockers act primarily on
“ASTHMA” the heart. Beta 2 beta blockers act primarily on the
Adrenergic (Albuterol) lungs. Beta 1: heart
Steroids Beta 2: lungs - You have one heart and two lungs
Theophylline BETA BLOCKERS
Hydration (IV) B1 Blocks the heart (only have ONE heart)
Mask (Oxygen) B2 Blocks the lungs (have TWO lungs)
Antibiotics BETA BLOCKER CONTRAINDICATIONS
ATRIAL FIBRILLATION – NEW ONSET CAUSES "ABCDE"
“THE ATRIAL FIBS” Asthma
Thyroid Block (heart block)
Hypothermia COPD
Embolism (PE) Diabetes mellitus
Alcohol Electrolyte (hyperkalemia)
Trauma (cardiac contusion) BETA BLOCKERS
Recent surgery (post CABG) "You have 1 heart and 2 lungs"
Ischemia Beta-1 act primarily on heart
Atrial enlargement Beta-2 act primarily on lungs
Lone or idiopathic BLEEDING PRECAUTIONS
Fever, anemia, high-output states “RANDI”
Infarct R- Razor Electric/Blades
Bad valves (mitral stenosis) A- Aspirin
Stimulants (cocaine, theo, amphet, caffeine) N- No needles (esp. in small gauge)
ATRIOVENTRICULAR VALVES D- Do decrease in needle sticks)
"LAB RAT" I - Injury (Protect from)
Left Atrium: Bicuspid BLEEDING PRECAUTIONS
Right Atrium: Tricuspid If a patient is taking an anticoagulant to prevent
ATROPINE blood clots there is increased risk for bleeding. Be
"A goes with B" careful with blades when shaving. Do not take
Atropine used to treat bradycardia. aspirin as it interferes with blood clotting and can
magnify the effect of the medication. Avoid excess
BENNER'S MODEL needle sticks and protect the patient from injury.
N - Nickerr's - easy to remember b/c it rhymes “RANDI”
with Benner's Novice – strictly able to focus on Razor Electric/Blades
, Aspirin Isoproterenol
Needles- small gauge Dopamine
Decrease needle sticks Epinephrine
Injury (Protect from) Atropine Sulfate
BLOOD FLOW THROUGH HEART VALVES BRADYCARDIA AND HYPOTENSION MEDS
"Tissue Paper My Ass" "IDEA"
Tricuspid Isoproterenol
Pulmonic Dopamine
Mitral Epinephrine
Aortic Atropine Sulfate
BLOOD GLUCOSE BREASTFEEDING ASSESSMENT
Symptom Implication (rhyme) "LATCH"
Cold and clammy . . . give hard candy Latch achieved by infant
Hot and dry . . . glucose is high Audible swallow
BLOOD TYPES Type of nipple
Picture type O as a huge circle, like the universe, Comfort of mother
because they are the universal donor. They can Help given to mother with nursing
give to everyone. BRONCHODILATORS
However, also think of them as the “odd man out” "TO A SIS"
because they can only receive type O as well. Terbutaline
They are universally odd, able to give to all but Orciprenaline
only receive from themselves! Adrenaline
BODY SYSTEMS Salbutamol
"MR DICE RUNS" Isoprenaline
Muscle Salmeterol
Respiratory “BULIMIA” – EATING DISORDER
Digestive B-binge eating
Integumentary U-under strict dieting
Circulatory L-lacks control over-eating
Endocrine I-induced vomiting
Reproductive M-minimum of two binge eating episodes
Urinary I-increased/Persistent concern of body size/shape
Nervous A-abuse of diuretics & laxatives
Skeletal BULIMIA CLIENT FINDINGS
BRADYCARDIA & LOW BP DRUGS “WASHED”
“IDEA” W-weight loss of 15% of original body weight
I - Isoproterenol A-amenorrhea
D - Dopamine S-social withdrawal
E - Epinephrine H-history of high activity & achievement
A - Atropine Sulfate E-electrolyte Imbalance
BRADYCARDIA & LOW BLOOD PRESSURE DRUGS D-depression/ Distorted Body Image
This refers to symptomatic bradycardia and CANCER ASSESSMENT
hypotension. Bradycardia and hypotension are "CAUTION"
not necessarily adverse clinical findings Change in bowel or bladder habits
requirement treatment in and of themselves. A sore that doesn't heal
“IDEA” Unusual bleeding or discharge
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