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5. TABLE OF CONTENT
Anatomy and Physiology
Medical Surgical Nursing
Hallmark Signs and Symptoms
Nutrition
EKGs
Pharmacology
Nursing Assessment
Maternity
Lab Values
Nursing Fun Facts
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6. ANATOMY AND PHYSIOLOGY
MADE EASY
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7. CONNECTIVE NERVOUS EPITHELIAL
aNATOMY
& pHYSIOLOGY
MUSCLE
Skeletal muscle cells
Musculoskeletal: Mechanical support,
posture and locomotion
Cardiovascular: Transportation of
oxygen, nutrients and hormones
throughout the body and elimination
of cellular metabolic waste
Respiratory: Exchange of oxygen
and carbon-dioxide between the
body and air, acid-base balance
regulation.
Nervous: Initiation and regulation of
vital body functions, sensation.
Digestive: Breaks down food to be
absorbed as nutrients
Urinary: Filters and removes waste
from the blood, maintains fluid and
electrolyte balance
Endocrine: secretion of hormones
Lymphatic: Draining of excess tissue
fluid, immune defense of the body.
Reproductive: Production of
reproductive cells, reproduction
process.
Integumentary: Physical protection
of the body surface, sensory
reception.
Body System
& function
TISSUE TYPE
Smooth muscle cells
Cardiac muscle cells
TISSUE TYPE
O
r
g
a
n
i
z
a
t
i
o
n
o
f
t
h
e
b
o
d
y
Cardiac Output: amount of blood pumped per
minute. (Formula: SV*heart rate= CO)
Cardiac cycle: a heartbeat, complete series of
systolic and diastolic events.
Blood pressure: the force that blood exerts
against the inner walls of blood vessels.
Systolic bp: maximum pressure during
ventricular contraction
Diastolic bp: minimum arterial pressure during
ventricular relaxation.
1.
2.
3.
4.
5.
CardiaC definitions
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8. Introduction
Introduction
Anatomy: the structure (example: the lungs, bronchi and
alveoli)
Physiology: the function (gaseous exchange)
Organization of the body
The human body is organized starting with the cell to human
organism.
Atoms Molecules Organelles
Cells
Tissues
Organs
Organ System Human Organism
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10. MEDSURG DISORDERS
MADE EASY
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18. Coronary Artery
Disease
Narrowing or occlusion of the coronary
arteries due to atherosclerosis.
Angina
Chest pain due to decreased myocardial
oxygenation.
Myocardial tissue damage as a result of
oxygen deprivation
Myocardial
Infarction
Heart failure
The inability of the heart muscle to pump
enough blood to meet the metabolic
demands of the body.
Cardiogenic
Shock
Decreased cardiac output and decreased
tissue perfusion.
Pericarditis
Pericarditis is an infection of the
pericardium.
Endocarditis
Inflammation and infection of the
endocardium
Myocarditis
Myocarditis is the inflammation of the heart
muscles (myocardium).
Cardiac
Tamponade
Cardiac tamponade decreases ventricular
filling and cardiac output. Due to pericardial
effusion.
Aortic
Aneurysm
Aortic aneurysm is an enlargement/dilation
of the aorta.
CARDIOVASCULAR DISORDERS
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19. asthma Smooth muscle constriction of the bronchi.
COPD- Chronic
Bronchitis
Overproduction of mucus due to
inflammatory response.
Progressive respiratory disease
characterized by the enlargement of the
alveolar.
COPD-
EMPHYSEMA
PLEURAL
EFFUSION Accumulation of fluid in the pleural space.
HEMOTHORAX Accumulation of blood in the pleural cavity.
PNEUMOTHORAX
Air leaks into pleural space. Causes impaired
lung expansion.
PNEUMONIA Inflammation of the pulmonary tissue
caused by bacteria, fungi and viruses
RESPIRATORY DISORDERS
Pancreatitis Inflammation of the pancreas. Digestive
enzymes starts digesting the pancreas.
Cholecystitis Inflammation of the gallbladder.
Most of cholelithiasis is caused by
cholesterol gallstones.
Cholelithiasis
pancreatic disorders
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20. Hiatal Hernia
Hiatal hernia occurs when a portion of the
stomach herniates through the diaphragm
and into the thorax.
GERD A digestive disorder that occurs due to the
backflow of gastric content.
Gastritis is the inflammation of the gastric
mucosa.
Gastritis
Appendicitis Inflammation of the vermiform appendix.
Peptic Ulcer
Disease
Ulceration that erodes the gastric or
duodenal mucosa.
Ulcerative
Colitis
Characterized by the ulceration and
inflammation of the colon and rectum.
Causes poor nutrient absorption.
Crohns Disease Inflammation in the gastrointestinal tract
GASTROINTESTINAL DISORDERS
Cirrhosis Cirrhosis is a chronic progressive disease of
the liver characterized by fibrosis
Portal
Hypertension
Increased pressure in the portal veins due to
obstruction of the portal blood flow.
Increased pressure from the portal vein
causes blood to flow into smaller veins in the
esophagus. Smaller veins may rupture.
Esophageal
Varices
hepatic disorders
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21. Acute Kidney
Injury
Renal cell damage characterized by a
sudden deterioration in kidney function.
chronic kidney
disease
Slow, progressive and irreversible loss of
kidney function.(GFR <60mL/min).
A group of renal diseases caused by
immunologic response that triggers the
inflammation of the glomerular tissue.
Glomeruloneph
ritis
Nephrotic
Syndrome
Nephrotic syndrome is characterized by
proteinuria, leading to low protein levels in
the blood (hypoproteinemia).
Renal Calculi Renal calculi is also known as kidney stones.
Urinary Tract
Infection
UTI is the infection/inflammation of any part
of the urinary system.
Pyelonephritis Inflammation of the renal pelvis caused by
bacterial infection.
Genitourinary DISORDERS
Head Injury Trauma to the skull that causes brain
damage.
Stroke Stroke is the loss of neurological functions
due to the lack of blood flow to the brain.
Seizures is characterized by a sudden,
uncontrolled electrical disturbance in the
brain.
Seizures
neurological DISORDERS
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22. Age, Gender
Family hx, HTN
High blood cholesterol level,
Diabetes,
Smoking,
Obesity
1.
2.
3.
4.
5.
6.
Chest pain
Dyspnea/SOB
Fatigue
Dizziness
Syncope
Cough
Normal findings
during asymptomatic
period
1.
2.
3.
4.
5.
6.
7.
coronary artery disease
pathophysiology
CAD is caused by atherosclerosis (plaque formation) that
results in the narrowing or occlusion of one or more
coronary arteries.
Risk factor
signs & symptoms
Pain assessment, vital signs/ECG
Administer oxygen
Administer medications
Promote bed rest
Place client in a Semi-Fowler's
position.
Lifestyle modifications
Low-sodium and low-cholesterol
diet.
Stress management
1.
2.
3.
4.
5.
Patient Education
1.
2.
3.
nursing interventions
Electrocardiography
-ST segment elevation, t-wave
inversion and abnormal Q
wave(MI)
2. Cardiac catheterization
-may show atherosclerotic lesions.
3. Blood lipids level would be
elevated.
diagnostic tests
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23. 1.Heart failure (HF) occurs when the heart is unable to pump enough
blood to meet the body's demands.
2.Heart failure can affect the left or right side of the heart (left and
right HF)
3.Left sided heart failure is evident in the pulmonary system. Remember:
Left = Lungs
4.Right sided heart failure is evident in the systemic system
Note: in order to understand the signs and symptoms based on left sided and right sided heart
failure, you need to understand the flow of blood through the heart and body.
Right-sided HF
Edema of the extremities,
abdominal distention, JVD,
splenomegaly, hepatomegaly,
weight gain
Left-sided HF
Dyspnea, crackles, tachypnea,
pulmonary congestion, dry cough
1.Cardiac contractility: force and
velocity of contraction
2.Cardiac Output: the amount of
blood pumped by the ventricles
per minute.
3.Stroke volume: the volume of
blood discharged from the
ventricle with every contraction
4.Preload: ventricular stretch at
the end of diastole.
5.Afterload: the 'load' to which
the heart must pump against.
1.CAD
2.MI
3.Myocarditis/Endocarditis
4.Diabetes
5.Hypertension
6.Abnormal heart valves
7.Cardiomyopathy
8.Congenital heart disease
RISK FACTORS SIGNS/SYMPTOMS
Anatomy
PATHOPHYSIOLOGY
Physiology
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24. Pericarditis is the inflammation of the pericardium (mostly
with fluid accumulation)
Acute pericarditis: inflammation of the pericardium+ a
pericardial effusion. Symptoms develops quickly.
Subacute pericarditis: within weeks to months
Chronic pericarditis: pericarditis >6 months
Pericardial effusion z: fluid accumulation in the pericardium.
Complication: cardiac tamponade
1.
2.
3.
4.
5.
6.
Pain
Pain that radiates to the
left side of neck, shoulders
and back
Pain experienced during
inspiration
Pain experienced when in a
supine position
Fever
Fatigue
Pericardial friction rub (during
auscultation)
MI
Autoimmune diseases
Injury
Heart surgery
Bacterial, viral and
fungal infections
1.
2.
3.
4.
5.
Protects the heart
Lubricates to reduce
friction (The pericardial
sac contains 5-20ml of
pericardial fluid)
Major functions of the
pericardium:
1.
2.
The pericardium can be
divided into:
The parietal pericardium is
the outer membrane.
The visceral pericardium is
the inner membrane.
pericarditis
pericarditis
pericarditis
RISK FACTORS SIGNS/SYMPTOMS
PATHOPHYSIOLOGY
Anatomy Physiology
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25. Epicardium: outermost
layer of the heart
Myocardium: middle
layer of the heart
Endocardium: innermost
layer of the heart
LAYERS OF THE HEART
Angina is characterized by chest pain due to the imbalance of
myocardial oxygen demand and oxygen supply by the
coronary arteries.
Types of Angina:
Stable angina-occurs due to physical exertion. It has a
regular pattern. Pain relieved by rest.
Unstable angina- unexpected chest pain that increases in
severity, duration and occurrence (may occur at rest).
Variant angina- occurs due to coronary artery spasm.
Occurs at rest.
Intractable angina- chronic (recurrent angina)
Preinfarction angina- occurs before an MI
1.
2.
a.
b.
c.
d.
e.
Pain
Dyspnea/SOB
Tachycardia
Palpitations
Dizziness
Syncope
Diaphoresis (Sweating)
Pallor
Elevated BP
1.
2.
3.
4.
5.
6.
7.
8.
9.
The myocardium is also
known as the heart
muscle.
It is responsible for the
involuntary contractions
and relaxation of the
heart.
Family history of
heart disease
Hypertension
High blood
cholesterol
Diabetes
Smoking
Obesity
1.
2.
3.
4.
5.
6.
angina
angina
angina
RISK FACTORS SIGNS/SYMPTOMS
PATHOPHYSIOLOGY
Anatomy Physiology
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26. A prolonged and severe imbalance between myocardial
oxygen supply and demand causes myocardial infarction.
Myocardial infarction is mostly caused by coronary
atherosclerosis.
Acute MI + unstable angina = acute coronary syndrome.
Acute MI can be non ST segment elevation myocardial infarction
(NSTEMI) or ST segment elevation myocardial infarction
(STEMI).
1.
2.
3.
4.
Pain- crushing substernal
pain that radiates to the
left arm, jaw or back.
Dyspnea
Dysrhythmias
Pallor
Cyanosis
Diaphoresis
Anxiety
1.
2.
3.
4.
5.
6.
7.
CAD
Atherosclerosis
High cholesterol level
Diabetes
Hypertension
Smoking
Stress
1.
2.
3.
4.
5.
6.
7.
Epicardium: outermost
layer of the heart
Myocardium: middle
layer of the heart
Endocardium: innermost
layer of the heart
LAYERS OF THE HEART The myocardium is also
known as the heart
muscle.
It is responsible for the
involuntary contractions
and relaxation of the
heart.
Myocardial Infarction
Myocardial Infarction
Myocardial Infarction
RISK FACTORS SIGNS/SYMPTOMS
PATHOPHYSIOLOGY
Anatomy Physiology
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27. Chest tightness
Wheezing
Shortness of breath
Cough
Restlessness
ABGs
Pulmonary function tests
Peak expiratory flow
Spirometry
Allergy test
Pulse oximetry
CBC
Allergies
Stress
Hormonal changes
asthma
pathophysiology
Chronic inflammatory disease of the airway.
Inflammation and hypersensitivity to a trigger
(stimuli). Smooth muscle constriction of the bronchi.
Intermittent airflow obstruction.
Risk factor
signs & symptoms
Assess patient's respiratory rate,
depth and pattern
Monitor pulse ox
Monitor vital signs
Maintain patent airway
Administer O2 therapy as
prescribed
Administer medications as
ordered.
Medication regimen.
Identify and avoid triggers.
Long term management.
Patient Education
nursing interventions
diagnostic tests
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28. Heart burn
Dysphagia
Regurgitation
Epigastric pain
Dyspepsia
(indigestion)
Upper endoscopy
Esophageal pH studies
Barium swallow
(esophagram)
Hiatal Hernia
Pregnancy
Pyloric surgery
Smoking
Obesity
Alcohol
Fatty foods
gerd
pathophysiology
A digestive disorder that occurs due to the backflow of gastric
content.
Impaired or dysfunctional lower esophageal sphincter (LES)
causes regurgitation of stomach content into the esophagus.
Risk factor
signs & symptoms
Assess pain
Elevate head of bed (HOB)
Avoid eating 2 to 3 hours before bedtime
Avoid lying down after eating
Administer medications as ordered
Avoid alcohol, fatty foods, caffeine,
tobacco, and other irritants
Avoid eating 2 to 3 hours before bedtime
Avoid lying down after eating
Avoid NSAIDS and anticholinergics
Maintain healthy body weight (exercise)
Patient Education
nursing interventions
diagnostic tests
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29. CT scan
MRI
Electroencephalography
Carotid ultrasound
Cerebral arteriography
TIA
Hypertension
Smoking
Atherosclerosis
Diabetes
High cholesterol
Drooping of face
One sided weakness
Slurred speech
Blurred vision
Agnosia
High BP
Unilateral neglect
Apraxia
STROKE
pathophysiology
Stroke is the loss of neurological functions due to the lack of blood
flow to the brain.
Types
Ischemic Stroke, Hemorrhagic Stroke, Transient Ischemic Attack
Risk factor
signs & symptoms
Maintain patent airway
Administer 02
Administer tPA
Monitor VS-maintain BP @
150/100
Monitor LOC
Monitor for signs of increase ICP
Elevate HOB
Administer IV fluids
Insert Foley's catheter
Prevention of DVT
Assist with self care and ADLs
nursing interventions
diagnostic tests
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31. Cardiovascular system
example:
respiratory system
signs and symptoms
signs and symptoms
disorderS
pain- crushing substernal pain that radiates to the
left arm, jaw or back.
crushing pain (relieved by NTG)
beck's triad
homan's sign (dorsiflexon sign test)
myocardial
infarction:
Angina:
Cardiac Tamponade:
Deep Vein
Thrombosis:
signs and symptoms
signs and symptoms
disorderS
barrel chest
absent breath sounds on affected side
rust-colored sputum
low grade afternoon fever.
Emphysema:
Pneumothorax:
Pneumonia:
Pulmonary
Tuberculosis:
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32. ENDOCRINE system
signs and symptoms
signs and symptoms
disorder
goiter + bulging eyes
moon face + buffalo hump
large hands and feet + husky-sounding voice
polyuria, polydipsia, polyphagia
Graves Disease:
Cushings
Syndrome:
Acromegaly:
Diabetes mellitus:
DKA: kussmaul's respiration
GASTROINTESTINAL system
signs and symptoms
signs and symptoms
disorderS
rovsign sign and localized pain in RLQ-McBurney's
point
heart burn.
Appendicitis:
Gastroesophageal
Reflux Disease:
Pancreatitis: cullen’s sign
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33. ENDOCRINE system
signs and symptoms
signs and symptoms
disorder
bronzelike skin pigmentation.
ptosis
ascending muscles weakness.
Addison’s disease:
Myasthenia Gravis:
Guillain-Barre
Syndrome:
DKA:
example:
neurological system and others
signs and symptoms
signs and symptoms
disorder
positive kernig's and brudzinski's sign
tremor described as pin-rolling
strawberry tongue.
Meningitis:
Parkinsons:
Kawasaki Syndrome:
increased icp: cushing's triad
sle: butterfly rash
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34. example:
MATERNITY DISORDERS
signs and symptoms
signs and symptoms
disorderS
high Bp after 20 weeks gestation with no proteinuria
hypertension + proteinuria after 20 weeks gestation
painless bright red bleeding
Gestational
Hypertension:
Preeclampsia:
Placenta Previa:
Abruptio Placenta: bleeding: dark red
example:
ecg/ekg
signs and symptoms
description
ecg
P wave: sawtooth
fibrillatory waves before QRS complex.
mountain peaks
atrial flutter
atrial fibrillation:
Ventricular
TACHYCARDIA
sinus bradycardia rate: less than 60 beats/min
sinus TACHYCARDIA rate: >100 beats/min
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35. example:
pediatric DISORDERS
signs and symptoms
signs and symptoms
disorderS
high Na + Cl in sweat (skin)
projectile vomiting + Olive-shaped mass
mass (sausage-shaped).
Cystic Fibrosis:
Hypertrophic
pyloric stenosis:
Intussusception:
Epiglottitis: drooling, tripod position
example:
pediatric DISORDERS
signs and symptoms
signs and symptoms
disorderS
ribbon-like stool
cyanosis especially during feeding
strawberry tongue, fine red rash feels like sandpaper
Hirschsprungs
Disease:
Tetralogy of
Fallot:
Scarlet fever:
Croup: barking like cough
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37. Clear- Liquid Diet
Clear fluids that are thicker (opaque).
Use: short-term diet used as a
transition step between clear liquids
and soft diet.
pureed diet
MASHED
POTATO
PUREED
PASTA
PUREED
RICE
TENDER
FRUITS
GROUND
MEAT
CHOPPED
FOODS
WATER BROTH FRUIT JUICE ICE
CREAM PUDDING
THIN
CEREALS
A clear liquid diet is a diet consisting
of exclusively light clear liquid at
room temperature.
Use: post-surgically
FULL LIQUID DIET
A puréed food diet is a texture-
modified diet (requires no chewing)
Use: patients who have trouble
chewing or swallowing
MECHANICAL SOFT DIET
Foods that are easy to chew and
swallow
Use: patients who have trouble
chewing or swallowing
TEA COFFEE CLEAR SODAS
4 THERAPEUTIC DIETS
4 THERAPEUTIC DIETS
4 THERAPEUTIC DIETS
MILK SOUP JELLO
YOGURT PUMPKIN PUREE COOKED VEGES TOFU
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38. MADE EASY
EKGs
DOWNLOAD THE
FULL EKG GUIDE IN THE
BUNDLE
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39. Calculate the rate: Normal, Bradycardia,
Tachycardia
Determine R-R interval: Regular or
Irregular
Calculate PR interval: 0.10-0.20 (<5 small
squares)
QRS complex for every P wave, <0.12
seconds
STEP 1: DETERMINE THE HEART RATE
Count a 6 second strip and multiply by 10
Rate: 60-100
step 2: determine the rhythm
regular
r - r r - r
Evaluate the P wave
step 3: Evaluate the P wave
Present, Regular, P wave for
each QRS complex.
step 4: PR INTERVAL
<5 small squares
step 5: Analyze the QRS complex
0.06-0.12 seconds
Steps in EKG Interpretation
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40. sinus bradycardia
sinus TACHYCARDIA
Normal heart beat
Rate: less than 60 beats/min
Rate: >100 beats/min
atrial flutter
P wave: sawtooth
atrial fibrillation
Ventricular TACHYCARDIA
Ventricular FIBRILLATION
No P wave. Fibrillatory waves before
QRS complex.
pvc
QRS complex: QRS complex is wide, bizarre
VT can lead to Ventricular Fibrillation and then death.
VT is fatal
Rhythm: chaotic rapid rhythm
P wave: absent (no P wave with PVCs). QRS complex:
QRS complex in PVC is premature, wide and
abnormal
PAC
P wave: premature, appears different than normal. P
wave may be buried in the preceding T wave.
FIRST-degree block
PR interval: prolonged
SECOND-DEGREE av bLOCK (TYPE 1)
PR: lengthens progressively until QRS drops
PR: Normal and consistent
SECOND-DEGREE av bLOCK (TYPE 2)
NORMAL SINUS RHYTHM
THIRD-DEGREE av bLOCK
P wave: no relationship with QRS complex
ECG MADE EASY
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50. DRUG CLASS MEDICATIONS MECHANISM OF ACTION
Thrombolytics
Thrombolytic drugs dissolve clots by
activating plasminogen that forms plasmin.
Antiplatelet drugs prevent the aggregation or
adhesion of platelets.
Antiplatelets
Anticoagulants interfere and prevent the
formation of clots by inhibiting factors in the
clotting cascade.
Anticoagulants
Cardiac glycosides- increase cardiac
contractility/positive inotropic effect,
negative chronotropic effect
Cardiac
Glycosides
ASPIRIN
HEPARIN
digoxin
Tenecteplase
Thiazide
Diuretics
Chlorothiazide
Thiazide diuretics increase the excretion of Na
and water in the distal convoluted tubule.
Loop Diuretics Furosemide
Loop diuretics decrease the reabsorption of
sodium and chloride in the ascending Loop of
Henle.
Potassium-
Sparing Diuretics
Spironolactone
Potassium-sparing diuretics cause sodium
and water excretion in the distal tubule,
whilst promoting potassium retention (blocks
aldosterone receptors)
ACE Inhibitors Enalapril
Angiotensin-Converting Enzyme Inhibitor
(ACE Inhibitors) prevents the conversion of
angiotensin I to angiotensin II which
prevents vasoconstriction.
CARDIOVASCULAR DRUGS
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51. Calcium
Channel Blockers
Beta
Adrenergic Blockers
Atenolol,
DRUG CLASS MEDICATIONS MECHANISM OF ACTION
ARBS
ARBs prevent aldosterone release and
peripheral vasoconstriction by selectively
blocking angiotensin II receptors.
Calcium channel blockers prevent calcium
ions movement across myocardial cell
membrane. This causes relaxation of
smooth muscle.
Beta adrenergic blockers block the effect of
epinephrine at the receptor sites.
Adrenergic agonist stimulates the adrenergic
receptors (both alpha or beta receptors) of
target organs.
Adrenergic
Agonist
Nifedipine
Epinephrine
Losartan
Antianginal
Agents
Nitroglycerin
Nitrates are antianginal agents that relax
smooth muscles, resulting in vasodilation,
reduced preload (dilating veins) and afterload
(dilating arteries) and decreased myocardial
oxygen demand.
DRUG CLASS MEDICATIONS MECHANISM OF ACTION
Inhaled
Anticholinergics
Inhaled anticholinergics prevent the binding of
acetylcholine (neurotransmitter) by blocking
muscarinic receptors.
This results in bronchodilation (relaxation of
smooth muscle in the bronchi).
Decreases bronchial secretions
Antihistamines Brompheniriamine
Atrovent
Expectorants Guaifenesin
Expectorants reduce the surface tension of
bronchial secretion and induce productive
cough to promote patent airway.
respiratory DRUGS
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52. Benzonatate
Histamine (H2)
Receptor Antagonist
DRUG CLASS MEDICATIONS MECHANISM OF ACTION
Mucolytics Mucolytics liquefy or thins respiratory
secretions (mucus) for airway clearance
(productive cough).
Decongestants cause vasoconstriction in the
upper respiratory system. This leads to
shrinking swollen mucous membrane and
reduced fluid secretion.
Decongestant
Antitussives suppress the cough reflex by
directly acting on the cough control center in
the medulla.
Antitussives
Glucocorticoids are anti-inflammatory agents
that decrease inflammatory response in the
airway.
Glucocorticoids
(Corticosteroids)
Oxymetazoline
Beclomethasone
Acetylcysteine
Sympathomimetic
Bronchodilators
Salmeterol
Sympathomimetic affects the beta-receptors
found in the bronchi which leads to the
relaxation of smooth muscle in the bronchi.
DRUG CLASS MEDICATIONS MECHANISM OF ACTION
Proton Pump
Inhibitor
Proton pump inhibitors suppress the
secretion of HCL in the stomach
Histamine (H2) receptor antagonist blocks the
action of histamine, which produces HCL
secretion.
Omeprazole
Antacid Calcium
carbonate
Antacid are alkaline compounds that
neutralizes acids and prevents the conversion
of pepsinogen to pepsin in the stomach.
Ranitidine
gastrointestinal DRUGS
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53. DRUG CLASS MEDICATIONS MECHANISM OF ACTION
Antiemetics Antiemetics suppress nausea and vomiting
by acting on the brain's control center to
stop the nerve impulse.
Laxatives promote bowel elimination.
Laxatives Psyllium
Ondansetron
DRUG CLASS MEDICATIONS MECHANISM OF ACTION
Penicillin
Penicillins inhibit bacterial cell wall synthesis.
Therefore, the bacteria's cell wall swells,
ruptures and dies.
Cephalosporins inhibit bacterial cell wall
synthesis.
Cephalosporin
Aminoglycosides inhibit bacteria protein
synthesis. They inhibit the translation of mRNA
to protein by irreversibly binding to bacteria
ribosome.
Aminoglycosides
Tetracycline are broad-spectrum and inhibits
protein synthesis which causes the inability for
bacterial growth
Tetracycline
Cefazolin
gentamicin
doxycycline
Penicillins
Sulfonamides sulfadiazine
Sulfonamides inhibit the metabolic process
essential for the function and growth of the
bacterial cell.
Fluoroquinolones levofloxacin
Flouroquinolones interfere with DNA gryase
(an enzyme) needed by the bacteria for the
synthesis of DNA
ANTIBIOTICS
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54. DRUG CLASS MEDICATIONS MECHANISM OF ACTION
NSAIDs NSAIDs have anti-inflammatory, analgesic and
antipyretic properties. NSAIDs inhibits
prostaglandin synthesis
Salicylates inhibit synthesis of prostaglandin.
Salicylates have anti-inflammatory,
antipyretic and analgesic properties.
Salicylates
Acetaminophen inhibits prostaglandin
synthesis (limited to CNS and not periphery)
Acetaminophen
Suppresses pain impulses.
Opioid Analgesics
ASPIRIN
Morphine
Acetaminophen
diclofenac
Anti-
cholinesterases
Edrophonium
Used to treat muscle weakness in myasthenia
gravis. Anticholinesterases blocks
acetylcholine breakdown.
Dopaminergics Apomorphine
Dopaminergic drugs stimulate dopamine
receptors and increase dopamine
concentration.
Benzodiazepines DiazepaM
Benzodiazepines are used to treat absence
seizures.
They enhance the effect of GABA
Hydantoins Phenytoin
Blocks sodium channels and inhibits neurons
from firing to stabilize central nervous
system membrane
NEUROLOGICAL DRUGS
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58. Assess physical appearance,
mood, affect and grooming.
Assess orientation: Oriented to
Person, Place, Time and Situation.
Assess level of consciousness.
Assess speech.
1.
2.
3.
4.
Pulse: 60-100 bpm
Blood Pressure Systolic: 120
Diastolic: 80
Respiratory Rate: 12-18 bpm
O2 Saturation: 95-100%
Temperature: 36.5-37.5 degrees C
Assess head size, shape,
symmetry.
Inspect and palpate head,
scalp
Palpate sinuses and TMJ
Assess facial symmetry
Assess cranial nerve 7
1.
2.
3.
Face
1.
2.
Inspect external eye structures,
conjunctiva and sclera.
Test cranial nerve III, IV, VI
PERRLA- Pupils are Equal,
Round, Reactive to Light and
Accommodation.
Pupil size: 3-5mm
Ears: Assess for redness, drainage.
Test cranial nerve-
Vestibulocochlear
Nose: Assess shape, symmetry, size,
patency. Test cranial nerve I
HEART
Inspect, Auscultate, Percuss,
Palpate
Inspect skin color, contour and
aortic pulsations.
Auscultate bowel sounds from
RLQ clockwise.
1.
2.
3.
ABDOMEN
Eyes/ Ears/ Nose
Palpate lymph node, carotid
artery, presence of goiter.
Auscultate for bruits.
Test cranial nerve 11
1.
2.
3.
Inspect lip color, sores, gums,
tongue, teeth, soft and hard
palate, uvula
Test cranial nerve 9, 12 and 10
1.
2.
NURSING ASSESSMENT REVIEW
GENERAL SURVEY
Vital Signs
Mouth
Neck
HEAD AND FACE
Inspect symmetrical chest
movement
Palpate for pain and lumps
Percuss using the Z-block
method
Auscultate lung sounds
1.
2.
3.
4.
Lungs
Auscultate heart sounds (Aortic,
Pumonic, Erb's Point, Tricuspid
and Mitral)
1.
Assess and inspect skin, nails,
muscle strength, ROM,
curvature of spine.
Palpate pulses
1.
2.
SKIN + EXTREMITIES
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60. HEALTH
MATERNAL AND CHILD
DOWNLOAD THE
FULL MATERNITY GUIDE IN
THE BUNDLE
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61. Number of pregnancies
(twins and triplets are
counted as one)
Present pregnancy included.
1.
2.
gtpal
TERMBIRTHS
PRETERMBIRTHS
ABORTIONS
LIVINGCHILDREN
GRAVIDITY
The number born at term
(longer than 37 weeks of
gestation)
Twins and triplets are
counted as one.
1.
2.
20-37 weeks of gestation.
(Count twins and triplets as
one)
Includes alive and still birth
also includes miscarriages
Less that 20 weeks of
gestation.
Count twins and triplets as one
current living children.
Count children individually
GTPAL: DESCRIBES PREGNANCY OUTCOMES
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62. LAB VALUES & IV GAUGES
CHEAT SHEET
DOWNLOAD THE
FULL LAB VALUES GUIDE IN
THE BUNDLE
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66. T
r
o
p
o
n
i
n
I
C
h
o
l
e
s
t
e
r
o
l
t
o
t
a
l
A
m
m
o
n
i
a
Theophylline
10-20 mcg/mL
PhenobarbitaL
15-40 mcg/mL
meds
Carbamazepine:
4-12 mg/L
0
-
0
.
4
n
g
/
m
L
0
-
8
5
n
g
/
m
L
0
-
3
n
g
/
m
L
3
%
-
5
%
M
y
o
g
l
o
b
i
n
C
K
-
M
B
C
P
K
-
M
B
<
2
0
0
m
g
/
d
L
<
1
0
0
m
g
/
d
L
>
6
0
m
g
/
d
L
<
1
5
0
m
g
/
d
L
L
D
L
H
D
L
T
r
i
g
l
y
c
e
r
i
d
e
s
1
5
-
4
5
U
/
d
L
5
-
1
5
m
m
H
g
1
8
.
5
-
2
4
.
9
<
0
.
5
0
7
0
-
1
0
0
m
m
H
g
i
c
p
b
m
i
D
-
D
i
m
e
r
m
a
p
4
-
5
.
6
%
5
.
7
-
6
.
4
%
6
.
5
%
&
a
b
o
v
e
p
r
e
-
d
i
a
b
e
t
i
c
d
i
a
b
e
t
i
c
:
hba1c
n
o
n
d
i
a
b
e
t
i
c
other
Lipid
Cardiac
meds
Digoxin:
0.5-2 ng/mL
Lithium
0.8-1.5 mmol/L
pharmacy
pharmacy pharmacy
pharmacy
Phenytoin
10-20mg/L
Lidocaine
1.5-5mg/L
pharmacy
pharmacy
pharmacy
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lab values
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71. NURSING
FUN FACTS
BLOOD TYPE
COMPATIBILITY
IV CATHETER GAUGE
PREFIXES AND SUFFIXES
INSULIN
PHARMACOLOGY
CONVERSIONS
LAB VALUES
ROME-ABGS
OXYGEN THERAPY
BREATHING PATTERN
ANTIDOTES
ANTIBIOTICS
MEDICAL TERMINOLOGIES
FRACTURES
EKGS
SHOCK
CARDIOVASCULAR
DISORDERS
RESPIRATORY
DISORDERS
PULMONARY EMBOLISM
SPINAL CORD INJURY
STROKE
PAD VS PVD
GI DISORDERS
CANCER
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72. 0-
0+ A+ A- B+ B- AB+AB-
0+
0-
A+
A-
B+
B-
AB+
AB-
donor
recipient
color uses
size
14G TRAUMA, RAPID INFUSION
16G TRAUMA, SURGERY
18G
20G
22G
24G
26G NEONATES
FRAGILE VEINS, PEDIATRICS
IV FLUIDS, SMALL VEINS
IV FLUIDS AND
MEDICATIONS
BLOOD TRANSFUSIONS
@nursebossessentials
-LOL
BETA BLOCKERS
-PINE
CC BLOCKERS
-SARTAN
ARBS
-PRIL
ACE INHIBITORS
-SEMIDE
LOOP DIURETICS
-STATIN
STATINS
-PHYLLINE
XANTINE
CEF-,CEPH-
CEPHALOSPORIN
-CILLIN
PENICILLIN
-FLOXACIN
QUINOLONES:
-MYCIN
MACROLIDES
SULF-
SULFONAMIDES
-THIAZIDE
THIAZIDE DIURETICS
-OPRAZOLE
PPIS:
-TIDINE
H2 RECEPTOR
ANTAGONISTS
-PROFEN
NSAIDS
-VIR
ANTIVIRAL
OPIOIDS
-DONE
CARDIOVASCULAR
GI
RESP PAIN
ANTIBIOTICS ANTIVIRAL
CARDIO
@nursebossessentials
@nursebossessentials
Prefixes and Suffixes
blood type COMPATIBILITY iv catheter gauge
nset
eak
uration
1-2HOURS
NO PEAK
nset
eak
uration
15 MINS
1 HOUR
nset
eak
30 MINS
2-4 HR
24 HRS
nset
eak
uration
1-2 HRS
8 HR
12-18 HRS
2-4 HRS uration
5-8 HRS
R
A
P
ID
A
C
T
IN
G
S
H
O
R
T
A
C
T
IN
G
IN
TE
R
M
ED
IA
TE
L
O
N
G
A
C
T
IN
G
insulin
DISSOLVE CLOTS
THROMBOLYTICS
CARDIAC GLYCOSIDES
INCREASE
CARDIAC
CONTRACTILITY
MUCOLYTICS
THINS MUCUS
SUPPRESS
NAUSEA AND
VOMITING
ANTIEMETICS
REDUCE
GASTRIC ACID
ANTICOAGULANTS
PPI
BRONCHODILATOR
LAXATIVES
DILATE AIRWAY
LAXATIVES
PROMOTE BOWEL
ELIMINATION.
PREVENT THE
FORMATION OF
CLOTS
ANTILIPIDEMIC
LOWERS
CHOLESTEROL
LEVEL
AMINOGLYCOSIDES
ANTIBIOTIC
FLUOROQUINOLONES
ANTIBIOTIC
DIURETICS
PROMOTES
DIURESIS
ANTIPLATELETS
PREVENT THE
AGGREGATION
OF PLATELETS.
ACE INHIBITORS
LOWERS BLOOD
PRESSURE
ANTIHISTAMINES
DECREASES
BRONCHIAL
SECRETIONS
ANTACID
NEUTRALIZES
ACIDS
SUPPRESSES
PAIN IMPULSES
OPIOID ANALGESICS SSRI
ANTI-
DEPRESSANT
PENICILLIN
ANTIBIOTIC
SULFONAMIDES
ANTIBIOTIC
1MG=1000MCG 1G=1000MG 1KG=1000G 1KG=2.2LBS
1GR=60MG 1L=1000ML 1ML=1CC 1 TSP=5ML
1OZ= 2 TBSP
1 TBSP=3 TSP
1OZ=30ML
1 TBSP= 15ML
pharmacology conversions
nursing fun facts
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73. oxygen therapy breathing pattern
antidotes antibiotics
CBC
ELECTROLYTES ABGS
RENAL
WBC: 4,500-11,000
RBC: 4.5-5.5
HgB (F): 12-16 g/dL
HgB (M): 14-18 g/dL
Platelets: 150,000-
400,000 cells/mcL
BUN: 7-20mg/dL
Creatinine: O.6-1.2
GFR: 90-120
Specific gravity:
1.010-1.030
Na+: 135-145 mEq/L
K+: 3.5-5.0 mEq/L
Mg+: 1.5-2.5 mEq/L
Ca+: 9-11 mg/dL
PO4: 3.0-4.5 mg/dL
Cl-: 95-105 mEq/L
pH: 7.35-7.45
PaCO2: 35-45mmHg
PaO2: 80-100mmHg
HCO3: 22-26 mmHg
SaO2: 95%-100%
lab values
PH CO2 ALKALOSIS
PH CO2 ACIDOSIS
PH HCO3 ALKALOSIS
PH HCO3 ACIDOSIS
ESPIRATORY
PPOSITE
ETABOLIC
QUAL
rome
FIO2: 24% TO
50%
FLOW RATE:
4 TO 15 L/MIN
FIO2: 24% TO
44%
FLOW RATE:
1 TO 6 L/MIN
FIO2: 60% TO 80%
FLOW RATE:
6 TO 10 L/MIN
FIO2: 60%-100%
FLOW RATE:
10 TO 15 L/MIN
FIO2: 40% TO
60%
FLOW RATE:
6 TO 8 L/MIN
Simple face mask:
Venturi Mask
Nasal Cannula
Partial Rebreather
Non- Rebreather
FLOW RATE: 10 L/MIN
Face Tent
EUPNEA:
NORMAL BREATHING RATE + PATTERN
BRADYPNEA:
DECREASED RESPIRATORY RATE
CHEYNE-STOKES:
INCREASE AND DECREASE IN
RESPIRATIONS WITH APNEA
TACHYPNEA:
INCREASED RESPIRATORY RATE
APNEA:
ABSENCE OF BREATHING
HYPERPNEA:
DEEP RESPIRATIONS/BREATHING
BIOT'S:
RAPID GASPS WITH SHORT PAUSES
BETWEEN SETS
KUSSMAUL'S:
TACHYPNEA AND HYPERPNEA
APNEUSTIC:
PROLONGED INSPIRATION AND
SHORTENED EXPIRATION
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ANTIDOTE:
VIT K
ANTIDOTE:
PROTAMINE
ANTIDOTE:
ATROPINE
ANTIDOTE:
FLUMAZENIL
@nursebossessentials
OPIOIDS
ANTIDOTE:
NALAXONE
WAFARIN
HEPARIN
CHOLINERGICS
ACETAMINOPHEN
INSULIN
BENZODIAZEPINES DIGOXIN
ANTIDOTE:
ACETYLCYSTEINE
ANTIDOTE:
GLUCAGON
ANTIDOTE:
DIGOXIN IMMUNE FAB
PENICILLIN
Penicillins inhibit bacterial
cell wall synthesis.
CEPHALOSPORIN
Cephalosporins inhibit
bacterial cell wall synthesis.
AMINOGLYCOSIDES
Inhibit bacteria protein
synthesis. They inhibit the
translation of mRNA to protein
TETRACYCLINE
Inhibits protein synthesis
which causes the inability for
bacterial growth
SULFONAMIDES
Inhibit the metabolic process
essential for the function and
growth of the bacterial cell.
FLUORO-
QUINOLONES
Interfere with DNA gryase
needed by the bacteria for the
synthesis of DNA
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74. ekgs shock
cardiovascular respiratory
medical terminologies fractures
gastritis
INFLAMMATION OF
LINING OF THE STOMACH
INFLAMMATION OF THE
KIDNEYS
nephritis
myelitis
INFLAMMATION OF THE
SPINAL CORD
colitis
INFLAMMATION OF THE
INNER LINING OF THE
COLON
carditis
INFLAMMATION OF THE
HEART
pharyngitis
INFLAMMATION OF THE
PHARYNX
enteritis
INFLAMMATION OF THE
SMALL INTESTINE
laryngitis
INFLAMMATION OF THE
LARYNX
hepatitis
INFLAMMATION OF THE
LIVER
glossitis
INFLAMMATION OF THE
TONGUE
cystitis
INFLAMMATION OF THE
URINARY BLADDER
metritis
INFLAMMATION OF THE
UTERUS
Instagram:
@nursebossessentials
Instagram:
@nursebossessentials
TRANSVERSE
STRAIGHT ACROSS
THE BONE.
IMPACTED: A PART
OF THE BONE THAT
IMPACT ANOTHER
BONE
FISSURE FRACTURE
ARE CRACKS IN THE
BONE.
COMMINUTED
BREAK INTO
MORE THAN
TWO
FRAGMENTS.
OPEN FRACTURE
(COMPOUND):
FRACTURE WITH
AN OPEN
WOUND.
OBLIQUE: FRACTURE
THAT RUN AT AN
ANGLE ACROSS
A NORMAL BONE
SPIRAL: FRACTURE
THAT CIRCLES OR
SPIRALS AROUND
THE SHAFT.
GREENSTICK: ONE
SIDE OF THE BONE
IS BROKEN, THE
OTHER SIDE IS
BENT
CLOSED
FRACTURE: BONE
BREAK WITHOUT
OPEN WOUND IN
SKIN.
COMPLETE FRACTURE:
COMPLETE BREAK
THROUGH THE BONES
THAT SEPARATES
INTO TWO.
COMPRESSION:
ONE BONE
COMPRESSES
ANOTHER
BONE
@nursebossessentials
normal sinus rhythm
ATRIAL AND VENTRICULAR RHYTHMS ARE
REGULAR.
RATE: 60-100 BEATS/MIN
PR INTERVAL AND QRS WIDTH ARE WITHIN
NORMAL LIMIT
SINUS BRADYCARDIA
sinus TACHYCARDIA
atrial fibrillation
ATRIAL AND VENTRICULAR RHYTHMS ARE
REGULAR
RATE: LESS THAN 60 BEATS/MIN
NORMAL P WAVE PRECEDES EACH QRS COMPLEX
PR. INTERVAL & QRS WIDTH= NORMAL LIMITS
ATRIAL AND VENTRICULAR RHYTHMS ARE REGULAR
RATE: >100 BEATS/MIN
NORMAL P WAVE PRECEDES EACH QRS COMPLEX
PR INTERVAL AND QRS WIDTH ARE WITHIN NORMAL
LIMITS
ATRIAL RHYTHM IS IRREGULAR
VENTRICULAR RHYTHM IS IRREGULAR
RATE: 350-600BPM, NO P WAVE
PR INTERVAL IS NOT MEASURABLE
FIBRILLATORY WAVES BEFORE QRS COMPLEX
atrial flutter
ATRIAL RHYTHM IS REGULAR
RATE: 250-400 BEATS/MIN
P WAVE: SAWTOOTH
PR INTERVAL: NOT MEASURABLE
QRS COMPLEX: LESS THAN OR EQUAL TO 0.12S
Ventricular TACHYCARDIA
Ventricular FIBRILLATION
pvc
RHYTHM: REGULAR
RATE: 140-250 BEATS/MIN
P WAVE: ABSENT
PR: NOT MEASURABLE
QRS COMPLEX: QRS COMPLEX IS WIDE, BIZARRE
RHYTHM: CHAOTIC RAPID RHYTHM
RATE: NOT MEASURABLE
P WAVE: ABSENT
PR: NOT MEASURABLE
QRS COMPLEX: NOT MEASURABLE
RHYTHM: IRREGULAR, RATE: IS THAT OF
UNDERLYING RHYTHM.
P WAVE: ABSENT (NO P WAVE WITH PVCS) PR: NOT
MEASURABLE, QRS COMPLEX: QRS COMPLEX IN PVC
IS PREMATURE, WIDE AND ABNORMAL
Instagram:
@nursebossessentials
CARDIO-
GENIC
HYPO-
VOLEMIC
ANAPHY
LACTIC
SEPTIC
NEURO-
GENIC
CARDIAC:
RESP:
SKIN:
GU:
CNS:
IMMUNE:
CHEST PAIN
FAST/WEAK
PULSE,
SYSTOLIC BP
ORTHOPNEA,
RAPID, SHALLOW
RESPIRATIONS,
CRACKLES
COOL/CLAMMY
SKIN, CYANOSIS
OLIGURIA
CONFUSION
HYPOTENSION,
TACHYCARDIA
(RAPID, WEAK AND
THREADY PULSE)
RAPID, SHALLOW
BREATHING
PALE,
COOL/CLAMMY
SKIN
OLIGURIA
CONFUSION,
RESTLESSNESS,
ANXIETY
TACHYCARDIA,
HYPOTENSION
SHORTNESS OF
BREATH,
BRONCHOCONSTRIC
TION
HIVES, FLUSHED,
ITCHING, LOCALIZED
EDEMA
OLIGURIA
DECREASED LOC
HYPOTENSION,
TACHYCARDIA
INCREASED
RESPIRATIONS
INITIAL STAGE-
FLUSHED & WARM
OLIGURIA (LATE
STAGE)
ANXIETY,
RESTLESSNESS,
LETHARGY
FEVER
HYPOTENSION,
BRADYCARDIA
AFFECTS BREATHING
(DEPENDING ON THE
TYPE OF INJURY)
DRY, WARM SKIN
NO BLADDER
CONTROL
(DEPENDING ON THE
TYPE OF INJURY)
CAD
BUILDUP OF PLAQUE IN
THE ARTERIES
ANGINA
CHEST PAIN DUE TO
DECREASED MYOCARDIAL
OXYGENATION
MI
MYOCARDIAL TISSUE
DAMAGE AS A RESULT
OF OXYGEN DEPRIVATION
INABILITY OF THE HEART
MUSCLE TO PUMP ENOUGH
BLOOD.
HEARTFAILURE
PERICARDITIS IS AN INFECTION
OF THE PERICARDIUM.
PERICARDITIS ENDOCARDITIS
INFLAMMATION AND
INFECTION OF THE
ENDOCARDIUM
AN INCREASE IN BLOOD
PRESSURE (CHRONIC).
HYPERTENSION
ACCUMULATION OF FLUID IN
THE PERICARDIAL CAVITY
CARDIACTAMPONADE
BALLOON-LIKE BULGE IN
THE AORTA
AORTICANEURYSM
ACCUMULATION OF BLOOD IN
THE PLEURAL SPACE.
BLOOD
FLUID
ACCUMULATION OF FLUID IN
THE PLEURAL SPACE.
AIR
AIR IN THE PLEURAL SPACE
CAUSING LUNG COLLAPSE
PUS
COLLECTION OF PUS IN THE
PLEURAL SPACE
PLEURAL
EFFUSION
HEMOTHORAX
PNEUMO-
THORAX EMPYEMA
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