Final

Myocardial ischemia due to reduced coronary blood flow

CAD, smoking, hypertension, hyperlipidemia

Chest pain with exertion relieved by rest or nitroglycerin

ECG, stress test, cardiac enzymes

Nitroglycerin, aspirin, antiplatelets

Monitor ECG, give meds, educate on lifestyle changes

Electrolyte imbalance disrupting cardiac conduction

Diuretics, renal failure, vomiting

Palpitations, dizziness, ECG changes

Serum potassium, ECG

Potassium replacement or binding agents

Monitor ECG and potassium, teach diet and meds

Coronary artery blockage leading to myocardial necrosis

CAD, smoking, diabetes, obesity

Crushing chest pain, left arm pain

Fatigue, jaw pain, nausea

ECG, troponin, CK-MB

MONA, PCI, thrombolytics

CPR if pulseless, cardiac rehab, medication education

Clot obstructs pulmonary artery causing impaired gas exchange

DVT, immobility, surgery, cancer

Sudden dyspnea, chest pain, tachycardia

CT angiography, D-dimer

Heparin, warfarin, thrombolytics

Monitor O₂, bleeding precautions, early ambulation

CO₂ retention due to hypoventilation

COPD, sedation, airway obstruction

Confusion, lethargy, ↓ pH, ↑ CO₂

ABG

Improve ventilation

Administer bronchodilators, support airway

Accumulation of acids or loss of bicarbonate

Vomiting, diuretics

Hyperventilation

Treat cause, monitor ABGs and electrolytes

Air in pleural space leading to lung collapse

Dyspnea, absent breath sounds, tracheal deviation

Chest X-ray

Chest tube insertion

Monitor lung sounds, maintain chest tube system

Insulin deficiency leading to ketone production

Type 1 DM, infection, missed insulin

Fruity breath, polyuria, dehydration

Glucose >250, ketones, ABG

IV fluids, insulin, K⁺ replacement

Monitor glucose, electrolytes, ABGs

Severe hyperglycemia without ketosis

Elderly, infection, dehydration

Altered LOC, extreme dehydration

Glucose >600, no ketones

IV fluids, insulin

Monitor neuro status, educate on hydration

Viral infection of liver

IV drug use, blood exposure

Fatigue, jaundice, RUQ pain

HCV antibody, RNA PCR

Antivirals

Educate on transmission, monitor liver function

Inflammation of conjunctiva

Purulent discharge

Watery discharge

Antibiotic ointment

Hygiene, apply ointment inner to outer canthus

Infection of meninges

Crowded living, head trauma

Nuchal rigidity, fever, photophobia

Lumbar puncture

Antibiotics, antivirals

Droplet precautions, monitor neuro status

Inflammation of bronchial tubes, usually viral

Smoking, pollution, recent upper respiratory infection

Cough, wheezing, chest discomfort, low-grade fever

Clinical exam, chest X-ray to rule out pneumonia

Supportive care, bronchodilators, antipyretics

Encourage rest and fluids, educate on smoking cessation, monitor for pneumonia

Inflammation of pancreas due to autodigestion by enzymes

Alcohol use, gallstones, high triglycerides

Epigastric pain radiating to back, nausea, vomiting, fever, tenderness

Elevated amylase/lipase, abdominal CT

NPO, IV fluids, pain control

Monitor for hypocalcemia, administer analgesics, educate on low-fat diet

Sudden decline in kidney function

Hypovolemia, nephrotoxins, sepsis

Oliguria, fluid overload, elevated creatinine/BUN

AKIN staging, labs, urine output

Fluid management, dialysis if needed

Monitor I&O, daily weights, avoid nephrotoxic drugs

Decreased renal perfusion without structural damage

Dehydration, hypotension, heart failure

Decreased urine output, increased BUN:creatinine ratio

Labs and clinical history

Restore perfusion with fluids

Monitor BP and perfusion, administer IV fluids

Crystallized bile components blocking ducts

Obesity, female, age over 40, high-fat diet

RUQ pain after fatty meals, nausea, vomiting

RUQ ultrasound, HIDA scan

Cholecystectomy

Low-fat diet, monitor for bile duct obstruction, post-op care

Weak lower esophageal sphincter allowing acid reflux

Obesity, pregnancy, hiatal hernia

Heartburn, regurgitation, chronic cough

Endoscopy, pH monitoring

PPIs, H2 blockers, lifestyle changes

Elevate HOB, avoid trigger foods, small frequent meals

Malignant growth in breast tissue

Family history, BRCA mutation, estrogen exposure

Lump, nipple changes, skin dimpling

Mammogram, biopsy

Surgery, chemo, radiation

Educate on BSE, support body image, monitor for lymphedema

Malignant growth in colon often from polyps

Age over 50, low-fiber diet, family history

Change in bowel habits, occult bleeding

Colonoscopy, biopsy

Surgical resection, chemotherapy

Educate on screening, monitor bowel function

Malignant growth in lung tissue

Smoking, pollution, occupational exposure

Persistent cough, hemoptysis, weight loss

Chest X-ray, CT scan, biopsy

Surgery, chemo, radiation

Smoking cessation education, monitor respiratory status

Cancer of blood-forming tissues

Radiation, chemicals, genetic disorders

Fatigue, infections, bleeding or bruising

CBC, bone marrow biopsy

Chemotherapy, stem cell transplant

Neutropenic and bleeding precautions, monitor CBC

Musculoskeletal strain, disc herniation, degenerative changes

Poor posture, obesity, repetitive lifting, aging

Localized or radiating pain, spasms, limited mobility

Physical exam, MRI, X-ray

NSAIDs, muscle relaxants, physical therapy

Teach body mechanics, apply heat or cold, encourage stretching

Break in proximal femur, often due to fall or trauma

Osteoporosis, age over 65, female, fall risk

Shortened, externally rotated leg, pain, immobility

X-ray, CT scan

Surgical repair or replacement

Monitor for DVT, pain control, fall prevention

Pressure buildup in skull from trauma, bleeding, swelling

TBI, stroke, infection

Headache, vomiting, altered LOC, pupil changes

CT or MRI, neuro exam

Mannitol, elevate HOB, surgery

Avoid straining, monitor neuro status, maintain airway

Mild TBI from impact

Sports, falls, accidents

Headache, confusion, amnesia, dizziness

Clinical assessment, CT if indicated

Rest and symptom management

Monitor for worsening symptoms, limit stimulation

Damage to spinal cord affecting motor and sensory function

Trauma, falls, motor vehicle crashes

Paralysis, sensory loss, autonomic dysfunction

CT/MRI, neuro exam

Stabilization, corticosteroids, surgery

Maintain spinal precautions, monitor for autonomic dysreflexia

Exaggerated autonomic response in SCI above T6

Full bladder, fecal impaction, skin irritation

Severe hypertension, bradycardia, headache, flushing

Remove trigger, give antihypertensives

Elevate HOB, check bladderowel, prevent recurrence

Assessing level of consciousness

Eye, verbal, motor

15

Coma

Monitor regularly, document accurately

Induced loss of sensation or consciousness

Respiratory depression, malignant hyperthermia

Monitor ABCs, watch for complications

Pre-op, intra-op, post-op

Consent, NPO, education

Sterile field, anesthesia

Recovery, pain control, mobility

Assess for complications, promote ambulation

Legal and clinical record of care

Use approved abbreviations, be objective, record responses

Judgmental or vague language

Right task, circumstance, person, direction, supervision

Stable patients and routine tasks

Follow up and evaluate outcome

Holistic support of patient beliefs

Offer chaplain, provide quiet space, respect beliefs

Acute confusion from a medical cause

Age, infection, medications

Fluctuating LOC, agitation, disorientation

Treat underlying cause

Ensure safety, reorient gently

Prolonged, intense grief interfering with function

Sudden loss, lack of support

Validate feelings, refer to mental health

Mottled skin, altered breathing, decreased appetite

Provide comfort care, support family, honor culture

Respecting diverse patient values and preferences

Ask about preferences, use interpreters

Autonomy, beneficence, nonmaleficence, justice

Maintain confidentiality, practice within scope, uphold professionalism