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Study Plan for Test Taking for the NCLEX® designed for Bolivar Technical College
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Alcohol Withdrawal (Addiction)

Alcohol Withdrawal (Addiction)

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Nichole Weaver
MSN/Ed,RN,CCRN
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Included In This Lesson

Study Tools
Outline
ADPIE Related Lessons
Transcript
Additional Lessons

Study Tools For Alcohol Withdrawal (Addiction)

Addiction – Behavioral Problems (Mnemonic)
Alcoholism – Outcomes (Mnemonic)
Alcohol Abuse Interventions (Picmonic)
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Outline

Overview

  1. Definition: a set of symptoms that result after one attempts to quit or abruptly stops consuming alcohol for a long period of time.  
    1. The brain gets used to chronic regular alcohol (ETOH) consumption resulting in changes in brain chemistry, so once it abruptly stops, it goes into withdrawal.

Nursing Points

General

  1. Most hospitals have a protocol: assessment screening and PRN administration of a benzodiazepine (Librium, Ativan)
    1. MINDS
    2. CIWAA
  2. It’s important to assess when the last drink was and how much they drink daily
    1. Very early signs can begin within a few hours
    2. Signs and symptoms typically peak around 48-72 hours and then go away after 2-3 days…unless they go into delirium
    3. Goal is to treat symptoms and prevent seizures, delirium

Assessment

    1. Minor Withdrawal (6+ hours after last drink)
      1. Tremor
      2. Anxiety
      3. Nausea
      4. Vomiting
      5. Insomnia
      6. Typically they look malnourished
      7. **Note – this feeling is what drives alcoholics to keep drinking – to avoid feeling this way**
    2. Major Withdrawal (10+ hours after last drink)
      1. Above symptoms plus:
      2. Whole body tremor
      3. Seizures
      4. Hypertension
      5. Diaphoresis
      6. Hallucinations
    3. Withdrawal delirium (delirium tremens/DT’s) (3-10 days after last drink)
      1. Above symptoms plus:
      2. Global confusion (hallmark)
      3. High Fever
      4. Autonomic Instability (Hypertension, Tachycardia)
      5. Disorientation
      6. Severe Hallucinations
      7. Agitation
      8. Severe Diaphoresis

Therapeutic Management

    1. Monitor for withdrawal delirium – this is a medical emergency
      1. People die from this from an MI, aspiration pneumonia, fat embolism.
    2. Meds
      1. Benzodiazepines for withdrawal
        1. Usually utilize CIWAA scoring protocol to drive administration of meds
      2. Vitamin replacement
        1. Banana bag / rally pack / IV fluids with added vitamins (especially thiamine)
        2. Vitamin B12 injection + PO for several days to attempt to prevent encephalopathy
      3. Antabuse: deterrent for ETOH, produces an acute sensitivity to ETOH.
        1. Become violently ill within about 5 min and can last up to 2 hours.
        2. No alcohol 12 hours before first dose.
        3. Educate patients about not consuming mouthwashes, cold meds, various aftershaves or anything else that may contain alcohol, as it may elicit a reaction
        4. Educate that effects of Antabuse may continue for several days after they stop taking it
    3. General interventions for the patient experiencing alcohol withdrawal
      1. Assess and monitor vitals and neuro checks frequently
      2. Assess alcohol withdrawal protocol and provide meds per protocol
      3. Seizure and fall precautions
      4. May need a sitter
      5. Reorient as needed
      6. May need to give antiemetics meds before eating, if they do eat
      7. Maintain a safe, quiet, calm environment
      8. After acute withdrawal phase is over, patient will need long term therapy and support (Connect with Social Work)
        1. Alcoholics Anonymous
        2. Halfway houses
        3. Meds
        4. Therapy (one-on-one or group)
        5. Family support and therapy (support groups available for family members)
    4. Interacting with a patient addicted to alcohol
      1. Assess risk for self-harm and suicide
      2. Try to identify what triggers alcohol use
      3. Promote boundaries and accountability
      4. be consistent with rules and consequences
      5. Identify strengths, focus there
      6. Promote various support groups, therapy

Nursing Concepts

  1. Mood Affect
  2. Coping
  3. Gastrointestinal/Liver Metabolism

Patient Education

  1. Identify and avoid triggers
  2. Help them understand what to expect in the coming days to ease anxiety
    1. “You’re in a safe place”
    2. “Things might get worse before they get better, but we’re going to take good care of you”
  3. s/s to report to nurse or provider

[lesson-linker lesson=221441 background=”white”]

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Transcript

Let’s talk about Alcohol Withdrawal. Now, technically the withdrawal portion of this is a medical condition, not mental health. But alcohol use disorder is a mental health condition that can cause some pretty serious medical issues, so we’re going to kind of touch on all of it here.

So what is Alcohol Withdrawal – it is a set of symptoms that results after someone attempts to quit or abruptly stops consuming alcohol after regular long-term consumption. With Alcohol Use Disorder, someone drinks compulsively, can’t control how much they drink, and tends to be super anxious or irritable when they aren’t drinking. When you consume that much alcohol for a long period of time, your brain starts to get used to it and it changes some of your brain chemistry. So when someone stops drinking – their brains can go haywire. Now keep in mind, this might not be someone who is trying to quit – this might be someone who was in a car accident and is now hospitalized and can’t drink like they usually would.

So, we always want to ask the question and be very specific – how much do you drink on a daily basis and when was your last drink? This helps us to start to establish a timeline and be able to predict when their symptoms will progress. Symptoms of withdrawal can occur as early as 6 hours after the last drink and usually involve tremor, anxiety, nausea and vomiting, and trouble sleeping – THIS feeling is usually what drives someone with alcohol use disorder to take another drink. This is what makes it really hard to quit. These symptoms will peak at about 48-72 hours and will get worse and worse before they start to get better – including a severe version of these initial symptoms plus hypertension, diaphoresis, hallucinations and even seizures. Left untreated, these symptoms can progress to what’s known as Withdrawal Delirium or Delirium Tremens.

Delirium Tremens, also sometimes called “DT’s” is a medical emergency. It usually comes on about 3 or more days after their last drink. They’ll have all the previous symptoms at severe levels – so severe tremors, diaphoresis, nausea, hypertension, etc. PLUS global confusion and disorientation, which is the hallmark sign. They’ll also have agitation, a high fever, autonomic instability, and seizures. This condition CAN and WILL kill someone if left untreated. So, even if you have a client come in for something completely unrelated, like a car accident – it’s SO important to ask them if they drink regularly and when their last drink was – that way we can get them some treatments early and monitor them closely to prevent it from getting this bad.

So when we are assessing a client who is at risk for alcohol withdrawal, there is usually a protocol to follow. We’ve attached a couple of examples to the lesson under references – the MINDS score and the CIWAA score. So our primary intervention will always be anything having to do with safety – that might include airway protection, seizure precautions, and possibly even a sitter or restraints if they’re super agitated. Then we’re going to assess the symptoms and give them a score based on the method we’re using. Most protocols then have a guideline as to how to intervene based on that score. For example, at one facility I’ve worked at, we would assess the CIWAA score every 2 hours and if their score was over 25, we would give 1 mg of Lorazepam and reassess in 1 hour. Again, you just need to know YOUR facility’s specific protocols and make sure you’re following them.

We want to assess frequently, institute seizure and fall precautions, and reorient them as needed. Again, maintain safety at all times, and perform a self-harm assessment. With alcohol use disorder, clients may be so dependent on the alcohol for their coping strategies that it can be very difficult not to have that. And we definitely want to encourage them to seek long-term therapy or support, including things like Alcoholics Anonymous meetings. Expressing their feelings can be very therapeutic. As far as medications for Alcohol Withdrawal, we use Benzodiazepines almost every time – I already mentioned Lorazepam is common. We’ll also use antiemetics for the nausea and we’ll give Vitamin replacements. Those who overuse alcohol tend to be quite deficient in B12 and Thiamine and other micronutrients so we will give them something called a Banana Bag or a Rally Pack that’s full of vitamins like Thiamine and electrolytes and can prevent encephalopathy. Check out the neuro lesson on encephalopathies to learn more about why that occurs. Another medication we can give for someone trying to quit drinking is called Disulfiram or Antabuse. Essentially if they take this medication and then get even one sip of alcohol in their system, it makes them violently ill. This includes things like mouthwash or over-the-counter cough medicine – so make sure you educate your patient that they shouldn’t start the Antabuse until they haven’t had alcohol for 12 hours and that the effects can last for days after taking it. So no alcohol!

Priority nursing concepts for a patient with Alcohol Withdrawal are safety, nutrition, and coping.

Okay, so let’s recap – Alcohol Withdrawal occurs after someone who uses alcohol chronically or excessively for an extended period of time stops abruptly or attempts to quit. Make sure you’re assessing the timeline because symptoms can start as soon as 6 hours after the last drink and will peak at about 48-72 hours. We need to monitor them closely and assess them frequently to intervene and prevent Withdrawal Delirium or Delirium Tremens, which is a medical emergency and can be deadly. So we give benzodiazepines and vitamins to manage the symptoms to get them through the dangerous period of withdrawal, and we always prioritize safety, including fall and seizure precautions. If they have severe agitation, they may even require a sitter or restraints, so just make sure you’re following your facility’s protocol for those things.

So that’s it for Alcohol Withdrawal. Make sure you check out the resources attached to this lesson to learn more. Now, go out and be your best self today. And, as always, happy nursing!

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Study Plan for Test Taking for the NCLEX® designed for Bolivar Technical College

Concepts Covered:

  • Noninfectious Respiratory Disorder
  • Test Taking Strategies
  • Respiratory Disorders
  • EENT Disorders
  • Prenatal Concepts
  • Studying
  • Prefixes
  • Suffixes
  • Acute & Chronic Renal Disorders
  • Disorders of the Adrenal Gland
  • Legal and Ethical Issues
  • Preoperative Nursing
  • Integumentary Disorders
  • Oncology Disorders
  • Musculoskeletal Trauma
  • Bipolar Disorders
  • Disorders of the Posterior Pituitary Gland
  • Hematologic Disorders
  • Community Health Overview
  • Immunological Disorders
  • Renal Disorders
  • Childhood Growth and Development
  • Labor Complications
  • Upper GI Disorders
  • Medication Administration
  • Neurological Emergencies
  • Adulthood Growth and Development
  • Disorders of Pancreas
  • Musculoskeletal Disorders
  • Cardiac Disorders
  • Disorders of the Thyroid & Parathyroid Glands
  • Integumentary Important Points
  • Pregnancy Risks
  • Urinary Disorders
  • Vascular Disorders
  • Eating Disorders
  • Learning Pharmacology
  • Anxiety Disorders
  • Basic
  • Basics of NCLEX
  • Factors Influencing Community Health
  • Lower GI Disorders
  • Intraoperative Nursing
  • Integumentary Disorders
  • Neurologic and Cognitive Disorders
  • Trauma-Stress Disorders
  • Central Nervous System Disorders – Brain
  • Somatoform Disorders
  • Fundamentals of Emergency Nursing
  • Dosage Calculations
  • Depressive Disorders
  • Personality Disorders
  • Cognitive Disorders
  • Substance Abuse Disorders
  • Psychological Emergencies
  • Circulatory System
  • Postoperative Nursing
  • Hematologic Disorders
  • Liver & Gallbladder Disorders
  • Infectious Respiratory Disorder
  • Central Nervous System Disorders – Spinal Cord
  • Emergency Care of the Cardiac Patient
  • Concepts of Population Health
  • Peripheral Nervous System Disorders
  • Emotions and Motivation
  • Note Taking
  • Female Reproductive Disorders
  • Delegation
  • Oncologic Disorders
  • Prioritization
  • Postpartum Complications
  • Endocrine and Metabolic Disorders
  • Fetal Development
  • Shock
  • Emergency Care of the Neurological Patient
  • Respiratory Emergencies
  • Labor and Delivery
  • Gastrointestinal Disorders
  • Communication
  • Concepts of Mental Health
  • Health & Stress
  • EENT Disorders
  • Urinary System
  • Digestive System
  • Tissues and Glands
  • Developmental Theories
  • Postpartum Care
  • Cardiovascular Disorders
  • Newborn Care
  • Renal and Urinary Disorders
  • Newborn Complications
  • Musculoskeletal Disorders
  • Infectious Disease Disorders
  • Nervous System
  • Behavior
  • Respiratory System
  • Basics of Human Biology
  • Neurological Trauma
  • Concepts of Pharmacology
  • Microbiology
  • Psychotic Disorders
  • Emergency Care of the Trauma Patient

Study Plan Lessons

Nursing Care and Pathophysiology of COPD (Chronic Obstructive Pulmonary Disease)
12 Points to Answering Pharmacology Questions
ABGs Nursing Normal Lab Values
Care of the Pediatric Patient
Glaucoma
Menstrual Cycle
Time Management
X-Ray (Xray)
54 Common Medication Prefixes and Suffixes
ABG (Arterial Blood Gas) Interpretation-The Basics
Nursing Care and Pathophysiology of Acute Kidney (Renal) Injury (AKI)
Addisons Disease
Advance Directives
Burn Injuries
Cataracts
Computed Tomography (CT)
Family Planning & Contraception
Informed Consent
Lung Sounds
Study Setting
Vitals (VS) and Assessment
Alveoli & Atelectasis
Nursing Care and Pathophysiology for Cushings Syndrome
Goal Setting
Macular Degeneration
Magnetic Resonance Imaging (MRI)
Preoperative (Preop)Assessment
Pressure Ulcers/Pressure injuries (Braden scale)
Therapeutic Drug Levels (Digoxin, Lithium, Theophylline, Phenytoin)
Nursing Care and Pathophysiology for Diabetes Insipidus (DI)
Nursing Care and Pathophysiology for Disseminated Intravascular Coagulation (DIC)
Epidemiology
Essential NCLEX Meds by Class
Gas Exchange
Nursing Care and Pathophysiology of Glomerulonephritis
Growth & Development – Infants
Nursing Care and Pathophysiology for Herpes Zoster – Shingles
Isotonic Solutions (IV solutions)
Nursing Care and Pathophysiology of Osteoarthritis (OA)
Nursing Care and Pathophysiology for Pancreatitis
Preoperative (Preop) Education
6 Rights of Medication Administration
Cerebral Angiography
Growth & Development – Toddlers
Health Promotion & Disease Prevention
Hearing Loss
Hypotonic Solutions (IV solutions)
Nursing Care and Pathophysiology of Osteoporosis
Nursing Care and Pathophysiology for Peptic Ulcer Disease (PUD)
Preoperative (Preop) Nursing Priorities
Respiratory Acidosis (interpretation and nursing interventions)
Thrombocytopenia
Blood Transfusions (Administration)
Cardiovascular Angiography
Fractures
Growth & Development – Preschoolers
Nursing Care and Pathophysiology for Hyperthyroidism
Hypertonic Solutions (IV solutions)
Integumentary (Skin) Important Points
Preload and Afterload
Respiratory Alkalosis
Nursing Care and Pathophysiology of Urinary Tract Infection (UTI)
Echocardiogram (Cardiac Echo)
Growth & Development – School Age- Adolescent
Nursing Care and Pathophysiology for Hypothyroidism
Legal Considerations
Metabolic Acidosis (interpretation and nursing diagnosis)
Performing Cardiac (Heart) Monitoring
HIPAA
Metabolic Alkalosis
The SOCK Method – Overview
Ultrasound
The SOCK Method – S
The SOCK Method – O
Base Excess & Deficit
The SOCK Method – C
The SOCK Method – K
Biopsy
Anxiety
Basics of Calculations
Brief CPR (Cardiopulmonary Resuscitation) Overview
Critical Thinking
Cultural Care
Gestation & Nägele’s Rule: Estimating Due Dates
Potassium-K (Hyperkalemia, Hypokalemia)
Nursing Care and Pathophysiology of Angina
Nursing Care and Pathophysiology for Appendicitis
Nursing Care and Pathophysiology for Asthma
Bloom’s Taxonomy
Nursing Care and Pathophysiology of Chronic Kidney (Renal) Disease (CKD)
Nursing Care and Pathophysiology of Diabetes Mellitus (DM)
Dimensional Analysis Nursing (Dosage Calculations/Med Math)
Environmental Health
Fire and Electrical Safety
General Anesthesia
Generalized Anxiety Disorder
Gravidity and Parity (G&Ps, GTPAL)
Impetigo
Leukemia
Levels of Consciousness (LOC)
Sodium-Na (Hypernatremia, Hyponatremia)
Nursing Care and Pathophysiology of COPD (Chronic Obstructive Pulmonary Disease)
Diabetes Management
Dialysis & Other Renal Points
Local Anesthesia
Lymphoma
Nursing Care and Pathophysiology of Myocardial Infarction (MI)
Oral Medications
Pediculosis Capitis
Post-Traumatic Stress Disorder (PTSD)
Routine Neuro Assessments
What is the NCLEX?
Adjunct Neuro Assessments
Anatomy of an NCLEX Question
Burn Injuries
Chloride-Cl (Hyperchloremia, Hypochloremia)
Nursing Care and Pathophysiology of Diabetic Ketoacidosis (DKA)
Fundal Height Assessment for Nurses
Injectable Medications
Moderate Sedation
Oncology Important Points
Somatoform
Technology & Informatics
Nursing Care and Pathophysiology of Coronary Artery Disease (CAD)
Fall and Injury Prevention
Hyperglycaemic Hyperosmolar Non-ketotic syndrome (HHNS)
Nursing Care and Pathophysiology for Inflammatory Bowel Disease (IBD)
IV Infusions (Solutions)
Malignant Hyperthermia
Maternal Risk Factors
Complex Calculations (Dosage Calculations/Med Math)
Intracranial Pressure ICP
Mood Disorders (Bipolar)
Nursing Care and Pathophysiology for Ulcerative Colitis(UC)
Cerebral Perfusion Pressure CPP
Nursing Care and Pathophysiology for Crohn’s Disease
Depression
Isolation Precaution Types (PPE)
Paranoid Disorders
Personality Disorders
Cognitive Impairment Disorders
Eating Disorders (Anorexia Nervosa, Bulimia Nervosa)
Alcohol Withdrawal (Addiction)
Grief and Loss
Suicidal Behavior
Normal Sinus Rhythm
Physiological Changes
Post-Anesthesia Recovery
Red Blood Cell (RBC) Lab Values
SATA
Sickle Cell Anemia
Absolute Words
Nursing Care and Pathophysiology for Acquired Immune Deficiency Syndrome (AIDS)
Nursing Care and Pathophysiology for Cholecystitis
Discomforts of Pregnancy
Nursing Care and Pathophysiology for Heart Failure (CHF)
Hemoglobin (Hbg) Lab Values
Nursing Care and Pathophysiology for Influenza (Flu)
Nursing Care and Pathophysiology for Multiple Sclerosis (MS)
Postoperative (Postop) Complications
Sinus Bradycardia
Nursing Care and Pathophysiology for Anaphylaxis
Antepartum Testing
Hematocrit (Hct) Lab Values
Hemophilia
Nursing Care and Pathophysiology for Hepatitis (Liver Disease)
Opposites
Sinus Tachycardia
Nursing Care and Pathophysiology for Tuberculosis (TB)
Nursing Care and Pathophysiology for Cirrhosis (Liver Disease, Hepatic encephalopathy, Portal Hypertension, Esophageal Varices)
Discharge (DC) Teaching After Surgery
Nutrition in Pregnancy
Pacemakers
Nursing Care and Pathophysiology of Pneumonia
Same
White Blood Cell (WBC) Lab Values
Atrial Fibrillation (A Fib)
Communicable Diseases
Platelets (PLT) Lab Values
Priority
Coagulation Studies (PT, PTT, INR)
Disasters & Bioterrorism
Nursing Process
Acute vs Chronic
Miscellaneous Nerve Disorders
Premature Ventricular Contraction (PVC)
What do you want me to know?
Duplicate Facts
Ventricular Tachycardia (V-tach)
Repeating Words
Ventricular Fibrillation (V Fib)
Denying Feelings
NCLEX® Question Traps
Albumin Lab Values
Maslow’s Hierarchy of Needs in Nursing
Outline Question Method (Note taking)
Nursing Care and Pathophysiology for Pelvic Inflammatory Disease (PID)
Benzodiazepines
Cholesterol (Chol) Lab Values
Delegation
Drawing Pictures
Nursing Care and Pathophysiology for Hemorrhagic Stroke (CVA)
Nursing Care and Pathophysiology of Hypertension (HTN)
Ammonia (NH3) Lab Values
Artificial Airways
Nursing Care and Pathophysiology for Endometriosis
Nursing Care and Pathophysiology for Ischemic Stroke (CVA)
Nephroblastoma
Prioritization
Airway Suctioning
Chorioamnionitis
Nursing Care and Pathophysiology for Menopause
Stroke Assessment (CVA)
Triage
Nursing Care and Pathophysiology for Cardiomyopathy
Gestational Diabetes (GDM)
Stroke Therapeutic Management (CVA)
Disseminated Intravascular Coagulation (DIC)
Stroke Nursing Care (CVA)
Ectopic Pregnancy
Nursing Care and Pathophysiology for Thrombophlebitis (clot)
Hydatidiform Mole (Molar pregnancy)
Gestational HTN (Hypertension)
Infections in Pregnancy
Preeclampsia: Signs, Symptoms, Nursing Care, and Magnesium Sulfate
Blood Urea Nitrogen (BUN) Lab Values
Fever
Overview of the Nursing Process
Creatinine (Cr) Lab Values
Dehydration
Fetal Development
Nursing Care and Pathophysiology for Hypovolemic Shock
Seizure Causes (Epilepsy, Generalized)
Nursing Care and Pathophysiology for Cardiogenic Shock
Fetal Environment
Seizure Assessment
Chest Tube Management
Nursing Care and Pathophysiology for Distributive Shock
Fetal Circulation
Seizure Therapeutic Management
Urinalysis (UA)
Nursing Care and Pathophysiology for Seizure
Glucose Lab Values
Process of Labor
Vomiting
Pediatric Gastrointestinal Dysfunction – Diarrhea
Hemoglobin A1c (HbA1C)
Mechanisms of Labor
Therapeutic Communication
Defense Mechanisms
Leopold Maneuvers
Celiac Disease
Fetal Heart Monitoring (FHM)
Nursing Care and Pathophysiology for Meningitis
Appendicitis
Intussusception
Abuse
Constipation and Encopresis (Incontinence)
Patient Positioning
Complications of Immobility
Conjunctivitis
Prolapsed Umbilical Cord
Acute Otitis Media (AOM)
Placenta Previa
Abruptio Placentae (Placental abruption)
Tonsillitis
Preterm Labor
Urinary Elimination
Bowel Elimination
Precipitous Labor
Dystocia
Pain and Nonpharmacological Comfort Measures
Hygiene
Overview of Developmental Theories
Postpartum Physiological Maternal Changes
Bronchiolitis and Respiratory Syncytial Virus (RSV)
MAOIs
Postpartum Discomforts
Breastfeeding
Asthma
SSRIs
Cystic Fibrosis (CF)
TCAs
Congenital Heart Defects (CHD)
Intake and Output (I&O)
Defects of Increased Pulmonary Blood Flow
Blood Glucose Monitoring
Postpartum Hemorrhage (PPH)
Defects of Decreased Pulmonary Blood Flow
Mastitis
Insulin
Obstructive Heart (Cardiac) Defects
Mixed (Cardiac) Heart Defects
Specialty Diets (Nutrition)
Enteral & Parenteral Nutrition (Diet, TPN)
Histamine 1 Receptor Blockers
Initial Care of the Newborn (APGAR)
Nephrotic Syndrome
Enuresis
Newborn Physical Exam
Body System Assessments
Histamine 2 Receptor Blockers
Newborn Reflexes
Babies by Term
Cerebral Palsy (CP)
Renin Angiotensin Aldosterone System
Head to Toe Nursing Assessment (Physical Exam)
Meconium Aspiration
Meningitis
Transient Tachypnea of Newborn
Hyperbilirubinemia (Jaundice)
Spina Bifida – Neural Tube Defect (NTD)
ACE (angiotensin-converting enzyme) Inhibitors
Autism Spectrum Disorders
Attention Deficit Hyperactivity Disorder (ADHD)
Newborn of HIV+ Mother
Angiotensin Receptor Blockers
Calcium Channel Blockers
Cardiac Glycosides
Scoliosis
Metronidazole (Flagyl) Nursing Considerations
Ciprofloxacin (Cipro) Nursing Considerations
Vancomycin (Vancocin) Nursing Considerations
Anti-Infective – Penicillins and Cephalosporins
Atypical Antipsychotics
Rubeola – Measles
Mumps
Varicella – Chickenpox
Pertussis – Whooping Cough
Autonomic Nervous System (ANS)
Sympathomimetics (Alpha (Clonodine) & Beta (Albuterol) Agonists)
Parasympathomimetics (Cholinergics) Nursing Considerations
Parasympatholytics (Anticholinergics) Nursing Considerations
Diuretics (Loop, Potassium Sparing, Thiazide, Furosemide/Lasix)
Epoetin Alfa
HMG-CoA Reductase Inhibitors (Statins)
Magnesium Sulfate
NSAIDs
Corticosteroids
Hydralazine (Apresoline) Nursing Considerations
Nitro Compounds
Vasopressin
Nursing Care and Pathophysiology of Acute Kidney (Renal) Injury (AKI)
Addiction – Behavioral Problems Nursing Mnemonic (The 5 D’s)
Addisons Assessment Nursing Mnemonic (STEROID)
ADLs (Activity of Daily Living) Nursing Mnemonic (BATTED)
Adrenal Gland Hormones Nursing Mnemonic (The 3 S’s)
Airborne Precaution Diseases Nursing Mnemonic (MTV)
Alcoholism – Outcomes Nursing Mnemonic (BAD)
Alkalosis and Acidosis Nursing Mnemonic (Kick Up, Drop Down)
Altered Mental Status Nursing Mnemonic (AEIOU TIPS)
Alzheimer – Diagnosis Nursing Mnemonic (The 5 A’s)
Nursing Care and Pathophysiology for Anemia
Anion Gap Acidosis 1 Nursing Mnemonic (KULT)
Anion Gap Acidosis 2 Nursing Mnemonic (MUDPILES)
Anorexia – Signs and Symptoms Nursing Mnemonic (ANOREXIA)
Anticholinergics – Side Effects Nursing Mnemonic (4 Can’ts)
Aortic Aneurysm – Management Nursing Mnemonic (CRAM)
Aortic Aneurysm – Thoracic signs Nursing Mnemonic (PEE BADS)
Aortic Stenosis Symptoms Nursing Mnemonic (SAD)
Appendicitis – Assessment Nursing Mnemonic (PAINS)
ARDS causes Nursing Mnemonic (GUT PASS)
Arterial Blood Gases Nursing Mnemonic (ROME)
Assessment for Myasthenic Crisis Nursing Mnemonic (BRISH)
Assessment of a Burn Nursing Mnemonic (SCALD)
Assessment of Guillain-Barre Syndrome Nursing Mnemonic (GBS=PAID)
Asthma management Nursing Mnemonic (ASTHMA)
At Risk for Gout Nursing Mnemonic (MALE)
AVPU Mnemonic (The AVPU Scale)
Bacterial Endocarditis – Symptoms Nursing Mnemonic (Be Joan Of Arc)
Benzodiazepines Nursing Mnemonic (Donuts and TLC)
Beta 1 and Beta 2 Nursing Mnemonic (1 Heart, 2 Lungs)
Bleeding Complications (Minor) Nursing Mnemonic (BEEP)
Bleeding Precautions Nursing Mnemonic (RANDI)
Blood Type O Nursing Mnemonic (Universally Odd)
BPH Symptoms Nursing Mnemonic (FUN WISE)
Bulimia – Signs and Symptoms 1 Nursing Mnemonic (BULIMIA)
Bulimia – Signs and Symptoms 2 Nursing Mnemonic (WASHED)
Cancer – Early Warning Signs Nursing Mnemonic (CAUTION UP)
Cancer – Nursing Priorities Nursing Mnemonic (CANCER)
Canes Nursing Mnemonic (COAL)
Cardiac Valves Blood Flow Nursing Mnemonic (Toilet Paper my Ass)
Caring Licensed Practical Nurse Nursing Mnemonic (CLPN)
Causes of Anaphylaxis Nursing Mnemonic (Many Boys Love Food)
Causes of Chorioamnionitis Nursing Mnemonic (Pregnancies Are Very Interesting)
Causes of Dyspnea Nursing Mnemonic (The 6 P’s)
Causes of Labor Dystocia Nursing Mnemonic (Having Extremely Frustrating Labor)
Causes of Pancreatitis Nursing Mnemonic (BAD HITS)
Causes of Poor Gas Exchange Nursing Mnemonic (All People Can Value Lungs)
Causes of Postpartum Hemorrhage Nursing Mnemonic (4 T’s)
Causes of Renal Calculi Nursing Mnemonic (Patients Complain of Pain and Difficulty Urinating)
Chest Tube Assessment Nursing Mnemonic (Two AA’s)
CHF Treatment Nursing Mnemonic (UNLOAD FAST)
Child Abuse/Neglect – Warning Signs Nursing Mnemonic (CHILD ABUSE)
CHO, CHO, CHON Nursing Mnemonic (CHO, CHO, CHON)
Cholinergic Crisis – Signs and Symptoms Nursing Mnemonic (SLUDGE)
Circulatory Checks (5 P’s) Nursing Mnemonic (The 5 P’s)
Cirrhosis Complications Nursing Mnemonic (Please Bring Happy Energy)
Cleft Lip Repair – Post Op Care Nursing Mnemonic (CLEFT LIP)
Common Pathogens for UTI Nursing Mnemonic (KEEPS)
Common Signs of Parkinson’s Nursing Mnemonic (SMART)
Community Health Tool Nursing Mnemonic (MAP-IT)
Complications of Spinal Cord Injuries Nursing Mnemonic (ABCDEFG)
Complications of Thoracentesis Nursing Mnemonic (Patients Sometimes Bleed Internally)
Nursing Care and Pathophysiology for Heart Failure (CHF)
COPD management Nursing Mnemonic (COPD)
Cor Pulmonale – Signs & Symptoms Nursing Mnemonic (Please Read His Text)
Coronary Arteries – Location Nursing Mnemonic (I have a RIGHT to CAMP if you LEFT off the AC)
Cranial Nerve Mnemonic 01 Nursing Mnemonic (Olympic Opium Occupies Troubled Triathletes After Finishing Vegas Gambling Vacations Still High)
Cranial Nerve Mnemonic 02 Nursing Mnemonic (Oh Oh Oh To Touch And Feel Very Good Velvet AH!)
Cranial Nerve Mnemonic 03 Nursing Mnemonic (On Old Obando Tower Top A Filipino Army Guards Villages And Huts)
Crohn’s Morphology and Symptoms Nursing Mnemonic (CHRISTMAS)
Cushings Assessment Nursing Mnemonic (STRESSED)
Cyanotic Defects Nursing Mnemonic (The 4 T’s)
Decrease ICP Nursing Mnemonic (Craniums Excite Me)
Dementia Nursing Mnemonic (DEMENTIA)
Depression Assessment Nursing Mnemonic (SIGNS)
Diabetes Insipidus Nursing Mnemonic (DDD)
Nursing Care and Pathophysiology of Diabetes Mellitus (DM)
Diabetes Mellitus Type 1- Signs & Symptoms Nursing Mnemonic (The 3 P’s)
Diagnostic Criteria for Lupus Nursing Mnemonic (SOAP BRAIN MD)
Diarrhea – Treatment Nursing Mnemonic (BRAT)
Dissociative Disorders
Diverticulitis Complications Nursing Mnemonic (Please Fix His Abscess SOon)
DKA Treatment Nursing Mnemonic (KING UFC)
Drug Interactions Nursing Mnemonic (These Drugs Can Interact)
Drugs for Bradycardia & Low Blood Pressure Nursing Mnemonic (IDEA)
Drugs that Cause SJS Nursing Mnemonic (I C NASA)
Eczema
Electrolytes – Location in Body Nursing Mnemonic (PISO)
Emergency Drugs Nursing Mnemonic (LEAN)
Environmental Health Assessment Nursing Mnemonic (I PREPARE)
Epiglottitis – Signs and Symptoms Nursing Mnemonic (AIR RAID)
Episiotomy – Evaluation of Healing Nursing Mnemonic (REEDA)
Evaluation of Irregular Moles Nursing Mnemonic (ABCDE)
Exercise Guidelines Nursing Mnemonic (FIT)
Factors That Can Put a Pregnancy at Risk Nursing Mnemonic (RIBCAGE)
Fetal Distress Interventions Nursing Mnemonic (Stop MOAN)
Fetal Wellbeing Assessment Tests Nursing Mnemonic (ALONE)
Fire Safety 1 Nursing Mnemonic (PASS)
Fire Safety 2 Nursing Mnemonic (RACE)
Flu Symptoms Nursing Mnemonic (FACTS)
Fractures
GERD causes Nursing Mnemonic (Reflux Is Probably Mean)
Global Symptoms for Brain Tumors Nursing Mnemonic (HAS)
Gluten Free Diet Nursing Mnemonic (BROW)
Heart Failure – Right Sided Nursing Mnemonic (HEAD)
Heart Failure-Left-Sided Nursing Mnemonic (CHOP)
Heart Failure-Origin Nursing Mnemonic (Left – Lung|Right – Rest)
Heart Sounds Nursing Mnemonic (APE To Man – All People Enjoy Time Magazine)
HELLP Syndrome – Signs and Symptoms Nursing Mnemonic (HELLP)
Hemodynamics
Nursing Care and Pathophysiology for Hemorrhagic Stroke (CVA)
Hemorrhagic Stroke Risk Factors Nursing Mnemonic (HATS)
Hiatal Hernia Symptoms Nursing Mnemonic (Her Belly Really Hurts Following Dinner)
High Pressure Vent Alarms Nursing Mnemonic (Kings Eat Big Cakes)
High Risk Behavior Nursing Mnemonic (HEADSS)
Hypercalcemia – Signs and Symptoms Nursing Mnemonic (GROANS, MOANS, BONES, STONES, OVERTONES)
Hyperglycemia Management Nursing Mnemonic (Dry and Hot – Insulin Shot)
Hyperkalemia – Causes Nursing Mnemonic (MACHINE)
Hyperkalemia – Management Nursing Mnemonic (AIRED)
Hyperkalemia – Signs and Symptoms Nursing Mnemonic (Murder)
Hypernatremia – Causes Nursing Mnemonic (MODEL)
Hypernatremia – Signs and Symptoms 2 Nursing Mnemonic (FRIED)
Hypernatremia – Signs and Symptoms 2 Nursing Mnemonic (SWINE)
Hypernatremia – Signs and Symptoms 3 Nursing Mnemonic (SALT)
Hypertension – Nursing care Nursing Mnemonic (DIURETIC)
Hypertension- Complications Nursing Mnemonic (The 4 C’s)
Hypocalcemia – Definition, Signs and Symptoms Nursing Mnemonic (CATS)
Hypoglycemia – Signs and Symptoms Nursing Mnemonic (TIRED)
Hypoglycemia Management Nursing Mnemonic (Cool and Clammy – Give ‘Em Candy)
Hypoglycemia symptoms Nursing Mnemonic (DIRE)
Hypokalemia – Signs and Symptoms Nursing Mnemonic (6 L’s)
Hyponatremia- Definition, Signs and Symptoms Nursing Mnemonic (SALT LOSS)
Hypoxia – Signs and Symptoms (in Pediatrics) Nursing Mnemonic (FINES)
Hypoxia – Signs and Symptoms Nursing Mnemonic (RAT BED)
IADLS (Instrumental Activities of Daily Living) Nursing Mnemonic (SCUM)
Increase MAP Nursing Mnemonic (VAK)
Inflammation- Signs and Symptoms Nursing Mnemonic (HIPER)
Insulin Mnemonic (Ready, Set, Inject, Love)
Interventions for Aphasia Nursing Mnemonic (PROP)
Intra Uterine Device – Potential Problems Nursing Mnemonic (PAINS)
Intrarenal Causes of Acute Kidney Injury Nursing Mnemonic (TONIC)
Leukemia – Signs and Symptoms Nursing Mnemonic (ANT)
Levels of consciousness Nursing Mnemonic (Never Carry Dirty Socks Or Smelly Clothes)
Lidocaine Toxicity – Signs and Symptoms Nursing Mnemonic (SAMS)
Low Pressure Vent Alarms Nursing Mnemonic (Cake Everyday)
Lymphoma – Signs and Symptoms Nursing Mnemonic (NURSE For Pete’s Sake)
Management of Glomerulonephritis Nursing Mnemonic (Please Help Deliver Diuretics)
Management of Lyme Disease Nursing Mnemonic (BAR)
Management of Pressure Ulcers (Pressure Injuries) Nursing Mnemonic (SKIN)
Manic Attack – Signs and Symptoms Nursing Mnemonic (DIG FAST)
MAO Inhibitors Nursing Mnemonic (TIPS)
Medication Classess for IBD Nursing Mnemonic (Sometimes I Can’t Answer)
Medications for Pancreatitis Nursing Mnemonic (Please Make Tummy Better)
Medications to Prevent Seizures Nursing Mnemonic (Pretty Little Liars Forever)
Meningitis Assessment Findings Nursing Mnemonic (FAN LIPS)
Mnemonic for Organ Systems (MR DICE RUNS)
Multiple Sclerosis Symptoms Nursing Mnemonic (DEMYELINATION)
Murmur locations Nursing Mnemonic (hARD ASS MRS. MSD)
Nursing Care and Pathophysiology of Myocardial Infarction (MI)
Myocardial Infarction Nursing Mnemonic (MONATAS)
OB Non-Stress Test Results Nursing Mnemonic (NNN)
OLD CARTS Mnemonic (OLD CARTS)
Oral Birth Control Pills – Serious Complications Nursing Mnemonic (Aches)
Pain Assessment Questions Nursing Mnemonic (OPQRST)
Nursing Care and Pathophysiology for Parkinsons
Asthma
Pediatric Gastrointestinal Dysfunction – Diarrhea
Pharmacokinetics Nursing Mnemonic (ADME)
Planning Community Health Interventions Nursing Mnemonic (PRECEDE-PROCEED)
Pneumonia Risk Factors Nursing Mnemonic (VENTS)
Pneumothorax Signs and Symptoms Nursing Mnemonic (P-THORAX)
Possible Infections During Pregnancy Nursing Mnemonic (TORCH)
Post-Partum Assessment Nursing Mnemonic (BUBBLE)
Postpartum Hemorrhage (PPH)
Preeclampsia: Signs, Symptoms, Nursing Care, and Magnesium Sulfate
Pregnancy Outcomes Nursing Mnemonic (GTPAL)
Probable Signs of Pregnancy Nursing Mnemonic (CHOP BUGS)
Process of Labor – Mom Nursing Mnemonic (4 P’s)
Process of Labor – Baby Nursing Mnemonic (ALPPPS)
Promotion and Evaluation of Normal Elimination Nursing Mnemonic (POOPER SCOOP)
Prostate Nursing Mnemonic (FUN)
Proton Pump Inhibitors
Pulmonary edema treatment Nursing Mnemonic (MAD DOG)
Pupil Reactions Nursing Mnemonic (PERRLA)
Reactivation of Herpes Zoster Nursing Mnemonic (FICA)
Reasons for a Bronchoscopy Nursing Mnemonic (Please Assess His Weird Bronchoscopy Results)
Reasons for Chest Tube Nursing Mnemonic (Don’t Ever Fail)
Restrictive Lung Disease Causes Nursing Mnemonic (PAINT)
Rheumatoid Arthritis Assessment Nursing Mnemonic (RHEUMATOID)
Risk Factors for Cholelithiasis Nursing Mnemonic (5-F’s)
Risk Factors for Osteoporosis Nursing Mnemonic (ACCESS)
Safety Check Nursing Mnemonic (MADLE)
SBAR Communication Nursing Mnemonic (SBAR)
Schizophrenia
Scleroderma Symptoms Nursing Mnemonic (CREST)
Seizure Causes Nursing Mnemonic (VITAMIN)
Seizure Documentation Nursing Mnemonic (TDOC)
Senile Dementia – Assess for Changes Nursing Mnemonic (JAMCO)
Shock – Signs and symptoms Nursing Mnemonic (TV SPARC CUBE)
Nursing Care and Pathophysiology for SIADH (Syndrome of Inappropriate antidiuretic Hormone Secretion)
Signs of Osteoarthritis Nursing Mnemonic (OSTEO)
Sprains and Strains – Nursing Care Nursing Mnemonic (RICE)
SSRI’s Nursing Mnemonic (Effective For Sadness, Panic, and Compulsions)
Stages of Fetal Development Nursing Mnemonic (Proficiently Expanding Fetus)
Stages of Hepatitis Nursing Mnemonic (PIP)
Steps in the Nursing Process 1 Nursing Mnemonic (ADPIE)
Steps in the Nursing Process 2 Nursing Mnemonic (AAPIE)
Steps In The Nursing Process 3 Nursing Mnemonic (SOAPIE)
Steroids – Side Effects Nursing Mnemonic (6 S’s)
Stoke Assessments Nursing Mnemonic (FAST)
Symptoms of Hyperthyroidism Nursing Mnemonic (SWEATING)
Symptoms of Hypothyroidism Nursing Mnemonic (MOM’S SO TIRED)
Symptoms of Nephrotic Syndrome Nursing Mnemonic (NAPHROTIC)
Symptoms of Wernicke’s Encephalopathy Nursing Mnemonic (COAT)
TB Drugs Nursing Mnemonic (RIPE)
Toxicity Sepsis- Signs and Symptoms Nursing Mnemonic (The 6 T’s)
Tracheal Esophageal Fistula – Sign and Symptoms Nursing Mnemonic (The 3 C’s)
Traction – Nursing Care Nursing Mnemonic (TRACTION)
Transient Incontinence – Common Causes Nursing Mnemonic (P-DIAPERS)
Trauma – Assessment (Emergency) Nursing Mnemonic (ABCDEFGHI)
Trauma – Complications Nursing Mnemonic (TRAUMATIC)
Trauma Surgery – Medical History Nursing Mnemonic (AMPLE)
Treatment of Sickle Cell Nursing Mnemonic (HOP to the hospital)
Triage Nursing Mnemonic (START)
Two pathways of the peripheral nervous system Nursing Mnemonic (SAME)
Types of Anemia Nursing Mnemonic (Always Introduce Special Patients)
Types of Hemorrhoids Nursing Mnemonic (Pie)
Ulcerative Colitis – Assessment Nursing Mnemonic (MADE 10)
Umbilical Cord Vasculature Nursing Mnemonic (2A1V)
Vascular Disease – Deep Vein Thrombosis Nursing Mnemonic (HIS Leg Might Fall off)
Vascular disease – Raynaud’s symptoms Nursing Mnemonic (COLD HAND)
Vasospasm Therapy Nursing Mnemonic (Triple H Therapy)
VEAL CHOP Nursing Mnemonic (Fetal Accelerations and Decelerations) (VEAL CHOP)
Vitamins – Fat Soluble Nursing Mnemonic (All Dogs Eat Kibble)
Vitamins – Water Soluble Nursing Mnemonic (Birth Control)
Walkers Nursing Mnemonic (Wandering Wilma Always Late)
Who Needs Dialysis Nursing Mnemonic (AEIOU)