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Table of Contents
1. Causes of Acute Kidney Injury
2. Acute Kidney Injury
3. Pulmonary Embolism
4. Insulin and Glucagon
5. Diabetic Keto Acidosis
6. Hyperosmolar Hyperglycaemic State
7. Spinal Cord Injury
8. Ulcerative Colitis
9. Crohn's Disease
10. Heart Failure
11. Disorders and Triads
12. EKG Review
13. Types of Shock
14. Electrolytes
15. ABGs
16. Cranial Nerves
17. Common Diets
18. Hormones
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CAUSES OF AKI @nursebossessentials
Disorder: Acute Kidney Injury
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Sudden deterioration in kidney function.

Prerenal:
outside the kidneys
1. Dehydration, infection

outside of the kidney,

decreased cardiac output

Intrarenal:
within the kidneys

1. Infection within the kidney,

parenchyma tubular

necrosis, renal ischemia

Postrenal:
between kidney and urethral
meatus
1. Calculi, cystitis,
tumors/obstruction, surgery
ACUTE KIDNEY INJURY
Pathophysiology: Sudden deterioration in kidney function.
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Fluid Retention Nitrogenous waste Electrolyte Imbalance

Causes:
Prerenal: Intrarenal:
damage outside the damage within the kidneys
kidneys

Postrenal:
between kidney and urethral meatus

Phases:

Oliguric Phase: Diuretic Phase: Recover Phase:

Urine output: Increase in urine Recovery may take

<400mL/d output 5L/day. 6 to 12 months

Strict I/O & daily weights, Monitor labs (dialysis may be needed.)

Monitor: dehydration, hypokalemia, hypotension

Patient education- low protein diet

PULMONARY EMBOLISM
Disorder: Pulmonary Embolism
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Pulmonary embolism is the obstruction/blockage of

a pulmonary artery mostly caused by blood clots
(travel from the deep vein in the legs to the lungs)

Causes:

Blood Clot Tumor Fat Air Embolism

Signs and Symptoms:

1. Sudden SOB 2. Tachycardia 3. Hypotension

4. Increase Temp 5. Syncope 6. Cool, clammy skin

Treatment:

1. Assess respiratory rate, depth and pattern

2. Administer O2 therapy as ordered
3. Position: High Fowler's

Pharmacology:

Anticoagulants: prevent clots Thrombolytics: clot busters.

 INSULIN AND GLUCAGON
High glucose Low
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glucose
in the blood
in the
blood

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GLUCAGON
OF
EA
SE
IN O
S
N
EO
F
RE
L L
U Insulin allows LEG
A
S RE
CA
IN U
GL
INSULIN

glucose to enter
the body's cells to
provide energy.
Glucose OG EN N
LYC DOW E
G KS
A COS
E U
BR O GL
T

Insulin
Insulin
Receptor

Decrease in blood glucose Increase in blood

glucose
DKA vs HHS
Disorder: Diabetic Ketoacidosis (DKA)
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Type 1 Diabetes:
No Insulin Production
Pathophysiology:

1. DKA is a complication of type 1 diabetes

2. Characterized by a sudden onset.

Hyperglycemia Dehydration Ketosis Acidosis

Nursing Actions

IV fluid replacement
IV Fluids
IV insulin: treat hyperglycemia (monitor glucose level)

Monitor potassium levels

Disorder: Hyperosmolar Hyperglycaemic State (HHS)

Not enough insulin
Pathophysiology: production. Insulin
resistance.
1. HHS is a complication of type 2 diabetes
2. Characterized by a gradual onset.
3. No ketosis or Acidosis
IV Fluids
Nursing Actions IV fluid replacement

Insulin: If applicable

Correct electrolyte imbalance

SPINAL CORD INJURY
Disorder: Spinal Cord Injury
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Pathophysiology:

Damage that occurs to any part of the

spinal cord/nerves causing permanent
changes.

Tetraplegia Paraplegia

(Quadriplegia)

Risk Factors/Causes:

Accidents Injury Disease Falls Violence

Signs and Symptoms:

1. Loss of motor function and decreased sensation

2. Loss of bladder/bowel control, Muscle spasm

3. If C3-C5 are involved, it affects breathing

Nursing Actions: Emergency management

Immobilize spine Maintain Use the logrolling

(on spinal backboard) patent airway technique.
ULCERATIVE
COLITIS vs CROHN'S
DISEASE
Disorder: Ulcerative Colitis
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Pathophysiology:
Ulcerative Colitis

1. Ulceration and inflammation of

the colon and rectum
2. Affects innermost lining

Signs and Symptoms:

a. Diarrhea with blood Inflammation is

b. Fecal urgency continuous + NO
c. Abdominal pain patches

Disorder: Crohn's Disease

Pathophysiology:
Crohn's Disease

1. Inflammation in the
gastrointestinal tract
2. Affects entire wall.

Signs and Symptoms:

a. Diarrhea The inflammation

occurs in patches-
b. Weight loss
cobblestone
c. Abdominal distention appearance
HEART FAILURE
Pathophysiology:
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1. Heart Failure is the inability of the heart muscle to

pump enough blood to meet the metabolic demands
of the body.

Left-Sided Heart Failure Right-Sided Heart Failure

Left = Lungs Right = Rest of the

body

1. Dyspnea
2. Crackles
3. Tachypnea,
1. Edema
4. Pulmonary
2. Abd distention
congestion
5. Cough 3. JVD
4. Spleno/hepato

Treatment: megaly
5. Weight gain
Positioning: Semi-Fowler's
O2 therapy
Provide balance between Strict I/O
rest and activities. Diet: low salt diet
DISORDERS +TRIADS
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Disorder: Cardiac Tamponade

Beck's Triad: Muffled heart sounds + Low BP + JVD

Disorder: Increased Intracranial Pressure

Cushing's Triad: Increased Sys BP + Irregular RR + Low HR

Disorder: Deep Vein Thrombosis

Virchow's Triad: Venous stasis + Vascular injury +

Hypercoagulability

Disorder: Parkinson's

Triad: Rigidity + Bradykinesia + Tremor

Disorder: Appendicitis

Murphy's Triad: Pain-RLQ + Vomiting + Fever

Disorder: Pre-eclampsia

Triad: Proteinuria + Rising BP + Edema (PRE)

Disorder: Diabetes

Triad: Polyuria + Polyphagia + Polydypsia

Disorder: Meniere Disease

Triad: Tinnitus + Vertigo + Hearing loss

EKGS REVIEW
Sinus Bradycardia Ventricular Fibrillation
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Rate: less than 60 beats/min VF is fatal. Rhythm: chaotic

Sinus Tachycardia rapid rhythm

PVC
Rate: >100 beats/min

Atrial Fibrillation P wave: absent (no P wave

with PVCs). QRS complex:
QRS complex in PVC is
No P wave. Fibrillatory
premature, wide and abnormal
waves before QRS complex.
PAC
Atrial Flutter

P wave: premature, appears

P wave: sawtooth
different than normal. P wave
Ventricular Tachycardia
may be buried in the
preceding T wave.

QRS complex: QRS Asystole: flat line

complex is wide, bizarre
(tombstone)
TYPES OF SHOCK
Cardiogenic Shock: heart's inability to pump enough blood
S/S: BP P RR Oliguria Confusion

Tx: IV fluids, O2 therapy, vasopressors and inotropes

Hypovolemic Shock: Severe bleeding or fluid loss

S/S: BP P RR Oliguria Confusion

Tx: IV fluids, O2 therapy, blood transfusion may be required.

Septic Shock: Severe complication of sepsis

S/S: BP P RR Oliguria (late stage)

Fever Initial stage-flushed & warm

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Tx: IV fluids, O2 therapy, Antibiotics, Inotropes

Anaphylactic Shock: Severe allergic reaction

S/S: BP P SOB (bronchoconstriction)

Oliguria Hives, flushed, itching, localized edema

Tx: O2 therapy, IV therapy Meds: Epinephrine, Albuterol,

Antihistamines, Hydrocortisone (corticosteroids)

Neurogenic Shock: Damage to the nervous system

S/S: BP P RR Dry, warm skin

Tx: IV fluids, O2 therapy, atropine: severe bradycardia

ELECTROLYTE RELATIONSHIP
SODIUM AND POTASSIUM (An inverse relationship)

Sodium (Na)
= Potassium (K)
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CALCIUM AND PHOSPHORUS (An inverse relationship)

Calcium (Ca)
= Phosphorus (PO4)

MAGNESIUM AND PHOSPHORUS (An inverse relationship)

Magnesium (Mg)
= Phosphorus (PO4)

MAGNESIUM AND CALCIUM (A similar relationship)

Magnesium (Mg)
= Calcium (Ca)

MAGNESIUM AND POTASSIUM (A similar relationship)

Magnesium (Mg)
= Potassium (K)

CALCIUM and VITAMIN D (A similar relationship)

Calcium (Ca)
= Vitamin D (Vit. D.)
ABGS BASICS
Alkalosis
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Ranges: Acidosis

pH: 7.35-7.45

PaCO2: >45-<35

HCO3: 22-26

Respiratory:
Respiratory Acidosis: Level: pH= <7.35 | CO2= >45
Causes: CO2 Retention = Pneumonia, airflow

obstruction, paralysis, over sedation, COPD

Respiratory Alkalosis: Level: pH= >7.45 | CO2= <35

Causes: CO2 Lose= Hyperventilation, fever

Metabolic:
Metabolic Acidosis: Level: pH= <7.35 | HCO3= <22
Causes: DKA, Renal Failure, Diarrhea

( serum potassium)

Metabolic Alkalosis: Level: pH= >7.45 | HCO3= >26

Causes: Antacid, Vomiting, Diuretics

( serum potassium)
 nursebossstore.com
CRANIAL NERVES @nursebossessentials
Mnemonics:

Oh Oh Oh to Touch And Feel

Very Good Velvet AH!

I 1. Olfactory: Sense of smell

II 2. Optic: Ability to see

III 3. Oculomotor: Ability to move and blink your eyes.

IV 4. Trochlear: Ability to move your eyes up and down or

back and forth.

V 5. Trigeminal: Sensations in your face and cheeks, taste

and jaw movements.

VI 6. Abducens: Ability to move your eyes

VII 7. Facial: Facial expressions and sense of taste.

VIII 8. Vestibulocochlear: Sense of hearing and balance.

IX 9. Glossopharyngeal: Ability to taste and swallow.

X 10. Vagus: Digestion and heart rate

XI 11. Spinal Accessory: Shoulder and neck muscle

movement

XII 12. Hypoglossal: Ability to move your tongue.

 COMMON DIETS
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Heart failure: fluid restriction

Coronary artery disease: low cholesterol, low fat

Hypertension: low sodium

Constipation: high fiber, high fluids

Celiac Disease: gluten-free

Vomiting/Diarrhea: electrolyte replacement, fluids

Pancreatitis: NPO in acute phase, low fat

Lactose Intolerance: lactose-free

Crohn's Disease: low fat, low residue, low protein

Hepatic Disease: no alcohol

Cholecystitis: low fat

Diverticulitis: Acute- clear liquid diet. Low residue,

no nuts and seeds

Gastritis: Avoid spicy, caffeine, alcohol, smoking

Ostomies: Avoid food that causes gas and odor.

Avoid nuts and seeds.

Burns: high protein, calories

Obesity: calorie restriction

hormones

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Anterior Posterior
Pituitary Gland Pituitary Gland
V Ox
as yto Breast and
e op cin
on re Ovaries
Bones rm ss
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Follicle-stimulating hormone
H in

TS
Muscles th ACT (A

H
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Organs ro H
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H
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ng H
Pr

inizi

Kidneys
Lute

Thyroid
Breast

Adrenals Thyroid
Hormone
Ovaries
Cortisol
Testes

Estrogen,
Progesterone
Testosterone
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