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Steps in the Nursing Process ADPIE (A Delicious PIE)

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A-ssessment D- iagnosis P-lanning I-mplementation E-valuaton

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Inflammation (HIPER)

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H-eat I-nduration P-ain E-dema R-edness

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Acid-Base (ROME)

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R-espiratory O-pposite M-etabolic E-qual

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CANCER'S Early Warning Signs CAUTION UP

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C-hange in bowel or bladder A- lesion that does not heal U-nusual bleeding or discharge T-hickening or lump in breast or elsewhere I-ndigestion or difficulty swallowing O-bvious changes in wart or mole N-agging cough or persisten hoarseness U-nexplained weight loss P-ernicious Anemia

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CANCER Interventions

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C-omfort A-ltered Body Image N-utrition C-hemotherapy E-valuate response to meds R-espite for caretakers

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Hypoglycemia (TIRED) - an abnormal decrease of blood in the sugar

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T-achycardia I-rritability R-estless E-xcessive Hunger D-iaphoresis/ Depression

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Adrenal Gland Hormones (SSS)

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S-ugar (Glucocorticoids) S-alt (Mineralcorticoids) S-ex (Androgens)

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Pulmonary Edema (MAD DOG)

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M-Morphine A-Aminophylline D- Digitalis D-Diuretics (Lasix) O- Oxygen G- ases (Blood Gases ABG's)

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5 P's of Circulatory Checks

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P-Pain P-Paresthesia P-Paralysis P-Pulse P-Pallor (Paleness)

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Hypertension Nursing Care (DIURETIC)

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D-aily Weight I- ntake and Output (I & O) U- rine Output R-esponse of BP E-lectrolytes T-ake Pulses I-schemic Episodes (TIA) C-omplications: 4C's

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4 C's of Hypertension (Complications)

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C- Coronary Artery Disease C- Coronary Rheumatic Fever C- Congestive Heart Failure C- Cardio Vascular Accident

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Complications of Trauma Client (TRAUMATIC)

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T-issue Perfusion Problems R-espiratory Problems A-nxiety U-nstable Clotting Factors M-alnutrition A-ltered Body Image T-hromboembolism I-nfection C-oping Problems

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Cyanotic Defects: 4 T's

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T- Tetralogy of Fallot T- Truncus Arteriosus T- Transportation of the Great Vessels T- Tricuspid Atresia

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Cranial Nerve Mnemonic 01

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O-Lympic (Olfactory) O-Pium (Optic) O-Ccupies (Oculomotor) T-ROubled (Trochlear) T-RIathletes (Trigeminal) A-fter (Abducens) F-inishing (Facial) V-Egas (Vestibulocochlear) G-ambling (Glossopharyngeal) V-Acations (Vagus) S-till (Spinal Accessory) H-igh (Hypoglossal)

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Cranial Nerve Mnemonic 02

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O- Oh O- Oh O- Oh T- To T- Touch A- And F - Feel A G - irl's V - agina S - So H- Heavenly

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Cranial Nerve Mnemonic 03

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O- On O -Old O- Obando T- Tower T- Top A- F- Filipino A - Army G - Guards V - Villages A - And H - Huts

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Cranial Nerve Mnemonics (Sensory, Motor or Both)

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S - Some S - Says M- Marilyn M- Monroe B - But M- My B- Brother S- Says B- Bridget B - Bardot M- Mmm M- Mmm

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Cranial Nerve Mnemonics 02 (Sensory, Motor or Both)

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S- Some S- Say M - Marry M- Money B- But M- My B - Brother S- Says B- Bad B- Business M - Marry M - Money

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Nursing Care for Sprains and Strains (RICE)

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R- Rest I - Ice C - Compression E- Elevation

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Care of Client in Traction (TRACTION)

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T- Temperature (Extremity, Infection) R - Ropes hang freely A - Alignment C - Circulation Check (5 P's) T- Type & Location of fracture I - Increase fluide intake O - Overhead trapeze N - No weights on bed or floor

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OB Non-Stress Test (NNN) 3 negatives in a row to interpret results of Non-Stress Test

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N - Non-reactive N - Non- Stress is N - Not good

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Severe Pre-Eclampsia (HELLP)

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H- emolysis E- levated L- iver function tests L- ow P- latelet count

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Assessment Tests for Fetal Well-Being (ALONE)

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A- Amniocentesis L- L/S Ratio O - Oxytocin Test N - Non-Stress Test E - Estriol Level

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Evalution of Episiotomy Healing (REEDA)

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R- Redness E- Edema E - Ecchymosis D - Discharge, Drainage A - Approximation

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Evalution of Episiotomy Healing (REEDA)

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R- Redness E- Edema E - Ecchymosis D - Discharge, Drainage A - Approximation

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Post-Partum Assessment (BUBBLE)

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B-reasts U-terus B-owels B-ladder L-ochia E-pisiotomy/lateration/C-section incision

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Tracheal Esophageal Fistula (3 C's)

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C- Choking C- Coughing C - Cyanosis

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Cleft Lip - Post Op Care (CLEFT LIP)

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C-hoking L-ie on back E-valuate Airway F-eed Slowly T-eaching L-arger nipple opening I-ncidence incerase in males P-revent crust formation and aspiration

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ADLs (Activity of Daily Living) BATTED

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B-athing A-mbulation T-oileting T-ransfers E-ating D-ressing

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IADLS (Instrumental Activities of Daily Living) SCUM

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S-hopping C-ooking and Cleaning U-sing telephone or transportaiton M-anaging money and medications

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Bleeding Precautions (RANDI)

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R- Razor Electric/ Blades A- Aspirin N- No needles (esp. in small gauge) D- Do decrease in needle sticks) I - Injury (Protect from)

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Canes and Walkers (COAL)

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C- Cane O- Opposite A- Affected L- Leg

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Canes and Walkers (WWAL) Wandering Wilma's Always Late

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W- Walker W- With A- Affected L - Leg

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Common Causes of Transient Incontinence (DIAPPERS)

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D-elirium I-nfection A-trophic Urethra P-harmaceuticals P-sychologic E-xcess Urine Output R-estricted Mobility S-tool Impaction

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Promotion of Normal Elimination (POOPER SCOOP)

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P-osition O-utput O-ffer Fluids P-rivacy E-xercise R-eport Results S-ize (Amount) C-onsistency O-ccult Blood O-dor P-eristalsis

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Emergency Trauma Assessment (ABCDEFGHI)

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A-irway B-reathing C-irculation D-isability E-xamine F-ahrenheit G-et Vitals H-ead to Toe Assessment I-ntervention

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Trauma Surgery (AMPLE) after initial assessment

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A-llergies M-edications P-ast Medical History L-ast Meal E-vents Surrounding Injury

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Trauma Surgery (AMPLE) after initial assessment

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A-llergies M-edications P-ast Medical History L-ast Meal E-vents Surrounding Injury

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6 P's of Dyspnea

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P- Pulmonary Bronchial Constriction P- Possible Foreign Body P- Pulmonary Embolus P- Pneumothorax P- Pump Failure P- Pneumonia

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Lidocaine Toxicity (SAMS)

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S-lurred Speech A-ltered Central Nervous System M-uscle Twitching S-eizures

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TDCI (These Drugs Can Interact)

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T - Theophyline D - Dilantin C - Coumadin I - losone (Erythromycin)

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Serious Complications of Oral Birth Control Pills (ACHES)

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A- Abdominal Pain C - Chest Pain H - Headache E - Eye Problems S - Severe Leg Pain

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Emergency Drugs to LEAN on

answer

L- Lidocaine E - Epinephrine A- Atropine Sulfate N - Narcan

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Drugs for Bradycardia & low BP (IDEA)

answer

I - Isoproterenol D - Dopamine E - Epinephrine A - Atropine Sulfate

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Cholinergic Crisis (SLUD)

answer

S-alivation L-acrimation U-rination D-efecation

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Depression Assessment (SIG)

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S-leep Disturbances I-nterest Decreased G-uilty Feelings

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Energy Decreased (CAPS)

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C-oncentration decreased A-ppetite P-sychomotor function decreased S-uicidal Ideations

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5 A's to Alzheimer Diagnosis

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A-mnesia A-nomia A-praxia A-gnosia A-phasia

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Major Symptoms of a Manic Attack (DIG FAST)

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D- Distractibility I - Indiscretion G - Grandiosity F- Flight of Ideas A- Activity Increase S- Sleep Deficit T - Talkative

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3 P's of Blindness

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P- Preventable P- Painless P- Permanent

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Symptoms of Leukemia (ANT)

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A- Anemia N- Neutropenia T- Thrombocytopenia

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Exercise Guide for Diabetic Fitness (FIT)

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F - Frequency (3x per week) I - Intensity (60-80% of Maximal Heart Rate) T- Time (Aerobic Activity)

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Symptoms of Hypoxia (RAT BED)

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Early Hypoxia: R-estlessness A-nxiety T-achycardia/ Tachypnea Late Hypoxia: B-radycardia E-xtreme Restlessness D-yspnea

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Symptoms of Hypoxia (in Pediatrics) - FINES

answer

F-eeding difficulty I-nspiratory Stridor N-ares Flares E-xpiratory Grunting S-ternal Retractions

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Management of ASTHMA

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A-drenergics (Albuterol) S-teroids T-heophylline H-ydration (IV) M-ask (Oxygen) A-ntibiotics

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Epiglottitis (AIR RAID)

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A-irway Closed I-ncreased Pulse R-estlessness R-etractions A-nxiety Increased I-nspiratory Stridor D-rooling

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Blood Flow Through the Cardiac Valves (Tissue Paper My Assets)

answer

T-ricuspid P-ulmonic M-itrial A-ortic

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Immediate Treatment of a Myocardial Infarction Client (MONA)

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M- Morphine O- Oxygen N- Nitroglycerine A- ASA

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Treating CHF (UNLOAD FAST)

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U-pright Position N-itrates (in low dose) L-asix O-xygen A-minophylline D-igoxin F-luids (decrease) A-fterload (decrease) S-odium restriction T-est (Dig level, ABGs, K level)

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DEMENTIA

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Make sure they don't have problems with: D-rug and alcohol E-yes and ears M-etabolic and endocrine disorders E-motional disorders N-eurologic disorders T-umors and trauma I-nfection A-rteriovascular disease

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Osteoporosis Risk Factors (ACCESS)

answer

A-lcohol Use C-orticosteroid Use C-alcium low E-strogen low S-moking S-edentary lifestyle/s ACCESS leads to OSTEOPOROSIS

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Who needs dialysis? (Check the vowels: AEIOU)

answer

A- Acid-Base Problems E- Electrolyte Problems I- Intoxications O- Overload of fluids U - Uremic Symptoms

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Prostate Problems are no... FUN

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F- Frequency U- Urgency N- Nocturia

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BRAT Diet (for severe dehydration)

answer

B- Banana R- Rice A- Apple T- Toasted Bread

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Gluten Free Diet (ROW)

answer

R- Rye O- Oats W- Wheat

question

Assess Changes in Senile Dementia (JAMCO)

answer

J- Judgment A- Affect M- Memory C- Cognition O- Orientation

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3 P's of Diabetes Mellitus - Type 1 Signs & Symptoms

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P- Polyuria (excessive urination) P- Polydypsia (excessive thirst) P- Polyphagia (excessive hunger)

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Right-Sided Heart Failure (HEAD)

answer

H- Hepatomegaly E- Edema (Bipedal) A- Ascites D- Distended Neck Vein

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Left-Sided Heart Failure (CHOP)

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C- Cough H- Hemoptysis O- Orthopnea P- Pulmonary Congestion (crackles/ rales)

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Hyperkalemia Management (KIND)

answer

K- Kayexalate (orally/ enema) I- Insulin N- Na HCO3 D- Diuretics (Furosemide & Thiazides)

question

Management of Myocardial Infarction (MONATAS)

answer

M- Morphine O- Oxygen N- Nitrates (Nitroglycerin) A- Aspirin (ASA) T- Thormbolytics A- Anti-Coagulants S- Stool Softeners

question

Electrolytes - PISO

answer

P- Potassium I- Inside S- Sodium O- Outside

question

Eating Disorder: ANOREXIA

answer

A-menorrhea delayed N-o organic factors accounts for weight loss O-bviously thin but feels FAT R-efusal to maintain normal body weight E-pigastric discomfort is common X-symptoms (peculiar symptoms) I-ntense fears of gaining weight A-lways thinking of foods

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Eating Disorder: BULIMIA

answer

B-inge eating U-nder strict dieting L-acks control over-eating I-nduced vomiting M-inimum of to binge eating episodes I-ncrease/Persistent concern of body size/shape A-buse of diuretics & laxatives

question

Findings of a Bulimia client: WASHED

answer

W-eight loss of 15% of original body weight A-menorrhea S-ocial withdrawal H-istory of high activity & achievement E-lectrolyte Imbalance D-epression/ Distorted Body Image

question

Outcome of Alcoholism: BAD

answer

B- Brain Damage A- Alcoholic Hallucinosis D- Death

question

5 D's of Behavioral Problems of Alcoholism

answer

D- Denial D- Dependency D- Demanding D- Destructive D- Domineering

question

Situations requiring Crisis Situation: RAPE

answer

R- Ruthless A- Abusive P- Personal E- Experience

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Warning Signs of a Child Abuse/ Neglect: CHILD ABUSE

answer

C-hild's excessive knowledge on sex & abusive words H-air growth in various lengths I-nconsistent stories from the child & parent/s L-ow self-esteem D-epression A-pathy, no emotion B-ruised U-nusual injuries S-erious injuries E-vidence of old injuries not reported

question

The HYPERKALEMIA "Machine" - Causes of Increased Serum K+

answer

M - Medications - ACE inhibitors, NSAIDS A - Acidosis - Metabolic and respiratory C - Cellular destruction - Burns, traumatic injury H - Hypoaldosteronism, hemolysis I - Intake - Excesssive N - Nephrons, renal failure E - Excretion - Impaired

question

MURDER Signs and Symptoms of Increased Serum K+

answer

M - Muscle weakness U - Urine, oliguria, anuria R- Respiratory distress D - Decreased cardiac contractility E - ECG changes R - Reflexes, hyperreflexia, or areflexia (flaccid)

question

HYPERNATREMIA "You Are Fried"

answer

F - Fever (low grade), flushed skin R - Restless (irritable) I - Increased fluid retention and increased BP E - Edema (peripheral and pitting) D - Decreased urinary output, dry mouth Can also use this one: SALT S = Skin flushed A = Agitation L = Low-grade fever T = Thirst

question

"CATS" of "HYPOCALCEMIA"

answer

C - Convulsions A- Arrhythmias T - Tetany S - Spasms and stridor

question

To remember which blood types are compatible, visualize the letter "O" as an orb representing the universe, because type O blood is the universal donor blood. Patients with any blood type can receive it. But O also means "odd man out": Patients with type O blood can receive only type O blood. Think BEEP to remember the signs of minor bleeding:

answer

B: Bleeding gums E: Ecchymoses (bruises) E: Epistaxis (nosebleed) P: Petechiae (tiny purplish spots)

question

Having difficulty distinguishing hypoplasia from hyperplasia?

answer

When you see plasia in any word, think of "plastic." Plastic, in turn, means forming or developing. As for hypo and hyper, that's the easy part. Hypo means under, or below normal. Hyper means excessive, or above normal. Thus, hypoplasia means underdevelopment, and hyperplasia means overdevelopment.

question

To remember the four causes of cell injury, think of how the injury tipped (or TIPD) the scale of homeostasis:

answer

T: Toxin or other lethal (cytotoxic) substance I: Infection P: Physical insult or injury D: Deficit, or lack of water, oxygen, or nutrients.

question

When asking assessment questions, remember the American Cancer Society's mnemonic device CAUTION:

answer

C: Change in bowel or bladder habits A: A sore that doesn't heal U: Unusual bleeding or discharge T: Thickening or lump I: Indigestion or difficulty swallowing O: Obvious changes in a wart or mole N: Nagging cough or hoarseness.

question

Use the ABCD rule to assess a mole's malignant potential:

answer

A: Asymmetry--Is the mole irregular in shape? B: Border--Is the border irregular, notched, or poorly defined? C: Color--Does the color vary (for example, between shades of brown, red, white, blue, or black)? D: Diameter--Is the diameter more than 6 mm?

question

Side effects of steroids. The 5 S's.

answer

Sick- easier to get sick Sad-causes depression Sex-increases libido Salt-retains more and causes weight gain Sugar-raises blood sugar

question

PERRLA

answer

Pupils Equally Round and Reactive to Light and Accomodation

question

Learning the Systems of the Body? MR DICE RUNS

answer

M= Muscle R= Respiratory D=Digestive I= Integumentary C= Circulatory E= Endocrine R= Reproductive U= Urinary N= Nervous S= Skeletal

question

Trouble figuring out which eye is which?

answer

OS is left eye OD is the right eye You can remember which one is the right eye (OD), because you can make the D into an R - You just have to draw to stick legs on the bottom of the D. Write it down on paper, you'll see what I mean (it's hard to show you when all I can do is type)

question

S/S of Hyponatremia

answer

S tupor/coma A norexia, N&V L ethargy T endon reflexes decreased L imp muscles (weakness) O rthostatic hypotension S eizures/headache S tomach cramping

question

Immediate treatment of MI, think MONA:

answer

M Morphine sulfate O Oxygen N Nitroglycerin A ASA

question

Treatment of CHF, think UNLOAD FAST:

answer

U sit Upright N Nitro L Lasix O Oxygen A Aminophylline D Digoxin F Fluids- decrease A Afterload - decrease S Sodium - decrease T Tests: dig level, ABG, K+

question

Assistive devices -- Canes:

answer

C Cane O Opposite A Affected L Leg

question

Signs of a Cholinergic Crisis, think SLUD:

answer

S Salivation L Lacrimation U Urination D Defication

question

Memory Trick:Need to remember which kind of beta blocker has which action?

answer

B1 Blocks the heart (you have only one heart) B2 Blocks the lungs (you have two lungs)

question

fetal accelerations and decelerations!!! Just remember VEAL CHOP

answer

Variable Cord compression Early Head compression Accelerations OK Late Placental insufficiency

question

Heart sounds:

answer

S3= Heart fail-ure (3 syllables) S4=Hy-per-ten-sion (4 syllables)

question

effects of anticholinergics:

answer

Can't see Can't pee Can't spit Can't --defecate

question

Nine-point Postpartum Assessment... BUBBLEHER

answer

B- Breasts U- Uterus B- Bladder B- Bowel function L- Lochia E- Episiotomy H- Homan's sign E- Emotional Status R- Respiratory System

question

The 5 P's of circulation loss in a limb.

answer

Pain, Pallor, Pulselessness, Parasthesia, Poikilothermia

question

side effects & adverse reactions to immunizations:

answer

F- Fever I- Itching S- Stiffness H- Headache E- Edema R- Redness F- Fussy L- Localized Tenderness A- Appetite decrease G- General Aches Pains

question

Remember that here in the USA you D drive on the right side of the road. O= optical A= auditory

answer

AD - right ear AS - left ear AU - both ears OD - right eye OS - left eye OU - both eyes

question

Mneumonic device for remembering questions to ask emergency room admits:

answer

Car? (circumstances of event) Please (precipitating events) Listen (location of event) To This: (Time of event) Watch (when symptoms appeared) Underage (unconsciousness after injury?) Alcoholics (arrival time in ER) Heading (hospital admits previously?) Home (previous history/health status) And (allergies) Maybe (medications) Flattening (fears for safety) My (meal, time of last) Poodle (period, time of last menstrual) Dog (primary doctor, name and location of) Tonight (tetanus, date of last immunization)

question

Everyone knows to make the ABCD (airway breathing circulation and neurologic disability) assessment first. Then as soon as possible, further assessment/intervention is done, which includes:

answer

His (health history) Head (head to toe assessment) Is (insert monitoring devices -- caths, ECG, arterial lines) So (splints for fractures) Wide (wound care) Olivia (other interventions)

question

Parkinson's Medications: "Ali Loves Boxing Matches"

answer

A-Amantadine L- Levodopa B- Bromocriptine M-MAO inhibitors

question

The 4 H's that invalidate a neuro exam:

answer

Hypotension Hpoxia Hypoglycemia Hypothermia*

question

Pinpoint pupils: Drugs, drops & nearly dead

answer

Drugs: opiates Drops: meds for glaucoma Nearly dead: damage in the pons area of the brainstem

question

Dilated pupils: Fear, Fits & Fast Living

answer

Fear: panic, extreme anxiety Fits: seizures Fast Living: cocaine, crack, phencyclidine (PCP)

question

The pathophysiology of ARDS:

answer

Assault on the respiratory system Respiratory distress Decreased lung compliance Severe respiratory failure

question

Diagnostic criteria of ARDS

answer

Acute onset Ratio (PaCO2/FiO2) <200 Diffuse infiltration Swan-Ganz wedge pressure (PAWP) <18mm Hg

question

Complications of thrombolytic therapy: The 3 B's

answer

Bleeding Brady's (dysrhythmias) Bloodclots (d/t excessive thrombin)

question

Complications of cardiopulmonary bypass (CPB): The 3 H's

answer

Hypothermia (to decrease O2 consumption)...Effects SVR (vasoconstriction) and causes myocardial depression (decreases contractility) Hemodilution (to improve macrocirculation)...fluid shifting (third-spacing), e-lyte imbalances (K+, Mg+ & Ca++ often need replacing!) Heparinzation (to prevent clots in circuit)...monitor aPTT.

question

Signs and symptoms of cardiac tamponade (Beck's Triad): The Three D's

answer

Distant heart sounds Distended jugular veins Decreased pulse pressure (think of a narrow pulse pressure as opposed to a wide one)

question

Atrial Arrhythmias: ABCDE

answer

Adenosine/amiodorone or anticoagulate (if Afib/Flutter has been present >48h) Beta blockers Calcium channel blockers Digoxin Electrocardiovert (if <48h)

question

For ventricular arrhythmias: AL

answer

Amiodorone Lidocaine

question

NSAID Drugs

answer

N - Naproxen S - Salicylates A - Advil I - Ibuprofen D - Diclofenac S - Sulinclac

question

8 A's for Hepatotoxic Drugs (Check SGPT/SGOT)

answer

Antituberculosis Anticonvulsant S - sodium Luminal G - gabapentin P - phenytoin T - tegretol Anticancer Aspirin Alcohol Antifamily (contraceptice pills) Acetaminophen Aflatoxins

question

Breast self examination (i made a song out of this)

answer

♫ ♪ ♪ ♫1 little 2, little 3 little fingers Do BSE 7 days after menses Press nipple once check for discharge Call your doctor I'm sure you will do it more...♫ ♪ ♪ ♫

question

Alkalosis and Acidosis

answer

Alkalosis - has a 'k' - Kicking the pH up Acidosis - has a 'd' - Dropping the pH down

question

Solutions: Isotonic, Hypotonic, Hypertonic

answer

Isotonic - "Same as I" - the solution used will be the same as normal body fluid composition. Fluids remain inside intravascular space. Hypotonic - "Hypo, hippo" - the solution pulls fluid from the intravascular space into the ICF - the cell "swells like a hippo".

question

For remembering the coronary arteries and which side they are on: I have a RIGHT to CAMP if you LEFT off the AC

answer

Right = Right C=oronary A=Artery M=Marginal Artery P=Posterior Interventricular Artery Left=Left A=Anterior Interventricular Artery C=Circumflex Artery

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