I.

Maladaptive • Clients with anorexia have a body weight that is less

than the minimum expected weight considering age,
ALZHEIMER’S DISEASE height, and overall physical health
Description: Types:
• A neurodegenerative disorder of the cerebral cortex, • Restricting subtype – losing weight through dieting,
especially the frontal lobe ‘fasting, or excessive exercise
Causes:
• Binge eating and purging subtype – consuming a large
• Idiopathic amount of food then involves compensatory
Factors: behaviors designed to eliminate food by means of
• Predisposing Factors self-induced vomiting
o Age Causes:
o Female sex • Idiopathic
o Genetics (family history of the disease) Risk Factors:
o Presence of down syndrome
• Dissatisfaction with body image
• Precipitating Factors
• Family lacks emotional support
o Exposure aluminum and manganese
• Societal pressures regarding body image
o Neurochemical deficiency (decreased
Pathophysiology:
acetylcholine)
• Imbalances in neurotransmitters serotonin,
o Repeated head trauma
dopamine, and norepinephrine play a role in the
Pathophysiology:
development of the disorder
• Neurofibrillatory tangles
• Abnormalities in brain structure and function,
o Bundles of filaments inside the neuron that
particularly in areas involved in appetite regulation
abnormally twist around one another
(hypothalamus) and reward processing
• Neuritic plaques
Signs and Symptoms: “STARVE”
o Amyloid plaques are found outside neurons
• S – severe weight loss
and can also occur in the walls of cerebral
blood vessels • T – thin appearance
• Granuvascular degeneration • A – amenorrhea
o An abnormally high number of fluid-filled • R – refusal to maintain a healthy weight
spaces, called vacuoles, enlarge the cell’s • V – vomiting or purging
body • E – excessive exercise
Signs and Symptoms: “4A’s” Diagnostics:
• A – agnosia (impaired senses e.g. loss of smell) • Assessment of eating behaviors
• A – amnesia (gradual loss of recent and remote/long • Psychological assessment tools
term memory) • Laboratory tests
• A – aphasia (impaired ability to express or understand Management:
speech) • Medications
• A – apraxia (impaired voluntary movements) o Atypical antipsychotics: olanzapine
Diagnostics: • Nutritional counseling
• Positron-emission tomography • Psychotherapy
• CT scan o Cognitive behavioral therapy
• MRI Nursing considerations:
• EEG • Assess nutritional intake, weight, VS, and electrolyte
• Cerebral blood flow studies levels
Management: • Promote a supportive and nonjudgmental
• No cure or definitive treatment, rather focuses on environment, facilitating adherence to treatment
drug therapy, which include recommendations
o Cholinesterase inhibitors • Provide emotional support and therapeutic
o Acetylcholinesterase inhibitors communication, and education about the nature of
o Psychostimulants anorexia nervosa
o Antidepressants
Nursing Considerations: ANXIETY
• Provide patient with safe environment Description:
• Intervene by helping the patient focus on another • Anxiety is a response to external or internal stimuli
activity that can have behavioral, cognitive, emotional, and
• Establish an effective communication system with physical symptoms
the patient and family to help them adjust • It is characterized by feelings of apprehension, worry,
• Offer emotional support to the patient and family and nervousness
members Causes:
• Chronic stress
ANOREXIA NERVOSA • Family history of anxiety disorders
Description: • Neurotransmitter imbalances (serotonin and
• Anorexia nervosa is a life-threatening eating disorder dopamine)
characterized by intense fear of gaining weight, • Traumatic life experiences
distorted body image, and significant restriction of Pathophysiology:
food intake, leading to dangerously low body weight • The amygdala, a part of the brain involved in
emotional processing, which plays a crucial role in
the body's response to perceived threats, sends
Transcribed by: Basti M. Sanchez RN 2024
 signals to the hypothalamus, which activates the
sympathetic nervous system, leading to the "fight or
flight" response
• This response involves the release of hormones like
adrenaline, which prepares the body to react to the
perceived danger
Signs and Symptoms: “WORRY”
• W – worrying excessively
• O – overthinking
• R – restlessness or irritability
• R – rapid heartbeat
• Y – your muscles are tense or shaky
Diagnostics:
• Diagnosis is based on DSM-5 criteria
• Psychological assessment tools
Management:
• Drug therapy
o Benzodiazepines: alprazolam, diazepam
o SSRIs: fluoxetine
• Psychotherapy
o Cognitive behavioral therapy (CBT)
o Positive reframing
• Stress management techniques
Nursing considerations: “ANXIETYS”
• A – assessment of anxiety level and triggers
• N – non-judgmental environment
• X – eXplore and encourage coping strategies
• I – individualize care to address unique needs
• E – educate the patient and family about the disorder
• T – therapeutic communication to establish rapport
• Y – you collaborate with interdisciplinary team
• S – safety assessment for risk of self-harm
BIPOLAR DISORDER
Description:
• Bipolar disorder involves extreme mood swings from
episodes of mania to episodes of depression
• These mood shifts can significantly disrupt daily
functioning and impact relationships, work, and
overall quality of life
Causes:
• The exact cause in not fully understood/idiopathic
Risk Factors:
• Family history of mood disorders
• Neurotransmitter imbalances
• Stressful life events
• Substance abuse
Pathophysiology:
• Bipolar disorder involves dysregulation of
neurotransmitters (such as dopamine, serotonin, and
norepinephrine) and disruptions in neural circuits
involved in mood regulation, emotional processing,
and cognition
• Abnormalities in brain structure and function,
including the prefrontal cortex, amygdala, and
hippocampus
Signs and Symptoms: “MOODSWING”
• M – mania (elevated mood, increased energy)
• O – overactivity (racing thoughts)
• O – overconfidence (inflated self-esteem)
• D – depressive episodes (persistent sadness)
• S – suicidal thoughts (thoughts of death)
• W – weight changes (appetite)
• I – irritability (easily agitated)
• N – notable changes in behavior (social withdrawal)
• G – grief (loss of interest)
Transcribed by: Basti M. Sanchez
Diagnostics:
• Diagnosis is based on DSM-5 criteria
• Standardized screening tools
o Bipolar spectrum diagnostic scale (BSDS)
o Mood disorder questionnaire (MDQ)
Management:
• Drug therapy
o Mood stabilizers: lithium
• Lifestyle modifications
o Adequate sleep
o Healthy nutrition
o Regular exercise
o Stress management
• Psychotherapy
o Cognitive behavioral therapy
o Interpersonal therapy
Nursing considerations:
• Asses thoroughly mood symptoms
• Monitor medication adherence
• Promote safety during acute manic or depressive
episodes
• Provide emotional support and crisis intervention as
needed
• Educate the patient and family about bipolar
disorders and treatment options
BULIMIA NERVOSA
Description:
• An eating disorder characterized by recurrent
episodes of binge eating followed by inappropriate
compensatory behaviors to avoid weight gain, such
as purging, fasting, or excessively exercising
Causes:
• Idiopathic
Risk Factors:
• Self-perception of being overweight
• Serotonin and norepinephrine disturbances
• Weight-related teasing
Pathophysiology:
• Dysregulation of neurotransmitters, particularly
serotonin, may play a role in the development and
maintenance of the disorder
• Additionally, abnormalities in brain structure and
function, including regions involved in appetite
regulation and reward processing, have been
observed in individuals with bulimia nervosa
Signs and Symptoms: “PURGE”
• P – preoccupation with body weight and shape
• U – uncontrollable binge eating episodes
• R – regular use of purging behaviors
• G – gastrointestinal disturbances (constipation)
• E – electrolyte imbalances and dehydration
Diagnostics:
• Assessment of eating behaviors
• Psychological assessment tools
• Laboratory tests
Management:
• Drug therapy
o Antidepressants: desipramine, amitriptyline
• Nutritional counseling
• Psychotherapy
o Cognitive behavioral therapy (CBT)
o Dialectal behavior therapy
Nursing Considerations:
• Assess nutritional intake, weight, VS, electrolyte
levels, and signs of medical complications
RN 2024
 • Promote a supportive and nonjudgmental Diagnostics:
environment, facilitating adherence to treatment • Diagnosis is based on DSM-5 criteria
recommendations • Psychological assessment tools
• Provide emotional support, therapeutic Management:
communication, and education about the nature of • Drug therapy
bulimia nervosa o Antidepressants
o Benzodiazepines
DELIRIUM • Psychotherapy
Description: o Cognitive behavioral therapy
• A syndrome that involves a disturbance of o Deep breathing and relaxation
consciousnes, accompanied by a change in cognition Nursing Considerations:
• Develops over a short period (acute) • Provide a safe and environment and ensure client’s
Causes: privacy during a panic attack
• Idiopathic • Help the client focus on deep breathing
Risk Factors: • Remain with the client during a panic attack
• Physioliogical or metabolic disturbances • Teach the client to use relaxation techniques
• Infection
• Drug related side effects SCHIZOPHRENIA
Pathophysiology: Description:
• Involve in the disruptions of neurotransmitter • A chronic and severe mental disorder characterized
function, particularly acetylcholine, dopamine, and by psychotic features (hallucinations and delusions),
serotonin. distorted thought prcesses, and disrupted
• Factors such as inflammation, oxidative stress, and interpersonal relationships
alterations in neuronal signaling pathways Causes:
Signs and Symptoms: “DREAMS” • Idiopathic
• D – disorientation Risk Factors:
• R – restlessness • Early childhood trauma
• E – emotional instability • Neurochemical imbalances (decreased dopamine)
• A – attention deficit • Prenatal exposure to toxins or viruses
• M – memory impairment (short term memory loss) Signs and Symptoms:
• S – sleep-wake disturbances • Positive/hard symptoms: “HEAD”
Diagnostics: o H – hallucinations
• Cognitive assessment tools o E – echopraxia
Management: o A – associative looseness
• Medications: o D – delusions
o Antipsychotics: haloperidol (Haldol) • Negative/hard symptoms: “SANA”
o Benzodiazepines: lorazepam (Ativan) o S – social withdrawal (asociality)
• Adequate nutrition and IV fluids o A – anhedonia
Nursing Considerations: o N – neglect of personal hygiene
• Provide a safe and supportive environment o A – alogia (speech reduction)
• Provide reassurance and orientation cues to reduce Diagnostics:
anxiety and agitation • Diagnosis is based on DSM-5 criteria
• Monitor closely cognitive functions, behavior, and VS • Psychlogical assessment tools
• Promote adequate nutrition and hydration Management:
• Medications:
o Antipsychotics: haloperidol, olanzapine
PANIC DISORDERS • Psychotherapy:
Description:
o Individual and group therapies
• Composed of discrete episodes of panic attacks, that o Social skills training
is 15-30mins of rapid, intense, escalating anxiety Nursing Considerations: “SUPPORT”
Causes:
• S – safety
• Idiopathic
• U – understanding – display empathy
Risk Factors:
• P – pscyhopharmacology – monitor medications
• Neurotransmitter imbalances (serotonin and
• P – psychoeduction – educate the family
norepinephrine)
• O – observation – for signs of relapse and changes
• Stressful life events and trauma
• R – rehabilitaion – encourage participation
Pathophysiology:
• T – teamwork – collaborate to provide comprehensive
• Involves dysregulation of the body’s stress response
care
system, including hypothalmic-pituitary-arenal (HPA)
axis and the autonomic nervous system
Signs and Symptoms: “PANICS” II. Perception and Coordination
• P – palpitations or pounding heart CARPAL TUNNEL SYNDROME
• A – abdominal distress (SNS) Description:
• N – numbness or tingling sensations • Occurs when one of the major nerves to the hand, the
• I – intense fear of losing control median nerve, is squeezed or compressed, which
• C – chills causes numbness, pain, and tingling in the hand and
• S – sweating, shaking, SOB to the forearm

Transcribed by: Basti M. Sanchez RN 2024

Causes: “PRESS” o Intrauterine nutritional deficiencies
• P – pregnancy • Senile cataracts show evidence of:
• R – repetitive strain o Increased pigmentation in the center of the
• E – edema lens
• S – systemic disease (DM) o Oxidative injury
• S – structural changes o Protein aggregation
Pathophysiology: • Traumatic cataracts:
• Inflammation or fibrosis of the tendon sheaths that o Phagocytosis of the lens or inflammation
causes edema and compression of the median nerve may occur when a lens rupture
• This compression neuropathy causes sensory and Signs and Symptoms: “FOGGY”
motor changes, initially impairing sensory • F – foggy or cloudy vision
transmission to the thumb • O – opacity of vision
Signs and Symptoms: • G – glare sensitivity
• Inability to make a fist • G – gradual loss of central vision
• Paresthesia (burning, numbness, pain, tingling, or • Y – yellowing of vision (blue and green hard to see)
weakness in one or both hands) Diagnostics:
• Pain spreading to the forearm • Indirect ophthalmoscopy
• Decreased sensation • Visual acuity test
Diagnostics: Management:
• Tinel’s sign • Extracapsular cataract lens extraction
• Phalen’s maneuver o Irrigation and aspiration
• Compression test o Phacoemulsification
• Electromyography • Intracapsular cataract lens extraction
• Laboratory tests Nursing Considerations Post-Op:
Management: • Instruct the patient to protect the eye from accidental
• Medications: injury
o NSAIDs • Teach the patient to administer antibiotic ointment
o Hydrocortisone and lidocaine injection • Advise the patient to immediately report a sharp pain
• Surgical decompression in the eye
• Neurolysis • Caution about activity restrictions
Nursing Considerations:
• Administer mild analgesics as needed CEREBROVASCULAR ACCIDENT
• Maintain adequate fluids as indicated (HEMORRHAGIC STROKE)
• Assist in ambulation Description:
• Demonstrate how to perform daily gentle ROM • Cerebrovascular accident, known as stroke or brain
exercises attack, is a sudden impairment of the brain’s
• Teach the patient how to apply and remove a splint circulation in one or more blood vessels
(device that supports a broken bone) • A stroke interrupts or diminishes oxygen supply and
commonly causes serious damage in the brain
CATARACT Causes:
Description: • Hypertension
• A cataract is a gradually developing opacity of the • Ruptured aneurysm
lens or lens capsule of the eye • Arteriovenous malformations
• Commonly occur bilaterally, and each progresses • Head trauma,
independently • Hemorrhagic disorders (DIC)
Causes: Risk Factors:
• Aging (senile cataracts) • Predisposing:
• Congenital disorders o Cardiac disease
• Diabetes mellitus o Family history of stroke
• Drugs toxic to the lens • Precipitating:
• Exposure to UV rays – common in farmers o Cigarette smoking
• Genetic abnormalities o DM
• Maternal rubella o Head trauma
Factors: o Obesity
• Predisposing Pathophysiology:
o Age • Regardless of the cause of stroke, the underlying
o Genetic abnormalities event is deprivation of oxygen and nutrients to the
• Precipitating tissues of the brain
o DM (diabetic retinopathy) • When hemorrhage is the cause, not only does the
o Exposure to ultraviolet rays impaired perfusion cause infarction, but the blood
o Maternal rubella during 1st tri itself acts as a space-occupying mass, exerting
Pathophysiology: pressure on the brain tissues
• Congenital cataracts may be caused by: Signs and Symptoms: “FAST”
o Infection during pregnancies • F – face drooping
o Metabolic disease • A – arm weakness
o Chromosomal abnormalities • S – speech difficulties

Transcribed by: Basti M. Sanchez RN 2024

 • T – trouble seeing • Teach parents to feed the infant in near sitting
Diagnostics: position, with the flow directed to the side of infant’s
• CT scan tongue
• MRI • Encourage mother of infant to breastfeed if the cleft
• Cerebral angiography lip doesn’t prevent effective sucking
• EEG
Management: FRACTURE
• Medications: “COAT” Description:
o C – corticosteroids: prednisone • A fracture will occur when a force exceeds the
o O – osmotic diuretics: mannitol compressive or tensile strength of the bone
o A – analgesics: codeine sulfate Causes:
o T – thrombolytic: TPA • Bone tumors
• ICP management • Falls
o Semi fowler’s • Sports
o If GCS is 8 = intubate • Vehicular accident
Nursing Considerations: Pathophysiology:
• Maintain patent airway and provide supplemental • When a bone is fractured, the periosteum and blood
oxygenation as indicated vessels in the cortex, marrow, and surrounding soft
• Continuous neurologic assessment, respiratory tissue are disrupted
support, and monitoring VS • A hematoma forms between the broken ends of the
• Be alert for signs that the patient is straining at bone and beneath the periosteum, eventually
elimination because this causes increased ICP replaces the hematoma
• Establish and maintain communication with the Signs and Symptoms:
patient • Deformity due to unnatural alignment
• Muscle spasm
CLEFT LIP AND CLEFT PALATE • Severe pain
Description: • Swelling
• Cleft lip and cleft palate may occur separately or in Diagnostics:
combination • X-ray
• They originate in the 2nd month of pregnancy if the Management:
front and sides of the face and the palatine shelves • For the first 24hrs: “RICE”
fuse imperfectly o R – rest
Causes: o I – ice
• Chromosomal syndrome o C – compression
• Combined genetic and environmental factors o E – elevation
• Exposure to teratogens during fetal development • Medications:
Factors: o Analgesics
• Predisposing o Muscle relaxant
o Family history of cleft defects • Elastic bandages
o Male sex • Immobilization of the fracture
o Native Americans • Local anesthetics
• Precipitating factors Nursing Consideration:
o Chromosomal abnormalities • Maintain safety – side rails up
o Exposure to teratogens • Administer analgesics as needed for pain =
o Folic acid deficiency • Monitor VS and be alert for changes
Pathophysiology • Assist in ambulation
• During the second month of pregnancy, the front and • Provide compassionate and supportive care
sides of the face and the palatine shelves develop but
because of such factors, the lip or palate fuses
imperfectly
GLAUCOMA
Signs and Symptoms: Description:
• Obvious cleft lip or palate • Glaucoma is a group of disorders characterized by an
abnormally high IOP that damages the optic nerve
• Feeding difficulties
and other intraocular structures
Diagnostics:
• It leads to a gradual loss of vision and ultimately
• Physical examination upon birth
blindness
• Prenatal targeted ultrasound
Causes:
Management:
• Chronic open-angle glaucoma
• Surgical correction
o Aging
o Cheiloplasty (before 6 months)
o DM
o Palatoplasty (on the 6th month)
o Genetics
o Cheilopalatoplasty (both)
o Hypertension
• Orthodontic prosthesis
o Severe myopia
• Speech therapy
• Acute angle-closure glaucoma
Nursing Considerations:
o Drug-induced mydriasis (extreme dilation of
• Maintain adequate nutrition by experimenting with the pupil)
feeding devices o Emotional excitement

Transcribed by: Basti M. Sanchez RN 2024

 • Secondary glaucoma Pathophysiology:
o DM • When uric acid becomes supersaturated in blood and
o Infections other body fluids, it crystallizes and forms a
o Steroids precipitate of urate salts that accumulates in
o Surgery connective tissues throughout the body
o Trauma Signs and Symptoms:
o Uveitis • Joint pain
Factors: • Redness and swelling in joints
• Predisposing: • Trophi in great toe, ankle, and pinna of the ear
o Age Diagnostics:
o Genetics • Blood studies
o Black American • Urinalysis
• Precipitating • Needle aspiration
o DM • X-ray
o Hypertension Management:
o Steroids • Medications:
Pathophysiology: o Corticosteroids: dexamethasone
• Chronic open-angle glaucoma results from o NSAIDs
overproduction or obstruction of the outflow of • Immobilization and protection of the inflamed joint
aqueous humor, causing increased IOP • Local application of heat or cold
• In secondary glaucoma, conditions such as trauma or Nursing Considerations:
surgery increases the risk of obstruction caused by • Maintain safety – side rails up
edema • Administer analgesic medication as needed for pain
• Acute angle-closure glaucoma results from
• Maintain adequate fluids as indicated
obstruction to the outflow of aqueous humor, causing
• Assist in ambulation
IOP to increase suddenly
• Teach the patient to avoid high-purine foods, such as:
Signs and Symptoms: “SIGHT”
o S – seafood L – lambs
• S – severe eye pain
o T – tuna A – alcohol
• I – increased IOP
o O – organ meats B – beef
• G – gradual loss of peripheral vision o P – pork S – sardines
• H – halos around lights
• T – tunnel vision
Diagnostics:
HYDROCEPHALUS
Description:
• Tonometry
• An excessive accumulation of CSF within the
• Perimetry
ventricular spaces of the brain
• Gonioscopy
• Normal CSF: 75-150mL
Management:
• Hydro = water, cephalus = head
• Medications: “EBAHM”
• Occurs most commonly in neonates
o E – epinephrine eye drops
Causes:
o B – beta blockers: timolol maleate
o A – anhydrase inhibitors: acetazolamide • Faulty absorption of CSF (communicating)
o H – hyperosmotics: mannitol • Obstruction in CSF flow (non-communicating)
o M – miotic eyedrops: pilocarpine sodium Pathophysiology:
• Surgical Treatment: • In non-communicating, the obstruction occurs most
o Argon laser trabeculoplasty frequently between the third and fourth ventricles, at
o Peripheral iridectomy the aqueduct of sylvius, which may result from faulty
o Trabeculectomy fetal development or infection
Nursing considerations: • In communicating, faulty absorption of CSF may
• Maintain safety – side rails up result from surgery or meningeal hemorrhage, in
• Stress the importance of compliance with prescribed either type, both CSF pressure and volume increase
therapy Signs and Symptoms: “WATER”
• Give medications as ordered and prepare him for • W – worsening headache
laser iridotomy or surgery • A – altered mental status/decreased LOC
• T – trouble with vision
• E – eyes fixed downward (sunset eyes)
GOUT
• R – rapid enlargement of head in infants =
Definition:
Diagnostics:
• Also called gouty arthritis, gout is metabolic disease
• CT scan
marked by urate deposits that cause painful arthritic
• Lumbar puncture
joints
• It’s found mostly in the foot, especially the great toe, • Ventriculography
Management:
ankle, and midfoot, but may affect any joint
Causes: “D’GOUT” • Medications:
• D – drug therapy result of hydrochlorothiazide o Osmotic diuretics: mannitol
• Surgery:
• G – genetic defect in purine metabolism
o Ventriculoperitoneal shunt
• O – obesity due to increased production of uric
o Ventriculoatrial shunt
• U – uric acid levels increased (hyperuricemia)
o Temporary external ventricular
• T – trigger foods high in purines
Transcribed by: Basti M. Sanchez RN 2024
Nursing Consideration: Pathophysiology:
• Encourage maternal-infant bonding when possible • The immune system attacks myelin sheath, which
• Place the infant on his side to and reposition every results in inflammation, demyelination, and damage
2hrs to prevent post-feeding aspiration and to nerve fibers, impairing the transmission of
hypostatic pneumonia electrical signals between the brain and other parts of
• When turning the infant, move his head, neck, and the body
shoulders together with his body to reduce strain on Signs and Symptoms:
his neck • Charcot’s triad:
o Dysarthria (difficulty articulating words)
MENIERE’S DISEASE o Intention tremors
Description: o Nystagmus (involuntary eye movement)
• An accumulation of fluid in the inner air • Uhtoff’s sign (heat makes S/Sx worse)
Diagnostics:
compartments, which can disrupt balance
Causes: • MRI
• Ear trauma • CSF via lumbar puncture
• Fluid build-up • Lhermitte’s sign
• Infection Management:
Pathophysiology: • Medications:
• Abnormalities in the fluid dynamics of the inner ear, o For acute exacerbation
particularly within the membranous labyrinth, leading ▪ Beta blockers: propranolol
to endolymphatic hydrops (buildup of fluids) ▪ Corticosteroids: prednisone,
Signs and Symptoms: “TSV” dexamethasone
▪ Corticotrophin: ACTH
• T – tinnitus (ringing sounds)
▪ Muscle relaxant: baclofen,
• S – sensory neural hearing loss
dantrolene sodium
• V – vertigo (dizziness)
o For chronic treatment
Diagnostics:
▪ Immunosuppressants: B-
• Audiometry interferon (Avonex, Rebif)
Management:
• IV methylprednisolone
• Medications: Nursing Considerations:
o Antiemetic: prochlorperazine
• Prevent worsening of S/Sx – avoid heat, stress
o Diuretics: spironolactone
• Maintain safety – side rails up
• Surgery:
• Assist in passive ROM exercises
o Endolymphatic sac decompression
• Assist in ambulation
Nursing Consideration: “CARLESS”
• Increase fluid intake and fiber diet
• C – comfortable and dark environment
• Assist in plasmapheresis/therapeutic plasma
• A – avoid smoking, avoid driving
exchange
• R – restrict sodium
• L – limit OFI
• E – emetic basin prepared OSTEOPOROSIS
• S – side rails up Description:
• S – surgery assist • A metabolic bone disorder in which the rate of bone
resorption accelerates while the rate of bone
formation slows, causing a loss of bone mass
MULTIPLE SCLEROSIS • Bones affected by this disease lose calcium and
Description: phosphate sals and become porous, brittle, and
• A chronic autoimmune disorder that causes abnormally vulnerable to fractures
demyelination of the myeline sheath of the brain and Causes:
spinal cord and damage to nerve fibers and their • The cause of primary osteoporosis is unknown
targets. Factors:
Types:
• Predisposing
• Elapsing-remitting – clear lapses with full recovery or o Age
partial recovery and lasting disability o Female sex
• Primary progressive – steady progression from the • Precipitating
onset with minor recovery o Endocrine disorders (hypoparathyroidism)
• Secondary progressive – begins as a pattern of clear- o Malnutrition (inadequate calcium and
cut relapses and recovery Vitamin D intake)
• Progressive relapsing – steadily progressive from the Pathophysiology:
onset, but also has clear acute attacks • Osteoporosis develops when the remodeling cycle is
Causes: interrupted and new bone formation falls behind
• Idiopathic, but current theories suggest that a slow- resorption
acting or latent viral infection triggers an autoimmune • When bones is reabsorbed faster than it forms, the
response bones becomes less dense
• Conditions that precede to onset or exacerbation: Signs and Symptoms:
o Acute respiratory infections • A snapping sound is heard when a postmenopausal
o Emotional stress bends and feels a sudden pain in her lower back
o Fatigue • Back pain that radiates around the trunk
o Pregnancy
• Colle’s fractures and hip fractures
Transcribed by: Basti M. Sanchez RN 2024
Diagnostics: • Assist in ambulation
• X-ray • Increase fluid intake and fiber diet
• CT scan • Assist in surgery – DBS
• Blood studies
• Bone biopsy SEIZURE DISORDER
Management: Definition:
• Medications: • Seizure disorder, or epilepsy, is a condition of the
o Analgesics brain characterized by susceptibility to recurrent
o Biphosponates: alendronate, ibandronate, seizures
risedronate Types:
o Calcium and Vitamin D supplements • Primary epilepsy is idiopathic without apparent
• Physical therapy structural changes in the brain
• Supportive devices • Secondary epilepsy is characterized by structural
• Surgery, if indicated changes or metabolic alterations of the neural
Nursing Considerations: membranes, causes increased automaticity
• Maintain safety – side rails up Causes:
• Administer analgesics as needed for pain • Anoxia
• Maintain adequate fluids as indicated • Birth trauma
• Assist in ambulation • Brain tumors
• Teach the patient good body mechanics • Head injury or trauma
• Infectious diseases
PARKINSON’S DISEASE • Injections of toxins (mercury, lead, or carbon
Definition: monoxide)
• Named for James Parkinson, the English physician • Degenerative disorders
who wrote the first accurate description of the • Metabolic disorders
disease in 1817 Pathophysiology:
• A progressive neurodegenerative disorder that affects • Some neurons in the brain may depolarize easily or be
movements, hyper-excitable; this epileptogenic focus fires more
• Characteristically produces progressive muscle readily than normal when stimulated
rigidity, akinesia, and involuntary tremor • These cells fire in turn and the impulse cascades to
Causes: one side of the brain (partial seizure), both sides of
• Idiopathic the brain (generalized seizure), or specific cortical,
Factors: subcortical, or brain stem areas
• Dopamine deficiency Signs and Symptoms:
• Exposure to toxins, such as manganese or carbon • Generalized seizure
monoxide o Tonic-clonic seizure:
Pathophysiology: ▪ Initial sign: aura
• Parkinson’s disease is a degenerative process ▪ Loss of consciousness
involving the dopaminergic neurons in the substantia ▪ Tonic-clonic contractions
nigra o Petit mal/absence seizure:
• Degeneration of the dopaminergic neurons and loss ▪ Blank stare
of available dopamine leads to an excess of excitatory ▪ Decreased blinking
acetylcholine at the synapse and consequent rigidity, ▪ Loss of consciousness
tremors, and bradykinesia ▪ Pausing amidst conversation
Signs and Symptoms: “PARKINS” • Status epilepticus
• P – pill-rolling tremors – especially at rest o Continuous seizure activity > 5mins
• A – akinesia (difficulty initiating movement) o 2 or more seizures within 5mins period
• R – rigidity (stiffness of the limbs) Diagnostics:
• K – bradykinesia (slowness of movement) • Health history – history of convulsion
• I – impaired posture and balance • CT scan
• N – non-motor symptoms (anxiety, depression) • EEG
• S – shuffling gait (small steps with feet closed) Treatment:
Diagnostics: • Medications:
• Catecholamine tests – to measure levels of dopamine o Anticonvulsants: phenytoin (Dilantin),
Management: carbamizepine, valzepine – for absence
seizure, phenobarbital
• Medications:
Nursing Considerations: “SEIZURE”
o Dopamine replacement agents: levodopa,
carbidopa • S – safety – ensure a safe environment:
o Antiparkinson’s: amantadine HCl o Don’t restrain
(Symmetrel) o Side rails up
o Turn to side
• Surgery:
o Deep brain stimulation (DBS) • E – evaluate – assess the patient’s ABC
o • I – identify and observe the seizure activity
Nursing Considerations: • Z – zone – maintain a calm environment
• Maintain safety – side rails up • U – unobstructed airway
• Assist in passive ROM exercises • R – reassurance – reorient the client
• E – eliminate triggers – reduce stimuli
Transcribed by: Basti M. Sanchez RN 2024
 III. INFLAMMATORY AND Nursing Considerations: “CHICKEN”
• C – comfort measure – provide relief for itching
IMMUNOLOGIC RESPONSE • H – hydration management
CEREBRAL ANEURYSM • I – infection control – isolation precautions
Description: • C – calamine lotions – to sooth the skin
• All called brain aneurysm, is a weak or bulging spot on • K – keep fingernails short to prevent scratching
the wall of a blood vessel in the brain that can rupture, • E – educate the patient and family about the disease
leading to subarachnoid hemorrhage • N – notify MD for worsening symptoms
Causes:
• High blood pressure
• Smoking
DENGUE HEMORRHAGIC FEVER
Description:
• Traumatic head injury
• A severe form of dengue virus infection, characterized
Pathophysiology:
by fever, bleeding, and plasma, leakage
• The walls of cerebral blood vessels weaken overtime,
Causes:
leading to the formation of a bulge or sac
• Caused by Aedes aegypti
• When it ruptures, blood leaks to the subarachnoid
Pathophysiology:
space, leading to subarachnoid hemorrhage
• The dengue virus enters the bloodstream and infects
Signs and Symptoms:
immune cells, leading to widespread dissemination
• Headache
throughout the body
• Eye pain
• The virus targets endothelial cells lining blood
• Loss of balance or coordination
vessels, causing endothelial dysfunction and
• Difficulty speaking increased vascular permeability, resulting in leakage
Diagnostics: of plasma from blood vessels into surrounding
• Cerebral angiography tissues
• CSF via lumbar puncture Signs and Symptoms:
Management: • Sudden onset of high fever
• Surgery • Headache and retro-orbital pain
o Endovascular procedures • Hemorrhagic manifestations (petechia, ecchymosis)
o Surgical clipping
• Nausea and vomiting
Nursing Considerations:
• Muscle and joint pain
• Maintain a patent airway
Diagnostics:
• Administer oxygen as prescribed
• NS1 antigen test – to detect dengue virus antigen
• Provide a quiet environment
• Hematological tests – platelet, hematocrit
• Monitor VS, I&O, neuro check Management:
• Avoid taking rectal temperature • Fever and pain management
• Fluid replacement therapy
CHICKEN POX • BT for severe bleeding
Description: Nursing Considerations:
• Also known as varicella, a highly contagious viral • Monitor VS, I&O, and platelet count
infection caused by varicella-zoster virus (VZV) • Maintain adequate fluids as indicated
• Characterized by a widespread rash of itchy, fluid- • Provide adequate rest and comfort measures
filled blisters that eventually crust over • Observe signs of bleeding and hemorrhagic
Causes: complications
• Caused by VZV, which spreads easily through:
o Respiratory droplets
o Direct contact with rash or blisters
EBOLA VIRUS
Description:
Pathophysiology:
• Also known as ebola hemorrhagic fever, a severe viral
• The varicella-zoster virus enters the body's respiratory
illness cause by ebola virus
tract and replicates in the respiratory mucosa, it then
• Characterized by a high mortality rate, causing severe
spreads to the regional lymph nodes and enters the
bloodstream hemorrhagic symptoms, organ failure, and death
Causes:
• The virus targets epithelial cells, causing
• Caused by ebola virus, a member of the Filoviridae
characteristic skin lesions (vesicles)
family
Signs and Symptoms:
Pathophysiology:
• Fever
• The virus infects various cell types, including immune
• Headache
cells, endothelial cells, and hepatocytes
• Loss of appetite
• The virus replicates rapidly, causing immune
• Malaise
dysregulation, endothelial dysfunction, and
• Rash – red spots that progress to fluid filled vesicles
coagulation abnormalities
Diagnostics:
Signs and Symptoms: “EBOLA V”
• Laboratory tests – viral culture
• E – extreme fatigue
Management:
• B – bleeding
• Medications:
• O – organ failure
o Antipyretic: acetaminophen
• L – loss of appetite
o Antiviral: acyclovir
• A – abdominal pain
o Antihistamine: diphenhydramine
o VZV immunoglobulin • V – vomiting and diarrhea
Transcribed by: Basti M. Sanchez RN 2024
Diagnostics: • Monitor VS, I&O, and neuro check
• PCR test – to detect RNA of virus • Assist in passive ROM exercises
• Serological tests • Assist in plasmapheresis
Management:
• Fever and pain management GERMAN MEASLES
• Fluid replacement therapy Description:
• Isolation precautions • A viral infection characterized by a mild rash and
Nursing Considerations: fever, however rubella infection during pregnancy can
• Implement standard infection control precautions have serious effects to the developing fetus
• Monitor VS, I&O – for complications Causes:
• Maintain adequate fluids as indicated – for hydration • Caused by the rebulla virus
• Provide compassionate and supportive care Pathophysiology:
• Educate the patient and family about disease • The virus enters the respiratory tract and replicates in
the nasopharyngeal mucosa
GUILLAIN-BARRÉ SYNDROME • The virus targets epithelial cells, lymphocytes, and
Description: endothelial cells, causing mild to moderate
• Also known as infectious polyneuritis, GBS is an inflammation and immunopathology, particularly in
acute, rapidly progressive and potentially fatal form of lymphoid tissues and skin
polyneuritis that causes muscle weakness and mild Signs and Symptoms: “RUBELLA”
distal sensory loss • R – rash (pink or light red spots)
Phases: • U – upset stomach or nausea
• Acute phase – beginning with the onset of the first • B – body aches
definitive symptom and ends 1 to 3 weeks later • E – enlarged lymph nodes
• Plateau phase – lasting several days to 2 weeks • L – low-grade fever
• Recovery phase – believed to coincide with • L – lethargy or fatigue
remyelinization and regrowth of axonal processes, • A – arthralgia (joint pain)
extending over 4 to 6 months Diagnostics:
Causes: • PCR test – to detect RNA of virus
• Idiopathic • Serological tests
Factors: Management:
• Predisposing • Fever and pain management
o Ages 30 to 50 • Fluid replacement therapy
• Precipitating • Isolation precautions
o Hodgkin’s or other malignant disease Nursing Considerations:
o Rabies or swine influenza vaccination • Implement standard infection control precautions
o Surgery • Monitor for VS, I&O – for complications
o Systemic lupus erythematous • Maintain adequate fluids as indicated – for hydration
Pathophysiology: • Provide compassionate and supportive care
• The major pathologic manifestation is segmental • Educate the patient and family about disease
demyelinization of the peripheral nerves, this
prevents normal transmission of electrical impulses
along the sensorimotor nerve roots HEPATITIS (VIRAL INFECTION)
• Signs of sensory and motor losses occur Description:
simultaneously because this syndrome causes • Viral hepatitis is a common infection of the liver,
inflammation and degenerative changes in both the resulting cell destruction, necrosis, and autolysis
posterior and anterior nerve roots Types:
Signs and Symptoms: • Hepa A – most common among male homosexuals
• Initial sign: clumsiness and people with HIV, spread via the fecal-oral route
• Muscle weakness (ascending type) • Hepa B – also common in HIV positive individuals,
• Numbness or tingling in the extremities transmitted by needles shared by drug abusers
• Paresthesia • Hepa C – accounts for 20% of all viral hepatitis cases
• Respiratory difficulties (DOB) and for most post-transfusion cases
Diagnostics: • Hepa D – causes unremitting liver failure with
• CSF analysis by lumbar puncture – to check CSF encephalopathy, progresses to coma and leads to
protein levels death in 2 weeks
• Electromyography • Hepa E – occurs primarily among patients who have
Management: recently returned from an endemic area
• Medications: Causes:
o Anti-arrhythmic: amiodarone • The five major forms of viral hepatitis results from
o Corticosteroids: prednisone, infection with the causes viruses: A, B, C, D, or E
dexamethasone Pathophysiology:
o IV immunoglobulins • On entering the body, the virus causes hepatocyte
• Plasmapheresis injury and death, either by directly killing the cells or
• Physical therapy and rehabilitation by activating inflammatory and immune reactions
Nursing Considerations: • The inflammatory and immune reactions will in turn
• Maintain a patent airway injure or destroy hepatocytes by lysing the infected or
• Maintain safety – side rails up neighboring cells
Transcribed by: Basti M. Sanchez RN 2024
Signs and Symptoms: Management:
• H – jaundice (yellowing of the skin and eye) • Antiretroviral therapy:
• E – elevated liver enzymes o Fusion inhibitors
• P – pale stools (clay colored stools) – decreased bile o Non-nucleoside reverse-transcriptase
• A – abdominal pain or discomfort inhibitors
• T – tiredness or fatigue o Nucleotide reverse transcriptase inhibitors
• I – itching (pruritus) o Protease inhibitors
• T – tea colored urine (dark color) – from urobilinogen Nursing Considerations:
• I – inappetence (loss of appetite) • Implement standard infection control precautions
• S – stomach upset or diarrhea • Monitor for VS, I&O, and CD4 cell counts
Diagnostics: • Maintain adequate fluids as indicated – for hydration
• Liver function tests (LFT) • Provide compassionate and supportive care – to help
• Serological tests the patient cope with emotional burden of serious-
• Serum bilirubin level illness and the threat of death
Management: • Educate the patient and family about disease
• Medications:
o Antiviral for hepa B: tenofovir, adefovir MERS-CoV
• Management of symptoms Description:
• Vaccination against hepa • Middle East Respiratory Syndrome Coronavirus is a
• Diet therapy with small, high-calorie meals to combat viral respiratory illness leading to acute respiratory
anorexia distress syndrome
Nursing Considerations: Causes:
• Implement standard infection control precautions • Caused by MERS-CoV virus via close contact with
• Monitor for VS, I&O, LFTs – for complications infected individuals
• Maintain adequate fluids as indicated – for hydration Pathophysiology:
• Provide compassionate and supportive care • The virus infect cells in the respiratory tract, including
• Educate the patient and family about disease the lower respiratory tract
• The virus primarily targets cells expressing the
dipeptidyl peptidase 4 (DPP4) receptor
HUMAN IMMUNODEFICIENCY VIRUS (HIV) Signs and Symptoms:
Description:
• Fever
• HIV is an infection characterized by gradual
• Chest pain
destruction of the immune system, specially targeting
• Cough
CD4 cells (T cells), weakening the body’s ability to
• Shortness of breath
fight infections and diseases
• Sore throat
• The resulting immunodeficiency makes the patient
susceptible to opportunistic infections, cancers, and • Muscle aches
other abnormalities that define AIDS Diagnostics:
Causes: • RT-PCR – to detect RNA of virus
• Contact with infected blood or body fluids • Serological tests
• Neonates of infected women • Chest X-ray
• Recipients of contaminated blood or blood products Management:
• Sharing contaminated needles or syringes • Maintain patent airway and provide supplemental
Pathophysiology: oxygenation as indicated
• History of AIDS begins with infection by the HIV • Implement standard infection control precautions
retrovirus, detectable only by laboratory tests • Maintain adequate fluids as indicated – for hydration
• HIV strikes the helper T cells bearing the CD4 antigen • Monitor for VS, I&O – for signs of complications
• HIV copies its genetic material in a reverse manner • Provide compassionate and supportive care
compared with other viruses and cells • Educate the patient and family about disease
• Through reverse transcriptase, HIV produces from its
viral RNA MYASTHENIA GRAVIS
• The viral DNA enters the nucleus of the cell and is Description:
incorporated into the host cell’s DNA, transcribing • Chronic autoimmune disorder in impulse
into more viral RNA transmission at neuromuscular junction
Signs and Symptoms: “IMMUNO” • Characterized by muscle weakness and fatigue
• I – intermittent fever Causes:
• M – malaise • Idiopathic
• M – mouth or genital ulcers 2 Types:
• U – unexplained weight loss • Myasthenic crisis
• N – night sweats o Causes: “USI”
• O – opportunistic infections (pneumonia) ▪ U – under medication
• D – diarrhea ▪ S – stress
• E – enlarged lymph nodes ▪ I – infection
Diagnostics: o S/Sx:
• HIV antibody tests (EIA) ▪ Can’t see (ptosis)
• PCR test – to detect RNA of virus ▪ Can’t swallow (dysphagia)
▪ Can’t breathe
• CD4 T-cell count of less than 200 cells/mm3
Transcribed by: Basti M. Sanchez RN 2024
 • Cholinergic crisis o In the second stage, pannus (thickened
o Causes: layer of granulation tissue), covers and
▪ Over medication invades cartilage and eventually destroys
o S/Sx: “SLUDGE” the joint capsule and bone
▪ S – salivation o In the third stage, fibrous ankylosis (fibrous
▪ L – lacrimation invasion of the pannus and scar formation)
▪ U – urination occludes the joint space
▪ D – defecation o In the last stage, fibrous tissue calcifies,
▪ G – GI distress/cramping resulting in bony ankylosis and total
▪ E – emesis/vomiting immobility
Pathophysiology: Signs and Symptoms: “RHEUMA”
• Antibodies mistakenly attacks the acetylcholine • R – redness and warmth at affected joints
receptors (AChR) at the neuromuscular junction • H – hand deformities (carpal tunnel syndrome)
• This results in decreased binding of acetylcholine to • E – early morning stiffness
its receptors, leading to impaired neuromuscular • U – u feel numbness and pain
transmission, muscle weakness, and paralysis • M – malaise
Signs and Symptoms: “MYASTHENIA” • A – affected joints tender to touch
• Initial sign: ptosis Diagnostics:
• M – muscle weakness (descending) • RF titer
• Y – you can’t see (ptosis) • Synovial fluid analysis
• A – altered facial expression (mask like facies) • X-ray
• S – swallowing difficulties Management:
• T – trouble speaking • Medications:
• H – hoarseness of voice o Corticosteroids: dexamethasone
• E – eye muscle weakness o NSAIDs
• N – neck weakness o salicylates (aspirin)
• I – ineffective breathing • Disease modifying anti-rheumatic drug
• A – apneic episodes o azathiopine and methotrexate
Diagnostics: • Biological response modifiers
• Tensilon (edrophonium) test o Tumor necrosis inhibtors
o Strengthens muscle only for 5-10mins o Anakinra
• CSF analysis via lumbar puncture • Joint reconstruction/joint arthroplasty
o Reveals increased cholinesterase level • Osteotomy
Management: • Synovectomy
• Medications: Nursing Considerations:
o Cholinergic: pyridostigmine (Mestinon) • Maintain safety – side rails up
o Corticosteroids: prednisone, • Administer analgesics as needed for pain
dexamethasone • Maintain adequate fluids as indicated
o Immunosuppressants: azathioprine, • Assist in ambulation
methotrexate • Provide meticulous skin care and check for
Nursing Considerations: rheumatoid nodules as well as pressure ulcers
• Maintain a patent airway
• Maintain safety – side rails up SEPTIC SHOCK
• Monitor VS, I&O, and neuro check Description:
• Assist in passive ROM exercises • A condition that occurs as a result of a severe
• Assist in plasmapheresis infection leading to systemic inflammatory response
syndrome (SIRS)
RHEUMATOID ARTHRITIS • Characterized by profound drop in blood pressure,
Description: inadequate tissue perfusion, and organ failure
• RA is a chronic, systemic inflammatory disease that Causes:
primarily attacks peripheral joints and the • Arises from a sever infection
surrounding muscles, tendons, ligaments, and blood Pathophysiology:
vessels • The body’s immune response to infection becomes
Causes: dysregulated, leading to systemic inflammation,
• The cause of chronic inflammation characteristic of vasodilation, and impaired tissue perfusion
RA is unknown • This results in hypotension, hypoxia, and cellular
• Theories include: dysfunction
o Abnormal immune system activation Signs and Symptoms: “SEPTIC”
o Development of IgM antibody against the • S – sudden onset of fever or hypothermia
body’s own IgG • E – extreme hypotension
o Possible infection • P – pale or mottled skin
Pathophysiology: • T – tachycardia
• The inflammatory process in the joints occurs in four • I – increased RR
stages: • C – confusion or altered mental status
o In the first stage, synovitis develops from Diagnostics:
congestion and edema of the synovial • Blood culture – to identify causative organism
membrane and joint capsule • CBC with differential count
Transcribed by: Basti M. Sanchez RN 2024
Management: Diagnostics:
• Medications: • Blood culture – to detect Clostridium tetani
o Broad spectrum antibiotics: ceftriaxone, Management:
cefepime • Medications:
o Corticosteroids o Analgesics: opioids
• Fluid resuscitation o Muscle relaxant: benzodiazepines
• Surgery to remove infected tissue • Tetanus immunglobulin
Nursing Considerations: • Tetanus vaccination
• Monitor VS, I&O, and neuro check Nursing consideration:
• Administer medications as prescribed • Monitor VS, I&O, and neuro check
• Maintain adequate fluids as indicated • Administer medications as prescribed
• Observe for signs of complications • Provide compassionate and supportive care
• Observe for signs of complications
SYSTEMIC LUPUS ERYTHEMATOUS • Educate the patient and family about the importance
Description: of tetanus vaccination
• A chronic autoimmune disease characterized by
inflammation and damage to various organs, as well IV. DISTURBANCES IN OXYGENATION
as the skin ANEMIA
Causes: Description:
• Idiopathic • A blood disorder characterized by a reduction in the
Pathophysiology: number of RBCs or the amount of hemoglobin in the
• The body’s immune system produces autoantibodies blood.
that target and attack healthy tissues and organs, • This leads to insufficient oxygen transport to the
leading to inflammation and tissue damage body’s tissues, causing various sympytoms
Signs and Symptoms: Causes:
• Butterfly shaped rash on the face (malar rash) • Bloods
• Fatigue • Pregnancy
• Photosensitivity • Inadequate iron intake
• Raynaud’s phenomenon Pathophysiology:
• Swollen joints • Iron deficiency anemia involves inadequate iron for
Diagnostics: hemoglobin synthesis, leading to smaller and paler
• Antinuclear antibody test – hallmark of lupus RBCs
• Immunological tests – for specific autoantibodies Signs and Symptoms: “WASHED THE PEAS”
Management: • W – weight loss
• Medications: • A – anorexia
o Corticosteroids: prednisone • S – syncope
o Immunosuppressants: methotrexate • H – headache
o NSAIDs
• E – easy fatiguability
o Vasodilator: pentoxifylline
• D – dizziness
Nursing Considerations:
• T – tachycardia
• Monitor VS, I&O, and neuro check
• H – hair and nail brittle
• Administer medications as prescribed
• E – energy lacking
• Maintain adequate fluids as indicated
• P – paresthesia, pallor, PICA
• Provide compassionate and supportive care
• E – exertion dyspnea
• Observe for signs of complications
• A – amenorrhea
• S – sensitivity to cold
TETANUS (LOCKJAW) Diagnostics:
Description: • CBC – RBC, Hgb, Hct, Iron
• A serious bacterial infection caused by Clostridium Management:
tetani, leading to muscle stiffness and spasms • Medications:
Causes: o Iron supplement:
• Cause by C. tetani, which produces a potent ▪ Oral: ferrous sulfate
neurotoxin called tetanospasmin ▪ IV: Iron Dextran
Pathophysiology: ▪ IM: Iron Sorbitex
• The Clostridium tetani bacteria releases o Vitamin C
tetanospasmin, blocking the release of inhibitory Nursing Consideration:
neurotransmitter GABA at the neuromuscular • Monitor VS, I&O, and neuro check
junction • Administer medications as prescibred
• This lead to uncontrolled muscle contractions • Provide adequate rest and comfort measures
Signs and Symptoms: “TETANY” • Teach patient on dietary modifications
• T – trismus (lockjaw) • Educate on the importance of follow up
• E – excruciating muscle spasms
• T – tetanic contractions
ASTHMA
• A – autonomic disturbances (rapid HR, HTN)
Description:
• N – neck stiffness and dysphagia
• A chronic respiratory condition characterized by
• Y – yawning frequently
inflammation and narrowing of the airways
Transcribed by: Basti M. Sanchez RN 2024
Causes: Management:
• Idiopathic • Medications:
Risk Factors: o Analgesics
• Exposure to allergens o Bronchodilators
• Air pollutants o Mucolytics
• Cold air • Incentive spirometry
• Stress and physical activity • Chest physiotherapy
Pathophysiology: • Oxygen therapy
• Inflammation leads to airway edema, mucus Nursing Considerations:
production, and bronchoconstriction, contributing to • Assess for signs or worsening condition
the narrowing of the airways and difficulty breathing • Administer medications and oxygen as prescribed
Signs and Symptoms: “BRONCHIAL” • Monitor response to treatment
• B – breathing difficulties • Provide compassionate and supportive care
• R – recurrent coughs, at night or early morning • Educate the patient and family about the disease
• O – overproduction of mucus
• N – noisy breathing CHRONIC OBSTRUCTIVE PULMONARY
• C – chest tightness
DISEASE
• H – hyperinflation of lungs
Description:
• I – increased RR
• A chronic inflammatory lung disease causing
• A – anxiety or panic during asthma attacks
obstructed airflow in the lungs
• L – low O2 in blood Risk Factors:
Diagnostics:
• Exposure to allergens
• Metacholine challenge test
• Genetics
• Spirometry
• Second hand cigarette smoke
Management:
Types:
• Medications: “ASTHMA”
• Chronic bronchitis
o A – aerosol: salbutamol/albuterol
o Inflammation of the bronchus
o S – steroids: budesonide inhaler
o Blue bloaters – due to hypoxemia and
o T – theophylline
cyanosis
o H – hydration IV
• Emphysema
o M – mucolytics
o Irreversible terminal stage of COPD
o A – antibiotics
o Alveoli hyperinflation causing
Nursing Considerations:
anteroposterior chest diameter (barre chest)
• Assess for signs or worsening asthma
o Pink puffers – due to hyperventilation
• Administer medications and oxygen as prescribed Pathophysiology:
• Monitor response to treatment • Inflammation and thickening of the bronchial walls,
• Demonstrate the correct use of inhalers and other causing decreased airflow and gas exchange,
devices resulting in difficulty breathing
• Educate the patient and family about asthma and its • Increased mucus production, causing obstruction
triggers airflow, resulting in chronic coughing
Signs and Symptoms: COPD”
ATELECTASIS • C – chronic cough
Description: • O – overproduction of mucus
• A condition characterized by the partial or complete • P – persistent dyspnea
collapse of a lung or lobe of a lung • D – decreased O2
Causes: Diagnostics:
• Obstructive: airway obstruction • ABG
• Compression: external pressure on the lung • Chest X-ray
• Contraction: fibrotic changes in the lung • Pulmonary function test
• Postoperative: anesthesia effects Management:
• Cicatrization: lung scarring • Medications:
Pathophysiology: o Antitussives: dexthromethorphan
• Disruption in the normal balance of forces between o Bronchodilators: albuterol, isoproterenol
the chest wall and lung tissue, leading to collapse due o Corticosteroid inhaler: beclomethasone
to the inherent elastic recoil of the lung o Expectorant: guaifenesin
• Lack of ventilation results in impaired oxygen o Leukotriene antagonists: montelukast,
exchange and can lead to hypoxia zafirlukast
Signs and Symptoms: • Oxygen therapy: 2-3L/min
• DOB Nursing Considerations:
• Chest pain • Assess for signs or worsening condition
• Cyanosis • Administer medications and oxygen as prescribed
• Decreased breath sounds • Monitor response to treatment
Diagnostics: • Monitor respiratory status and oxygen saturation
• Chest X-ray • Provide compassionate and supportive care
• Bronchoscopy • Educate the patient and family about the disease
• Pulmonary function test

Transcribed by: Basti M. Sanchez RN 2024

 COVID-19 • Assist in surgery – thoracotomy
Description: • Educate the patient and family about post-op care
• A contagious disease caused by the severe acute
respiratory syndrome coronavirus 2 (SARS-CoV-2), PNEUMONIA
characterized by asymptomatic to severe respiratory Description:
illness • An acute respiratory infection that affects the lung
Causes: parenchyma, impairing gas exchange
• Caused by SARS-CoV 2 virus via close contact with Causes:
infected individuals • Bacterial pneumonia: Streptococcus pneumoniae
Pathophysiology: • Fungal pneumonia: Pneumocystis jirovecii
• The virus infects the body by binding to the • Viral pneumonia: RSV, SARS-CoV
angiotensin-converting enzyme (ACE 2) receptors, Pathophysiology:
disrupting normal cellular processes, leading to the • Involves invasion of the lung parenchyma by a
disease manifestations pathogen, overcoming the body’s defense
Signs and Symptoms: “COVID” mechanisms
• C – cough • The alveoli fills with inflammatory cells and fluid,
• O – onset of fever or chills interfering with oxygen exchange
• V – vomiting or nausea Signs and Symptoms:
• I – increased fatigue or weakness • Cough
• D – diarrhea • Chest pain
Diagnostics: • Fever and chills
• RT-PCR – to detect RNA of virus • Fatigue
Management: • Shortness of breath
• Medications: Diagnostics:
o Antiviral • Chest X-ray
o corticosteroids • Sputum tests
• Oxygen therapy Management:
• Mechanical ventilation • Medications:
Nursing Considerations: o Antipyretic: acetaminophen
• Implement standard infection control precautions o Bacterial: antibiotics
• Assess for signs or worsening condition o Fungal: antifungal
• Administer medications and oxygen as prescribed o Viral: antiviral
• Monitor respiratory status and oxygen saturation • Oxygen therapy
• Provide compassionate and supportive care Nursing Considerations:
• Educate the patient and family about the disease • Implement standard infection control precautions
• Assess for signs or worsening condition
HEMOTHORAX • Administer medications and oxygen as prescribed
Description: • Monitor respiratory status and oxygen saturation
• Accumulation of blood in the pleural cavity, the space • Provide compassionate and supportive care
between the lungs and the chest wall • Educate the patient and family about the disease
Causes:
• Penetrating chest injuries PNEUMOTHORAX
• Surgical complications Description:
Pathophysiology: • Presence of air in the pleural space, causing partial or
• Disruption in the integrity of blood vessels in the complete lung collapse
chest wall, leading to blood accumulation in the Causes:
pleural space • Chest injuries
• This accumulation ca compress the lung, impairing • Iatrogenic
respiratory function by limiting lung expansion Pathophysiology:
Signs and Symptoms: “HEMO T” • Air enters the pleural space, disrupting the negative
• H – hemoptysis (coughing out blood) pressure essential for lung expansion, leading to lung
• E – extreme chest pain (sharp or stabbing) collapse on the affected side, reducing gas exchange
• M – mediastinal shift (deviation of the mediastinum) and oxygenation
• O – oxygen desaturation Signs and Symptoms:
• T – tachypnea • A – absent breath sounds on one side of the chest
Diagnostics: • I – increased RR
• Chest X-ray • R – respiratory distress
• Thoracentesis Diagnostics:
Management: • Chest X-ray
• Surgery: Management:
o Thoracotomy – to drain blood and relieve • Chest tube insertion
pressure Nursing Considerations:
• Blood transfusion – if significant blood loss occurred • Assess for signs or worsening condition
Nursing Considerations: • Monitor respiratory status and oxygen saturation
• Assess for signs or worsening condition • Assist in chest tube insertion
• Monitor respiratory status and oxygen saturation • Educate the patient and family about post-op care
Transcribed by: Basti M. Sanchez RN 2024
 PULMONARY EMBOLISM
Description:
• Occurs when a blood clot forms in one part of the
body, usually the legs, and travels to the lungs, where
it blocks blood flow
Causes:
• Deep vein thrombosis (DVT)
Risk Factors: “D’CHOPS”
• D – diet high in saturated fats, DM
• C – chronic anemia, CHF
• H – hyperlipidemia
• O – obesity
• P – prolonged use of oral contraceptives
• S – smoking, sedentary lifestyle
Pathophysiology:
• When a blood clot forms in the deep veins
(thrombus), it can dislodge and travel through the
bloodstream (embolus)
• Until it reaches the lungs, it can block one of the
pulmonary arteries, leading to pulmonary embolism
Signs and Symptoms:
•

Transcribed by: Basti M. Sanchez RN 2024