On TODDLERHOOD naman Nega at Tantrums ginagawa Separation PRODESDEN May physio-logic anorexia pa
Push pull toys like tarak tarak Autonomy vs. Shame and Doubt First dental visit ay 2 and a half Risk for poisoning problema jan
PRESCHOOL naman ay PHALLIC Associative Play lagi ang gimik Common fear is mutilation Fear of dark and ghost din yun
Behavior ay gender specific At may magi-cal thinking Ang patay is sleeping Initiative vs. guilt
Ang SCHOOL AGE latent yan Concrete thinking, Logic reasoning Same sex stage, normal na bading Heroworship and plays competitive
Schooler starts to have a bestfriend Takot parati control niya ay mag end Permanent ang concept of death Industry vs inferiority
Formal ang adolescent Sa body image may disturbance Ang thelarche ang first sign sa girls At last sign yan ang menarche!
MI Management (MONA)
Morphine O2 therapy Nitropglycerine! Aspirin
HYPOGLYCEMIA TIRED!!!!
T Tired I Irritability (Nightmares) R Restlessness E Excessive Hunger (Polyphagia) D Depression/Diaphoresis
HYPERNATREMIA 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
Pressure Ulcer Staging
Stage I erythema Stage II breakdown of the dermis Stage III full thickness skin Breakdown Stage IV bones, muscles
HEART MURMURS: SPASM!!
S Stenosis P Partial obstruction A Aneurysms S Septal defect M Mitral regurgitation
Miotic: Little word= Little pupil (constrict) Mydriatic: Big word= Big pupil (dilated)
Anticholingergics Side
Effects: Can't see Can't pee Can't spit Can't sh*t
Hyperthyroidism (s/s) THYROIDISM
Tremor Heart rate up Yawning (fatigueability) Restlessness Oligomenorrhea & amenorrhea Intolerance to heat Diarrhea Irritability Sweating Muscle wasting & weight loss
5W's of common causes of post-op fever
Wind (think pneumonia, splinting, incentive spirometer exercises not done, DB+ coughing NOT DONE) Water (dehydration...) Wound (infection, dehiscence...) Walking (PE...) Wonder drug (approriate antibiotic...)
To apply a telemetry monitor:
White over right (top right shoulder) Black beside the white (Over lt shoulder) Checkers (red below the black) Christmas (Green beside the red) Then ofcourse, the brown will be in the middle!
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
Signs and Symptoms of Increased Serum K+: MURDER !!
M - Muscle weakness U - Urine, oliguria, anuria R- Respiratory distress D - Decreased cardiac contractility E - ECG changes R - Reflexes, hyperreflexia, or areflexia (flaccid)
HYPOKALEMIA (SUCTION)
SKELETAL MUSCLE WEAKNESS U-WAVE ON ECG CONSTIPATION TOXICITY TO DIGOXIN IRREGULAR WEAK PULSE OTOSTASIS NUMBNESS PARESTHESIA
General rules regarding psychiatry drugs:
1) Cannot be taken with alcohol, stimulants,depressants. 2) Cannot be given to pregnant, lactatingand patients with glaucoma. 3) Cannot be abruptly stooped but mus be tapered slowly 4) All are given after meals except anti anxiety agents( because food interferes with their absorption) 5) All psychiatry drugs have anti cholinergic side effects: Dizziness, drowsiness, dry mouth, constipation, urinary retention
"CATS" of "HYPOCALCEMIA"
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)
TETRALOGY OF FALLOT
DISPLACED AORTA RIGHT VENTRICULAR HYPERTROPHY OPENING INTO THE SEPTUM (VSD) PULMONARY STENOSIS
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
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:
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"
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)
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"
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)
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)
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
SIGNS OF CANCER 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)
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.
"Point and Shoot!"
For remembering that Parasympathetics are involved with erection and Sympathetics with ejaculation.