ACE (angiotensin-converting enzyme) Inhibitors

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Tarang Patel
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Study Tools For ACE (angiotensin-converting enzyme) Inhibitors

HTN Pathochart (Cheatsheet)
Heart Failure Pathochart (Cheatsheet)
Common Antihypertensives Cheatsheet (Cheatsheet)
RAAS and Cardiac Drugs (Cheatsheet)
140 Must Know Meds (Book)
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Outline

Overview

  1. Medication that BLOCKS the Angiotensin Converting Enzyme (ACE)
    1. Indications…
      1. High blood pressure
      2. Heart failure
      3. Kidney failure secondary to Diabetes
    2. How they work…
      1. Inhibit ACE from converting Angiotensin I to Angiotensin II
      2. Without Angiotensin II there will be…
        1. Decreased vasoconstriction
        2. Decreased sodium and water reabsoprtion in the kidneys.
        3. Review lesson on RAAS for better understanding
      3. Metabolised in the liver

Nursing Points

General

  1. Decreased vasoconstriction =
    1. Decreased blood pressure
    2. Decreased resistance for heart to pump against (decreased workload)
  2. Decreased sodium and water reabsorption in the kidneys =
    1. Decreased blood volume
    2. Decreased fluid overload
    3. Increased potassium reabsorption in kidneys
    4. Decreased blood flow to kidneys

Assessment

  1. Side Effects-
    1. Severe hypotension
      1. Dizziness
      2. Light-headedness
      3. Feeling faint when standing
    2. Hyperkalemia (increased potassium levels)
      1. Confusion
      2. Numbness/tingling in hands
      3. Cardiac arrythmias
    3. Dry cough
    4. Swelling around eyes, lips, throat (Angioedema)
      1. Can be severe causing swelling in throat, compromising airway
    5. Decreased kidney function
    6. Neutropenia
      1. Specific to ACE Inhibitor – Captopril

Therapeutic Management

  1. Monitor blood pressure closely. Especially with first dose.
  2. Monitor potassium levels for hyperkalemia
    1. Do not prescribe ACE Inhibitors and Potassium-sparing Diuretics together because they can both cause high levels of potassium
  3. Cough suppressant to help with cough
    1. If cough is intolerable may change to Angiotensin II Receptor Blocker (ARB)
  4. Monitor for facial swelling and inflammation/swelling in airway
  5. Monitor kidney function
    1. BUN & Creatinin levels
  6. Contraindications-
    1. Decreased kidney function
    2. Liver damage
      1. Medication will build up in the system causing toxicity
    3. Immunospression (specific to Captopril)

Nursing Concepts

  1. Perfusion
    1. ACE Inhibitors lower blood pressure by decreasing vasoconstriction and decreasing sodium and water reabsorption in the kidneys
  2. Pharmacology

Patient Education

  1. Do not get up suddenly because blood pressure may drop causing dizziness and faintness.
  2. Be aware that swelling of face, eyes and throat is a possible side effect of ACE Inhibitors. Contact your provider immediately if this happens because it could affect your breathing.

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Transcript

Okay, so we gonna talk about ACE inhibitor also known as a angiotensin converting enzyme inhibitors. In this module, we gonna cover this drugs but before we cover these drugs, we highly recommend you watch our video, RAA system on Renin Angiotensin Aldosterone System, because if you understand that one, you’ll understand these drugs better.

So, let’s talk about the indication first. These medications are used for high blood pressure, so, if someone has a high blood pressure, these medications are used to control the high blood pressure. Also, these medications are also used for the control of Diabetes symptoms related to the kidneys. So, symptoms related to kidneys. And it also used in the heart failure as well. Now, in the next slide, we’ll go over the mechanism of action and we’ll see why do we use these medications for these disease processes, okay?

So, this image is basically showing the RAA system and if you have looked at the video about the RAA system, you know, the angiotensin converting enzyme right here converts the Angiotensin I into Angiotensin II. And the Angiotensin II has a wide variety of effect in our body including increase in the sympathetic system, it increases the vasoconstriction, and increases the blood pressure. It also increases the sodium reabsorption, and also the water, while it increases the potassium excretion and so forth. So, when we block this ACE enzyme, nothing’s gonna convert from here. The Angiotensin I is not gonna be able to convert to Angiotensin II. So, we are breaking this chain from right here and that means, there’s no sympathetic activity, no sodium and water reabsorption is gonna happen and no vasoconstriction.

So, let’s see what’s gonna happen now when we block the ACE enzyme. Let’s go to the next slide and take a look. So, this is a kind of a simplified version of the RAA system. So, when we block this enzyme right here, decreased in sodium reabsorption, decrease in water reabsorption, now, this is gonna decrease in blood volume and fluid overload. And that is the reason why we use these drugs for heart failure. Now, at the same time, when the sodium reabsorption and the water reabsorption gonna decrease, it’s gonna increase the potassium reabsorption, and potassium level is gonna increase. Okay, so remember this one from the previous slide. In the normal RAA system, potassium level goes down but when we block this angiotensin converting enzyme, the potassium reabsorption is gonna go up and the potassium level is gonna go up. This will help you to remember one of the side effect that we will go over in the next slide. Now, when we block this enzyme, the angiotensin won’t be used and it’s not gonna work on sympathetic nervous system as well and it’s not gonna cause the vasoconstriction. So, what it’s gonna do? It’s gonna decrease the vasoconstriction. When it decreases the vasoconstriction, the blood pressure is gonna decrease, when the blood pressure is decreased, heart will be able to pump blood more easily. So, heart able to pump blood more easily because it won’t have that resistance to pump, the heart won’t have that resistance to come over when the blood pressure high because it’s not gonna do vasoconstriction anymore. And that is the reason, it’s also we use this medication to decrease the blood pressure and also for the heart failure. ‘Cause it’s gonna decrease the heart workload. Alright, so, that’s how, the basically, the mechanism of action of the ACE inhibitors.

Let’s look at into the next slide, the side effects, contraindication and the nursing consideration to remember. The very first one is severe hyppotension after the first dose. So, there are many patient can have severe hypotension after the first dose and hypotension symptoms would be, you have to look for as a nurse is dizziness, lightheadedness, and faintness upon rising. So, you have to instruct the patient after the first dose to not get up suddenly because it can decrease the blood pressure significantly and they can feel dizzy and they can fall. As a nurse, you want to assess the blood pressure before giving the first dose and then after periodically to make sure their blood pressure is not falling down significantly. Okay, now, as we talked into the previous slide, let’s go back to the previous slide really quickly. That it increases the potassium reabsorption when you block the Angiotensin converting enzyme, it’s gonna increase the potassium reabsorption, it’s gonna increase the potassium level. And that is the reason one of the side effects of this medication is high potassium level. So, what are the symptoms of the high potassium? Could have been confusion, numbness or tingling in hands and feet, can cause a cardiac arrhythmia. And also, since it can cause the high potasssium level, it is contraindicated into the potassium sparing diuretic and also the salt substitute. Potassium sparing diuretic much increases the potassium reabsorption as well, so you don’t really want to put patient on 2 different medication which both increases the potassium reabsorption and increases the potassium level. So, they are contraindicated in a patient who’s taking potassium sparing diuretic. And also, the salt substitute because in the salt substitute, they add potassium. So, that’s gonna, if they are on salt substitute, it’s gonna even increase more potassium in the body. So, that’s why they are contraindicated.

One of the main side effects that as a nurse you have to remember and for the NCLEX as well, is a dry cough. Remember like the ACE enzymes is located in the lungs. Now, this medication inhibits the ACE enzyme in the lungs can increase the level of bradykinins in the lungs, which is basically an inflammatory agent. And because of that accumulates this bradykinin in the lungs, it can cause a dry persistent cough. So, in that case, what do you do is either tell the patient to take a cough medication per doctor’s instructions or they usually change medication if it’s really intolerable and really persistent dry cough, they change medication to the ARBs which is Angiotensin II receptor blocker, which we gonna cover in different presentation. Angiotensin II Receptor Blockers. This medication can also change the ability to taste, so, the patient can have salty or metallic taste and also sometimes decreases the ability to taste. And in that case, you really want to tell the doctor and change the medication to something else to control either the blood pressure or the heart failure, okay? Now, another important side effects to remember is Angioedema which is swelling around the lips, eyes, throat and other body regions. Now, since this can cause swelling around the throat, it can lead to airway closure. So, this is kinda serious side effects of this medication, is the Angioedema. So, you really want to educate the patient about this Angioedema and kind of lock after the first dose or in a few weeks. So, you really wanna tell the patient to monitor the swelling of these lips, eyes, throat, and if it happens, tell the doctor as soon as possible, emergently, I would say. Now, there’s a particular drug in this class, it’s called Captopril. It can cause a neutropenia which is basically decrease in white blood cells. So, you want to monitor the white blood cells before you give the medication periodically to make sure the patient is not gonna have Neutropenia. And since this medication decreases the blood flow to the renal, I mean, kidneys, you really wanna monitor the BUN and creatinine which represents kidney function.

Now, in which patient these medications are contraindicated? Now, if we go back to the side effects, and the mechanism of action, it’s kinda self-explanatory like in which patients this is contraindicated. First, it definitely decreases the blood flow to the kidneys. So, it is contraindication in a patient who has a decreased renal function. Most of the medication is metabolized by the liver, so, if the liver, if a patient has a liver damage, you don’t wanna really give this medication because it can accumulate in the body to toxic level. Now, Captopril can cause neutropenia. So, if a patient has either one of these: bone marrow depression, immunosuppressant medication or if they have any kind of autoimmune disease, we don’t really wanna give patient this medication because it can even cause more decrease in immune system. And if they have decreased in immune system, they can have, the indication would be like a sore throat and all other infections. So, you wanna educate the patient about that too.

Now, how do you find these ACE inhibitors? There’s a really easy way. You can call these drugs -pril drugs. If you look at the names of this medication, where end of all drugs it ends with prils. So, any drugs that ends with prils, it’s ACE inhibitors. Quite easy.

Alright, so, if you have any questions about this medication, or any mechanism of action or side effects, you can e-mail us or contact us. Thanks for watching.

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Concepts Covered:

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Study Plan Lessons

Community Health Course Introduction
EKG (ECG) Course Introduction
Fluid & Electrolytes Course Introduction
Fundamentals Course Introduction
OB Course Introduction
12 Points to Answering Pharmacology Questions
Care of the Pediatric Patient
Electrical A&P of the Heart
Glaucoma
Intro to Community Health
Menstrual Cycle
Overview of Developmental Theories
What Guides Nurses Practice
54 Common Medication Prefixes and Suffixes
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Addisons Disease
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Cataracts
Community Health Nursing Theories
Electrolytes Involved in Cardiac (Heart) Conduction
Family Planning & Contraception
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Kohlberg’s Theory of Moral Development
Vitals (VS) and Assessment
Community Health Education
Nursing Care and Pathophysiology for Cushings Syndrome
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Macular Degeneration
Nursing Care Delivery Models
Piaget’s Theory of Cognitive Development
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Nursing Care and Pathophysiology for Diabetes Insipidus (DI)
Nursing Care and Pathophysiology for Disseminated Intravascular Coagulation (DIC)
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Growth & Development – Infants
Health Promotion Model
Nursing Care and Pathophysiology for Herpes Zoster – Shingles
Isotonic Solutions (IV solutions)
Nursing Care and Pathophysiology of Osteoarthritis (OA)
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6 Rights of Medication Administration
Environmental and Genetic Influences on Growth & Development
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Fractures
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Body Image Changes Throughout Development
Growth & Development – School Age- Adolescent
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Care of Vulnerable Populations
Nursing Care and Pathophysiology for Cirrhosis (Liver Disease, Hepatic encephalopathy, Portal Hypertension, Esophageal Varices)
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Nutrition in Pregnancy
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SBAR Communication
Atrial Fibrillation (A Fib)
Atrial Fibrillation (A Fib)
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Growth & Development – School Age- Adolescent
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Premature Atrial Contraction (PAC)
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Anemia in Pregnancy
Benzodiazepines
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Growth & Development – Middle Adulthood
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Growth & Development – Late Adulthood
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Disseminated Intravascular Coagulation (DIC)
Ectopic Pregnancy
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Nursing Care and Pathophysiology for Distributive Shock
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Postpartum Physiological Maternal Changes
Kohlberg’s Theory of Moral Development
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MAOIs
Piaget’s Theory of Cognitive Development
Postpartum Discomforts
Postpartum Discomforts
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Breastfeeding
Erikson’s Theory of Psychosocial Development
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Family Structure and Impact on Development
SSRIs
Body Image Changes Throughout Development
Cystic Fibrosis (CF)
Cultural Awareness and Influences on Development
Developmental Considerations for the Hospitalized Individual
TCAs
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Hierarchy of O2 Delivery
Histamine 1 Receptor Blockers
Initial Care of the Newborn (APGAR)
Initial Care of the Newborn (APGAR)
Nephrotic Syndrome
Artificial Airways
Enuresis
Newborn Physical Exam
Newborn Physical Exam
Airway Suctioning
Body System Assessments
Body System Assessments
Histamine 2 Receptor Blockers
Newborn Reflexes
Newborn Reflexes
Babies by Term
Babies by Term
Cerebral Palsy (CP)
Introduction to Health Assessment
Renin Angiotensin Aldosterone System
Head to Toe Nursing Assessment (Physical Exam)
Meconium Aspiration
Meningitis
Transient Tachypnea of Newborn
Transient Tachypnea of Newborn
Retinopathy of Prematurity (ROP)
Hyperbilirubinemia (Jaundice)
Spina Bifida – Neural Tube Defect (NTD)
ACE (angiotensin-converting enzyme) Inhibitors
Autism Spectrum Disorders
Erythroblastosis Fetalis
Addicted Newborn
Attention Deficit Hyperactivity Disorder (ADHD)
Newborn of HIV+ Mother
Newborn of HIV+ Mother
Angiotensin Receptor Blockers
Calcium Channel Blockers
Cardiac Glycosides
Tocolytics
Betamethasone and Dexamethasone
Scoliosis
Magnesium Sulfate
Metronidazole (Flagyl) Nursing Considerations
Opioid Analgesics
Prostaglandins
Uterine Stimulants (Oxytocin, Pitocin)
Meds for PPH (postpartum hemorrhage)
Rh Immune Globulin (Rhogam)
Lung Surfactant
Eye Prophylaxis for Newborn (Erythromycin)
Phytonadione (Vitamin K)
Hb (Hepatitis) Vaccine
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
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ABG (Arterial Blood Gas) Interpretation-The Basics
ABG (Arterial Blood Gas) Oxygenation
ABG Course (Arterial Blood Gas) Introduction
ABGs Nursing Normal Lab Values
ABGs Tic-Tac-Toe interpretation Method
Absolute Neutrophil Count (ANC) Lab Values
Absolute Neutrophil Count (ANC) Lab Values
Absolute Reticulocyte Count (ARC) Lab Values
Absolute Reticulocyte Count (ARC) Lab Values
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)
Alanine Aminotransferase (ALT) Lab Values
Alanine Aminotransferase (ALT) Lab Values
Albumin Lab Values
Albumin Lab Values
Alcoholism – Outcomes Nursing Mnemonic (BAD)
Alkaline Phosphatase (ALK PHOS) Lab Values
Alkaline Phosphatase (ALK PHOS) Lab Values
Alkalosis and Acidosis Nursing Mnemonic (Kick Up, Drop Down)
Alpha-fetoprotein (AFP) Lab Values
Alpha-fetoprotein (AFP) Lab Values
Altered Mental Status Nursing Mnemonic (AEIOU TIPS)
Alzheimer – Diagnosis Nursing Mnemonic (The 5 A’s)
Ammonia (NH3) Lab Values
Ammonia (NH3) Lab Values
Anion Gap
Anion Gap
Anion Gap Acidosis 1 Nursing Mnemonic (KULT)
Anion Gap Acidosis 2 Nursing Mnemonic (MUDPILES)
Anorexia – Signs and Symptoms Nursing Mnemonic (ANOREXIA)
Antepartum Testing
Anticholinergics – Side Effects Nursing Mnemonic (4 Can’ts)
Antinuclear Antibody Lab Values
Antinuclear Antibody Lab Values
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)
Base Excess & Deficit
Benzodiazepines Nursing Mnemonic (Donuts and TLC)
Beta 1 and Beta 2 Nursing Mnemonic (1 Heart, 2 Lungs)
Beta Hydroxy (BHB) Lab Values
Beta Hydroxy (BHB) Lab Values
Bicarbonate (HCO3) Lab Values
Bicarbonate (HCO3) Lab Values
Bleeding Complications (Minor) Nursing Mnemonic (BEEP)
Bleeding Precautions Nursing Mnemonic (RANDI)
Blood Type O Nursing Mnemonic (Universally Odd)
Blood Urea Nitrogen (BUN) Lab Values
Blood Urea Nitrogen (BUN) Lab Values
BPH Symptoms Nursing Mnemonic (FUN WISE)
Brain Natriuretic Peptide (BNP) Lab Values
Brain Natriuretic Peptide (BNP) Lab Values
Bulimia – Signs and Symptoms 1 Nursing Mnemonic (BULIMIA)
Bulimia – Signs and Symptoms 2 Nursing Mnemonic (WASHED)
C-Reactive Protein (CRP) Lab Values
C-Reactive Protein (CRP) Lab Values
Cancer – Early Warning Signs Nursing Mnemonic (CAUTION UP)
Cancer – Nursing Priorities Nursing Mnemonic (CANCER)
Canes Nursing Mnemonic (COAL)
Carbon Dioxide (Co2) Lab Values
Carbon Dioxide (Co2) Lab Values
Carboxyhemoglobin Lab Values
Carboxyhemoglobin Lab Values
Cardiac (Heart) Enzymes
Cardiac (Heart) Enzymes
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)
Cholesterol (Chol) Lab Values
Cholesterol (Chol) Lab Values
Cholinergic Crisis – Signs and Symptoms Nursing Mnemonic (SLUDGE)
Chorioamnionitis
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)
Coagulation Studies (PT, PTT, INR)
Coagulation Studies (PT, PTT, INR)
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)
Congestive Heart Failure (CHF) Labs
Congestive Heart Failure (CHF) Labs
COPD (Chronic Obstructive Pulmonary Disease) Labs
COPD (Chronic Obstructive Pulmonary Disease) Labs
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)
Cortisol Lab Vales
Cortisol Lab Vales
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)
Creatine Phosphokinase (CPK) Lab Values
Creatine Phosphokinase (CPK) Lab Values
Creatinine (Cr) Lab Values
Creatinine (Cr) Lab Values
Creatinine Clearance Lab Values
Creatinine Clearance Lab Values
Crohn’s Morphology and Symptoms Nursing Mnemonic (CHRISTMAS)
Cultures
Cultures
Cushings Assessment Nursing Mnemonic (STRESSED)
Cyanotic Defects Nursing Mnemonic (The 4 T’s)
Cyclic Citrullinated Peptide (CCP) Lab Values
Cyclic Citrullinated Peptide (CCP) Lab Values
D-Dimer (DDI) Lab Values
D-Dimer (DDI) Lab Values
Decrease ICP Nursing Mnemonic (Craniums Excite Me)
Dementia Nursing Mnemonic (DEMENTIA)
Depression Assessment Nursing Mnemonic (SIGNS)
Diabetes Insipidus Nursing Mnemonic (DDD)
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)
Direct Bilirubin (Conjugated) Lab Values
Direct Bilirubin (Conjugated) Lab Values
Disseminated Intravascular Coagulation (DIC)
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)
Dysrhythmias Labs
Dysrhythmias Labs
Ectopic Pregnancy
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)
Erythrocyte Sedimentation Rate (ESR) Lab Values
Erythrocyte Sedimentation Rate (ESR) Lab Values
Evaluation of Irregular Moles Nursing Mnemonic (ABCDE)
Exercise Guidelines Nursing Mnemonic (FIT)
Factors That Can Put a Pregnancy at Risk Nursing Mnemonic (RIBCAGE)
Family Planning & Contraception
Fetal Alcohol Syndrome (FAS)
Fetal Distress Interventions Nursing Mnemonic (Stop MOAN)
Fetal Wellbeing Assessment Tests Nursing Mnemonic (ALONE)
Fibrin Degradation Products (FDP) Lab Values
Fibrin Degradation Products (FDP) Lab Values
Fibrinogen Lab Values
Fibrinogen Lab Values
Fire Safety 1 Nursing Mnemonic (PASS)
Fire Safety 2 Nursing Mnemonic (RACE)
Flu Symptoms Nursing Mnemonic (FACTS)
Fluid Compartments
Free T4 (Thyroxine) Lab Values
Free T4 (Thyroxine) Lab Values
Gamma Glutamyl Transferase (GGT) Lab Values
Gamma Glutamyl Transferase (GGT) Lab Values
GERD causes Nursing Mnemonic (Reflux Is Probably Mean)
Gestational Diabetes (GDM)
Global Symptoms for Brain Tumors Nursing Mnemonic (HAS)
Glomerular Filtration Rate (GFR)
Glomerular Filtration Rate (GFR)
Glucagon Lab Values
Glucagon Lab Values
Glucose Lab Values
Glucose Lab Values
Glucose Tolerance Test (GTT) Lab Values
Glucose Tolerance Test (GTT) Lab Values
Gluten Free Diet Nursing Mnemonic (BROW)
Gravidity and Parity (G&Ps, GTPAL)
Growth Hormone (GH) Lab Values
Growth Hormone (GH) Lab Values
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)
Hematocrit (Hct) Lab Values
Hematocrit (Hct) Lab Values
Hemodynamics
Hemoglobin (Hbg) Lab Values
Hemoglobin (Hbg) Lab Values
Hemoglobin A1c (HbA1C)
Hemoglobin A1c (HbA1C)
Hemorrhagic Stroke Risk Factors Nursing Mnemonic (HATS)
Hepatitis B Virus (HBV) Lab Values
Hepatitis B Virus (HBV) Lab Values
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)
Homocysteine (HCY) Lab Values
Homocysteine (HCY) Lab Values
Human Growth & Development Course Introduction
Hyperbilirubinemia (Jaundice)
Hypercalcemia – Signs and Symptoms Nursing Mnemonic (GROANS, MOANS, BONES, STONES, OVERTONES)
Hyperemesis Gravidarum
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)
Incompetent Cervix
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)
Ionized Calcium Lab Values
Ionized Calcium Lab Values
Iron (Fe) Lab Values
Iron (Fe) Lab Values
Ischemic (CVA) Stroke Labs
Ischemic (CVA) Stroke Labs
Lab Panels
Lab Panels
Lab Values Course Introduction
Lab Values Course Introduction
Lactate Dehydrogenase (LDH) Lab Values
Lactate Dehydrogenase (LDH) Lab Values
Lactic Acid
Leukemia – Signs and Symptoms Nursing Mnemonic (ANT)
Levels of consciousness Nursing Mnemonic (Never Carry Dirty Socks Or Smelly Clothes)
Levels of Prevention
Lidocaine Toxicity – Signs and Symptoms Nursing Mnemonic (SAMS)
Lipase Lab Values
Lipase Lab Values
Lithium Lab Values
Lithium Lab Values
Liver Function Tests
Liver Function Tests
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)
Maslow’s Hierarchy of Needs in Nursing
Mastitis
Maternal Risk Factors
Mean Corpuscular Volume (MCV) Lab Values
Mean Corpuscular Volume (MCV) Lab Values
Mean Platelet Volume (MPV) Lab Values
Mean Platelet Volume (MPV) Lab Values
Meconium Aspiration
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)
Menstrual Cycle
Metabolic Acidosis (interpretation and nursing diagnosis)
Metabolic Alkalosis
Methemoglobin (MHGB) Lab Values
Methemoglobin (MHGB) Lab Values
Mnemonic for Organ Systems (MR DICE RUNS)
Multiple Sclerosis Symptoms Nursing Mnemonic (DEMYELINATION)
Murmur locations Nursing Mnemonic (hARD ASS MRS. MSD)
Myocardial Infarction Nursing Mnemonic (MONATAS)
Myoglobin (MB) Lab Values
Myoglobin (MB) Lab Values
OB Non-Stress Test Results Nursing Mnemonic (NNN)
OLD CARTS Mnemonic (OLD CARTS)
Oral Birth Control Pills – Serious Complications Nursing Mnemonic (Aches)
Order of Lab Draws
Order of Lab Draws
Pain Assessment Questions Nursing Mnemonic (OPQRST)
Pediatric Bronchiolitis Labs
Pediatric Bronchiolitis Labs
Pharmacokinetics Nursing Mnemonic (ADME)
Phosphorus (PO4) Blood Test Lab Values
Phosphorus (PO4) Blood Test Lab Values
Planning Community Health Interventions Nursing Mnemonic (PRECEDE-PROCEED)
Platelets (PLT) Lab Values
Platelets (PLT) Lab Values
Pneumonia Labs
Pneumonia Labs
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)
Potassium-K (Hyperkalemia, Hypokalemia)
Prealbumin (PAB) Lab Values
Prealbumin (PAB) Lab Values
Pregnancy Labs
Pregnancy Labs
Pregnancy Outcomes Nursing Mnemonic (GTPAL)
Premature Rupture of the Membranes (PROM)
Preterm Labor
Probable Signs of Pregnancy Nursing Mnemonic (CHOP BUGS)
Procalcitonin (PCT) Lab Values
Procalcitonin (PCT) Lab Values
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)
Prostate Specific Antigen (PSA) Lab Values
Prostate Specific Antigen (PSA) Lab Values
Protein (PROT) Lab Values
Protein (PROT) Lab Values
Protein in Urine Lab Values
Protein in Urine Lab Values
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)
Red Blood Cell (RBC) Lab Values
Red Blood Cell (RBC) Lab Values
Red Cell Distribution Width (RDW) Lab Values
Red Cell Distribution Width (RDW) Lab Values
Renal (Kidney) Failure Labs
Renal (Kidney) Failure Labs
Respiratory Acidosis (interpretation and nursing interventions)
Respiratory Alkalosis
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)
ROME – ABG (Arterial Blood Gas) Interpretation
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)
Sepsis Labs
Sepsis Labs
Shock – Signs and symptoms Nursing Mnemonic (TV SPARC CUBE)
Shorthand Lab Values
Shorthand Lab Values
Nursing Care and Pathophysiology for SIADH (Syndrome of Inappropriate antidiuretic Hormone Secretion)
Signs of Osteoarthritis Nursing Mnemonic (OSTEO)
Signs of Pregnancy (Presumptive, Probable, Positive)
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)
Thyroid Stimulating Hormone (TSH) Lab Values
Thyroid Stimulating Hormone (TSH) Lab Values
Thyroxine (T4) Lab Values
Thyroxine (T4) Lab Values
Total Bilirubin (T. Billi) Lab Values
Total Bilirubin (T. Billi) Lab Values
Total Iron Binding Capacity (TIBC) Lab Values
Total Iron Binding Capacity (TIBC) Lab Values
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)
Triiodothyronine (T3) Lab Values
Triiodothyronine (T3) Lab Values
Troponin I (cTNL) Lab Values
Troponin I (cTNL) Lab Values
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)
Urinalysis (UA)
Urinalysis (UA)
Urinary Elimination
Urine Culture and Sensitivity Lab Values
Urine Culture and Sensitivity Lab Values
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)
Vitamin B12 Lab Values
Vitamin B12 Lab Values
Vitamin D Lab Values
Vitamin D Lab Values
Vitamins – Fat Soluble Nursing Mnemonic (All Dogs Eat Kibble)
Vitamins – Water Soluble Nursing Mnemonic (Birth Control)
Walkers Nursing Mnemonic (Wandering Wilma Always Late)
White Blood Cell (WBC) Lab Values
White Blood Cell (WBC) Lab Values
Who Needs Dialysis Nursing Mnemonic (AEIOU)