DO NOT delegate what you can EAT!

E – evaluate A – assess T – teach

addisons= down, down down up downcushings= up up up down upaddisons= hyponatremia, hypotension,

decreased blood vol, hyperkalemia, hypoglycemia

cushings= hypernatremia, hypertension, incrased blood vol, hypokalemia, hyperglycemia 

No Pee, no K (do not give potassium without adequate urine output) 

EleVate Veins; dAngle Arteries for better perfusion 

A= appearance (color all pink, pink and blue, blue [pale])

P= pulse (>100, < 100, absent)
G= grimace (cough, grimace, no response)
A= activity (flexed, flaccid, limp)
R=respirations (strong cry, weak cry, absent)

TRANSMISSION-BASED PRECAUTIONS:

AIRBORNE
My - MeaslesChicken - Chicken Pox/VaricellaHez - Herpez Zoster/ShinglesTB
 
or remember...
MTV=Airborne
Measles
TB
Varicella-Chicken Pox/Herpes Zoster-Shingles 
Private Room - negative pressure with 6-12 air exchanges/hr
  Mask, N95 for TB

DROPLET
 think of SPIDERMAN!
S – sepsis
S - scarlet fever
S - streptococcal pharyngitis
P - parvovirus B19
P – pneumonia
P - pertussisI – influenza
D - diptheria (pharyngeal)
E - epiglottitisR - rubellaM – mumps
M – meningitis
M - mycoplasma or meningeal pneumonia
An - Adenovirus
  Private Room or cohort
Mask

CONTACT PRECAUTION 
MRS.WEE
M - multidrug resistant organism
R - respiratory infection
S - skin infections *
W - wound infxn
E - enteric infxn - clostridium difficile
E - eye infxn – conjunctivitis

SKIN INFECTIONS
VCHIPS
V - varicella zoster
C - cutaneous diphtheria
H - herpez simplex
I – impetigo
P – pediculosis
S – scabies

 
2
M - mumps
 
M - meningitis
 
M - mycoplasma or meningeal pneumonia
 
An - Adenovirus
 -
Private Room or cohort
 -
MaskCONTACT PRECAUTION MRS.WEE
 
M - multidrug resistant organism
 
R - respiratory infectionS - skin infections *
 
W - wound infxn
 
E - enteric infxn - clostridium dificile
 
E - eye infxn - conjunctivitis
 
SKIN INFECTIONS
 
VCHIPS
 
V - varicella zoster
 
C - cutaneous diphtheria
 
H - herpes simplex
 
I - impetigo
 
P - pediculosis
 
S-cabies

Diagnostic Tests and Examinations

1.Air/Pulmonary Embolism (S&S: chest pain, difficulty breathing, tachycardia, pale/cyanotic, sense of

impending doom) --> turn pt to left  side and lower  the head of the bed.

2.Woman in Labor w/ Un-reassuring FHR  (late decels, decreased variability, fetal bradycardia, etc) --> turn
on
Left side (and give O2, stop Pitocin, increase IV fluids)

3.Tube Feeding w/ Decreased LOC--> position pt on right side (promotes emptying of the stomach) with the
HOB elevated (to prevent aspiration)

4.During Epidural Puncture --> side-lying

5.After Lumbar Puncture (and also oil-based Myelogram)--> pt lies in flat supine  (to prevent headache and
leaking of CSF)

6. Pt w/ Heat Stroke --> lie flat  w/ legs elevated

7. During Continuous Bladder Irrigation (CBI) --> catheter is taped to thigh so leg should be kept straight. No
other positioning restrictions.
8. After Myringotomy --> position on side of affected ear  after surgery (allows drainage of secretions)

9. After Cataract Surgery --> pt will sleep on unaffected side with a night shield for 1-4weeks.

10. After Thyroidectomy --> low or semi-Fowler's, support head, neck and shoulders.

11. Infant w/ Spina Bifida  --> position prone (on abdomen) so that sac does not rupture

12.Buck's Traction (skin traction) --> elevate foot of bed for counter-traction

13. After Total Hip Replacement --> don't sleep on operated side, don't flex hip more than 45-60 degrees,
don't elevate HOB more than 45 degrees. Maintain hip abduction by separatingthighs with pillows.

14. Prolapsed Cord --> knee-chest position or Trendelenburg

15.Infant w/ Cleft Lip --> position on back or in infant seat to prevent trauma to suture line.While feeding,
hold in upright position.
16.To Prevent Dumping Syndrome (post-operative ulcer/stomach surgeries) --> eat inreclining position, lie
down after meals for 20-30 minutes (also restrict fluids during meals, lowCHO andfiber diet, small frequent
meals)
17.Above Knee Amputation --> elevate for first 24 hours on pillow, position prone daily toprovide for hip
extension.
18.Below Knee Amputation --> foot of bed elevated for first 24 hours, position prone daily toprovide for hip
extension.
19.Detached Retina --> area of detachment should be in the dependent position
20.Administration of Enema --> position pt inleft side-lying (Sim's) with knee flexed
21.After Supratentorial Surgery (incision behind hairline) --> elevate HOB 30-45 degrees
22.After Infratentorial Surgery (incision at nape of neck)--> position ptflat and lateral oneither side.
23.During Internal Radiation --> onbedrest while implant in place
24.Autonomic Dysreflexia/Hyperreflexia (S&S: pounding headache, profuse sweating, nasalcongestion,
goose flesh, bradycardia,hypertension) --> place client insitting position (elevateHOB) first before any other
implementation.
25.Shock --> bedrest with extremities elevated 20 degrees, knees straight, head slightlyelevated (modified
Trendelenburg)
26.Head Injury --> elevate HOB 30 degrees to decrease intracranial pressure
27.Peritoneal Dialysis when Outflow is Inadequate --> turn pt from side to sideBEFORE checking for kinks in
tubing (according to Kaplan)
28.Lumbar puncture => AFTER the procedure, the client should be placed in the supineposition for 4 to 12
hrs as prescribed. (Saunders 3rd ed p. 229)
Demorol for pancreatitis, NOT morphine sulfate
Myasthenia Gravis: worsens with exercise and improves with rest.
Myasthenia Crisis: a positive reaction to Tensilon--will improvesymptoms
Cholinergic Crisis: caused by excessive medication-stop med-giving Tensilon will make it worse
Head injury medication: Mannitol (osmotic diuretic)-crystallizes at room temp so ALWAYS usefilter needle
Prior to a liver biospy its important to be aware of the lab result for prothrombin time
From the a** (diarrhea)= metabolic acidosis
From the mouth (vomitus)=metabolic alkalosis
Myxedema/hypothyroidism: slowed physical and mental function, sensitivity to cold, dry skinand hai