Indicate the appropriate position/s (as well as the head position prn) for each of the following

conditions:

1. Post vein stripping and ligation: Dorsal Recumbent

2. Varicosities: Elevated leg with pillow
3. During insertion of TPN access: Supine
4. Post-tonsillectomy: Semi Fowler’s
5. Post thyroidectomy: Semi Fowler’s
6. Thrombophlebitis & DVT: Elevated leg with pillow
7. Post-thoracentesis: Semi Fowler’s
8. Spinal cord injury: Supine
9. Shock (except cardiogenic): Trendelenburg
10. Seizure: Side lying
11. Retinal detachment: Semi Fowler’s
12. Implanted radium in the cervix: Lithotomy
13. Pyloric stenosis: Supine
14. Pulmonary edema: High Flower’s
15. Cord prolapse: Knee-to-chest
16. Post-myelogram: water-based dye: Prone
: oil-based dye: Prone
17. Post mastectomy: Semi Fowler’s
18. Post lumbar tap: Supine
19. Post lobectomy/segmentectomy/wedge resection: Semi Fowler’s
20. Post liver Biopsy: Semi Fowler’s
21. Post laryngectomy: Semi Fowler’s
22. Increased ICP/Intracranial HPN: High Fowler’s/sitting
23. Post hypophysectomy: Semi Fowler’s
24. Post hip surgery: Supine
25. Hiatal hernia: High Fowler’s
26. Post hemorrhoidectomy: Supine
27. Flail chest: Semi Fowler’s
28. Epistaxis: Face down while applying pressure
29. Dumping syndrome: Semi Fowler’s
30. Craniotomy- supratentorial: Low Fowler’s
- Infratentorial: Supine
31. CVA/stroke: Semi Fowler’s
32. CHF: High Fowler’s
33. Post-uranoplastic:
34. Post-cheiloplasty: Semi Fowler’s
35. Post-cataract extraction: Semi Fowler’s
36. Casted extremity: Supine
37. Pre-eclampsia/PIH: Side Lying
38. Post cardiac catheterization: Upright/ High Fowler’s
39. Epiglottitis: Flexed
40. Chronic bronchitis & emphysema:
41. During bronchoscopy: Semi Fowler’s with Hyperflexion
42. Post-bronchoscopy: Side Lying
43. Autonomic dysreflexia:
44. Bronchial asthma: High Fowler’s
45. Abdominal pain: Knee-to-chest
46. Pina peritonitis: Semi Fowler’s
47. Air embolism: Semi Fowler’s
48. Hypotension during pregnancy: Supine
49. MI and angina pectoris: High Fowler’s
50. Post eye surgery: Semi Fowler’s
51. During thoracentesis: Straddling
52. During hemorrhoidectomy: Lithotomy
53. Stump within 1st 24 hours: Supine
54. Poisoning: Sims
55. NGT insertion/gastrostomy: High Fowler’s
56. Echocardiography: Semi Side Lying with Left hand under the head
57. CVP monitoring: Supine
58. Post tympanoplasty: Side Lying and Semi Fowler’s on the opposite side
59. Gastroscopy: Side Lying
60. Endotracheal intubation: Supine with head hyperflexion
61. Insertion of oral airway: Supine with head hyperflexion
 Bedside Equipment: Indicate the appropriate equipment that should be at the bedside for each
condition

1. CTT/ Chest tube drainage

• Clamps (for emergency use only) — the type and number as per facility or unit protocol
(Howard Kelly: smooth angle bladed clamps).
• Bottle frame or carrier (if not inbuilt in the UWSD system).
• UWSD (Under water seal drainage) observation chart.
• Non stretch tape to secure all connections.

2. Amputation
• Gloves • Compression Bandage • Sterile Bandage

3. Autonomic dysreflexia
• Blood pressure Monitor • Indwelling Foley or Suprapubic catheter

4. CVA/ Stroke
• Oxygen • Cardiac Monitor • ECG machine • Intubation Set

5. Parkinson’s Disease

6. DVT and thrombophlebitis

• Compression Stockings

7. Varicose veins
• Compression Stockings

8. Hydrocephalus
• Shunt

9. Post-tonsillectomy
• Suction Machine

10. Esophageal varices with Sengstaken-blakemore tube

• Balloon Tamponade • Endoscopy

11. Radium implant

12. Epiglottitis
• Oxygen • Intubation Set (Tracheostomy, Cricothyrotomy)

13. Croupe/LTB
• Oxygen • Nebulizer

14. Myasthenic crisis

• Intubation Set • Mechanical Ventilator
• Nasogastric Tube Feeding (If patient can’t swallow

15. Cholinergic crisis

• Oxygen • Suction Machine • Intubation Set • IV Fluids

16. Cervical neck injury

• Cervical Collar or neck brace • Oxygen •Tracheostomy set

17. Post-thyroidectomy
• Intubation Set • Endotracheal Tube • Suction Machine • Oxygen

18. Guillain barre syndrome

• Supplemental Oxygen • Intubation Set • Anti-Embolism Stockings
 III. ANTIDOTES Indicate the appropriate drug that will counteract the toxic dose of each of these
drugs

1. Acetaminophen- Acetylcysteine
2. Anticholinesterases & organophosphate poisoning- Atropine and Pralidoxime
3. Calcium channel blockers - Calcium chloride, Glucagon
4. Iron - Deferoxamine mesylate
5. Caffeine and theophylline Diazepam
6. Cardiac glycosides Digoxin
7. Methanol – Fomepizole, Ethanol
8. Benzodiazepines Flumazenil
9. Beta Blockers- Glucagon
10. Narcotic/Opioid analgesics- Naloxone
11. Carbon monoxide O2 Administration
12. Anticholinergics- Physostigmine
13. Allergic reaction to dye Anti Histamine
14. Mg S04 Calcium Gluconate
15. Heparin Na- Protamine sulfate
16. Warfarin - Phytonadione (Vitamin K1)
17. Aspirin/ASA Sodium Bicarbonate
18. Mercury Dimercaprol EDTA
19. Lead- Calcium disodium EDTA
20. Copper- Dimercaprol EDTA
21. Iron- Deferoxamine mesylate
IV. COMMON INITIAL MANIFESTATIONS- Indicate the most initial assessment sign or symptom of each
medical condition

1. Acute Glomerulonephritis (AGN)

• Hematuria • Pruteinuria • Hypotension and Edema.

2. Leukemia
• Malaise • Nausea and Vomiting • Epistaxis, Dysphagia
• Weight Loss • ↓ Urine Output.

3. Alzheimer’s Disease
• Dysphasia • Apraxia • Agnosia • Dysgraphia.

4. Anemia
• Hypoxic Tissue • Dyspnea • Palpitation • Fatigue.

5. Autonomic Dysreflexia
• Pounding Headache • Heavy Sweating • Anxiety
• Blurred Vision • Bradycardia.

6. Rheumatoid Arthritis
• Fatigue • Anorexia • Weight Loss • Generalized Stiffness

7. Benign Prostatic Hyperplasia (BPH)

• Nocturia • Urinary Tract Infection • Urinary Retention • Hematuria.

8. Lung Cancer
• Chronic Cough • Persistent Pneumonitis • Fever and Chills.

9. Urinary Bladder Cancer

• Painless Hematuria • Dysuria • Urinary Frequency (Urgency of Urinating)

10. Breast Cancer

• Breast Mass Lump • Nipple Retraction • Breast and Nipple Pain
• Nipple Discharge.
11. Cervical Cancer
• Leukorrhea • Vaginal Bleeding (Spotting) • Weight Loss
• Anorexia • Cachexia (wasting syndrome in which both fat and muscle are lost)

12. Esophageal Cancer

• Dysphagia • Sore Throat • Hoarseness • Weight Loss
• Worsening indigestion or heartburn.
13. Laryngeal Cancer
• Sore Throat • Ear pain • Weight Loss • Sore doesn’t heal • Difficult swallowing.

14. Ovarian Cancer

• Abdominal Bloating or swelling • Quickly feeling full when eating
• Weight Loss • Discomfort in the pelvis area
• A Frequent need to urinate • Changes in Bowel habits, such as constipation

15. Cataract
• Clouded, blurred or dim vision
• Sensitivity to light and glare
• Seeing Halos around lights
• Fading or yellowing of Colors
• Increasing Difficulty with vision at night
• Need for brighter light for reading and other activities
• Double Vision in a single eye
• Frequent Changes in eyeglass or contact lens
prescription

16. Left-sided failure

• Fatigue • Lack of Appetite • Nausea • Dyspnea • Edema
• ascites • Irregular Heart Beat

17. Right sided failure

• Dizziness • Fatigue • Sudden Weight Gain • Coughing • Wheezing
• Difficulty in Exercising

18. Crohn’s disease

• RLQ Pain • Nausea • Fever • Diarrhea • Tenderness
• Spasm • Flatulence

19. Cystic fibrosis

• Wheezing • Breathlessness • Persistent cough with thick mucus

20. Diabetes Mellitus

• Weight loss • Polydipsia • Polyphagia • Polyuria

21. Guillain- Barre syndrome

• Prickling, pins and needles sensation in fingers, toes, ankles or wrists
• Weakness in legs that spreads to upper body
• Difficult in eye or facial movements, including speaking, chewing or swallowing
• Severe pain that may feel achy or cramp like and may be worse at night
• Difficulty with bladder control or bowel function
• Rapid Heart Rate
• Low or High Blood Pressure
• Difficult Breathing
22. Hepatic encephalopathy
• Personality changes • Confusion • Forgetfulness • musty/ sweet breath odor
• Fatigue

23. Hyperthyroidism
• Unintentional weight loss
• Irregular Heartbeat (Arrythmia)
• Increased Appetite
• Tremor
• Increased sensitivity to heat
• Changes in bowel movements
• Fatigue, Muscle weakness
• Skin thinning
• Rapid Heartbeat (Tachycardia)
• Pounding of Heart (Palpitations)
• Anxiety and Irritability
• Changes in menstrual pattern
•Sweating
• Enlarged thyroid gland (Goiter)
• Difficulty sleeping
• Fine, Brittle Hair

24. Tetany
• Abdominal pain or cramping
• Grimacing
• Muscle achiness or pain
• Rapid breathing (Tachypnea) or SOB
• Twitching or shaking of the fingers
• Chronic or persistent diarrhea
• Malaise or Lethargy
• Numbness
• Tingling or unusual sensations in the hands or feet

25. Hypokalemia
• Weakness and Fatigue • Muscle cramps of spasms • Digestive Problems
• Heart Palpitations • Muscle aches and stiffness • Tingling and Numbness
• Breathing Difficulties • Mood Changes or Mental Fatigue

26. Hypoxia
• Changes in skin color, ranging from blue to cherry red • Confusion
• Cough • Fast heart rate • Rapid breathing
• Shortness of breath • Slow heart rate • Sweating
• Wheezing

27. Increased↑ ICP

• Headache • Nausea • Vomiting
• Decreased mental abilities • Confusion (Time, Place, Surrounding) • Seizures
• Double Vision • Increased blood pressure • Shallow Breathing
• Loss of consciousness • Coma
• Pupils don’t respond to changes in light
28. Liver cirrhosis
• Fatigue • easily bleeding or bruising • Loss of Appetite • Nausea
• Weight Loss • Itchy Skin • Spiderlike blood vessels in skin
• Yellow Discoloration in the skin and eyes (Jaundice)
• Fluid accumulation in abdomen (Ascites)
• Redness in the palms of the hands
• For Women. Absent of loss of periods not related to menopause
• For Men, los of sex drive, breast enlargement (Gynecomastia) or testicular atrophy
• Confusion, drowsiness and slurred speech (Hepatic Encephalopathy)
• Swelling in your legs, feet or ankles (Edema)
29. Meniere’s Disease
• Recurring Episodes of Vertigo • Hearing Loss
• Ringing in the ear (Tinnitus) • Feeling of Fullness in the ear

30. Meningitis
Possible Signs and Symptoms in anyone older than (2) years old
• Sudden high fever • Stiff neck • Severe headache that seems different than normal
• Headache with nausea or vomiting • Confusion or difficulty concentrating
• Seizures • Sleepiness or difficulty waking • Sensitivity to light
• No Appetite or thirst • Skin rash

Signs in newborns
• High fever • Constant Crying • Excessive sleepiness or irritability
• Inactivity or sluggishness • Poor Feeding • Stiffness in a baby’s body and neck
• A bulge in the soft spot on the top of a baby’s head (Fontanel)

31. Myasthenia gravis

Eye Muscles
• Drooping of one or both eyelids (Ptosis)
• Double vision (Diplopia)

Face and throat Muscles

• Impair speaking • Difficulty swallowing • Difficult chewing
• Change facial expressions

Neck and Limb

Myasthenia gravis can also cause weakness in your neck, arms and legs. Weakness in your legs
can affect how you walk. Weak neck muscles make it hard to hold up your head.
32.Nephrotic syndrome
• Severe swelling (Edema), particularly around the eyes, feet and ankles
• Foamy Urine, which may be caused by excess protein in urine
• Fatigue
• Loss of Appetite

33. Pancreatitis
Acute Pancreatitis
• Fever • Nausea • Rapid Pulse • Vomiting
•Upper abdominal pain • Abdominal pain that radiates up to the back
• Abdominal pain that feels worse after eating
• Tenderness when touching the abdomen
Chronic Pancreatitis
• Upper abdominal Pain
• Losing weight without trying
• Oily, Smelly stools (Steatorrhea)

34. Parkinson’s disease

• Tremor • Slowed movement (Bradykinesia) • Rigid Muscles
• Speech changes • Writing changes •Loss of automatic movements
• Impaired posture and balance

35. Retinal Detachment

• Blurred Vision • Gradually reduced side (Peripheral) Vision
• Curtain-like shadow over visual field • Flashes of light in one or both eyes (Photopsia)
• Sudden appearance of many floaters – tiny specks that seem to drift through field of vision

36. Retinoblastoma
• Eye redness • Eye Swelling
• Eyes that appear to be looking in different directions
• White color in the center circle of the eye (Pupil) when light is shone in the eye. Such as when
taking a flash photograph

37. Thyroid crisis

• High Fever, sometimes above 105.8°F (Common signs of Thyroid Storm)
• Jaundice • Goiter, or thyroid eye disease • Dehydration
• Nausea • Vomiting • Unconsciousness • Diarrhea
• Weakness • Heart Failure • Shaking • Sweating
• Weakness • Rapid heart rate
38. Ulcerative Colitis
Symptoms can vary, depending on the severity of inflammation and where it occurs.
• Diarrhea, often with blood or pus
• Abdominal pain and cramping
• Rectal Pain
• Rectal Bleeding – Passing small amount of blood with stool
• Urgency to defecate
• Inability to defecate despite of urgency
• Weight Loss • Fatigue • Fever • In Children, failure to grow

39. Intussusception
Children
• Loud crying caused by abdominal pain – (First Sign on Infant)
• Stool mixed with blood and mucus (Currant Jelly Appearance)
• Vomiting • Lump in the abdomen • Lethargy
• Diarrhea • Fever
Not everyone has all the symptoms. Some infants have no obvious pain, and some children
don’t pass blood or have a lump in the abdomen. Some older children have pain but no other
symptom

Adults
Intussusception is rare in adults and symptoms of the disorder often overlap with the symptoms
of other disorders, its more challenging to identify. The most common symptom is abdominal pain
that comes and goes. Nausea and vomiting may also occur. People sometimes have symptoms for
weeks before seeking medical attention