Solution 2024/2025
Pepper
AACN Exam
Charcot's Triad ANS✔✔ RUQ pain, fever, jaundice (indicates cholangitis)
Reynold's pentad ANS✔✔ RUQ pain, fever, jaundice, AMS, hypotension (indicates worsening cholangitis)
Murphy's sign ANS✔✔ pain with palpation of the RUQ during inspiration, indicative of cholecystitis
Psoas sign ANS✔✔ RLQ pain with extension of right thigh/hip indicative of appendicitis
Kehr's sign ANS✔✔ Left shoulder pain caused by irritation of the undersurface of the diaphragm by blood leaking from a
ruptured spleen. While Kehr's sign (left shoulder pain) is commonly a symptom of splenic rupture, right shoulder pain
typically signals liver or gallbladder irritation
Cullen's sign ANS✔✔ Ecchymosis in periumbilical area, seen with pancreatitis
Grey Turner's sign ANS✔✔ Atraumatic ecchymosis in the flank, typically indicating hemorrhagic pancreatitis
Beck's triad ANS✔✔ JVD, muffled heart sounds, decreased BP (indicate cardiac tamponade)
Cushing's triad ANS✔✔ bradycardia, bradypnea, hypertension (indicate increased ICP; normal ICP=5-15 mm Hg)
Charcot's neurologic triad ANS✔✔ Nystagmus, staccato speech, intentional tremor (indicate MS)
Virchow's triad ANS✔✔ Venous stasis, hypercoagulability, endothelial damage (high risk of thrombosis)
Shock Triad ANS✔✔ Hypotension, tachycardia, tachypnea
, Solution 2024/2025
Pepper
Opioid Poisoning Triad ANS✔✔ CNS depression (AMS, coma), respiratory depression, miosis (pinpoint pupils)
Wolf-Parkinson-White Syndrome: 3 signs ANS✔✔ short PR interval, delta waves, and wide QRS complex
Behcet's disease ANS✔✔ Recurrent oral ulcers, genital ulcers, eye inflammation
3 D's of pellagra (niacin, vit B3, deficiency) ANS✔✔ Diarrhea, dementia, dermatitis
Serotonin Syndrome ANS✔✔ Similar to NMS but caused by serotonin medications, and has HYPERreflexive muscle
activity
Symptoms= mental status changes and hyperthermia. Treatment=cyproheptadine
Neuroleptic Malignant Syndrome ANS✔✔ Adverse reaction to antipsychotics with severe "lead pipe" rigidty, FEVER
(102-104), tachycardia, tachypnea, mental status changes
lethal triad of trauma ANS✔✔ Hypothermia, acidosis, coagulopathy
Neurogenic shock: 3 symptoms ANS✔✔ Hypothermia, hypotension, bradycardia
Whipple's triad ANS✔✔ 1. Fasting hypoglycemia <50
2. Symptoms during hypoglycemia
3. Immediate relief of symptoms after the administration of IV glucose
(suggest insulinoma)
Reactive arthritis rhyme ANS✔✔ Can't see (conjunctivitis), can't pee (urethritis or cervicitis), can't climb a tree (arthritis)
Murphy's Triad ANS✔✔ RLQ pain, nausea/vomiting, fever (indicates appendicitis)
, Solution 2024/2025
Pepper
Acidosis vs Alkalosis ANS✔✔ ROME:
Respiratory - Opposite
Acidosis: pH is down, pCO2 is up
Alkalosis: pH is up, pCO2 is down
Metabolic - Equal
Acidosis: pH is down, pCO2 is down
Alkalosis: pH is up, pCO2 is up
ACE Inhibitors ANS✔✔ "PRIL" Captopril, Enalapril, Afosiopril
Antihypertensive. Blocks ACE in lungs from converting angiotensin I to angiotensin II (powerful vasoconstrictor).
Decreases BP, Decreased Aldosterone secretions, Sodium and fluid loss.
Check BP before giving (hypotension)
*Orthostatic Hypotension
ARBs ANS✔✔ "SARTAN"
Angiotensin II receptor blockers
They decrease blood pressure, increase CO
-Examples: Valsartan (Diovan), Losartan (Cozaar), and Irbesartan (Avapro)
-Uses: hypertension and heart failure
-Nursing Considerations: watch for hyperkalemia, hypotension, and renal dysfunction
Cholesterol Medications end in ANS✔✔ -statin
Beta blockers end in ANS✔✔ -olol
, Solution 2024/2025
Pepper
Calcium Channel Blockers end in ANS✔✔ -dipine (and verapamil and diltiazem)
5 P's of compartment syndrome ANS✔✔ Pain, pallor, pulselessness, paresthesia, paralysis
Hypoglycemia rhyme ANS✔✔ Cold and clammy, need some candy
"TIRED"
T: tachycardia
I: irritable
R: restlessness
E: excessive hunger
D: diaphoresis
Hyperglycemia rhyme ANS✔✔ Hot and dry, sugar high
3 Ps
Polyphagia, polydipsia, polyuria
WBC range ANS✔✔ 4.5-11 x 10^3/uL
RBC range ANS✔✔ Male: 4.5 - 5.5 x 10^6/uL
Female: 4 - 5 x 10^6/uL
Hgb range ANS✔✔ Male: 14-18 g/dL
Female: 12-16 g/dL
Hct range ANS✔✔ Male: 42-52%
Female: 36-46%