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• C-Choking
• C-Coughing
• C-Cyanosis

A tracheal esophageal fistula (TEF) is a congenital abnormality in which there is an opening between the trachea and the esophagus. Surgery is required to repair the opening before a baby can receive oral nutrition. Signs and symptoms to identify TEF are choking, coughing, and cyanosis.

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• F-Feeding difficulty
• I-Inspiratory Stridor
• N-Nares Flares
• E-Expiratory Grunting
• S-Sternal Retractions

The above signs are indications that the patient is attempting to draw in more oxygen. The patient will begin to compensate for the decreased tissue oxygenation by exhibiting the following signs and symptoms.

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• V-Variable
• E-Early
• A-Accelerations
• L-Late
• C-Cord Compression
• H-Head Compression
• O-Okay
• P-Placental Insufficiency

A fetal acceleration is an abrupt increase in fetal heart rate above the established baseline. A fetal deceleration is a decrease in fetal heart rate below the established fetal heart rate. The VEAL CHOP nursing mnemonic can be used to help remember how to interpret fetal heart rate during labor. For example, early decelerations in FHR (fetal heart rate) indicate head compression. It is typical for decels in FHR during a contraction because of head compression, but FHR should return to normal when contraction ends.

A cholinergic crisis can occur if the body stops properly breaking down Acetylcholine. This can cause overactivity of Acetylcholine at the neuromuscular junction. Acetylcholine is part of Rest & Digest (Parasympathetic) – so we see overactive digestion and secretion.

These treatments used in conjunction will help in reducing the symptoms and complications associated with CHF.

This simple mnemonic helps to remember the order in which blood passes through the four heart valves in sequential order.

Cancer can sometimes be difficult to identify, but the earlier it is detected the better chance treatment will be effective.

If a patient is taking an anticoagulant to prevent blood clots there is increase 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.

The therapeutic management for a patient with asthma. Asthma is a spasming of the airways, which causes difficulty breathing.

Psoas sign is pain when a patient extends their thigh while lying on their side with knees extended. It indicates irritation to certain abdominal muscles.
McBurney's sign is if there is deep tenderness at McBurney's point, which is located on the right side of the abdomen, one-third the distance from the anterior superior iliac spine to the navel.

First look at the pH: if it is low it is acidosis, high indicates alkalosis. Second use the ROME mnemonic to determine if you have respiratory vs. metabolic. For Metabolic look at HCO3. For Respiratory, look at pCO2.
Metabolic Acidosis – pH Low, HCO3 Low. Metabolic Alkalosis – pH High, HCO3 High. Respiratory Acidosis – pH Low, pCO2 High. Respiratory Alkalosis – pH High, pCO2 Low.

There are many reasons why a patient may present with altered mental status. Neurological injury is not the only reason for AMS! Make sure you explore all possibilities.

The 5 A's of Alzhemiers Disease. These signs point to a diagnosis of Alzheimer's Type Dementia

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• R-Redness
• E-Edema
• E-Ecchymosis
• D-Discharge, Drainage
• A-Approximation

Redness with pain, excess edema, ecchymosis (bruising), or discharge/drainage from the wound can all be signs of problems with healing after an episiotomy. Wound edges should be well approximated. Topical ointments and ice packs may be indicated if there is pain or excess swelling, or other signs of infection.

There are three different adrenal gland hormones which can be remembered as the 3 Ss: sugar (glucocorticoids) affects glucose utilization, fat metabolism and aid in reducing inflammation. Salt (mineralcorticoids) plays a role in electrolyte regulation. Androgens are commonly referred to as sex hormones.

Vitamins A, D, E, and K are all fat soluble vitamins. Dogs get fat eating too much kibble

Steroids are an effective treatment for asthma, COPD, Crohn's, Lupus and more. However,they have the potential for very serious side effects, which are indicated by the 6 S's. Steroids can be taken by mouth, via an inhaler, topically, or via injection.

Nursing care and responsibilities with patients in traction

These four basic interventions can help to alleviate the symptoms of a sprain or a strain. A strain is excessive stretching of muscle. A sprain is excessive stretching of ligament.

These are the steps of the nursing process. Gather information, determine the problem and the best approach. Implement your interventions, and then evaluate! Never skip a step!!

These are the steps of the nursing process. Gather information, determine the problem and the best approach. Implement your interventions, and then evaluate! Never skip a step!!

The instrumental activities of daily living are used to determine a patient's ability to carry out necessary functions for independent living. If they are unable to manage the activities below, they will likely require some sort of assistance from family or a home health agency, etc.

Use the mnemonic BEEP to remember minor bleeding precautions. Think – if the patient sees any bleeding, they'll BEEP the call light!

When teaching a patient how to walk with a cane it is important to instruct them to keep the cane on the opposite side of the affected extremity.

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• T-Tetralogy of Fallot
• T-Truncus Arteriosus
• T-Transposition of the Great Vessels
• T-Tricuspid Atresia

Cyanotic heart defects are a group of congenital heart defects that result from deoxygenated blood by-passing the lungs and going into systemic circulation. Tetralogy of Fallot includes 4 anatomical abnormalities that are pictured below. Truncus Arteriosus is a condition where the pulmonary trunk and aorta don't properly divide in development. This results in one large vessel carrying mixed blood to the heart, lungs, and systemic circulation. Transportation of the Great Vessels is a condition where vessels are swapped or may be in abnormal positions. Tricuspid Atresia is a condition where there is no tricuspid valve, which leads to an undersized or absent right ventricle.

To remember the 10 major body systems.

When assessing a patient's ability to care for him or herself at home we must assess their ability to complete activities of daily living. A patient's ability to bath, walk, and toilet on their own will help us determine the level of care they will need when they leave the hospital.

Lidocaine is an anesthetic that prevents painful impulses from reaching the brain. These are signs that the patient may have had too much lidocaine (like buying in bulk)

The above drugs work in a variety of emergency settings, they are good drugs to LEAN on. Lidocaine can be used in emergency situations for ventricular arrhythmias. Epinephrine is a vital drug in the ACLS protocol. Atropine can be given with symptomatic bradycardia. Narcan is a reversal agent for opiate overdose.

Coumadin and ilosone: Ilosone can increase the effects of Coumadin, increase risk for bleeding. Coumadin and Dilantin: potential for increased effects of both. Coumadin and Dilantin: Increased Coumadin metabolism (decreased effect). Theophylline and Dilantin: if taken orally they can interfere with absorption of each other and decrease medication effect.

A cholinergic crisis can occur if the body stops properly breaking down Acetylcholine. This can cause overactivity of Acetylcholine at the neuromuscular junction. Acetylcholine is part of Rest & Digest (Parasympathetic) – so we see overactive digestion and secretion.

This refers to symptomatic bradycardia and hypotension. Bradycardia and hypotension are not necessarily adverse clinical findings requiring treatment in and of themselves.

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.

Alkalosis has a K, therefore it is Kicking the pH UP! | Acidosis has a D, therefore it is dropping the pH DOWN!

Potassium and sodium are the two most abundant cations in the body and have an inverse relationship in regards to intracellular and extracellular concentrations. Potassium is primarily located within the cell and sodium is primarily located outside the cell.

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• D-Distractibility
• I-Indiscretion
• G-Grandiosity
•  
• F-Flight of Ideas
• A-Activity Increase
• S-Sleep Deficit
• T-Talkative

The above signs would be indicative of a patient experiencing a manic episode. A manic episode is a state in which the patient experiences abnormally elevated mood, typically lasting at least one week. Think of a dog 'manically' digging for a bone.

Hyponatremia is decreased levels of sodium in the blood. It can be caused by inadequate sodium or excess free water which leads to lower concentration of sodium. Sodium and potassium work together to allow depolarization of muscles. Low sodium levels can limit this ability and cause muscle weakness. Sodium in the blood helps maintain the oncotic pressure. If fluid leaves the blood vessels, it can lead to decreased blood pressure.

Hypokalemia is LOW potassium, which starts with L. So the 6 L's can help you recognize the signs and symptoms of LOW potassium or hypokalemia

The BONES store the most calcium – remember these words that rhyme with BONES to help you remember possible signs and symptoms of hypercalcemia.

Normal serum sodium levels are 134-145 mmol/L. Hypernatremia is defined as a serum sodium level exceeding 145 mmol/L. Think "fried food is salty". Hypernatremia can be caused by too much sodium in the blood, but it also is caused by too little free water in the body. You must first assess the patient's volume status before knowing how to treat appropriately. Hypernatremia signs can be very subtle, with changes in the level of consciousness typically being the earliest indicator. Sodium is closely related to blood pressure and blood volume. It is also necessary for muscle and nerve function.

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!

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• S-Sleep Disturbances
• I-Interest Decreased
• G-Guilty Feelings
• N-No Energy
• S-Sadness (Crying spells)

Monitor for these SIGNS in patients that may be at risk for depression.

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• DEMENTIA Make certain they don't have problems with:
• D-Drugs and alcohol
• E-Eyes and ears
• M-Metabolic and endocrine disorders
• E-Emotional disorders
• N-Neurologic disorders
• T-Tumors and trauma
• I-Infection
• A-Arteriovascular disease

When assessing a patient for dementia it is important to ensure that one of the following listed conditions isn't an underlying cause for the dementia symptoms.

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• A-Amenorrhea
• N-No 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-X-symptoms (peculiar symptoms)
• I-Intense fears of gaining weight
• A-Always thinking of food

Anorexia nervosa is an eating disorder characterized by low body weight and periods of starvation or binging and purging. The lack of adequate nutrition and fat stores can lead to amenorrhea. Patients with anorexia will feel fat even if underweight, as anorexia is an unhealthy way to cope with emotional problems. Binging and purging can lead to damage of the GI tract and epigastric discomfort. Some peculiar symptoms may also be seen: abnormal blood counts, bluish discoloration of the fingers, hair that thins, breaks or falls out, or soft downy hair covering the body.

• B-Binge eating
• U-Under strict dieting
• L-Lacks control/over-eating Induced vomiting
• M-Minimum of two binge eating episodes
• I-Increase/Persistent concern of body size/shape
• A-Abuse of diuretics and laxatives

Bulimia is an eating disorder characterized by binging and purging. Patients may go through periods of excessive eating and then try to purge be inducing vomiting, taking laxatives or diuretics, or going through periods of fasting.

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• B-Brain Damage
• A-Alcoholic Hallucinations
• D-Death

Abuse of alcohol can lead to very BAD outcomes. Emergent treatment should be provided for patients who have overdosed.

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• A-Acid-Base Problems
• E-Electrolyte Problems
• I-Intoxications
• O-Overload of fluids
• U-Uremic Symptoms

As a patient progresses from chronic kidney disease to end stage renal disease the need for dialysis becomes more imminent. When the kidneys are no longer able to filter the blood alone you will see problematic metabolic acidosis since they kidneys can't excrete excess acids that are in the blood. During kidney failure, excess potassium isn't excreted and levels will start to rise. The kidneys help remove certain medications from the body, and when they aren't working, toxicity can occur even with normal doses. Patients with ESRD become fluid overloaded due to inadequate urine production. Uremia will occur as the body can't excrete enough urea.

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• T-Tissue Perfusion Problems
• R-Respiratory Problems
• A-Anxiety
• U-Unstable Clotting Factors
• M-Malnutrition
• A-Altered Body Image
• T-Thromboembolism / fat embolism
• I-Infection
• C-Coping Problems

In trauma the patient needs to be quickly assessed for adequate perfusion as part of the trauma survey. Trauma can lead to overt or covert blood loss resulting in shock. If there is significant blood loss, the patient may develop disseminated intravascular coagulation as they begin to deplete their available clotting factors.

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• C-Choking
• L-Lie on back
• E-Evaluate Airway
• F-Feed Slowly
• T-Teaching
• L-Larger nipple opening
• I-Increased incidence in males
• P-Prevent crust formation and aspiration

Cleft lip is a congenital slit in the skin above the lip, typically also associated with a cleft palate. The typical treatment is reconstructive surgery. Post op care includes monitoring for choking. Baby should lie on their back during sleep to prevent trauma to sutures. Make sure to evaluate the airway and ensure it is open and monitor for aspiration. Feed the baby slowly in an upright position with a larger nipple opening. Prevent crust formation. Lastly, provide teaching to parents regarding feeding and common care.

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• A-Airway
• B-Breathing
• C-Circulation
• D-Disability
• E-Expose / Examine
• F-Full set of Vitals
• G-Give Comfort Measures
• H-Head to Toe Assessment
• I-Inspect Posterior

Rapid assessment and treatment of the trauma patient is essential to their overall survival. Working through this framework will aid in remembering where to focus your efforts. Always remember your ABC and patient safety. Once those have been secured, you can move on to less vital components.

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• P-Psychologic
• D-Delirium
• I-Infection
• A-Atrophic Urethra
• P-Pharmaceuticals – blood pressure medication, antidepressants, diuretics, sleeping pills
• E-Excess Urine Output
• R-Restricted Mobility
• S-Stool Impaction

These are common causes of transient incontinence – when a patient cannot hold their urine and becomes incontinent without warning, periodically. This occurs in children and commonly in older adults