ADULT CONCEPTS:
RESPI:
1. CRACKLES – FINE HIGH-PITCHED CRACKLING AND POPPING SOUND HEARD DURING END OF
INSPIRATION. NOT CLEARED BY COUGHING. MAY BE HEARD IN PNEUMONIA, CHF, CHRONIC
BRONCHITIS, ASTHMA ETC.
2. WHEEZING – HIGH PITCH MUSICAL SOUNDS COMMONLY HEARD DURING EXPIRATION
3. RHONCHI – COARSE LOW-PITCHED SNORING SOUNDS
4. PLEURAL FRICTION RUB – LOW-PITCHED GRATING SOUND
CARDIO:
1. PITTING LOWER EDEMA – IF BILATERAL INDICATION FLUID OVERLOAD EX: HEART FAILURE
- IF UNILATERAL INDICATION EX: DEEP VEIN THROMBOSIS
2. DO NOT PUT SEQUENTIAL COMPRESSION DEVICE IN A CLIENT ALREADY WITH DEEP VEIN
THROMBOSIS. PUT SCD ONLY IF THE PT IS RISK NOT WITH DVT ALREADY IT IS CONTRAINDICATED
GASTRO
1. ACUTE PANCREATITIS – INFLAMMATION OF PANCREAS.
INTERVENTIONS:
1. MANAGE PAIN - MORPHINE
2. DECREASE PANCREATIC STIMULATION – MAINTAINING NPO
3. NASOGASTRIC SUCTIONING – REDUCED G.I ACTIVITY
4. MAY GIVE ANTI SPASMODICS AND PPI – PANTOPRAZOLE
5. HYPOCALCEMIA – MONITOR FOR TETANY
2. CHRON’S DISEASE – SEVERE DIARRHEA THAT CAN CAUSE DEHYDRATION AND ELECTROLYTE
IMBALANCE.
TIPS:
1. NPO THE PATIENT
2. GIVE IV FLUIDS TO REHYDRATE
3. ACUTE PANCREATITIS
MGT:
1. IV FLUIDS
2. PAIN MEDS EX: HYDROMORPHONE IV
3. VOMITING MEDS EX: ODANSENTRON IV
4. CHECK BREATH SOUNDS AND O2 SAT LEVEL
PHARMA
1. THEOPHYLLINE TOXICITY – MGT OF NOCTURNAL ASTHMA.
S/SX OF TOXICITY: (CENTRAL NERVOUS SYSTEM STIMULATION)
1. TREMORS
2. INSOMNIA
3. RESTLESSNESS
4. SEIZURES
S/SX OF TOXICITY: (G.I)
1. DIARRHEA
2. N&V
S/SX OF TOXICITY: (CARDIO)
1. DYSRHYTHMIAS
2. PYRIDOSTIGMINE BROMIDE – USED IN MAYESTHENIA GRAVIS
3. GABAPENTIN – ANTICONVULSANT. MANAGES NEUROPATHIC PAIN. SHOULD NOT TAKE
TOGETHER WITH ANTACIDS, MUST WAIT 2 HOURS SEPERATELY. PT WILL FEEL SLEEPY. DOUBLE
VISION IS EXPECTED SIDE EFFECT.
RARE SIDE EFFECT: SUICIDAL THOUGHTS. MUS REFER IMMEDIATELY
4. NITROFURANTOIN – ANTIBIOTIC FOR UTI. NEED TO REPORT ASAP IF HYPERSENSITIVITY
REACTIONS OCCURS SUCH AS DYSPNEA AND COUGH. EARLY SIGNS OF PERIPHERAL
NEUROPATHY NEEDS TO REPORT SUCH AS TINGLING, MUSCLE WEAKNESS OR NUMBNESS.
5. ATROPINE EYEDROPS (ANTICHOLINERGIC EYE DROPS) – ASK FIRST IF PT HAS HX OF
GLAUCOMA OR TUNNEL VISION. A PAINFUL SURGICAL EMERGENCY.
OTHER SIDE EFFECTS OF ANTICHOLINERGIC DRUGS: EX. SCOPOLAMINE PATCH
1. BLURRED VISION (CAN’T SEE)
2. URINARY RETENTION (CAN’T PEE)
3. DRY MOUTH (CAN’T SPIT)
4. CONSTIPATION (CAN’T POO)
5. CYCLOBENZAPRINE – MUSCLE RELAXANT THAT DEPRESS CNS TO TREAT MUSCLE SPASMS.
SHOULD NOT BE GIVEN WITH MAOI’S (PHENELZINE, SELEGILINE) CAN BE FATAL
TIPS:
1. SHOULD NOT BE COMBINED WITH OTHER CNS DEPRESSANTS SUCH AS ALCOHOL,
OPIATES OR BENZODIAZEPINES DUE TO RISK OF EXCESSIVE SEDATION OF
RESPIRATORY DEPRESSION
2. DO NOT TAKE WITH ALCOHOL.
3. AVOID DRIVING.
4. DISCONTINUE IF WITH EXPERIENCED RAPID HEART BEAT
7. TAMSULOSIN – DO NOT TAKE WITH SILDENAFIL AND TADALAFIL
8. SODIUM NITROPUSSIDE – USE IN HYPERTENSIVE CRISIS. CAUSES ABRUPT HYPOTESION
PRIORITY:
1. CHECK FOR BP
NEURO:
1. GUILLAIN-BARRE SYNDROME – CAUSED BY VIRAL INFECTION.
S/SX: ASCENDING MUSCLE WEAKNESS THAT MAY PROGRESS TO RESPIRATORY COMPROMISE.
NUMBNESS AND TINGLING THAT CAN PROGRESS TO PARALYSIS.
2. MAP: MUST BE >60MMHG (MEAN ARTERIAL PRESSURE)
CPP: MUST BE > 60 MMHG (CEREBRAL PERFUSION PRESSURE)
ICP: MUST BE <20MMHG (INTRACRANIAL PRESSURE)
3. VENTRICULOSTOMIES – DRAIN CSF. SHOULD BE CLEAR AND COLORLESS, (CLOUDY AND
BLOODY INDICATES INFECTIONS OR NEW CEREBRAL BLEEDING)
NSG MGT:
1. ADMINISTER SEDATION FOR AGITATION
2. ADMINISTRATION OF STOOL SOFTENER
3. MAINTAIN HEAD OF THE BED 30 DEGREES AND NEUTRAL NECK POSITION
4. MAINTAIN CPP > 60MMHG
5. LEVEL VENTRICULOSTOMY AT TRAGUS LEVEL FOR ACCURATE READING
O.B
1. PELVIC INFLAMMATORY DISEASE – CAUSES LOWER ABDOMINAL PAIN, DYSMENORRHEA, SCARRING
OF THE FALLOPIAN TUBE AND INFERTILITY
OTHER DISEASE:
1. ADRENAL CRISIS OR ADDISIONIAN CRISIS: LIFE THREATENING CONDITION WITH DEFICIENT
AMOUNT OF CORTISOL AND ALDOSTERONE LEADING TO DEHYDRATION AND SEVERE HYPOTENSION
S/SX:
1. SEVERE HYPOTENSION – MAY LED TO SHOCK. MUST ADDRESS ‘’ FIRST ‘’
2. HYPOGLYCEMIA
3. HYPONATREMIA
4. HYPERKALEMIA
2. VON WILLEBRAND DISEASE – CHARACTERIZE BY CLOTTING FACTOR DEFICIENCY. CAUSING
PROLONGED BLEEDING TIMES. EX. BLEEDING IN NOSTRILS AND GENITALS. PATIENTS MAY
EXPERIENCING LARGE CLOTS, OR PROLONGED BLEEDING FROM MENSTRUATION
MGT:
1. EDUCATE ON MINIMIZING THE RISK OF BLEEDING AND MANAGING BLEEDING
2. AVOID CONTACT SPORTS
3. LEAN FORWARD AND APPLY PRESSURE DURING EPISTAXIS
4. AVOID NSAIDS
5. SEEK MEDICAL TREATMENT IF EXPERIENCE HEAVY BLEEDING OR CLOTS
3. METABOLIC SYNDROME – 3 CRITERIA OR MORE OF THESE… HIGH WAIST CIRCUMFERENCE,
INCREASE BLOOD PRESSURE, INCREASE TRIGLYCERIDES, HIGH HDL, HIGH GLUCOSE (WBTHG)
