12 cranial nerves Oh, Oh, Oh, To Touch And Feel Virgin Girls Vagina, And Hymen/Hooters I - Olfactory nerve II - Optic nerve Oculomotor nerve IV - Trochlear nerve/pathic nerve V - Trigeminal nerve/dentist nerve VI - Abducens nerve VII - Facial nerve VIII - Vestibulocochlear nerve/Auditory nerve IX - Glossopharyngeal nerve X - Vagus nerve XI - Accessory nerve/Spinal accessory nerve XII - Hypoglossal nerve III - ------------------------------------------------------------------------------------------------------------ CHOLELITHIASIS Patients are predisposed to Cholelithiasis (aka Gallstones) by the: 4 F's (Fat, Forty, Female, and Fertile). MOLE’S MALIGNAT use the abcd rule to assess a mole’s malignant potential: 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? HYPOPLASIA VS HYPERPLASIA having difficulty distinguishing hypoplasia from hyperplasia? 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. BLOOD TYPE 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: b: bleeding gums e: ecchymoses (bruises) e: epistaxis (nosebleed) p: petechiae (tiny purplish spots) SICKLE CELL DISEASE- HOPIA HYDRATION OXYGENATION PAIN INFECTION AVOID HIGH PLACES CONGESTIVE HEART FAILURE- D MAD DOG DIGOXIN MORPHINE AMINOPHYLLINE DOPAMINE DIURETICS O2 GASSES – MONITOR (ABG) EARLY SIGNS OF HYPOXIA RESTLESSNESS AGITATION TACHYCARDIA LATE SIGNS OF HYPOXIA BRADYCARDIA EXTREME RESTLESSNESS DYSPNEA CYANOSIS INCREASE ICP – HYPERBRADYBRADY CUSHINGS TRIAD: HYPERTENSION (WIDE PULSE PRESSURE) BRADYCARDIA BRADYPNEA Days of appearance of rashesVaricella(chickenpox) - "Very Sick Patients Must Take Double Exercise" 1st dayScarlet fever 2nd dayPox(smallpox) 3rd dayMumps 4th dayTyphus 5th dayDengue 6th dayEnteric fever(typhoid) Parkinson's Disease Cardinal Symptoms of Parkinson's Disease - "TRAP" Tremor Rigidity Akinesia and bradykinesia Postural Instability Spleen Causes of huge spleen - "3M's" Myelofibrosis Mlaria Myelogenous leukemia Anti-cholinergic Crisis Signs of anti-cholinergic crisis - "SLUD" Salivation Lacrimation Urination Defecation Scarlet Fever , Six "S" in Scarlet Fever Streptococci causal organism Sorethroat Swollen tonsils Strawberry tongue Sandpaper rash miliary Sudamina vesicles over hands, feet, abdomen Cor Pulmonale Signs of cor pulmonale - "Please Read His Text" Peripheral edema Raised JVP Hepatomegaly Tricuspid incompetence Amino acids 10 essential amino acids - "PVT. TIM HALL" Phenylalanine Valine Tryptophan Threonine Isoleucine Metheonine Histidine(semi-essential) Arginine(semi-essential) Leucine Lysine Hematology Order of prevalence of White Blood Cells, most prevalent to least - "Never Let Monkeys Eat Bananas" Neutrophils Lymphocytes Monocytes Eosinophils Basophils Stages of mitosis/meiosis including interphase as a phase "In Philippines, Men Are Talented" Interphase Prophase Metaphase Anaphase Telophase Diarrhea Viruses causing diarrhea - "ACNE CAR" Adeno virus Corana virus Norwak virus Entero virus Calci virus Astro virus Rota virus Skeletal System Carpal bones of the hand (lateral to medial) - "She Looks Too Proud, Try To Chase Her" Proximal row: Scaphoid Lunate Triquetrum Pisiform Distal row: Trapezium Trapezoid Capitate Hamate Integumentary System Layers of the scalp - "SCALP" Skin Connective tissue Aponeurosis Loose areolar tissue Pericranium Joints Types of Joint movements - "FEEDPIPE CARDSHARP" Flexion Extension Eversion Dorsiflexion Pronation Inversion Plantarflexion Elevation Circumduction Abduction Rotation Depression Supination Hyperextension Adduction Retraction Protraction Nervous System "Cut C4, breathe no more" The 3rd, 4th and 5th cervical spinal nerves innervate the diaphragm. "Point and Shoot!" For remembering that Parasympathetics are involved with erection and Sympathetics with ejaculation. Cardiovascular System Location of the heart valve from right to left - "A Permanently Temperamental Man" Aortic Pulmonary Tricuspid Mitral Cancer SIGNS OF CANCER- "CAUTION US" Change in bowel /bladder habits A sore that doesn’t heal Unusual bleeding/ Discharge Thickening of lump – breast or elsewhere Indigestion/ Dysphagia Obvious change in wart/ mole NAgging cough/ hoarseness Unexplained anemia Sudden weight loss FOCUS OF PATIENT CARE IN CLIENTS WITH CANCER Chemotherapy Assess body image disturbance (related to alopecia) Nutritional needs when N/V present Comfort from pain Effective response to Tx? (Evaluate) Rest (for patient and family) NEUROLOGICAL FOCAL DEFICITS NEUROLOGICAL FOCAL DEFICITS 10 S's: Sugar (hypo, hyper) Stroke Seizure (Todd's paralysis) Subdural hematoma Subarachnoid hemorrhage Space Occupying lesion (tumor, avm, aneurysm, abscess) Spinal cord syndromes Somatoform (conversion reaction) Sclerosis (MS) Some migraines DIABETIC KETOACIDOSIS MANAGEMENT KING UFC: K+ (potassium) Insulin (5u/hour. Note: sliding scale no longer recommended in the UK) Nasogastic tube (if patient comatose) Glucose (once serum levels drop to 12) Urea (check it) Fluids (crytalloids) Creatinine (check it)/ Catheterize VENTRICULAR FIBRILLATION: TREATMENT "Shock, Shock, Shock, Everybody Shock, Little Shock, Big Shock, Momma Shock, Poppa Shock": Shock= Defibrillate Everybody= Epinephine Little= Lidocaine Big= Bretylium Momma= MgSO4 Poppa= Pocainamide SHOCK: SIGNS AND SYMPTOMS TV SPARC CUBE: Thirst Vomiting Sweating Pulse weak Anxious Respirations shallow/rapid Cool Cyanotic Unconscious BP low Eyes blan SHOCK – HYPOTACHYTACHY HYPOTENSION TACHYPNEA TACHYCARDIA --------------TRY PULLING MY AORTA": Tricuspid Pulmonary Mitral Aorta FEMORAL HERNIA FEMoral hernias are more common in FEMales. CARDIAC VALVES "TRI before you BI": Tricuspid valve is located in left heart and Bicuspid valve is located in right heart. Blood flows through the tricuspid before bicuspid. CROUP - Signs and Symptoms SSS S - Stridor S - Subglottic swelling S - Seal-bark cough PNEUMONIA - risk factors INSPIRATION I - Immunosuppression N - Neoplasia S - Secretion retention P - Pulmonary oedema I - Impaired alveolar macrophages R - RTI (prior) A - Antibiotics & cytotoxics T - Tracheal instrumentation I - IV dug abuse O - Other (general debility, immobility) N - Neurologic impairment of cough reflex, (eg NMJ disorders) PNEUMOTHORAX Signs and Symptoms P-THORAX P - Pleuritic pain T - Trachea deviation H - Hyper resonance O - Onset sudden R - Reduced breath sounds (& dypsnea) A - Absent fremitus X - X-ray shows collapse inducing drugs for Respiratory Depression STOP breathing S - Sedatives and hypnotics T - Trimethoprim O - Opiates P – Polymyxins BLEEDING - S/Sx BEEP B - Bleeding gums E - Ecchymoses (bruises) E - Epistaxis (nosebleed) P - Petechiae (tiny purplish spots) Trauma care: complications—"TRAUMA" Thromboembolism; Tissue perfusion, altered Respiration, altered Anxiety related to pain and prognosis Urinary elimination, altered Mobility impaired Alterations in sensory-perceptual functions and skin integrity (infections) Transient ischemic attacks: assessment—"3Ts" Temporary unilateral visual impairment Transient paralysis (one-sided) Tinnitus = vertigo Traction: nursing care plan—"TRACTION" Trapeze bar overhead to raise and lower upper body Requires free-hanging weights; body alignment Analgesia for pain, prn Circulation (check color and pulse) Temperature (check extremity) Infection prevention Output (monitor) Nutrition (alteration related to immobility) Tracheoesophageal fistula: assessment—"3Cs" Coughing Choking Cyanosis Sprain: nursing care plan—"RICE" Rest Ice Compression Elevation Postoperative complications: order—"4W's" Wind (pulmonary) Wound Water (urinary tract infection) Walk (thrombophlebitis) Myocardial infarction: treatment—"MONA" Monitor/ Morphine Oxygen Nitroglycerin Aspirin Basic MI management - "BOOMAR" Bed rest Oxygen Opiate Monitoring Anticoagulation Reduce clot size Melanoma characteristics—"ABCD" Asymmetry Border Color Diameter Hypoglycemia: signs and symptoms—"DIRE" Diaphoresis Increased pulse Restless Extra hungry Hypertension: complications—"4 C's" CAD (coronary artery disease) CHF (congestive heart failure) CRF (chronic renal failure) CVA (cardiovascular accident; now called brain attack or stroke) Hypertension: nursing care plan— "ITIRED" Intake and output (urine) Take blood pressure Ischemia attack, transient (watch for TIAs) Respiration, pulse Electrolytes Daily weight Portal hypertension features - "ABCDE" Ascites Bleeding (hematemesis, piles) Caput medusae Diminished liver Enlarged spleen Diabetes Diabetes: signs and symptoms—"3P's," Polydipsia (very thirsty) Polyphagia (very hungry) Polyuria (urinary frequency) Cushing's Syndrome Cushing's syndrome: symptoms—"3S's" Sugar (hyperglycemia) Salt (hypernatremia) Sex (excess androgens) Coma Coma: causes—"A-E-I-O-U TIPS" Alcohol, acidosis (hyperglycemic coma) Epilepsy (also electrolyte abnormality, endocrine problem) Insulin (hypoglycemic shock) Overdose (or poisoning) Uremia and other renal problems Trauma; temperature abnormalities (hypothermia, heat stroke) Infection (e.g., meningitis) Psychogenic ("hysterical coma") Stroke or space-occupying lesions in the cranium COMA: CONDITIONS TO EXCLUDE AS CAUSE MIDAS: Meningitis Intoxication Diabetes Air (respiratory failure) Subdural/ Subarachnoid hemorrhage Cleft lip Cleft lip: nursing care plan (postoperative)—"CLEFT LIP" Crying, minimize Logan bow Elbow restraints Feed with Brecht feeder Teach feeding techniques; two months of age (average age at repair) Liquid (sterile water), rinse after feeding Impaired feeding (no sucking) Position—never on abdomen Cholecystitis Cholecystitis: risk factors—"5F's" Female Fat Forty Fertile Fair Blood glucose Blood glucose (rhyme) Symptom Implication Cold and clammy . . . give hard candy Hot and dry . . . glucose is high Neurovascular Occlusion Neurovascular Occlusion: symptoms— "6 P's" Pain Pale Pulseless Paresthesia Poikilothermic Paralysis Appendicitis Appendicitis: assessment—"PAINS" Pain (RLQ) Anorexia Increased temperature, WBC (15,000–20,000) Nausea Signs (McBurney's, Psoas) Angina: precipitating factors—"4E's" Eating Emotion Exertion (Exercise) Extreme Temperatures (Hot or Cold weather) Acid-base—"ROME" (Respiratory Opposite, Metabolic Equal) Acidosis » Respiratory (opposite): pH Pco2 » Metabolic(equal): pH HCO3 Alkalosis » Respiratory (opposite): pH Pco2 » Metabolic(equal): pH HCO3 hypocalcemia "cats" of "hypocalcemia" c - convulsions a- arrhythmias t - tetany s - spasms and stridor hypocalcemia "cats" of "hypocalcemia" c - convulsions a- arrhythmias t - tetany s - spasms and stridor hypernatremia hypernatremia signs and symptoms "you are fried" 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 HYPERKALEMIA The HYPERKALEMIA "Machine" - Causes of Increased Serum K+ 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 murder signs and symptoms of increased serum k+ m - muscle weakness u - urine, oliguria, anuria r- respiratory distress d - decreased cardiac contractility e - ecg changes r - reflexes, hyperreflexia, or areflexia (flaccid) MEDICAL AND SURGICAL NURSING MNEMONICS MR. JEFF