MED END WITH

Statin-low LDL Sartin ACE

((bp)

ACE pril,ril,vil (CHF,MI) Zine - antipsychotic Osin alphaplocker BP Din

- GER

Dipin CCB ,MI, Trombos Parin

- Clott anticoagulan

Pam antianxiety Azoles antifugal Prazoles proton pum Triptan migrant

Normal Creatinin

.5-1.5mg/dl

BUN 10-20MG/DL Ritodrine = prevent preterm labor Methrotrexate

Med. For ectopic pregnancy

*BLOOD SUGAR LEVEL MORE THAN 140 mg/dl confirms diabetes. Mitral valve disease = sore throat

Cushings syndrom

= hyperseecretion of glucoxorticoids adrenal gland. Obese, moon face, buflo hump, hirsutism. Lab: high Na+, hypertension hyperglyceimia, low K+ Diet: high K+, Low Na+

Parkinsons disease = progressive neurologic disorder effect brain center responsible

for control movement due to depletion of dopamine( risk for injury) High protein . safety no high heel, rubber soled shoes

Chronic Renal failure

= med Epogen, diuretic, antihypertension . low Na, k+, protein, anorecia, n, v

Angina pectoris

= insufficient coronary blood flow result inadequate o2 cause chest pain, squeezing burning, bursting left ternal chest pain, headach, face flushing Lab: st segmen depression Med: nitroglycerine

CHF CONGESTIVE heart failure : fail o2 heart cant pump properly

*Right side = edema *Left side = dyspnea. Hight Na+ and colesterol

PTCA = PERCUTANEOUS TRANSLUMINAL CORONARY ANGIOPLASTY balloon tipple catheter wire into coronary vessel Deverticulitis
= inflame pouch or saccula colon. LLQ PAIN Lab: sigmoidoscopy Med: meperidine

Raynauds disease = vasospastict of artery of hand expose to cold or stress,

anteriolar vasoconstriction Allens test reveal circulatory problem, avoid cold, smoke Med: vasodilator

Peptic ulcer, gastric

= weak gastric mucosa left epigastric pain 30mn-1h after meal, relieve by vomit . Hight carb, fat. Low Protein, no coffee, alcohol, smoke

Peripheral vascular disorder( refer to Buerger disease and Rynauds disease)PKU

phenylketonuria. *deficiency of phenylalanine hydroxylase result decrease metabolism of aminoacid pheylalanine lead to mental retard. Observe: for diarrhea, anorexia, anemia, skin rash, lethargy. Guthrie test phenylalanine greater than 8mg/dl = positive metabolic disorder. Highe protein 24-48 hrs before test, restrict hight protein diet.

Chrons disease = inflame small intestine. Hight protein, carb, Low fat, small
frequent feed

PDA = PT. ductus arteriosus

= acyanotic congenital heart defect, between aorta and pulmonary artery .Med: Indomethacin

PID pelvic inflammatory disease

=infection fallopian tubes , ovary, uterus, peritoneum , STD infection

*heating pad on abdomen or low back to inc. circulation

Peptic ulcer duodenal: high hydrochloric acid in stomach right epigastric pain
2-3hrs after meals usually at night and relieve by eating *Low protein, hight carb and fat, no spicy , caffee, alcohol, smoke

Appendicitis : inflame appendix due to obstruct

intestinal lumen. Right lower pain

Lab: elevate WBC (Pt. high fowler) no hot compression. Med antibioticnemia

A pernicious: low B12 absorbtion absence intrinsic factor relat to gastrectomy and
atrophy gastric mucosa. Fatigue, red tongue, glositis, tingling sensation low extremities Lab: chilling test ingest b12

Cystitis = inflame urinary bladder. No bubble bath, silk underwear Cystic fibrosis = block exocrine gland 9pancrease, respiratory, saliva, and sweat gland)
Lab: sweat chloride test *Postural drainage before meal and bed time Diet : high calory , K+

DIC = disseminate intravascular coagulation = spread coagulation all over

the body resulting subsequent depletion of clotting factor

Giardiasis = barre syndrome = inflame peripheral nerve

Lab: elevat total protein *avoid crow, deep tracheostomy @@ bedside

Pelvic

= use to relieve back pain, position head of bed elevate

X linked recessive pattern of transmission color blindness, duchennes muscular dystrophy, G6PD DEFICIENCY, HEMOPHILIA.

Urinalysis = first void in the morning sample preferred 15ml.

*decrease specific gravity =diabetes, dehydration. *+ protein PIH nephritic syndrome. *+glucose diabetes, infection

Sputum examp : to detects microorganism in the sputum. First in the morning specimen
prefer approximately 15ml. Instruct Pt. take several deep breath and cough deeply, rinse mouth with water before collect

Stool analysis: assess of bacteria, virus, malabsorption and blood.

Avoid aspirin, red meat

and Vit. C three days before test as these may give a false positive result

Thoracentesis : aspirat fluid and air from pleural space. Informed consent, Pt. sitting on the
side of the bed with feet on a chair, leaning over bedside table, Pt not cough breath deeply or move during procedure. After Pt on the unaffected side/ puncture site up

Tonometry: measures intraocular pressure, normal reading 12-21mm.Hg. Reading

25mm.hg indicates glaucoma

Schillings test: used to detect Vit. B12

absorption, excretion 8%-40% of ingest

radioactive Vit. B12 within 23hrsis normal. Requires 24hrs urine specimen Pt. NPO only water 8-12 hrs before test.

Renal function test : test Kidney (BUN AND

Creatininine level).

RAIU ( Radioactive Iodine Uptake Test) : Detects Hkyperthyroidism and

hypothyroidism ,high Iodine uptake indicate hyperthyroidism, Low iodine uptake =hypothyroidism

Pericardiocentesis: to aspirate fluid from the pericardial SAC Pelvic ultrasound: detects abnormalities organ in abdomen incr. fluid intake 30-mn
1hr before test to distend bladder t promote visualization organ

Paracentesis:

to examine peritoneal fluid and to relieve shortness of breath when ventilation is impaired *inform consent *Void immediately prior to procedure to prevent addidental puncture, sit up with feet resting on footstool

* assessing abdominal girth, respiratory rate, note if urine bloody, pin or red

None stress test NST: assesses fetal activity and well being. Reactive testacceleration of fetal heart rate of more than 15 b/mn above baseline FHR lasting for 15 sec or more . Non-reactive test- acceleration of FHR of less than 15 b/mn above baselin FHR MA INDIATE FETAL JEOPARDY.

Needle biobsy of kidney: to obtain specimen/tissue sample from kidney, NPO 6-8hrs
*check bleeding, clotting and Prothrombine time , Prone with pillow under abd *supine positon for 24hrs, apply puncture site for 20mn *incr.fluid intake to 3000ml *assess hemoglobin and hematocrit 8hrs after *avoid strenuous activities at least 2weeks

MUGA (MULTIPLE GATED ACQUISITION SCAN) : detects valvular

abnormalities of the heart, coronary artery disease and determine effects of cardiovascular drug therapy. *obtain consent, pain less,

Myelogram: detects herniated intervertebral

discs, visualize spinal cord, head elevate

Mantoux test: determines exposure to mycobacterium tuberculosis

*Positive test induration 10mm or more for foreign-born Pt and children below 4yrs * induration of 5mm or more is considered positive if Pt. HIV + * RESULT read after48-72hrs

Lung scan: determines lung perfusion when pulmonary emboli and infarction suspected
( obtain consent) *assess for allergy to dys, iodine and seafoods, remove jewelry

Lumbar puncture:

withdraw CSF to determine abnormalities , empty bladder

and bowel before

*Inserted between L3-L4 or L4-L5, spinal cord end at L2 *After position Pt. flat 6-12hrs to prevent spinal headache, inc. fluid intake

Liver biobsy: rules out liver disorders (obtain consent)

*Position Pt Left side or supine during biobsy, Pt inhale, exhale and hold breath during needle insert to prevent puncture diaphragm *Position Pt. right side after biopsy for 2hrs to prevent hemorrhage *maintain bedrest for 24hr

Laparoscopy: evaluates pelvic pain and infertility and treats endometriosis lesions.
*enema administer prior to procedure *shoulder or abdominal discomfort expected after procedure due to use carbon dioxide

IVP (INTRAVENOUS PYELOPRAPHY) : visualize urinary tract

(obtain consent) NPO 7-10hrs before procedure, administer laxative to clear bowels before procedure *check for allergy to iodine, seafoods or shellfish before procedure sine use iodine based dye. *Keep Epinephrine at bedside

Glucose tolerance test: confirms presence of sugar in the blood, high= carbohydrate,
protein diet given 24-48hrs before test. *Blood draw after overnight fast *Normal level is 2mg/dl

Gastric analysis: assess ulcers or pernicious anemia, acidity, volume of gastric secretion
*duodenal ulcer, HCL is elevate *refrigerate gastric samples if not tested within 4hrs

Fetal Heart Monitor: assesses fetal heart rate abnormalities

*Early decelerations indicate fetal head compression no treatment required *Late decelerations indicate placental insufficiency give o2 *Variable decelerations indicate cord compression *U or W in monitor change Pt. to left lateral recumbent and administer o2

CVP (central venous pressure) monitor : Purpose provide pressure in

right atrium *the manometer at level of right atrium at 4th intercostals space *normal reading 2-12mm Hg

Cystoscopy : insert bladder and urethra (obtain consent)

Endoscopy (gastroscopy, esophagoscopy): assess esophags and stomach

(obtain consent) NPO 6-8 HRS BEFORE PROCEDURE

ERCP Indoscopic retrograde cholangio pancreatography :Visualize bile

and pancreases ducts, NPO before and after procedure, Pt. may be hoarse and sore throat several day *Keep Narcan at bedside

EEG (electrocardiogram) : Record electrical activity brain

detects intracranial

hemorrhage and tumors. Shampoo hair before and after procedure

Use acetone if gel not remove by shampoo *avoid caffeine before test *withhold stimulants antidepressant and anticonvulsant for 24-48hrs prior the test

Cholecystogram: assess gallstones, check for allergy to iodine , seafood or shellfish

before procedure , use iodine based dye. NPO after midnight, low fat diet *keep Epinephrine at bedside to allergic reaction

Cardiac catheterization: to measure o2, concentration saturation, tension and pressure

in various chamber of the heart to determine need for cardiac surgery ( obtain inform consent) *assess for allergy, NPO 6 hrs before procedure *check peripheral and apicl pulses very 1mn for 2-4hrs * Keep 20lbs sandbage at bedside to apply pressure incase bleeding occur *Keep extremity extened 4-6 hrs

Barium swallow: assessment of esophagus and stomach, NPO 6-8hrs. Administer laxative
after procedure since barium cause constipation, incr. fluid intake at least two days after to help pass barium

Barium enema: assessment of large colon liquid diet before procedure, laxative before to
procedure to promote visualize and after procedure.

Arteriography: used evaluation tool before coronary artery surgery to detect suspected
congenital abnormal *assess Pt. for allergy to iodine, seafoods or shellfish *have Epinephrine at bedside for allergic reaction *Inc. oral fluid intake after procedure to promote excretion f dys

Arterial blood gas analysis: to detect present acid base imbalance or to monitor pt.
response to o2 treatment. *avoid suctioning prio to drawing of blood specimen *assess bleeding or hematoma *apply firm pressue 5-10mn, place specemen on ice *Pt. ACIDOSIS

diarrhea observe for signs and symptoms of METATOLIC

* Pt. vomiting observe for METABOLIC ALKALOSIS

Amniocentesis: to assess fetal growth and maturity to determine genetic disorder and
sex of the fetus *Done between 14-16wk *assess for chromosomal aberration for other disorders *If done after 35wks gestation the purpose is t assess fetal lung maturity *instruct Pt. to viod if gestation is greater than 20 wks *position Pt on supine *L/S ratio of 2:1 indicates fetal lung maturity

Alopecia: LOSS OF HAIR causes hodgkins lymphoma- cancer of lymph nodes,

hypothyroidism, systemic lupus erythematosus- hair tend to become brittle an fall, chemo, radiotherapy.

Amnesia : loss of memory causes, alzheimers disease, encephalitis,

wernickes korsakoffs syndrom