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Registered Nurse (RN)
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NCLEX®
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NCLEX-RN® Test Plan: Client Needs
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Medical Emergencies

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NCLEX-RN® Test Plan: Client Needs | Registered Nurse (RN) School Study Aid

Medical Emergencies
36 Picmonics to Learn | 1 hr 14 mins
Stages of Hypothermia
Mild
32 to 35°C (90 to 95°F)
Shivering
Moderate
28 to 32°C (82 to 90°F)
Obvious Motor Impairment
Slowed Thinking
Severe
< 28°C (< 82°F)
Shivering Stops
Paradoxical Undressing
Arrhythmias
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3 mins
Hypothermia Interventions
Remove From Environment
Remove Wet Clothing
Passive Rewarming
Warm Clothing
Active Rewarming
Heated Blankets
Warm IV Solutions
Heated Oxygen
Warm Gastric Lavage
Considerations
Warm Trunk BEFORE Extremities
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2 mins
Types of Head Injuries
Open Head Injury
Linear Fracture
Comminuted Fracture
Depressed Fracture
Open Fracture
Basilar Skull Fracture
Closed Head Injury
Coup and Contrecoup
Brain Contusion
Concussion
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2 mins
Traumatic Brain Injury Assessment
Assessment
Change in LOC
Personality Changes
Amnesia
Increased Intracranial Pressure
Diplopia
Posturing
Location of Injury
Basilar Skull Fracture
Halo or Ring Sign
Considerations
Intracranial Bleeding
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2 mins
Disseminated Intravascular Coagulation (DIC)
Pathophysiology
Bleeding State
Activation of Clotting Factors
Deficiency of Clotting Factors
Causes
Sepsis
Trauma
Obstetric Complications
Acute Pancreatitis
Malignancy
Nephrotic Syndrome
Transfusion
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2 mins
Compartment Syndrome Assessment
Mechanism
Trauma
Increased Pressure
Compressed Nerves and Blood Vessels
Assessment
1 or more of 6 P's
Ankle-Brachial Index (ABI)
Considerations
May take Days to develop
Early Detection
Ischemia
Damage often Irreversible
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2 mins
Flail Chest
Cause/Mechanism
Trauma
Assessment
Shallow Respirations
Chest Pain
Paradoxical Chest Movement
Interventions
Mechanical Ventilation
Analgesics
Intercostal Nerve Blocks
Considerations
Surgical Rib Fixation
Monitor Pulmonary Contusion
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2 mins
Cauda Equina Syndrome
Acute Loss of Lumbar Plexus Function
Surgical Emergency
Saddle Anesthesia
Causes
Inflammatory Disorders
Spinal Stenosis
Trauma
Lesions
Symptoms
Urinary and Fecal Incontinence
Sciatica
Diagnosis
Magnetic Resonance Imaging (MRI)
Clinical
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1 min
Anterior Shoulder Dislocation
Axillary Nerve Damage
Axillary Artery
Rotator Cuff Injury
Supraspinatus Tendon
Anterior Glenohumeral Ligament
Anatomic Lesions
Bankart's Lesion
Hill-Sachs Lesion
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1 min
Abusive Head Trauma (Shaken Baby Syndrome)
Presentation
Subdural Hemorrhage
Retinal Hemorrhages
Bruising and Fractures
Diagnosis
CT of Head
Skeletal Survey
Treatment
Document Injuries
Notify Child Protective Services
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1 min
Epidural Hematoma
Mechanism
Middle Meningeal Artery Rupture
Temporal Bone Fracture
Hematoma Between Skull And Dura Mater
Transtentorial Herniation
Lucid Interval
Imaging
Lens-shaped on CT
Does Not Cross Suture Lines
Treatment
Craniotomy
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1 min
Subarachnoid Hemorrhage
Bleeding into Subarachnoid Space
Mechanisms
Trauma
Aneurysm Rupture
AVM Rupture
Vasospasm causes Ischemia
Signs & Symptoms
"Worst Headache Of My Life"
Diagnosis
Noncontrast Head CT
Lumbar Puncture
Angiography
Considerations
Surgery
Blood Pressure Control
Intracranial Pressure Control
Nimodipine for Vasospasm Prophylaxis
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3 mins
Subdural Hematoma
Mechanism
Tear of Bridging Veins
Slow Bleeding, Over Time
Imaging
Subdural Space
Crescent-shaped on CT
Crosses Suture Lines
Midline Shift
Causes
Elderly
Whiplash
Abusive Head Trauma (Shaken Baby Syndrome)
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2 mins
Cardiac Tamponade
Mechanism
Fluid in the Pericardial Sac
Pericarditis
Decreased Cardiac Output
Signs/Symptoms
Beck's Triad
Hypotension
Jugular Venous Distention (JVD)
Distant Heart Sounds
Pulsus Paradoxus
Electrical Alternans
Treatment
Pericardiocentesis
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1 min
Traumatic Aortic Rupture
ETIOLOGY
Blunt Thoracic Trauma
Presentation
Hemorrhagic Shock
Diagnosis
Chest X-Ray
Ultrasound
CT Angiography
Management
Fluid Resuscitation
Blood Pressure Control
Surgery
Considerations
Grave Prognosis
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3 mins
Abdominal Aortic Aneurysm Rupture
Clinical Features
Acute Tearing Pain
Pulsatile Abdominal Mass
Grey Turner Sign
Cullen Sign
Hypovolemic Shock
Diagnosis
Diagnosis by Clinical Impression
Treatment
Emergent Surgical Intervention
Considerations
Poor Prognosis
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3 mins
Types of Fractures
Nondisplaced
Displaced
Incomplete
Complete
Closed
Open
Direction of Fracture Line
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2 mins
Cardiopulmonary Resuscitation (CPR) for Adults
Steps Before CPR
Scan Scene
Activate Emergency Response System
Check For Breathing (Max 10 Seconds)
Open Airway
Compressions, Airway, Breathing (CAB)
Compressions: 2 Inches Deep (100-120 Compressions/Min)
Airway: Ensure Airway is Still Open
Breathing: Administer 2 Rescue Breaths
Considerations
Repeat C-A-B Sequence (30:2) Until Help Arrives
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3 mins
Pneumothorax
Mechanism
Air Enters Pleural Space
Assessment
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
Considerations
High Fowler's Position With Oxygen
Prepare For Chest Tube Placement
Educate High Risk Patients
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2 mins
Compartment Syndrome Interventions
Interventions
Frequent Neurovascular Assessments
Evaluate Pain
Do Not Elevate Extremity
Remove or Loosen Restrictive Items
Fasciotomy
Amputation
Considerations
Infection
Monitor Urine Output
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2 mins
Snake Bite Injury
Local Findings
Edema
Erythema
Tissue Necrosis
Systemic Findings
Neurotoxicity
Distributive Shock
Disseminated Intravascular Coagulation (DIC)
Diagnosis
Diagnosis by Clinical Impression
Management
Antivenom
Closely Monitor Patient
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2 mins
Acquired Diaphragmatic Hernia
Etiology
Trauma
Clinical Features
Bowel in the Chest
Respiratory Distress
Abdominal Pain
Diagnosis
Chest X-ray
CT Scan
Management
Surgery
Considerations
Bowel Incarceration or Perforation
Avoid Chest Tube
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4 mins
Types of Burns
Superficial Thickness
Sunburn
Superficial Partial Thickness
Blisters
Blanching
Deep Partial Thickness
Little or Non-blanching
Full Thickness
Waxy White, Yellow or Black
Decreased Pain
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2 mins
Burns Assessment
Stage and Extent of Burn
Dyspnea
Singed Nasal Hairs
Pain
Initial Decrease Urinary Output
Paralytic Ileus
Signs of Inadequate Hydration
Shock
Hypothermia
Hyperkalemia
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2 mins
Burns Interventions
Ensure Airway Patency
O2
IV Fluid Replacement
Dry Sterile Dressing
Debridement
Elevate Burned Limbs
Analgesics
Silver Sulfadiazine
Escharotomy
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2 mins
Burns Considerations
Maintain Body Temperature
Increased Risk of Infection
Venous Thromboembolism (VTE) Prophylaxis
Curling's Ulcer
Excision and Grafting
Adequate Nutrition
Contractures
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2 mins
Stages of Burn Care
Phase / Stage 1
Resuscitative/Emergent Phase
Injury to Return of Capillary Permeability
48-72 hours
IV Fluid Replacement
Phase / Stage 2
Acute Phase
Diuresis to Near Wound Closure
Phase / Stage 3
Wound Closure to Return of Optimal Level
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2 mins
Rule of 9's for Burns
Total Body Surface Area (TBSA)
Head
Anterior Torso (18%)
Chest
Abdomen
Posterior Torso (18%)
Upper Back
Lower Back
Extremities
Posterior Leg (each)
Anterior Leg (each)
Each Arm
Genitalia 1%
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2 mins
Parkland Formula
Burn victims
24 hours
TBSA% x Weight x 4 = Fluids
TBSA %
x Weight (kg)
x 4
= Fluid Requirement (in first 24 hrs)
Fluids in first 8 hours
1/2 of fluid given in first 8 hours
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1 min
Types of Shock
Hypovolemic
Depleted Volume
Cardiogenic
Pump Failure
Obstructive
Indirect Pump Failure
Distributive
Lost Vascular Tone
Neurogenic
Anaphylactic
Septic
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2 mins
Sepsis Assessment
Signs and Symptoms
Systemic Infectious Process
Fever
Hypotension
Change in LOC
Increased WBC
Shift to the Left
Tachycardia
Tachypnea
Hyperglycemia
Edema
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2 mins
Severe Sepsis and Septic Shock Assessment
Microthrombi
DIC
Decreased Oxygen Saturation
Decreased WBC
Oliguria
High Output Heart Failure
Multiple Organ Failure
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2 mins
Systemic Inflammatory Response Syndrome (SIRS) Criteria
Must have 2 or more of the following:
Temperature < 36C or > 38C
Pulse > 90 beats per minute
Respirations > 20/min or PCO2 < 32
WBC < 4,000 or > 12,000 or 10% bands
Mechanism
Subset of Cytokine Storm and Related to Sepsis
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2 mins
Transfusion Reactions
Acute Hemolytic
Febrile, Non-Hemolytic
Mild Allergic
Anaphylactic
Circulatory Overload
Sepsis Reaction
Transfusion-Related Acute Lung Injury (TRALI)
Massive Blood Transfusion
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2 mins
Blood Transfusion Administration
Proper Patient Identification
Large Bore Needle
Y Tubing
Baseline Vital Signs
Slow IV Infusion
Monitor During First 15 Minutes or 50 mL of Blood
Monitor for Reactions
Considerations
Do Not Add Anything To Same IV Line
No Dextrose or Lactated Ringers
Jehovah's Witnesses, No Transfusions
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3 mins
Malignant Hyperthermia vs. Neuroleptic Malignant Syndrome vs. Serotonin Syndrome
Autonomic Instability
Muscle Rigidity
Malignant Hyperthermia
Ryanodine Receptor 1 Mutation
Inhaled Anesthetics
Succinylcholine
Dantrolene
Neuroleptic Malignant Syndrome
Antidopaminergic Medications
Hyporeflexia
Myoglobinuria
Dantrolene
Serotonin Syndrome
Serotonergic Medications
Hyperreflexia
Clonus
Cyproheptadine
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3 mins

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