Fundamentals of Nursing, 9th Ed., Potter, Perry, Stockert & Hall, 2017 |  Practical Nurse (LPN) School Study Aid
Respiratory Anatomy
- Nasal Cavity
 - Hair Filters
 - Mucus Filters and Moistens
 - Capillaries Warm
 - Pharynx (Throat)
 - Larynx (Voice Box)
 - Cilia Expel Mucus and Dust
 - Trachea
 - Bronchi
 - Alveoli
 
Alveolar Gas Exchange
- Pulmonary Artery Blood is O2-Poor, CO2-Rich
 - Two-Cell Thick Air-Blood Barrier
 - CO2 Diffuses Into Air
 - O2 Diffuses Into Blood
 - Gases Equilibrate
 - Pulmonary Vein is O2-Rich, CO2-Poor
 - Thermoregulation
 
Coronary Arteries
- Aortic Root
 - Right Coronary Artery (RCA)
 - Right (Acute) Marginal Artery
 - Posterior Descending Artery (PDA)
 - Left Coronary Artery (LCA)
 - Left Anterior Descending (LAD) Artery
 - Circumflex Artery
 - Left Marginal Artery
 
Cardiac Cycle - Systole
- AV Node
 - AV Node Conducts Signal to Bundle of His
 - Bundle of His Signals Purkinje Fibers to Contract Ventricles
 - Tricuspid Valve Closes
 - Pulmonary Valve Opens
 - Mitral Valve Closes
 - Aortic Valve Opens
 
Cardiac Cycle - Diastole
- Aortic Valve Closes
 - Pulmonary Valve Closes
 - Ventricles Relax
 - Mitral Valve Opens
 - Tricuspid Valve Opens
 - Ventricles Fill
 - Sinoatrial (SA) Node Fires
 - Atrial Contraction
 
ECG Interpretation
- Rate
 - Rhythm
 - P Waves
 - Upright, Rounded, Before Every QRS
 - PR Interval (< 0.20 seconds)
 - Normal QRS (< 0.12 seconds)
 
Hypoxia (Early Symptoms)
- Diaphoresis
 - Restlessness
 - Tachypnea
 - Dyspnea on Exertion
 - Tachycardia
 - Hypertension
 - Arrhythmias
 - Decreased Urine Output
 - Unexplained Fatigue
 
Hypoxia (Late Symptoms)
- Cyanosis
 - Cool, Clammy Skin
 - Use of Accessory Muscles
 - Retractions
 - Hypotension
 - Arrhythmias
 
Unstable Angina
- Chest Pain with Rest or Exertion
 - Limits ADLs
 - > 15 Minutes
 - Less Likely Relieved by Nitroglycerin
 - ST Depression
 - Fatigue
 - Acute Coronary Syndrome (ACS) Treatment
 - Emergency Treatment
 
Right Heart Failure Assessment
- Jugular Venous Distention (JVD)
 - Peripheral Edema
 - Hepatosplenomegaly
 - Nocturia
 - Weight Gain
 - Ascites
 - Fatigue
 
Myocardial Infarction Interventions
- Morphine
 - Oxygen
 - Nitrates
 - Aspirin
 - Thrombolytics (tPA)
 - Cardiac Catheterization
 - Stent Placement
 - Angioplasty
 - Coronary Artery Bypass Grafting (CABG)
 - Decrease Modifiable Risk Factors
 - Resuming Activity (Physical, Sexual)
 
Types of Heart Failure
- Left Sided
 - Pulmonary Congestion
 - Right Sided
 - Peripheral Edema
 - High Output
 - Unable to Meet Metabolic Needs
 
ECG: Atrial Fibrillation
- Variable Rate
 - Irregular Rhythm
 - No P Wave
 - No PR Interval
 - QRS < 0.12 Seconds
 
Left Heart Failure Assessment
- Pulmonary Congestion
 - Pink Frothy Sputum
 - Wheezing or Crackles
 - Dyspnea with Exertion
 - Cough
 - Fatigue
 - Tachycardia
 - Weak Peripheral Pulse
 - S3, S4 Heart Sounds
 
Myocardial Infarction Assessment
- Substernal Chest Pain
 - Crushing or Dull Sensation
 - Arm, Jaw, and Neck
 - > 20 Minutes
 - Unrelieved by Nitro
 - Palpitations
 - Diaphoresis
 - Fear of Impending Doom
 - Nausea and Vomiting
 - Shortness of Breath
 - Monitor for Arrhythmias
 
Tuberculosis Assessment
- Airborne Droplet
 - 3 Week Productive Cough
 - Night Sweats
 - Chest Pain
 - Fever
 - Weight Loss
 - Fatigue
 - Chest X-Ray
 - Blood Tests
 - Mantoux Skin Test
 - 3 Positive Sputum Tests
 
Myocardial Infarction Diagnosis
- 12 Lead ECG
 - ST Elevation
 - Q Wave
 - T Wave Inversion
 - Troponin T and I
 - CK-MB
 - Early ECG
 - Cardiac Stress Test
 
Mitral Regurgitation
- Holosystolic
 - Blowing Murmur
 - Loudest at Apex
 - Radiates toward Axilla
 - Louder by Squatting
 - Hand Grip
 - Expiration
 
Tricuspid Regurgitation
- Holosystolic
 - Blowing Murmur
 - Radiates to Right Sternal Border
 - Enhanced by Inspiration
 
Aortic Regurgitation
- Diastolic Murmur
 - Immediate High-pitched
 - Blowing Murmur
 - Wide Pulse Pressure
 - Water Hammer Pulse
 - Head Bobbing
 - Pulsating Nail Bed
 - Can Cause Austin Flint Murmur
 
Stable Angina
- Chest Pain with Exertion
 - Relieved within 15 Minutes
 - ST Depression
 - Nitroglycerin
 - Up to 3 Doses q 5 Minutes
 - Rest
 - Antiplatelet Medication
 - CABG
 - Angioplasty
 
Substance Use Disorder Assessment (Formerly Substance Abuse Assessment)
- Changes in Mood
 - Poor Hygiene
 - Odd Sleep Patterns
 - Frequent Injuries
 - Relationship or Job Difficulty
 - Poor Performance
 - Anorexia OR Weight Loss
 - Social Isolation
 - Financial Problems
 
Lung Sounds - Wheezes
- Throughout Lung
 - High Pitched
 - Musical
 - Air Moving through Narrowed Airways
 
Inhaled Anesthetics
- Unknown Mechanism
 - HEISMN Drug Name Acronym
 - Respiratory Depression
 - Myocardial Depression
 - Lower Metabolic Demand, Increased Cerebral Blood Flow
 - Hepatotoxicity (Halothane)
 - Nephrotoxicity (Methoxyflurane)
 - Seizure (Enflurane)
 - Malignant Hyperthermia
 - Expansion of Trapped Gas
 
Warfarin (Coumadin)
- Inhibits Clotting Factors
 - Atrial Fibrillation
 - Venous Thrombosis
 - Pulmonary Embolism
 - PT/INR Levels
 - Observe for Bleeding
 - Pregnancy
 - Vitamin K and Fresh Frozen Plasma
 - Prolonged Therapeutic Onset
 - Maintain Same Diet
 
Marijuana Intoxication Assessment
- Euphoria
 - Slowed Reaction Time
 - Conjunctival Injection
 - Increased Appetite
 - Anxiety
 - Social Withdrawal
 - Paranoid Delusions
 
Cocaine Intoxication Assessment
- Euphoria
 - Delusions
 - Mydriasis
 - Hallucinations
 - Agitation
 - Hypertension
 - Arrhythmias
 - Hyperthermia
 - Seizures
 - Nasal Septum Perforation
 
Tuberculosis Skin Mantoux Test (PPD)
- Delayed Hypersensitivity (Cell Mediated Response)
 - Intradermal Injection
 - Read 48-72 hours
 - ≥ 5 mm Induration
 - Immunosuppressed
 - ≥ 10 mm Induration
 - High Risk Patients
 - ≥ 15 mm Induration
 - Chest X-Ray
 
Cardiac Enzyme Evaluation: Troponin
- Cardiac Muscle Injury
 - Detection in Blood: 4 Hours
 - Peak: 24 - 36 Hours
 - Return to Normal: 5 - 14 Days
 - Most Specific for Cardiac Muscle
 - Treat Aggressively
 
Cardiac Enzyme Evaluation: Creatine Kinase CK-MB
- Skeletal or Cardiac Muscle Injury
 - Onset: 4-8 Hours
 - Peak: 12-24 Hours
 - Return to Normal: 2-3 Days
 
Troponin Lab Values
- Troponin T (cTnT)
 - < 0.1 ng/mL Normal
 - Troponin I (cTnI)
 - < 0.5 ng/mL Normal
 - > 2.3 ng/mL Myocardial Injury
 
Cholesterol Lab Values
- LDL (Low Density Cholesterol)
 - < 100 mg/dL
 - HDL (High Density Cholesterol)
 - > 40 mg/dL Males
 - > 50 mg/dL Females
 - Total Cholesterol
 - < 200 mg/dL
 
Cardiac Catheterization
- Fluttering Sensation
 - Contrast Media
 - NPO 6-12 Hours
 - Bed Rest
 - Assess Circulation
 - Assess for Bleeding
 - Monitor Vital Signs
 
pH - Blood and Urine Lab Value
- Blood
 - 7.35 - 7.45
 - Urine
 - 4.0 - 8.0
 
Pediatric Vaccinations - Age 4 Months
- DTaP - Diphtheria Tetanus acellular pertussis
 - RV - Rotavirus
 - HiB - Haemophilus Influenzae Type B
 - IPV - Inactivated Polio Vaccine
 - PCV - Pneumococcal
 
Pediatric Vaccinations - Age 6 Months
- Hepatitis B
 - DTaP - Diphtheria Tetanus acellular pertussis
 - RV - Rotavirus
 - HiB - Haemophilus Influenzae Type B
 - IPV - Inactivated Polio Vaccine
 - PCV - Pneumococcal
 - Influenza
 
Pediatric Vaccinations - Age 12 to 15 Months
- Varicella Zoster
 - MMR
 - Hepatitis A
 - DTaP - Diphtheria Tetanus acellular pertussis
 - HiB - Haemophilus Influenzae Type B
 - IPV - Inactivated Polio Vaccine
 - PCV - Pneumococcal
 
Tracheostomy Care
- Inner Cannula Removed and Cleaned
 - Clean Q8 Hours Around Stoma
 - One Finger Under Ties
 - Speak with Deflated Cuff
 - Can Eat with Tube in Place
 - Keep Replacement Tube Nearby
 - Immediately Replace if Dislodged
 - Physician Does First Tube Change
 
Obstructive Sleep Apnea (OSA)
- Narrowed or Obstructed Air Passage
 - Apnea
 - Loud Snoring
 - Startle Response
 - Daytime Drowsiness
 - Positional Therapy
 - Oral Appliance
 - Continuous Positive Airway Pressure (CPAP) 
 - Surgery
 - Weight Loss
 
Pneumothorax
- Air Enters Pleural Space
 - Sudden Dyspnea
 - Absent or Restricted Movement on Affected Side
 - Decreased or Absent Breath Sounds on Affected Side
 - Chest Pain
 - Tracheal Deviation
 - Vital Sign Changes
 - Crepitus
 - High Fowler's Position With Oxygen
 - Prepare For Chest Tube Placement
 - Educate High Risk Patients
 
Chest Tubes: Management and Care
- Confirm suction order
 - Crepitus
 - Kinking
 - Shortness of Breath (SOB)
 - Infection
 - Excessive bubbling
 - If tube dislodges from patient, use petroleum gauze taped 3 ways
 - If drainage system is damaged, place disconnected drainage tube in sterile water
 
Oxygen Delivery Methods
- Nasal Cannula
 - Simple Face Mask
 - Non-Rebreather Mask
 - Venturi-Mask
 - Oxygen In Use Sign
 - No Electrical Sparks
 - Six Feet Away from Open Flames
 - Dry Nasal and Upper Airway Mucosa
 - Skin Irritation
 - Home Education