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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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Pathophysiology

Ace Your NCLEX-RN® Test Plan: Client Needs Classes and Exams with Picmonic: #1 Visual Mnemonic Study Tool for Registered Nurse (RN) Students

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

Pathophysiology
528 Picmonics to Learn | 17 hrs 30 mins
Aortic Stenosis
Characteristics
Age-related Calcifications
Bicuspid Aortic Valve
Crescendo-decrescendo Murmur
Systolic Murmur
Ejection Murmur
Ejection Click
Radiates to Carotids and Apex
Pulsus Parvus et Tardus
Syncope
Helmet Cells
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2 mins
Aortic Regurgitation
Auscultation
Diastolic Murmur
Immediate High-pitched
Blowing Murmur
Clinical Findings
Wide Pulse Pressure
Water Hammer Pulse
Head Bobbing
Pulsating Nail Bed
Considerations
Can Cause Austin Flint Murmur
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1 min
Tricuspid Regurgitation
Holosystolic
Blowing Murmur
Radiates to Right Sternal Border
Enhanced by Inspiration
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1 min
Mitral Stenosis
Characteristics
Murmur Follows Opening Snap
Late Diastolic Murmur
Enhanced by Expiration
Low-Pitched Rumbling
Dilation of Left Atrium (LA)
Recurrent Attacks of Rheumatic Fever
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2 mins
Mitral Regurgitation
Characteristics
Holosystolic
Blowing Murmur
Loudest at Apex
Radiates toward Axilla
Louder by Squatting
Hand Grip
Expiration
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1 min
Patent Ductus Arteriosus
Continuous
Machine like murmur
Often Due to Congenital Rubella
Prematurity
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1 min
Tetralogy of Fallot
Blue Baby Syndrome (Cyanosis)
Crying or Feeding
PROVe
Pulmonary Stenosis
Right Ventricular Hypertrophy
Overriding Aorta
Ventricular Septal Defect (VSD)
Diagnosis and Treatment
Boot-Shaped Heart
Squatting for Tet Spells
Surgery
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2 mins
Hypertrophic Cardiomyopathy Mechanisms
Pathophysiology
2/3 Autosomal-Dominant
1/3 Sporadic Type
Mutation in Gene for Sarcomere Protein
Cardiac Myosin Binding Protein C
Asymmetric Septal Hypertrophy
Outflow Tract Obstruction
Diastolic Dysfunction
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2 mins
Hypertrophic Cardiomyopathy Signs, Symptoms and Treatment
Signs and Symptoms
Sudden Death Of Young Athlete
Heart Failure
Angina
Arrhythmias
Syncope
Harsh Systolic Ejection Murmur
S4 Heart Sound
Treatment
Beta Blocker
Non-dihydropyridine Calcium Channel Blocker
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2 mins
Cardiac Enzyme Evaluation: Troponin
Measures
Cardiac Muscle Injury
Time Ranges
Detection in Blood: 4 Hours
Peak: 24 - 36 Hours
Return to Normal: 5 - 14 Days
Considerations
Most Specific for Cardiac Muscle
Treat Aggressively
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2 mins
Cardiac Enzyme Evaluation: Myoglobin
Measures
Skeletal or Cardiac Muscle Injury
Time Ranges
Onset: 1 - 4 Hours
Peak: 12 Hours
Return to Normal: 24 Hours
Considerations
Elevation After 24 Hours: Reinfarction
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2 mins
Cardiac Enzyme Evaluation: Creatine Kinase CK-MB
Measures
Skeletal or Cardiac Muscle Injury
Time Ranges
Onset: 4-8 Hours
Peak: 12-24 Hours
Return to Normal: 2-3 Days
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1 min
Parts of an ECG
PQRST
P Wave
Atrial Depolarization
QRS Complex
Ventricular Depolarization
T Wave
Ventricular Repolarization
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2 mins
ECG Interpretation
Rate
Rhythm
P Waves
Upright, Rounded, Before Every QRS
PR Interval (< 0.20 seconds)
Normal QRS (< 0.12 seconds)
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2 mins
ECG: Sinus Bradycardia
Rate
< 60 bpm
Rhythm
Regular
P Wave
Present, Upright, Every QRS
PR Interval
< 0.20 seconds
QRS Interval
< 0.12 seconds
Treatment
Atropine
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1 min
ECG: Sinus Tachycardia
Rate
> 100 bpm
Rhythm
Regular
P Wave
Present, Upright, Every QRS
PR Interval
< 0.20 seconds
QRS Interval
< 0.12 seconds
Treatment
Treat Underlying Cause
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2 mins
ECG: Atrial Flutter
Rate
Variable
Rhythm
Regular or Irregular
P Wave
Saw Tooth, Multiple Before Every QRS
PR Interval
Non-measurable
QRS Interval
< 0.12 seconds
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2 mins
ECG: Atrial Fibrillation
Rate
Variable Rate
Rhythm
Irregular Rhythm
P Wave
No P Wave
PR Interval
No PR Interval
QRS Interval
QRS < 0.12 Seconds
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1 min
Torsades de Pointes
Characteristics
Polymorphic Ventricular Tachycardia
Prolonged QT Interval
QRS Twist Around Isoelectric Line
Causes
Congenital
Antibiotics
Antiarrhythmics
Antipsychotics
Antidepressants
Electrolyte Deficiencies
Complications
Ventricular Fibrillation
Treatment
Stable: Magnesium Sulfate
Unstable: Defibrillation
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3 mins
MET Levels
Metabolic Equivalent
MET Levels
MET Levels 1.0-1.4
Bedrest
MET Levels 1.4-2.0
Sitting Up in Chair
MET Levels 2.0-3.0
Seated Warm Shower
MET Levels 3.0-3.5
Standing Warm Shower
MET Levels 3.5-4.0
Golfing
MET Levels 4.0-10
High-Impact Aerobics
Considerations
Cardiac Rehabilitation
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3 mins
Phases of Cardiac Rehabilitation
Scores
MET Levels
Phase 1
Acute Phase
Assessment
Education
Discharge
Goals
Phase 2
Outpatient Phase
Reinforcing Phase 1
Ergonomic Approach
Phase 3
Community Based
Therapy Settings and Cardiac Rehab
Acute Care
Long-Term Acute Care
Skilled Nursing Facilities (SNF)
Independent Living
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5 mins
Primary Hypertension Risk Factors
Excessive Alcohol Consumption
High Sodium Diet
Dyslipidemia
Obesity
People of African Descent
Advanced Age
Vitamin D Deficiency
Reduced Nephron Number
Diabetes
Lack of Physical Activity
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2 mins
Blood Pressure Classification (JNC 7)
Classifications
Normal
Systolic (<120)
Diastolic (< 80)
Prehypertension
Systolic +20 (120-139)
Diastolic +10 (80-89)
Stage 1 Hypertension
Systolic +20 (140-159)
Diastolic +10 (90-99)
Stage 2 Hypertension
Systolic + > 20 (160)
Diastolic + > 10 (100)
Hypertensive Crisis
Systolic > 180
Diastolic > 110
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4 mins
Blood Pressure Classification (ACC/AHA 2017)
Classifications
Normal
Systolic Less than 120
Diastolic Less than 80
Elevated
Systolic +10 (120-129)
Diastolic Less than 80
Stage 1 Hypertension
Systolic +10 (130-139)
Diastolic +10 (80-89)
Stage 2 Hypertension
Systolic +40 (140-179)
Diastolic +30 (90-119)
Hypertensive Crisis
Systolic greater than or equal to 180
Diastolic greater than or equal to 120
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5 mins
Hypertension Assessment
Mechanism
Essential Hypertension
Secondary Hypertension
Assessment
Headache
Vision Changes
Nosebleed (Epistaxis)
Chest Pain
Syncope (Fainting)
Diagnosis
Average 2 Sets, 2 Minutes Apart
After 2 or More Visits (within 1-4 weeks)
Nursing Considerations
Take BP Both Arms
Common in African Americans
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2 mins
Hypertension Intervention
Lifestyle Modifications
Weight Reduction and Exercise
Diet Changes
Relaxation Techniques
Smoking Cessation
Medications
Encourage Self Monitoring
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1 min
Hypertension Medications
Diuretics
ACE Inhibitors
Angiotensin Receptor Blockers (ARBs)
Beta Blockers
Dihydropyridine Calcium Channel Blockers
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2 mins
Supine Hypotension (Vena Cava Syndrome)
Mechanism
Compression of the Vena Cava and Descending Aorta
Signs and Symptoms
Hypotension
Dizziness
Tachycardia
Decreased Renal Perfusion
Decreased Uteroplacental Perfusion
Intervention
Side-lying Position
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2 mins
Peripheral Artery Disease (PAD)
Mechanism
Atherosclerosis
Assessment
Intermittent Claudication
Pain with Exercise
Paresthesias
Arterial Ulcers
Critical Limb Ischemia
Amputation
Consideration
Ankle-Brachial Index (ABI)
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2 mins
Arterial Ulcer Assessment
Absent or Decreased Pulses
Intermittent Claudication
Sharp Pain
Dependent Rubor
Well Defined Edges
Over Bony Areas
Smooth, Shiny Skin
Toes, Heels, Lateral Lower Legs
Cool
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2 mins
Arterial Ulcer Interventions
Saline Dressing
Structured Exercise Programs
Fibrinolytics
Antiplatelet Medication
No Caffeine, Nicotine
Surgery
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1 min
Chronic Venous Insufficiency (Venous Stasis Ulcer) Assessment
Venous Stasis Ulcer
Uneven Edges
Dull Persistent Pain
Medial Malleolus
Necrotic
Normal Pulses
Lower Leg Edema
Bronze-Brown Pigmentation
Warm
Pruritus
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2 mins
Chronic Venous Insufficiency (Venous Stasis Ulcer) Interventions
Frequently Elevate Legs
Avoid Standing/Sitting for Long Periods of Time
Elastic Compression Stockings
Bilayer Artificial Skin
Daflon
Wound Dressings
Proper Foot and Leg Care
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2 mins
Superficial Thrombophlebitis
Cause/Mechanism
IV Catheter Irritation
Assessment
Erythema
Cord-like Vein
Edema
Interventions
Remove IV Catheter
Elevate
Warm Compress
Considerations
Rotate Sites Q3 Days
Aseptic Technique
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2 mins
Abdominal Aortic Aneurysm (AAA) Assessment
Mechanism
Atherosclerosis
Assessment
Bruit
Pulsation in Abdomen
Abdominal or Lower Back Pain
Tearing Pain
Diagnosis
Ultrasound
Considerations
Rupture
Shock
Surgical Repair
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1 min
Thoracic Aortic Aneurysm
Characteristics
Elderly Men
Above the Diaphragm
Usually Asymptomatic
Risk Factors
Hypertension
Smoking
Connective Tissue Disorders
Vasculitis
Diagnosis
Chest X-Ray
Chest CT Angiography
Management
Manage Risk Factors
Surgery if Rupture or Dissection
Observation if Asymptomatic
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4 mins
Arterial vs. Venous Insufficiency Interventions
Arterial Insufficiency
Arterial Insufficiency
Venous Insufficiency
Venous Insufficiency
Arterial Insufficiency Interventions
Aerobic Exercise
Strength Training
Soft Tissue Mobilization
Lifestyle Modifications
Vascular Surgery
Venous Insufficiency Interventions
Compression Therapy
Lower Extremity/Calf Exercises
Manual Therapy
Skin Care
Lifestyle Modifications
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3 mins
Angiodysplasia
Pathophysiology
Tortuous Dilation of Vessels
Fragile Blood Vessels
Right-Sided Colon
Signs and Symptoms
Hematochezia
Painless
Diagnosis
Endoscopy
Angiography
Associations
Von Willebrand Disease
Aortic Stenosis
Elderly
Chronic Renal Failure
Treatment
Supportive
Surgery
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2 mins
Cognitive Abilities Assessment
Mental Status Examination (MSE)
Collecting/Organizing Objective Information
Cognitive assessment tests
Mini-Mental State Examination (MMSE)
Montreal Cognitive Assessment Test (MoCA)
Mini-Cog
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2 mins
Cerebellar Assessment
Coordination
Observe Rapid Alternating Movements (RAM)
Touch Thumb to Each Finger
Finger-Nose-Finger Test
Heel-to-Shin Test
Observe Gait
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2 mins
Skull, Scalp and Hair Assessment
Skull
Inspect Size, Shape and Contour
Inspect and Palpate Areas for Tenderness or Lesions
Scalp
Inspect for Tenderness, Lesions or Rashes
Inspect for Dandruff
Inspect for Lice or Nits
Hair
Inspect Quality and General Appearance of Hair
Observe Hair Distribution
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2 mins
Head, Face and Neck Assessment
Head
Inspect Size and Shape of Skull
Palpate Temporal Artery
Face
Observe Facial Expression
Inspect Facial Structures and Symmetry
Neck
Look for Symmetry
Check Range of Motion
Inspect Lymph Nodes and Thyroid Gland
Confirm Trachea is Midline
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2 mins
Eye Assessment
Inspect External Structures
Eye and Eyebrow Symmetry
Eyeball Alignment
Inspect Eyeball Structures
Examine Cornea and Lens for Cloudiness
Iris and Pupil Shape and Size
Pupillary Light Reflex and Accommodation
P.E.R.R.L.A
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2 mins
Visual Perceptual Hierarchy
Foundation of Visual Perceptual Hierarchy
Oculomotor Control
Visual Fields
Visual Acuity
Visual Perceptual Hierarchy
Visual Attention
Visual Scanning
Pattern Recognition
Visual Memory
Visual Cognition
Adaptation Through Vision
Mnemonic
A Child Makes Parents See Appropriately
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3 mins
Nose Assessment
External Nose
Inspect for Deformity or Asymmetry
Inspect for Inflammation and Skin Lesions
Nasal Cavity
Check for Nasal Obstruction
Inspect Nasal Mucosa
Note Discharge, Bleeding or Foreign Body
Sinus Area
Palpate the Sinus Areas
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2 mins
Ear Assessment
EXTERNAL EAR
Inspect Position and Symmetry
Inspect for Lesions, Drainage, Nodules or Redness
Inspect Opening of Ear Canal
OTOSCOPIC EXAMINATION
Insert Speculum
Position Scope
View Structures
Light Reflect
HEARING ACUITY TESTS
Whisper Test
Weber’s Test
Rinne Test
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4 mins
Throat and Mouth Assessment
MOUTH
Inspect for Color, Asymmetry and Swelling
Inspect Lips, Teeth, Gums and Oral Mucosa
Assess Tongue
THROAT
Examine Pharynx with Tongue Depressor
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2 mins
Skin Assessment
Inspect the skin
Observe for Abnormal Skin Pigmentation
Inspect for Cyanosis
Observe Skin for Pallor
Observe for Jaundice
Inspect for Erythema
Palpate the Skin
Check the Temperature
Observe the Skin for Moisture
Inspect for Diaphoresis or Dehydration
Check skin for edema
Imprint Thumb Firmly for 3 to 4 Seconds
Look for lesions
Note the Characteristics
Palpate Lesion
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4 mins
Nail Assessment
Observe the Nails
View Index Finger at its Profile
Look at Consistency
Observe Color
Check Capillary Refill
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2 mins
Gastrointestinal System Assessment
Mouth
Inspect Mouth, Jaw, Teeth, Gums and Oral Mucosa
Inspect Tongue
Palpate Areas for Tenderness/Lesions
ABDOMEN
Inspect Abdominal Quadrants
Auscultate
Percuss
Palpate
Light Palpation
Deep Palpation
Check for Rebound Tenderness and Ascites
Rectum and Anus
Inspect Perianal Area
Palpate Rectum with Gloved Index Finger
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6 mins
Abdomen Assessment
Inspect the Abdomen
4 Quadrants
Contour, Shape, Symmetry
Umbilicus
Auscultate
Bowel Stethoscope
Vascular Sounds
Percussion
Percuss 4 Quadrants
Tympany or Dullness
Palpate
Light Palpation
Deep Palpation
Rebound Tenderness
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5 mins
Reflexes Assessment
Grading
Hyperactive
Hypoactive
Deep Tendon Reflexes (DTRs)
Biceps
Triceps
Brachioradialis
Patellar (Quadriceps)
Achilles Tendon
Cutaneous (Superficial) Reflexes
Plantar Reflex (Babinski Sign)
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3 mins
ROM Assessment
Types of ROM
Active ROM (AROM)
Active Assisted ROM (AAROM)
Passive ROM (PROM)
Upper Extremity
Neck Flexion, Extension and Rotation
Shoulder Flexion, Extension and Rotation
Elbow Flexion and Extension
Fingers and Wrist Flexion and Extension
Lower Extremity
Hip and Knee Flexion
Hip Abduction and Rotation
Ankle Rotation
Toe Flexion and Extension
Lumbar Rotation and Spine Inspection
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4 mins
Cardiac and Circulation Assessment
HEART ASSESSMENT
Inspect General Appearance
Inspect Chest
Note Location of Apical Impulse
Percuss Chest Wall
Auscultate Heart Sounds: S1, S2, S3, S4
Auscultate for Pericardial Friction Rub and Murmurs
VASCULAR SYSTEM ASSESSMENT
Assess Skin, Fingernails and Toenails
Check Carotid Artery and Jugular Vein
Palpate Skin for Temperature, Texture, Turgor
Check Capillary Refill Time
Palpate Arterial Pulses Bilaterally
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5 mins
Male Urinary System Assessment
Health History
Past Medical History
Medications
Urination Pattern
Physical Examination
Inspection
Palpation
Auscultation
Percussion
Assessment of Urine
Intake and Output
Characteristic of Urine
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2 mins
Male Reproductive System Assessment
Inspection
Inspect the Penis and Urethral Meatus
Inspect the Scrotum, Testicles and Pubic Hair
Inspect the Inguinal and Femur
Palpation
Palpate the Entire Penile Shaft
Palpate Both Testicles
Palpate Epididymides and Both Spermatic Cords
Palpate for Direct or Indirect Inguinal Hernia and Femoral Hernia
Palpate Prostate Gland
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3 mins
Female Reproductive System Assessment
HEALTH HISTORY
Past Genitourinary and Gynecological History
Current and Past Medication Use
Urine Collection and Characteristics
EXTERNAL GENITALIA EXAM
Inspect External Genitalia
Palpate External Genitalia
INTERNAL GENITALIA EXAM
Inspect Internal Genitalia Using Lubricated Speculum
Examine Vaginal Wall for Color, Texture, and Integrity
Examine Cervix for Color, Position, Size, Shape, Mucosal Integrity and Discharge
Palpate Internal Genitalia
Note Abnormal Findings
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4 mins
Airway and Lungs Assessment
Inspection
Examine Back of Chest
Determine Respiratory Rate for 1 Minute
Assess for Abnormalities with Uneven Movement or Use of Accessory Muscles
Inspect Skin, Nails and Mucous Membrane
Palpation
Palpate for Crepitus, Tenderness, Alignment, Masses or Retraction
Palpate for Tactile Fremitus
Check Chest-Wall Symmetry and Expansion
Note Resonance, Hyperresonance, Dullness and Tympany
AUSCULTATION
Use Diaphragm of Stethoscope to Listen to Full Inspiration and Full Expiration
Ask Patient to Breathe Through Mouth
Normal Breath Sounds
Abnormal Breath Sounds
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5 mins
Strength Assessment
Inspection
Assess Patient Appearance for Abnormalities
Observe ROM of Upper and Lower Extremities
Assess Motor Power
Hand Grips
Dorsiflexion and Plantarflexion
Hip and Knee Flexion Against Resistance
Manual Muscle Test (MMT) Grading System
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2 mins
Female Urinary System Assessment
Health History
Past Medical History
Urination Pattern
Medications
Urine Collection
Assessment
Inspect Areas Over Kidney and Bladder
Percuss Kidneys
Palpate Kidneys and Bladder
Note Abnormal Findings
Assessment of Urine
Intake and Output
Characteristic of Urine
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2 mins
Cranial Nerves I and II Assessments
Cranial Nerve I - Olfactory Nerve
Use Familiar Attainable Smells
Note Any Sense of Smell Asymmetry
Cranial Nerve II - Optic Nerve
Test Visual Fields
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2 mins
Cranial Nerves III, IV and VI Assessments
Cranial Nerve III - Oculomotor Nerve
Cranial Nerve IV - Trochlear Nerve
Cranial Nerve VI - Abducens Nerve
Assess Extraocular Movements, P.E.R.R.L.A
Note Any Nystagmus
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2 mins
Cranial Nerves V and VII Assessments
Cranial Nerve V - Trigeminal Nerve
Assess Temporal and Masseter Muscles
Assess Light Touch Sensation
Cranial Nerve VII - Facial Nerve
Note Mobility and Facial Symmetry
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2 mins
Cranial Nerves VIII, IX and X Assessments
Cranial Nerve VIII - Acoustic (Vestibulocochlear) Nerve
Test Hearing to Normal Conversation
Whisper Test
Cranial Nerve IX - Glossopharyngeal Nerve
Cranial Nerve X - Vegus Nerve
Depress the Tongue and Say “Ahh”
Touch the Posterior Pharyngeal
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2 mins
Cranial Nerves XI and XII Assessments
Cranial Nerves XI - Spinal Accessory Nerve
Examine Sternocleidomastoid Muscles
Examine Trapezius Muscles
Cranial Nerve XII - Hypoglossal Nerve
Inspect the Tongue
Note Lingual Speech
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2 mins
Shoulder Exam
Inspect
Skin
Shape
Palpate
Humeral Head
Acromioclavicular Joint
Rotator Cuff
Clavicle
Spine of Scapula
Range of Motion
Flexion
Extension
Abduction
Adduction
Internal Rotation
External Rotation
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3 mins
Low Back Assessment
Low Back Assessment
Inspection
Functional Exam
Movement
Palpation
Flexion and Extension
Rotation
Lateral Bend
Hyperextension
Special Tests
Straight Leg Raise Test
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4 mins
Knee Assessment
Facts
Inspection
Palpation
Check Range of Motion
Assess Strength
Neurovascular Assessment
Special Tests
Ballottement and Effusion
Ligament Integrity
Meniscal Integrity
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4 mins
Stable Angina
Assessment
Chest Pain with Exertion
Relieved within 15 Minutes
ST Depression
Interventions
Nitroglycerin
Up to 3 Doses q 5 Minutes
Rest
Antiplatelet Medication
CABG
Angioplasty
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2 mins
Unstable Angina
Assessment
Chest Pain with Rest or Exertion
Limits ADLs
> 15 Minutes
Less Likely Relieved by Nitroglycerin
ST Depression
Fatigue
Considerations
Acute Coronary Syndrome (ACS) Treatment
Emergency Treatment
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2 mins
Myocardial Infarction Assessment
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
Considerations
Monitor for Arrhythmias
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2 mins
Myocardial Infarction Diagnosis
Diagnosis
12 Lead ECG
ST Elevation
Q Wave
T Wave Inversion
Troponin T and I
CK-MB
Considerations
Early ECG
Cardiac Stress Test
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2 mins
Myocardial Infarction Interventions
MONA
Morphine
Oxygen
Nitrates
Aspirin
Thrombolytics (tPA)
Invasive Procedures
Cardiac Catheterization
Stent Placement
Angioplasty
Coronary Artery Bypass Grafting (CABG)
Considerations
Decrease Modifiable Risk Factors
Resuming Activity (Physical, Sexual)
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2 mins
Coronary Artery Bypass Grafting (CABG)
Indications
ST-Segment Elevation Myocardial Infarction (STEMI)
Cardiovascular Disease (CAD)
Uncontrolled Angina
Considerations
Internal Mammary Artery
Saphenous (Leg) Vein
Transient Limb Edema
Closely Monitor Patients
Venous Thromboembolism (VTE) Prophylaxis
Incentive Spirometer
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2 mins
Cardiac Catheterization
Considerations
Fluttering Sensation
Contrast Media
NPO 6-12 Hours
After Procedure
Bed Rest
Assess Circulation
Assess for Bleeding
Monitor Vital Signs
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2 mins
Evolution of Myocardial Infarction and Complications
Hours to Days
Arrhythmia
Before 7 Days
Fibrinous Pericarditis
Papillary Muscle Rupture
Interventricular Septum Rupture
Before 14 Days
Ventricular Pseudoaneurysm
Ventricular Free Wall Rupture
After 14 Days
True Ventricular Aneurysm
Dressler Syndrome
Other
Left Ventricular Failure
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2 mins
Infarction Types
Red Infarct
Venous Occlusion
Organ with Multiple Blood Supplies
Liver
Intestine
Testes
Reperfusion Injury
White Infarct
Arterial Occlusion
Organ with Single Blood Supplies
Heart
Kidney
Spleen
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2 mins
Types of Heart Failure
Left Sided
Pulmonary Congestion
Right Sided
Peripheral Edema
High Output
Unable to Meet Metabolic Needs
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1 min
Right Heart Failure Assessment
Jugular Venous Distention (JVD)
Peripheral Edema
Hepatosplenomegaly
Nocturia
Weight Gain
Ascites
Fatigue
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1 min
Left Heart Failure Assessment
Pulmonary Assessment
Pulmonary Congestion
Pink Frothy Sputum
Wheezing or Crackles
Dyspnea with Exertion
Cough
Systemic Assessment
Fatigue
Tachycardia
Weak Peripheral Pulse
S3, S4 Heart Sounds
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1 min
Heart Failure Interventions
Diagnostic Tests
Echocardiogram
Invasive Hemodynamic Monitoring
Improve Gas Exchange
High Fowler's Position
Oxygen
Advanced Airway
Drugs and Devices
Diuretics
Beta Blockers
Angiotensin II Receptor Blockers (ARBs)
ACE Inhibitors
Digoxin (Lanoxin)
Pacemaker
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2 mins
Acute Pericarditis Assessment
Pericardial Sac Inflammation
Assessment
Sharp Chest Pain
Increased with Inspiration
Pain Decreased by Leaning Forward
Pericardial Friction Rub
Diffuse ST-Elevation
T Wave Inversion
Fever
Considerations
May Be Asymptomatic
Cardiac Tamponade
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2 mins
Acute Pericarditis Causes
Idiopathic
Infection
Trauma
Cardiac
Myocardial Infarction
Autoimmune Diseases
Uremia
Tumor
Radiation
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2 mins
Acute Pericarditis Interventions
Interventions
Treat Underlying Disorder
Antibiotics
Colchicine + NSAIDs
Corticosteroids
Place Patient Upright with Head of Bed at 45°
Pericardiocentesis
Pericardial Window
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2 mins
Endocarditis Assessment
Infection of Inner Layer and Valves
Assessment
Fever
Fatigue
New or Changed Murmurs
Roth's Spots
Splinter Hemorrhages
Janeway Lesions
Osler's Nodes
Considerations
Heart Failure
Embolization
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2 mins
Endocarditis Interventions
Interventions
IV Antibiotics
4-6 Weeks
Anticoagulants
Good Hygiene
Considerations
Closely Monitor
Antibiotic Prophylaxis
Dental Procedures
Invasive Procedures
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1 min
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
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
Respiratory Anatomy
Characteristics
Nasal Cavity
Hair Filters
Mucus Filters and Moistens
Capillaries Warm
Pharynx (Throat)
Larynx (Voice Box)
Cilia Expel Mucus and Dust
Trachea
Bronchi
Alveoli
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2 mins
Alveolar Gas Exchange
Characteristics
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
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2 mins
Hypoxia (Early Symptoms)
Diaphoresis
Restlessness
Tachypnea
Dyspnea on Exertion
Tachycardia
Hypertension
Arrhythmias
Decreased Urine Output
Unexplained Fatigue
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1 min
Hypoxia (Late Symptoms)
Cyanosis
Cool, Clammy Skin
Use of Accessory Muscles
Retractions
Hypotension
Arrhythmias
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2 mins
Tracheostomy Care
Inner Cannula Removed and Cleaned
Clean Q8 Hours Around Stoma
One Finger Under Ties
Considerations
Speak with Deflated Cuff
Can Eat with Tube in Place
Keep Replacement Tube Nearby
Immediately Replace if Dislodged
Physician Does First Tube Change
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2 mins
Lung Sounds - Wheezes
Location
Throughout Lung
Description
High Pitched
Sounds Like
Musical
Cause
Air Moving through Narrowed Airways
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38 secs
Lung Sounds - Crackles
Location
Lower Lobes
Description
Fine/Coarse
Sounds Like
Fine: Twisting Hair through Fingers
Coarse: Velcro
Cause
Collapsed Small Airways and Alveoli "Popping Open"
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1 min
Lung Sounds - Rhonchi
Location
Trachea and Bronchi
Description
Low Pitched Rumbling
Sounds Like
Gurgling
Cause
Narrowed Airway
Secretions or Bronchospasm
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49 secs
Lung Sounds - Pleural Friction Rub
Location
Anterior Lateral Lung
Description
Dry, Rubbing, or Squeaking
Sounds Like
Rubbing a Balloon with Finger
Cause
Inflamed Pleura
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50 secs
Oxygen Delivery Methods
Nasal Cannula
Simple Face Mask
Non-Rebreather Mask
Venturi-Mask
Safety Precautions
Oxygen In Use Sign
No Electrical Sparks
Six Feet Away from Open Flames
Nursing Considerations
Dry Nasal and Upper Airway Mucosa
Skin Irritation
Home Education
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1 min
Restrictive vs. Obstructive Lung Diseases
Restrictive Lung Disease
Decreased Lung Volume
FEV1/FVC Ratio Normal to Increased
Obstructive Lung Disease
Increased Lung Volume
Decreased FEV1/FVC Ratio
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2 mins
COPD Overview (Chronic Obstructive Pulmonary Disease Overview)
Causes
Inhaled Toxins
Smoking
AAT Deficiency
Assessment
Emphysema
Chronic Bronchitis
Asthma
Considerations
Spirometry
Slow Progression
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2 mins
Asthma Assessment
Assessment
Triggers (Cold air, Dander, Dust, Infection, Mold, Pollen, Smoke)
Shortness of Breath (SOB)
Tachypnea and Tachycardia
Wheezing
Diaphoresis
Accessory Muscles
Decreased Pulmonary Function Tests
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2 mins
Asthma Implementation and Education
Medication
Oxygen
Corticosteroids
Ipratropium (Anticholinergic)
Albuterol
Implementation
Inhaler/nebulizer
Pulse Oximetry
Pursed Lip Breathing
Education
Carry Inhaler
Rinse Mouth after Inhaler
Identify Trigger (Cold Air, Dander, Dust, Infection, Mold, Pollen, Smoke)
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2 mins
Chronic Bronchitis Assessment
Clinical Findings
Chronic Productive Cough
> 3 Months for 2 Years
Increased Mucus Production
Dyspnea
Cyanosis
Wheezes
Complications
Right Side Heart Failure
Jugular Venous Distention (JVD)
Peripheral Edema
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2 mins
Chronic Bronchitis Interventions
Tripod Position
Humidified Oxygen
Pursed Lip Breathing
Increase Fluid Intake
ABGs
Early Detection of Exacerbation
Considerations
Lowest O2 Therapy
Assisted Ventilation
Increased Infection Risk
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2 mins
Emphysema
Mechanism
Hyperinflation and Loss of Elasticity
Assessment
Pursed Lip Breathing
Barrel Chest
Dyspnea on Exertion
Clubbing
Depression and Anxiety
Thin Appearance
Nursing Considerations
CO2 Retention
Low Concentration of O2
High Fowler's Position
High Calorie, High Protein Diet
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2 mins
Pneumonia Assessment
Risk Factors
Older Adult
Immunocompromised
Long Term Care
Assessment
Shortness of Breath (SOB)
Hypoxemia
Cough and Sputum Production
Wheezing or Crackles
Fever
Pleuritic Pain
Diagnosis
Chest X-ray
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2 mins
Pneumonia Intervention
Interventions
Humidified Oxygen
Deep Breathing Exercises
Position of Comfort
Increase Fluid Intake
Manage Fever
Medications
Antibiotics
Mucolytics
Expectorants
Considerations
Pneumococcal Vaccine
Sepsis
Acute Respiratory Failure (ARF)
Prevention Education
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2 mins
Pulmonary Embolism Causes
Causes
FAT BAT Mnemonic
Fat
Air
Deep Vein Thrombosis (DVT)
Bacteria
Amniotic Fluid
Tumor
Risk Factors
Hypercoagulable
Central Venous Lines
Immobilized
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1 min
Tuberculosis Assessment
Etiology
Airborne Droplet
Assessment
3 Week Productive Cough
Night Sweats
Chest Pain
Fever
Weight Loss
Fatigue
Diagnosis
Chest X-Ray
Blood Tests
Mantoux Skin Test
3 Positive Sputum Tests
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1 min
Pulmonary Embolism Assessment
Assessment
Shortness of Breath (SOB)
Pleuritic Chest Pain
Tachypnea
Hemoptysis
Hypoxemia
Considerations
Sudden Death
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52 secs
Tuberculosis Intervention
Hospital Care
Airborne Isolation
Drug Therapy
Combination Drug Therapy (RIPE)
6-12 Months
Considerations
DOT
BCG Vaccination
Medication Education
3 Negative Sputum Specimens
Infection Control
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2 mins
Respiratory Acidosis Assessment
Assessment
Decreased pH < 7.35
Increased PaCO2 > 45
Reduced Respirations
Anxiety
Change in LOC
Tachycardia
Cyanosis
Increased Electrolytes
ECG Changes
Muscle Weakness
Hyporeflexia
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2 mins
Cystic Fibrosis Assessment
Thickened Mucus
Recurrent Pulmonary Infections
Pulmonary Congestion
Pancreatic Insufficiency
Steatorrhea
Fat-Soluble Vitamin Deficiencies
Salty Taste to Skin
Meconium Ileus
Delayed Growth and Poor Weight Gain
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2 mins
Respiratory Acidosis Interventions
Improve Respiration
Pharmacologic Interventions
Bronchodilators
Respiratory Stimulants
Drug Antagonists
Nonpharmacologic Interventions
Oxygen
Assisted Ventilation
Prevent Complications
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1 min
Cystic Fibrosis Interventions
Bronchodilators
N-Acetylcysteine (Mucolytics)
Inhaled Hypertonic Saline
Early Antibiotics
Dornase Alfa (Mucolytic Agent)
Postural Drainage with Percussion
Fat Soluble Vitamin Supplements
Pancreatic Enzymes with Every Meal
High Protein, High Calorie Diet
Added Dietary Salt
Glucose Monitoring
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2 mins
Respiratory Alkalosis Assessment
Assessment
Increased pH > 7.45
Decreased PaCO2 < 35 mmHg
Hyperventilation
Brainstem Stimulation
Head Injury
Shock
Lightheadedness
Tingling Lips or Fingers
Trousseau's
Chvostek's Sign
Anxiety
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2 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
Respiratory Alkalosis Interventions
Treat Underlying Cause
Mechanically Ventilated Patients
Decrease Tidal Volume and/or Respiratory Rate
Give Adequate Pain Control and Sedation
Hyperventilation Syndrome
Rebreathing into Paper Bag
Sedatives
Antidepressants
Considerations
Compensatory Drop in Serum Bicarbonate
Correct CO2 Slowly
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2 mins
Croup (Laryngotracheobronchitis)
Mechanism
Parainfluenza Virus
Assessment
3 Months to 3 Years
Nighttime
Barking Seal Cough
Inspiratory Stridor
Interventions
Cool Humidified Air
Dexamethasone
Racemic Epinephrine
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2 mins
Obstructive Sleep Apnea (OSA)
Cause/Mechanism
Narrowed or Obstructed Air Passage
Assessment
Apnea
Loud Snoring
Startle Response
Daytime Drowsiness
Interventions
Positional Therapy
Oral Appliance
Continuous Positive Airway Pressure (CPAP)
Surgery
Considerations
Weight Loss
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3 mins
Lung Cancer Assessment
2nd Most Common Cancer
Assessment
Chronic Cough
Hoarseness
Abnormal Breath Sounds
Hemoptysis
Chest Pain
Anorexia or Weight Loss
Considerations
Symptoms Appear Late in Disease
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2 mins
Adenocarcinoma of the Lung
Characteristics
Most Common Lung Cancer
Most Common in Nonsmokers
Peripheral Location
KRAS, EGFR, and ALK Mutations
Diagnosis
Glandular Pattern
Often Stains with Mucin
Clinical Features
Presents with Hemoptysis
Clubbing
Treatment
Surgical Resection
Chemotherapy and Radiation
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2 mins
Small Cell (Oat Cell) Carcinoma
Characteristics
Aggressively Malignant
Strong Correlation with Smoking
Central Location
Amplification of Myc Oncogenes
Signs and Symptoms
Narrowing of Bronchial Airways
Cushing's Syndrome
Ectopic ACTH
Syndrome Of Inappropriate Antidiuretic Hormone (SIADH)
Lambert-Eaton Syndrome
Diagnosis
Kulchitsky Cells
Neuron-Specific Enolase Positive
Chromogranin A Positive
Treatment
Chemotherapy and Radiation
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3 mins
Squamous Cell Carcinoma of the Lung
Characteristics
Strong Correlation with Smoking
More Common in Men
Central Location
Cavitating Lesion Extending to Hilum
PTHrP Causes Hypercalcemia
Diagnosis
Keratin Pearls
Intercellular Bridges
Treatment
Surgical Resection (if Early Stage)
Chemotherapy and Radiation (if Later Stage)
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2 mins
Atypical Pneumonia
CHARACTERISTICS
Diffuse Patchy Inflammation
Interstitial Pattern
"Walking Pneumonia"
Etiologies
Mycoplasma pneumoniae
Chlamydia pneumoniae
Legionella pneumophila
Adenovirus
Respiratory Syncytial Virus (RSV)
Cytomegalovirus (CMV)
Influenza
Presentation
Dry Cough
Treatment
Macrolides
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2 mins
Acute Respiratory Distress Syndrome (ARDS) Assessment
Cause
Damaged Alveolar-Capillary Membrane
Assessment
Restlessness
Dyspnea
Refractory Hypoxemia
Decreased PaO2
Diffuse Pulmonary Infiltrates
Atelectasis
Pulmonary Hypertension
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2 mins
Acute Respiratory Distress Syndrome (ARDS) Interventions
Interventions
Closely Monitor Patient
ABG's (Arterial Blood Gases)
Oxygen
Assess for O2 Toxicity
Mechanical Ventilation
PEEP
Assess for Pneumothorax
Permissive Hypercapnia
Considerations
High Mortality Rate
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2 mins
Neonatal Respiratory Distress Syndrome
Cause/Mechanism
Fetal Lung Immaturity
Lack of Surfactant
Assessment
Respiratory Distress
Nasal Flaring
Retractions
Grunting
Interventions
Surfactant
Oxygen
Mechanical Ventilation
Considerations
Total Parenteral Nutrition (TPN)
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2 mins
Alpha 1 Antitrypsin Deficiency
Characteristics
Decreased Alpha Anti Trypsin
Increased Elastase Activity
Decreased Elastic Tissue
Misfolded Protein Aggregates
PAS+ Globules
Clinical Features
Panacinar Emphysema
Dyspnea
Cirrhosis
Hepatocellular Carcinoma
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2 mins
Idiopathic Pulmonary Fibrosis
Interstitial Restrictive Lung Disease
Age over 50 years, Males, Tobacco
CLINICAL FEATURES
Dyspnea and Cough
Fatigue
Crackles
Digital Clubbing
DIAGNOSIS
Bronchiectasis
Honeycomb Pattern
Restrictive Pattern
COMPLICATIONS
Respiratory Failure
Right Heart Failure
TREATMENT
Oxygen
Antifibrotic Medications
Lung Transplant
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5 mins
Beta-2 Agonists
Short-term Treatment
Terbutaline
Asthma
Tocolysis
Albuterol
Asthma
Long-term Treatment
Salmeterol
Asthma
Chronic Obstructive Pulmonary Disease (COPD)
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3 mins
Albuterol (Proventil)
Mechanism
Short-Acting Beta-2 Agonist
Indications
Bronchospasm
Asthma
Side Effects
Angina
Tachycardia
Tremor
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1 min
Cromolyn (Mast Cell Stabilizers)
Mechanism
Mast Cell Stabilizer
Indications
Asthma Prophylaxis
Bronchial Inflammation
Allergic Rhinitis
Side Effects
Cough
Bronchospasm
Consideration
Fixed Schedule Administration
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2 mins
Theophylline (Theo-24)
Mechanism
Bronchial Smooth Muscle Relaxation
Indications
Asthma
Side Effects
Insomnia
Restlessness
Arrhythmias
Seizures
Considerations
Narrow Therapeutic Range
Monitor Plasma Levels
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1 min
Montelukast (Singulair)
Mechanism
Leukotriene Receptor Blocker
Indications
Allergic Rhinitis
Asthma Prophylaxis
Exercise Induced Bronchospasm
Side Effects
Fatigue
Headache
Mood Changes
Suicidal Thoughts
Considerations
Increased Risk of Churg Strauss
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2 mins
Terbutaline (Brethine)
Mechanism of Action
Beta-2 Agonists
Indications
Asthma
Tocolytic
Side Effects
Hypotension
Tremor
Tachycardia
Pulmonary Edema
Hyperglycemia
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2 mins
Second Generation Antihistamines
Indications
Allergies
Mechanism of Action
Lipophobic
Histamine H1 Receptor Antagonist
Drugs
Azelastine + Fluticasone (Dymista)
Intranasal Spray
Cetirizine (Zyrtec)
Loratadine (Claritin)
Fexofenadine (Allegra)
Considerations
Fewer Anticholinergic Effects
Fewer CNS Effects
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2 mins
First Generation Antihistamines
Mechanism of Action
Histamine H1 Receptor Antagonist
Indications
Allergies
Nausea and Vomiting
Motion Sickness
Anaphylaxis
Drug Names
Diphenhydramine (Benadryl)
Promethazine (Phenergan)
Chlorpheniramine
Side Effects
Sedation
Anticholinergic Effects
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2 mins
Stages of Asthma Treatments
Mild Intermittent
Short-acting Inhaled Beta-Agonist
Mild Persistent
Low-Dose Inhaled Corticosteroid
Montelukast (Leukotriene Receptor Antagonist)
Moderate Persistent
Low to Medium-dose Inhaled Corticosteroid
Zileuton
Severe Persistent
High-Dose Inhaled Corticosteroid
Systemic Corticosteroids
Omalizumab (Allergies)
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2 mins
Hypothalamus
Characteristics
Anterior Pituitary Stimulated Through the Hypophyseal Portal
GHRH
GnRH
TRH
PIF
CRF Released During Stress
Posterior Pituitary Stimulated Through Neural Control
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3 mins
Anterior Pituitary
Characteristics
Hypothalamic Control
FLAT PeG Mnemonic
Tropic Hormones
Follicle-Stimulating Hormone (FSH)
Lutenizing Hormone (LH)
Adrenocorticotropic Hormone (ACTH)
Thyroid-Stimulating Hormone (TSH)
Direct Hormones
Prolactin (PRL)
Growth Hormone (GH)
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2 mins
Posterior Pituitary
Characteristics
Neuroendocrine Reflex Stimulation (By Hypothalamus)
Direct Hormones
Vasopressin
Increased Water Retention (In Kidneys)
Oxytocin
Increased Uterine Contraction
Mammary Glands Contraction
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2 mins
Thyroid Gland
Characteristics
TSH Stimulates T3 and T4 Release
Metabolism Regulation
Blood Calcium Sensor
Calcitonin Release
Blood Calcium Decreases
Bone Building
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2 mins
Parathyroid Gland
Characteristics
Blood Calcium Sensor
Parathyroid Hormone
Bone Resorption
Blood Calcium Increases
Vitamin D Activation
Calcium Absorption From The Small Intestine
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1 min
Adrenal Gland (Basic)
Characteristics
Adrenal Cortex
RAAS Stimulates Aldosterone
CRF (CRH) acts on Anterior Pituitary Gland to Release ACTH
Cortisol Released
Androgens Released
Adrenal Medulla
Epinephrine & Norepinephrine
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2 mins
Adrenal Gland (Advanced)
Characteristics
Adrenal Cortex
Zona Glomerulosa
Aldosterone
Zona Fasciculata
Cortisol
Zona Reticularis
Androgens
Adrenal Medulla
Chromaffin Cells
Epinephrine & Norepinephrine
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2 mins
Peptide Hormones
Characteristics
Fast-Acting and Short-Lived
Bind To Cell Membrane Receptors
Stimulate Secondary Messengers
Amino Acid-Derived
Examples
Insulin
Parathyroid Hormone (PTH)
Vasopressin
Oxytocin
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2 mins
Steroid Hormones
Characteristics
Nuclear Membrane
Long-Lived and Slow-Acting
Cholesterol-Derived
Intracellular Receptors
DNA Transcription
Examples
Testosterone
Aldosterone
Estrogen
Cortisol
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2 mins
Pancreas
Characteristics
Acinar Cells Release Digestive Enzymes
Ductal Epithelial Cells Release Bicarbonate
Islets of Langerhans
Beta Cells Release Insulin
Alpha Cells Release Glucagon
Delta Cells Release Somatostatin
Somatostatin Inhibits Alpha and Beta Cells
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3 mins
Addison's Disease Assessment
Assessment
Deficiency of Cortisol and Aldosterone
Irritability
Hyperkalemia
Muscle Weakness
Skin Hyperpigmentation
Hyponatremia
Hypotension
Hypoglycemia
Considerations
Addisonian Crisis
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2 mins
Testes
Characteristics
FSH Stimulates Sertoli Cells
Inhibin B Release
LH Stimulates Leydig Cells
Leydig Cells Secrete Testosterone
Testosterone Causes Male Development
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2 mins
Addison's Disease Intervention
Drug Therapy
Hydrocortisone
2/3 Dose in Morning
1/3 Dose in Late Afternoon
Fludrocortisone
Androgen Replacement Therapy
Considerations
Salt Additives
Increase Dosage During Stress and Infection
Medic Alert Bracelet
Lifelong Hormone Therapy
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2 mins
Syndrome Of Inappropriate Antidiuretic Hormone (SIADH)
Pathophysiology
Hypersecretion of ADH
Increased Sensitivity to ADH
Signs & Symptoms
Serum Hypoosmolality
Coma and Seizure
Dilutional Hyponatremia
Cramps and Tremors
Euvolemia
Change in LOC
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2 mins
Addisonian Crisis
Assessment
Severe Symptoms
Shock
Interventions
High-Dose Hydrocortisone
Large Volumes of IV Fluid
Insulin with Dextrose
Kayexalate
Loop or Thiazide Diuretics
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2 mins
Syndrome of Inappropriate Antidiuretic Hormone (SIADH) Pharmacologic Interventions
Diuretics
Hypertonic IV Fluids
Demeclocycline
Tolvaptan and Conivaptan
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1 min
Pheochromocytoma
Cause/Mechanism
Adrenal Medulla Tumor
Increased Catecholamines
Assessment
Episodic Hypertension
Diaphoresis
Abdominal or Chest Pain
Interventions
Surgery
Antihypertensives
Phenoxybenzamine
Metyrosine (Demser)
Considerations
Do Not Palpate Abdomen
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3 mins
Syndrome of Inappropriate Antidiuretic Hormone (SIADH) Nonpharmacologic Interventions
Monitor Serum and Urine Osmolality
IandOs with Daily Weights
Restrict Fluid Intake
Monitor Cardiovascular and Neurological Status
Seizure Precautions
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2 mins
Primary Hyperaldosteronism
Etiology
Increased Aldosterone Secretion
Adrenal Adenoma
Bilateral Adrenal Hyperplasia
Clinical Features
Hypertension
Hypokalemic Metabolic Alkalosis
No Significant Edema
Diagnosis
Increased Aldosterone
Decreased Renin
Abdominal CT Scan
Management
Aldosterone Antagonists
Surgery
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3 mins
Sheehan's Syndrome
Postpartum Pituitary Gland Necrosis
Agalactorrhea
Amenorrhea
Secondary Hypothyroidism with Cold Intolerance
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1 min
Peripheral Precocious Puberty
Characteristics
Secondary Sex Characteristics before 8 Years (Girls) or 9 Years (Boys)
Breast Development (Girls) or Testicular Enlargement (Boys)
GnRH Independent
Etiologies
Congenital Adrenal Hyperplasia
Exogenous Sex Steroids
Granulosa Cell Tumor
Non-Germ Cell Tumor
Diagnostic Features
GnRH Stimulation Test
No Increase in LH
Bone Age
Hormone Levels
Management
Treating Underlying Disorders
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3 mins
Central Diabetes Insipidus
Characteristics
ADH Deficiency
Increased Serum and Urine Osmolality
Etiologies
Mental Illness
Brain Injuries
Treatment
Desmopressin
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1 min
Dawn Phenomenon
Cause/Mechanism
Increased Hormone Production
Assessment
Hyperglycemia Upon Awakening
Interventions
Long-Acting Evening Insulin
Change Administration Times
Insulin Pump
Considerations
Closely Monitor Glucose Levels
Between 2-6AM
Limit Carbohydrates Before Bedtime
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2 mins
Hypothyroidism Assessment
Assessment
Weight Gain - Edema
Lethargy
Cold Intolerance
Bradycardia
Hypertension
Brittle Nails and Dry Skin
Constipation
Goiter
Prolonged Menses
Slowed Thinking
Diagnostic Tests
Decreased Free T4
Increased TSH
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2 mins
Diabetes Assessment
Assessment Type 1
Juvenile Onset
Absent Insulin Production
Ketosis Prone
Assessment Type 2
Adult Onset
Insulin Resistance
Obesity
Gestational Diabetes
Onset During Pregnancy
Glucose Intolerance
Complications
Retinopathy
Peripheral Vascular Disease
Nephropathy
Neuropathy
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2 mins
Hypothyroidism Intervention
Medications
Levothyroxine (Synthroid)
Liothyronine (Cytomel)
Complication
Myxedema Coma
Nursing Considerations
Lifelong Replacement Hormone
Monitor Vital Signs
Fluids and Fiber
Low Calorie, Low Fat Diet
Medication Education
No Switching Brands
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2 mins
Diabetes Interventions
Early Diagnosis
Insulin
Oral Hypoglycemics
Glucose Monitoring
Routine Exercise
Diabetic Diet
Monitor for Complications
Insulin Therapy
Diabetic Ketoacidosis (DKA)
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2 mins
Hyperthyroidism Assessment
Assessment
Heat Intolerance
Exophthalmos
Warm, Moist Skin and Silky Hair
Tremors
Goiter
Diarrhea
Weight Loss
Tachycardia
Hypertension
Amenorrhea
Diagnosis
Decreased TSH with Elevated Free T4
Radioactive Iodine Uptake (RAIU)
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2 mins
Diabetes Education
Self-Monitoring (Blood Glucose)
SubQ Injection Technique
Lifestyle Changes
Symptoms of Hyperglycemia and Hypoglycemia
Sick Day Care
Foot Care
Exercise Therapy
Medication
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1 min
Hyperthyroidism Interventions
Drug Therapy
Propylthiouracil (PTU)
Methimazole (Tapazole)
Iodine
Beta Blockers
Other Therapies
Radioiodine Ablation
Thyroidectomy
Complications
Thyrotoxicosis
Post-Surgery Hypocalcemia
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2 mins
Diabetes Insipidus Assessment
Polyuria
Nocturia
Low Specific Gravity (USG)
Polydipsia
Dehydration
Hypotension
Tachycardia
Confusion
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2 mins
Graves' Disease Characteristics
Women 20-40 years old
Pathophysiology
Anti-TSH Receptor Antibodies
Symptoms
Ophthalmopathy
Exophthalmos
Hyperthyroidism
Goiter
Pretibial Myxedema
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1 min
Metabolic Syndrome
Assessment
Dyslipidemia
Central Obesity
Insulin Resistance
Hypertension
Increased C-Reactive Protein (CRP)
Increased Fibrinogen
Considerations
Increased Risk Cardiovascular Disease
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1 min
Graves' Disease Labs and Treatment
Labs
Decreased TSH
Increased T3
Increased T4
Radioactive Iodine Uptake (RAIU)
Treatment
Beta blocker
Methimazole
Radioiodine Ablation
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1 min
Acromegaly Assessment
Mechanism
Excess Growth Hormone (GH)
Signs and Symptoms
Protruding Jaw
Large Lips and Nose
Hearing Loss
Enlargement of Hands and Feet
Vision Changes and Headache
Joint Pain
Peripheral Neuropathy
Hyperglycemia
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2 mins
Hashimoto's Thyroiditis
Symptoms
Hypothyroidism with Bouts of Hyperthyroidism
Enlarged, Nontender Thyroid
Mechanism
Autoimmune
Anti-Thyroid Peroxidase (TPO)
Anti-Thyroglobulin
Lab Findings
Hurthle Cells
Lymphoid Follicles
Associations
HLA-DR5 and HLA-DR3
Increased Risk Of Non-Hodgkin Lymphoma
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2 mins
Hypocalcemia Causes
Hypoalbuminemia
Hypomagnesemia (Less Common Hypermagnesemia)
Hypovitaminosis D
Hypoparathyroidism
Medications
Hyperphosphatemia
Malnutrition
Acute Pancreatitis
Alkalosis
Sepsis
Chronic Kidney Disease
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2 mins
Riedel Thyroiditis
Pathophysiology
Autoimmune
IgG4
Fibrous Invasion of Thyroid
Findings
Very Firm on Palpation
Nontender
Slowly Enlarging Mass
Invades Local Structures
Hypothyroidism
Histology
Fibrous Tissue
Eosinophilic Infiltrate
Treatment
Prednisone
Tamoxifen
Surgery
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2 mins
Hypocalcemia
Muscle Spasms
Assessment
< 8.5 mg/dL Ca2+
Decreased Bone Density
Tetany
Chvostek's Sign
Trousseau's Sign
Increased DTR
ECG Changes
QT Prolongation
Considerations
Oral and IV Replacement of Ca2+
Seizure Precautions
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2 mins
Hypoparathyroidism
Assessment
Hypocalcemia
Lethargy
Tetany
Arrhythmias
Diagnostic Tests
Decreased Calcium and Increased Phosphorus
Considerations
IV Calcium Chloride
Rebreather Mask
Lifelong Medications
Oral Calcium Supplements with Vitamin D
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2 mins
Hypocalcemia Treatments
Characteristics
Treat Underlying Disorder
Acute Treatments
IV Calcium Gluconate
Cardioprotective
Chronic Treatments
Calcium Carbonate
Calcium Citrate
Vitamin D Supplements
Considerations
Treat Hypomagnesemia
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2 mins
Primary Hyperparathyroidism
Assessment
Hypercalcemia
Kidney Stones
Osteoporosis
Arrhythmias
Diagnostic Tests
Increased Calcium and Decreased Phosphorus
Considerations
Prevent Injury
Medication Education
Surgery
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1 min
Hypercalcemia Causes
Two CHIMPANZEES Acronym
Thyroid Disorders
Calcium Supplements
Hyperparathyroidism
Iatrogenic (Drugs, immobility)
Milk-Alkali Syndrome
Paget's Disease of Bone
Acromegaly or Addison's Disease
Neoplasms
Zollinger-Ellison Syndrome
Excessive Vitamin A
Excessive Vitamin D
Sarcoidosis
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2 mins
Cushing's Syndrome Assessment
Assessment
Increased Cortisol Levels
Truncal Obesity
Purple Abdominal Striae
Buffalo Hump
Decreased Bone Density
Moon Face
Thinning Skin
Hyperglycemia
Hypertension
Considerations
Long Term Glucocorticoid Use
Immunosuppression
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2 mins
Hypercalcemia
Assessment
> 10.5 mg/dL Ca2+
Pathologic Fractures
Lethargy
Hypercoagulation
Constipation
ECG Changes
QT Shortening
Interventions
No Calcium Intake
Chelating Drugs
Calcitonin
Bisphosphonates
Loop Diuretics instead of Thiazide Diuretics
Considerations
Increased Risk for Renal Calculi
Increase Fluids
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3 mins
Hypercalcemia Treatments
Treat Underlying Disorder
Hydration
Dialysis
Calcium Restriction
Bisphosphonates
Calcitonin
Cinacalcet
Glucocorticosteroids
Denosumab
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2 mins
Parkinson's Disease Assessment
Assessment
Decreased Dopamine
Older Adult
Cogwheel Rigidity
Bradykinesia
Shuffling Gait
Resting Tremor
Pill-Rolling
Mask-Like Face
Cognitive Decline
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2 mins
Parkinson's Disease Interventions
Medications
Levodopa/Carbidopa (Sinemet)
Entacapone (Comtan)
Selegiline (Eldepryl)
Amantadine (Symmetrel)
Bromocriptine (Parlodel)
Benztropine (Cogentin)
Considerations
Allow Extra Time
Ensure Patient Safety
Surgery As Last Resort
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2 mins
5 A's of Alzheimer's Disease
Agnosia
Anomia
Aphasia
Apraxia
Amnesia
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1 min
Alzheimer's Disease Assessment (Early Symptoms)
Risk Factors
Advanced Age
Early Signs and Symptoms
Poor Judgment and Decision-Making
Difficulty Having a Conversation
Inability to Manage a Budget
Losing Track of the Date or Season
Misplacing Things
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1 min
Alzheimer's Disease Assessment (Late Symptoms)
Late Signs and Symptoms
Memory Impairment
Wandering Behavior
Confabulation
Perseveration
Lack of Abstract Thinking
Severe Cognitive Decline
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1 min
Alzheimer's Disease Interventions
Diagnostic Tests
PET Scan and CT
Mini-Mental State Examination
Interventions
Drug Therapy
Safe Environment
Moderate Exercise
Behavioral Modification
Assistance with Functional Independence
Assistance and Support for Caregiver
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2 mins
Huntington's Disease Assessment and Interventions
Assessment
Decreased GABA
Appears around Age 40
Slow Cognitive Decline
Choreiform Movements
Non Repetitive Jerks
Interventions
Neuroleptics
Tetrabenazine
Genetic Counseling
Considerations
Stages of Disease
High Calorie Diet
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2 mins
Multiple Sclerosis Assessment
Cause/Mechanism
Nerve Fiber Demyelination
Assessment
Motor Issues
Cerebellar Signs
Fatigue
Paresthesias
Spasticity
Urinary Incontinence
Optic Neuritis
Considerations
Women Between 20-50 Years Old
Relapse and Remission of Symptoms
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2 mins
Multiple Sclerosis Interventions
Drug Therapy
Corticosteroids
Interferon Beta
Dimethyl Fumarate (Tecfidera)
Fingolimod (Gilenya)
Mitoxantrone (Novantrone)
Natalizumab (Tysabri)
Considerations
Increase Exercise
Identify Triggers
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2 mins
Down Syndrome
Pathophysiology
Trisomy 21
Meiotic Nondisjunction
Signs and Symptoms
Intellectual Disability (Mental Retardation)
Single palmar crease
Flat Facies
Duodenal Atresia
Hirschsprung's Disease
Septum Primum Type ASD
Endocardial Cushion Defects
Prominent Epicanthal Folds
Increased Risk of Acute Lymphoblastic Leukemia
Alzheimer's Disease
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3 mins
Guillain-Barre Syndrome Assessment
Assessment
Ascending Paralysis
Muscle Weakness
Paresthesias (Pins and Needles)
Diplopia
Difficulty Speaking
Dysphagia
Labile Blood Pressure
Loss of Bowel and Bladder Control
Considerations
Aggressive Airway Management
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2 mins
Myasthenia Gravis Assessment
Weakness with Muscle Use
Diplopia
Ptosis
Dysphagia
Difficulty Speaking
Fatigue
Complications
Cholinergic Crisis
Overmedicated
Myasthenic Crisis
Not Enough Medication
Respiratory Muscle Paralysis
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2 mins
Amyotrophic Lateral Sclerosis (ALS)
Assessment
Progressive Muscle Weakness
Systemic Muscle Wasting
Fasciculations
Spasticity
Fatigue
Considerations
Riluzole (Rilutek)
Stretching
Little to No Cognitive Decline
Respiratory Support
Palliative Care
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2 mins
Sciatica
Cause
Compression or Damage to Sciatic Nerve
Herniated Disc
Assessment
Shooting Pain
Lower Back Down to Thigh
Interventions
Anti-Inflammatories
Steroid Injections
IDET (Intradiscal Electrothermoplasty)
Considerations
Straight-leg Raising Test
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2 mins
Autonomic Dysreflexia
Injury Above T6
Assessment
Paroxysmal Hypertension
Bradycardia
Diaphoresis
Flushing Above Lesion
Piloerection
Nasal Congestion
Headache
Interventions
Elevate Head of Bed
Remove Noxious Stimuli
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2 mins
Essential Tremor
Characteristics
Most Common Tremor in Adults
Positive Family History
Clinical Findings
Bilateral Upper Extremities
Worse with Physical and Psychological Stress
Better with Rest and Alcohol
Management
Beta Blockers
Primidone
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1 min
Cranial Nerve Pathologies
Cranial Nerve Pathologies
Horner Syndrome
Trigeminal Neuralgia
Bell's Palsy
Brain or Brainstem Lesion
Microvascular Cranial Nerve Palsy
Glossopharyngeal Neuralgia
Multiple Sclerosis
Arnold Chiari Malformation
Amyotrophic Lateral Sclerosis (ALS)
Guillain Barre’ Syndrome
Parkinson's Disease
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3 mins
Types of Seizures
Tonic-clonic
Tonic
Clonic
Absence (Petit Mal)
Myoclonic
Atonic
Partial (Focal) Seizure
Simple Partial
Complex Partial
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2 mins
Seizure Interventions
Maintain Airway
Side-lying Position
Support Head
Move to Floor
Benzodiazepines
Considerations
Never Restrain
No Objects in Mouth
Document Details
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2 mins
Seizure Precautions
Reduce Environmental Stimuli
Identify Triggers
Aura
Pad Side Rails
Bed Lowest Position
Oxygen and Suction Available
Consideration
Monitor Therapeutic Drug Levels
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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
Increased Intracranial Pressure (ICP) Assessment
Change in LOC
Headache
Cushings Triad
Irregular Respirations
Widening Pulse Pressure
Bradycardia
Projectile Vomiting
Abnormal Pupils
Papilledema
Posturing
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2 mins
Increased Intracranial Pressure (ICP) Interventions
Interventions
Elevate Head Of Bed
Foley Catheter
Mannitol (Osmitrol)
High Dose Barbiturates
Passive Hyperventilation
Dexamethasone (Neoplasm or Infection)
Considerations
Neuro Assessment
Maintain Normal Temperature
Avoid Activities That Increase ICP
Intracranial Monitoring System
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2 mins
Types of Strokes
Warning Signs
Transient Ischemic Attack (TIA)
Reversible Ischemic Neurologic Deficit (RIND)
Types
Ischemic
Thrombotic
Atherosclerosis
Embolic
Atrial Fibrillation
Hemorrhagic
Severe Hypertension
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3 mins
Right Hemisphere Stroke Assessment
Opposite Side Weakness (Hemiplegia)
Poor Proprioception
Disoriented to Person, Place, Time
Can't Recognize Faces (Prosopagnosia)
Loss of Judgement and Awareness
Impulsiveness
Personality Changes
Tonal Hearing Loss
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2 mins
Left Hemisphere Stroke Assessment
Opposite Side Weakness (Hemiplegia)
Side to Side Discrimination
Aphasia
Agraphia
Slow Performance
Aware of Deficits
Anxiety
Depression
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2 mins
Hydrocephalus
Cause
Increased CSF in Ventricles of Brain
Assessment
Signs of Increased ICP
Infant Assessment
High Pitched Cry
Irritability
Opisthotonus
Increased Head Circumference
Bulging Fontanel
Setting Sun Sign
Interventions
Seizure Precautions
Elevate HOB
CSF Shunt
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2 mins
Lesions of the Brain and Presentations
Lesions of the Brain and Presentations
Frontal Lobe
Parietal Lobe
Temporal Lobe
Occipital Lobe
Brainstem
Cerebellum
Main TBI Lesions
Epidural Hematoma
Subdural Hematoma
Contusion/ Parenchymal Hemorrhage
Intraventricular Hematoma
Subarachnoid Hemorrhage
Diffuse Axonal Injury
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3 mins
Concussion
Cause
Brain Trauma
Pathophysiology
Neurometabolic Cascade
Signs & Symptoms
Visual Disturbances
Cognitive Dysfunction
Sleep Disturbances
Emotional Instability
Diagnosis
Sport Concussion Assessment Tool 5th Edition (SCAT5)
Diagnostic Imaging
Treatment
Physical and Cognitive Rest
Monitored Exercise
Vestibular Rehabilitation
Considerations
Second Impact Syndrome
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4 mins
Aphasia Post Stroke
Causes
Cerebrovascular Accident
Non-Fluent Aphasia
Broca’s Aphasia
Fluent Aphasia
Wernicke’s Aphasia
Other Types of Aphasia
Global Aphasia
Conduction Aphasia
Verbal Apraxia
Dysarthria
Diagnosis
Cerebral Angiography
Computed Tomography
Magnetic Resonance Imaging (MRI)
Intervention
Simple Short Sentences
Visual and Tactile Cues
Speech Therapy
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4 mins
Rancho Los Amigos Levels of Cognitive Functioning Scale
Total Assistance
Level I - No Response
Level II - Generalized Response
Level III - Localized Response
Maximal Assistance
Level IV - Confused/Agitated
Level V - Confused, Inappropriate Non-Agitated
Moderate Assistance
Level VI - Confused, Appropriate
Minimal Assistance for Daily Living Skills
Level VII - Automatic, Appropriate
Stand-By Assistance
Level VIII - Purposeful, Appropriate with Stand-by Assistance
Stand-By Assistance on Request
Level IX - Purposeful, Appropriate with Stand-by Assistance on Request
Modified Independent
Level X - Modified Purposeful, Appropriate
Mnemonic
No General Localizes Aggresively Inappropriate Apples Automatically on Purpose
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4 mins
Meningitis Assessment
Assessment
Nausea and Vomiting
Fever
Nuchal Rigidity
Severe Headache
Purpura
Seizures
Photophobia
Infants and Young Children
Opisthotonus Position
High-Pitched Cry
Bulging Fontanel
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2 mins
Meningitis Interventions
Drug Therapy
IV Antibiotics
Dexamethasone
Analgesics
Antipyretics
Considerations
Closely Monitor for Increased ICP
Bed Rest
Preventative Vaccinations
Droplet-Airborne Precautions
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2 mins
Herpes Zoster (Shingles)
Cause/Mechanism
Varicella-Zoster Virus
Assessment
Linear, Unilateral Rash Along a Dermatome
Pruritus
Postherpetic Neuralgia
Interventions
Acyclovir
Analgesics
Gabapentin
Considerations
Contagious Vesicles
Shingrix
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3 mins
Primary Angle-Closure Glaucoma (PACG - Acute)
Mechanism
Rapid Increase in IOP
Signs and Symptoms
Rapid Onset
Pain
Blurred Vision
Halos Around Lights
Nausea and Vomiting
IOP over 30 mm Hg
Considerations
Drug Therapy
Surgery
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1 min
Primary Open-Angle Glaucoma (POAG - Chronic)
Mechanism
Flow of Aqueous Humor Slowed
Signs and Symptoms
Slow Onset
No Pain
Tunnel Vision
IOP 22-32mm Hg
Considerations
Drug Therapy
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1 min
Age-Related Macular Degeneration (AMD)
Mechanism
Dry (nonexudative)
Wet (exudative)
Signs and Symptoms
Scotomas
Blurred, Darkened Vision
Loss of Central Vision
Distortion of Vision
Considerations
Drug Therapy
Surgery
Low-vision Assistive Devices
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2 mins
Detached Retina
Assessment
Flashes of Light
Floaters
Curtain Like Shadow
Interventions
Eye Patch
Bed Rest
Surgical Emergency
Considerations
No Vigorous Activity
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2 mins
Cataract
Mechanism
Age-related
Assessment
No Pain
Cloudy Opaque Lens
Decreased Visual Acuity
Occurs Gradually
Treatment
Surgery
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1 min
Nystagmus
Pathophysiology
Vestibulo-Ocular Reflex (VOR) Dysfunction
Vestibular Injury
Signs & Symptoms
Concussion
Upbeating or Horizontal Beating Eyes
Oscillopsia
Diagnosis
HINTS (Head Impulse-Nystagmus-Test of Skew)
History Examination
INFARCT (Impulse Normal Fast-phase Alternating Refixation on Cover Test)
Visual Acuity Test
Treatment
Brandt-Daroff Maneuver
Epley Maneuver
Baclofen
Considerations
Congenital vs Acquired
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4 mins
Internal Eye Abnormalities
Lens Opacities
Nuclear Cataract
Cortical Cataract
Optic Disc Abnormalities
Papilledema
Optic Atrophy
Excessive Cup-Disc Ratio
Visual Field Loss
Macular Degeneration
Scotomas
Increased Ocular Pressure
Retinal Detachment
Optic Tract Lesions
Vascular Abnormalities of the Retina
Arteriovenous Crossing
Attenuated Arteries
Diabetic Retinopathy
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4 mins
External Eye Abnormalities
Extraocular Muscle Dysfunction
Strabismus
Eyelid Abnormalities
Exophthalmos
Ptosis
Ectropion
Entropion
eyelid lesions
Blepharitis
Dacryocystitis
Hordeolum (Stye)
Chalazion
Pupil Abnormalities
Anisocoria
Mydriasis
Miosis
Abnormalities on Cornea and Iris
Pterygium
Hyphema
Hypopyon
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4 mins
Age-Related Dizziness
Presbystasis
Pathophysiology
Visual Decline
Somatosensory Dysfunction
Vestibular Dysfunction
Muscular Atrophy
Signs and Symptoms
Increased Loss of Balance
Vertigo
Treatment
Vestibular Rehabilitation
Strength Training
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3 mins
Common Eye Disorders
Common Eye Disorders
Conjunctivitis
Refractive Errors
Presbyopia
Cataract
Glaucoma
Uveitis
Age-Related Macular Degeneration
Diabetic Retinopathy
Retinal Detachment
Leukocoria
Cranial Nerve Palsies
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4 mins
Retinoblastoma
Characteristics
Loss of Heterozygosity
Chromosome 13
Children
Presentation
Leukocoria
Strabismus
Vision Loss
Association
Osteosarcoma
Diagnosis
Genetic Testing
Management
Cryotherapy
Photocoagulation
Chemotherapy or Radiation
Surgery
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3 mins
Otitis Media Assessment
Red or Bulging Tympanic Membrane
Ear Pain
Pulling at Ear
Fever
Upper Respiratory Infection
Considerations
More Common in Young Children
Eustachian Tube Narrower
Conductive Hearing Loss
Smoking Increases Risk
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2 mins
Otitis Media Interventions
Antipyretics
Analgesics
Antibiotics
Irrigation
Position on Affected Side
Myringotomy
Tympanostomy Tube
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2 mins
Meniere's Disease
Mechanism
Excess Endolymph
Signs and Symptoms
Tinnitus
One-sided Sensorineural Hearing Loss
Vertigo
Nausea and Vomiting
Considerations
Meclizine (Antivert)
Low Salt Diet
Surgery
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2 mins
Labyrinthitis/Vestibular Neuritis
Causes
Inner Ear Infection
Signs and Symptoms
Postural & Gait Instability
Vertigo
Nystagmus
Increased Fall Risk
Dizziness
Nausea and Vomiting
Diagnosis and Treatment
Medication
Vestibulo-Ocular Reflex (VOR)
Postural Control & Balance Training
Gait Training
Habituation Exercise
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3 mins
Vestibular Disorders
Peripheral Vestibular Disorders
Unilateral Vestibular Hypofunction
Vestibular Neuritis
Labyrinthitis
Vestibular Schwannoma (Acoustic Neuroma)
Bilateral Vestibular Hypofunction
Benign Paroxysmal Positional Vertigo
Meniere's Disease
Perilymphatic Fistula
Central Vestibular Disorders
Vertebrobasilar Insufficiency
Traumatic Head Injury
Vestibular Migraine
Brainstem & Cerebellar Conditions
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3 mins
Brachial Plexus Roots
C5 through T1
Long Thoracic Nerve
Dorsal Scapular Nerve
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43 secs
Brachial Plexus Trunks
Superior Trunk
Suprascapular Nerve
Middle Trunk
Inferior Trunk
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1 min
Brachial Plexus Divisions
Anterior (Division)
Posterior (Division)
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27 secs
Brachial Plexus Cords
Lateral Cord
Lateral Pectoral Nerve
Posterior Cord
Upper Subscapular Nerve
Thoracodorsal Nerve
Lower Subscapular Nerve
Medial Cord
Medial Pectoral Nerve
Medial Cutaneous Nerve of Arm and Forearm
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1 min
Brachial Plexus Branches
Musculocutaneous Nerve
Axillary Nerve
Radial Nerve
Median Nerve
Ulnar Nerve
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56 secs
Gastroesophageal Reflux Disease (GERD) Assessment
Pathophysiology
Relaxed Lower Esophageal Sphincter
Signs and Symptoms
Dyspepsia (Indigestion)
Belching
Nighttime Coughing
Dysphagia
Epigastric Pain
Regurgitation
Heartburn (Pyrosis)
Globus
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2 mins
Barrett's Esophagus
Histological findings
Metaplasia in Lower Esophagus
Columnar Epithelium
Associated Pathologies
Gastroesophageal Reflux Disease (GERD)
Esophagitis
Esophageal Ulcers
Increased Risk of Esophageal Adenocarcinoma
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1 min
Mallory-Weiss
Characteristics
Bleeding From Tears in Mucosa
Forceful Vomiting
Alcoholism
Eating Disorders (Bulimia)
Painful Hematemesis
Diagnosis
Endoscopy
Management
Observation
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2 mins
Boerhaave Syndrome
Pathophysiology
Esophageal Rupture
Increased Esophageal Pressure while Vomiting
Lower 1/3 of Esophagus
Signs and Symptoms
Chest Pain
Odynophagia
Subcutaneous Emphysema
Management
Shock
Surgical Emergency
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2 mins
Tracheoesophageal Fistula (TEF)
Cause
Esophageal Atresia
Ends in Blind Pouch
Assessment
Coughing
Choking
Cyanosis
Drooling
Considerations
NPO
Surgical Emergency
Aspiration Pneumonia
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2 mins
Esophageal Adenocarcinoma Characteristics and Presentation
Characteristics
Most Common Esophageal Cancer in USA
Lower 1/3 of Esophagus
Risk Factors
Gastroesophageal Reflux Disease (GERD)
Barrett's Esophagus
Achalasia
Obesity
Smoking
Presentation
Weight Loss
Progressive Dysphagia
Anemia
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2 mins
Dysphagia
Etiology
Neurological Disorders
Muscular Disorders
Structural Abnormalities
Gastroesophageal Reflux Disease (GERD)
Inflammatory Conditions
Signs & Symptoms
Difficulty Swallowing
Choking or Coughing
Regurgitation
Diagnosis
Clinical History and Physical Examination
Fiberoptic Endoscopic Evaluation of Swallowing (FEES)
Videofluoroscopy (Modified Barium Swallow Study - MBSS)
Interventions
Treat Underlying Cause
Therapy
Dietary Modifications
Medications
Surgery
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3 mins
Sialolithiasis
Characteristics
Stone Formation
Ducts of Major Salivary Glands
Clinical Manifestations
Recurrent Periprandial Pain
Swelling
Trouble Swallowing
Associations
Dehydration
Smoking Tobacco
Trauma
Treatment
NSAIDs
Stimulation of Salivary Flow
Antibiotics
Surgery
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2 mins
Peptic Ulcer Disease Interventions
Combination Drug Therapy
Two Antibiotics
Proton Pump Inhibitor (PPI)
Decrease Acid Secretion
Avoid NSAIDs
Diet and Lifestyle Changes
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1 min
Peptic Ulcer Disease Assessment
Mechanism/Cause
Helicobacter Pylori
Increased Stomach Acid
Assessment
Abdominal Pain
Heartburn (Pyrosis)
Melena
Weight Changes
GI Distress
Considerations
Most Commonly in Duodenum
Duodenal: Pain Relieved by Eating
Gastric: Pain Caused by Eating
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2 mins
Gastroenteritis
Cause/Mechanism
Viruses
Bacteria
Food Intolerances
Assessment
Flu-Like Symptoms
GI Distress
Bloody Stool
Interventions
Oral Rehydration
Considerations
Self-Limiting
Prevention
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2 mins
Hypertrophic Pyloric Stenosis (HPS) Assessment
Mechanism
Hypertrophied Pylorus
Risk Factor
Macrolide Use