Medsurg Review Bundle

NURSING BUNDLE
A Review Guide For Nursing Students
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Authors: Fiskvik Antwi RN, MN.
Simon Osei RN, MN.
Copyright © 2020 by NurseBoss Store
All rights reserved. This book or any portion thereof
may not be reproduced, shared or used in any manner
whatsoever.
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Authors: Fiskvik Antwi RN, MN.
Simon Osei, RN, MN
Copyright © 2020 by NurseBossStore
MEDSURG PART 1
Cardiovascular DISORDERS PANCREAS & GALLBLADDER
Coronary Artery Disease Pancreatitis
Angina Cholecystitis
Myocardial Infarction Cholelithiasis
Heart Failure
Cardiogenic Shock
Pericarditis
Hepatic Disorders
Endocarditis Cirrhosis
Myocarditis
Portal Hypertension
Cardiac Tamponade
Esophageal Varices
Aortic Aneurysm
Hypertension
Genitourinary DISORDERS
Acute Kidney Injury
respiratory DISORDERS
Asthma Chronic Kidney Disease
COPD-Chronic Bronchitis Glomerulonephritis
COPD-Emphysema Nephrotic Syndrome
Pleural Effusion Renal Calculi
Hemothorax Urinary Tract Infection
Pneumothorax Pyelonephritis
Pneumonia
GASTROINTESTINAL DISORDERS NEURO DISORDERS

Hiatal Hernia Traumatic Head Injury
Gastroesophageal Meningitis
Reflux Disease Stroke
Gastritis Multiple Sclerosis
Appendicits Seizures
Peptic Ulcer Disease Parkinson's Disease
Ulcerative Colitis
Crohn's Disease
MEDSURG PART 2
THYROID DISORDERS HEMATOLOGY DISORDERS
Hypothyroidism Iron Deficiency Anemia
Hyperthyroidism Thrombocytopenia
Hypoparathyroidism
Hyperparathyroidism REPRODUCTIVE DISORDERS
PCOS
Endometriosis
PANCREATIC DISORDERS
Type 1 Diabetes Pelvic Inflammatory
Type 2 Diabetes Disease
Diabetes Ketoacidosis
Hyperosmolar REPRODUCTIVE DISORDERS
Varicocele
Hyperglycaemic State
Hypoglycemia
Hyperglycemia
ADRENAL CORTEX DISORDERS

Addison's Disease
Cushings
PITUITARY GLAND DISORDERS

Hypopituitarism
Hyperpituitarism
Diabetes Insipidus
SIADH
SKELETAL DISORDERS
Gout
Rheumatoid Arthritis
Osteoarthritis
MEDSURG PART 3
SKIN DISORDERS CANCER
Pressure ulcers Cancer
Psoriasis Pain
Acne vulgaris Breast cancer
Skin cancer Endometrial cancer
Frostbite Ovarian cancer
Cervical cancer
disorders of the eye Testicular cancer
Legal blindness
Prostate cancer
Cataract
Bladder cancer
Glaucoma
Pancreatic cancer
Retinal detachment
Gastric cancer
Lung cancer
disorders of the ear Leukemia
Otitis media
Lymphoma
External otitis
Multiple myeloma
Meniere's Disease
PERIPHERAL VASCULAR DISORDERS

IMMUNE DISORDERS
Allergy Peripheral Arterial Disease
Systemic Lupus Erythematosus Peripheral Venous Disease
(SLE)
Goodpasture's Syndrome
HIV/AIDS
Fever
Musculoskeletal disorders
Osteoporosis
Strains
Sprains
Fractures
MEDSURG PART 4- critical care
respiratory disorders CARDIOVASCULAR DISORDERS
Pulmonary Embolism Deep Vein Thrombosis
ARDS Disseminated
intravascular
NEURO disorders coagulation
Increased Intracranial
Pressure
Spinal Cord Injury
Autonomic Dysreflexia
Cerebral Aneurysm
Traumatic Brain Injury
Stroke
Seizures
PART 1
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Table of Content
1. Cardiovascular Disorders
2. Respiratory Disorders
3. Gastrointestinal Disorders
4. Pancreatic Disorders
5. Hepatic Disorders
6. Genitourinary Disorders
7. Neuro Disorders
Cardiovascular
TABLE OF CONTENT
1. Coronary Artery Disease
2. Angina
3. Myocardial Infarction
4. Heart Failure
5. Cardiogenic Shock
6. Pericarditis
7. Endocarditis
8. Myocarditis
9. Cardiac Tamponade
10. Aortic Aneurysm
11. Hypertension
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Disease: Coronary Artery Disease Cardiovascular

Risk Factors Pathophysiology
1. Age Coronary artery disease is caused by
2. Gender
3. Family history atherosclerosis (plaque formation) that
4. Hypertension results in the narrowing or occlusion of one
5. High blood cholesterol or more coronary arteries.
level
6. Diabetes
7. Smoking CAD results in decreased myocardial tissue
8. Obesity perfusion and decreased myocardial
Signs and Symptoms oxygenation which leads to angina, MI, HF
or death.
1. Chest pain
2. Dyspnea/SOB
Diagnostic Tests
3. Fatigue
1. Electrocardiography
4. Dizziness
2. Cardiac catheterization
5. Syncope
-may show atherosclerotic lesions.
6. Cough
3. Blood lipids level would be elevated.
7. Normal findings during
asymptomatic period
Nursing Management
Nursing Assessment
Treatment 1. Pain assessment, vital signs/ECG
Pharmacology Nursing Interventions
1. Calcium Channel Blocker 1. Administer oxygen
2. Nitrates 2. Administer medications
3. Cholesterol-lowering 3. Promote bed rest
medications
4. Place client in a Semi-Fowler's position.
Surgical Interventions
Patient Education
1. Coronary Angioplasty
1. Lifestyle modifications
2. Vascular stent
2. Low-sodium and low-cholesterol diet.
3. Coronary artery bypass
3. Stress management
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Disease: Angina Cardiovascular

1. Family history of heart Angina is chest pain due to decreased
disease myocardial oxygenation. This causes
myocardial ischemia.
2. Hypertension Types of angina.
3. High blood cholesterol 1. Stable angina-occurs due to activity.
Pain relieved by rest.
4. Diabetes 2. Unstable angina- unexpected chest pain
5. Smoking that increases in severity, duration and
6. Obesity occurrence (may occur at rest).
3. Variant angina- occurs due to coronary
Signs and Symptoms artery spasm. Occurs at rest.
1. Pain 4. Intractable angina- chronic
5. Preinfarction angina- occurs before an
2. Dyspnea/SOB MI
3. Tachycardia Diagnostic Tests
4. Palpitations 1. Electrocardiography
5. Dizziness 2. Stress test
6. Syncope 3. Cardiac catheterization
7. Diaphoresis
(Sweating)
8. Pallor Nursing Management
9. Elevated BP Nursing Assessment
1. Pain assessment, vital signs/ECG
Treatment
Pharmacology Nursing Interventions
1. Calcium Channel Blocker 1. Administer oxygen
2. Administer nitroglycerin
2. Nitrates 3. Cardiac monitoring
3. Cholesterol-lowering 4. Pain management
medications 5. Promote bed rest
6. Place client in a Semi-Fowler's position.
4. Anti-platelet therapy 7. Establish an IV access.
Surgical Interventions
1. Coronary Angioplasty Patient Education
1. Lifestyle and dietary modifications
2. Vascular stent
3. Coronary artery bypass
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Disease: Myocardial Infarction Cardiovascular

1. CAD MI occurs due to myocardial tissue damage
2. Atherosclerosis as a result of oxygen deprivation. Ischemia
3. High cholesterol level may lead to necrosis if myocardial tissue
4. Diabetes oxygenation is not restored.
5. Hypertension Obstruction locations of an MI
6. Smoking 1. Left anterior descending artery
7. Stress 2. Right coronary artery
Signs and Symptoms 3. Circumflex artery
1. Pain- crushing substernal
pain that radiates to the
left arm, jaw or back. Diagnostic Tests
1. Troponin- level rises between 4-6 hours
2. Dyspnea
2. CK-MB- peaks after 18 hours.
3. Dysrhythmias
3. Myoglobin- level rises between 2-3
4. Pallor
hours
5. Cyanosis
4. ECG- May show ST-elevation MI (STEMI)
6. Diaphoresis
-or non-ST-elevation MI (NSTEMI)
7. Anxiety
Nursing Management
Treatment Nursing Assessment
Pharmacology 1. Pain, respiratory status, vital signs, ECG,
1. Morphine peripheral pulse and skin temperature.
2. Nitroglycerin Nursing Interventions
3. Thrombolytic therapy 1. Administer oxygen
4. Beta-blockers 2. Administer aspirin, nitroglycerin and morphine
5. Antidysrhythmic medications 3. Cardiac monitoring
Immediate treatment: 4. Administer thromobolytic therapy,
Oxygen: Increase oxygen antidysrhythmics, beta-blockers.
delivery 5. Monitor BP
Aspirin: reduce blood clotting 6. Monitor intake and output
Nitroglycerin: vasodilation 7. Notify HCP if the systolic pressure is lower than
Morphine: pain reliever 100 mm Hg after medication administration.
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Disease: Heart Failure Cardiovascular

1. CAD HF is the inability of the heart muscle to
2. MI pump enough blood to meet the metabolic
3. Myocarditis/Endocarditis
demands of the body. Therefore, there is
4. Diabetes
5. Hypertension
a decrease in cardiac output.
6. Abnormal heart valves Types:
7. Cardiomyopathy Right-sided heart failure and left-sided
8. Congenital heart disease heart failure.
Signs and Symptoms
Right-sided HF (evident in
systemic circulation)
Edema of the extremities, Diagnostic Tests
1. Blood tests/ Cardiac bio markers
abdominal distention, JVD,
2. Chest X-ray
splenomegaly, hepatomegaly, 3. Electrocardiogram (ECG)
weight gain 4. Echo cardiogram
Left-sided HF (evident in the 5. Stress test
pulmonary system) 6. Cardiac computerized tomography (CT) scan,
Dyspnea, crackles, tachypnea, Magnetic resonance imaging (MRI). and
Coronary angiogram.
pulmonary congestion, dry cough
Nursing Management
Monitor for acute pulmonary edema
Treatment 1. Place patient in a high Fowler's
Pharmacology position.
2. Oxygen therapy
1. Morphine 3. Administer morphine sulfate and
2. Digoxin diuretics.
4. Insert Foley's catheter.
3. ACE-Inhibitors 5. Intubation and ventilation support if
prescribed.
4. Beta-blockers Other nursing interventions
5. Diuretics 1. Administer prescribed medication regime.
2. Monitor daily weight
3. Monitor intake and output.
4. Provide balance between rest and
activities.
5. Educate patient on lifestyle and dietary
modifications.
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Disease: Cardiogenic Shock Cardiovascular

1. CAD
Cardiogenic shock is a condition caused by
2. MI
failure of the heart to pump adequately.
3. Myocarditis/Endocarditis
4. Diabetes This results in decreased cardiac output
5. Hypertension and decreased tissue perfusion.
6. Abnormal heart valves
7. Cardiomyopathy
8. Congenital heart disease
Signs and Symptoms
1. Hypotension
2. Tachycardia
3. Chest pain/discomfort Diagnostic Tests
1. Blood tests/ Cardiac bio markers
4. Decreased urine output,
2. Chest X-ray
less than 30ml/hr.
3. Electrocardiogram (ECG)
5. Diminished peripheral 4. Echo cardiogram
pulse 5. Stress test
6. Confusion/disorientation 6. Coronary angiogram
Nursing Management
Assessment
Treatment Orientation, respiratory status, pain, vital
Treatment Goal signs, peripheral pulse, intake and output
To improve the heart's
Interventions
pumping ability and maintain 1. Administer medications (see pharmacologic
tissue perfusion. interventions).
Pharmacology 2. Oxygen therapy
3. Monitor vital signs
1. Morphine sulfate 4. Monitor BP after diuretic and nitrate
2. Diuretics administration.
3. Nitrates 5. Prepare client for procedures to improve
coronary tissue perfusion and cardiac output:
4. Vasopressors and positive PTCA, coronary atery bypass grafting,
inotropes (Improve organ insertion of intraaortic balloon pump, etc.
6. Monitor urinary output
tissue perfusion)
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Disease: Pericarditis Cardiovascular

1. MI Pericarditis is an infection of the
2. Autoimmune diseases pericardium. The pericardium is comprised
3. Injury of two thin sac layers that surrounds the
4. Heart surgery heart.
5. Bacterial, viral and fungal Chronic pericarditis causes thickening of
infections the pericardium which results in the
accumulation of fluid (and causes a
Signs and Symptoms decrease in pericardial elasticity).
1. Pain This may result in further complications such
a. Pain that radiates to as heart failure and cardiac tamponade.
the left side of neck,
shoulders and back
Diagnostic Tests
b. Pain experienced during 1. History and physical examination
inspiration 2. Chest X-ray
c. Pain experienced when 3. Electrocardiogram (ECG)
in a supine position 4. Echo cardiogram
2. Fever
3. Fatigue 5. Blood culture
4. Pericardial friction rub
(during auscultation)
Nursing Management
1. Pain assessment
Treatment 2. Assess for signs of cardiac tamponade.
Pharmacology
1. Analgesics
3. Auscultate lungs (listen for pericardial
friction rub).
2. NSAIDS 4. Position patient in a high Fowler's
3. Corticosteroids position (leaning forward to reduce pain).
4. Antibiotics (for bacterial 5. Blood culture
infections) 6. Administer medications
5. Diuretics
6. Digoxin
Surgical Intervention
1. Pericardiectomy
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Disease: Endocarditis Cardiovascular

1. Congenital heart defects. Inflammation and infection of the
2. IV illegal drug use
endocardium, the inner lining of the
3. Damaged heart valves
heart chambers and heart valves.
4. Valve replacement
5. Prosthetic heart valve Entry:
1. Oral cavity
2. Infection
Signs and Symptoms 3. Invasive procedures
1. Fever
2. Weight loss
3. Heart murmurs
4. Pallor Diagnostic Tests
5. Clubbing of fingers 1. Blood culture test
6. Petechiae 2. ECG
7. Splenomegaly 3. Chest X-ray
8. Red tender lesions on
4. Echo-cardiogram
hands and feet- Osler's
nodes 5. CT scan
9. Nontender hemorrhagic 6. MRI
nodular lesions- Janeway
lesions Nursing Management
Assessment
Treatment 1. Assess skin for petechiae
2. Assess nail beds and clubbing of fingers
Pharmacology 3. Assess for Janeway lesios and Osler's nodes
4. Assess blood culture results
1. Antibiotics Interventions
1. Monitor cardiovascular status
2. Monitor signs of emboli and heart failure.
3. Provide rest and activity balance to prevent
thrombus formation
4. Maintain antiembolism stockings
5. Administer antibiotics
Education
1. Temperature monitoring
2. Oral hygiene
3. Teach client on the signs and symptoms of
complications (emboli and heart failure).
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Disease: Myocarditis Cardiovascular

1. Previous pericarditis Myocarditis is the inflammation of the
2. Bacterial, viral or heart muscles (myocardium).
fungal infection. Myocarditis may affect the heart's
3. Allergic response pumping ability and cause
arrhythmias.
Signs and Symptoms

1. Fever
2. Chest pain
Diagnostic Tests
3. Pericardial friction rub 1. Blood test (Cardiac enzymes-CPK
4. Tachycardia level)
2. ECG
5. Murmur
3. Chest X-ray
6. Dyspnea 4. Echo-cardiogram
7. Fatigue 5. CT scan
6. MRI
Nursing Management
1. Place client in a comfortable position
Treatment
(Semi-Fowler's position).
Pharmacology
2. Oxygen therapy
1. Analgesics
2. Salicylates 3. Administer medications as prescribed (see
3. NSAIDs pharmacologic therapy)
4. Antidysrhythmic drugs 4. Provide rest periods
5. Antibiotics 5. Avoid activities that causes overexertion
6. Monitor for heart failure,
cardiomyopathy and thrombus as signs of
complications.
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Disease: Cardiac Tamponade Cardiovascular

1. Cancer Cardiac tamponade is a syndrome caused
2. Tuberculosis by accumulation of fluid in the pericardial
3. Hypothyroidism cavity (pericardial effusion). Cardiac
4. Kidney failure tamponade decreases ventricular filling
5. Chest trauma and cardiac output.
6. Pericarditis
This may cause complications such as
Signs and Symptoms pulmonary edema, shock, or death.
1. Increase central venous

pressure (CVP).
Diagnostic Tests
2. Jugular venous distention
1. Chest X-rays (an enlarged, globe-
3. Muffled heart sound
shaped heart may indicate cardiac
4. Pulsus paradoxus tamponade).
5. Decreased cardiac output 2. Thoracic CT scan (fluid accumulation).
3. Magnetic Resonance Angiogram
(determine cardiac blood flow).
4. Echo cardiography
Nursing Management
1. Place client on hemodynamic monitoring.
Treatment
1. Cardiac tamponade is a 2. Administer IV fluids as prescribed.
medical emergency 3. Prepare client for pericardiocentesis
2. Client is managed in a critical
care unit for hemodynamic procedure.
monitoring
3. IV fluids are prescribed for 4. Monitor client after the procedure for any
decreased cardiac output.
recurrence of tamponade.
4. Pericardiocentesis is
performed (a procedure to
remove fluids in the
pericardium).
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Disease: Aortic Aneurysm Cardiovascular

1. Tobacco use Aortic aneurysm is an
2. Hypertension
enlargement/dilation of the aorta.
3. Family history
Aneurysm may occur anywhere along
4. Age (65 and older)
5. Gender (male) the abdominal aorta.
6. High blood cholesterol
level
Signs and Symptoms
Thoracic aneurysm:
dyspnea, cyanosis, weakness,
hoarseness, syncope, pain.
Abdominal aneurysm:
Diagnostic Tests
abdominal pain, abdominal 1. Abdominal ultrasound
tenderness, systolic bruit over
aorta, mass above the
2. CT scan
umbilicus. 3. Ateriography
Rupturing aneurysm:
tachycardia, hypotension,
abdominal pain, s/s of shock,
hematoma at the flank
region.
Nursing Management
1. Assess abdominal distension
Treatment
Pharmacology 2. Assess peripheral pulse, temperature,
1. Antihypertensive drugs-to
maintain BP and prevent color and capillary refill.
pressure on the aneurysm. 3. Monitor vital signs
Surgical Intervention 4. Monitor for signs of aneurysm rupture
1. Abdominal aortic aneurysm
resection- section is replaced 5. Administer medication (see
with a graft.
2. Thoracic aneurysm repair- a pharmacologic interventions).
thoractomy procedure is used 6. Prepare client for surgical procedure
to enter the thoracic cavity,
expose the aneurysm and a 7. Implement post operative interventions
graft is sewn on the aorta.
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Disease: Hypertension Cardiovascular

1. Obesity Hypertension is the most common lifestyle
2. DM
disease.
3. Physical inactivity
4. Tobacco use Hypertension is multifactorial that causes
5. Alcoholism an increase in peripheral vascular
6. Family history resistance and an increase in blood
7. Secondary hypertension:
caused by underlying
pressure (chronic).
condition
Signs and Symptoms Elevated BP: >120-129/<80
Stage 1 Hypertension: 130-139/80-89
1. Increased BP Stage 2 Hypertension: >140/>90
2. Headache
3. Dizziness Diagnostic Tests
1. History/BP monitoring
4. Chest pain 2. ECG
5. Blurred vision 3. Echocardiography
6. Tinnitus 4. Blood chemistry
5. Urinalysis
6. Lipid panel
Remember: it may be
7. CT scan
asymptomatic 8. Chest xray
Nursing Management
1. Assess and monitor BP
Treatment
Goal of treatment: 2. Obtain family history
1. Reduction of BP 3. Monitor weights
2. Prevention of organ
damage 4. Goal: weight reduction or maintenance
5. Diet: sodium restriction
Lifestyle changes 6. Smoking cessation
1. Diet
2. Exercise 7. Educate patient on pharmacological
treatment
Pharmacology
1. Anti-hypertensive
medications
RESPIRATORY
TABLE OF CONTENT
1. Asthma
2. COPD-Chronic Bronchitis
3. COPD-Emphysema
4. Pleural Effusion
5. Hemothorax
6. Pneumothorax
7. Pneumonia
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Disease: ASTHMA Respiratory

Risk Factors/Causes Pathophysiology
1. Allergies
Chronic inflammatory disease of the
2. Stress airway.
3. Hormonal changes Inflammation and hypersensitivity to
a trigger (stimuli).
Smooth muscle constriction of the
bronchi.
Signs and Symptoms
Intermittent airflow obstruction.
1. Chest tightness
2. Wheezing Diagnostic Tests
3. Shortness of breath 1. ABGs
4. Cough 2. Pulmonary function tests
3. Peak expiratory flow
5. Restlessness
4. Spirometry
5. Allergy test
6. Pulse oximetry
7. CBC
Treatment Nursing Management
1. Assess patient's respiratory rate, depth
Pharmacology and pattern
1. Bronchodilators 2. Monitor pulse ox
2. Corticosteroids
4. Maintain patent airway
3. Anticholinergics 5. Administer O2 therapy as prescribed
6. Administer medications as ordered.
Patient Education
1. Medication regimen.
2. Identify and avoid triggers.
3. Long term management.
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Disease: COPD- Chronic Bronchitis Respiratory
1. Smoking
Progressive respiratory disease.
2. Exposure to dust Overproduction of mucus due to
and chemicals. inflammatory response.
3. Air pollution Causes airway narrowing and
ventilation-perfusion imbalance.
Signs and Symptoms

1. SOB
2. Cough Diagnostic Tests
3. Sputum production 1. ABGs
4. Fatigue 2. Pulmonary function tests
3. Spirometry
5. Wheezing, crackles
4. Chest X-ray
6. Cyanosis
5. Sputum culture

1. Assess respiratory rate, depth and
Pharmacology pattern.
2. Auscultate lungs
1. Bronchodilators 3. Maintain patent airway
2. Glucocorticosteroids 4. Place patient in Fowler's position
3. Anticholinergics 5. Provide O2 therapy as ordered.
6. Increase oral fluids and maintain
4. Mucolytic agents hydration.
7. Perform chest physiotherapy
Patient Education
1. Deep breathing exercises
2. Nutrition and hydration
3. Smoking cessation
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Disease: COPD- EMPHYSEMA Respiratory

1. Smoking
Progressive respiratory disease
2. Exposure to dust characterized by the enlargement of
and chemicals. the alveolar.
3. Air pollution Enlargement causes decrease in
alveolar elasticity, alveolar wall
damage and decrease in alveolar
Signs and Symptoms
surface area.
1. SOB
2. Cough Diagnostic Tests
3. Sputum production 1. ABGs
4. Fatigue 2. Pulmonary function tests
3. Chest X-ray
5. Wheezing, crackles
6. Cyanosis
7. Barrel chest
8. Clubbing of nails
Pharmacology pattern.
2. Auscultate lungs
1. Bronchodilators 3. Maintain patent airway
4. Place patient in Fowler's position
2. Glucocorticosteroids 5. Provide O2 therapy as ordered.
3. Anticholinergics 6. Increase oral fluids and maintain
hydration.
4. Mucolytic agents 7. Perform chest physiotherapy
Patient Education
1. Deep breathing exercises (pursed lip
breathing)
2. Nutrition and hydration
3. Smoking cessation
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Disease: PLEURAL EFFUSION Respiratory

Transudative Effusion
1. Cirrhosis Accumulation of fluid in the pleural
2. Heart failure space.
3. Hypoalbuminemia
Exudative Effusion Fluid accumulates between the
1. Pneumonia
2. Cancer visceral and parietal pleura of the
3. Pulmonary embolism lungs.
4. Tuberculosis
Pleural fluid: transudate or exudate
Signs and Symptoms
1. SOB
2. Chest pain Diagnostic Tests
3. Dry, nonproductive 1. Pleural fluid analysis
cough 2. CT scan
4. Diminished breath 3. Chest radiography
4. Transthoracic ultrasonography
sounds
5. Pain during
inspiration
1. Thoracentesis 1. Identify underlying cause
2. Chest tube insertion 2. Assess respiratory rate, depth
3. Pleurectomy
4. Pleurodesis and pattern
5. Treatment of underlying 3. Monitor vital signs
condition
4. Elevate the head of bed
Pharmacology 5. Administer O2 therapy as ordered
(Depends on the underlying 6. Administer medications as
condition)
ordered
1. Diuretics- congestive 7. Prepare patient for possible
heart failure. thoracentesis.
2. Antibiotics
3. Anticoagulants- 8. Chest tube management
pulmonary embolism
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Disease: HEMOTHORAX Respiratory

1. Thoracic/heart surgery
2. Chest trauma Accumulation of blood in the pleural
3. Blood clotting defect cavity.
4. Anticoagulant therapy Causes respiratory distress.
5. Lung cancer
6. Tuberculosis
Signs and Symptoms

1. sOB
2. Tachypnea
3. Chest pain Diagnostic Tests
4. Tachycardia 1. Thoracentesis
5. Hypotension
6. Diminished breath 2. ABGs
sounds on affected 3. CT scan
side
7. Restlessness
8. Cyanosis
9. Anxiety
1. Stabilize patient 1. Assess diagnostic test results.
2. Stoppage of bleeding 2. Assess respiratory rate, depth and
3. Thoracentesis
4. Chest tube insertion pattern
4. Elevate the head of bed
Surgical Intervention 5. Administer O2 therapy as ordered
1. Thoracotomy
2. VATS-Video assisted 6. Pharmacologic pain management
thoracoscopic surgery 7. Non-pharmacologic pain management
8. Chest tube management/care
9. Administer IV fluids as ordered
10. Administer blood transfusion as ordered
11. Prepare patient for surgery, if indicated.
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Disease: PNEUMOTHORAX Respiratory

1. Chest injury Air leaks into pleural space. Pleural space is
2. Ruptured air blebs exposed to positive atmospheric pressure
3. Mechanical ventilation (pressure is normally negative). Causes
4. Lung disease: cystic fibrosis impaired lung expansion.
5. Chest surgery Results in full lung collapse or partial lung
6. Smoking collapse.
7. Genetics
8. Invasive procedures Types
1. Spontaneous pneumothorax
Signs and Symptoms 2. Tension pneumothorax
Spontaneous pneumothorax 3. Traumatic pneumothorax
1. SOB/ Cyanosis
2. Tachycardia
3. Asymmetrical chest
movement Diagnostic Tests
4. Diminished breath sounds on 1. ABGs
affected side
5. Chest pain
2. Thoracic CT scan
Tension pneumothorax 3. CBC
1. Tracheal deviation away
from affected side 4. Thoracentesis
2. SOB/ Tachypnea/Cyanosis 5. Chest X-ray
3. Hypotension/weak pulse
4. Chest pain
5. Decreased CO

1. Oxygen therapy 1. Assess respiratory status
2. Chest tube insertion 2. Maintain patent airway
Pharmacology 3. Monitor vital signs
1. Antibiotics 4. Administer O2 therapy as ordered
5. Chest tube management: monitor for
Surgical Intervention kinks and bubbling
Sometimes surgery may be
necessary to close the air 6. Pain management
leak. 7. Maintain bed rest
Patient Education
2. Educate patient on the use of Incentive
spirometer
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Disease: PNEUMONIA Respiratory

Causes Pathophysiology
Community acquired pneumonia Inflammation of the pulmonary tissue
1. Streptococcus pneumoniae caused by bacteria, fungi and viruses
Hospital acquired pneumonia Types:
1. Prolonged hospitalization
2. Mechanical ventilation 1. Community acquired pneumonia: onset
3. Chronic illness/co morbid of pneumonia symptoms that occurs in
Aspiration Pneumonia the community setting or for the first
1. Substance entering the 48 hours after admission
airway due to vomiting or
impaired swallowing 2. Hospital acquired pneumonia: onset of
pneumonia symptoms after 48 hours of
Signs and Symptoms admission
3. Aspiration pneumonia: bacterial
1. SOB infection from aspiration
2. Productive cough
Diagnostic Tests
3. Tachypnea
4. Use of accessory 1. ABGs
muscles 2. Sputum culture
5. Fever 3. Chest X-ray
6. Cyanosis 4. CBC-WBC
7. Pleuritic chest pain 5. Blood culture
6. Pulmonary function studies
7. Bronchoscopy
1. Hydration (IV fluids) 1. Assess respiratory status
2. Blood culture 2. Maintain patent airway
3. Respiratory Management 3. Monitor vital signs
4. Assess swallowing if cause is aspiration
Pharmacology
1. Antibiotics 5. NPO status maintained if cause is aspiration
2. Antiviral angents 6. Administer O2 therapy as ordered
3. Antitussives 7. Chest physiotherapy
4. Antipyretics 8. Maintain bed rest/Semi-Flower's position
5. Analgesics 9. Increase fluid intake
10. High-calorie, protein diet
Patient Education
1. Fluid intake
2. Deep breathing/coughing
3. Medication regimen
Gastrointestinal
TABLE OF CONTENT
1. Hiatal Hernia
2. Gastroesophageal Reflux Disease
3. Gastritis
4. Appendicits
5. Peptic Ulcer Disease
6. Ulcerative Colitis
7. Crohn's Disease
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Disease: Hiatal Hernia Gastrointestinal

Causes/Risk Factors Pathophysiology
The diaphragm has a small opening
1. Injury
2. Aging (hiatus) through which the esophagus
3. Obesity passes before connecting to the
stomach.
Hiatal hernia occurs when a portion of

the stomach herniates through the
Signs and Symptoms diaphragm and into the thorax.
1. Heart burn
2. Dysphagia Diagnostic Tests
3. Regurgitation
1. Upper endoscopy
4. Epigastric pain
2. Barium swallow (esophagram)

Pharmacology 1. Assess pain
1. Antacid 2. Elevate head of bed (HOB)
a. Neutralizes 3. Avoid eating 2 to 3 hours before bedtime
stomach acids 4. Provide small frequent meals
2. Proton pump inhibitors 5. Avoid lying down after eating
a. Blocks acid 6. Administer medications as ordered
production- reduces
stomach acid Patient Education
1. Avoid alcohol, fatty foods, caffeine,
tobacco, and other irritants
Surgical intervention may 2. Avoid eating 2 to 3 hours before bedtime
be required 3. Avoid lying down after eating
4. Avoid anticholinergics
5. Maintain healthy body weight (exercise)
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Disease: GERD Gastrointestinal

A digestive disorder that occurs due to the
1. Hiatal Hernia
2. Pregnancy backflow of gastric content.
3. Pyloric surgery Impaired or dysfunctional lower
4. Smoking esophageal sphincter (LES) causes
5. Obesity
6. Alcohol regurgitation of stomach content into the
7. Fatty foods esophagus.
Complications- esophagitis, Barrett
esophagus, esophageal stricture.
Signs and Symptoms
1. Heart burn
2. Dysphagia Diagnostic Tests
3. Regurgitation
1. Upper endoscopy
4. Epigastric pain
2. Esophageal pH studies
5. Dyspepsia
3. Barium swallow (esophagram)
(indigestion)

1. Antacid 2. Elevate head of bed (HOB)
a. Neutralizes stomach 3. Avoid eating 2 to 3 hours before bedtime
acids 4. Avoid lying down after eating
2. Proton pump inhibitors 5. Administer medications as ordered
a. Blocks acid
production- reduces
3. Histamine H2 antagonist 1. Avoid alcohol, fatty foods, caffeine, tobacco,
a. Blocks histamine and other irritants
(decreases 2. Avoid eating 2 to 3 hours before bedtime
stimulation of
stomach acid 3. Avoid lying down after eating
production). 4. Avoid NSAIDS and anticholinergics
5. Maintain healthy body weight (exercise)
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Disease: Gastritis Gastrointestinal

Gastritis is the inflammation of the gastric
1. Bacterial infection
2. Autoimmune disease mucosa.
3. Prolong use of NSAIDs
4. Excessive alcohol use Acute gastritis- caused by the overuse of
5. Smoking
6. Dietary factors NSAIDs, aspirin or excessive alcohol intake.
Chronic gastritis-consistent inflammation of
the gastric mucosa. May be caused by H.
pylori bacteria, or autoimmune diseases.
Signs and Symptoms
Acute Gastritis
1. Nausea/vomiting
2. Anorexia
3. Abdominal pain Diagnostic Tests
4. Acid reflux
5. Hiccups
1. Endoscopy
Chronic Gastritis 2. H. pylori test
1. Indigestion 3. Upper GI X-ray
2. Heart burn after meals
3. Vitamin B12 deficiency
4. Anorexia/nausea/vomiting

1. Antacid 2. Monitor signs of hemorrhagic gastritis
a. Neutralizes stomach
acids 3. Maintain NPO status until symptoms
2. Proton pump inhibitors subsides
a. Blocks acid 4. Administer medications as ordered.
production- reduces
stomach acid
3. Histamine H2 antagonist Patient Education
a. Blocks histamine 1. Educate patient to avoid irritating
(decreases
stimulation of foods.
stomach acid 2. Educate patient on the importance of
production). medication regime and adherence.
4. Antibiotics: to treat
bacterial infection
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Disease: Appendicitis Gastrointestinal

Inflammation of the vermiform appendix.
1. Abdominal trauma
2. Inflammatory bowel Inflammation causes obstruction of the
disease appendiceal lumen.
3. Infection in the Complications: Prolong inflammation may
gastrointestinal tract
4. Foreign body cause the appendix to burst/rupture
5. Viral infection leading to peritonitis.
Signs and Symptoms

1. Rovsing's sign: pain
experienced at the RLQ
when pressure is applied Diagnostic Tests
and released at the LLQ
2. Periumbilical abdominal 1. CBC (WBC)
pain 2. CT scan
3. RLQ pain 3. Abdominal ultrasound
4. Fever
5. Abdominal rigidity

1. Appendectomy: surgical 1. Assess pain
removal of the appendix 2. Abdominal assessment
2. Pain management
3. IV fluids 3. Monitor VS
4. Pre-operative care: NPO + IVF
Pharmacology 5. Post-operative care: Monitor surgical site
1. Antibiotics
+ monitor for signs of infection
Patient Education
1. Post-operative education
a. Early ambulation
b. Deep breathing exercises
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Disease: Peptic Ulcer Disease Gastrointestinal

Ulceration that erodes the gastric or
1. H. pylori bacteria
2. NSAIDS duodenal mucosa.
3. Irritants Mucosal inflammation and ulceration
4. Smoking is caused by H. pylori bacteria.
Complications: GI hemorrhage,
Signs and Symptoms bowel obstruction
1. Epigastric pain after
meals
2. Dark, tarry stools Diagnostic Tests
3. Weight loss 1. Laboratory tests for H. pylori
4. Coffee ground emesis 2. Endoscopy
3. Barium Swallow (Upper
gastrointestinal series)

Pharmacology 1. Abdominal Assessment (abdominal
1. Antibiotics sounds)
2. Histamine H2 blockers
2. Monitor vital signs (BP,P)
a. Blocks histamine
(decreases
3. Monitor stools for blood
stimulation of
production). 1. Dietary modification: avoid
3. Proton pump inhibitor irritants
a. blocks acid 2. Smoking cessation
production to 3. Avoid NSAIDS
promote healing
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Disease: Ulcerative Colitis Gastrointestinal

Known as an Inflammatory Bowel
1. Age
2. Family history Disease.
Characterized by the ulceration and
inflammation of the colon and rectum.
Causes poor nutrient absorption.
Complications: Nutritional deficiencies,

Signs and Symptoms hemorrhage and perforated colon
1. Diarrhea with pus or
blood
3. Abdominal 1. Colonoscopy
tenderness 2. Stool specimen analysis
4. Fever
5. Fecal urgency

Pharmacology 1. Assess and monitor vital signs
1. 5-aminosalicylic acid (5- 2. Assess pain
ASA) 3. Monitor fluid balance
2. Corticosteroids- 4. I/O charting
moderate to severe 5. Monitor electrolyte levels (lab studies)
ulcerative colitis 6. Monitor stool frequency and
3. Immunosuppresants- characteristics
reduces inflammation. 7. Obtain daily weights
8. Pain management
9. Maintain NPO status if indicated (severe
condition)
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Disease: Crohn's Disease Gastrointestinal

Crohn's disease is a type of
1. Autoimmune
2. Heredity inflammatory bowel disease (IBD) that
causes inflammation in the
gastrointestinal tract (leads to
thickening, scarring and narrowing)
Signs and Symptoms

1. Diarrhea with pus
2. Fever
4. Abdominal distention 1. Colonoscopy
5. Weight loss 2. Stool specimen analysis
6. Reduced appetite 3. CT scan
7. Iron deficiency 4. MRI

Pharmacology 1. Assess and monitor vital signs
1. 5-aminosalicylic acid (5- 2. Assess pain
ASA) 3. Monitor fluid balance
2. Corticosteroids 4. I/O charting
3. Immunosuppresants- 5. Monitor electrolyte levels (lab studies)
reduces inflammation. 6. Monitor stool frequency and
characteristics
7. Obtain daily weights
8. Pain management
9. Maintain NPO status if indicated (severe
condition)
Pancreas & Gallbladder
TABLE OF CONTENT
1. Pancreatitis
2. Cholecystitis
3. Cholelithiasis
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Disease: Pancreatitis Gastrointestinal

1. Hyperlipidemia Inflammation of the pancreas.
2. Hypercacemia Obstruction of pancreatic secretory
3. Gallstones
4. Abdominal surgery flow, activation and release of
5. Abdominal trauma pancreatic enzymes. Digestive
6. Obesity enzymes starts digesting the
7. Infection
pancreas.
Signs and Symptoms
1. Left upper abdominal
pain that radiates to the
back Diagnostic Tests
2. Abdominal pain that 1. Electrolyte levels (Calcium)
worsens after meals 2. Elevated level of pancreatic enzymes
3. Abdominal tenderness 3. WBC
4. Fever 4. CT scan
5. Tachycardia 5. Abdominal ultrasound
6. Hypotension 6. Endoscopic ultrasound
7. Steatorrhea: chronic 7. MRI
8. stool test: for chronic pancreatitis
pancreatitis
1. NPO status
2. Pancreatic enzyme
1. Assess pain
supplements 2. Provide pharmacologic and non-
3. Pain management pharmacologic pain management
4. IV fluids 3. Monitor fluid and electrolytes
5. Surgical procedure to 4. Maintain NPO status as ordered
remove bile duct 5. Manage biliary drainage
obstruction.
6. Cholecystectomy (if cause
is gallstones)
7. Pancreatic Jejunostomy
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Disease: Cholecystitis Gastrointestinal

1. Gallstones Inflammation of the gallbladder.
2. Tumor Acute inflammation: is often due to
3. Infection cholelithiasis.
Chronic inflammation: repeated
acute inflammation that causes the
gallbladder to be thick-walled and
Signs and Symptoms scarred.
1. Epigastric pain that
radiates to the right
shoulder
Diagnostic Tests
1. CBC- WBC
2. Fever
3. Nausea/Vomiting 2. Abdominal ultrasound
4. Murphy's sign 3. Endoscopic ultrasound
5. Belching 4. CT scan
6. Flatulence
7. Abdominal tenderness

1. NPO status
2. Pain management 1. Assess pain
3. Antiemetics: for nausea 2. Provide pharmacologic and non-
pharmacologic pain management
and vomiting
3. Maintain NPO status
4. Analgesics: pain
4. Prepare patient for procedures
Surgical intervention
1. Cholecystectomy:
Post operative interventions
removal of the
1. Monitor respiratory complications
gallbladder.
2. Encourage coughing and deep breathing
2. Choledocholithotomy: 3. Encourage early ambulation
removal of gallstones 4. Tube drainage management (if any).
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Disease: Cholelithiasis Gastrointestinal

1. Obesity Gallstones are hard, crystalline
2. High cholesterol
structures that abnormally forms
levels
3. Women over 40 years and obstruct the gallbladder / bile
4. Diabetes duct.
5. Cirrhosis Most of cholelithiasis is caused by
cholesterol gallstones.
Signs and Symptoms
1. Sudden pain in the right
upper quadrant
2. Abdominal distention Diagnostic Tests
3. Dark urine 1. Cholesterol levels/LDLs
4. Abdominal pain after 2. Cholecystogram
eating fatty foods. 3. Laparoscopy
4. Abdominal ultrasound
5. Endoscopic ultrasound
6. CT scan
7. MRI
Pharmacology Preoperative Care
1. Analgesics 1. Prepare patient for surgery
Postoperative Care
2. Antibiotics 1. Monitor vital signs
Surgical intervention 2. Monitor respiratory status
3. Pain management
1. Cholecystectomy: 4. Monitor drainage/incision site
removal of the 5. Monitor intake and output
gallbladder. 6. Maintain NPO status
Medications to dissolve 8. Early ambulation
stones Patient Education
1. Ambulation/ 2. Avoid heavy lifting/ 3. Avoid
1. Chenodeoxycholic
bathing for 48 hours/ 4. Report fever/ 5. Dietary
2. Ursodeoxycholic acid modification/ 6. Assess wound site daily.
Hepatic Disorders
TABLE OF CONTENT
1. Cirrhosis
2. Portal Hypertension
3. Esophageal Varices
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Gastrointestinal
Disease: Cirrhosis Hepatic Disorders
1. Chronic alcoholism Cirrhosis is a chronic progressive
2. Hepatitis
disease of the liver characterized by
3. Biliary obstruction
4. Right-sided HF fibrosis (scarring).
Signs and Symptoms

1. Jaundice
2. Edema
3. Splenomegaly
4. Liver enlargement Diagnostic Tests
5. Ascities 1. Liver Function Test
6. Abdominal pain 2. INR/Prothrombin time
7. Steatorrhea
8. Bleeding- decreased Vit K 3. MRI
9. Red palms 4. CT scan
10. Itchiness 5. Liver Biopsy
11. Weight loss/ Loss of
appetite
12. White nails
1. Treatment of underlying
1. Identify underlying/precipitating factors
cause 2. Perform daily weights
a. Alcohol dependency 3. Administer vitamin supplements- KADE
b. Hepatitis treatment 4. Monitor for signs of infection
2. Treatment of Cirrhosis 5. Monitor for signs of bleeding
complications- ascites, 6. Nutrition- low sodium
gastric distress, portal
Patient Education
hypertension, etc.
1. Alcohol cessation
3. Liver Transplant- in severe 2. Low sodium diet
cases of Cirrhosis 3. Low saturated fats
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Gastrointestinal
Disease: Portal Hypertension Hepatic Disorders
1. Cirrhosis Portal veins carries blood from the
2. Portal vein digestive organs to the liver.
thrombosis Portal hypertension-increased pressure
in the portal veins due to obstruction of
the portal blood flow.
Complications- Hepatic encephalopathy,

Signs and Symptoms
1. Gastrointestinal bleeding ascites, GI bleed, varices rupture.
a. Dark/tarry stools
b. bleeding from varices
2. Ascites Diagnostic Tests
3. Decreased platelets and 1. CBC- low platelets
WBC 2. Hemoccult
4. Splenomegaly
5. Thrombocytopenia 3. Endoscopy
6. Encephalopathy 4. Ultrasound

1. Endoscopic therapy
1. Monitor intake and output
2. Dietary/lifestyle
2. Assess level of consciousness
modifications
3. Monitor coagulation studies
3. Transjugular intrahepatic 4. Perform daily weights
portosystemic shunt 5. Administer diuretics as ordered
(TIPS)-radiological 6. Administer Vit K as ordered
procedure
4. Distal splenorenal Patient Education
shunt (DSRS)-surgical 1. Low sodium diet
procedure 2. Alcohol cessation
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Gastrointestinal
Disease: Esophageal Varices Hepatic Disorders
1. Cirrhosis Esophageal varices occurs when there is a
blockage in the blood flow to the liver due to
2. Thrombosis in the
scarring or clotting in the liver.
portal vein
3. Heart failure This results in an increased pressure from the
4. Schistosomiasis portal vein.
The increased pressure causes blood to flow into

Signs and Symptoms smaller veins in the esophagus. The smaller
1. Jaundice fragile veins may become distended and
2. Dark-colored urine rupture, causing life--threatening hemorrhage.
3. Ascites
4. Nausea/Vomiting Diagnostic Tests
5. Spontaneous 1. CBC
bleeding/easy bruising 2. Coagulation studies
6. Spider nevi
7. Hypotension 3. Liver function test
8. Tachycardia 4. Endoscopy
9. Pallor 5. CT scan
10. General malaise
11. Pruritus

1. Primary goal is to prevent
bleeding. 1. Monitor vital signs
2. Monitor lung sounds
2. Beta blockers- to reduce
3. Elevate HOB
pressure in the portal
4. Administer O2 as ordered
veins
5. Administer IV fluids as ordered
3. Vasopressin
6. Monitor lab values-coagulation studies
4. Somatostatin/Sandostatin
7. Administer Vit K as ordered
5. Sclerotherapy
6. Endoscopic band ligation
Genitourinary
TABLE OF CONTENT
1. Acute Kidney Injury
2. Chronic Kidney Disease
3. Glomerulonephritis
4. Nephrotic Syndrome
5. Renal Calculi
6. Urinary Tract Infection
7. Pyelonephritis
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Disease: Acute Kidney Injury Genitourinary

Prerenal-outside the kidney Renal cell damage characterized by a
1. Dehydration, infection outside of
the kidney, decreased cardiac sudden deterioration in kidney function.
output
Intrarenal-parenchyma of the kidney AKI can cause cell death, decompensation
1. Infection within the kidney of renal function and hypoperfusion.
parenchyma, obstruction, tubular
necrosis, renal ischemia
Postrenal-between kidney and
urethral meatus The signs and symptoms of AKI are due to
1. Calculi, cystitis, bladder
cancer/obstruction the retention of fluids, the retention of
nitrogenous waste and electrolyte
Signs and Symptoms
Oliguric Phase imbalances.
1. Urine output: <400mL/d,
pericarditis, excessive
fluid volume, uremia, Diagnostic Tests
metabolic acidosis, 1. Urinalysis
neurological changes. 2. Urine output measurement
Diuretic Phase
1. An increase in urine 3. BUN/ Creatinine
output 5L/day. 4. Kidney ultrasound/Imaging
Recovery Phase
1. Recovery may take 6
months to 2 years.

1. Treatment of underlying Oliguric Phase
cause 1. Administer diuretics
2. Treatment of 2. Fluid restriction-if hypertension is
complications present
a. Fluids and Diuretic Phase
electrolytes 1. Administer IV fluids
imbalances 2. Monitor Lab values
3. Pharmacology Recovery Phase
a. Antibiotics 1. Patient education-decrease sodium,
b. NSAIDs protein, fluid and potassium intake
c. Diuretics 2. Monitor intake and output.
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Disease: Chronic Kidney Disease Genitourinary

1. AKI Slow, progressive and irreversible loss of kidney
2. Hypertension function.(GFR <60mL/min).
3. Urinary obstruction Results in uremia, electrolyte imbalances,
4. Diabetes hypervolemia (inability to excrete sodium and
water) or hypovolemia (inability to conserve
sodium and water).
Stages of CKD
1. At risk: >90mL/min
2. Mild CKD: 60-89mL/min
3. Moderate CKD: 30-59mL/min
Signs and Symptoms 4. Severe CKD: 15-29mL/min
1. Hypertension 5. ESKD: <15mL/min
2. SOB
3. Kussmaul respirations
4. Oliguria/anuria Diagnostic Tests
5. Uremia 1. Kidney function test-
6. Edema BUN/Creatinine
7. Irritability
8. Restlessness 2. Glomerular filtration rate
9. Pulmonary edema 3. CBC
10. Pulmonary effusion 4. Kidney ultrasound
11. Body weakness
12. Yellow-gray pallor 5. Urinalysis
13. Proteinuria
1. Hemodialysis 1. Monitor vital signs
2. Peritoneal Dialysis 2. Monitor cardiopulmonary system
Kidney transplant 3. Perform daily weights
Pharmacology 4. Monitor lab values
1. Angiotensin-converting 5. Monitor intake and output
enzyme (ACE) inhibitors 6. Low protein/sodium diet
2. Angiotensin II receptor 7. Fluid restriction
blockers 8. Dialysis treatment
3. Diuretics 9. Administer medications
4. Corticosteroids
5. Erythropoietin
supplements
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Disease: Glomerulonephritis Genitourinary

1. Immunological diseases
2. Strep throat A group of renal diseases caused by
3. Autoimmune diseases immunologic response that triggers
the inflammation of the glomerular
tissue.
Signs and Symptoms

1. Dark colored urine
2. Hematuria
3. Proteinuria
4. Azotemia Diagnostic Tests
5. Oliguria 1. Urinalysis
6. Edema 2. CT Scan
7. Elevated BP
8. JVD 3. MRI
9. Dyspnea 4. Bun-increased
5. Creatinine-increased
6. Decreased GFR
7. Increased Urine Specific Gravity
1. Antibiotics 2. Monitor respiratory status
2. Antihypertensive drugs 3. Monitor BP
4. Monitor fluids and electrolytes level
5. Maintain fluid restrictions as ordered
Patient Education
1. Medication adherence
2. Fluid restrictions
3. Dietary modifications
4. Increase carbohydrates in diet
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Disease: Nephrotic Syndrome Genitourinary

1. Diabetes Mellitus
2. Heart failure Nephrotic syndrome is characterized
3. SLE by excessive excretion of protein in
4. Amyloidosis the urine (proteinuria), leading to
low protein levels in the blood
(hypoproteinemia).
This leads to edema and
hypovolemia.
Signs and Symptoms
1. Periorbital and facial
edema
2. Ascites
3. Peripheral edema Diagnostic Tests
4. Proteinuria 1. Urinalysis
5. Hypoproteinemia 2. BUN, Creatinine
6. Hyperlipidemia
7. Electrolyte imbalance 3. Elevated Albumin
8. Fatigue 4. Blood cholesterol and blood
9. Lethargy triglycerides-increased
5. Electrolytes

1. Diuretics 2. Monitor BP
2. ACE-Inhibitors/ ARBS 3. Monitor lab values-protein
3. Corticosteroids 4. Intake and output charting
4. Immunosuppressant 5. Obtain daily weights
6. Low salt/sodium diet/Low cholesterol
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Disease: Renal Calculi Genitourinary

1. Dehydration
2. Family history Renal calculi is also known as kidney
3. UTI stones. Calculi is made up of minerals and
4. Hypercalcemia salt deposits that is found in the urinary
5. Obesity tract.
6. High calcium diet Types
1. Calcium stones
2. Cystine stones
3. Struvite stones
Signs and Symptoms 4. Uric acid stones
1. Pain in the costovertebral
region
2. Fever
3. Persistent need to Diagnostic Tests
urinate 1. 24-hours urine collection
4. Elevated RBC,WBC noted 2. Urinalysis
in urine
3. CBC
4. Ultrasound
5. KUB radiography

Treatment depends on the 1. Monitor vital signs
type, size and cause of the 2. Monitor temperature
calculi. 3. Pain management
Pharmacology-antibiotics 4. Encourage fluid intake of 3L/day
Small Calculi 5. Encourage ambulation
1. Increase water intake 6. Monitor urine output
2. Pain medications 7. Strain urine
3. Alpha blockers 8. Administer medication as ordered.
Large Calculi Patient Education
1. Extracorporeal shock 1. Increase fluid intake
wave lithotripsy (ESWL) 2. Dietary restrictions
2. Surgical intervention
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Disease: Urinary Tract Infection Genitourinary

1. Vesicoureteral reflux
2. Urinary catheters- UTI is the infection/inflammation of
continuous or long term any part of the urinary system.
use
3. Female
4. Renal calculi 1. Acute pyelonephritis:
5. Sexual activity inflammation of the kidneys
2. Cystitis: Inflammation of the
bladder
Signs and Symptoms 3. Urethritis: Inflammation of the
Acute pyelonephritis urethra
1. Flank pain, Fever, chills,
bacteriuria, pyuria
Cystitis
Diagnostic Tests
1. Lower abdominal pain, 1. Urine sample
burning on urination, 2. Urine culture
hematuria, frequent
urination, incontinence 3. Kidney ultrasound
Urethritis
4. CT scan
1. Lower abdominal pain,
burning on urination,
hematuria, frequent
urination, incontinence
1. Antibiotics 2. Monitor temperature
2. Analgesics 3. Encourage fluid intake 3L/day
3. Antipyretics 4. Monitor intake and output
6. Administer medications as ordered
Patient Education
1. High calorie, low protein diet
2. Non-pharmacologic pain management
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Disease: Pyelonephritis Genitourinary

1. Vesicoureteral reflux
2. Urinary catheters- Inflammation of the renal pelvis
continuous or long term caused by bacterial infection.
use
3. Female
4. Renal calculi
Signs and Symptoms

1. Fever/chills
2. Flank pain
3. Costovertebral angle
tenderness Diagnostic Tests
4. Hematuria 1. Urine sample
5. Tachypnea 2. Urine culture
6. Tachycardia
7. Nausea 3. Blood culture
8. Cloudy urine 4. Kidney ultrasound
9. Increased urine frequency 5. CT scan
and urgency
10. Pyuria
11. Bacteriuria
1. Antibiotics 2. Monitor temperature
2. Analgesics 3. Encourage fluid intake 3L/day
3. Antipyretics 4. Monitor intake and output
4. Antiemetics 5. Obtain daily weights
5. Urinary antiseptics 6. Administer medications as ordered
Patient Education
1. High calorie, low protein diet
Neuro
TABLE OF CONTENT
1. Traumatic Head Injury
2. Meningitis
3. Stroke
4. Multiple Sclerosis
5. Seizures
6. Parkinson's Disease
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Disease: TRAUMATIC BRAIN INJURY NEURO

Causes/ Risk Factors Pathophysiology
1. Falls Trauma to the skull that causes brain damage.
2. Sports injury Types:
1. Concussion-injury that causes the head to
3. Vehicular accident move back and forth forcefully
4. Violence 2. Contusion-bruising
3. Epidural hematoma- hematoma between
skull and dura
4. Subdural hematoma-blood between
between the dura and arachnoid
5. Intracerebral hemorrhage-bleeding inside
the brain
Signs and Symptoms 6. Subarachnoid hemorrhage-bleeding into
1. Increased ICP the subarachnoid space
2. LOC changes 7. Skull fractures- break in the cranial bone
3. Confusion/altered mental
status Diagnostic Tests
4. Papilledema 1. GCS
5. Body weakness
6. Seizures
2. Physical Assessment
7. Paralysis 3. CT scan
8. Slurred speech
9. CSF drainage from the ears
or nose
Signs and symptoms depends on Nursing Management

the type of injury and severity. 1. Monitor respiratory status
Treatment
3. Initiate seizure precautions
Mild Injury
1. Close monitoring 4. Assess neurological changes
2. Antibiotics 5. Assess pupil size
3. Wound care 6. Monitor vital signs
Moderate to severe injury 7. Monitor for signs of increase
1. Treatment focuses on
increasing cerebral intracranial pressure.
oxygenation, maintaining BP 8. Prevent neck flexion
and preventing further 9. Pain management
injury.
2. Craniotomy
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Disease: Meningitis Neuro

1. Streptococcus pneumoniae Meningitis is the inflammation of the
2. Neisseria meningitidis
3. Haemophilus influenzae meninges. The meninges covers the brain
and spinal cord. Meningitis is mostly
caused by bacterial or viral infection.
Signs and Symptoms

1. Fever
2. Headache
3. Skin rash
4. Rigidity of the neck
Diagnostic Tests
muscles (nuchal rigidity)
1. Lumbar puncture: CSF fluid is
5. Positive Kernig's sign and collected to test for the
Brudzinski's sign pathogen
6. Decreased LOC 2. CT scan
3. MRI
4. Blood culture

Bacterial meningitis 1. Infection control precautions
1. Antibiotics 2. Monitor neurological status
3. Assess LOC
IV fluids: fluids replacement 4. Monitor vital signs
Antipyretics 5. Initiate seizure precautions
6. Administer antipyretics as ordered
7. Encourage and increase hydration
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Disease: Stroke Neuro

1. TIA Stroke is the loss of neurological functions
2. Hypertension due to the lack of blood flow to the brain.
3. smoking
4. Atherosclerosis Types
5. Diabetes 1. Ischemic Stroke (Clots)- an obstruction
in the blood vessel that supplies blood
6. High cholesterol to the brain.
2. Hemorrhagic Stroke (Bleeding)-
weakened blood vessel ruptures.
Signs and Symptoms 3. Transient Ischemic Attack- temporary
1. Drooping of face stroke (a warning stroke)
2. One sided weakness
3. Slurred speech Diagnostic Tests
4. Blurred vision 1. CT scan
5. Agnosia 2. MRI
6. High BP
3. Electroencephalography
7. Unilateral neglect
4. Carotid ultrasound
8. Apraxia
5. Cerebral arteriography

1. An IV injection of 1. Maintain patent airway
recombinant tissue 2. Administer 02
plasminogen activator 3. Administer tPA
(tPA)-ischemic stroke 4. Monitor VS-maintain BP @ 150/100
2. Hemorrhagic stroke: stop 5. Monitor LOC
bleeding. Prevention of 6. Monitor for signs of increase ICP
increased ICP 7. Elevate HOB
8. Administer IV fluids
9. Insert Foley's catheter
10. Prevention of DVT
11. Assist with self care and ADLs
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Disease: Multiple Sclerosis Neuro

1. Autoimmune disorders Multiple sclerosis is a CNS inflammatory
2. Viral infection disease (chronic), characterized by
the demyelination axons. This damage
results in varied neurological dysfunctions.
Signs and Symptoms

1. Weakness
2. Fatigue
3. Blurred vision
Diagnostic Tests
4. Nystagmus 1. CT scan
5. Sensory loss
2. MRI
6. Dysphagia
3. Lumbar puncture
7. Bowel and bladder
dysfunction
8. Electric-shock sensations
9. Neuralgias

There is no cure. Treatment 1. Assess muscle function and mobility
goal is focused on managing 2. Pain management
symptoms, acute attacks and 3. Assess sensory function
slowing the progression of the 4. Monitor vision changes
disease. 5. Cluster nursing activities
6. Patient's safety measures
7. Encourage independence
8. Encourage bladder and bowel training
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Disease: Seizures Neuro

1. Meningitis Seizures is characterized by a sudden, uncontrolled
electrical disturbance in the brain.
2. Head trauma Epilepsy: chronic seizure activity.
3. Stroke
Types:
4. Fever Generalized Seizures-all areas of the brain are
5. Brain tumor affected
Tonic-Clonic- may begin with an aura.
Tonic phase- muscle rigidity , then loss of
consciousness
Clonic-hyperventilation and jerking
Absence-loss of awareness (stare blankly into
space)
Myoclonic-brief, jerking movement of a
muscle/muscle group
Signs and Symptoms Atonic-sudden loss of muscle strength
The signs and symptoms depends
Partial Seizures-affects one part of the brain
on seizure history and type. Simple partial
Before seizure Complex partial
1. Aura
During seizure
Diagnostic Tests
1. Loss of consciousness during 1. An electroencephalogram
seizures 2. Computerized tomography
2. Uncontrollable involuntary
muscle movements 3. Magnetic resonance imaging
3. Loss of bladder and bowel (MRI)
control
After seizure 4. Neurological exam
1. Headache
2. Confusion
3. Slurred speech
Pharmacology 1. Assess time and duration of seizure
1. Anti-seizure medication activity
2. Provide patient safety
3. Turn patient to the side
4. Maintain airway
5. Avoid restraining patient
6. Loosen clothing
7. Administer O2
8. Monitor behavior before and after
seizure activity
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Disease: Parkinson's Disease Neuro

1. Age >65 A progressive neurological disease
2. Family history characterized by depletion of dopamine
and acetycholine imbalances.
Signs and Symptoms

1. Bradykinesia
2. Tremors
3. Slow movement
4. Blank facial expression Diagnostic Tests
5. Posture: forward tilt 1. Medical history
6. Rigidity of extremities 2. Signs and symptoms
7. Pill rolling
8. Drooling 3. Neurological examination
4. Physical examination

Pharmacology 1. Neuro assessment
1. Carbidopa-levodopa 2. Assess ability to swallow
2. Dopamine agonist 3. Provide patient's safety
3. Catechol O- 4. Promote independence
methyltransferase (COMT) 5. Promote physical therapy
inhibitors 6. Diet: high calorie & soft diet
Treatment goal
1. Increase/maintain independence
2. Improve mobility
3. Improve nutritional status
PART 2
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Table of Content
1. Thyroid Disorders
2. Pancreatic Disorders
3. Adrenal Cortex Disorders
4. Pituitary Gland Disorders
5. Skeletal Disorders
6. Hematology Disorders
7. Reproductive Disorders (F)
8. Reproductive Disorder (M)

THYROID DISORDERS
TABLE OF CONTENT
1. Hypothyroidism
2. Hyperthyroidism
3. Hypoparathyroidism
4. Hyperparathyroidism
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Disease: Hypothyroidism Thyroid Disorders

1. Autoimmune diseases The thyroid gland produce hormones that
2. Iodine deficiency or are responsible for regulating the body's
excess metabolic rate (energy).
3. Thyroiditis In hypothyroidism, the thyroid gland is
4. Thyroidectomy underactive (Hyposecretion of thyroid
hormones).
Remember: LOW ENERGY
Signs and Symptoms
1. Fatigue/body weakness
2. Weight gain
Diagnostic Tests
3. Oligomenorrhea
4. Hair loss
2. Thyroid Function Test
5. Bradycardia
3. Serum T3/T4
6. Coldness
7. Constipation
8. Myxedema
Nursing Management
1. Monitor HR
Treatment 2. Administer levothyroxine as prescribed.
Pharmacology
1. Levothyroxine Patient Education
1. Educate patient on medication
compliance. Levothyroxine is to be taken
for a life-time.
2. Constipation: High fiber diet and
increase fluids
3. Diet: low-calorie, high fiber diet
4. Weight reduction: exercise plan
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Disease: Hyperthyroidism Thyroid Disorders

1. Graves' disease The thyroid gland produce hormones that
are responsible for regulating the body's
metabolic rate (energy)
In hyperthyroidism, the thyroid gland is
overactive (Hypersecretion of thyroid
hormones (T3 and T4))
Remember: HIGH ENERGY
Signs and Symptoms Thyroid Storm: acute and life-threatening

1. Exophthalmos: bulging emergency for uncontrolled hyperthyroidism.
eyes
2. Palpitations
4. Weight loss 1. Physical examination
5. Oligomenorrhea
6. Hot flashes
2. Thyroid Function Test
7. Irritability 3. Serum T3/T4
8. Nervousness 4. Thyroid ultrasound
9. Diarrhea
Thyroid Storm
1. Fever
2. Tachycardia Nursing Management
3. Hypertension/Increased RR 1. Monitor BP, P
Treatment 2. Administer medications as prescribed.
Pharmacology
1. Propylthiouracil (PTU) Patient Education
1. Educate patient on medication compliance
2. Methimazole 2. Diet: High calorie diet
3. Radioactive iodine 3. Avoid stimulants
therapy Thyroid Storm

2. Medications: Antithyroid medication, Beta
1. Thyroidectomy Blockers, Glucocorticoids, Nonsalicylate
antipyretics
3. Cooling blankets
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Disease: Hypoparathyroidism Thyroid Disorders

1. Thyroidectomy (and the The parathyroid gland produces the
removal of the parathyroid hormone (PTH) that maintains
parathyroid). the serum calcium level in the body.
Hypoparathyroidism is caused by
hyposecretion of parathyroid hormones.
Signs and Symptoms

1. Positive Trousseau's sign
2. Positive Chvostek's sign
3. Hypocalcemia Diagnostic Tests
4. Hyperphosphatemia 1. Calcium and Phosphate serum levels
5. Hypotension 2. Positive Chvostek's and Trousseau's sign
6. Tetany
3. Patient History
7. Muscle cramps
8. Anxiety
9. Numbness and tingling
Nursing Management
1. Monitor BP, P
Treatment 2. Monitor calcium/ phosphorus level
Pharmacology 3. Administer medications as prescribed
4. Diet: high Calcium, low Phosphorus diet
1. IV Calcium Gluconate
5. Seizure precautions-(hypocalcemia)
2. Vitamin D supplements
3. Phosphate binders
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Disease: Hyperparathyroidism Thyroid Disorders

1. Chronic kidney failure The parathyroid gland produces the
parathyroid hormone (PTH) that maintains
the serum calcium level in the body.
Hyperparathyroidism is caused by
hypersecretion of parathyroid hormones.
Signs and Symptoms

1. Hypercalcemia
2. Hypophosphatemia
3. Weight loss Diagnostic Tests
4. High BP (Hypertension) 1. Calcium and Phosphate serum levels
5. Bone and joint pain 2. Patient History
6. Bone deformities
3. Bone X-ray
7. Fatigue
8. Cardiac dysrhythmias
9. Kidney stones
Nursing Management
1. Monitor BP
Treatment 2. Monitor calcium/ phosphorus level
Pharmacology 3. Increase fluid intake
4. Promote body alignment
1. Calcitonin
5. Promote safety precautions
2. Bisphosphonates (oral/IV) 6. Administer medications as prescribed
3. Furosemide 7. Diet: High fiber/ moderate calcium
4. Phosphates 8. Pre and post operative care
(parathyroidectomy)
1. Parathyroidectomy
PANCREATIC DISORDERS
TABLE OF CONTENT
1. Type 1 Diabetes
2. Type 2 Diabetes
3. Diabetes Ketoacidosis
4. Hyperosmolar Hyperglycaemic State
5. Hypoglycemia
6. Hyperglycemia
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Disease: Type 1 Diabetes Pancreas

1. Autoimmune response A chronic condition in which the
2. Genetics pancreas (beta cells) is unable to
3. Onset: childhood produce insulin.
Signs and Symptoms

1. Polyuria: increased
urination
2. Polydipsia: Increased Diagnostic Tests
thirst 1. Fasting blood sugar (FBS)
3. Polyphagia: Increased 2. Glycated hemoglobin
appetite 3. Random blood sugar
4. Weight loss 4. Urinalysis
5. Hyperglycemia
6. Blurred vision
Nursing Management
1. Monitor glucose levels
Treatment 2. Insulin administration
Pharmacology
1. Insulin Patient Education
1. Glucose monitoring
Monitoring
2. Insulin administration technique
1. Continuous glucose
monitoring
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Disease: Type 2 Diabetes Pancreas

1. Obesity Type 2 Diabetes is characterized by
2. Sedentary lifestyle insulin resistance and impaired insulin
3. Hypertension secretion.
4. Hyperglycemia
5. Onset: adulthood
Complication: Hyperosmolar
Hyperglycaemic State
Signs and Symptoms
1. Polyuria: increased
urination
2. Polydipsia: Increased
thirst Diagnostic Tests
3. Polyphagia: Increased 1. Fasting blood sugar (FBS)
appetite
2. Glycosylated hemoglobin (HbA1C)
4. Weight gain
5. Poor wound healing 3. Random blood sugar
6. Fatigue 4. Urinalysis
7. Blurred vision
8. Recurrent infections
9. Numbness and tingling of
hands and feet
10. Dry skin
Nursing Management
Treatment 2. Medication administration
Pharmacology
1. Oral hypoglycemic Patient Education
medications 1. Diabetic Diet
2. Insulin
2. Exercise
3. Medication adherence
Nonpharmacologic therapy
1. Glucose monitoring
2. Dietary plan
3. Exercise regime
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Disease: Diabetic Ketoacidosis (DKA) Pancreas

1. Onset: Sudden DKA is a sudden, life-threatening
2. Infection complication of Type 1 Diabetes.
3. Complication of Type 1 Characteristics:
Diabetes 1. Hyperglycemia
2. Dehydration
3. Ketosis
Signs and Symptoms 4. Acidosis
1. Fruity breath
2. Kussmaul's respiration
3. Ketosis Diagnostic Tests
4. Acidosis 1. Serum glucose
5. Electrolyte loss 2. Serum ketones
6. Lethargy 3. Osmolarity
7. Coma 4. Electrolyte level
5. BUN level
6. Creatinine level
Nursing Management
Treatment 2. Administer IV insulin as prescribed
1. IV fluid replacement 3. Administer IV fluids
2. IV insulin: treat 4. Monitor potassium levels
5. Monitor cardiac status
hyperglycemia
6. Monitor signs of increased
3. Correct electrolyte intracranial pressure
imbalance: Monitor
potassium levels
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Disease: Hyperosmolar Hyperglycaemic State (HHS) Pancreas

1. Onset: Gradual Hyperosmolar Hyperglycaemic State
2. Infection (HHS) is a complication of Type 2
3. Complication of Type 2 Diabetes.
Diabetes Characteristics:
1. Extreme hyperglycemia
2. There is no presence of ketosis or
Signs and Symptoms acidosis
1. Dehydration
2. Hyperglycemia
3. Electrolyte loss Diagnostic Tests
4. Dry skin 1. Serum glucose: >800mg/dL
5. Lethargy 2. Serum ketones: negative
3. Osmolarity
4. Electrolyte level
5. BUN level: elevated
6. Creatinine level: elevated
Nursing Management
Treatment 2. Administer IV fluids
1. IV fluid replacement 3. Monitor electrolyte levels
2. Insulin: If applicable 4. Administer insulin if applicable
3. Correct electrolyte
imbalance
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Disease: Hypoglycemia Pancreas

1. Too much insulin or Hypoglycemia occurs when there is a
diabetic medication sudden decrease of blood glucose level
2. Skipping meals <60 mg/dL.
3. Increased physical
activity
Mild: <60mg/dL
Moderate: <40mg/dL
Signs and Symptoms Severe: <20mg/dL
1. Confusion
2. Palpitations
3. Blurred vision Diagnostic Tests
4. Inability to concentrate
1. Serum glucose
5. Fatigue
2. Physical assessment
6. Body weakness
7. Lightheadedness
8. Diaphoresis
9. Cold and clammy skin
Remember: The symptoms
depends on the level of the
blood glucose.
Nursing Management
1. Assess glucose level
Treatment 2. Administer 15g of simple carbohydrates
1. Simple carbohydrates 3. Recheck blood glucose level in 15 minutes
4. Administer 15 g of simple carbohydrates if
2. Glucagon (IV,IM) necessary.
3. 50% Dextrose (IV) 5. If blood glucose level is still <60mg/dL or in
severe cases (altered LOC): Administer 50%
dextrose (IV)
Unconscious patients:(DO NOT ADMINISTER ORAL

FOOD OR FLUID)
2. Administer Glucagon (IV,IM) or 50% Dextrose
(IV)
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Disease: Hyperglycemia Pancreas

1. Diet Hyperglycemia occurs when there is an
2. Inactivity increase in blood glucose >200mg/dL
3. Not taking
insulin/diabetic
medication
Signs and Symptoms

1. Polyuria
2. Polyphagia
3. Polydipsia Diagnostic Tests
4. Dehydration 1. Serum glucose
5. Blurred vision 2. Physical assessment
6. Fruity breath 3. Urinalysis
7. Dry skin
Nursing Management
Treatment 2. Insulin administration as prescribed
1. Insulin
2. Glucose monitoring Education
3. Diabetic diet 1. Educate patient on glucose
monitoring
2. Educate patient on diabetic diet
3. Educate patient on exercise.
ADRENAL CORTEX DISORDERS
TABLE OF CONTENT
1. Addison's Disease
2. Cushings
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Disease: Addison's Disease Adrenal Cortex

1. Autoimmune disease Addison's disease is the inadequate
production of steroid hormones by the
adrenal cortex.
Addisonian Crisis: life-threatening

condition. Caused by stress, infection or
surgery.
Signs and Symptoms
1. Weight loss
2. Fatigue
3. Lethargy
4. Hypotension
Diagnostic Tests
1. ACTH stimulation test
5. Hyperkalemia
2. Elevated Potassium, Calcium levels
6. Hypercalcemia
3. CT Scan
7. Hyponatremia
8. Hyperpigmentation 4. MRI
Nursing Management
1. Monitor BP
Treatment 2. Monitor daily weights
Pharmacology 3. Monitor intake and output
4. Monitor electrolyte level
1. Glucocorticoid
5. Monitor glucose level
2. Mineralocorticoid 6. Administer medications as prescribed
Addisonian Crisis:
1. Administer glucocorticoids IV
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Disease: Cushings Adrenal Cortex

1. Adrenal tumor Cushing syndrome is the excessive level of
adrenocortical hormones (cortisol).
Remember: Addison's disease is the

hyposecretion of steroids. Cushing
syndrome is the hypersecretion of steroids.
Signs and Symptoms

1. Moon face
2. Buffalo hump
3. Truncal obesity
4. Hypertension
Diagnostic Tests
1. Stimulation test
5. Hyperglycemia
2. Electrolyte levels
6. Hypernatremia
3. CT Scan
7. Hypocalcemia
8. Hypokalemia 4. MRI
9. Masculine features
(Hirsutism)
Nursing Management
1. Monitor BP
Treatment 2. Monitor daily weights
1. Chemotherapeutic 3. Monitor intake and output
4. Monitor electrolyte level
agents: for adrenal
5. Monitor glucose level
tumors 6. Administer medications as prescribed
2. Glucocorticoid 7. Prepare patient for adrenalectomy if
replacement: lifelong applicable
Surgical intervention:
1. Adrenalectomy
PITUITARY GLAND DISORDERS
TABLE OF CONTENT
1. Hypopituitarism
2. Hyperpituitarism
3. Diabetes Insipidus
4. SIADH
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Disease: Hypopituitarism Pituitary

1. Pituitary tumor Pituitary gland is located at the base of
2. Head injury the brain.
3. Stroke Hypopituitarism is the hyposecretion of
4. Autoimmune pituitary hormones.
5. Encephalitis Hormones that may be affected:
1. Growth hormone (GH)
2. Luteinizing hormone (LH) and follicle-
stimulating hormone (FSH)
3. Thyroid-stimulating hormone (TSH)
Signs and Symptoms 4. Adrenocorticotropic hormone (ACTH)
Signs and symptoms depend 5. Anti-diuretic hormone (ADH)
on the hormone affected.
Growth Hormones: Diagnostic Tests

1. Obesity, Decreased BP 1. Blood test: Hormonal level
TSH
2. ACTH stimulation test
1. Obesity, Fatigue,
decrease BP 3. CT Scan
ACTH 4. MRI
1. Sexual dysfunction
Gonadotropins
1. Sexual dysfunction
ADH
1. Low BP, Decreased CO Nursing Management
1. Daily weights
Treatment 2. Hormonal replacement may be
Pharmacology prescribed
3. Provide emotional support
1. Hormone replacement
4. Allow patient to verbalize feelings
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Disease: Hyperpituitarism/ Acromegaly Pituitary

1. Pituitary Tumors Pituitary gland is located at the base of
the brain.
Hyperpituitarism is caused by the
hypersecretion of growth hormone.
Signs and Symptoms

1. Enlarged Organs
2. Large hands and feet
3. Hypertension
4. Cardiomegaly
Diagnostic Tests
1. Oral Glucose Tolerance Test
5. Oily skin
2. IGF-1
6. Diaphoresis
3. CT Scan
7. Hyperglycemia
8. Husky-sounding voice 4. MRI
9. Sleep apnea
10. Joint pain
Nursing Management
1. Administer medication
Treatment 2. Prepare patient for hypophysectomy if
Pharmacology applicable
1. Growth Hormone
4. Pain management
Receptor Antagonist
1. Hypophysectomy:
removal of pituitary
tumor
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Disease: Diabetes Insipidus Pituitary

1. Stroke Diabetes Insipidus is characterized by the
2. Trauma hyposecretion of ADH. This results in
3. Craniotomy abnormal increase in urine output.
Remember: Antidiuretic hormone (ADH)

causes the kidneys to release less water.
If ADH level is low, there is an increase in
water loss.
Signs and Symptoms
1. Polyuria
2. Diluted urine
3. Dry mucous membranes
4. Postural hypotension
Diagnostic Tests
1. Water deprivation test
5. Tachycardia
2. Increased BUN
6. Low urinary specific
3. Low urinary specific gravity
gravity
7. Headache
8. Body weakness
9. Fatigue
Nursing Management
1. Monitor fluids and electrolytes
Treatment 2. Monitor weights
Pharmacology 3. Monitor intake and output
4. Monitor skin integrity
1. Desmopressin
5. Administer hypotonic saline (IV)
acetate/Vasopressin 6. Administer medications as prescribed
IV Therapy
1. IV hypotonic saline
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Disease: SIADH Pituitary

1. Stroke Syndrome of Inappropriate Antidiuretics
2. Trauma Hormone Secretion (SIADH) is the secretion
3. Lung disease of ADH in excess levels. This results in
water retention.
Remember: Antidiuretic hormone (ADH)

causes the kidneys to release less water.
If ADH is high, there is an increase in water
retention.
Signs and Symptoms
1. Fluid overload
2. Weight gain
3. Hypertension Diagnostic Tests
4. Hyponatremia 1. Urine osmorality
5. Tachycardia 2. Serum Sodium levels
6. Concentrated urine
7. Low urinary output
8. Nausea/Vomiting
Nursing Management
1. Monitor BP/P
Treatment 2. Monitor serum Na levels
Pharmacology 3. Initiate seizure precautions
1. Loop diuretics 4. Restrict fluid intake
5. Monitor weights
2. Vasopressin
6. Elevate HOB
antagonists 7. Administer medications as
prescribed
SKELETAL DISORDERS
TABLE OF CONTENT
1. Gout
2. Rheumatoid Arthritis
3. Osteoarthritis
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Disease: Gout Skeletal

1. Diet Gout is a systemic disorder characterized
2. Obesity by elevated uric acid and urate crystals
3. Kidney disease that accumulate deposits in the joints and
other body tissues.
Stages
1. Asymptomatic stage
2. Acute Gouty arthritis
3. Chronic Gout
Signs and Symptoms
1. Joint pain (Intense) Complications: Kidney stones
2. Inflammation
3. Swelling and redness Diagnostic Tests
4. Low grade fever 1. Uric acid level
5. Pruritus
2. X-ray imaging
6. Tophi
3. Joint fluid test
Nursing Management
1. Assess ROM
Treatment 2. Diet: low-purine
Pharmacology 3. Encourage fluid intake
(2000mL/day)
1. Analgesics
4. Administer medications
2. Anti-inflammatory 5. Provide comfort and
Agents nonpharmacologic interventions
3. Uricosuric Agents
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Disease: Rheumatoid Arthritis Skeletal

1. Higher risk in women Rheumatoid Arthritis is an autoimmune
2. Age: Onset is most disorder.
frequent between the The immune system attacks the joints,
ages of 40-50 leading to dislocation and permanent
deformity.
Signs and Symptoms

1. Joint stiffness
2. Joint tenderness
3. Joint deformity
4. Pain (moderate to
Diagnostic Tests
1. Xray
severe)
5. Rheumatoid nodules 2. Rheumatoid Factor: Blood test
6. Fatigue
(Negative or <60 units/mL)
7. Fever
8. Weight loss
Nursing Management
1. Assess pain
Treatment 2. Administer medications as prescribed
Pharmacology 3. Assess ROM
1. NSAIDs 4. Provide nonpharmacologic pain
2. Glucocorticoids management such as positioning, heat
3. DMARDs: Disease- or cold therapy.
modifying antirheumatic 5. Assess and assist patient with self care
drugs 6. Promote energy conservation
Surgical Intervention 7. Pre and post operative care if applicable
A surgical intervention
would be recommended
to restore function.
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Disease: Osteoarthritis Skeletal

1. Aging Osteoarthritis is the most common
2. Obesity form of arthritis.
3. Genetics Osteoarthritis causes deterioration of
joint cartilage.
Signs and Symptoms

1. Joint pain
2. Joint stiffness
3. Crepitus Diagnostic Tests
4. Swelling 1. MRI
5. Limited ROM
2. Joint fluid analysis
Temperature affects
symptom severity.
Nursing Management
1. Assess pain
Treatment 2. Administer medications as
Pharmacology prescribed
1. NSAIDs 3. Assess ROM
2. Acetaminophen 4. Provide non-pharmacologic pain
3. Muscle relaxant management
Therapy 5. Encourage balance between rest
1. Physical therapy and physical therapy (low impact
Surgical Intervention:
exercises).
May be required
HEMATOLOGY DISORDERS
TABLE OF CONTENT
1. Iron Deficiency Anemia
2. Thrombocytopenia
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Disease: Iron Deficiency Anemia Hematology

1. Diet Iron deficiency anemia is characterized by
2. Blood loss (GI bleeds) insufficient iron which leads to depletion of
3. Pregnancy red blood cells. This results in decreased
4. Mensuration hemoglobin and decreased oxygen-
5. Inability to absorb iron carrying capacity of the blood.
Signs and Symptoms

1. Fatigue
2. Pallor
3. Brittle nails
Diagnostic Tests
1. CBC
2. Hematocrit
3. Hemoglobin
4. RBC size: smaller
5. Serum iron levels
6. Stool testing
7. Ferritin
Nursing Management
1. Administer Iron supplements as
Treatment prescribed (Oral, IM or IV)
1. Iron supplement 2. Educate patient on the side effects of
2. Treatment of underlying iron supplements: Constipation and black
cause stools
3. Diet: Iron-rich foods 3. Educate patient on iron-rich diet/foods
4. Educate patient to increase vitamin C
consumption in their diet
5. Educate patient to take liquid iron
supplements with a straw to prevent
teeth staining.
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Disease: Thrombocytopenia Hematology

1. Bone marrow disease Platelets (thrombocytes) stops bleeding by
2. Autoimmune disease clumping and forming plugs in the blood
vessel injury site.
3. Splenomegaly
4. Alcoholism Thrombocytopenia is a condition
5. Anemia characterized by low blood platelet count.
Causes:
1. Platelet destruction: autoimmune
2. Platelet sequestration: trapped platelet
Signs and Symptoms in the spleen (enlarged spleen)
3. Decreased platelet production: bone
1. Easy bruising (Purpura) marrow disease.
2. Petechia
3. Prolonged bleeding time
4. Bleeding gums
Diagnostic Tests
1. Platelet count: <150,000
5. Epistaxis (Nose bleeds)
2. Increase INR & PT/PTT
6. Blood in urine or stools
3. Physical examination and patient
7. Heavy menstrual flows
history
Nursing Management
1. Monitor lab values
Treatment 2. Monitor INR, PT/PTT
1. Platelet transfusions 3. Use electric razors
2. Corticosteroid treatment 4. Avoid anticoagulants, aspirin and
3. Bone marrow transplant. thrombolytics
5. Protect patient from falls/injury
REPRODUCTIVE DISORDERS
TABLE OF CONTENT
1. PCOS
2. Endometriosis
3. Pelvic Inflammatory Disease
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Disease: PCOS Reproductive

1. Excess androgen Polycystic ovary syndrome (PCOS) is a
2. Heredity hormonal disorder characterized by excess
androgen levels.
The ovaries may develop follicles.
Signs and Symptoms

1. Diabetes
2. Infertility
3. Sleep apnea Diagnostic Tests
4. Irregular periods 1. Pelvic examination
5. Polycystic ovaries 2. Ultrasound
Nursing Management
1. Educate patient on the importance
Treatment of
1. Diet a. Weight loss
2. Weight loss b. Low fat diet
3. Metformin c. Medication adherence
4. Oral contraceptives d. Glucose monitoring
5. Anti-androgens
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Disease: Endometriosis Reproductive

1. No known cause Endometriosis occurs when the tissues
lining the uterus grows outside the uterus.
With endometriosis, the tissues outside
the uterus thickens, breaks down and
bleeds with each menstrual cycle.
Signs and Symptoms

1. Dysmenorrhea
2. Painful intercourse
3. Excessive bleeding
4. Infertility
Diagnostic Tests
1. Ultrasound
2. Laparoscopy
Nursing Management
1. Educate patient on
Treatment a. Pain management
1. Hormone therapy b. Anemia
2. Treatment of anemia c. Hormone therapy
1. Hysterectomy
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Disease: Pelvic Inflammatory Disease Reproductive

1. Being sexually active Pelvic inflammatory disease (PID) is an
2. Having multiple infection of the female reproductive
partners organs
3. Unprotected
intercourse
Signs and Symptoms

1. Fever
2. Pelvic pain
3. Increased vaginal Diagnostic Tests
discharge 1. WBC/Urinalysis
2. Medical history
3. Ultrasound
4. Laparoscopy
Nursing Management
1. Educate patient on
Treatment a. Antibiotic regimen
1. Antibiotics b. Protected intercourse
2. Treatment for partner c. Treatment of partner
3. Temporary abstinence d. Temporary abstinence
until treatment is
complete
REPRODUCTIVE DISORDER
TABLE OF CONTENT
1. Varicocele
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Disease: Varicocele Reproductive

1. No known risk factors Varicocele is the enlargement of the veins
that transport oxygen-depleted blood
away from the testicles.
Signs and Symptoms

1. Dull pain in scrotum
2. Varicocele may be
visible Diagnostic Tests
3. Swelling 1. Physical examination
2. Scrotal Ultrasound
Nursing Management
1. Educate patient to
Treatment a. Wear athletic supporter to
Treatment depends on relieve pressure
the severity and
complications
PART 3
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Table of Content
1. integumentary Disorders
2. DISORDERS OF THE EYES
3. dISORDERS OF THE EARS
4. cancers
5. IMMUNE DISORDERS
6. skeletal disorders
7. PERIPHERAL VASCULAR DISORDERS

INTEGUMENTARY
TABLE OF CONTENT
1. pressure ulcers
2. psoriasis
3. acne vulgaris
4. skin cancer
5. frostbite
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Disease: PRESSURE ULCERS SKIN

1. Malnutrition Pressure ulcers- skin integrity is impaired
2. Friction
due to prolonged pressure.
3. Pressure
4. Shear
5. Prolonged immobility
6. Lack of sensory perception
7. Incontinence
Signs and Symptoms

Stage I
Skin remains intact, redness
Stage II
Partial-thickness loss of the
epidermis and some of the dermis
Stage III Diagnostic Tests
Full-thickness loss of the dermis &
subcutaneous tissue. 1. Skin assessment
Stage IV
Full-thickness loss of the skin
(muscle, bone and tendons are
exposed). Slough, eschar,
undermining and tunneling may
be present.
Suspected Deep-Tissue Injury
Localized area of skin is
discolored. Skin feels "boggy".
Skin is intact but there is ischemic
subcutaneous tissue injury below
skin.
Unstageable Nursing Management
Full-thickness tissue loss covered Prevention
by eschar/necrotic tissue/slough
1. Assess patients at risk for developing pressure
ulcers
Treatment 2. Assess skin integrity
1. Wound care- to promote 3. Initiate measures to prevent the development
wound healing of ulcers: adequate nutrition, positioning and
turning immobilized patients every 2 hours,
2. Pain management passive/active ROM exercises, pressure relief
3. Adequate nutrition devices, keeping patient skin dry, preventing
wrinkled sheets, using lotions to keep skin
lubricated
Nursing Interventions
1. Assess wound (location, size, type/amount of
exudate, undermining, tunneling)
2. Provide appropriate wound care (wound
dressing, debridement, skin grafting)
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Disease: PSORIASIS SKIN

1. Stress A chronic, inflammatory skin disorder
2. Infection that causes rapid buildup of skin cells.
3. Weather
4. Skin injury
5. Autoimmune reaction
Signs and Symptoms

1. Itchy skin (Pruritus)
2. Red patches of skin
3. Silvery-white scales Diagnostic Tests
4. Joint pain observed with 1. Skin assessment
psoriatic arthritis 2. Skin biopsy
Nursing Management
Patient education
1. Educate patient on medication regimen
Treatment 2. Educate the patient to avoid scratching
Pharmacology 3. Provide emotional support
1. Topical Corticosteroids
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Disease: ACNE VULGARIS SKIN

1. Excess sebum A chronic skin disorder characterized
production by skin lesions (usually begins at
2. Bacteria puberty).
3. Inflammation Types
1. Comedones
2. Nodules
Signs and Symptoms 3. Papules
1. Whiteheads (closed 4. Pustules
comedones)
2. Blackheads (open Diagnostic Tests
comedones) 1. Skin assessment
3. Painful, red and pus-
filled (Cystic acne)
4. Painful lumps deep
under the skin (nodules)
5. Red small bumps
(papules)
6. Red small bumps with Nursing Management
pus (Pustules) Patient education
1. Educate patient on the use of
Treatment
Treatment goals: oral and topical medications
1. Avoid or lessen skin 2. Educate patient to avoid
damage squeezing the lesions
2. Acne control
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Disease: SKIN CANCER SKIN

1. Excessive sun exposure Skin cancer is the abnormal
2. Exposure to radiation
(malignant) growth of skin cells.
3. Family history of skin
cancer
Types:
1. Basal cell carcinoma
2. Squamous cell carcinoma
Signs and Symptoms 3. Melanoma.
Basal cell carcinoma
1. Pearly, waxy nodule
Squamous cell carcinoma Diagnostic Tests
1. Red nodule 1. Skin assessment
2. Rough, reddish scaly
patch 2. Skin biopsy
3. Oozing/bleeding
Melanoma
1. Irregular border
2. Color: black, brown,
and tan Nursing Management
3. Circular Prevention
1. Educate patient on the causes/risk
Treatment
Surgical interventions:
factors
1. Cryosurgery 2. Educate patient on preventative
2. Curettage practices (sunscreen, wearing
3. Electrodesiccation protective clothing, self assessment
4. Excisional surgery and reporting skin changes)
Other nursing interventions:
1. Provide nursing care for surgical/
nonsurgical interventions
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Disease: FROSTBITE SKIN

1. Cold weather Skin cell and tissue damage caused
by prolonged exposure to extreme
low temperatures.
Areas mostly affected:
1. Fingers
2. Toes
Signs and Symptoms 3. Nose
First-degree 4. Ears
Skin redness + edema
Second-degree Diagnostic Tests
Fluid-filled blisters 1. Skin assessment
Third-degree
Blood-filled blisters +
eschar formation
Fourth-degree
Full-thickness necrosis
Nursing Management
1. Rewarming the area affected
2. To prevent tissue damage, avoid
Treatment
1. Rewarming of the skin massaging the area
2. Protecting skin- sterile 3. Monitor for signs of complications
dressing applied loosely
(compartment syndrome)
Pharmacology 4. Administer medications
1. Analgesics
2. Tetanus prophylaxis
3. Antibiotics Patient education
Other treatment depending on
severity:
1. Educate patient on preventative
1. Debridement practices
2. Amputation
EYES
TABLE OF CONTENT
1. legal blindness
2. cataract
3. glaucoma
4. retinal detachment
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Disease: LEGAL BLINDNESS EYES

1. Eye trauma Vision is 20/200 or less in the better eye
2. Diabetic retinopathy or field of vision is less than 20 degrees.
3. Cataracts
4. Glaucoma
5. Age (macular
degeneration)
Signs and Symptoms

1. Inability to see (Vision is
20/200 or less in the
better eye or field of Diagnostic Tests
vision is less than 20 1. Visual acuity test
degrees) 2. Visual field test
Nursing Management
1. Orient the patient to the environment
(using a focal point and allowing the
Treatment patient to touch objects)
1. Patient education on 2. Speak to the patient in a normal tone
adaptive products and 3. Ensure that you alert the patient when
learning new skills approaching (and introduce yourself)
4. Assess patient's level of independence
5. Educate patient on the proper use of a
cane
6. Assist patient during ambulation
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Disease: CATARACTS EYES

1. Congenital cataracts Cataract is the clouding or opacity of
2. Traumatic cataracts-due to
injury the lens of eye.
3. Senile cataracts- due to
age
4. Secondary cataracts-
arising from another eye
disease
Signs and Symptoms

Early signs
1. Blurred vision
Late signs Diagnostic Tests
1. Double vision 1. Visual acuity test
2. White pupils 2. Retinal exam
3. Vision loss-gradual 3. Slit Lamp
Nursing Management
1. Assess patient's visual acuity
2. Prepare patient for cataract surgery
Treatment Medications: Cycloplegics & Mydriatics
1. Cataract surgery 3. Postoperative care:
Position: Semi-Fowler's
Preoperative Medications Assist patient during ambulation
1. Cycloplegics & Mydriatics Provide patient safety
(ophthalmic medications Maintain eye patch
that are used to dilate 4. Patient education
the pupil) Avoid lifting heavy objects
Postoperative medications Avoid eye straining & pressure
1. Antibiotic eye drops Prevent constipation
2. NSAID eye drops Medication adherence (eye drops)
The use of sunglasses
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Disease: GLAUCOMA EYES

1. >60 years of age Glaucoma (a group of eye diseases) is characterized
by increased intraocular pressure (IOP) and
2. Family history subsequently, damage to the optic nerve.
3. increased IOP
4. Diabetes, HTN In glaucoma, there is fluid buildup which causes
increased eye pressure (due to inadequate
drainage of aqueous humor or overproduction of
aqueous humor)
Normal eye pressure (IOP): 10-21 mm Hg
Complication: blindness
Signs and Symptoms Types:
1. Open-angle glaucoma: most common
Open-angle glaucoma 2. Closed-angle glaucoma- AN EMERGENCY
1. No pain
2. Tunnel vision Diagnostic Tests
Closed-angle glaucoma 1. Tonometry: to measure IOP
1. Eye pain 2. Visual acuity test
2. Blurred vision 3. Gonioscopy: observe drainage
3. Eye redness angle
4. Halos around lights 4. Pachymetry: measure the
Other s/s thickness of the eye's cornea.
1. Increased IOP
Nursing Management
1. Educate patient of the importance of
medication adherence (life-long use)
Treatment 2. Educate patient to avoid
Glaucoma damage cannot be
reversed. Anticholinergic medication
The treatment goal is to
1. prevent complication (vision loss) 3. Educate patient to report any vision
and
2. lower intraocular pressure changes + other developing symptoms
Pharmacology
a. Miotics: cause the pupil to 4. Remember to treat closed-angle
constrict
b. Beta-blockers: decrease IOP glaucoma as a medical emergency
c. Carbonic anhydrase
inhibitors: reduce the
production of fluid in the eye
Surgical Management
1. Trabeculectomy
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Disease: RETINAL DETACHMENT EYES

1. Trauma Retinal detachment is the separation of
2. Hemorrhage the retina from the epithelial layer.
3. Aging Complete retinal detachment results in
4. Family history blindness.
5. Myopia
Signs and Symptoms

1. Blurred vision
2. Photopsia- flashes of
light Diagnostic Tests
3. Floating spots 1. Retinal examination
4. The feeling of curtain-
like shadow blocking
portion of the visual
5. Loss of peripheral vision
Nursing Management
1. Providing a calm environment
2. Encouraging bed rest
Treatment 3. Patch both eyes as prescribed
Surgical management: 4. Ensure patient safety
5. Patient education: avoid touching the
The goal is to repair the
eyes, medication adherence, avoid
retina detachment. straining activities
The surgical interventions Postoperative management
include: 1. Patch both eyes as prescribed
1. Scleral buckling 2. Monitor for any complications
2. Laser surgery 3. Encourage bed rest
3. Cryosurgery 4. Prevent straining activities that can
4. Diathermy increase IOP
5. Educate patient to follow up & at home
eye care
EARS
TABLE OF CONTENT
1. Otitis media
2. External otitis
3. Meniere's Disease
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Disease: OTITIS MEDIA EARS

1. Age (children) Otitis media is an
2. Infant feeding (Bottle- infection/inflammation of the middle
fed) ear (common among children)
Signs and Symptoms

1. Ear pain
2. Fever
3. Fluid drainage from Diagnostic Tests
ears 1. Ear examination using an
4. Loss of balance otoscope
5. Hearing difficulties 2. Pneumatic otoscope
6. Tugging on ear 3. Tympanometry
(children)
7. Irritability (children)
Nursing Management
1. Position child sitting upright
(Fowler's) or on unaffected side
Treatment 2. Encourage mothers to breastfeed
1. Pain management
baby
2. Antibiotic therapy
3. For bottle-fed babies, educate
mother to position baby upright
during feeding
4. Educate mother/adult patient on
antibiotic therapy adherence
5. Monitor for signs of complications
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Disease: EXTERNAL OTITIS EARS

1. Age (common in children) Infection of the structure of the
2. Allergies
external ear canal (common among
3. Skin conditions (eczema
children)
or psoriasis)
4. Injury to ear
5. Irritants: hair spray, etc
Signs and Symptoms

1. Pain
2. Redness
3. Edema Diagnostic Tests
4. Ear Tenderness 1. Ear inspection
5. Blocked ear
6. Itching
7. Exudate
Nursing Management
1. Administer medications as prescribed
2. Provide a calm environment & promote
Treatment rest.
Pharmacology
3. Provide non-pharmacologic pain
1. Antibiotics
2. Corticosteroids
management (apply heating pad to
3. Analgesics affected ear)
4. Educate patient to avoid irritants
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Disease: MENIERE'S DISEASE EARS

1. The cause is unknown Meniere's disease is a disorder of the
2. Infection
inner ear caused by the
3. Genetics
overproduction or decreased
absorption of endolymphatic fluid.
Signs and Symptoms

Major Signs and Symptoms
1. Vertigo-dizziness
2. Uni-lateral Diagnostic Tests
sensorineural hearing 1. Medical history to assess the
loss signs and symptoms
3. Tinnitus-ringing in the 2. Audiometric testing
ear
Other Signs and Symptoms
1. Headaches
2. Nausea and vomiting Nursing Management
1. Provide patient safety
2. Provide a calm environment and bed
Treatment rest
There is no cure. Care provided is 3. Administer prescribed medications
supportive.
(see treatment)
Pharmacology: 4. Low salt diet and fluid restriction as
1. Antihistamines
2. Diuretics prescribed
3. Antiemetics 5. Provide pre and post operative care
4. Tranquilizers 5. Anticholinergics Patient Education
Diet:
1. Low salt diet 1. Low salt diet
2. Avoid alcohol, smoking and caffeine
Surgical Management:
1. Labyrinthectomy
2. Endolymphatic sac, or shunt,
surgery
CANCER
TABLE OF CONTENT
1. cancer
2. pain
3. breast cancer
4. endometrial cancer
5. ovarian cancer
6. cervical cancer
7. testicular cancer
8. prostate cancer
9. bladder cancer
10. pancreatic cancer
11. gastric cancer
12. lung cancer
13. leukemia
14. lymphoma
15. multiple myeloma
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Disease: CANCER CANCER

1. Genetics Cancer is characterized by abnormal
2. Prolonged sun exposure growth of cells (cells mutate + change in
3. Diet their morphology), whereby it
4. Smoking
proliferates and can metastasize.
5. Chemical + radiation
6. Pollutants
7. Or no known cause
Signs and Symptoms
1. C-hanges in bladder or
bowel
2. A-sore that doesn’t heal
3. U-nusual bleeding or
Diagnostic Tests
discharges 1. Biopsy
4. T-hickening or lumps 2. Physical examination
5. I-ndigestion
6. O-bvious changes in the 3. Imaging: CT scan, MRI, Ultrasound
skin 4. Lab test: Urinalysis, CBC
7. N-agging cough or
hoarseness
8. U-nexplained anemia
Nursing Management
9. S-udden weight loss
1. Initiate infection control
2. Treatment of nausea and vomiting
Treatment 3. Patient education on surgical and non
1. Chemotherapy
surgical interventions
2. Radiation therapy
4. Monitor adverse effects of
3. Surgery
4. Hormone therapy chemotherapy and radiation therapy
5. Pre and post operative care
7. Pain management
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Disease: PAIN CANCER

1. Inflammation According to the International
2. Psychological factors Association for the Study of Pain, pain is
3. Compression of nerves an unpleasant, subjective sensory and
4. Obstruction of an organ
emotional experience associated with
actual or potential tissue damage, or
described in terms of such damage.
Signs and Symptoms

The best indicator of pain is
through verbalization since it
is a subjective experience Diagnostic Tests
1. Pain assessment tools
Behavioral & Physiologic
Indicators of Pain
1. Facial grimace
2. Crying/screaming
3. Clench eyes
4. Guarding
5. Vital signs: Increased HR, Nursing Management
BP, RR 1. Assess pain
2. Assess the underlying cause of pain
Treatment 3. Provide pharmacologic pain
Treat the underlying cause management as prescribed
of pain. (analgesics, opioids)
a. Physical- positioning
b. Environmental- dimming lights,
providing a calm environment
c. Cognitive technique- Guided
imagery
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Disease: BREAST CANCER CANCER

1. Age (older women) Breast cancer is the most common type
2. Gender-women of cancer diagnosed among women.
3. Family history of Breast cancer common sites of
breast cancer metastasis are the lungs, bone, liver,
and the brain.
Signs and Symptoms

1. Mass-firm irregular mass
that is painless (located
in the upper outer
quadrant of the breast)
Diagnostic Tests
2. Asymmetry of the breast 1. Breast examination
3. Nipple discharge (blood 2. Mammography
or clear)
4. Lymphedema 3. Breast biopsy
5. Skin changes over the
breast- dimpling
6. Scaling & peeling of the
skin around areola
Nursing Management
7. Orange skin over breast 1. Patient education on surgical and non
Treatment 2. Monitor adverse effects of chemotherapy
Early detection: and radiation therapy
1. Patient education on 3. Provide emotional support
Breast-self examination For postoperative interventions
Other interventions: 1. Monitor vital signs
1. Chemotherapy 2. Encourage deep breathing and coughing
2. Radiation therapy 3. Monitor for signs of infection
Surgical Interventions: 4. Drainage management if any
1. Lumpectomy 5. Patient education: home care and follow
2. Mastectomy
up care
3. Mammoplasty
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Disease: ENDOMETRIAL CANCER CANCER

1. Older age Cancer of the uterus. Endometrial
2. Obesity cancer begins from the endometrium
3. Family history of of the uterus.
endometrial cancer
Common sites of metastasis: ovaries,
4. Hormone therapy
pelvis, lungs, liver and bone.
5. Polycystic ovary disease
Signs and Symptoms

1. Postmenopausal
bleeding
2. Pelvic pain-late sign Diagnostic Tests
3. Enlarged uterus 1. Endometrial biopsy
4. Vaginal discharge 2. Hysteroscopy
Nursing Management
1. Patient education on surgical and non
Treatment 2. Providing emotional support
1. Chemotherapy
3. Hormone therapy 4. Patient education: home care and
follow up plan
1. Total abdominal
hysterectomy (removal of
the uterus) and bilateral
salpingo-oophorectomy
(removal of both of the
fallopian tubes and ovaries)
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Disease: OVARIAN CANCER CANCER

1. Older age Ovarian cancer arises from the ovaries
2. Family history and has a higher mortality rate.
3. Endometriosis Ovarian cancer grows rapidly and
4. Obesity
spreads quickly.
Signs and Symptoms

1. Abdominal swelling
2. Abdominal
discomfort Diagnostic Tests
3. Constipation (and 1. Elevated CA-125 (tumor marker)
other GI 2. Exploratory laparotomy
disturbances) 3. Transvaginal ultrasound
4. Weight loss
Nursing Management
1. Patient education on surgical and non
1. Chemotherapy
4. Supportive and palliative care
1. Total abdominal
hysterectomy and
bilateral salpingo-
oophorectomy
Palliative care
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Disease: CERVICAL CANCER CANCER

1. HPV-Human The cervix connects the vagina and
papillomavirus uterus. Cervical cancer arises from the
2. Early sexual activity cervix.
3. Smoking
Common sites of metastasis is confined
4. Multiple sexual partners
in the pelvis or can occur via lymphatic
spread
Signs and Symptoms
1. Vaginal discharge
(foul odor)
2. Painful urination Diagnostic Tests
(Dysuria) Screening:
3. Blood in urine 1. Pap test
(hematuria) Diagnostic tests
4. Pelvic pain 1. Colposcopic examination
5. Weight loss 2. Biopsy
Nursing Management
1. Patient education on surgical and non surgical
interventions
1. Chemotherapy 3. Pre and post operative care
2. Laser therapy Hysterectomy
3. Radiation
4. Cryosurgery 1. Monitor vital signs
2. Encourage patient to perform deep breathing
Surgical Management
1. Hysterectomy-removal of the exercises
uterus 3. Monitor vaginal bleeding
2. Conization- removal of the Pelvis exenteration
cylindrical part of the cervix
3. Pelvis exenteration-removal of 1. Educate patient on ileal conduit and
organs from the urinary, colostomy
gastrointestinal, and 2. Sexual counseling
reproductive system.
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Disease: TESTICULAR CANCER CANCER

1. History of cryptorchidism Testicular cancer arises from the
2. Age (men between 15- testicles.
35) Common sites of metastasis: liver,
3. Family history
lungs, bone and adrenal glands.
Signs and Symptoms

1. Swelling of the
testicles
2. The sensation of Diagnostic Tests
Early detection:
heaviness in the
1. Testicular self-examination
scrotum
Diagnostic tests:
Late signs 1. Testicular ultrasound
1. Abdominal mass 2. Blood test- determine levels of tumor
2. Respiratory markers
symptoms
Nursing Management
3. Bone pain 1. Patient education on surgical and non surgical
interventions
1. Chemotherapy 3. Pre and post operative care
2. Radiation therapy Post operative care
Surgical Management
1. Radical inguinal 2. Monitor for signs of bleeding
orchiectomy- removal of a 3. Monitor for signs of infection
testicle 4. Pain management
2. Retroperitoneal lymph Patient education
node dissection- removal 1. Reproductive health/options
of lymph nodes
2. Avoid heavy lifting
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Disease: PROSTATE CANCER CANCER

1. Age (>50) Prostate cancer is cancer that occurs in
2. Family history the prostate.
3. Smoking Common sites of metastasis:
4. Hx of STI
surrounding tissues + through the
lymphatics and blood vessels (bone,
liver, lungs & kidneys).
Signs and Symptoms
1. Hematuria
2. Nocturia
3. Urinary retention Diagnostic Tests
1. Digital rectal exam
4. Increased urinary
2. Prostate-Specific Antigen will be
frequency
elevated (but also in BPH. Further
5. Urinary hesitancy testing needs to be done)
3. Transrectal ultrasound
4. Biopsy of prostate gland
Nursing Management
1. Monitor urinary output (red to light pink
urine would be seen for 24 hours) + monitor
Treatment for excessive bleeding
1. Chemotherapy 2. Monitor vital signs
2. Radiation therapy 3. Encourage increase fluid intake
3. Hormone therapy 2000mL/day to 3000 mL/day
4. Maintain continuous bladder irrigation-as
Surgical Management
indicated
1. Prostatectomy
5. Medications such as antibiotics & analgesics
2. Orchiectomy- removal of
testicles should be administered as prescribed.
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Disease: BLADDER CANCER CANCER

1. Family history Papillomatous growth in the bladder
2. Smoking urothelium that progress to
3. Older age malignancy.
4. Gender-males Common sites of metastasis: bone,
liver & lungs
Signs and Symptoms

1. Hematuria
2. Painful urination
(Dysuria) Diagnostic Tests
3. Urinary frequency 1. Cystoscopy
4. Urinary hesitancy 2. Biopsy
Nursing Management
1. Provide preoperative care
2. Educate patient on the post surgical
Treatment interventions.
1. Chemotherapy Postoperative care
2. Radiation therapy 1. Assess: stoma, incision site, bowel
function
Surgical Management 2. Monitor: urinary output, vital signs, signs
1. Transurethral resection of
bladder tumor (TURBT)
of complication (shock, hemorrhage,
2. Cystectomy peritonitis), skin integrity around
3. Ileal conduit drainage
4. Neobladder reconstruction 3. Notify physician: necrosis of the stoma,
5. Kock pouch urine output is less than 30mL/hr
6. Indiana pouch 4. Maintain NPO status as prescribed
7. Ureterostomy
8. Vesicostomy 5. Provide emotional support
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Disease: PANCREATIC CANCER CANCER

1. Diabetes Pancreas cancer arises from the
2. Smoking pancreatic tissues (pancreatic ductal
3. Older age adenocarcinoma- the most common
4. Family history type of pancreatic cancer)
Signs and Symptoms

1. Jaundice
2. Weight loss
4. Stools- clay colored 1. Elevated tumor marker- CA19-9
5. Urine- dark colored 2. An endoscopic ultrasound
6. Nausea and vomiting
Poor prognosis
Nursing Management
1. Provide preoperative care
2. Educate patient on the post surgical
Treatment interventions.
1. Chemotherapy
2. Radiation therapy Postoperative care
1. Monitor blood glucose levels
Surgical Management 2. Pain management
1. Pancreaticoduodenectomy
-Whipple procedure
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Disease: GASTRIC CANCER CANCER

1. H. pylori infection Gastric cancer is the malignant growth
2. Smoking of cells in the stomach.
3. Gastric ulcers/gastritis Complications
4. Alcohol 1. Dumping syndrome
5. Men 2. Hemorrhage
6. Diet 3. Metastasis
Signs and Symptoms
Initial symptoms
1. Dyspepsia
2. Gastric fullness/bloated Diagnostic Tests
3. Epigastric pain 1. Endoscopy
4. Indigestion 2. Biopsy
Late symptoms
1. Weight loss
2. Nausea/vomiting
3. Body weakness
4. Gastric obstruction
Nursing Management
5. Ascites 1. Monitor: VS, hematocrit and
hemoglobin
Treatment 2. Administer vitamin supplements
1. Chemotherapy
3. Pain management
Postoperative management
3. Palliative care
1. Position: Fowler's
2. Administer parenteral Nutrition as
Surgical Management
prescribed
1. Gastrectomy
3. Monitor : NG suction, intake and
output
4. Maintain NPO status
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Disease: LUNG CANCER CANCER

1. Smoking Lung cancer is also known bronchogenic
2. Air pollutant cancer. Bronchogenic cancer originate
3. Family history in the epithelium of the bronchus.
Types:
1. Squamous cell
2. Adenocarcinoma
Signs and Symptoms 3. Small cell lung cancer (SCLC)
1. Cough 4. Non-small cell lung cancer (NSCLC)
2. Dyspnea
3. Wheezing Diagnostic Tests
4. Blood-tinged sputum 1. Chest x-ray
5. Weight loss 2. CT scan
6. Decreased breath 3. MRI
sounds 4. Fiberoptic bronchoscopy
7. Fatigue/body weakness 5. Sputum cytology
8. Chest pain 6. Biopsy
9. Hoarseness
Nursing Management
2. Assess respiratory status
Treatment 3. O2 therapy
1. Chemotherapy 4. Positioning: Fowler's
3. Oxygen therapy
5. Administer medications
Pharmacology- analgesics, 6. Diet: high-protein, high-calorie diet.
expectorants, bronchodilators, 7. Provide a calm environment
corticosteroids
Surgical Management
1. Laser therapy Postoperative management
2. Thoracentesis- to remove pleural
fluid 1. Maintain patent airway
3. Pneumonectomy-removal of an 2. Monitor vital signs and respiratory status
entire lung
4. Lobectomy-removal of the entire 3. Chest tube management
lobe of one lung 4. O2 therapy
5. Segmental resection
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Disease: LEUKEMIA CANCER

1. No known cause Leukemia is a type of cancer that affects the white
blood cells and the bone marrow due to the abnormal
2. Risk factors: genetics, overproduction of leukocytes.
exposure to chemicals Because leukemia affects the bone marrow, there is an

underproduction of red blood cells, platelets (and
overproduction of immature leukocytes). This therefore
causes anemia, leukopenia, thrombocytopenia and
increased risk for infections due to low immunity.
Types of leukemia:
1. Lymphocytic
2. Myelocytic/myelogenous
Signs and Symptoms Classification
1) Acute Lymphocytic Leukemia 2) Acute Myelogenous
1. Fever & frequent Leukemia 3) Chronic Myelogenous Leukemia 4) Chronic
infections Lymphocytic Leukemia
2. Easy bleeding and
Diagnostic Tests
bruising
3. Petechiae
1. CBC
4. Anemia 2. Bone marrow aspiration and biopsy
5. Pallor, body weakness,
fatigue and weight loss
6. Enlarged liver, spleen
and lymph nodes
7. Tachycardia,
hypotension, dyspnea Nursing Management
8. Bone pain Infection
1. Initiate infection precautions
2. Care for patient in a private room (protective
Treatment isolation)
1. Chemotherapy 3. Hand washing and strict aseptic technique
2. Radiation therapy 4. Monitor for signs of infection
5. Avoid invasive procedures
3. Transfusions of red 6. Avoid constipation, diarrhea and rectal trauma
blood cells and platelets 7. Administer antimicrobials
Bleeding
4. Bone marrow transplant 1. Monitor for signs of bleeding
2. Monitor lab values
3. Administer blood components
Pharmacology 4. Ensure patient's safety
1. Antibiotics, antifungal Nutrition
1. High calorie, high carbohydrates and high
and antiviral
protein
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Disease: LYMPHOMA CANCER

1. Viral infection Two types of lymphomas: Hodgkin's and
2. Family hx non-Hodgkin's
Lymphoma- cancer of the lymph nodes

and lymphocytes
Spreads through the lymphatic system

involving the lymph nodes, spleen and
Signs and Symptoms then through the blood stream.
1. Enlarged lymph nodes,
spleen and liver
2. Fever + chills Diagnostic Tests
3. Night sweats 1. Lymph node biopsy- shows the
4. Weight loss presence of Reed-sternberg giant
cell
2. CT scan
Nursing Management
1. Initiate infection & bleeding
precautions
Treatment 2. Monitor side effects due to
1. Chemotherapy
chemotherapy and radiation therapy
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Disease: MULTIPLE MYELOMA CANCER

1. No known cause Multiple myeloma is characterized by
2. Risk: Family hx cancerous plasma cells that accumulate
within the bone marrow.
The accumulation of plasma cells in the

bone marrow causes decrease
production of immunoglobulin and
antibodies.
Signs and Symptoms
1. Bone pain The cancerous plasma cells produces
2. Osteoporosis abnormal proteins.
3. Thrombocytopenia (low Diagnostic Tests
platelet count) 1. Blood tests
4. Leukopenia (low white 2. Urinalysis: shows Bence Jones
blood cell count) proteinuria
5. Anemia
3. Bone marrow aspiration
6. Frequent infections
4. Elevated calcium and uric acid
7. Fatigue
Nursing Management
1. Ensure patient's safety: monitor for
skeletal fractures (provide skeletal
Treatment support)
1. Chemotherapy
2. Initiate infection & bleeding precautions
3. Blood transfusion 3. Increase fluid intake
4. Administer medications (see treatment)
Pharmacology
1. Antibiotics Patient education
2. Analgesics
1. Signs and symptoms of an infection
3. Diuretics: increase the
2. Safety measures at home to prevent
excretion of Ca
4. Bisphosphonate: slow down fractures.
or prevent bone loss
IMMUNE
TABLE OF CONTENT
1. Allergy
2. Systemic Lupus Erythematosus (SLE)
3. Goodpasture's Syndrome
4. hiv/AIDS
5. Fever
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Disease: ALLERGY IMMUNE

1. Drugs Allergy: An immune response to a
2. Food foreign substance that triggers a
3. Insect reaction.
4. Airborne (pollen)
5. Latex
Latex allergy: hypersensitivity to
latex
Signs and Symptoms Anaphylactic shock: occurs due to a
1. Hives severe allergic reaction (drugs, food,
2. Itching skin insect bite, etc)
3. Sneezing Diagnostic Tests
4. Wheezing 1. Skin test
5. Tearing, red or swollen 2. Blood test
eyes 3. History taking
6. Swelling of the lips,
tongue, face or throat
Nursing Management
1. Identify and remove allergen
Treatment 3. Administer medications (see treatment)
Anaphylactic Reaction
Pharmacology 1. Remove allergen, maintain patent
1. Antihistamines airway
2. Corticosteroids 2. Monitor vital signs
3. Administer epinephrine promptly
3. Anti-inflammatory 4. Initiate 02 therapy
agents 5. Initiate IV therapy & monitor urine
output
Anaphylaxis: 6. Position: supine position with leg
1. Epinephrine elevated
Patient education
1. Educate patient to avoid allergen
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Disease: Systemic Lupus Erythematosus (SLE) IMMUNE

1. No known cause Systemic Lupus Erythematosus (SLE) is
Risk factors: a chronic, inflammatory autoimmune
1. Genetics disease where the body attacks
2. Environmental
healthy tissues.
3. Hormonal
4. Medications
Signs and Symptoms

1. Butterfly rash on the
face
2. Joint pain/swollen joints Diagnostic Tests
3. Fever
1. Positive antinuclear antibody (ANA)
4. Fatigue
2. Elevated erythrocyte
5. Sensitivity to sunlight
sedimentation rate and C-reactive
6. Weight loss
7. Hair loss protein level
8. Chest pain when 3. CBC
breathing 4. Urinalysis
9. Edema
Nursing Management
10. Raynaud’s phenomenon 1. Monitor skin integrity, signs of bruising and
bleeding, intake and output, signs of
Treatment complications, BUN and creatinine
There is no cure for SLE. The goal is to 2. Encourage deep breathing exercises.
control symptoms and provide 3. Pain management (pharmacologic and non-
supportive care when major organs pharmacologic management).
are affected.
Pharmacology 4. Administer medications (see treatment)
1. NSAIDs 5. Diet: high-iron, high-protein (unless
2. Topical corticosteroids contraindicated)
3. Systemic Corticosteroids
4. Immunosuppressants (for serious
cases) Patient Education
5. For anemia: iron, folic acid 1. Avoid prolong exposure to sunlight
6. Antimalarials 2. Healthy diet
(Hydroxychloroquine)
Pain management 3. Adequate rest
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Disease: Goodpasture's Syndrome IMMUNE

1. No known cause Goodpasture's syndrome is a rare,
Risk factors: autoimmune disease that forms
1. Genetics autoantibodies and attack the
2. Environmental factors
basement membranes of the lungs and
kidneys.
Signs and Symptoms

Lung-related symptoms:
1. Shortness of breath
2. Cough
Diagnostic Tests
3. Chest pain
1. Serum anti-GBM antibody tests
4. Hemoptysis (coughing up
blood) 2. Urinalysis
Kidney-related symptoms 3. CT scan, chest X-ray
1. Edema 4. Bronchoscopy
2. Weight gain 5. Kidney biopsy
3. Oliguria
4. Hematuria
5. Increased BP Nursing Management
6. Increased HR 1. Monitor respiratory status
2. Elevate head of bed
Treatment 3. Oxygen therapy as prescribed
Pharmacology
1. Corticosteroids
2. Immunosuppressant drugs
6. Monitor weights and I/O, creatinine
Plasma exchange
(plasmapheresis) and BUN
7. Diet: low protein diet
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Disease: HIV/AIDS IMMUNE

High risk groups: Acquired immunodeficiency syndrome
1. Use of IV drugs (AIDS) is a chronic illness caused by the
2. Multiple sexual human immunodeficiency virus (HIV) which
partners + unprotected attacks the T cells.
sex
3. Receiving blood Mode of transmission:
products 1. Sexual contact
2. Blood and blood products (& sharing of
needles)
Signs and Symptoms
3. Mother to baby- preventive treatment
Primary infection (Acute HIV)
Two to four weeks (up to 3 to reduce the risk of transmission.
months)
1. Flu-like illness Diagnostic Tests
Clinical latent infection (Chronic
HIV) 1. ELISA Test & Western Blot
1. Infected person do not have 2. Viral load: polymerase chain
any symptoms of HIV
infection (can last for 10
reaction (PCR)
years or longer) 3. T lymphocyte and B lymphocyte
Progression to AIDS subsets; CD4 counts, CD4
1. Fever, weight loss, fatigue
2. Night sweats, chills, swollen percentages
lymph nodes
3. Diarrhea, nausea & vomiting Nursing Management
4. Opportunistic Infections 1. Provide respiratory support (monitor
respiratory status + O2 therapy)
Treatment 2. Initiate protective isolation
Pharmacology
precautions
1. Anteroviral drugs
3. Practice universal/standard precaution
a. Reverse
trancriptase
inhibitors Patient Education
b. Protease inhibitors 1. Proper nutrition
2. Compliance to treatment
3. Skin care
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Disease: Fever IMMUNE

1. Infections Fever is the elevation in body
2. Inflammatory diseases temperature.
3. Prolong exposure to
hot environment (may Temperature:
cause hyperthermia) Normal: 36.4-37.0 (degrees
celsius)
Fever: >38.0 (degrees celsius)
Signs and Symptoms
1. Temperature: >38.0
(degrees celsius)
2. Skin: warm, flushed Diagnostic Tests
3. Lethargy
1. Increased temperature
4. Chills
5. Sweating 2. High White Blood Cell Count (due
6. Malaise to an infection)
Nursing Management
1. Monitor temperature
2. Assess and treat underlying cause
Treatment 3. Non-pharmacologic management:
Treat underlying cause remove excess clothing, cooling
(infection) measures, sponge bath.
Pharmacology 4. Increase fluid intake
1. Antipyretics 5. Medications: Antipyretics
MUSCULOSKELETAL DISORDERS
TABLE OF CONTENT
1. Osteoporosis
2. STRAINS
3. SPRAINS
4. FRACTURES
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Disease: Osteoporosis MSD

1. Gender: among Osteoporosis- a metabolic disorder
postmenopausal women
2. Age that is defined as bone
3. Family history demineralization.
4. Low calcium intake Bone mass decreases- which causes
5. Sedentary lifestyle
6. Smoking the bone to become porous & fragile
(risk for fractures).
Signs and Symptoms
1. Asymptomatic during
early stages
2. Back & hip pain Diagnostic Tests
1. Bone mineral density (BMD)
3. Decline in height
2. Bone x-rays
4. Kyphosis of the dorsal 3. Serum calcium level
spine
Nursing Management
1. Ensure patient safety
2. Move patient gently when
Treatment repositioning
1. Diet- increased calcium 3. Encourage ROM exercises
and vitamin D 4. Diet- high in calcium, vitamin D, protein
Pharmacology and iron
1. Calcium supplements 5. Administer medications (see treatment)
2. Bone resorption inhibitor
3. Analgesics Patient education
1. Proper body mechanics
2. The use of assistive devices
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Disease: STRAINS MSD

1. Poor body mechanics Strains- Injury to the muscle or
2. Higher risk among
athletes tendons due to overstretching.
Signs and Symptoms

1. Ecchymoses (bruising)
2. Pain or tenderness
3. Swelling Diagnostic Tests
2. X-ray
3. MRI
Nursing Management
1. Heat and cold application
2. Encourage the patient to rest to
Treatment promote healing
Pharmacology
1. Antiinflammatory
medications
2. Analgesics
3. Muscle relaxants
For severe strains- surgical
repair
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Disease: SPRAINS MSD

1. Direct or indirect injury A sprain is a stretching or tearing of
2. Higher risk among
athletes ligaments.
Signs and Symptoms

1. Pain
2. Swelling
3. Limited joint Diagnostic Tests
movement
2. Xray
3. MRI
Nursing Management
1. Encourage the patient to rest to
promote healing
Treatment 2. Apply ice packs to affected joint
Management:
3. Elevate limb
Rest, ice, compression and
elevation (RICE) 4. Assist in applying with tape, splint or
Pharmacology cast
1. Antiinflammatory 5. Administer medications as prescribed
medications
2. Analgesics
3. Muscle relaxants
Moderate Sprain- cast
Severe Sprain- Surgery
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Disease: FRACTURES MSD

1. Injury A fracture is a broken bone. There is a break in the continuity of
2. Persons with the bone structure.
Types
osteoporosis 1. Closed fracture: bone break without open wound in skin.
2. Open fracture (compound): fracture with an open wound.
3. Complete fracture: complete break through the bones that
separates into two.
4. Incomplete fracture: the bone doesn't break completely.
5. Comminuted fracture: break into more than two fragments.
6. Greenstick: one side of the bone is broken, the other side is
bent
7. Transverse fractures: fracture straight across the bone.
Signs and Symptoms 8. Oblique: fracture that run at an angle across
9. Spiral: fracture that circles or spirals around the shaft.
1. Pain 10. Impacted: a part of the bone that impact another bone
11. Compression: one bone compresses another bone
2. Loss of
function/deformity Diagnostic Tests
1. X-ray
3. Crepitus
2. CT
4. Edema
3. MRI
5. Ecchymosis (skin
discoloration)
Nursing Management
1. For open fractures, cover wound with sterile
dressing
2. Assess neurovascular status
Treatment 3. Provide pharmacologic and non-pharmacologic
1. Reduction pain management
Traction care:
2. Fixation 1. Ensure that the traction weight bag is hanging
3. Traction freely.
2. Monitor for any complication of immobilization.
4. Cast 3. Assess skin integrity
Pharmacology Casts:
1. Monitor for circulatory impairment
1. Analgesics 2. Assess skin integrity
3. Educate the patient to avoid placing any
object inside the casts.
Prevent and manage potential complications.
1. Compartment syndrome, Skin breakdown,
Pressure ulcers, Neurovascular impairment
PERIPHERAL VASCULAR DISORDERS
TABLE OF CONTENT
1. PERIPHERAL ARTERIAL DISEASE
2. PERIPHERAL VENOUS DISEASE
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PERIPHERAL
Disease: PERIPHERAL ARTERIAL DISEASE VASCULAR DISORDERS
1. Smoking Arterial narrowing or occlusion
2. Diabetes (arteriosclerosis) which causes O2
3. Hypertension and nutrients to the lower
4. High blood cholesterol extremities.
level
Leads to tissue damage (ischemia +
necrosis)
Signs and Symptoms
1. Pain (sharp)
2. Absent pulse
3. Skin:
a. cool to touch Diagnostic Tests
b. pale skin
c. absent hair + shiny 1. Ankle-brachial index (ABI)
skin 2. Doppler ultrasound
d. thin, dry + scaly skin
e. no edema
4. Lesions:
a. Red sores on the
toes/feet
b. punched out
appearance
5. Gangrene (death of Nursing Management
tissues) 1. HANG (DANGLE) the patient's legs
Treatment
Pharmacology an "a" shape
1. Antiplatelets
2. Cholesterol-lowering 2.Monitor pain
a= PAD
drugs 3.Monitor for any signs of gangrene
4. Provide a warm environment + warm clothing
Surgical Intervention 5. Do NOT apply direct heat to the extremities
1. Angioplasty (such as heating pads.
2. Bypass surgery Patient Education
3. Endarterectomy 1. Avoid caffeine + smoking (due to vasoconstrictive
effects)
2. Skin assessment
3. Hydration
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PERIPHERAL
Disease: PERIPHERAL VENOUS DISEASE VASCULAR DISORDERS
1. Smoking Pooling of blood in the extremities
2. Diabetes
3. Hypertension
due to the inability to bring blood
4. High blood cholesterol back to the heart (vascular
level insufficiency)
Signs and Symptoms

1. Pain (achy + dull)
2. Presence of a strong
pulse
3. Skin:
Diagnostic Tests
a. presence of edema 1. Ankle-brachial index (ABI)
b. Warm legs 2. Doppler ultrasound
c. yellow/brown
ankles
4. Lesions:
a. irregular shaped
sores
5. No presence of Nursing Management
gangrene 1. ELEVATE the patient's legs
Treatment
v= PvD
Pharmacology v shape
1. Antiplatelets
2. Cholesterol-lowering
drugs 2. Administer medications as prescribed
Patient Education
1. Angioplasty 1. Avoid caffeine + smoking (due to
2. Bypass surgery vasoconstrictive effects)
2. Skin assessment
3. Endarterectomy 3. Hydration
CRITICAL CARE conditions
PART 4
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Table of Content
1. respiratory disorders
2. neuro disorders
3. cardiovascular disorders
RESPIRATORY
TABLE OF CONTENT
1. PULMONARY EMBOLISM
2. ACUTE RESPIRATORY DISTRESS SYNDROME
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Disease: PULMONARY EMBOLISM RESPIRATORY

1. Blood clots Pulmonary embolism is the
2. Fat, Tumor obstruction/blockage of a pulmonary
3. Air emboli (due to IV artery mostly caused by blood clots
therapy) (travel from the deep vein in the legs to
Risk Factors: the lungs)
DVT, Surgery, prolonged
immobility, trauma
Signs and Symptoms
1. Sudden SOB
2. Chest pain (sharp)
4. Hypotension 1. Pulmonary angiogram
5. Cool and clammy skin 2. CT pulmonary angiography
6. Cough (bloody 3. Ventilation-perfusion scan
sputum) 4. Chest X-ray
7. Dizziness 5. MRI
8. Fever
Nursing Management
pattern
Treatment
2. Administer O2 therapy as ordered
Pharmacology
3. Position: High Fowler's
1. Anticoagulants:
4. Active/passive leg exercises
prevent clot formation
5. Monitor thrombolytic and
2. Thrombolytics: dissolve
anticoagulant therapy (coagulation
clots studies)
Surgical Interventions:
1. Surgical embolectomy:
removal of clot
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Disease: ACUTE RESPIRATORY DISTRESS SYNDROME RESPIRATORY

Direct Injury ARDS is characterized by the build up of fluid
1. Trauma to the chest in the alveoli. This results in decreased gas
2. Smoke and toxic chemical exchange and leads to deprivation of
inhalation oxygen to the vital organs.
3. Aspiration, drowning
3 PHASES: exudative, proliferative, and
Indirect Injury
1. Sepsis, 2. Pancreatitis, 3. fibrotic
Blood transfusion, 4. Drug 1. Exudative phase: leakage of fluid +
overdose protein to the alveoli lumen (pulmonary
edema)
Signs and Symptoms 2. Proliferative phase: repair of damaged
alveolar structure
1. Rapidly progressive 3. Fibrotic phase: Damage and fibrosis of
dyspnea the alveoli and lung tissues.
2. Tachypnea Diagnostic Tests
3. Hypoxemia 1. Blood test to measure oxygen
4. Crackles level
5. Tachycardia 2. Chest x-ray
6. Altered mental status 3. Echocardiogram- to rule out heart
7. Cyanosis failure
Nursing Management
2. Monitor respiratory status
Treatment
3. Administer supplemental oxygen as
1. Mechanical ventilation
prescribed
using PEEP (PEEP
maintains the patient's 4. Position: Prone position
airway pressure) 5. Administer medications as prescribed
2. Supplemental oxygen 6. Prepare patient for intubation &
Pharmacology mechanical ventilation using PEEP
1. Diuretics
2. Anticoagulants
3. Corticosteroids
NEURO
TABLE OF CONTENT
1. increased intracranial pressure
2. spinal cord injury
3. AUTONOMIC DYSREFLEXIA
4. cerebral aneurysm
5. traumatic brain injury
6. stroke
7. seizures
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Disease: INCREASED INTRACRANIAL PRESSURE NEURO

1. Brain tumor Increased ICP is a rise in the pressure
2. Hydrocephalus inside the skull.
3. Hemorrhage The normal intracranial pressure is
4. Meningitis between 5-15 mmHg.
5. Hematoma
6. Head injury
Signs and Symptoms
1. Altered LOC, Double vision
2. Pupils-dilated, Headache
3. Irregular respiration
4. Vomiting
Diagnostic Tests
Late signs: 1. MRI
1. Increased systolic BP,
decreased HR 2. CT scan
2. Body weakness + decreased
motor function
3. Positive Babinski reflex
4. Posture:
Decorticate/decerebrate
5. Seizures
(Cushing's triad are signs that

indicates increased ICP. This Nursing Management
includes: increased systolic BP,
decreased HR and decreased RR) 1. Position: elevate head of bed to 30
degrees (prevent flexion of neck & hips)
Treatment 2. Monitor respiratory status, neurological
Pharmacology status, vital signs
1. Antiseizures 3. For mechanical ventilation: maintain the
2. Antihypertensive PaCO2 at 30 to 35 mm Hg (this results in
3. Antipyretics decreased ICP due to vasoconstriction)
4. Monitor ABGs
4. Muscle relaxants 5. Maintain normal body temperature
5. Corticosteroids Patient Education
1. Avoid Valsalva's maneuver
2. Avoid straining activities
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Disease: SPINAL CORD INJURY NEURO

1. Motor vehicle accidents SCI- damage that occurs to any part of the
2. Sporting injuries spinal cord/nerves causing permanent changes
3. Violence (gun shots, (such as loss of motor function, changes in
wounds) sensation, reflexes and strength).
4. Falls
5. Diseases: cancer Tetraplegia (Quadriplegia)- paralysis of all
extremities
6. Fractures/compression of the Paraplegia-paralysis of the lower extremities
spinal cord
Classification
Signs and Symptoms 1. Complete- total loss of sensation & function
1. Loss of motor function and 2. Incomplete (partial)- some sensory & motor
decreased sensation function remains
2. Loss of bladder/bowel
control Diagnostic Tests
3. If C3-C5 are involved, it 1. X-rays
affects breathing
4. Muscle spams 2. MRI
3. CT scan
Remember: the signs and
symptoms is dependent on 4. Neurological examination
the level and severity of
injury
Nursing Management
Emergency management:
1. Immobilize the spine (on spinal backboard
with head in a neutral position)
Treatment 2. Maintain patent airway
3. Use the logrolling technique to maintain
1. Immobilizing the spine alignment.
2. Respiratory management Acute phase
1. Monitor respiratory status
3. Prevention/management 2. Monitor for signs of neurologic shock
3. Monitor for signs of Autonomic dysreflexia
of long-term (damage above T6)
Other nursing care:
complications 1. Turn patient every 2 hours to maintain skin
4. Surgical intervention integrity.
2. Educate patient on physical rehabilitation
3. Range of motion exercises
4. Prevention and management of long-term
complications of SCI
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Disease: AUTONOMIC DYSREFLEXIA NEURO

Common causes Autonomic dysreflexia is a sudden
1. Distended bladder uncontrolled sympathetic response
2. Constipation (overreaction) to stimulation.
Autonomic dysreflexia is common among

people with spinal cord injuries (damage
above T6)
Signs and Symptoms This is a medical emergency.

1. Severe high blood
pressure
2. Severe bradycardia Diagnostic Tests
3. Throbbing headache 1. Blood and urine tests
4. Blurred vision
2. CT or MRI scan
5. Flushed skin above
injury level 3. ECG
6. Pale skin below injury
level
7. Goosebumps
8. Nasal congestion Nursing Management
9. Sweating 1. Position: High Fowler's
2. Remove the stimulus
Treatment
Pharmacology 3. Loosen clothing
4. Assess for bladder distention,
1. Antihypertensive drugs
constipation or other stimulus (check
Treatment depends on the
for any kinks if the client has a urinary
cause. catheter).
5. Medication: antihypertensive drug
6. Monitor VS (BP & P every 5 mins)
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Disease: CEREBRAL ANEURYSM NEURO

1. Hypertension A bulge or ballooning of a weakened
2. Smoking blood vessel in the brain.
3. Older age
4. Excessive alcohol use A brain aneurysm can rupture, resulting
5. Head trauma in hemorrhagic stroke.
Signs and Symptoms

1. Headache
2. Changes in vision
3. Tinnitus Diagnostic Tests
4. Seizures 1. CT scan
5. Nuchal rigidity
2. MRI
3. Cerebral angiogram
Nursing Management
2. Monitor VS
Treatment
3. Position: semi-Fowler's
Pharmacology
4. Administer supplemental oxygen as
1. Antiseizure medication prescribed
2. Anti-hypertensive 5. Provide a calm environment
medication 6. Pain management
(hypertensive patients)
Pain management Patient Education:
1. Educate patient to avoid straining
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Disease: TRAUMATIC BRAIN INJURY NEURO

1. Falls Trauma to the skull that causes brain damage.
2. Sports injury Types:
1. Concussion-injury that causes the head to
3. Vehicular accident move back and forth forcefully
4. Violence 2. Contusion-bruising
3. Epidural hematoma- hematoma between
skull and dura
4. Subdural hematoma-blood between
between the dura and arachnoid
5. Intracerebral hemorrhage-bleeding inside
the brain
Signs and Symptoms 6. Subarachnoid hemorrhage-bleeding into
1. Increased ICP the subarachnoid space
2. LOC changes 7. Skull fractures- break in the cranial bone
3. Confusion/altered mental
status Diagnostic Tests
4. Papilledema 1. GCS
5. Body weakness
6. Seizures
2. Physical Assessment
7. Paralysis 3. CT scan
8. Slurred speech
9. CSF drainage from the ears
or nose
Signs and symptoms depends on Nursing Management

the type of injury and severity. 1. Monitor respiratory status
Treatment
3. Initiate seizure precautions
Mild Injury
1. Close monitoring 4. Assess neurological changes
2. Antibiotics 5. Assess pupil size
3. Wound care 6. Monitor vital signs
Moderate to severe injury 7. Monitor for signs of increase
1. Treatment focuses on
increasing cerebral intracranial pressure.
oxygenation, maintaining BP 8. Prevent neck flexion
and preventing further 9. Pain management
injury.
2. Craniotomy
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Disease: STROKE NEURO

1. TIA Stroke is the loss of neurological functions
2. Hypertension due to the lack of blood flow to the brain.
3. smoking
4. Atherosclerosis Types
5. Diabetes Ischemic Stroke (Clots)- an obstruction
6. High cholesterol in the blood vessel that supplies blood
to the brain.
Hemorrhagic Stroke (Bleeding)-
weakened blood vessel ruptures.
Signs and Symptoms Transient Ischemic Attack- temporary
1. Drooping of face stroke (a warning stroke)
2. One sided weakness
3. Slurred speech
Diagnostic Tests
4. Blurred vision
5. Agnosia 1. CT scan
6. High BP 2. MRI
7. Unilateral neglect
8. Apraxia 3. Electroencephalography
4. Carotid ultrasound
5. Cerebral arteriography
Nursing Management
2. Administer 02
Treatment
3. Administer tPA
1. An IV injection of
4. Monitor VS-maintain BP @ 150/100
recombinant tissue
5. Monitor LOC
plasminogen activator
(tPA)-ischemic stroke
6. Monitor for signs of increase ICP
2. Hemorrhagic stroke: stop 7. Elevate HOB
bleeding. Prevention of 8. Administer IV fluids
increased ICP 9. Insert Foley's catheter
10. Prevention of DVT
11. Assist with self care and ADLs
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Disease: SEIZURES NEURO

1. Meningitis Seizures is characterized by a sudden, uncontrolled
electrical disturbance in the brain.
2. Head trauma Epilepsy: chronic seizure activity.
3. Stroke Types:
1. Generalized Seizures-all areas of the brain are
4. Fever affected
a. Tonic-Clonic- may begin with an aura.
5. Brain tumor i. Tonic phase- muscle rigidity , then loss of
consciousness
ii. Clonic-hyperventilation and jerking
b. Absence-loss of awareness (stare blankly into
space)
c. Myoclonic-brief, jerking movement of a
muscle/muscle group
Signs and Symptoms d. Atonic-sudden loss of muscle strength
The signs and symptoms Partial Seizures-affects one part of the brain
depends on seizure history and Simple partial
Complex partial
type.
Before seizure Diagnostic Tests
Aura
During seizure
1. An electroencephalogram
Loss of consciousness during 2. Computerized tomography
seizures
Uncontrollable involuntary 3. Magnetic resonance imaging
muscle movements
Loss of bladder and bowel (MRI)
control
After seizure
4. Neurological exam
Headache Nursing Management
Confusion
Slurred speech Assess time and duration of seizure
activity
Treatment
Provide patient safety
Pharmacology
Turn patient to the side
Anti-seizure medication
Maintain airway
Avoid restraining patient
Loosen clothing
Administer O2
Monitor behavior before and after
seizure activity
CARDIOVASCULAR
TABLE OF CONTENT
1. deep vein thrombosis
2. Disseminated intravascular
coagulation
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Disease: DEEP VEIN THROMBOSIS CARDIOVASCULAR

1. Age (older age), Deep vein thrombosis (DVT)- thrombus
obesity, smoking (blood clot) forms mostly in the deep vein
2. Prolong immobilization of the lower extremities.
3. Trauma
4. Increased blood Complication:
Pulmonary Embolism (PE)- life-threatening
coagulability
The blood clot in the legs can break and
Signs and Symptoms travel to the lungs causing pulmonary
1. Edema of the embolism
affected extremity
2. Warmth & discolored Diagnostic Tests
skin in the affected 1. D-dimer blood test: a type of
leg protein produced when there is
3. Pain blood clots
4. Tenderness 2. Duplex ultrasound
Nursing Management
Prevention
1. Nursing interventions to prevent DVT
Treatment (see treatment)
Prevention Other nursing interventions:
1. Prevent prolonged
immobilization 1. Administer anticoagulants and
2. Active, passive ROM thrombolytics
3. Compression stockings 2. Prevention of pulmonary embolism
Treatment:
1. Anticoagulants: prevent
further formation of clots
2. Thrombolytics: dissolve
clots
3. Prevention of PE
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DISEASE: DISSEMINATED INTRAVASCULAR COAGULATION

1. Blood transfusion Disseminated intravascular coagulation
reaction-major cause (DIC) is characterized by an
2. Cancer overstimulation of the proteins that
3. Pancreatitis control blood clotting which causes
4. Sepsis microclots throughout the body.
5. Pregnancy complications
Signs and Symptoms

1. Bleeding (various
parts in the body)
2. Bruising Diagnostic Tests
3. Blood clots 1. D-dimer
4. Fever 2. Partial thromboplastin time
5. Decreased BP (PTT)
6. SOB 3. Prothrombin time (PT)
7. Confusion 4. CBC
Nursing Management
1. Assess respiratory status
2. Monitor VS
Treatment
3. Monitor coagulation studies
1. Treatment of the
underlying cause
4. Monitor patient's level of
2. Plasma transfusions- consciousness/mental status
replace blood clotting 5. Administer O2 as prescribed
factors 6. Administer medications
Pharmacology 7. Provide supportive care
1. Anticoagulants-prevent
further formation of clots
References
Silvestri, L. A., & Silvestri, A. E. (2019). Saunders
comprehensive review for the NCLEX-RN examination.
Elsevier Health Sciences.
Hinkle, J. L., & Cheever, K. H. (2017). Brunner &

Suddarth's textbook of medical-surgical
nursing (14th ed.). Lippincott Williams & Wilkins.
Brown, D., Edwards, H., Seaton, L., & Buckley, T.

(2017). Lewis's medical-surgical nursing: Assessment and
management of clinical problems. Elsevier Health
Sciences.

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NURSING BUNDLE

A Review Guide For Nursing Students

GASTROINTESTINAL DISORDERS NEURO DISORDERS

ADRENAL CORTEX DISORDERS

PITUITARY GLAND DISORDERS

PERIPHERAL VASCULAR DISORDERS

Disease: Coronary Artery Disease Cardiovascular

Disease: Angina Cardiovascular

Disease: Myocardial Infarction Cardiovascular

Disease: Heart Failure Cardiovascular

Disease: Cardiogenic Shock Cardiovascular

Disease: Pericarditis Cardiovascular

Disease: Endocarditis Cardiovascular

Disease: Myocarditis Cardiovascular

Signs and Symptoms

Disease: Cardiac Tamponade Cardiovascular

1. Increase central venous

Disease: Aortic Aneurysm Cardiovascular

Disease: Hypertension Cardiovascular

Disease: ASTHMA Respiratory

Signs and Symptoms

Treatment Nursing Management

Disease: COPD- EMPHYSEMA Respiratory

Disease: PLEURAL EFFUSION Respiratory

Disease: HEMOTHORAX Respiratory

Signs and Symptoms

Disease: PNEUMOTHORAX Respiratory

Treatment Nursing Management

Disease: PNEUMONIA Respiratory

Disease: Hiatal Hernia Gastrointestinal

Hiatal hernia occurs when a portion of

Treatment Nursing Management

Disease: GERD Gastrointestinal

Treatment Nursing Management

Disease: Gastritis Gastrointestinal

Treatment Nursing Management

Disease: Appendicitis Gastrointestinal

Signs and Symptoms

Treatment Nursing Management

Disease: Peptic Ulcer Disease Gastrointestinal

Treatment Nursing Management

Disease: Ulcerative Colitis Gastrointestinal

Complications: Nutritional deficiencies,

Treatment Nursing Management

Disease: Crohn's Disease Gastrointestinal

Signs and Symptoms

Treatment Nursing Management

Disease: Pancreatitis Gastrointestinal

Disease: Cholecystitis Gastrointestinal

Treatment Nursing Management

Disease: Cholelithiasis Gastrointestinal

Signs and Symptoms

Complications- Hepatic encephalopathy,

Treatment Nursing Management

The increased pressure causes blood to flow into

Treatment Nursing Management

Disease: Acute Kidney Injury Genitourinary

Treatment Nursing Management

Disease: Chronic Kidney Disease Genitourinary

Disease: Glomerulonephritis Genitourinary

Signs and Symptoms

Disease: Nephrotic Syndrome Genitourinary

Treatment Nursing Management

Disease: Renal Calculi Genitourinary