NCLEX RN 1000 RN MNEMONICS ABC

ABDOMINAL AORTIC ANEURISM “4-A’s” Asymptomatic Abdominal mass Abdominal pulse Aches low back ABDOMINAL DISTENSTION "5-F's" Fat Fluid Feces Flatus Fetus ACE INHIBITOR SIDE EFFECTS "CAPTOPRIL" Cough Anaphylaxis Palpitations Taste Orthostatic -↓BP Potassium - ↑K+ Renal impairment Impotence Leukocytosis 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 ACIDOSIS/ALKALOSIS “ROME” Respiratory Opposite: pH↑ PCO2↓ = alkalosis pH↓ PCO2↑ = acidosis Metabolic Equal: pH↑ HCO3↑ = Alkalosis pH↓ HCO3↓ = Acidosis ACIDOSIS/ALKALOSIS – COMPENSTATION “RUB MUB” Respiratory Uses Bicarb Metabolic Uses Breathing ALKALOSIS AND ACIDOSIS AlKalosis has “K” – it’s “K”icking pH up = PH↑ AciDosis has “D” – it’s “D”ropping pH Down = PH↓ ACUTE INFLAMMATION FEATURES Think: "what a cute pair of SLIPpeRs" to tie acute inflammation to “SLIPR”mnemonic). “SLIPR” Swelling Loss of function Increased heat Pain Redness ADRENAL GLAND HORMONES “SSS” S-sugar (Glucocorticoids) S-salt (Mineralocorticoids) S-sex (Androgens) AIMS for improvement “PETEES” AIMS P - Patient centered care E - Efficient T - Timely E - Effective E - Equitable S - Safety ALCOHOL WITHDRAWAL – CLINICAL FEATURES "HITS" Hallucinations (visual, tactile) Increased vital signs & insomnia Tremens delirium tremens (potentially lethal) Shakes/Sweat/Seizures/Stomach pain (N/V) ALCOHOLISM – BEHAVIORAL PROBLEMS “5-D's” D- Denial D- Dependency D- Demanding D- Destructive D- Domineering ALCOHOLISM OUTCOME “BAD” B- Brain Damage A- Alcoholic Hallucinosis D- Death ALDOSTERONE IS REGULATED BY: "RNA’S" Renin-angiotensin mechanism Na concentration in blood Anp (ANP – atrial natriuretic peptide) Stress ALZHEIMER – “5 A’s” to DIAGNOSIS “5-A's” Amnesia – loss of memories Anomia – unable to recall names of everyday objects Apraxia – unable to perform tasks of movement Agnosia – inability to process sensory information Aphasia – disruption with ability to communicate ANGINA – PRECIPITATING FACTORS "4-E's" Eating Emotion Exertion (Exercise) Extreme Temperatures (Hot/Cold weather) “ANOREXIA” – EATING DISORDER A-menorrhea delayed N-o organic factors accounts for weight loss O-obviously thin but feels FAT R-refusal to maintain normal body weight E-epigastric discomfort is common X-symptoms (peculiar symptoms) I-intense fears of gaining weight A-always thinking of foods ANOREXIA NERVOSA – CLINICAL FEATURES "ANOREXIC" A-adolescent women/Amenorrhea N-GT alimentation (most severe cases) O-obsession w/ wt. loss/becoming fat though underweight R-refusal to eat (5% die) E-electrolyte abnormalities (e.g., K+, cardiac arrhythmia) X-exercise I-intelligence often above average/Induced vomiting C-cathartic use (and diuretic abuse) ANTICHOLINERGIC CRISIS Can't see (blurred vision) Can't spit (dry mouth) Can't pee (urinary retention) Can't shit (constipation) ANTICHOLINERGIC CRISIS – SIGNS "SLUD" Salivation Lacrimation Urination Defecation ANTI-TB DRUGS & SIDE EFFECTS “RIPES” Rifampicin – red-orange urine Isoniazid – peripheral neuritis Pyrazinamide – increase uric acid Ethambutol – eye problems Streptomycin – ototoxic (use a star as these drugs stain the teeth) – ??? (H-eat, I-nduration) – ??? APGAR SCORING "APGAR" Appearance: cyanosis--peripheral, central, none Pulse: pulse rate Grimace: response to stimulation Activity: movement of the baby (muscle tone) Respiration: respiratory rate APPENDICITIS - ASSESSMENT “PAINS” Pain (RLQ) - pain in RLQ of abdomen Anorexia - loss of appetite Increased temperature, WBC (15,000-20,000) Nausea Signs (McBurney's, Psoas) ARTERIAL BLOOD GASES 1. look at pH: Low pH = acidosis High pH = alkalosis 2. use “ROME” mnemonic (to determine if its respiratory or metabolic): Respiratory – Opposite Metabolic – Equal ASSESSING CHANGES IN BEHAVIOR "DEMENTIA" Drug and alcohol Eyes and ears Metabolic and endocrine disorders Emotional disorders Neurologic disorders Tumors and trauma Infection Arterial vascular disease ASTHMA MANAGEMENT "ASTHMA" Adrenergics (Albuterol) Steroids Theophylline Hydration (IV) Mask (Oxygen) Antibiotics ASTHMA - MANAGEMENT Asthma is a spasm of the airways, which causes difficulty breathing. “ASTHMA” Adrenergic (Albuterol) Steroids Theophylline Hydration (IV) Mask (Oxygen) Antibiotics ATRIAL FIBRILLATION – NEW ONSET CAUSES “THE ATRIAL FIBS” Thyroid Hypothermia Embolism (PE) Alcohol Trauma (cardiac contusion) Recent surgery (post CABG) Ischemia Atrial enlargement Lone or idiopathic Fever, anemia, high-output states Infarct Bad valves (mitral stenosis) Stimulants (cocaine, theo, amphet, caffeine) ATRIOVENTRICULAR VALVES "LAB RAT" Left Atrium: Bicuspid Right Atrium: Tricuspid ATROPINE "A goes with B" Atropine used to treat bradycardia. BENNER'S MODEL N - Nickerr's - easy to remember b/c it rhymes with Benner's Novice – strictly able to focus on learning the rules, onset of education A - and - "ad"vanced beginners – distinguish abnormal findings but cannot readily understand significance C - Comp - Competent – able to handle their pt. load and prioritize situation P - Planetary – big picture is the key word - Proficiency E - Experts – Leader/ role model not every nurse becomes one. BETA 1 AND BETA 2 Beta 1 adrenergic receptors are mostly found in the heart. Beta 2 adrenergic receptors are found in lungs, GI tract, vascular smooth muscle, skeletal muscle, liver. Beta 1 beta blockers act primarily on the heart. Beta 2 beta blockers act primarily on the lungs. Beta 1: heart Beta 2: lungs - You have one heart and two lungs BETA BLOCKERS B1 Blocks the heart (only have ONE heart) B2 Blocks the lungs (have TWO lungs) BETA BLOCKER CONTRAINDICATIONS "ABCDE" Asthma Block (heart block) COPD Diabetes mellitus Electrolyte (hyperkalemia) BETA BLOCKERS "You have 1 heart and 2 lungs" Beta-1 act primarily on heart Beta-2 act primarily on lungs BLEEDING PRECAUTIONS “RANDI” R- Razor Electric/Blades A- Aspirin N- No needles (esp. in small gauge) D- Do decrease in needle sticks) I - Injury (Protect from) BLEEDING PRECAUTIONS If a patient is taking an anticoagulant to prevent blood clots there is increased risk for bleeding. Be careful with blades when shaving. Do not take aspirin as it interferes with blood clotting and can magnify the effect of the medication. Avoid excess needle sticks and protect the patient from injury. “RANDI” Razor Electric/Blades Aspirin Needles- small gauge Decrease needle sticks Injury (Protect from) BLOOD FLOW THROUGH HEART VALVES "Tissue Paper My Ass" Tricuspid Pulmonic Mitral Aortic BLOOD GLUCOSE Symptom Implication (rhyme) Cold and clammy . . . give hard candy Hot and dry . . . glucose is high BLOOD TYPES Picture type O as a huge circle, like the universe, because they are the universal donor. They can give to everyone. However, also think of them as the “odd man out” because they can only receive type O as well. They are universally odd, able to give to all but only receive from themselves! BODY SYSTEMS "MR DICE RUNS" Muscle Respiratory Digestive Integumentary Circulatory Endocrine Reproductive Urinary Nervous Skeletal BRADYCARDIA & LOW BP DRUGS “IDEA” I - Isoproterenol D - Dopamine E - Epinephrine A - Atropine Sulfate BRADYCARDIA & LOW BLOOD PRESSURE DRUGS This refers to symptomatic bradycardia and hypotension. Bradycardia and hypotension are not necessarily adverse clinical findings requirement treatment in and of themselves. “IDEA” Isoproterenol Dopamine Epinephrine Atropine Sulfate BRADYCARDIA AND HYPOTENSION MEDS "IDEA" Isoproterenol Dopamine Epinephrine Atropine Sulfate BREASTFEEDING ASSESSMENT "LATCH" Latch achieved by infant Audible swallow Type of nipple Comfort of mother Help given to mother with nursing BRONCHODILATORS "TO A SIS" Terbutaline Orciprenaline Adrenaline Salbutamol Isoprenaline Salmeterol “BULIMIA” – EATING DISORDER B-binge eating U-under strict dieting L-lacks control over-eating I-induced vomiting M-minimum of two binge eating episodes I-increased/Persistent concern of body size/shape A-abuse of diuretics & laxatives BULIMIA CLIENT FINDINGS “WASHED” W-weight loss of 15% of original body weight A-amenorrhea S-social withdrawal H-history of high activity & achievement E-electrolyte Imbalance D-depression/ Distorted Body Image CANCER ASSESSMENT "CAUTION" Change in bowel or bladder habits A sore that doesn't heal Unusual bleeding or discharge Thickening or lump Indigestion or difficulty swallowing Obvious changes in a wart or mole Nagging cough or hoarseness CANCER - EARLY WARNING SIGNS Cancer can sometimes be difficult to identify, but the earlier it is detected the better chance treatment will be effective. “CAUTION UP” Change in bowel or bladder A lesion that does not heal Unusual bleeding or discharge Thickening or lump in breast or elsewhere Indigestion or difficulty swallowing Obvious changes in wart or mole Nagging cough or persistent hoarseness Unexplained weight loss Pernicious Anemia CANCER - INTERVENTIONS “CANCER” Comfort Altered Body Image Nutrition Chemotherapy Evaluate response to meds Respite for caretakers CANCERS THAT METASTASIZE IN BONE "Particular Tumors Love Killing Bone" Prostate Thyroid Lung Kidney Breast CANES AND WALKERS "COAL" and "WWAL" Cane Opposite Affected Leg Walker With Affected Leg CANES AND WALKERS “COAL & WWAL” C- Cane O- Opposite A- Affected L- Leg W- Walker W- With A- Affected L – Leg CARDIAC VALVES BLOOD FLOW This simple mnemonic helps to remember the order in which blood passes through the four heart valves in sequential order. “Toilet Paper My A**” Tricuspid Pulmonic Mitral Aortic CEREBELLAR DAMAGE SYMPTOMS "VANISHED" Vertigo Ataxia Nystagmus Intention tremor Slurred (or staccato) speech Exaggerated broad based gait Hypotonic reflexes Dysdiadochokinesia. CHF TREATMENT "UNLOAD FAST" Upright Position Nitrates (in low dose) Lasix Oxygen Aminophylline Digoxin Fluids (decrease) Afterload (decrease) Sodium restriction Test (Dig level, ABGs, K level) CHF - TREATMENT These treatments used in conjunction will help in reducing the symptoms and complications associated with CHF. “UNLOAD FAST” U sit Upright Nitro Lasix Oxygen Aminophylline Digoxin Fluids - decrease Afterload - decrease Sodium - decrease Tests: dig level, ABG, K+ CHILD ABUSE/NEGLECT – WARNING SIGNS “CHILD ABUSE” C-child’s excessive knowledge on sex & abusive words H-hair growth in various lengths I-inconsistent stories from the child & parent/s L-low self-esteem D-depression A-apathy, no emotion B-bruised U-unusual injuries S-serious injuries E-evidence of old injuries not reported Wernicke-Korsakoff syndrome (WKS) – (alcohol- associated neurological disorder) "COAT RACK" Wernicke's encephalopathy (acute phase) clinical features: C-confusion O-ophthalmoplegia A-ataxia Thiamine is an important aspect of T-x Korsakoff's psychosis (chronic phase) characteristic findings: R-retrograde amnesia (recall of some old memories) A-anterograde amnesia (ability to form new memories) C-confabulation K-korsakoff's psychosis CHLOROQUINE USES (OTHER THAN MALARIA) "RED LIP" Rheumatoid arthritis Extra intestinal amoebiasis Discoid lupus erythematosus Lepra reaction Infectious mononucleosis Photogenic reactions CHOLECYSTITIS – RISK FACTORS “5 F's” Female Fat Forty Fertile Fair CHOLINERGIC CRISIS "SLUD" Salivation Lacrimation Urination Defecation CHOLINERGIC CRISIS - SIGNS AND SYMPTOMS “SLUDGE” Salvation Lacrimation Urination Defecation Gastric upset Emesis CHRONIC OBSTRUCTIVE PULMONARY DISEASE "blue bloater vs. pink puffer" emPhysema has letter P (and not B) so Pink Puffer. chronic Bronchitis has letter B (and not P) so Blue Bloater. CIRCULATION CHECKS "5 P's" Pain Paresthesia Paralysis Pulse Pallor (Paleness) CIRCULATORY CHECKS “The 5 P’s” Pain Paresthesia (numbness/tingling) Paralysis Pulse Pallor (Paleness) CLEFT LIP – POST-OP NURSING CARE PLAN "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) CLEFT LIP POST OP CARE "CLEFT LIP" Choking Lie on back Evaluate Airway Feed Slowly Teaching Larger nipple opening Incidence increase in males Prevent crust formation and aspiration CLIENT IN TRACTION NURSING CARE "TRACTION" Temperature (Extremity, Infection) Ropes hang freely Alignment Circulation Check (5 P's) Type & Location of fracture Increase fluid intake Overhead trapeze No weights on bed or floor COAGULATION TESTS "PiTT" (PTT - I for Intrinsic pathway) - PiTTsburgh "PeT" (PT - E for Extrinsic pathway) **Bleeding Time – provides assessment of platelet count & function (normal value: 2-8 minutes). **Prothrombin Time (PT) – measures effectiveness of “E”xtrinsic pathway. Mnemonic – PET (normal value: 10-15 seconds). **Partial Thromboplastin Time (PTT) – measures effectiveness of “I”ntrinsic pathway. Mnemonic – PITT (normal value: 25-40 seconds).