Physiological Adaptation: NCLEX Cheat Sheets

Abdominal Aortic Aneurysm (AAA)Pulsatile mass → rupture = fatal Abruptio PlacentaePAINFUL dark bleeding + rigid uterus AcromegalyExcess GH in adults Acute GlomerulonephritisPost-strep, tea-colored urine Acute Kidney InjurySudden ↓GFR, often reversible Acute Pancreatitis↑ lipase/amylase + epigastric pain Acute Respiratory FailurePaO2 <60 or PaCO2 >50 Acute Stroke Recognition (FAST)Time is brain — note onset Addison Disease (Adrenal Insufficiency)↓ cortisol → ↓ Na, ↑ K, hypotension Adrenal CrisisAcute cortisol deficiency = shock Alcohol Withdrawal (DTs)DTs peak 48–72 hrs, fatal Ammonia Level↑ = hepatic encephalopathy Amniotic Fluid EmbolismSudden collapse during labor Amputation CareHemorrhage = #1 early risk Amyotrophic Lateral SclerosisMotor neuron death, mind intact AnaphylaxisEpinephrine IM = first drug Anaphylaxis ManagementEpinephrine IM first-line Anesthesia RecoveryAirway first in PACU Angina PectorisChest pain, no muscle death Aortic StenosisTriad: angina, syncope, dyspnea APGAR ScoringScore at 1 and 5 min; max 10 AppendicitisRLQ McBurney's point pain ARDSRefractory hypoxemia Arterial Blood Gas InterpretationpH 7.35-7.45 normal Arterial Blood Gas SamplingAllen test, ice, pressure 5min AsthmaReversible airway narrowing AtelectasisCollapsed alveoli → ↓ gas exchange Atrial FibrillationIrregular, no P waves Autonomic DysreflexiaInjury ≥T6: severe HTN + headache Bacterial MeningitisNuchal rigidity + fever = droplet Basic Metabolic PanelNa K Cl CO2 BUN Cr Glu Ca Bell PalsyCN VII → one-sided facial droop Benign Prostatic HyperplasiaEnlarged prostate, weak stream Blood Transfusion ReactionSTOP transfusion → saline first Bone Marrow BiopsyIliac crest, pressure after Bowel ObstructionNo stool/flatus, distension Brain Tumor↑ICP from mass effect Breast CancerNew painless breast lump Bronchiolitis (RSV)Wheezing infant < 2 yrs Burns and Rule of NinesAirway first, then fluids Burns Emergency CareAirway first, then fluids Cardiac Arrest and CPR BasicsPush hard 100-120/min Cardiac Biomarkers (troponin/BNP)Troponin = MI; BNP = HF Cardiac CatheterizationCheck pulses, lie flat after Cardiac TamponadeFluid compresses heart Cardiogenic ShockPump failure → ↓ CO CataractsCloudy lens, blurred vision Cauda Equina SyndromeSurgical emergency <48h Celiac DiseaseGluten → villi destruction CellulitisSpreading skin infection Cerebral Aneurysm"Worst headache of life" Cesarean CareSurgical birth, abdominal Chest Tube ManagementDrains air/fluid, re-expands lung Choking and Airway ObstructionCan't cough/speak = abdominal thrusts CholecystitisRUQ pain + Murphy's sign Chronic Kidney DiseaseGFR <60 for >3 months Chronic Venous InsufficiencyStasis ulcers + brown skin CirrhosisScarred liver → portal HTN Cluster HeadacheSevere unilateral periorbital pain Colonoscopy PrepClear liquids + bowel cleanse Colorectal CancerColonoscopy at age 45 Compartment SyndromePain out of proportion = emergency Complete Blood CountWBC, Hgb, Hct, platelets ConcussionMild TBI, transient dysfunction COPDChronic airflow obstruction Creatinine and BUNKidney function markers Crohn DiseaseMouth→anus, skip lesions, transmural CroupBarky cough + inspiratory stridor CT with ContrastCheck renal + iodine allergy Cushing Syndrome↑ cortisol → ↑ Na, ↓ K, ↑ glucose Cystic FibrosisSweat chloride > 60 mEq/L Deep Vein ThrombosisClot in deep vein Detached RetinaCurtain over vision — emergency Diabetes InsipidusToo little ADH → massive dilute urine Diabetes Insipidus vs SIADHDI = dry, SIADH = soaked Diabetic Ketoacidosis (DKA)Glucose > 250, pH < 7.35 Disseminated Intravascular Coagulation (DIC)Clotting THEN bleeding everywhere DiverticulitisLLQ pain + fever DrowningRescue breaths first priority EclampsiaPreeclampsia + seizures Ectopic PregnancyTubal → unilateral pain + shock Electroconvulsive TherapyInduced seizure for severe depression EncephalitisBrain inflammation → altered LOC Enteral Tube FeedingVerify placement before each feed EpididymitisGradual scrotal pain + fever Epiglottitis4 D's — airway EMERGENCY Fat Embolism SyndromeLong-bone fx → petechiae + dyspnea Febrile SeizuresRapid temp rise, 6mo–5yr Fetal Heart Rate DecelerationsLate = bad; VEAL CHOP Fetal Heart Rate Monitoring BasicsBaseline 110-160 bpm Fluid Volume Deficit (dehydration)Fluid loss > intake Fluid Volume ExcessFluid intake > output Fracture5 P's = neurovascular check GERDWeak LES → acid reflux Gestational DiabetesScreen 24-28 wks OGTT Glaucoma↑IOP → optic nerve damage Gluten-Free DietNo wheat, barley, rye GoiterEnlarged thyroid gland GoutUric acid → big toe pain Graft-versus-Host DiseaseDonor cells attack host Guillain-Barre SyndromeAscending paralysis, watch breathing Hashimoto ThyroiditisAutoimmune hypothyroidism Heart Blocks (AV block)Impaired AV conduction Heart FailurePump fails → congestion Heat StrokeTemp > 104°F + no sweat HemodialysisAV fistula = lifeline, protect it Hemoglobin A1C3-month avg glucose HemophiliaX-linked, ↓ clotting factor Hemorrhage ControlDirect pressure first Hepatic Encephalopathy↑ ammonia → confusion, asterixis HepatitisA/E fecal-oral, B/C/D blood HIV/AIDSAIDS = CD4 < 200 cells Huntington DiseaseAutosomal dominant → chorea + dementia Hydatidiform MoleGrape-like cluster, huge hCG HydronephrosisUrine backup → kidney swelling HypercalcemiaCa+ > 10.5 mg/dL Hyperemesis GravidarumSevere vomiting → wt loss + ketones HyperkalemiaK+ > 5.0 mEq/L HypermagnesemiaMg²⁺ > 2.5 mEq/L HypernatremiaNa+ > 145 mEq/L Hyperosmolar Hyperglycemic State (HHS)Glucose >600, NO ketosis Hyperparathyroidism↑ PTH → ↑ Ca, ↓ phosphate HypertensionBP ≥ 130/80 mmHg Hypertensive CrisisBP > 180/120 → organ damage Hyperthyroidism (Graves Disease)↓ TSH, ↑ T3/T4 → hypermetabolic HypocalcemiaCa²⁺ < 9.0 mg/dL HypoglycemiaGlucose < 70 mg/dL HypokalemiaK+ < 3.5 mEq/L HypomagnesemiaMg²⁺ < 1.5 mEq/L HyponatremiaNa+ < 135 mEq/L Hypoparathyroidism↓ PTH → ↓ Ca, ↑ phosphate HypophosphatemiaPhos < 3.0 mg/dL Hypopituitarism↓ anterior pituitary hormones HypothermiaCore temp < 95°F (35°C) Hypothyroidism (Myxedema)↑ TSH, ↓ T3/T4 → hypometabolic Hypovolemic Shock↓ blood/fluid volume Immune Thrombocytopenic PurpuraPlatelets <100k, autoimmune Infective EndocarditisInfected heart valves/lining Inguinal HerniaGroin bulge w/ straining IntussusceptionCurrant-jelly stool = classic Iron-Deficiency AnemiaMicrocytic, ↓ferritin Kawasaki DiseaseCoronary aneurysm = top risk Leukemia↑↑ immature WBCs, ↓ everything else Liver Function TestsALT/AST = hepatocyte damage Low-Protein DietFor liver/kidney failure Low-Residue DietLow fiber, ↓bowel bulk Lumbar Drain CareDrains CSF, level at tragus Lumbar PunctureFetal position, lie flat after Lung CancerSmoking = #1 cause LymphomaPainless lymph node + B symptoms Macular DegenerationLoss of CENTRAL vision Meniere DiseaseVertigo + tinnitus + hearing loss MenopauseNo menses ×12 months Metabolic Acidosis↓ pH, ↓ HCO₃⁻ Metabolic Alkalosis↑ pH, ↑ HCO₃⁻ Migraine HeadacheUnilateral throbbing + photophobia Mitral Valve StenosisLA → LV obstruction → pulm congestion Multiple MyelomaPlasma cell cancer → bone + Ca↑ Multiple SclerosisDemyelination → relapse/remit Myasthenia Gravis↓ ACh receptors → weakness worse w/ use Myocardial InfarctionIschemic heart muscle death Nasogastric Tube Insertion and CareVerify placement → X-ray gold standard Necrotizing EnterocolitisPreterm gut emergency Neonatal JaundiceBili before 24h = pathologic Nephrolithiasis (kidney stones)Severe colicky flank pain Nephrotic SyndromeMassive proteinuria >3.5 g/day Newborn AssessmentNormal HR 110-160, RR 30-60 Opioid WithdrawalUncomfortable, NOT life-threatening Orthostatic Hypotension↓20 SBP standing → dizzy/fall OsteoarthritisAsymmetric, worse with use OsteomyelitisBone infection → fever + bone pain Otitis MediaMiddle ear infection Oxygen Delivery DevicesNasal cannula 1-6 L = 24-44% O2 ParacentesisDrain ascites from abdomen Parkinson Disease↓ dopamine → TRAP Pediatric DehydrationSunken fontanel = severe sign Pediatric Fluid Maintenance4-2-1 mL/kg/hr rule Peptic Ulcer DiseaseH. pylori + NSAIDs = ulcer PericarditisInflamed pericardial sac Peripheral Arterial Disease↓ arterial flow to limbs Peritoneal DialysisCloudy effluent = peritonitis Pernicious AnemiaB12 def → neuro damage PheochromocytomaAdrenal tumor → catecholamine surge Placenta PreviaPainless bright red bleeding Pleural EffusionFluid in pleural space PneumoniaLung infection, alveoli fill PneumothoraxAir in pleural space Polycystic Kidney DiseaseGenetic cysts → renal failure Polycystic Ovary SyndromeAnovulation + hyperandrogenism Polycythemia Vera↑↑ RBCs → thick blood Postoperative Atelectasis PreventionIS 10× per waking hour Postoperative CareAirway → breathing → circulation Postoperative IleusNo bowel sounds/flatus = ileus Postpartum Assessment (BUBBLE-HE)Fundus firm, midline, at umbilicus Postpartum HemorrhageAtony = #1 cause; firm fundus Potassium-Modified DietK+ normal 3.5-5.0 mEq/L PreeclampsiaBP ≥ 140/90 + proteinuria > 20 wk Pregnancy-Induced HypertensionBP ≥ 140/90 after 20 wks Preoperative CareConsent + NPO before OR Preterm LaborContractions 20-37 wks Prostate CancerMost common male cancer Pulmonary EdemaPink frothy sputum = hallmark Pulmonary EmbolismClot blocks lung artery PyelonephritisKidney infection + flank pain Pyloric StenosisProjectile vomit, olive mass Raynaud PhenomenonVasospasm → white-blue-red fingers Renal DietLow Na, K, phos, protein Respiratory Acidosis↓ pH, ↑ CO₂ (hypoventilation) Respiratory Alkalosis↑ pH, ↓ CO₂ (hyperventilation) Respiratory Distress Syndrome (newborn)Surfactant deficiency in preterm Rheumatic FeverPost-strep → damages heart valves Rheumatoid ArthritisSymmetric joints + morning stiffness Seizure DisorderSafety first → never restrain Sepsis and Septic ShockInfection → organ failure Sepsis RecognitionInfection + organ dysfunction Shock Recognition↓BP, ↑HR, ↓UO = shock SIADH (Syndrome of Inappropriate Antidiuretic Hormone)Too much ADH → dilutional ↓ Na Sickle Cell CrisisSickled RBCs → vaso-occlusion Spinal Cord InjuryC3-C5 keeps diaphragm alive Stages of Labor4 stages; full dilation = 10 cm Stevens-Johnson SyndromeStop drug — skin emergency Stroke (CVA)FAST → time = brain SuctioningSuction OUT only · ≤10-15 sec Superior Vena Cava SyndromeOncologic emergency, face swelling Systemic Lupus ErythematosusButterfly rash + multi-organ Tetralogy of Fallot4 defects → TET spells ThoracentesisDrain pleural fluid, sit up Thromboangiitis Obliterans (Buerger Disease)Smoking → small-vessel occlusion ThrombocytopeniaPlatelets < 150,000 Thyroid Storm (Thyrotoxic Crisis)Temp >104°F + tachycardia = emergency Tracheostomy CareKeep obturator + spare tube bedside Transient Ischemic AttackStroke signs <24h, NO infarct Trigeminal NeuralgiaCN V → stabbing facial pain Tumor Lysis Syndrome↑K ↑PO4 ↑uric acid, ↓Ca Ulcerative ColitisColon only, bloody diarrhea Umbilical Cord ProlapseCord before fetus = emergency Upper GI BleedHematemesis + melena = bleed Urinary Tract InfectionDysuria, frequency, urgency Varicose VeinsIncompetent valves → venous pooling Von Willebrand DiseaseMost common inherited bleed Wound Dehiscence and EviscerationOrgans out = cover sterile saline