Platelets (PLT) Lab Values

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Chance Reaves
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Included In This Lesson

Study Tools For Platelets (PLT) Lab Values

Leukemia – Signs and Symptoms (Mnemonic)
63 Must Know Lab Values (Cheatsheet)
Clotting Cascade Anticoagulants Cheatsheet (Cheatsheet)
Complications of Immobility – DVT (Image)
Platelet response (Image)
63 Must Know Lab Values (Book)
Platelet Lab Value (Picmonic)
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Outline

Overview

  1. Platelets
    1. Normal Value Range
    2. Pathophysiology
    3. Special considerations
    4. Elevated platelet levels
    5. Decreased platelet levels

Nursing Points

General

  1. Normal value ranges
    1. 100,000 – 450,000/mcL
    2. Also known as – Thrombocytes
  2. Pathophysiology
    1. Formed from Megakaryocyte
      1. Formed from bone marrow
      2. Produces 1000-3000 platelets
    2. Injury occurs at site
      1. Collagen releases activators
      2. Thrombocytes activate “sticky fingers”, which allow them to bind together.
      3. Travel to site (along with other clotting factors)
      4. Adhere to site, increase stimulation for other PLT, until clot is formed with fibrin
  3. Special considerations
    1. Use a lavender top tube (EDTA)
    2. Often sent in CBC
  4. Abnormal lab values
    1. Elevated platelets (thrombocytosis)
      1. Cancers
      2. Absence of a spleen
        1. Breaks down platelets
      3. Birth control
      4. Polycythemia vera
        1. Overproduction of cells
        2. Treatment via bloodletting, medications or hydration
    2. Decreased platelets (thrombocytopenia)
      1. ITP (Idiopathic thrombocytopenic purpura)
        1. Autoimmune disease
        2. Medications
      2. Hemorrhage
        1. Treated with transfusion
      3. Leukemia
        1. Treated with chemotherapy/radiation
      4. Medications
        1. Some diuretics
        2. Nonsteroidal anti-inflammatory drugs (NSAIDs)
        3. Ranitidine
        4. Some antibiotics

Assessment

  1. Assess for signs of petechia (small purplish blemishes, indicating bleeding)

Therapeutic Management

  1. Control and stop hemorrhage
    1. Replace platelets via transfusion
  2. Consider stopping or changing medications that cause thrombocytopenia

Nursing Concepts

  1. Lab Values
  2. Clotting

Patient Education

  1. For patients who have bleeding disorders, instruct patients to be cautious of injury.
  2. If patient has thrombocytopenia, instruct patient to seek emergency treatment in the event of bleeding that does not stop.

**DISCLAIMER – The video states that the normal value of platelets is 100,000 – 400,000 cells/mcL. The correct information is 100,000 – 450,000 cells/mcL.

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Transcript

In this lesson we’re going to talk about platelets and how they play a role in your patient’s ability to clot.

The normal values for platelets are going to be a hundred thousand to 400,000 cells per microliter. Anything less than a hundred thousand cells per microliter is considered to be a condition called thrombocytopenia. Platelets are also called thrombocytes, so that’s where we get the word from beside of penia meaning low platelets.

In this picture you can see that the thrombocyte, this yellow cell is much smaller than red blood cells or white blood cells.

Let’s look at how platelets work.

Platelets are formed from the cells called megakaryocytes, and they’re these really large cells, and they break off all of the little platelets. I’m megakaryocytes can actually produce anywhere from 1000 to 3000 platelets during its lifetime. These are all derived from the bone marrow.

Now the way platelets work is that you’ll have an injury at a particular site, so maybe a laceration. What happens is the collagen in the skin triggers a reaction that stimulates platelets to come to the site. Normally platelets are these little round flat cells, and when they’re triggered they actually activate and create these little finger-like projections. Think of them as like sticky fingers. That makes them more likely to stick to whatever site they’re going to. The entire clotting Cascade is very very complicated, and there are a lot of other factors that play into it, but what you need to know is that the platelets arrive to the site and stick to the injury, and that triggers more of an active response and it brings in all these other platelets and as you can see in this picture, the platelets all start to form this little clot. The platelets will also interact with fibrin to create a clot at the site and that’s what stops the bleeding.

So what do you need to be considerate of whenever you’re drawing a sample? Just know that you’re platelet samples are going to be submitted in a lavender top tube, that has the EDTA in it. It’s often submitted with the CBC, and that helps to give a general overview of all the cells in your patient. So you also get results that’ll include things like yours white blood cells, red blood cells, hematocrit and hemoglobin.

The next question you probably have is what do high and low values of platelets indicate?

With elevated platelets, a condition known as thrombocytosis, is when the platelets are greater than 400000 cells per microliter. Conditions that will trigger this are things like cancers or malignancy. Another situation is the absence of a spleen. The spleen’s responsibility is to break down old or damaged platelets, and if there’s no spleen, that can’t occur and therefore your platelet values may go up. Certain types of birth control can also cause increase in platelets, and also the condition that we talked about in some other lessons called polycythemia vera. Polycythemia vera is in uncommon type of bone marrow cancer causes this massive overproduction of cells. These will include white blood cells, red blood cells and platelets. Treatment is typically bloodletting, or the actual removal of blood from a patient through phlebotomy to decrease the overall blood volume. The blood becomes really thick and viscous when there’s as overproduction of cells, and that’s how they treated. It can also be treated through making sure the patient is adequately hydrated, and some medications can help this condition.

If a platelet values are low it’s a condition called thrombocytopenia. There are a couple of specific conditions, one called ITP. This is idiopathic thrombocytopenia purpura, and what it is is it’s an autoimmune disease that attacks antibodies on the platelets and destroys them. If you don’t have platelets, you can’t clot, so these patients are at a much higher risk of clotting. Patients that have ITP will go through some sort of medication therapy that suppresses the immune system so that it doesn’t attack itself. These patients are definite risk for bleeding, and sometimes they’ll develop these little areas of bleeding underneath the skin called petechiae. Sometimes they look like little bleeding stars. So if you see that, you might want to suspect a platelet issue with your patient. Another condition that you’re going to see decreased platelets in is hemorrhage and you’re going to treat those patients with platelet transfusions. Patients that are undergoing chemotherapy or radiation for leukemia they also have decreased platelets. And another thing to consider is medications. Certain medications can have the potential to decrease platelet production. These are things like diuretics, NSAIDs, Ranitidine, and certain types of antibiotics. So be sure to review any medications if you’re suspicious of some sort of clotting issue for your patient.

Nursing concepts for this lesson include a lot of values and clotting, because that’s what the responsibilities of the platelets are.
So let’s recap.

The normal values for platelets are 100,000 to 400000 cells per microliter.

The responsibility of the platelet is for clotting.

If you have increased platelets, that could be from cancers, polycythemia vera, or over production. Also consider if the patient has had a splenectomy.

Decrease platelets are on much more concerning, so consider things like ITP, leukemia, or Hemorrhage.

If your patient does have decreased the values of platelets, or are at risk for having decrease platelets, make sure that they understand that they are always at risk for bleeding. Make sure that they know when to come to the emergency room if they have some sort of injury that won’t stop bleeding, and make sure that you go over any medications that could potentially cause bleeding issues.

That’s it for our lesson on platelets. Make sure you check out all the resources attached to this lesson. Now, go out and be your best selves today. And, as always, happy nursing!!

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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
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Same
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Platelets (PLT) Lab Values
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Alkalosis and Acidosis Nursing Mnemonic (Kick Up, Drop Down)
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Alzheimer – Diagnosis Nursing Mnemonic (The 5 A’s)
Nursing Care and Pathophysiology for Anemia
Anion Gap Acidosis 1 Nursing Mnemonic (KULT)
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Anorexia – Signs and Symptoms Nursing Mnemonic (ANOREXIA)
Anticholinergics – Side Effects Nursing Mnemonic (4 Can’ts)
Aortic Aneurysm – Management Nursing Mnemonic (CRAM)
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Appendicitis – Assessment Nursing Mnemonic (PAINS)
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At Risk for Gout Nursing Mnemonic (MALE)
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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)
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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)
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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)