LAB VALUES

Serum Electrolytes CBC

Na K RBC WBC
135-145 3.5-5 4.5-5.0 million 5,000-10,000

Cl Mg Hct Hgb
98-107 1.3-2.3 F: 37-48 M: 45-52 F: 12-16 M:14-18

Ca PO Platelet
8.5-10.5 2.5-4.5 150,000-400,000

Anticoagulants ABGs

INR - COUMADIN PT - COUMADIN pH PaCO2

2-3 sec 11-16 sec 7.35-7.45 35-45

PTT - HEPARIN PO2 HCO3

25-35 sec 80-100% 22-24

Urinalysis Chemistry
BUN Protein Glucose LDH
7-22 6.2-8.1 70-110 100-190

Specific Gravity Uric acid Triglyceride Total Cholesterol

1.010-1.030 3.5-7.5 40-50 130-200

Creatinine Albumin Bilirubin

0.6-1.35 3.4-5.0 <1.0

PAULA LUZADAS
 VITAL SIGNS

NEWBORN
Normal High Low
Blood Pressure 80-60/45-40 (at birth) > 100/50 < 100/50

Pulse Rate 100-180 bpm > 100 bpm < 60 bpm

Respiratory 30-60 bpm > 65 bpm < 25 bpm

Temperature 97.6ºF (36.5ºC) > 101ºF (38.3ºC) < 96.8ºF (36ºC)

CHILD

Normal High Low

Blood Pressure 90-120/60-75 > 130/85 < 100/60
Pulse Rate 60-110 bpm > 110 bpm < 60 bpm
Respiratory 14-22 bpm > 22 bpm < 14 bpm

Temperature 98.6ºF (37ºC) > 101ºF (38.3ºC) < 96.8ºF (36ºC)

ADULT

Normal High Low

Blood Pressure 110-120/85-90 > 140/95 < 100/60
Pulse Rate 60-100 bpm > 100 bpm < 60 bpm
Respiratory 12-18 bpm > 25 bpm < 12 bpm
Temperature 98.6ºF (37ºC) > 101ºF (38.3ºC) < 96.8ºF (36ºC)

PAULA LUZADAS
 CRANIAL NERVE ASSESSMENT

Cranial Nerve Name & Sensory (S) Motor (M)

Number Mnemonic Both (B) Assessment
Olfactory (I) Oh S – Some Smell

Optic (II) Oh S – Say Visual acuity and visual

fields

Oculomotor (III) Oh M – Marry Pupil constriction &

extraocular movements
Trochlear (IV) To M – Money Extraocular movements –
inferior addiction
Trigeminal (V) Touch B – But Clench teeth and light
touch

Abducens (VI) And M – My Extraocular movements –

lateral abduction
Facial (VII) Feel B – Brother Facial movement – close
eyes, smile
Acoustic (VIII) A S – Said Hearing and Romberg test

Glossopharyngeal (IX) Good B – Big Gag reflex

Vagus (X) Velvet B – Brains Say ‘ah’ – uvular & palate

movement
Spinal Accessory (XI) Such M – Matter Turn head & lift shoulders to
resistance
Hypoglossal (XII) Heaven M – More Stick out tongue

PAULA LUZADAS
 PHARMACOLOGY MNEMONICS

DIURETICS: "Leak Over The CAN" TRICYCLIC ANTIDEPRESSANT: s/e TORSADES DES POINTES: tx drugs
Loop diuretics Thrombocytopenia drugs causing APACHE:
Osmotic Cardiac (arrhythmia, MI, stroke) Amiodarone
Thiazides Anticholinergic (tachycardia, Procainamide
Carbonic anhydrase inhibitors urinary retention) Arsenium
Aldosterone inhibitors Seizures Cisapride
Na channel blockers Haloperidol
CARBAMAZEPINE: use Eritromycin
SULFONAMIDES: characteristics
SEROTONIN: s/e
CN(V) (trigeminal) neuralgia Steven-Johnson syndrome/ Skin
Bipolar disorder rash / Solubility low components cause HARM:
Zeisures Urine precipitation/ Useful for UTI Hyperthermia
Large spectrum (gram positives Autonomic instability (delirium)
MORPHINE: s/e
and negatives) Rigidity
Miosis
Folic acids synthesis blocker (as Myoclonus
Out of it (sedation)
Respiratory depression well as synthesis of nucleic PARKINSONISM: tx drugs
Pneumonia (aspiration) acids) SALAD:
Hypotension Analog of PABA Selegiline
Infrequency (constipation, WARFARIN: interactions Anticholinenergics
urinary retention) ACADEMIC QACS: (trihexyphenidyl, benzhexol,
Nausea Amiodarone ophenadrine)
Emesis Cimetidine L-Dopa + peripheral
CORTICOSTEROIDS: s/e Aspirin decarboxylase inhibitor
Dapsone (carbidopa, benserazide)
Cataracts
Erythromycin Amantadine
Up all night (sleep disturbances)
Metronidazole Dopamine postsynaptic
Suppression of HPA axis
Indomethacin receptor agonists
Hypertension/ buffalo Hump
Clofibrates (bromocriptine, lisuride,
Infections
Quinidine pergolide)
Necrosis (avascular)
Gain weight Azapropazone BENZODIAZEPINES
Striae Ciprofloxacin drugs decrease metabolism
Bone loss (osteoporosis) Statins "I'm Overly Calm"
Acne Isoniazid
Diabetes Oral contraceptive pills
Myopathy, moon faces Cimetidine
Depression

PAULA LUZADAS

AIR/PULMONARY EMBOLISM
Turn pt to left side and lower head of
bed
S/S: chest pain, difficulty breathing,
tachycardia, pale, impending doom
AFTER LUMBAR PUNCTURE
Pt placed in the supine position for
4-12hrs as prescribed
Rationale: prevent headache and
leaking of CSF
MENIERE’S DISEASE
Change position slowly; bedrest
during acute phase
Rationale: Provide protection when
ambulating
PAULA LUZADAS
POSITIONING
LABOR W/UN-REASSURING FHR
Turn on left side, and administer O2,
stop Pitocin, increase IV fluids
S/S: late decelerations, decreased
variability, fetal bradycardia
AFTER MYRINGOTOMY
Position on side of affected ear after
surgery
Rationale: allows drainage of
secretions
AUTOGRAFTING
Immobilize site for 3-7 days
Rationale: To promote healing and
maximal adhesion
TUBE FEEDING WITH DECREASED LOC
Position pt on right side with the HOB
elevated
Rationale: promotes emptying of the
stomach & prevent aspiration
AFTER CATARACT SURGERY
Pt will sleep on unaffected side with a
night shield for 1-4wks; semi-fowlers
Rationale: to prevent edema
HEART FAILURE W/PULMONARY
EDEMA
Sitting up, with legs dangling
Rationale: decrease venous return &
reduce congestion; promotes vent.
 POSITIONING

AUTONOMIC
DYSREFLEXIA/HYPERREFLEXIA SHOCK HEAD INJURY

place client in sitting position Bedrest; flat on bed Elevate HOB 30 degrees, head
(elevate HOB) first; legs dangling should be kept in neutral position
Rationale: reduce BP below Rationale: To improve or increase Rationale: decrease ICP; keep head
dangerous levels & provide relief circulation from rotating; avoid freq. suctioning

BUCKS TRACTION EVISCERATION GERD

Elevate FOB for counter-traction; use Place in low-Fowler’s position Reverse trendelenburg (head higher)
trapeze for moving Pediatric: prone with HOB elevated
Assess: Ask patient to dorsiflex foot of don’t cough; NPO; keep intestines Rationale: to promote gastric
the affected leg moist & covered w/sterile saline emptying and reduce reflux

CEREBRAL ANEURYSM SEIZURE RETINAL DETACHMENT

HOB elevated 30-45 degrees; Side-lying or recovery position Bed rest w/minimal activity; affected
bed rest area on dependent position
Rationale: To prevent pressure on Rationale: To drain secretions and Rationale: helps detached retina fall
aneurysm site prevent aspiration into place

PAULA LUZADAS
 ISOLATION PRECAUTIONS

AIRBORNE DROPLET CONTACT

o My – Measles
o Chicken – Chickenpox/Varicella
o Hez – Herpes Zoster/Shingles
o TB – Tuberculosis
Airborne precautions may be
needed for germs that are so small
they can float in the air and travel
long distances.
o Private room
o Negative pressure with 6-12 air
exchanges per hour
o Mask – N95 for TB
o S – sepsis o M – Multidrug resistant organism
o S – scarlet fever o R – respiratory infection
o S – streptococcal pharyngitis o S – skin infections*
o P – pneumonia o W – wound infection
o P – parvovirus B19 o E – enteric infection: c.diff
o P – pertussis o E – eye infection: conjunctivitis
o I – influenza
o D – diphtheria (pharyngeal) Skin Infections:
o E – epiglottis o V – varicella zoster
o R – rubella o C – cutaneous diphtheria
o M – mumps o H – herpes simplex
o M – meningitis o I – impetigo
o M – Meningeal pneumonia o P – pediculosis
o An – Adenovirus o S – scabies
Contact precautions may be
Droplet precautions are used to needed for germs that are spread
prevent contact with mucus and by touching.
other secretions from the nose and
sinuses, throat, airways, and lungs.
o Private room or cohort
o Gown
o Private room or cohort o Gloves
o Mask o Hand hygiene w/soap & water

PAULA LUZADAS

ADDISONS
DOWN, DOWN, UP, DOWN
Hyponatremia, hypotension,
hyperkalemia, hypoglycemia
CUSHINGS
UP, UP, DOWN, UP
hypernatremia, hypertension,
hypokalemia, hyperglycemia
HYPER VS. HYPO
MYXEDEMA/HYPOTHYROIDISM
slowed physical and mental
function; sensitivity to cold; dry skin;
brittle hair
GRAVESDISEASE/HYPERTHYROIDISM
accelerated physical and mental
function; sensitivity to heat;
fine/soft hair
HYPOPARATHYROIDISM
CATSS – convulsions, arrhythmias,
tetany, spasms, stridor (decreased
calcium); diet – low phosphorus
HYPERPARATHYROIDISM
fatigue, muscle weakness, renal
calculi, back and joint pain
(increased calcium)

HYPOCALCEMIA MYASTHENIA GRAVIS HYPOVOLEMIA

CATSS – convulsions, arrhythmias,
tetany, spasms and stridor
HYPERCALCEMIA:
muscle weakness, abdominal pain,
confusion, absent tendon reflexes,
sedative effect on CNS
weakness of muscles; worsens
w/exercise & improves w/rest
MYASTHENIA CRISIS
complication of myasthenia gravis;
resp. failure; positive reaction to
Tensilon will improve symptoms
High temp, rapid/weak pulse,
tachypnea, hypotension, urine
specific gravity >1.030
HYPERVOLEMIA
bounding pulse, SOB, dyspnea,
crackles, edema, HTN, urine
specific gravity <1.010

HYPOKALEMIA HYPONATREMIA HYPOMAGNESIA

dysrhythmias, diet – increase K
(raisins, bananas, apricots,
oranges, potatoes)
HYPERKALEMIA:
MURDER – muscle weakness, urine
(oliguria/anuria), resp. depression, decreased
cardiac contractility, ECG changes, reflexes
TX: 50%DEXT with regular insulin
muscle cramps, increased ICP,
muscular twitching, convulsion;
TX: osmotic diuretics, fluids
HYPERNATREMIA
increased temp, weakness, disorientation,
hypotension, tachycardia; TX: hypotonic
solution
tremors, tetany, seizures, dysrhythmias,
depression, confusion, dysphagia;
digoxin toxicity
HYPERMAGNESIA
depresses the CNS, hypotension, facial
flushing, absent deep tendon reflexes,
shallow respirations, emergency

DIABETES INSIPIDUS (LOW ADH) CHOLINERGIC CRISIS

excessive urine output and thirst, excess of acetylcholine leads to inactivity
dehydration, weakness or decrease of AChE enzyme, which
Tx: vasopressin breaks down acetylcholine; stop med

SIADH (HIGH ADH) PHEOCHROMOCYTOMA

change in LOC, decreased deep hypersecretion of epi/norepinephrine, HTN,
tendon reflexes, tachycardia
hyperglycemia, avoid stress; avoid cold
Tx: Declomycin, diuretics
PAULA LUZADAS

ISOTONIC
Ø Same/equal; cell has the same
concentration on the inside and
outside which in normal
conditions the cell’s intracellular
and extracellular are both
isotonic
Ø Used: to increase the
EXTRACELLULAR fluid volume
due to blood loss, surgery,
dehydration, fluid loss that has
been loss extracellularly;
BURNS; emergency
Ø Fluids:
o 0.9%NS
o Lactated Ringer’s
o 5% dextrose in water (D5W)
o 5% dextrose in 0.225% saline
(D5W 1/4NS)
o Hydroxyethyl starch
o Ringer’s
PAULA LUZADAS
TYPES OF FLUIDS
HYPERTONIC
Ø Under/beneath; cell has a low
amount of solute extracellularly
and it wants to shift inside the
cell to get everything back to
normal via osmosis. This will
cause CELL SWELLING which can
cause the cell to burst or lyses
Ø Used: when the cell is
dehydrated and fluids need to
be put back intracellularly. This
happens when patients develop
diabetic ketoacidosis (DKA) or
hyperosmolar hyperglycemia
Ø Fluids:
o 0.45%NS (1/2 NS)
o 0.225% Saline (1/4 NS)
o 0.33% saline (1/3 NS)
HYPOTONIC
Ø Excessive; cell has an excessive
amount of solute extracellularly
and osmosis is causing water to
rush out of the cell intracellularly
to the extracellular area which
will cause the CELL TO SHRINK
Ø Used: (very cautiously – most
likely to be given in the ICU due
to quickly arising side effects of
pulmonary edema/fluid
overload); preferred to give
hypertonic solutions via a central
line due to the hypertonic
solution being vesicant on the
veins and the risk of infiltration
Ø Fluids:
o 3% Saline
o 5% Saline
o 10% Dextrose in Water (D10W)
o 5% Dextrose in 0.9% Saline
o 5% Dextrose in 0.45% saline
o 5% Dextrose in Lactated
 ABG INTERPRETATION

ABNORMALITY pH CO2 HCO3 EXAMPLES

7.35-7.45 45-35 22-24
Uncompensated
normal SEVERE ASTHMA
¯ ­
PNEUMONIA
Partially
Respiratory HYPOVENTILATION
Compensated ­
Acidosis ¯ ­
Fully S/S: WHEEZING, DEPRESSED
Compensated normal ­ ­ MENTAL STATUS
Uncompensated
­ ¯ normal HYPERVENTILATION
Respiratory Partially PANIC ATTACK
Alkalosis Compensated ASPIRIN POISONING
­ ¯ ¯
Fully S/S: TACHYPNEA, DIZZINESS,
Compensated normal ¯ ¯ CONFUSION, SEIZURES
Uncompensated
¯ normal ¯ DIABETIC KETOACIDOSIS
Metabolic LACTIC ACIDOSIS
Acidosis Partially ALCOHOL, SALICYLATE
Compensated ¯ ¯ ¯
S/S: KUSSMAL’S BREATHING,
Fully
TACHYPNEA, COMA,
Compensated normal ¯ ¯ HYPOTENSION
Uncompensated
­ normal ­ LOSS OF ACID: SEVERE
Metabolic VOMITING
Alkalosis Partially LOSS OF POTASSIUM
Compensated ­ ­ ­
S/S: WEAKNESS, NEURALGIA,
Fully
POLYURIA, ALTERED MENTAL
Compensated normal ­ ­ STATUS, HYPERTENSION

PAULA LUZADAS
 MATERNITY – BELLY MAPPING

PAULA LUZADAS
 CHILD DEVELOPMENTAL STAGES

PAULA LUZADAS
 CHILD DEVELOPMENT

PAULA LUZADAS
 ERIKSON’S DEVELOPMENTAL STAGES

PAULA LUZADAS
 INSULIN ADMINISTRATION

PAULA LUZADAS
 SEPSIS INTERPRETATION

PAULA LUZADAS
 RULES OF NINES

PAULA LUZADAS
 SUCTION CHAMBER

PAULA LUZADAS
 AREAS OF PAIN TO THE ABDOMEN

PAULA LUZADAS
 ACLS

PAULA LUZADAS
 DRUG TERMINOLOGY
prefix,
root, examples (generic names) drug class or drug category actions/used for
suffix

betamethasone; dexamethasone; anti-inflammatory; useful in treating

-asone corticosteroid
fluticasone many conditions – lupus, asthma

doxorubicin; epirubicin; idarubicin; cancer chemotherapeutic agents;

-bicin antineoplastic; cytotoxic agent
valrubicin treat malgnancies

-bital butabarbital; phenobarbital barbiturate (sedative) depress the CNS; anxiety

depress the CNS; block nerve

-caine bupivacaine; lidocaine; prilocaine; local anesthetic
transmission to pain centers

cef-, cefaclor; cefdinir; cefixime; cefprozil; antibiotic; treat a wide range of

cephalosporin
ceph- cephalexin bacterial infections; ear infections

antibiotic; pneumonia, scarlet fever

-cillin amoxicillin; ampicillin; nafcillin penicillin
throat infections; rheumatic fever

-cycline doxycycline; tetracycline tetracycline antibiotic

-dazole albendazole; metronidazole anthelmintic antibiotic; antibacterial

-dipine amlodipine; felodipine; nifedipine; calcium channel blocker lowers BP; relax & widen blood vessels

-eprazole esomeprazole; omeprazole; proton pump inhibitor (PPI) antacid; peptic ulcers; GERD

-fenac bromfenac; diclofenac; nepafenac NSAID analgesics; arthritis;

-floxacin ciprofloxacin; levofloxacin quinolone antibiotic

-iramine chlorpheniramine; pheniramine antihistamine allergic reactions

acetazolamide; brinzolamide; anticonvulsant; control certain

-lamide carbonic anhydrase inhibitor
dorzolamide; methazolamide seizures in the treatment of epilepsy

anticholinergic; reducing spasms of

-nacin darifenacin; solifenacin muscarinic antagonist
smooth muscles

fluconazole; ketoconazole; antimycotic; ringworm, candidiasis

-nazole antifungal
miconazole; terconazole; tioconazole (thrush)
PAULA LUZADAS
 antagonist; lowers BP; angina;
-olol atenolol; metoprolol; timolol beta blocker
overactive thyroid symptoms

-parin enoxaparin; heparin antithrombotic blood thinner; DVT

-phylline aminophylline; theophylline xanthine derivative bronchodilator; asthma symptoms

-pramine clomipramine; imipramine tricyclic antidepressant (TCA) depression

pred- prednisolone; prednisone corticosteroid anti-inflammatory; asthma

benazepril; captopril; enalapril; blood vessels enlarge or dilate;

-pril ACE inhibitor
lisinopril; moexipril; ramipril lowers BP; heart failure

-sartan candesartan; losartan; valsartan angiotensin II receptor antagonist; ARB lowers BP; heart failure

-semide furosemide; torsemide loop diuretic (water pill) used for impaired kidney function

-setron ondansetron; palonosetron antiemetic and antinauseant nausea and vomiting

atorvastatin; lovastatin; pitavastatin; lower cholesterol levels; prevent

-statin HMG-CoA reductase inhibitor; statins
pravastatin; rosuvastatin; simvastatin heart attacks and strokes

sulfa- sulfadiazine; sulfamethoxazole anti-infective; anti-inflammatory antibiotic

-terol albuterol; formoterol; levalbuterol beta agonist bronchodilator; inhaler; asthma

chlorothiazide; hydrochlorothiazide; treat high BP and congestive heart

-thiazide thiazide diuretic (water pill)
methyclothiazide failure; edema

increase levels of norepinephrine and

-tyline amitriptyline; nortriptyline; protriptyline tricyclic antidepressant (TCA)
serotonin; depression

-vir acyclovir; famciclovir; penciclovir; antiviral anti-herpes

anxiety-reducing; sedative;
-zepam clonazepam; diazepam; lorazepam; benzodiazepine
anticonvulsant; insomnia

anxiety-reducing; sedative;
-zolam alprazolam; estazolam; midazolam; benzodiazepine
anticonvulsant; insomnia

blood vessels to dilate; lowers BP;

-zosin alfuzosin; doxazosin; prazosin; alpha blocker
prostate enlargement in men

PAULA LUZADAS
 TRANSMISSION OF INFECTIOUS DISEASE

PAULA LUZADAS
 INCENTIVE SPIROMETER

PAULA LUZADAS