HYPERNATREMIA PAIN HISTORY CHECKLIST

FRIED SALT
F - Fever (low), flushed skin  OLDER SAAB:
R - Restless (irritable) 
I - Increased fluid retention & increased BP  Onset
E - Edema (peripheral and pitting)  Location
D - Decreased urinary output, dry mouth  Description (what does it feel like)
Exacerbating factors
SALT  Radiation
S - Skin flushed  Severity
A - Agitation  Associated symptoms
L - Low-grade fever  Alleviating factors
T - Thirst Before (ever experience this before)

HYPERKALEMIA - Signs & Symptoms 

MURDER SHOCK: SIGNS AND SYMPTOMS
M - Muscle weakness 
U - Urine, oliguria, anuria  TV SPARC CUBE:
R - Respiratory distress 
D - Decreased cardiac contractility  Thirst
E - ECG changes  Vomiting
R - Reflexes, hyperreflexia, or areflexia (flaccid) Sweating
Pulse weak
HYPERKALEMIA - Causes Anxious
MACHINE Respirations shallow/rapid
M - Medications - ACE inhibitors, NSAIDS  Cool
A - Acidosis - Metabolic and respiratory  Cyanotic
C - Cellular destruction - Burns, traumatic injury  Unconscious
H - Hypoaldosteronism/ hemolysis  BP low
I - Intake - Excessive  Eyes blank
N - Nephrons, renal failure 
E - Excretion - Impaired
SUBARACHNOID HEMORRHAGE (SAH) CAUSES
HYPOCALCEMIA  BATS:
CATS
C - Convulsions  Berry aneurysm
A - Arrhythmias  Arteriovenous malformation/ Adult polycystic kidney disease
T - Tetany  Trauma (eg being struck with baseball bat)
S - Spasms and stridor Stroke

BLEEDING - S/Sx
BEEP VENTRICULAR FIBRILLATION: TREATMENT
B - Bleeding gums 
E - Ecchymoses (bruises)  "Shock, Shock, Shock, Everybody Shock, Little Shock, Big
E - Epistaxis (nosebleed)  Shock, Momma Shock, Poppa Shock":
P - Petechiae (tiny purplish spots)
Shock= Defibrillate
RESPIRATORY DEPRESSION - inducing drugs Everybody= Epinephine
STOP breathing  Little= Lidocaine
S - Sedatives and hypnotics  Big= Bretylium
T - Trimethoprim  Momma= MgSO4
O - Opiates  Poppa= Pocainamide
P - Polymyxins VFIB/VTACH DRUGS USED ACCORDING TO ACLS

PNEUMOTHORAX - S/Sx "Every Little Boy Must Pray":

P-THORAX
P - Pleuretic pain  Epinephrine
T - Trachea deviation  Lidocaine
H - Hyperresonance  Bretylium
O - Onset sudden  Magsulfate
R - Reduced breath sounds (& dypsnea)  Procainamide
A - Absent fremitus 
X - X-ray shows collapse
DIABETIC KETOACIDOSIS MANAGEMENT
PNEUMONIA -  risk factors 
INSPIRATION  KING UFC:
I - Immunosuppression 
N - Neoplasia  K+ (potassium)
S - Secretion retention 
P - Pulmonary oedema  Insulin (5u/hour. Note: sliding scale no longer recommended in the
I - Impaired alveolar macrophages  UK)
R - RTI (prior) 
A - Antibiotics & cytotoxics  Nasogastic tube (if patient comatose)
T - Tracheal instrumentation 
I - IV dug abuse  Glucose (once serum levels drop to 12)
O - Other (general debility, immobility) 
N - Neurologic impairment of cough reflex, (eg NMJ disorders) Urea (check it)

CROUP - S/Sx Fluids (crytalloids)

SSS
S - Stridor  Creatinine (check it)/ Catheterize
S - Subglottic swelling 
S - Seal-bark cough
NEUROLOGICAL FOCAL DEFICITS
SHORTNESS OF BREATH - Causes
AAAA PPPP  10 S's:
A - Airway obstruction 
A - Angina  Sugar (hypo, hyper)
A - Anxiety 
A - Asthma  Stroke
P - Pneumonia 
P - Pneumothorax  Seizure (Todd's paralysis)
P - Pulmonary Edema 
P - Pulmonary Embolus Subdural hematoma
CARDIAC VALVES
Subarachnoid hemorrhage
"TRI before you BI":
Space occupying lesion (tumor, avm, aneurysm, abscess)
Tricuspid valve is located in left heart and Bicuspid valve is located
in right heart. Blood flows through the tricuspid before bicuspid. Spinal cord syndromes

Somatoform (conversion reaction)

FEMORAL HERNIA
Sclerosis (MS)
FEMoral hernias are more common in FEMales.
Some migraines

"TRY PULLING MY AORTA":

COMA: CONDITIONS TO EXCLUDE AS CAUSE
Tricuspid
MIDAS:
Pulmonary
Meningitis
Mitral
Intoxication
Aorta
Diabetes

PLACENTA-CROSSING SUBSTANCES Air (respiratory failure)

"Want My Hot Dog": Subdural/ Subarachnoid hemorrhage

Wastes
MALIGNANT HYPERTHERMIA TREATMENT
Antibodies
"Some Hot Dude Better Give Iced Fluids Fast!" (Hot dude =
Nutrients hypothermia):

Teratogens Stop triggering agents

Microorganisms Hyperventilate/ Hundred percent oxygen

Hormones/ HIV Dantrolene (2.5mg/kg)

Drugs Bicarbonate

Glucose and insulin

EMERGENCY MEDICINE
ACTIVATED CHARCOAL: CONTRAINDICATIONS IV Fluids and cooling blanket
CHEMICAL CamP:
Cyanide Fluid output monitoring/ Furosemide/ Fast heart [tachycardia]

Hydrocarbons
Ethanol
Metals
RESUSCITATION: BASIC STEPS
Iron
Caustics ABCDE:
Airway unprotected
Lithium Airway
CAMphor
Potassium Breathing

Circulation
IPECAC: CONTRAINDICATIONS
Drugs
4 C's:
Environment
Comatose
Convulsing
Corrosive RLQ PAIN: DIFFERENTIAL
hydroCarbon
APPENDICITIS:

ATRIAL FIBRILLATION: CAUSES OF NEW ONSET Appendicitis/ Abscess

THE ATRIAL FIBS: PID/ Period

Thyroid Pancreatitis
Hypothermia
Embolism (P.E.) Ectopic/ Endometriosis
Alcohol
Trauma (cardiac contusion) Neoplasia
Recent surgery (post CABG)
Ischemia Diverticulitis
Atrial enlargement
Lone or idiopathic Intussusception
Fever, anemia, high-output states
Infarct Crohns Disease/ Cyst (ovarian)
Bad valves (mitral stenosis)
Stimulants (cocaine, theo, amphet, caffeine) IBD

Torsion (ovary)
ENDOTRACHEAL TUBE DELIVERABLE DRUGS
Irritable Bowel Syndrome
O NAVEL:
Stones
Oxygen
Naloxone
Atropine
Ventolin (albuterol)
Epinephrine
Lidocaine

MALARIA: COMPLICATIONS OF FALCIPARUM MALARIA

CHAPLIN:

Cerebral malaria/ Coma

Hypoglycemia
Anaemia
Pulmonary edema
Lactic acidosis
Infections
Necrois of renal tubules (ATN)

MI: IMMEDIATE TREATMENT

DOGASH:

Diamorphine
Oxygen
GTN spray
Asprin 300mg
Streptokinase
Heparin
PAGE 2 Complication of severe preeclampsia—"HELLP" syndrome
Acid-base—"ROME" (Respiratory Opposite, Metabolic Equal)
Hemolysis
Acidosis
Elevated Liver enzymes
» Respiratory (opposite): pH Pco2
Low Platelet count
» Metabolic(equal): pH HCO3
Cushing's syndrome: symptoms—"3S's"
Alkalosis
Sugar (hyperglycemia)
» Respiratory (opposite): pH Pco2
Salt (hypernatremia)
» Metabolic(equal): pH HCO3
Sex (excess androgens)
Alcohol withdrawal: clinical features—"HITS"
Diabetes: signs and symptoms—"3P's,"
Hallucinations (visual, tactile)
Polydipsia (very thirsty)
Increased vital signs and insomnia
Polyphagia (very hungry)
Tremens delirium tremens (potentially lethal)
Polyuria (urinary frequency)
Shakes/ Sweats/ Seizures/ Stomach pains (nausea, vomiting)

Diet: low cholesterol—avoid the "3C's"

Angina: precipitating factors—"4E's"
Cake
Eating
Cookies
Emotion
Cream (dairy, e.g., milk, ice cream)
Exertion (Exercise)

Extreme Temperatures (Hot or Cold weather)

Dystocia: etiology—"3P's"

Power
Anorexia nervosa: clinical features—"ANOREXIC"
Passageway
Adolescent women/ Amenorrhea
Passenger
NGT alimentation (most severe cases)

Obsession with losing weight/ becoming fat though underweight

Dystocia: general aspects (maternal)—"3P's"
Refusal to eat (5% die)
Psych
Electrolyte abnormalities (e.g., K+, cardiac arrhythmia)
Placenta
X - ercise
Position
Intelligence often above average/ Induced vomiting
Episiotomy assessment—"REEDA"
Cathartic use (and diuretic abuse)
Redness
Appendicitis: assessment—"PAINS"
Edema
Pain (RLQ)
Ecchymosis
Anorexia
Discharge
Increased temperature, WBC (15,000–20,000)
Approximation of skin
Nausea
Eye medications
Signs (McBurney's, Psoas)
Mydriatic = dilated pupils

Miotic = tiny (constricted) pupils

Neurovascular Occlusion: symptoms— "6 P's" Hypertension: complications—"4 C's"

Pain CAD (coronary artery disease)

Pale
Pulseless CHF (congestive heart failure)
Paresthesia
Poikilothermic CRF (chronic renal failure)

Paralysis CVA (cardiovascular accident; now called brain attack or stroke)

Blood glucose (rhyme) Hypertension: nursing care plan— "I-TIRED"

Symptom Implication Intake and output (urine)

Cold and clammy . . . give hard candy Take blood pressure

Hot and dry . . . glucose is high Ischemia attack, transient (watch for TIAs)

Respiration, pulse
Blood vessels in umbilical cord—"AVA" (2 arteries and 1 vein)
Electrolytes
Artery
Daily weight
Vein

Artery Hypoglycemia: signs and symptoms—"DIRE"

Diaphoresis
Cholecystitis: risk factors—"5F's"
Increased pulse
Female
Restless
Fat
Extra hungry
Forty

Fertile Infections during pregnancy—"TORCH"

Fair Toxoplasmosis

Other (hepatitis B, syphilis, group B beta strep)

Cleft lip: nursing care plan (postoperative)—"CLEFT LIP"
Rubella
Crying, minimize
Cytomegalovirus
Logan bow
Herpes simplex virus
Elbow restraints

Feed with Brecht feeder IUD: potential problems with use—"PAINS"

Teach feeding techniques; two months of age (average age at Period (menstrual: late, spotting, bleeding)
repair)
Abdominal pain, dyspareunia
Liquid (sterile water), rinse after feeding
Infection (abnormal vaginal discharge)
Impaired feeding (no sucking)
Not feeling well, fever or chills
Position—never on abdomen
String missing

Cognitive disorders: assessment of difficulties—"JOCAM"

Manipulation: nursing plan—promote the "3C's"
Judgment
Cooperation
Orientation
Compromise
Confabulation
Collaboration
Affect

Memory Medication administration—"six rights"

 RIGHT medication
Coma: causes—"A-E-I-O-U TIPS"
RIGHT dosage
Alcohol, acidosis (hyperglycemic coma)
RIGHT route
Epilepsy (also electrolyte abnormality, endocrine problem)
RIGHT time
Insulin (hypoglycemic shock)
RIGHT client
Overdose (or poisoning)
RIGHT technique
Uremia and other renal problems

Trauma; temperature abnormalities (hypothermia, heat stroke) Melanoma characteristics—"ABCD"

Infection (e.g., meningitis) Asymmetry

Psychogenic ("hysterical coma") Border

Stroke or space-occupying lesions in the cranium Color

Diameter

Mental retardation: nursing care plan—"3R's"

Regularity (provide routine and structure)

Reward (positive reinforcement)

Redundancy (repeat)

Myocardial infarction: treatment—"MONA"

Monitor/ Morphine

Oxygen

Nitroglycerin

Aspirin

Newborn assessment components—"APGAR"

Appearance

Pulse

Grimace

Activity

Respiratory effort

Obstetric (maternity) history—"GTPAL"

Gravida

Term

Preterm

Abortions (SAB, TAB)

Living children

Oral contraceptives: signs of potential problems—"ACHES"

Page 3 Cranial Nerves - "Oh Ohh Ohhh To Try And Fit A Gold Velvet So
Heavenly"
Abdominal pain (possible liver or gallbladder problem)
Olfactory CN I
Chest pain or shortness of breath (possible pulmonary embolus)
Optic CN II
Headache (possible hypertension, brain attack)
Occulomotor CN III
Eye problems (possible hypertension or vascular accident)
Trochlear CN IV
Severe leg pain (possible thromboembolic process)
Trigeminal CN V
Pain: assessment—"PQRST"
Abducens CN VI
What Provokes the pain?
Facial CN VII
What is the Quality of the pain?
Auditory CN VIII
Does the pain Radiate?
Glasopharyngeal CN IX
What is the Severity of the pain?
Vagus CN X
What is the Timing of the pain?
Spinal/Accessory CN XI

Hypoglossal CN XII
Pain: management—"ABCs"

Ask about the pain "Point and Shoot!"

Believe when clients say they have pain For remembering that Parasympathetics are involved with erection
and Sympathetics with ejaculation.
Choices—let clients know their choices

Deliver what you can, when you said you would Layers of the scalp - "SCALP"

Empower/Enable clients' control over pain Skin

Connective tissue
Aponeurosis
Postoperative complications: order—"4W's" Loose areolar tissue
Pericranium
Wind (pulmonary)

Wound
Carpal bones of the hand (lateral to medial) - "She Looks Too
Water (urinary tract infection) Proud, Try To Chase Her"

Walk (thrombophlebitis) Proximal row:

Scaphoid
Preterm infant: anticipated problems—"TRIES" Lunate
Triquetrum
Temperature regulation (poor) Pisiform
Distal row:
Resistance to infections (poor) Trapezium
Trapezoid
Immature liver Capitate
Hamate
Elimination problems (necrotizing enterocolitis [NEC])

Sensory-perceptual functions (retinopathy of prematurity [ROP])

Viruses causing diarrhea - "ACNE CAR"

Adeno virus
Psychotropic medications: common antidepressives (tricyclics)
Corana virus
—"VENT"
Norwak virus
Entero virus
Vivactil
Calci virus
Astro virus
Elavil
Rota virus
Norpramin

Tofranil
 The Krebs cycle - "Can I Actually See Some Filipina Mothers"

Schizophrenia: primary symptoms—"4A's" Citrate

Affect Isocitrate

Ambivalence alpha Ketoglutarate

Associative looseness Succinyl CoA

Autism Succinate

Fumarate
Sprain: nursing care plan—"RICE"
Malate
Rest
Oxaloacetate
Ice

Compression
Stages of mitosis/meiosis including interphase as a phase - "In
Elevation Philippines, Men Are Talented"

Interphase
Stool assessment—"ACCT" Prophase
Metaphase
Amount Anaphase
Telophase
Color

Consistency Order of prevalence of White Blood Cells, most prevalent to

least - "Never Let Monkeys Eat Bananas"
Timing
Neutrophils
Lymphocytes
Tracheoesophageal fistula: assessment—"3Cs" Monocytes
Eosinophils
Coughing Basophils
Choking
10 essential amino acids - "PVT. TIM HALL"
Cyanosis
Phenylalanine
Traction: nursing care plan—"TRACTION" Valine
Tryptophan
Trapeze bar overhead to raise and lower upper body Threonine
Isoleucine
Requires free-hanging weights; body alignment Metheonine
Histidine(semi-essential)
Analgesia for pain, prn Arginine(semi-essential)
Leucine
Circulation (check color and pulse) Lysine
Temperature (check extremity)

Infection prevention Uses of Chloroquine (other than malaria) - "RED LIP"

Output (monitor) Rheumatoid arthritis

Extra intestinal amoebiasis
Nutrition (alteration related to immobility) Discoid lupus erythematosus
Lepra reaction
Infectious mononucleosis
Transient ischemic attacks: assessment—"3Ts" Photogenic reactions

Temporary unilateral visual impairment Bronchodilators - "TO A SIS"

Transient paralysis (one-sided) Terbutaline

Orciprenaline
Tinnitus = vertigo Adrenaline
Salbutamol
Isoprenaline
Trauma care: complications—"TRAUMA"
 Salmeterol
Thromboembolism; Tissue perfusion, altered
Signs of cor pulmonale - "Please Read His Text"
Respiration, altered
Peripheral edema
Anxiety related to pain and prognosis
Raised JVP
Urinary elimination, altered
Hepatomegaly
Mobility impaired
Tricuspid incompetence
Alterations in sensory-perceptual functions and skin integrity
(infections)
Portal hypertension features - "ABCDE"
Wernicke-Korsakoff syndrome (alcohol-associated neurological Ascites
disorder)—"COAT RACK"
Bleeding (hematemesis, piles)
Wernicke's encephalopathy (acute phase) Caput medusae
clinical features: Diminished liver
Confusion Enlarged spleen
Ophthalmoplegia
Key questions needed in an emergency history taking situation
Ataxia - "AMPLE"

Thiamine is an important aspect of Tx Allergies

Medication
Past medical history
Korsakoff's psychosis (chronic phase) Last meal

characteristic findings: Events and environment related to injury

Retrograde amnesia (recall of some old memories)

Malignancies that metastisize to bone - "Laging Panalo Kung
Anterograde amnesia (ability to form new memories) Taga Bulacan"

Confabulation Lung
Prostat
Korsakoff's psychosis Kidney
Thyroid
SIGNS OF CANCER Breast

Change in bowel /bladder habits

Six "S" in Scarlet Fever
A sore that doesn’t heal
Streptococci causal organism
Unusual bleeding/ Discharge
Sorethroat
Thickening of lump – breast or elsewhere
Swollen tonsils
Indigestion/ Dysphagia
Strawberry tongue
Obvious change in wart/ mole
Sandpaper rash
Nagging cough/ hoarseness
miliarySudamina vesicles over hands, feet, abdomen

Unexplained anemia
Signs of anti-cholinergic crisis - "SLUD"
Sudden weight loss
Salivation

Lacrimation
FOCUS OF PATIENT CARE IN CLIENTS WITH CANCER
Urination
Chemotherapy
Assess body image disturbance (related to alopecia) Defecation

Nutritional needs when N/V present

Causes of huge spleen - "3M's"
Comfort from pain
Myelofibrosis
Malaria
Myelogenous leukemia

Effective response to Tx? (Evaluate)

Rest (for patient and family) Cardinal Symptoms of Parkinson's Disease - "TRAP"

Basic MI management - "BOOMAR" Tremor

Rigidity
Bed rest Akinesia and bradykinesia
Oxygen Postural Instability
Opiate
Monitoring
Anticoagulation Days of appearance of rashesVaricella(chickenpox) - "Very Sick
Reduce clot size Patients Must Take Double Exercise"

To Remember Immunoglobulins - "GAMED" 1st dayScarlet fever

IgG 2nd dayPox(smallpox)

IgA
IgM 3rd dayMumps
IgE
IgD 4th dayTyphus

5th dayDengue
Location of the heart valve from right to left - "A Permanently
Temperamental Man" 6th dayEnteric fever(typhoid)

Aortic SHOCK – HYPOTACHYTACHY

Pulmonary
Tricuspid
Mitral HYPOTENSION

TACHYPNEA
"Cut C4, breathe no more"
TACHYCARDIA
The 3rd, 4th and 5th cervical spinal nerves innervate the diaphragm.
INCREASE ICP – HYPERBRADYBRADY
Types of Joint movements - "FEEDPIPE CARDSHARP"
CUSHINGS TRIAD:
Flexion
Extension
HYPERTENSION (WIDE PULSE PRESSURE)
Eversion
Dorsiflexion
BRADYCARDIA
Pronation
Inversion
BRADYPNEA
Plantarflexion

Elevation

Circumduction
HYPOGLYCEMIA
Abduction
Rotation
Depression
TREMORS, TACHYCARDIA
Supination
Hyperextension
IRRITABILITY
Adduction
Retraction
RESTLESSNESS
Protraction
EXTREME

DIAPHORESIS
PAGE 4

EARLY SIGNS OF HYPOXIA

RESTLESSNESS
AGITATION
TACHYCARDIA

LATE SIGNS OF HYPOXIA

BRADYCARDIA
EXTREME RESTLESSNESS USE STRAW BECAUSE THESE DRUGS STAIN THE TEETH
DYSPNEA
CYANOSIS L - LUGOL'S SOLUTION

CONGESTIVE HEART FAILURE I - IRON

N - NITROFURANTOIN
DIGOXIN
MORPHINE T - TETRACYCLINE
AMINOPHYLLINE
DOPAMINE LR6 - LATERAL RECTUS : CN6
DIURETICS
O2 SO4 - SUPERIOR OBLIQUE : CN4
GASSES – MONITOR (ABG)
ALL3 - ALL THE REST : CN3
MG SO4 TOXICITY

RADIATION TX VIA:
BP DECREASE
URINE OUTPUT DECREASE MUSTARD
RESPIRATORY RATE DECREASE
PATELLAR REFLEX ABSENT ESTROGEN

SICKLE CELL DISEASE NITROGEN

HYDRATION STEROIDS
OXYGENATION
PAIN ANTIBIOTICS
INFECTION
AVOID HIGH PLACES
DILUTE DECREASE OSMOLALITY
PREGNANCY INDUCED HYPERTENSION

HEMOLYSIS
ELEVATED LIVER ENZYMES
LOW
PLATELETS

GI SYMPTOMS AND TOXICITY TO DIGOXIN

VOMITTING
ANOREXIA
NAUSEA
DIARRHEA
ABDOMINAL PAIN

FRACTURE

PRESSURE
REST
ICE
COMPRESSION
ELEVATION
TETRALOGY OF FALLOT

DISPLACED AORTA
RIGHT VENTRICULAR HYPERTROPHY
OPENING INTO THE SEPTUM (VSD)
PULMONARY STENOSIS

HYPOKALEMIA

SKELETAL MUSCLE WEAKNESS

U-WAVE ON ECG
CONSTIPATION
TOXICITY TO DIGOXIN
IRREGULAR WEAK PULSE
OTOSTASIS
NUMBNESS PARESTHESIA

PAIN ASSESSMENT

PROVOCATION
QUALITY
RADIATION, RELIEF
SEVERITY
TIME

NEUROVASCULAR CHECK

PAIN
PULSELESSNESS
PARESTHESIA
PARALYSIS
PALLOR

VIRCHOW’S TRIAD IN DVT

VENUS STASIS
DAMAGE TO VESSELS
HYPERCOAGUABILITY

ABDOMINAL AORTIC ANEURISM (4A)

ASSYMPTOMATIC
ABDOMINAL MASS
ABDOMINAL PULSE
ACHES LOW BACK

ANTI TB DRUGS AND SIDE EFFECTS

RIFAMPICIN – RED-ORANGE URINE

ISONIAZID – PERIPHERAL NEURITIS
PYRAZINAMIDE – INCREASE URIC ACID
ETHAMBUTOL – EYE PROBLEMS
STREPTOMYCIN – OTOTOXIC