Final 2

Myocardial ischemia due to reduced coronary blood flow

Coronary artery disease, smoking, hypertension, hyperlipidemia

Chest pain with exertion relieved by rest or nitroglycerin

ECG, stress test, cardiac enzymes

Nitroglycerin, aspirin, antiplatelets

Monitor ECG, administer medications, educate on lifestyle changes

Electrolyte imbalance disrupting cardiac conduction

Diuretics, renal failure, vomiting

Palpitations, dizziness, ECG changes (peaked T waves or U waves)

Serum potassium, ECG

Potassium replacement or binding agents

Monitor ECG and potassium, educate on diet and meds

Coronary artery blockage leading to myocardial necrosis

Coronary artery disease, smoking, diabetes, obesity

Crushing chest pain radiating to left arm

Fatigue, jaw pain, nausea

ECG changes, troponin, CK-MB

MONA (Morphine, Oxygen, Nitroglycerin, Aspirin), PCI, thrombolytics

CPR if pulseless, cardiac rehab, med 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

Viral respiratory infection caused by coronavirus

Exposure, travel, immunocompromised

Fever, dry cough, dyspnea

PCR testing

Supportive care, oxygen therapy

Isolation and monitoring of respiratory status

CO₂ retention due to hypoventilation

COPD, sedation, airway obstruction

Confusion, lethargy, ↓ pH, ↑ CO₂

Arterial blood gas (ABG)

Improve ventilation

Administer bronchodilators, support airway

Metabolic or respiratory disturbances altering blood pH

DKA, renal failure, diarrhea

Vomiting, diuretics

Hyperventilation

Treat underlying cause, monitor ABGs and electrolytes

Air in pleural space causing lung collapse

Spontaneous, traumatic, tension

Dyspnea, absent breath sounds, tracheal deviation

Chest X-ray

Chest tube insertion

Monitor lung sounds, maintain chest tube system

Accumulation of acids or loss of bicarbonate

DKA, renal failure, diarrhea

Kussmaul respirations, confusion

ABG, electrolytes

Treat cause, give bicarbonate if severe

Monitor K⁺, ABGs, hydration

Insulin deficiency leading to ketone production

Type 1 DM, infection, missed insulin doses

Fruity breath, polyuria, dehydration

Glucose >250, ketones, ABG

IV fluids, insulin, potassium 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 the liver

IV drug use, blood exposure

Fatigue, jaundice, RUQ pain

HCV antibody, RNA PCR

Antivirals

Educate on transmission, monitor liver function

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🦠 INFECTION

Inflammation of the conjunctiva

Purulent discharge

Watery discharge

Clinical exam

Antibiotic ointment or drops

Hand hygiene, apply ointment inner to outer canthus

Infection of meninges

Crowded living, head trauma

Nuchal rigidity, fever, photophobia

Lumbar puncture

Antibiotics or antivirals

Droplet precautions, monitor neuro status

Inflammation of bronchial tubes, usually viral

Smoking, pollution, recent URI

Cough, wheezing, low-grade fever

Clinical exam, chest X-ray

Supportive care, bronchodilators, antipyretics

Encourage fluids, rest, smoking cessation

Inflammation of the pancreas due to autodigestion by enzymes

Alcohol use, gallstones, high triglycerides

Epigastric pain radiating to back, nausea, vomiting

Increased amylase/lipase, abdominal CT

NPO, IV fluids, pain control

Monitor for hypocalcemia and respiratory distress, educate on alcohol cessation

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💧 FLUID & ELECTROLYTE

Sudden decline in kidney function

Hypovolemia, nephrotoxins, sepsis

Oliguria, fluid overload, elevated BUN/creatinine

AKIN staging, labs, urine output

Fluid management, dialysis if needed

Monitor I&O, daily weights, avoid nephrotoxins

Decreased renal perfusion without structural damage

Dehydration, hypotension, heart failure, diabetes

Low urine output, high BUN:creatinine ratio

Labs and history

Restore perfusion with fluids

Monitor BP and perfusion, give IV fluids

Crystallized bile components blocking bile ducts

Obesity, female gender, 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

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🧬 CELLULAR REGULATION

Malignant growth in breast tissue

Family history, BRCA mutation, estrogen exposure

Lump, nipple changes, skin dimpling

Mammogram, biopsy

Surgery, chemo, radiation

Teach 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, palliative support

Cancer of blood-forming tissues

Radiation, chemicals, genetic disorders

Fatigue, infection, bleedingruising

CBC, bone marrow biopsy

Chemotherapy, stem cell transplant

Neutropenic and bleeding precautions, monitor CBC

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🦴 MOBILITY

Musculoskeletal strain, disc herniation, degenerative changes

Poor posture, obesity, repetitive lifting, aging

Localized or radiating pain, muscle spasms, limited mobility

Physical exam, MRI, X-ray

NSAIDs, muscle relaxants, physical therapy

Teach body mechanics, apply heat/cold, encourage stretching

Break in proximal femur from 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, early mobilization, fall prevention

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🧠 INTRACRANIAL REGULATION / NEURO

Pressure buildup in skull from trauma, bleeding, or swelling

Headache, vomiting, altered LOC, pupil changes, Cushing’s triad

CT, MRI, neuro exam

Mannitol, elevate HOB, surgery

Avoid straining, monitor neuro status, maintain airway

Mild traumatic brain injury from impact

Headache, confusion, dizziness, amnesia

Clinical evaluation, CT if indicated

Rest, symptom management

Monitor for worsening symptoms, gradual return to activity

Damage to spinal cord affecting motor or sensory function

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, teach prevention

Induced loss of sensation or consciousness

Respiratory depression, malignant hyperthermia

Monitor ABCs, assess for complications

Pre-op, intra-op, post-op

Consent, NPO, patient education

Maintenance of sterile field, anesthesia administration

Recovery, pain control, mobility

Assess for bleeding, infection, and promote early ambulation

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🗣️ COMMUNICATION & DECISION-MAKING

Legal and clinical record of care

Use approved abbreviations, record timely and accurately

Judgmental or vague language

Right task, circumstance, person, direction, supervision

Trained personnel for stable patients

Follow up and evaluate care

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🙏 SPIRITUAL & COGNITION

Holistic support of beliefs and values

Offer chaplain services, respect beliefs, provide quiet space

Acute confusion from a medical cause

Age, infection, medications

Fluctuating LOC, agitation, disorientation

Treat underlying cause

Ensure safety, reorient gently, monitor medications

Prolonged, intense grief interfering with daily life

Sudden loss, lack of social support

Validate feelings, refer to counseling

Mottled skin, irregular breathing, decreased appetite

Provide comfort care, support family, honor cultural needs

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🌍 DIVERSITY

Respecting diverse beliefs, values, and practices

Ask preferences, avoid assumptions, use interpreters

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⚖️ ETHICS

Framework for professional conduct and moral decision-making

Autonomy, beneficence, nonmaleficence, justice

Maintain confidentiality, practice within scope, uphold professionalism