BCEN
Abrasion vs Laceration vs Avulsion - ✅✅ --Abrasion: rubbing of skin
against hard surface removing epithelium and exposing dermis
-Laceration: blunt trauma causing tissue tearing or crushing
-Avulsion: full thickness skin loss where approximation of wound edges
is not possible (includes degloving of hand/foot/digits/scalp)
✅✅
Abruptio Placentae (defintion, presentation, assessment, interventions) -
-Defintion: placental separation from uterine wall, rupture of arterial
vessels, inhibits supply of O2/nutrients to fetus, common cause of fetal
demise from maternal trauma
Presentation: backache/contractions/abd pain, uterine rigidity, frank/dark
red vag bleeding or concealed bleeding, maternal hemorrhagic shock,
abnormal fetal heart tones, elevated D-dimer, dec platelets
Assessment: OB consult, CBC, type and cross match, continuous fetal
heart monitoring
Interventions: transport to tertiary center or ob, high flow O2, fluid
resuscitation/transfusion, emergent delivery
ACE Inhibitors - ✅✅ --pril
RAAS system
Decreases preload and afterload
Monitor for cough/angioedema/rash and renal impairment
✅✅
Acetaminophen Overdose (definition, presentation, interventions) -
--Definition: found in OTC and prescription meds, toxic to liver in
small doses
-Presentation: progressive with time- malaise, nausea, diaphoresis, RUQ
pain/elevated LFTs, dec urinary output, jaundice, enlarged liver,
coagulopathies, coma (recovery starts in 7-8 days)
-Interventions: gastric lavage, activated charcoal, poison control,
administer N-acetylcysteine (initiate within 8 hours for best results,
effective up to 24 hrs post-ingestion)
✅✅
Achilles Tendon Rupture (cause, presentation, assessment,
interventions) - --Cause: sudden forced plantar flexion, unexpected
,dorsiflexion, systemic diseases (renal failure, lupus, arthritis), trauma,
fluoroquinolone use
-Presentation: sharp pain or pop, walking flat-footed, unable to stand on
ball of foot, unable to plantar flex foot
-Assessment: xray to r/o boney injury, US to r/o DVT or Baker cyst, MRI
for definitive diagnosis
-Interventions: RICE, splint in plantar flexion, crutches, surgery
Acid Ingestion -✅✅ -Common sources: batteries, drain cleaners, toilet
bowl cleaners, vinegar, sulfuric acid
Tissue Damage Type: coagulation-type necrosis
GI Damage: greater damage to the stomach
Interventions: NPO, consult toxicology
✅✅
Acute Adrenal Insufficiency (definition, causes, presentation,
assessment, interventions) - -Definition: insufficiency caused by
low levels of cortisol and aldosterone- medical emergency, life
threatening
Causes: sudden d/c of glucocorticoids, Addison disease, congenital
defects, infection, trauma, surgery, burns, hemorrhage, pregnancy
Assessment: CMP (hyponatremia, hypochloremia, hyperkalemia,
hypoglycemia), cortisol and adrenocorticotropic levels
Interventions: medical emergency, replacement of glucocorticoids and
mineralcorticoids, treatment of shock via IVF, tx electrolyte abnormalities
✅✅
Acute Angle Closure Glaucoma (definition, presentation, interventions, pt
edu) - -Defintion: aqueous humor cannot escape anterior chamber,
intraocular pressure inc, compression of CN III, blindness within hours if
untx'd
Presentation: pain, dec peripheral, halos around lights, N/V, HA, fixed
slightly dilated pupil, cornea w/ cloud appearance, globe may feel firm,
redness to eye
,Interventions: facilitate drainage, miotic eye drops (pilocarpine), topical
B-blockers (timolol maleate), carbonic anhydrase inhibitors
(acetazolamide)
Edu: do not have head lower than waist, avoid coughing/straining, optho
f/u
Acute Bronchitis - ✅✅ -viral in nature- OTC cough medication,
humidification, bronchodilators, and corticosteroids can be used
supportively
R/O: influenza (if febrile), pneumonia (if hypoxic or rales) and pertussis
(if paroxysmal cough)
Acute Coronary Syndrome - ✅✅-Stable angina--unstable angina--
NSTEMI-- STEMI
Check EKG, Trop and/or CK-MB
MONA
Percutaneous Coronary Intervention or thrombolytics
✅✅
Acute Gastroenteritis (definition, presentation, interventions) -
-Definition: bacterial, viral, or chemical in origin (including food
poisoning)
Presentation: N/V/D, lower abd cramping, fever, dehydration
Splenomegaly suggests bacterial infection
Interventions: fluids, monitor for metabolic acidosis, monitor for
K/glucose/Ca abnormalities, NPO, stool sample, meds for sx
management/treatment
✅✅
Acute Prostatitis (definition, causes, presentation, assessment,
interventions) - -Definition: inflammation of prostate
Causes: bacterial infection ascending ureters or refluxed from bladder-
associated with cystitis
Presentation: dysuria, malaise, urinary frequency/urgency, perineal/lower
and/penile/suprapubic pain, fever, chills, hematospermia
Assessment: UA, cultures, elevated PSA (prostate specific antigen),
boggy/tender prostate
, Interventions: analgesia, indwelling foley, abx (flouroquinolones),
encourage fluids
Adenosine - ✅✅ -Indicated for SVT and Wolff-Parkinson-White
Slows SA and AV node conduction
Rapid IVP
May cause transient heartblock or asystole
Airway Obstruction: Bronchi - ✅✅ -Cough, unilateral wheezing,
decrease in breath sounds
80-90% of aspirated objects lodge here
In adults more likely to lodge in R bronchus; peds either side is equally
likely
Airway Obstruction: Larynx - ✅✅ -Large obstructions will completely
block airway: no airway sounds/movement, no coughing
Smaller obstructions will cause hoarseness and aphonia
Airway Obstruction: Trachea - ✅✅ -large obstructions will cause
complete airway obstruction with lack of coughing, no airway
sounds/movement
Airway/Breathing of Burn Victims - ✅✅ --monitor closely, early
intubation may be necessary if: agitation, dec LOC,
hoarseness/stridor/vocal changes, progressive edema, oral/nasal
erythema, inability to manage secretions, extensive facial burns,
carbonaceous sputum
- Singed nose hairs alone are not a sign for early intubation
-Consider CO or cyanide poisoning
✅✅
Alkali Ingestion - -Common sources: drain cleaners, alkaline
batteries, fertilizers, lye, baking soda, ammonia
Tissue Damage Type: liquefaction of tissue
GI Damage: greater damage to esophagus