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76 Cheat Sheets For
Nursing Students
When the pH and the Bicarb (HCO3) are in the same direction Metabolic When the pH and the Bicarb (HCO3) are in different directions Respiratory Elevated pCO2 mean? Respiratory PH = 7.25 ⬇️ Bicarb (HCO3) = 20 ⬇️ Metabolic acidosis PH = 7.50 ⬆️ Bicarb (HCO3) = 30 ⬆️ Metabolic alkalosis PH = 7.21 ⬇️ Bicarb (HCO3) 38⬆️ Respiratory Acidosis PH = 7.50 ⬆️ Bicarb (HCO3) 25 normal Respiratory alkalosis As the PH goes up so does my patient expect for potassium (kalemia) Alkalosis Hyperreflexia Irritability Tachypnea Tachycardia Borborygmi (Gurgling) Seizures *need suction HYPOkalemia As the PH goes down so does my patient expect for potassium (kalemia) ACIDOSIS Headache Hyporeflexia Bradycardia Bradypnea
Paralytic/ 76 Cheat Sheets For Nursing Students
Coma Respiratory arrest *need ambu bag MACkussmau's (ONLY METABOLIC ACIDOSIS → "MAC") Heart block HYPERkalmia If a question ask about a lung scenario it is pertaining to? Metabolic or Respiratory Respiratory Causes for respiratory alkalosis.
- Pregnant woman hyper ventilating - ventilator setting is too high Causes for respiratory acidosis
- Emphysema
- Drowning
- Pneumonia
- PCA pump (toxicity)
- Ventilator setting is TOO LOW. If a question is NOT asking about a lung scenario it is pertaining to? Metabolic or Respiratory Metabolic Causes for metabolic alkalosis
- Prolong suctioning or vomiting
- Surgery with NG tube suction for three days
- Hyperemesis gravidum (Hyper...Emesis/Vomiting Gravidum/pregnant) Causes for Metabolic Acidosis
- Acute RF (renal failure)
- Infantile diarrhea
- 3rd degree burns over 60% of body
- Hyperemesis gravidum with dehydration
NOTE: Always pay attention to MODIFYING PHRASE rather than original statement. Vomiting vs Diarrhea Alkalosis or Acidosis Vomiting = Alkalosis Diarrhea = Acidosis PH normal range? 7.35-7. PaCO2 normal range? 35 - 45 mm Hg HCO2 normal range? 22 - 26 mEq/L aPTT (activated partial thromboplastin time) range on heparin and without? On Heparin = 47- 70 No Heparin = 30- 40
- Cocaine
- Adderol (ADD drug)
- PCP/LSD/Mushrooms (psychedelic hallucinogen) DOWNERS addiction: THERE ARE 135. Every drug that's not an UPPER. What to check for when it comes to upper medication versus downers medication? UPPERS = Seizure Risk → Check reflexes DOWNERS = Respiratory Depression → Check RR Difference between overdose and withdrawal Overdose = you have too much
Withdrawal = you don't have enough You can overdose on what but intoxication on the other? You can overdosed on upper but Intoxication on downer. What happens when you overdose and intoxication? Overdosed on upper → everything goes UP → pick the UP things.
Intoxication on downer → everything goes DOWN → pick the DOWN things. What happens with withdrawal on upper and downer : You don't have enough Withdrawal downer → you don't have enough downer → pick the UP things.
Withdrawal upper → you don't have enough upper → pick the DOWN things. Which two situations would respiratory arrest be of concern? Downer vs Upper Downer overdose Upper withdrawal Which two situations would seizure be biggest risk? Upper vs Downer Upper overdose Downer withdrawal UPPER overdose, think: "HOT, FAST, LOUD, TIGHT"
- Hot: ↑ temp
- Fast: ↑ HR, RR, reflexes
- Loud: Talkative, irritable
- Tight: Muscle tension, risk of seizures ALCOHOL WITHDRAWAL SYNDROME (AWS) when does it start? When = Begins within 24 hours after stopping drinking. ALCOHOL WITHDRAWAL SYNDROME (AWS) Severity? Severity = Not life-threatening. ALCOHOL WITHDRAWAL SYNDROME (AWS) Danger status? Danger = Not dangerous to self or others. ALCOHOL WITHDRAWAL SYNDROME (AWS) Diet status? Diet = Regular diet.
ALCOHOL WITHDRAWAL SYNDROME (AWS)
Room location in the hospital? Location = Semi-private room anywhere on the unit. ALCOHOL WITHDRAWAL SYNDROME (AWS) restraint needed? Restraints = Not needed. DELIRIUM TREMENS (DT) When does it start? When = Happens 72 hours after stopping alcohol. DELIRIUM TREMENS (DT) How severe is it? Severity = Life-threatening! DELIRIUM TREMENS (DT) Dangerous status Danger = Yes — dangerous to self and others. DELIRIUM TREMENS (DT) Diet status Diet = NPO or clear liquids (seizure risk). DELIRIUM TREMENS (DT) Room location in the hospital Location = Private room near nurse's station (unstable). DELIRIUM TREMENS (DT) Restraints needed? Restraints = Yes — use 2-point locked leather restraints (opposite arm and opposite leg, rotated every 2 hrs). Aminoglycosides = "A Mean Old Mycin"What are they? Super strong antibiotics — used only for serious, life-threatening infections Not your first choice — used when nothing else works What do Aminoglycosides treat? Only "Mean Old Infections" like:
- TB
- Fulminant pyelonephritis (suddenly kidney infection)
- Septic shock
- Burns over 85% of body How to recognize Aminoglycosides Most end in "-mycin" BUT...Not all "-mycins" are aminoglycosides!
If it ends in "THROmycin," it's NOT a mean old mycin.
- Zithromycin - NOT
- Clarithromycin - NOT
- Azithromycin - NOT
These are for regular infections, not the serious kind. nephrotoxicity
- Seizure risk
- Shrill high-pitched cry Cardiac arrhythmia QRS are? P WAVE are? QRS: VENTRICULAR P WAVE: ATRIAL Cardiac arrhythmia A lack of QRS's equal and are? = no QRS → asystole ( flat line) Cardiac arrhythmia Saw tooth equal and are? = Flutter → atrial flutter Cardiac arrhythmia Chaotic equal and are? = fibrillation → atrial fibrillation with P wave And or = Fibrillation → ventricular fibrillation with QRS Cardiac arrhythmia Bizarre equal and are? = tachycardia → ventricular tachycardia Cardiac arrhythmia Periodic widened QRS are? → PVC; one snapshot of tachycardia PVCs stand for? (Premature Ventricular Contractions) PVCs (Premature Ventricular Contractions) Usually low priority, but if ANY of these 3 are true, bump to MODERATE
- If there are more than 6 PVC's in a minute
- If there are more than 6 PVC's in a row
- If the PVC falls on the T wave of the previous beat (PVCs are never high priority because they don't kill you quickly) Lethal Arrhythmias = High Priority (Kill you in 8 minutes or less) are? Asystole = flat line = no heartbeat
Ventricular Fibrillation (V-Fib) = heart quivering = no output Potentially Life-Threatening = Ventricular Tachycardia (V-Tach) There can be cardiac output, depending on if there's a pulse. Always check: "Do you get a pulse with that?" Treatment for Ventricular tach and PVC? Amiodarone and lidocaine Treatment for arterial arrhythmias/superventricular tachycardia? ABCD's. What is the A? Adenosine/ADENOCARD ➤ FAST IV push (within 8 seconds or less)
➤ May pause the heart (asystole) briefly ➤ Use BIG vein Treatment for arterial arrhythmias/superventricular tachycardia? ABCD's. What is the B? Beta Blockers: ➤ End in - lol ➤ Slow the heart (watch for bradycardia) Treatment for arterial arrhythmias/superventricular tachycardia? ABCD's. What is the C? Calcium Channel Blockers: ➤ Like verapamil, diltiazem ➤ Lower heart rate and pressure Treatment for arterial arrhythmias/superventricular tachycardia? ABCD's. What is the D? Digitalis (Digoxin, Lanoxin): If someone ASYSTOLE what should you give? Epinephrine then Atropine What do chest tubes do? They restore negative pressure in the pleural space so your lungs can expand properly when you breathe. Chest Pressure Rules Negative pressure = GOOD ➤ Keeps lung layers (visceral + parietal pleura) stuck together ➤ Makes breathing easy and effective
Positive pressure = BAD ➤ Pushes pleura apart ➤ Causes lung collapse or less air in = more work to breathe Why is a chest tube needed for pneumothorax? Chest tube to remove air Why is a chest tube needed for Hemothorax? chest tube to remove blood Why is a chest tube needed for Pneumo-hemo thorax? chest tube removes both air and blood What are the location of tube placement and why? Apical (Pneumo) : chest tube is way up high → draining air because air rises
Basilar (Apical) : chest tube is at bottom of lungs → draining blood because it is subject to gravity What are the four defects of Tetralogy of Fallot? Very Poor Oxygen Return
- VD → ventricular defect
- PS → pulmonary stenosis
- OA → overriding aorta
- RH → right hypertrophy Contact Precautions means?
PH = 7.50 ⬆️
Bicarb (HCO3) = 30 ⬆️
Metabolic alkalosis
PH = 7.21 ⬇️ Bicarb (HCO3) 38⬆️
Respiratory Acidosis
PH = 7.50 ⬆️ Bicarb (HCO3) 25 normal
Respiratory alkalosis
As the PH goes up so does my patient expect for potassium (kalemia)
Alkalosis
Hyperreflexia
Irritability
Tachypnea
Tachycardia
Borborygmi (Gurgling)
Seizures *need suction
HYPOkalemia
As the PH goes down so does my patient expect for potassium (kalemia)
ACIDOSIS
Headache
Hyporeflexia
Bradycardia
Bradypnea
Paralytic/adynamic ileus
Coma
Respiratory arrest *need ambu bag
MACkussmau's (ONLY METABOLIC
ACIDOSIS → "MAC")
Heart block
HYPERkalmia
If a question ask about a lung scenario it is pertaining to? Metabolic or Respiratory
Respiratory
Causes for respiratory alkalosis.
- Pregnant woman hyper ventilating - ventilator setting is too high
Causes for respiratory acidosis
- Emphysema
- Drowning
- Pneumonia
- PCA pump (toxicity)
- Ventilator setting is TOO LOW.
If a question is NOT asking about a lung scenario it is pertaining to? Metabolic or Respiratory
Metabolic
Causes for metabolic alkalosis
- Prolong suctioning or vomiting
- Surgery with NG tube suction for three days
- Hyperemesis gravidum (Hyper...Emesis/Vomiting Gravidum/pregnant)
Causes for Metabolic Acidosis
- Acute RF (renal failure)
- Infantile diarrhea
- 3rd degree burns over 60% of body
- Hyperemesis gravidum with dehydration
NOTE: Always pay attention to MODIFYING PHRASE rather than original statement.
Vomiting vs Diarrhea Alkalosis or Acidosis
Vomiting = Alkalosis Diarrhea = Acidosis
PH normal range?
7.35-7.
Denial. It is #1 because how can you treat someone who can't admit that they have a problem?
Stages of Grief? Do All Birds Die Alone?
•Do = Denial •All = Anger •Birds = Bargaining •Die = Depression •Alone = Acceptance
Dependency vs. Codependency define
Dependency avoid responsibility by making others do things. Codependency feel good about themselves by helping—even when it's not healthy.
What are alcoholic deficient of?
Vitamin B1 (Thiamine)
Amnesia mean
Memory loss
What is the #1 most abused class of drug that is not an upper or downer?
Laxatives in the elderly.
UPPERS addiction: THERE ARE FIVE (MC CAP)
- Methamphetamines/Amphetamines (crystal meth, pseudopheds, etc.)
- Caffeine
- Cocaine
- Adderol (ADD drug)
- PCP/LSD/Mushrooms (psychedelic hallucinogen)
DOWNERS addiction: THERE ARE 135.
Every drug that's not an UPPER.
What to check for when it comes to upper medication versus downers medication?
UPPERS = Seizure Risk → Check reflexes DOWNERS = Respiratory Depression → Check RR
Difference between overdose and withdrawal
Overdose = you have too much
Withdrawal = you don't have enough
You can overdose on what but intoxication on the other?
You can overdosed on upper but Intoxication on downer.
What happens when you overdose and intoxication?
Overdosed on upper → everything goes UP → pick the UP things.
Intoxication on downer → everything goes DOWN → pick the DOWN things.
What happens with withdrawal on upper and downer : You don't have enough
Withdrawal downer → you don't have enough downer → pick the UP things.
Withdrawal upper → you don't have enough upper → pick the DOWN things.
Which two situations would respiratory arrest be of concern? Downer vs Upper
Downer overdose Upper withdrawal
Which two situations would seizure be biggest risk? Upper vs Downer
Upper overdose Downer withdrawal
UPPER overdose, think: "HOT, FAST, LOUD, TIGHT"
- Hot: ↑ temp
- Fast: ↑ HR, RR, reflexes
- Loud: Talkative, irritable
- Tight: Muscle tension, risk of seizures
ALCOHOL WITHDRAWAL SYNDROME (AWS) when does it start?
When = Begins within 24 hours after stopping drinking.
ALCOHOL WITHDRAWAL SYNDROME (AWS) Severity?
Severity = Not life-threatening.
ALCOHOL WITHDRAWAL SYNDROME (AWS) Danger status?
Danger = Not dangerous to self or others.
ALCOHOL WITHDRAWAL SYNDROME (AWS) Diet status?
Diet = Regular diet.
- Septic shock
- Burns over 85% of body
How to recognize Aminoglycosides
Most end in "-mycin" BUT...Not all "-mycins" are aminoglycosides!
If it ends in "THROmycin," it's NOT a mean old mycin.
- Zithromycin - NOT
- Clarithromycin - NOT
- Azithromycin - NOT
These are for regular infections, not the serious kind.
nephrotoxicity
- Creatinine is THE best indicator of kidney function (do not go for U/O, BUN) 24 hr creatinine clearance is BETTER than serum creatinine
- Serum creatinine comes next over anything else
What are the top 2 oral bowel sterilizers?
NEOMYCIN and CANOMYCIN
Who CAN sterilize my bowel?
NEO CAN.
What's the peak time of SL medication?
5 - 10 minutes after drug dissolved
What's the peak time of IM medication?
30 - 60 minutes after injected.
Choose 60 minutes, if both options given.
What's the peak time of IV medication?
15 - 30 minutes after drug is finished, not when you hang it.
CALCIUM CHANNEL BLOCKERS CCB are like Valium for the heart. What does Valium do?
VALIUM Calms you down.
What does calcium channel blockers due to the heart?
Calm the heart
Calcium channel blocker treats? 3A's
Anti-hypertensive - lowers blood pressure Anti-anginal - helps chest pain (less oxygen needed) Atrial Arrhythmias - any rhythm problem that starts above the ventricles
Common side effects of calcium channel blockers?
Headache - due to blood vessel dilation in the brain
Hypotension - because blood vessels relax and widen
Always check BP before giving - Hold if systolic BP is 100 or less
Common calcium channel blockers medication?
- dipine (e.g., nifedipine, amlodipine)
- Has to be Dipine not PINE
What is the term for drug abuse in newborn?
intoxication not withdrawal at birth.
When will it be intoxication VS withdrawal in a newborn?
Within 24 hours = intoxication After 24 hours = withdrawal
Caring for infant born to an addicted mom. 24 hours after birth, what are some common signs to look for in the baby? (Don't Let Every Reaction Scare Smalls)
- Difficult to console
- Low core body temp
- Exaggerated startle reflex
- Respiratory depression
- Seizure risk
- Shrill high-pitched cry
Cardiac arrhythmia QRS are? P WAVE are?
QRS: VENTRICULAR P WAVE: ATRIAL
Cardiac arrhythmia A lack of QRS's equal and are?
Treatment for arterial arrhythmias/superventricular tachycardia? ABCD's. What is the A?
Adenosine/ADENOCARD
➤ FAST IV push (within 8 seconds or less)
➤ May pause the heart (asystole) briefly
➤ Use BIG vein
Treatment for arterial arrhythmias/superventricular tachycardia? ABCD's. What is the B?
Beta Blockers:
➤ End in - lol
➤ Slow the heart (watch for bradycardia)
Treatment for arterial arrhythmias/superventricular tachycardia? ABCD's. What is the C?
Calcium Channel Blockers:
➤ Like verapamil, diltiazem
➤ Lower heart rate and pressure
Treatment for arterial arrhythmias/superventricular tachycardia? ABCD's. What is the D?
Digitalis (Digoxin, Lanoxin):
If someone ASYSTOLE what should you give?
Epinephrine then Atropine
What do chest tubes do?
They restore negative pressure in the pleural space so your lungs can expand properly when you breathe.
Chest Pressure Rules
Negative pressure = GOOD ➤ Keeps lung layers (visceral + parietal pleura) stuck together
➤ Makes breathing easy and effective
Positive pressure = BAD
➤ Pushes pleura apart
➤ Causes lung collapse or less air in = more work to breathe
Why is a chest tube needed for pneumothorax?
Chest tube to remove air
Why is a chest tube needed for Hemothorax?
chest tube to remove blood
Why is a chest tube needed for Pneumo-hemo thorax?
chest tube removes both air and blood
What are the location of tube placement and why?
Apical (Pneumo) : chest tube is way up high → draining air because air rises
Basilar (Apical) : chest tube is at bottom of lungs → draining blood because it is subject to gravity
What are the four defects of Tetralogy of Fallot? Very Poor Oxygen Return
- VD → ventricular defect
- PS → pulmonary stenosis
- OA → overriding aorta
- RH → right hypertrophy
Contact Precautions means?
Pathogens spread by DIRECT contact or contaminated objects.
Contact Precautions Mnemonic: "My Roommate's Skin Was Extra Extra contagious!"
M - MRSA
R - RSV (Even though it's droplet spread, it's contact precaution in children due to surfaces/toys)
S - Skin infections (impetigo, Herpes Simplex, Zoster, Scabies)
W - Wound infections
E - Enteric infections (C. diff, Hep A, cholera)
E - Eye infections (conjunctivitis
💦 Droplet Precautions 💦 means?
Pathogens that travel up to 3 feet via droplets (cough/sneeze)
💦 Droplet Precautions 💦 Mnemonic: "SPIDERMAn"
