Ace Your Medical-Surgical Nursing, 10th Ed., Lewis, Dirksen, Heitkemper & Bucher Classes and Exams with Picmonic: #1 Visual Mnemonic Study Tool for Registered Nurse (RN) Students

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Medical-Surgical Nursing, 10th Ed., Lewis, Dirksen, Heitkemper & Bucher | Registered Nurse (RN) School Study Aid

Types of Shock

Hypovolemic

Depleted Volume

Cardiogenic

Pump Failure

Obstructive

Indirect Pump Failure

Distributive

Lost Vascular Tone

Neurogenic

Anaphylactic

Septic

2 mins

Severe Sepsis and Septic Shock Assessment

Microthrombi

DIC

Decreased Oxygen Saturation

Decreased WBC

Oliguria

High Output Heart Failure

Multiple Organ Failure

2 mins

Respiratory Alkalosis Assessment

Increased pH > 7.45

Decreased PaCO2 < 35 mmHg

Hyperventilation

Brainstem Stimulation

Head Injury

Shock

Lightheadedness

Tingling Lips or Fingers

Trousseau's

Chvostek's Sign

Anxiety

2 mins

Metabolic Acidosis Assessment

Decreased pH < 7.35

Decreased HCO3 < 22

Abdominal Pain

CNS Depression

Coma

Hypotension

Arrhythmias

Increased Respirations

Kussmaul Respirations

Flushed, Warm, Dry Skin

Muscle Weakness

2 mins

Cardiac Enzyme Evaluation: Troponin

Cardiac Muscle Injury

Detection in Blood: 4 Hours

Peak: 24 - 36 Hours

Return to Normal: 5 - 14 Days

Most Specific for Cardiac Muscle

Treat Aggressively

2 mins

Cardiac Enzyme Evaluation: Creatine Kinase CK-MB

Skeletal or Cardiac Muscle Injury

Onset: 4-8 Hours

Peak: 12-24 Hours

Return to Normal: 2-3 Days

1 min

Sepsis Assessment

Systemic Infectious Process

Fever

Hypotension

Change in LOC

Increased WBC

Shift to the Left

Tachycardia

Tachypnea

Hyperglycemia

Edema

2 mins

Inflammatory Response

Pathogens Infect Tissue

Mast Cells Release Histamine

Histamine Dilates and Increases Capillary Permeability

Macrophages Engulf Pathogens

Macrophage Signals Cells With Cytokines

Responding Neutrophils Cross Capillary Wall

B And T Lymphocytes Arrive At Injury Site

2 mins

Physiologic Dead Space (VD)

Tidal Volume (VT)

Partial pressure of arterial CO2 (PaCO2)

Partial pressure of CO2 in expired air (PECO2)

VD = TV x (PaCO2-PECO2) / PaCO2

2 mins

IV Solutions

Hypotonic (< 280 mOsm/L)

1/4 Normal Saline (0.225% NaCl)

1/2 Normal Saline (0.45% NaCl)

Isotonic (280-300 mOsm)

Normal Saline (0.9% NaCl)

Lactated Ringer's (LR)

Dextrose 5% in Water (D5W)

Hypertonic (> 300 mOsm)

3% or 5% NaCl

Dextrose 5% in 0.45% NaCl

Dextrose 10% in Water (D10W)

3 mins

Nitroglycerin

Decreases Preload

Angina

Up to 3 doses q 5 mins

Headache

Hypotension

Viagra (Sildenafil)

Assess Blood Pressure

Protect From Light

Use Glass Bottle and Special Tubing

Gloves for Applying Topically

2 mins

Nitroprusside

Direct Release of NO

Increase cGMP

Short Half-Life

Malignant Hypertension

Cyanide Toxicity

1 min

Dobutamine

Beta-1 Agonist

Inotropic

Heart Failure

Tachycardia

Arrhythmias

Closely Monitor Patients

Other Meds May Increase Potency

1 min

Norepinephrine (Levophed)

Alpha Agonist

Beta-1 Agonist

Severe Hypotension

Decreases Renal Blood Flow

Arrhythmias

Hypertension

Tissue Necrosis

Last Resort Medication

2 mins

Epinephrine (Adrenaline)

Alpha and Beta Agonist

Anaphylaxis

Primary Open Angle Glaucoma (POAG)

Bleeding

Cardiac Arrest

Tachycardia

Hypertension

Tremors

Insomnia

Multiple Strengths

2 mins

Cimetidine and Famotidine (H2 Receptor Blockers)

-tidine Suffix

H2 Receptor Blocker

Suppress Gastric Acid Secretion

Pneumonia

Anti-androgen Effects

CNS Changes

2 mins

Atropine

Muscarinic Antagonist

Bradycardia

Increased Exocrine Secretions

Smooth Muscle Spasms

Tachycardia

Dry Mouth

Urinary Retention

2 mins

Hypothermia Interventions

Remove From Environment

Remove Wet Clothing

Warm Clothing

Heated Blankets

Warm IV Solutions

Heated Oxygen

Warm Gastric Lavage

Warm Trunk BEFORE Extremities

2 mins

Systemic Inflammatory Response Syndrome (SIRS) Criteria

Temperature < 36C or > 38C

Pulse > 90 beats per minute

Respirations > 20/min or PCO2 < 32

WBC < 4,000 or > 12,000 or 10% bands

Subset of Cytokine Storm and Related to Sepsis

2 mins

Acute Respiratory Distress Syndrome (ARDS) Assessment

Damaged Alveolar-Capillary Membrane

Restlessness

Dyspnea

Refractory Hypoxemia

Decreased PaO2

Diffuse Pulmonary Infiltrates

Atelectasis

Pulmonary Hypertension

2 mins

Acute Respiratory Distress Syndrome (ARDS) Interventions

Closely Monitor Patient

ABG's (Arterial Blood Gases)

Oxygen

Assess for O2 Toxicity

Mechanical Ventilation

PEEP

Assess for Pneumothorax

Permissive Hypercapnia

High Mortality Rate

2 mins

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