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MNEMONICS FOR NURSES 0 9HYPERNATREMIA
FRIED SALTF - Fever (low), flushed skinR- Restless (irritable)I - Increased fluid retention & increased BPE - Edema (peripheral and pitting)D - Decreased urinary output, dry mouth
SALTS - Skin flushedA - AgitationL - Low-grade feverT - Thirst
HYPERKALEMIA - Signs & SymptomsMURDERM - Muscle weaknessU - Urine, oliguria, anuriaR- Respiratory distressD - Decreased cardiac contractilityE - ECG changesR- Reflexes, hyperreflexia, or areflexia (flaccid)
HYPERKALEMIA - Causes
MACHINEM - Medications - ACE inhibitors, NSAIDSA - Acidosis - Metabolic and respiratoryC - Cellular destruction - Burns, traumatic injuryH - Hypoaldosteronism/ hemolysisI - Intake - ExcessiveN - Nephrons, renal failureE - Excretion - Impaired
HYPOCALCEMIACATSC - Convulsions
A - ArrhythmiasT - TetanyS - Spasms and stridor
BLEEDING - S/SxBEEPB - Bleeding gumsE - Ecchymoses (bruises)
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P - Pulmonary EdemaP - Pulmonary Embolus
CARDIAC VALVES
"TRI before you BI":
Tricuspid valve is located in left heart and Bicuspid valve is located in right heart. Blood flowsthrough the tricuspid before bicuspid.
FEMORAL HERNIA
FEMoral hernias are more common in FEMales.
"TRY PULLING MY AORTA":
Tricuspid
Pulmonary
Mitral
Aorta
PLACENTA-CROSSING SUBSTANCES
"Want My Hot Dog":
Wastes
Antibodies
Nutrients
Teratogens
Microorganisms
Hormones/ HIV
Drugs
EMERGENCY MEDICINE
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ACTIVATED CHARCOAL: CONTRAINDICATIONSCHEMICAL CamP:Cyanide
Hydrocarbons
Ethanol
Metals
Iron
Caustics
Airway unprotected
Lithium
CAMphor
Potassium
IPECAC: CONTRAINDICATIONS
4 C's:
Comatose
Convulsing
Corrosive
hydroCarbon
ATRIAL FIBRILLATION: CAUSES OF NEW ONSET
THE ATRIAL FIBS:
Thyroid
Hypothermia
Embolism (P.E.)
Alcohol
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Trauma (cardiac contusion)
Recent surgery (post CABG)
Ischemia
Atrial enlargement
Lone or idiopathic
Fever, anemia, high-output states
Infarct
Bad valves (mitral stenosis)
Stimulants (cocaine, theo, amphet, caffeine)
ENDOTRACHEAL TUBE DELIVERABLE DRUGS
O NAVEL:
Oxygen
Naloxone
Atropine
Ventolin (albuterol)
Epinephrine
Lidocaine
MALARIA: COMPLICATIONS OF FALCIPARUM MALARIA
CHAPLIN:
Cerebral malaria/ Coma
Hypoglycemia
Anaemia
Pulmonary edema
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Lactic acidosis
Infections
Necrois of renal tubules (ATN)
MI: IMMEDIATE TREATMENT
DOGASH:
Diamorphine
Oxygen
GTN spray
Asprin 300mg
Streptokinase
Heparin
PAIN HISTORY CHECKLIST
OLDER SAAB:
Onset
Location
Description (what does it feel like)
Exacerbating factors
Radiation
Severity
Associated symptoms
Alleviating factors
Before (ever experience this before)
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SHOCK: SIGNS AND SYMPTOMS
TV SPARC CUBE:
Thirst
Vomiting
Sweating
Pulse weak
Anxious
Respirations shallow/rapid
Cool
Cyanotic
Unconscious
BP low
Eyes blank
SUBARACHNOID HEMORRHAGE (SAH) CAUSES
BATS:
Berry aneurysm
Arteriovenous malformation/ Adult polycystic kidney disease
Trauma (eg being struck with baseball bat)
Stroke
VENTRICULAR FIBRILLATION: TREATMENT
"Shock, Shock, Shock, Everybody Shock, Little Shock, Big Shock, Momma Shock, PoppaShock":
Shock= Defibrillate
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Everybody= Epinephine
Little= Lidocaine
Big= Bretylium
Momma= MgSO4
Poppa= Pocainamide
VFIB/VTACH DRUGS USED ACCORDING TO ACLS
"Every Little Boy Must Pray":
Epinephrine
Lidocaine
Bretylium
Magsulfate
Procainamide
DIABETIC KETOACIDOSIS MANAGEMENT
KING UFC:
K+ (potassium)
Insulin (5u/hour. Note: sliding scale no longer recommended in the UK)
Nasogastic tube (if patient comatose)
Glucose (once serum levels drop to 12)
Urea (check it)
Fluids (crytalloids)
Creatinine (check it)/ Catheterize
NEUROLOGICAL FOCAL DEFICITS
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10 S's:
Sugar (hypo, hyper)
Stroke
Seizure (Todd's paralysis)
Subdural hematoma
Subarachnoid hemorrhage
Space occupying lesion (tumor, avm, aneurysm, abscess)
Spinal cord syndromes
Somatoform (conversion reaction)
Sclerosis (MS)
Some migraines
COMA: CONDITIONS TO EXCLUDE AS CAUSE
MIDAS:
Meningitis
Intoxication
Diabetes
Air (respiratory failure)
Subdural/ Subarachnoid hemorrhage
MALIGNANT HYPERTHERMIA TREATMENT
"Some Hot Dude Better Give Iced Fluids Fast!" (Hot dude = hypothermia):
Stop triggering agents
Hyperventilate/ Hundred percent oxygen
Dantrolene (2.5mg/kg)
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Bicarbonate
Glucose and insulin
IV Fluids and cooling blanket
Fluid output monitoring/ Furosemide/ Fast heart [tachycardia]
RESUSCITATION: BASIC STEPS
ABCDE:
Airway
Breathing
Circulation
Drugs
Environment
RLQ PAIN: DIFFERENTIAL
APPENDICITIS:
Appendicitis/ Abscess
PID/ Period
Pancreatitis
Ectopic/ Endometriosis
Neoplasia
Diverticulitis
Intussusception
Crohns Disease/ Cyst (ovarian)
IBD
Torsion (ovary)
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Irritable Bowel Syndrome
Stones
Acid-base"ROME" (Respiratory Opposite, Metabolic Equal)
Acidosis
Respiratory (opposite): pH Pco2
Metabolic(equal): pH HCO3
Alkalosis
Respiratory (opposite): pH Pco2
Metabolic(equal): pH HCO3
Alcohol withdrawal: clinical features"HITS"
Hallucinations (visual, tactile)
Increased vital signs and insomnia
Tremens delirium tremens (potentially lethal)
Shakes/ Sweats/ Seizures/ Stomach pains (nausea, vomiting)
Angina: precipitating factors"4E's"
Eating
Emotion
Exertion (Exercise)
Extreme Temperatures (Hot or Cold weather)
Anorexia nervosa: clinical features"ANOREXIC"
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Adolescent women/ Amenorrhea
NGT alimentation (most severe cases)
Obsession with losing weight/ becoming fat though underweight
Refusal to eat (5% die)
Electrolyte abnormalities (e.g., K+, cardiac arrhythmia)
X - ercise
Intelligence often above average/ Induced vomiting
Cathartic use (and diuretic abuse)
Appendicitis: assessment"PAINS"
Pain (RLQ)
Anorexia
Increased temperature, WBC (15,00020,000)
Nausea
Signs (McBurney's, Psoas)
Neurovascular Occlusion: symptoms "6 P's"
Pain
Pale
Pulseless
Paresthesia
Poikilothermic
Paralysis
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Blood glucose (rhyme)
Symptom Implication
Cold and clammy . . . give hard candy
Hot and dry . . . glucose is high
Blood vessels in umbilical cord"AVA" (2 arteries and 1 vein)
Artery
Vein
Artery
Cholecystitis: risk factors"5F's"
Female
Fat
Forty
Fertile
Fair
Cleft lip: nursing care plan (postoperative)"CLEFT LIP"
Crying, minimize
Logan bow
Elbow restraints
Feed with Brecht feeder
Teach feeding techniques; two months of age (average age at repair)
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Liquid (sterile water), rinse after feeding
Impaired feeding (no sucking)
Positionnever on abdomen
Cognitive disorders: assessment of difficulties"JOCAM"
Judgment
Orientation
Confabulation
Affect
Memory
Coma: causes"A-E-I-O-U TIPS"
Alcohol, acidosis (hyperglycemic coma)
Epilepsy (also electrolyte abnormality, endocrine problem)
Insulin (hypoglycemic shock)
Overdose (or poisoning)
Uremia and other renal problems
Trauma; temperature abnormalities (hypothermia, heat stroke)
Infection (e.g., meningitis)
Psychogenic ("hysterical coma")
Stroke or space-occupying lesions in the cranium
Complication of severe preeclampsia"HELLP" syndrome
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Hemolysis
Elevated Liver enzymes
Low Platelet count
Cushing's syndrome: symptoms"3S's"
Sugar (hyperglycemia)
Salt (hypernatremia)
Sex (excess androgens)
Diabetes: signs and symptoms"3P's,"
Polydipsia (very thirsty)
Polyphagia (very hungry)
Polyuria (urinary frequency)
Diet: low cholesterolavoid the "3C's"
Cake
Cookies
Cream (dairy, e.g., milk, ice cream)
Dystocia: etiology"3P's"
Power
Passageway
Passenger
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Dystocia: general aspects (maternal)"3P's"
Psych
Placenta
Position
Episiotomy assessment"REEDA"
Redness
Edema
Ecchymosis
Discharge
Approximation of skin
Eye medications
Mydriatic = dilated pupils
Miotic = tiny (constricted) pupils
Hypertension: complications"4 C's"
CAD (coronary artery disease)
CHF (congestive heart failure)
CRF (chronic renal failure)
CVA (cardiovascular accident; now called brain attack or stroke)
Hypertension: nursing care plan "I-TIRED"
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Intake and output (urine)
Take blood pressure
Ischemia attack, transient (watch for TIAs)
Respiration, pulse
Electrolytes
Daily weight
Hypoglycemia: signs and symptoms"DIRE"
Diaphoresis
Increased pulse
Restless
Extra hungry
Infections during pregnancy"TORCH"
Toxoplasmosis
Other (hepatitis B, syphilis, group B beta strep)
Rubella
Cytomegalovirus
Herpes simplex virus
IUD: potential problems with use"PAINS"
Period (menstrual: late, spotting, bleeding)
Abdominal pain, dyspareunia
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Infection (abnormal vaginal discharge)
Not feeling well, fever or chills
String missing
Manipulation: nursing planpromote the "3C's"
Cooperation
Compromise
Collaboration
Medication administration"six rights"
RIGHT medication
RIGHT dosage
RIGHT route
RIGHT time
RIGHT client
RIGHT technique
Melanoma characteristics"ABCD"
Asymmetry
Border
Color
Diameter
Mental retardation: nursing care plan"3R's"
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Regularity (provide routine and structure)
Reward (positive reinforcement)
Redundancy (repeat)
Myocardial infarction: treatment"MONA"
Monitor/ Morphine
Oxygen
Nitroglycerin
Aspirin
Newborn assessment components"APGAR"
Appearance
Pulse
Grimace
Activity
Respiratory effort
Obstetric (maternity) history"GTPAL"
Gravida
Term
Preterm
Abortions (SAB, TAB)
Living children
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Oral contraceptives: signs of potential problems"ACHES"
Abdominal pain (possible liver or gallbladder problem)
Chest pain or shortness of breath (possible pulmonary embolus)
Headache (possible hypertension, brain attack)
Eye problems (possible hypertension or vascular accident)
Severe leg pain (possible thromboembolic process)
Pain: assessment"PQRST"
What Provokes the pain?
What is the Quality of the pain?
Does the pain Radiate?
What is the Severity of the pain?
What is the Timing of the pain?
Pain: management"ABCs"
Ask about the pain
Believe when clients say they have pain
Choiceslet clients know their choices
Deliver what you can, when you said you would
Empower/Enable clients' control over pain
Postoperative complications: order"4W's"
Wind (pulmonary)
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Wound
Water (urinary tract infection)
Walk (thrombophlebitis)
Preterm infant: anticipated problems"TRIES"
Temperature regulation (poor)
Resistance to infections (poor)
Immature liver
Elimination problems (necrotizing enterocolitis [NEC])
Sensory-perceptual functions (retinopathy of prematurity [ROP])
Psychotropic medications: common antidepressives (tricyclics)
"VENT"
Vivactil
Elavil
Norpramin
Tofranil
Schizophrenia: primary symptoms"4A's"
Affect
Ambivalence
Associative looseness
Autism
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Sprain: nursing care plan"RICE"
Rest
Ice
Compression
Elevation
Stool assessment"ACCT"
Amount
Color
Consistency
Timing
Tracheoesophageal fistula: assessment"3Cs"
Coughing
Choking
Cyanosis
Traction: nursing care plan"TRACTION"
Trapeze bar overhead to raise and lower upper body
Requires free-hanging weights; body alignment
Analgesia for pain, prn
Circulation (check color and pulse)
Temperature (check extremity)
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Infection prevention
Output (monitor)
Nutrition (alteration related to immobility)
Transient ischemic attacks: assessment"3Ts"
Temporary unilateral visual impairment
Transient paralysis (one-sided)
Tinnitus = vertigo
Trauma care: complications"TRAUMA"
Thromboembolism; Tissue perfusion, altered
Respiration, altered
Anxiety related to pain and prognosis
Urinary elimination, altered
Mobility impaired
Alterations in sensory-perceptual functions and skin integrity (infections)
Wernicke-Korsakoff syndrome (alcohol-associated neurologicaldisorder)"COAT RACK"
Wernicke's encephalopathy (acute phase)
clinical features:
Confusion
Ophthalmoplegia
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Ataxia
Thiamine is an important aspect of Tx
Korsakoff's psychosis (chronic phase)
characteristic findings:
Retrograde amnesia (recall of some old memories)
Anterograde amnesia (ability to form new memories)
Confabulation
Korsakoff's psychosis
SIGNS OF CANCER
Change in bowel /bladder habits
A sore that doesnt heal
Unusual bleeding/ Discharge
Thickening of lump breast or elsewhere
Indigestion/ Dysphagia
Obvious change in wart/ mole
Nagging cough/ hoarseness
Unexplained anemia
Sudden weight loss
FOCUS OF PATIENT CARE IN CLIENTS WITH CANCER
Chemotherapy
Assess body image disturbance (related to alopecia)
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Nutritional needs when N/V present
Comfort from pain
Effective response to Tx? (Evaluate)
Rest (for patient and family)
Basic MI management - "BOOMAR"
Bed rest
Oxygen
Opiate
Monitoring
Anticoagulation
Reduce clot size
To Remember Immunoglobulins - "GAMED"
IgG
IgA
IgM
IgE
IgD
Location of the heart valve from right to left -"A Permanently Temperamental
Man"
Aortic
Pulmonary
Tricuspid
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Mitral
"Cut C4, breathe no more"
The 3rd, 4th and 5th cervical spinal nerves innervate the diaphragm.
Types of Joint movements - "FEEDPIPE CARDSHARP"
Flexion
Extension
Eversion
Dorsiflexion
Pronation
Inversion
Plantarflexion
Elevation
Circumduction
Abduction
Rotation
Depression
Supination
Hyperextension
Adduction
Retraction
Protraction
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Cranial Nerves - "Oh Ohh Ohhh To Try And Fit A Gold Velvet SoHeavenly"
Olfactory CN I
Optic CN II
Occulomotor CN III
Trochlear CN IV
Trigeminal CN V
Abducens CN VI
Facial CN VII
Auditory CN VIII
Glasopharyngeal CN IX
Vagus CN X
Spinal/Accessory CN XI
Hypoglossal CN XII
"Point and Shoot!"
For remembering that Parasympathetics are involved with erection andSympathetics with ejaculation.
Layers of the scalp - "SCALP"
Skin
Connective tissue
Aponeurosis
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Loose areolar tissue
Pericranium
Carpal bones of the hand (lateral to medial) - "She Looks Too Proud,
Try To Chase Her"
Proximal row:
Scaphoid
Lunate
Triquetrum
Pisiform
Distal row:
Trapezium
Trapezoid
Capitate
Hamate
Viruses causing diarrhea - "ACNE CAR"
Adeno virus
Corana virus
Norwak virus
Entero virus
Calci virus
Astro virus
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Rota virus
The Krebs cycle - "Can I Actually See Some Filipina Mothers"
Citrate
Isocitrate
alpha Ketoglutarate
Succinyl CoA
Succinate
Fumarate
Malate
Oxaloacetate
Stages of mitosis/meiosis including interphase as a phase - "In
Philippines, Men Are Talented"
Interphase
Prophase
Metaphase
Anaphase
Telophase
Order of prevalence of White Blood Cells, most prevalent to least -"Never Let Monkeys Eat Bananas"
Neutrophils
Lymphocytes
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Monocytes
Eosinophils
Basophils
10 essential amino acids - "PVT. TIM HALL"
Phenylalanine
Valine
Tryptophan
Threonine
Isoleucine
Metheonine
Histidine(semi-essential)
Arginine(semi-essential)
Leucine
Lysine
Uses of Chloroquine (other than malaria) - "RED LIP"
Rheumatoid arthritis
Extra intestinal amoebiasis
Discoid lupus erythematosus
Lepra reaction
Infectious mononucleosis
Photogenic reactions
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Bronchodilators - "TO A SIS"
Terbutaline
Orciprenaline
Adrenaline
Salbutamol
Isoprenaline
Salmeterol
Signs of cor pulmonale - "Please Read His Text"
Peripheral edema
Raised JVP
Hepatomegaly
Tricuspid incompetence
Portal hypertension features - "ABCDE"
Ascites
Bleeding (hematemesis, piles)
Caput medusae
Diminished liver
Enlarged spleen
Key questions needed in an emergency history taking situation -"AMPLE"
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Allergies
Medication
Past medical history
Last meal
Events and environment related to injury
Malignancies that metastisize to bone - "Laging Panalo Kung TagaBulacan"
Lung
Prostat
Kidney
Thyroid
Breast
Six "S" in Scarlet Fever
Streptococci causal organism
Sorethroat
Swollen tonsils
Strawberry tongue
Sandpaper rash
miliarySudamina vesicles over hands, feet, abdomen
Signs of anti-cholinergic crisis - "SLUD"
Salivation
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Lacrimation
Urination
Defecation
Causes of huge spleen - "3M's"
Myelofibrosis
Malaria
Myelogenous leukemia
Cardinal Symptoms of Parkinson's Disease - "TRAP"
Tremor
Rigidity
Akinesia and bradykinesia
Postural Instability
Days of appearance of rashesVaricella(chickenpox) - "Very Sick
Patients Must Take Double Exercise"
1st dayScarlet fever
2nd dayPox(smallpox)
3rd dayMumps
4th dayTyphus
5th dayDengue
6th dayEnteric fever(typhoid)|
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SHOCK HYPOTACHYTACHY
HYPOTENSION
TACHYPNEA
TACHYCARDIA
INCREASE ICP HYPERBRADYBRADY
CUSHINGS TRIAD:
HYPERTENSION (WIDE PULSE PRESSURE)
BRADYCARDIA
BRADYPNEA
HYPOGLYCEMIA
TREMORS, TACHYCARDIA
IRRITABILITY
RESTLESSNESS
EXTREME
DIAPHORESIS
EARLY SIGNS OF HYPOXIA
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RESTLESSNESS
AGITATION
TACHYCARDIA
LATE SIGNS OF HYPOXIA
BRADYCARDIA
EXTREME RESTLESSNESS
DYSPNEA
CYANOSIS
CONGESTIVE HEART FAILURE
DIGOXIN
MORPHINE
AMINOPHYLLINE
DOPAMINE
DIURETICS
O2
GASSES MONITOR (ABG)
MG SO4 TOXICITY
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BP DECREASE
URINE OUTPUT DECREASE
RESPIRATORY RATE DECREASE
PATELLAR REFLEX ABSENT
SICKLE CELL DISEASE
HYDRATION
OXYGENATION
PAIN
INFECTION
AVOID HIGH PLACES
PREGNANCY INDUCED HYPERTENSION
HEMOLYSIS
ELEVATED LIVER ENZYMES
LOW
PLATELETS
GI SYMPTOMS AND TOXICITY TO DIGOXIN
VOMITTING
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ANOREXIA
NAUSEA
DIARRHEA
ABDOMINAL PAIN
FRACTURE
PRESSURE
REST
ICE
COMPRESSION
ELEVATION
TETRALOGY OF FALLOT
DISPLACED AORTA
RIGHT VENTRICULAR HYPERTROPHY
OPENING INTO THE SEPTUM (VSD)
PULMONARY STENOSIS
HYPOKALEMIA
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SKELETAL MUSCLE WEAKNESS
U-WAVE ON ECG
CONSTIPATION
TOXICITY TO DIGOXIN
IRREGULAR WEAK PULSE
OTOSTASIS
NUMBNESS PARESTHESIA
PAIN ASSESSMENT
PROVOCATION
QUALITY
RADIATION, RELIEF
SEVERITY
TIME
NEUROVASCULAR CHECK
PAIN
PULSELESSNESS
PARESTHESIA
PARALYSIS
PALLOR
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VIRCHOWS TRIAD IN DVT
VENUS STASIS
DAMAGE TO VESSELS
HYPERCOAGUABILITY
ABDOMINAL AORTIC ANEURISM (4A)
ASSYMPTOMATIC
ABDOMINAL MASS
ABDOMINAL PULSE
ACHES LOW BACK
ANTI TB DRUGS AND SIDE EFFECTS
RIFAMPICIN RED-ORANGE URINE
ISONIAZID PERIPHERAL NEURITIS
PYRAZINAMIDE INCREASE URIC ACID
ETHAMBUTOL EYE PROBLEMS
STREPTOMYCIN OTOTOXIC
USE STRAW BECAUSE THESE DRUGS STAIN THE TEETH
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L - LUGOL'S SOLUTION
I - IRON
N - NITROFURANTOIN
T - TETRACYCLINE
LR6 -LATERAL RECTUS : CN6
SO4 - SUPERIOR OBLIQUE : CN4
ALL3 -ALL THE REST : CN3
RADIATION TX VIA:
MUSTARD
ESTROGEN
NITROGEN
STEROIDS
ANTIBIOTICS
DILUTE DECREASE OSMOLALITY