ABDOMINAL AORTIC ANEURYSM Local distention at a site of weakness in t e a!te!ial wall T o!acic o! a"do#inal CAUSES$ a% at e!oscle!osis "% wea!

and tea! c% i#&ai!ed n't!ition S(S)$ As*#&to#atic +initiall*, -'lsatin. a"do#inal #ass B!'it +"lowin. o! swis in. so'nd o! #'!#'!/ !es'ltin. f!o# "lood flowin. t !o'. a na!!ow o! &a!tiall* occl'ded a!te!*, La"o!ato!* Ele0ated BUN1 low CREATININE le0el MRI1 CT scan1 )-!a*1 ULT2 +"est to confi!#, Mana.e#ent Resection and 'se of Teflon o! Dac!on .!aft -OST O-$ Monito! &e!i& e!al &'lses1 intake and o't&'t A0oid a"do#inal &al&ation Dec% *&e!tension Cont!ol &ain -!e0ent fle3ion of i& and knees to eli#inate &!ess'!e on t e a!te!ial wall AC9UIRED IMMUNE DE7ICIENCY SYNDROME +AIDS, Slow de.ene!ation of i##'ne s*ste# MOT- contact wit 4I8 &!esent in "lood1 se#en1 0a.inal sec!etions1 tea!s1 "!east #ilk1 CS7 ;INDS -ne'#oc*stis ca!inii &ne'#onia +infection, ;a&osi sa!co#a +#ost co##on #ali.nanc*, C*to#e.alo0i!'s Candidiasis infection 4e!&es si#&le3 0i!'s AIDS de#entia D)% -ELISA and <este!n "lot- tests fo! 4I8 anti"od* - CD= l*#& oc*tes > "elow ?@@(c'"ic%## Ns.% Dia.nosis 6 RIS; 7OR IN7ECTION ANA-4YLA)IS +Ana& *lactic s ock,

ADDISONS DSE Ad!enal *&o f'nction !elated to a'toi##'ne disease S(S)$ 4*&otension B!on5e skin &i.#entation 4*&onat!e#ia1 *&e!kale#ia1 *&o.l*ce#ia Ns. Dia.nosis 6 7LUID 8OLUME DE7ICIT Mana.e#ent Lifelon. #edication of .l'coco!ticoids and #ine!aloco!ticoids 4i. sodi'#1 C4O1 C4ON1 low &otassi'# diet A0oid infection1 t!a'#a and st!ess ADDISONIAN CRISIS$ T!eat$ *d!oco!tisone and Saline sol'tion

ACUTE :ASTROENTERITIS +A:E, Infla##ation of t e sto#ac and intestines Inc!ease fl'id1 f!eA'enc* and 0ol'#e 7!eA'ent wate!* stools La"$ Dec% sodi'# and &otassi'#1 +B, "lood c'lt'!es 7l'id and elect!ol*te i#"alance Ns.% D3$ 7l'id 0ol'#e deficit C!itical in *o'n. &atients 6 inc!ease "od* fl'id C D .#% > I #l +dia&e!s, ORS

ANEMIA1 -ERNICIOUS +8ita#in BD? Deficienc*,

Alle!.ic !eaction t at ca'ses a !elease of 4ista#ine and s'"seA'ent 0asodilation S(S3 U!tica!ial Res&i!ato!* dist!ess +la!*n.eal ede#a, 4*&otension1 tac *ca!dia1 tac *&nea Ns.% Dia.nosis 6 ALTERED AIR<AY CLEARANCE +"!onc ial s&as#s and ede#a, Mana.e#ent SUCTION and INTUBATION SET No loss of conscio'sness 6 E-INE-4RINE &e! IM Loss of conscio'sness 6 E-INE-4RINE &e! I8 C-R fo! ca!diac a!!est Benad!*l and co!ticoste!oids Skin testin. 6 to detect alle!.ic !eactions ANEMIA1 7OLIC ACID DE7%(ME:ALOBLASTIC - Associated wit alco olis#1 #ala"so!&tion1 &!e.nanc*1 lactation S(S3 7ati.'e :lossitis +"eef !ed ton.'e, Ns.% Dia.nosis 6 ACTI8ITY INTOLERANCE Mana.e#ent Inc!eased .!een leaf* 0e.eta"les1 li0e!1 o!.an #eats1 and f!'its Rest

A"sence of int!insic facto! !elated to .ast!ecto#* and at!o& * w ic !ed'ces t e n'#"e! of e!*t !oc*tes fo!#ed S(S3 7ati.'e Beef* !ed ton.'e :lossitis1 &e!i& e!al ne'!itis +tin.lin. sensation in lowe! e3t!e#ities, Ns.% Dia.nosis 6 ACTI8ITY INTOLERANCE La"o!ato!* SC4ILLIN:S TEST 6 low 0al'e '!ina!* e3c!etion of in.ested 8ita#in BD? less t an D@C in ?= o'!s Mana.e#ent$ Mont l* IM 8ita#in BD? inEections fo! life

ANEMIA1 4EMOLYTIC E3cessi0e o! &!e#at'!e dest!'ctions of RBC RENAL 7AILURE co#&lication of se0e!e e#ol*sis Mana.e#ent AdeA'ate fl'ids to fl's t e kidne*s Na Bica!"onate and Na lactate to alkani5e '!ine S&lenecto#* O3*.en t e!a&* to &!e0ent tiss'e *&o3ia1 dec!ease wo!kload of ea!t E!*t !o&oietin 6 S9 +client #'st a0e "one #a!!ow ca&a"le of &!od'cin. RBCs, I!on !e&lace#ent ARR4YT4MIAS Affects ca!diac o't&'t and "lood &!ess'!e 4*&otension and dec!ease LOC Ns.% Dia.nosis 6 INE77ECTI8E TISSUE -ER7USION1 Dec!ease CO? <atc o't$ *&otension and dec!eased '!ine o't&'t Elect!ol*te !e&lace#ent O3*.en t e!a&* CARDIAC MONITOR ACLS #eas'!es Ea!l* DE7IB 6 8ent!ic'la! tac *ca!dia and 0ent!ic'la! fi"!illation CARDIO8ERSION 6 At!ial d*s! *t #ias ANTI-ARR4YT4MIAS 6 Lidocaine1

AN:INA -ECTORIS Inte!#ittent c est &ain Not #o!e t an ?@ #ins% 7eels like .as &ain1 ea!t"'!n o! indi.estion NITRO:LYCERINE 6 "'!nin. sensation 6 no!#al o S(E 6 eadac e and facial fl's in. o <atc o't fo! *&otension -TCA + -e!c'taneo's T!ans l'#inal Co!ona!* An.io&last*, o Balloon ti&&ed cat ete! 6 .'ide wi!e 6 co!ona!* 0essel

Inde!al and Co!da!one ART4RITIS1 OSTEO En5*#atic dest!'ction of a!tic'la! ca!tila.e Conside!ed a non-infla##ato!* Eoint disease1 no s*ste#ic effects -ain1 swellin. in wei. t "ea!in. Eoints a..!a0ated "* acti0it* D3$ )-!a* Ns.% Dia.nosis 6 -AIN Mini#i5e disco#fo!t $ <-ei. t cont!ol 4-ot co#&!ess o! ice &acks A-s&i!in T-!'nk assisti0e de0ice 6 CANES BURNS T e!#al1 c e#ical1 elect!ical1 and !adiation Dst de.!ee- s'&e!ficial &a!tial t ickness$ affects e&ide!#is1 e!*t e#a and &ainf'l ?nd de.!ee- dee& &a!tial t ickness$ affects e&ide!#is1 de!#is1 e!*t e#a1 &ainf'l1 0esicles wit oo5in. F!d de.!ee- f'll t ickness$ affects e&ide!#is1 de!#is1 s'"c'taneo's tiss'e1 c a!!ed o! &ea!l* w ite a&&ea!ance1 no &ain =t de.!ee- f'll t ickness(dee& &enet!ation/ affects skin1 fat1 #'scle1 "one1 c a!!ed a&&ea!ance1 no &ain La"o!ato!* - Ele0ated e#atoc!it Mana.e#ent Esta"lis ai!wa*1 I8 !e&lace#ent N-O fo! fi!st ?= to =G o'!s St!ict I(O #onito!in. Ad#iniste! fl'ids in ACUTE -4ASE Inc% calo!ie and &!otein intake I8 na!cotics and tetan's &!o& *la3is To&ical anti#ic!o"ial Re0e!se isolation -ain #ed$ &!io! to ROM1 a#"'lation1 w i!l&ool t e!a&* BLOOD TRANS7USION O"tain and doc'#ent info!#ed consent <it anot e! n'!se c eck identification1 "lood 'nit la"els and e3&i!ation1 "lood .!o'& and R co#&ati"ilit* Blood #'st "e 'n. F@ #in'tes of a!!i0in. in t e 'nit Use .a'.e DG needle @%H NaCl +co#&ati"le, -!e t!ansf'sion 0ital si.ns Dete!#ine &!e0io's BT !eaction -!i#e d!i& NSS +&!e0ent #i3in. wit de3t!ose, Inf'se slowl* fo! t e fi!st DI #in'tes at D@ .tts(#in Se0e!e BT !eactions occ'! wit in DI?@ #in'tes of t!ansf'sion- Sta* wit t e client1 #onito! 0ital si.ns BT s o'ld "e co#&leted wit in = o'!s CATARACT O&acit* of t e c!*stalline lens associated wit a.in.1 &!olon.ed intake of ste!oids1 c !o#oso#al alte!ation -AINLESS BLURRIN: O7 8ISION -ost-o&$ a0oid acti0ities t at !eA'i!es "endin. Re&o!t s'dden e*e &ain 6 e#o!! a.e

C4EST INJURY +7lail c est, Insta"ilit* of c est wall !elated to f!act'!es of t e !i"s o! detac ed ste!n'# D*s&nea -a!ado3ical c est #o0e#ent +detac ed &a!t of t e c est wall will "e &'lled In on ins&i!ation and "lown o't on e3&i!ation, D3$ )-!a* -lace in i. fowle!s &osition STABILI2E$ - ands o! i#&e!#ea"le d!essin. - t'!n &atient on affected side to &!o0ide s&ace fo! 'naffected l'n. to !e-e3&and - D@ l"s% sand"a. at t e side of flail

CON:ESTI8E 4EART 7AILURE RI:4T$ ede#a and e&ato#e.al*/ ankle ede#a is f!eA'entl* t e fi!st si.n of ankle ede#a LE7T$ d*s&nea and !ales +L-L'n.s, Ns.% Dia.nosis$ ALTERED CARDIAC OUT-UT R(T IM-AIRED CONTRACTILITY Mana.e#ent Se#i-fowle!s &osition O? t e!a&* Mo!& ine s'lfate to !ed'ce an3iet* and d*s&nea Di.italis and di'!etics Low sodi'# and c oleste!ol diet Monito! &otassi'# le0els C4RONIC OBSTRUCTI8E -ULMONARY DISEASE +CO-D, C !onic "!onc itis- infla##ation of t e "!onc ial walls E#& *se#a- distended1 inelastic o! dest!o*ed al0eoli Mana.e#ent I#&!o0e o3*.enation +.as e3c an.e, Monito! !es&i!ato!* &atte!ns1 !ate1 AB: !es'lts Low flow o3*.en +D-F L-M, 4i. -fowle!s &osition B!onc odilato!s and anti ista#ines Sto& s#okin. Ene!.* conse!0ation +&acin.1 acti0it* #n.t, AdeA'ate *d!ation +G-D@ .lasses, 7acilitate co'. in.1 dia& !a.#atic and &'!sed li& "!eat in. Ne"'li5ation1 "!onc odilato!s1 #'col*tic and c est & *siot e!a&* Ste!oids to &!e0ent and !ed'ce infla##ation CRO4NS DISEASE +Re.ional Ente!itis, C !onic infla##ation of disease of s#all intestines S(S3 C!a#&* a"do#inal &ain and !i. t lowe! A'ad!ant &ain 7at in t e feces- #ala"so!&ti0e diso!de! of *&e! #otilit* La"o!ato!* Ele0ated <BC

CUS4IN:S SYNDROME Res'lts f!o# e3cess sec!etion of ad!enoco!tical o!#ones S(S3 Cent!al t*&e t!'ncal o"esit* T in e3t!e#ities Moon face1 "'ffalo '#& 4i!s'tis# Slow wo'nd ealin. Inc!eased co!tisol1 *&e!nat!e#ia1 *&e!tension1 *&e!.l*ce#ia and *&okale#ia Mana.e#ent 4i. &otassi'# and low sodi'# diet Lifeti#e .l'coco!ticoid s*nt esis in i"ito!s +MITOTANE,

COM-ARTMENT SYNDROME -!ess'!e wit in t e #'scle and its s'!!o'ndin. st!'ct'!es Ci!c'lation i#&ai!#ent d'e to a&&lication of d!essin.1 ti. t castin.1 "'!ns1 closed f!act'!es and c!'s in. inE'!ies S(S3 I -s 6 -ain1 -a!est esia1 -allo!1 -'lseness1 and -a!al*sis Un!elie0ed "* na!cotic anal.esics

-ain w en st!etc in. Mana.e#ent -osition affected e3t!e#it* lowe! t an ea!t to inc!ease ci!c'lation to a!ea Bi0al0e o! !e#o0al of d!essin.s and const!icti0e co0e!in.s Ne'!o0asc'la! assess#ent CYSTITIS Infla##ation of t e '!ina!* "ladde! ca'sed "* ascendin. infection S(S3 U!ina!* f!eA'enc* and '!.enc* La"o!ato!* C'lt'!e and sensiti0it* 6 E% Coli Mana.e#ent Inc!ease fl'id intake A0oid "'""le "at s and silk 'nde!wea! wea! cotton instead1 0oidin. afte! inte!co'!se Maintain ACID as diet +c eese1 c!an"e!!*1 &o'lt!*1 &!'nes &l'#s1 and e..s, DIABETES MELLITUS C !onic diso!de! of C4O1 C4ON and fat #eta"olis# c a!acte!i5ed "* i#"alance "etween ins'lin de#and and s'&&l* T*&e I +no ins'lin, T*&e II +little ins'lin o! insensiti0it* of cells to ins'lin, S(S3 -ol*'!ia1 -ol*& a.ia1 &ol*di&sia 7BS a"o0e D?@ Ns.% Dia.nosis 6 ALTERED NUTRITION Mana.e#ent Diet$ I@-K@C C4O1 ?@-F@C fats1 D@?@C C4ON T*&e I- diet1 e3e!cise1 ins'lin o Ins'lin al#ost 'ni0e!sall* necessa!* in c ild!en wit t*&e I DM1 #a* also "e necessa!* fo! t*&e II T*&e II-diet1 e3e!cise1 o!al *&o.l*ce#ic o O!al *&o.l*ce#ic cont!aindicated fo! c ild!en DI8ERTICULITIS Infla##ation of a &o'c o! sac'la! dilation in colon +di0e!tic'la, S(S3

Mana.e#ent N-O and T-N w en infla##ation is se0e!e 4i. C4ON and C4O1 low fat Ste!oids S#all f!eA'ent feedin. Monito! in&'t and o't&'t DIABETES INSI-IDUS Dec!ease &!od'ction of Antidi'!etic o!#one +AD4, "* t e &oste!io! &it'ita!* .land S(S3 -ol*'!ia and -ol*di&sia Si.ns of de *d!ation Mana.e#ent Maintain fl'id intake Monito! s&ecific .!a0it* Ad#inist!ation of Des#o&!essin acetate o! 0aso&!essin

DISSEMINATED INTRA8ASCULAR COA:ULATION +DIC, - Bod*s !es&onse o0e!sti#'lation of clottin. and anticlottin. &!ocesses in !es&onse to inE'!* o! disease S(S3 -etec ial1 ecc *#osis on skin1 #'co's #e#"!ane1 ea!t1 l'n.s1 and ot e! o!.ans -!olon.ed -T and -TT Ns.% Dia.nosis 6 RIS; 7OR INJURY Mana.e#ent Monito! fo! si.ns of "leedin. +ta!!* stool1 e#o&t*sis1 and nose "leedin., 4e&a!in- to &!e0ent fo!#ation of t !o#"i A0oid as&i!in and as&i!in containin. co#&o'nds

DUM-IN: SYNDROME Ra&id e#&t*in. of sto#ac contents into s#all intestines 's'all* co#&lication of .ast!ic s'!.e!*%

C!a#&in.1 colick* left lowe! A'ad!ant &ain La"o!ato!* Si.#oidosco&* Ns.% Dia.nosis - -AIN Mana.e#ent -!o0ide i. fi"e! and i. fl'id Anti"iotics Me&e!idine fo! &ain

7ats dela*s e#&t*in. of t e sto#ac S(S3 FDs$ dia!! ea1 dia& o!esis1 d!owsiness Mana.e#ent Lie down o! !est afte! eatin. S#all f!eA'ent #eals <it old fl'ids d'!in. #eals Low fat and &!otein diet1 d!* diet1 and low in si#&le s'.a!s ENDOCARDITIS Infection of inne! linin. of ea!t and defo!#it* of 0al0e leaflets S(S3 7e0e! Ele0ated ESR Mana.e#ent Dail* wei. t Take anti"iotics "efo!e dental &!oced'!e t at can ca'se "leedin. A0oid of s a!in. needles

EM-4YSEMA +-ink -'ffe!, Dest!'ction of al0eoli1 na!!owin. of s#all ai!wa*s and t!a&&in. of ai! !es'ltin. to loss of l'n. elasticit* S(S3 S o!tness of "!eat 1 BARREL c est +late si.n, La"o!ato!* AB:$ Res&i!ato!* acidosis Mana.e#ent O!t o&neic &osition Low flow o3*.en -'!sed li& "!eat in. A0oid &owe!f'l odo!s1 e3t!e#es of te#&e!at'!e1 &ets1 fi!e &lace and feat e! &illows E-ILE-TIC SEI2URE A"no!#al disc a!.e of elect!ic i#&'lses in t e "!ain Ns.% Dia.nosis 6 ALTERED TISSUE -ER7USION La"o!ato!* EE: +a"no!#al "!ain wa0es, CT Scan +"!ain lesions, Mana.e#ent Maintain &atent ai!wa*- O3*.en and s'ction eA'i&#ent -!otect f!o# inE'!* Do not !est!ain Antie&ile&tic t e!a&* contin'ed t !o'. o't life

7RACTURES B!eak in "one contin'it* d'e to t!a'#a1 "one t'#o!s and osteo&o!osis S(S3 Ac'te &ain C*anosis Loss of f'nction1 defo!#it* Swellin. C!e&it's La"o!ato!* )-!a* Mana.e#ent R-est I-ce a&&lication C-old co#&!ess E-le0ate Anal.esics and na!cotics e3ce&t in ead inE'!ies S&lintin.1 castin.1 t!action1 and s'!.ical fi3ation :LAUCOMA T e &!ess'!e wit in t e e*e"all is i. e! t an no!#al% Inc!eased int!aoc'la!

:ASTRITIS Ac'te and c !onic infla##ation of t e

.ast!ic #'cosa1 ca'sin. ede#a1 e#o!! a.e and e!osion U&&e! :I endosco&* confi!#s dia.nosis w en &e!fo!#ed wit in ?= o'!s S(S3 A"do#inal c!a#&in.1 e&i.ast!ic disco#fo!t1 e#ate#esis and indi.estion Occ'lt "lood in stool and 0o#it's1 inc!ease 4." and inc!ease e#atoc!it Mana.e#ent I87 Antie#etic Bland diet in s#all and f!eA'ent Antacids "etween #eals and 4? "locke!s to &!o#ote ealin. Antic oline!.ic and 8ita#in BD?

&!ess'!e d'e to acc'#'lation of aA'eo's '#o! Inc!ease int!aoc'la! &!ess'!e 6 leads to "lindness :la'co#a cannot "e c'!ed "'t can "e cont!olled ACUTE +closed an.le, o Clos'!e o! i#&ai!ed &assa.e aA'eo's '#o! o Se0e!e &ain a!o'nd e*e o 4alos +!ain"ows a!o'nd li. ts, o Bl'!!in. of 0ision C4RONIC +o&en an.le, o De.ene!ati0e c an.es in t!a"ec'la! #es wo!k and local o"st!'ction o E*es ti!e easil* o Most co##on t*&e o T'nnel 0ision +loss of &e!i& e!al 0ision, o -'ll eadac e in #o!nin. Ns.% Dia.nosis 6 RIS; 7OR INJURY RT 8ISUAL IM-AIRMENT Mana.e#ent Miotics Ca!"onic an *d!ase in i"ito!s +aceta5ola#ide(Dia#o3, 6 !ed'ces &!od'ction of aA'eo's '#o! Antic olineste!ase +facilitate o'tflow of aA'eo's '#o!, Beta "locke!s 6 Ti#olol + s'&&!esses sec!etions of aA'eo's '#o!, -!e0ent inc!ease IO- "* a0oidin.$ 8alsal0a #ane'0e!1 e3cessi0e fl'ids1 an.e!1 ea0* liftin. o0e! I l"s%1 e*e st!ain1 const!icti0e clot in.1 "endin.1 co'. in.1 and 0o#itin. TRABECUL-LASTY 6 c!eation of o&enin. at t!a"ec'la! #es wo!k to inc!ease o'tflow of aA'eo's '#o! 4IATAL 4ERNIA -o!tion of t e sto#ac &!ot!'din. t !o'. a iat's+o&enin., in t e dia& !a.# into t e t o!acic ca0it* S(S3 as*#&to#atic 6 ea!t"'!n La"o!ato!* Endosco&*1 Ba!i'# swallow Mana.e#ent U&!i. t &osition afte! #eals1 a0oid "endin. S#all f!eA'ent feedin. A0oid antic oline!.ic d!'.s

:UILLAIN-BARRE SYNDROME C an.es in #oto! cells of s&inal co!d and #ed'lla wit a!eas of de#*elination S(S3 Ascendin. &a!al*sis1 weakness at fi!st CS7 6 i. in &!otein Mana.e#ent Monito! !es&i!ato!* in0ol0e#ent A0oid c!owded a!eas T!ac eosto#* and s'ction eA'i&#ent at "edside -las#a& e!esis

4EMO-4ILIA Deficienc* in clottin. facto!s Se3-linked !ecessi0e t!ait 7acto! 8III deficienc* +Classic e#o& ilia, 7acto! I) deficienc* + C !ist#as disease, S(S3 -!olon.ed "leedin. ti#e 4e#a!t !osis +"leedin. Eoints, Ns.% Dia.nosis$ Alte!ed tiss'e &e!f'sion Mana.e#ent 7acto! !e&lace#ent A0oid as&i!in R-est I-#o"ili5e C-old co#&!ess E-le0ate

4EMORR4OIDS 8a!icosities o! o't &o'c in. of t e 0eins of t e e#o!! oids &le3's S(S3 inte!nal1 &ainless "leedin. in defecation Ns.% Dia.nosis 6 -AIN RT IRRITATION1 -RESSURE1 SENSITI8ITY TO RECTAL ANAL AREA La"o!ato!* Rectal e3a#ination Mana.e#ent A&&lication of ot and cold co#&!ess Anal.esic s'&&osito!ies o! oint#ents 4ot sit5 "at Li.ation1 inEection o! scle!osin. a.ent -osition &!one &oste#o!! oidecto#* <atc o't fo! e#o!! a.e ?= !s% to D@ da*s &ost-o& w en s't'!es a!e slo'. in. off 4i. fi"e! diet1 inc!ease fl'ids 4I- 7RACTURE B!eak o! dislocation of i& S(S3 S o!tenin. and e3te!nal !otation of affected le. La"o!ato!* 4i& )-!a* Mana.e#ent -ost-o& o Ne'!o0asc'la! assess#ent$ I -s 6 -ain1 -'lseness1 -allo!1 -a!est esia1 -a!al*sis o Maintain le.s in a"d'ction "* &lacin. wed.e &illow "etween le.s o Monito! fo! si.ns of &etec ial o0e! c est indicates fat e#"olis#

4E-ATIC ENCELO-AT4Y(COMA Dec!eased LOC !elated to acc'#'lation of a##onia d'e to t e ina"ilit* of li0e! to co0e!t a##onia to '!ea S(S3 -e!sonalit* c an.es 7la&&in. t!e#o!s +aste!e3is, Inc!eased se!'# le0el a##onia Mana.e#ent Monito! LOC Maintain low C4ON diet Neo#*cin and Lact'lose

4Y-ERLI-IDEMIA 4i. c oleste!ol and t!i.l*ce!ides a"o0e ?@@#.(dl% Inc!eased in low densit* li&o&!otein c oleste!ol% Nonco#&liance to t e!a&e'tic !e.i#en S(S3 Initiall* as*#&to#atic

4Y-O8OLEMIC S4OC; Loss of effecti0e ci!c'latin. "lood 0ol'#e leadin. to ci!c'lato!* colla&se !es'ltin. to inadeA'ate tiss'e &e!f'sion S(S3 Na!!owin. &'lse &!ess'!e Dec!eased B- and C8Ns.% Dia.nosis 6 ALTERED TISSUE

La"o!ato!* Li&id &!ofile Test + i. , Mana.e#ent Eat sal#on and t'na at least se0e!al ti#es a week 4i. fi"e! diet Anitili&ide#ic wit #eals +Ant!o#id and c olest*!a#ine, 4Y-O-ARAT4YROIDISM S(S3 Tin.lin. sensation a!o'nd li&s and '&&e! e3t!e#ities Low se!'# calci'# Ne'!o#'sc'la! i!!ita"ilit* +C o0stekca!&o&edal s&as#1 and T!o'ssea' si.ncont!action of facial #'scle w en ta&&ed, Ns.% Dia.nosis 6 -OTENTIAL ALTERED CARDIAC OUT-UT Mana.e#ent 9'iet !oo#1 no sti#'l's 4i. calci'# and & os& o!'s diet Calci'# .l'conate and 8ita#in D 4Y-OT4YROIDISM S(S3 7ati.'e and facial ede#a Low TF and T= Most se0e!e de.!ee- M*3ede#a co#a Ns.% Dia.nosis 6 A8TI8ITY INTOLERANCE Mana.e#ent Low calo!ie diet1 low c oleste!ol and sat'!ated fat 7!eA'ent !est &e!iods S*nt !oid lifelon.

-ER7USION Mana.e#ent Maintain &atent ai!wa* Modified t!endelen"'!. &osition 7l'id !e&lace#ent i##ediatel* Ad#iniste! 0aso&!esso!s

4Y-ER-ARAT4YROIDISM S(S3 Bone &ain 4i. se!'# calci'# le0els Ns.% Dia.nosis 6 RIS; 7OR INJURY Mana.e#ent S'!.e!* Inc!ease fl'id intake Low calci'# diet St!ain all '!ine Co#&lication$ !enal calc'li Di'!etic+Lasi3, to inc!ease !enal e3c!etion of calci'# Calcitonin to lowe! calci'# le0el 4Y-ERT4YROIDISM S(S3 7ine and t!e#o!s Intole!ance to eat 4i. TF and T= Mana.e#ent 4i. calo!ie1 i. C4ON diet AdeA'ate !est Cool en0i!on#ent Ele0ate ead of "ed -!o& *t io'!acil lifeti#e Radioacti0e iodide T *!oidecto#* &ost-o&$ assess fo! e#o!! a.e "* sli&&in. and "e ind neck LI8ER CIRR4OSIS I!!e0e!si"le fi"!osis and de.ene!ation of t e li0e! S(S3 Ede#a and Ea'ndice Ele0ated S:OT1 S:-T1 AST1 ALT Ns.% Dia.nosis 6 ALTERED 7LUID 8OLUME Mana.e#ent Rest Rest!iction of alco ol intake 8ita#in t e!a&*$ ADE; +7at sol'"le 0ita#ins, and B

INTESTINAL OBSTRUCTION :as1 fl'id and di.ested #ate!ial s'"stance to acc'#'late and inc!ease &e!istalsis S(S3 A"do#inal distention1 colick* a"do#inal &ain1 dec!eased o! a"sent "owel so'nds Ns.% Dia.nosis 6 ACUTE -AIN RT ABDOMINAL DISTENTION1 CONSTI-ATION RT INABILITY O7 STOOL TO -ASS La"o!ato!* A"do#inal )-!a* 6 inc!ease a#o'nt of

.as in t e "owel Rest!iction of o!al intake/ ad#inist!ation of &a!ente!al fl'id and elect!ol*tes S'!.ical inte!0ention$ co!!ection of ca'se/ colosto#*1 cecosto#*1 ileosto#*

ca!e

Maintain low &!otein diet Assess fo! "leedin. Di'!etics -!e&a!e fo! &a!acentesis Monito! I(O- <ei. client dail* O"se!0e fo! "leedin.-&!o0ide skin

MENIERES DISEASE Dilation of endol*#& atic s*ste# ca'sin. de.ene!ation of t e 0esti"'la! and coc lea! ai! in t e inne! ea!% It affects c!anial ne!0e 8III S(S3 8e!ti.o1 tinnit's1 ea!in. loss Ns.% Dia.nosis 6 RIS; 7OR INJURY Mana.e#ent Safet* e%.% -'ll of t e !oad if d!i0in.1 lie down S'&ine &osition d'!in. attack Maintain a low sodi'# diet Sto& s#okin. ;ee& !oo# da!k w en &atient as & oto& o"ia

MULI-LE SCLEROSIS C !onic &!o.!essi0e disease of t e CNS c a!acte!i5ed "* s#all &atc es of de#*elination in t e "!ain and s&inal co!d S(S3 S 'fflin. .ait Di&lo&ia C a!cots t!iad$ intention t!e#o!/ n*sta.#'s1 scannin. s&eec Ns.% Dia.nosis 6 IM-AIRED -4YSICAL MOBILITY RT MUSCLE <EA;NESS1 RIS; 7OR INJURY Mana.e#ent Safet* St!ess #ana.e#ent Dail* e3e!cise La"o!ato!* MRI 6 s#all &laA'es scatte!ed in CNS Mana.e#ent Co!ticoste!oids o! ACT4 I##'nos'&&!essi0e d!'.s E#& asi5e on f!eA'ent !est &e!iods

METABOLIC ACIDOSIS -Base "ica!"onate deficit/ "elow ?? #EA(L Ca'se$ Cell'la! "!eakdown Inc!eased ketones Renal ins'fficienc* Di!ect loss of "ica!"onate S(S3 D!owsiness and ;'ss#a'ls !es&i!ations CNS de&!ession1 let a!.* and st'&o! Ns.% Dia.nosis 6 IM-AIRED :AS E)C4AN:E La"o!ato!* AB: Mana.e#ent Co!!ect 'nde!l*in. ca'se <atc o't fo! inc!ease &otassi'# 7!eA'ent #onito!in. of 8ital si.ns1 la"s and LOC Na4COF !ead* and instit'te SEI2URE -RECAUTION

METABOLIC AL;ALOSIS Base "ica!"onate e3cess/ "ica!"onate a"o0e ?K #EA(L Ca'se$ Loss of .ast!ic E'ice E3cessi0e in.estion of alkaline d!'.s -otent di'!etics S(S3 Conf'sion 4*&o0entilation1 i!!ita"ilit* and twitc in. Mana.e#ent Assess and t!eat 'nde!l*in. ca'se <atc o't fo!$ Tac *ca!dia and *&otension > *&okale#ia A0oid antacids and "ica!"onate of soda A0oid I87 wit i. concent!ation of "ica!"onate and lactate ACIDI7YIN: A:ENT$ A##oni'# C lo!ide I8 and -otassi'# c lo!ide%

U!ine and "lood tests fo! s'.a! and acetone St!ict ad e!ence to O4A and ins'lin

+ -otassi'# C lo!ide is not .i0en in e&atic and !enal diseases,1 slow inf'sion to &!e0ent e#odial*sis

-ANCREATITIS A'to di.estion of t e &anc!eas "* &anc!eatic en5*#es/ &!i#a!il* T!*&sin S(S3 -e!i'#"ilical &ain Inc!eased se!'# a#*lase Mana.e#ent Ad#iniste! De#e!ol to !elie0e &ain MOR-4INE 6 cont!aindicated as it ca'ses s&as# of t e s& incte! of oddi Maintain low fat diet N-O d'!in. ac'te & ase A0oid coffee and alco ol Bed !est to dec!ease #eta"olic de#ands and &!o#ote ealin.

-NEUMOT4ORA) Ai! ente!s &le'!al s&ace and colla&se l'n. S(S3 D*s&nea1 -a!ado3ical c est #o0e#ent +a"sent o! !est!icted #o0e#ent on t e affected side wit dec!ease o! a"sent "!eat so'nds 6 #a* lead to MEDIASTINAL S4I7T, La"o!ato!* -'l#ona!* f'nction test Mana.e#ent T o!acentesis 4i. fowle!s &osition Do 8alsal0a #ane'0e! d'!in. c est t'"e !e#o0al -E-TIC ULCER +:Ast!ic, <eak .ast!ic #'cosa +4% -*lo!i infection, Co##on to "lood t*&e A &atients S(S3 Left e&i.ast!ic &ain occ'!s F@ #ins 6 D !% afte! #eals 's'all* da*ti#e and is !elie0ed "* 0o#itin. Ns.% Dia.nosis 6 7LUID 8OLUME DE7ICIT La"o!ato!* Endosco&* Mana.e#ent Maintain i. fat and C4O1 low C4ON A0oid s&ic*1 caffeine1 alco ol and s#okin. Ad#iniste! antacids se&a!ate f!o# ot e! d!'.s SUR:ERY$ Bill!ot I1 II1 :ast!ecto#* and 8a.oto#*

-E-TIC ULCER +d'Odenal, 4i. 4CL acid le0els in sto#ac Co##on to "lood t*&e O &atients S(S3 Ri. t e&i.ast!ic &ain occ'!s ?-F o'!s afte! #eals 's'all* at ni. t and is !elie0ed "* eatin. Mana.e#ent Maintain 4i. fat and C4O1 Low C4ON A0oid s&ic* and caffeine containin. foods1 alco ol and s#okin.

-ULMONARY EDEMA Ra&id acc'#'lation of fl'id in inte!stitial s&aces s'!!o'ndin. t e al0eoli

-ULMONARY EMBOLISM O"st!'ction of "lood flow to &'l#ona!* 0essels +ai!1 fat1 e#"oli o!

S(S3 D*s&nea and o!t o&nea C!ackles -a!o3*s#al noct'!nal d*s&nea -ink f!ot * s&'t'# Mana.e#ent If on 0entilato! 6 s'ction f!eA'entl*1 #aintain o3*.en wit 0entilato! +on -EE-, 7owle!s &osition Rest!ict fl'id and sodi'# Inot!o&ic d!'.s +Do&a#ine and De"'ta#ine, Di'!etics in Ca!dio.enic &'l#ona!* ede#a St!ict ase&sis N't!ition

t !o#"'s,1 !es'ltin. to &'l#ona!* *&e!tension and infa!ction S(S3 S'dden onset of d*s&nea1 tac *&nea1 c!ackles and c est &ain I!!e.'la! &'lse +a!! *t #ia ca'sed "* *&o3e#ia, 4*&e!t e!#ia +&'l#ona!* e#"olis# ca'sed "* t !o#"o& le"itis, La"o!ato!* AB: 6 *&o3e#ia -'l#ona!* an.io.!a& * 6 location C est )-!a* 6 &ne'#oconst!iction Mana.e#ent Monito! AB:1 !es&i!ato!*1 ca!dio stat's C8Anticoa.'lants T !o#"ol*tic RENAL 7AILURE +C !onic, I!!e0e!si"le1 .!ad'all*1 &!o.!essi0e fail'!e of t e kidne*s to f'nction S(S3 :I #anifestations$ ano!e3ia1 na'sea and 0o#itin. Inc!eased C!eatinine Ns.% Dia.nosis 6 7LUID 8OLUME E)CESS1 ALTERED URINARY ELIMINATION Mana.e#ent Low C4ON1 sodi'# and &otassi'# diet 4e#odial*sis and -e!itoneal Dial*sis Monito! fo! S(S3 of ane#ia Ad#iniste! E&o.en1 di'!etics and anti *&e!tensi0e

RENAL 7AILURE +Ac'te, A"!'&t !e0e!si"le cessation of !enal f'nction as a !es'lt of t!a'#a1 alle!.*1 and kidne* stones Ca'se$ -!e-!enal+ !enal "lood flow is inte!!'&ted, Int!a-!enal+ da#a.e to t e filte!in. st!'ct'!es of t e kidne*s, -ost-!enal+ o"st!'ction in t e '!ine o'tflow, S(S3 Oli.'!ia +=@@#l(?= !s%,- 's'all* t e ea!liest si.n Ns.% Dia.nosis 6 ALTERED URINARY ELIMINATION1 7LUID AND ELECTROLYTE IMBALANCE La"o!ato!* Ele0ated BUN1 C!eatinine le0el Mana.e#ent Monito! in&'t and o't&'t Maintain low C4ON1 i. calo!ie diet 7l'id !e&lace#ent d'!in. di'!etic & ase RES-IRATORY ACIDOSIS Ca!"onic acid e3cess/ -CO? is .!eate! t an =I ## 4. Ca'se$ InadeA'ate 0entilation Res&i!ato!* o"st!'ction I#&ai!ed .as e3c an.e in t e al0eoli Ne'!o#'sc'la! i#&ai!#ent

RES-IRATORY AL;ALOSIS Ca!"onic acid deficit/ -CO? is less t an FI ## 4. Ca'ses$ 4*&e!0entilation E3cessi0e #ec anical 0entilation S(S3 Dee& !a&id "!eat in. 6 =@ "!eat s &e!

S(S3 Restlessness and conf'sion Mana.e#ent Monito! &'l#ona!* f'nction test INTUBATE o!(and MEC4ANICAL 8ENTILATOR if wit *&o3e#ia1 dec!ease LOC and !es&i!ato!* dist!ess Ad#iniste! anti"iotics1 Na4COF and "!onc odilato!s C est & *siot e!a&*1 s'ctionin. and o3*.en wit '#idification Dial*sis to !e#o0e to3ins

#in% -e!i& e!al -a!est esia Ca!&o&edal s&as#s and li. t eadedness Ns.% Dia.nosis 6 INE77ECTI8E BREAT4IN: -ATTERN La"o!ato!* AB: Mana.e#ent E!adicate 'nde!l*in. condition$ CNS disease1 fe0e!1 se&sis1 and !e#o0al of in.ested to3ins Dee& "!eat in. into &a&e! "a. <atc o't fo! ca!diac d*s! *t #ias Monito! AB: and se!'# elect!ol*tes