NLE Emergency & Critical Care Nursing — Common Medical EmergenciesConcept Map

Concept

Acute Respiratory Emergencies

Sub Concepts

• Respiratory Failure (hypoxia and hypercapnia)
• Asthma Exacerbation (silent chest = impending arrest)
• COPD Exacerbation
• Pulmonary Edema
• Pneumonia with Respiratory Compromise
• Pulmonary Embolism
• Signs: Tachypnea, accessory muscle use, anxiety, cyanosis, altered consciousness

Relationship To Central

Life-threatening condition requiring immediate airway and breathing support

Concept

Acute Cardiac Emergencies

Sub Concepts

• Acute Coronary Syndrome (ACS)
• STEMI vs NSTEMI
• Myocardial Ischemia
• Acute Decompensated Heart Failure
• Pulmonary Edema (cardiogenic)
• MONA Protocol (Morphine, Oxygen, Nitroglycerin, Aspirin)
• 12-lead ECG within 10 minutes
• Reperfusion therapy (PCI or fibrinolytics)

Relationship To Central

Critical circulatory emergencies requiring rapid ECG and medication intervention

Concept

Anaphylaxis

Sub Concepts

• Type I Hypersensitivity Reaction
• Airway Compromise (laryngeal edema, stridor)
• Bronchospasm and Wheezing
• Distributive Shock (vasodilation, capillary leak)
• Urticaria and Angioedema
• Rapid Onset (minutes)
• Epinephrine 0.3-0.5 mg IM (1:1000) in vastus lateralis
• Adjuncts: Antihistamines, Corticosteroids, IV fluids
• Biphasic Reaction Risk

Relationship To Central

Rapidly progressive systemic allergic reaction requiring immediate epinephrine

Concept

Hypertensive Crisis

Sub Concepts

• Hypertensive Urgency (no acute organ damage)
• Hypertensive Emergency (with acute organ damage)
• Target-Organ Damage Signs: Encephalopathy, acute HF, MI, aortic dissection, AKI, stroke
• Systolic >180 mmHg or Diastolic >120 mmHg
• IV Vasodilators: Labetalol, Nicardipine, Sodium Nitroprusside
• Gradual reduction (≤25% MAP in first hour)
• Avoid rapid pressure drop (stroke/infarction risk)
• Arterial line monitoring and frequent neuro checks

Relationship To Central

Severe blood pressure elevation requiring controlled reduction to prevent target-organ damage

Concept

Acute Abdomen

Sub Concepts

• Appendicitis
• Perforation
• Bowel Obstruction
• Mesenteric Ischemia
• Ruptured Ectopic Pregnancy
• Ruptured Aortic Aneurysm
• Warning Signs: Rigid board-like abdomen, rebound tenderness, guarding, distension, shock
• NPO Status
• IV Access and Fluid Resuscitation
• Contraindications: No heat, laxatives, enemas, or aspirin
• Nasogastric Tube for Decompression

Relationship To Central

Sudden severe abdominal pain signaling potential surgical emergency

Concept

Diabetic Emergencies

Sub Concepts

• Hypoglycemia (glucose <70 mg/dL)
• Rapid Onset
• Adrenergic symptoms: Shakiness, sweating, palpitations
• Neuroglycopenic symptoms: Confusion, slurred speech, seizures, coma
• Rule of 15 (conscious patients)
• IV Dextrose or IM Glucagon (unconscious patients)
• Diabetic Ketoacidosis (DKA)
• Hyperglycemic Crisis: High glucose, metabolic acidosis, ketones
• Gradual Onset (hours to days)
• Kussmaul Respirations and Fruity Breath
• Management: Fluids → Insulin → Potassium
• Hyperosmolar Hyperglycemic State (HHS)

Relationship To Central

Extreme blood glucose states requiring opposite interventions

To

Asthma Exacerbation

From

Respiratory Failure

Strength

strong

Relationship

Asthma exacerbation is one specific cause of respiratory failure with characteristic wheezing that becomes silent in severe cases

To

Impending Respiratory Arrest

From

Silent Chest in Asthma

Strength

strong

Relationship

Critical clinical sign indicating airflow obstruction is so severe that no air movement generates sound - imminent life threat

To

MONA Protocol

From

Acute Coronary Syndrome

Strength

strong

Relationship

MONA (Morphine, Oxygen, Nitroglycerin, Aspirin) is the evidence-based priority medication intervention for ACS management

To

Time-to-Reperfusion

From

12-Lead ECG

Strength

strong

Relationship

ECG within 10 minutes identifies STEMI requiring urgent reperfusion therapy; delays in ECG delay reperfusion

To

Acute Decompensated Heart Failure

From

Acute Pulmonary Edema

Strength

strong

Relationship

Pulmonary edema is the acute manifestation of cardiogenic pulmonary edema in heart failure decompensation

To

Contraindications in ACS

From

Nitroglycerin

Strength

strong

Relationship

Nitroglycerin is contraindicated in hypotension, after PDE-5 inhibitors (sildenafil), and in RV infarction to prevent further hemodynamic collapse

To

Epinephrine IM

From

Anaphylaxis

Strength

strong

Relationship

Epinephrine is the single, priority, first-line drug for anaphylaxis - must be given immediately IM regardless of other adjuncts

To

Cardiac Arrest Epinephrine Dosing

From

Anaphylaxis Epinephrine Dosing

Strength

strong

Relationship

Critically different: anaphylaxis uses 0.3-0.5 mg IM of 1:1000 versus cardiac arrest uses 1 mg IV of 1:10,000 - confusion is a dangerous medication error

To

Observation Period

From

Biphasic Anaphylactic Reaction

Strength

moderate

Relationship

Risk of recurrent anaphylaxis symptoms hours after apparent recovery requires extended monitoring and readiness to repeat epinephrine

To

Target-Organ Damage

From

Hypertensive Emergency

Strength

strong

Relationship

The distinguishing feature of emergency (vs urgency) is the presence of acute end-organ damage including encephalopathy, MI, stroke, or aortic dissection

To

Gradual Pressure Reduction

From

IV Vasodilators in HTN Emergency

Strength

strong

Relationship

Labetalol, nicardipine, and nitroprusside allow controlled titration to reduce MAP by ≤25% in first hour to prevent ischemic complications

To

Surgical Emergency

From

Acute Abdomen

Strength

strong

Relationship

Acute abdomen often represents a surgical condition (appendicitis, perforation, ischemia, ruptured AAA) requiring NPO status and surgical preparation

To

Contraindications in Acute Abdomen

From

Heat, Laxatives, Enemas

Strength

strong

Relationship

These interventions can rupture an inflamed appendix or worsen obstruction, worsening peritonitis and sepsis risk

To

Rapid Life Threat

From

Hypoglycemia

Strength

strong

Relationship

Hypoglycemia is more immediately dangerous than DKA because the brain is glucose-deprived within minutes, risking seizures and coma

To

Conscious Hypoglycemic Patient

From

Rule of 15

Strength

strong

Relationship

For alert patients able to swallow: give 15g fast carbohydrate, recheck in 15 minutes, repeat if needed, then provide complex carbohydrate

To

Unconscious Hypoglycemic Patient

From

IV Dextrose or IM Glucagon

Strength

strong

Relationship

For unconscious or unable-to-swallow patients, give D50 IV or IM glucagon to raise blood glucose; never give oral carbs (aspiration risk)

To

Type 1 Diabetes

From

DKA

Strength

strong

Relationship

DKA predominantly affects type 1 diabetics due to absolute insulin deficiency driving ketogenesis

To

Fluids-Insulin-Potassium Sequence

From

DKA Management

Strength

strong

Relationship

The priority management order is (1) IV fluids first to correct hypovolemia, (2) IV regular insulin to stop ketogenesis, (3) potassium monitoring to prevent hypokalemia

To

DKA Respiratory Compensation

From

Kussmaul Respirations

Strength

moderate

Relationship

Deep rapid respirations are the body's attempt to blow off CO2 and buffer metabolic acidosis in DKA

To

Type 2 Diabetes

From

HHS

Strength

strong

Relationship

Hyperosmolar hyperglycemic state occurs primarily in type 2 diabetes with very high glucose but minimal ketosis (residual insulin prevents ketogenesis)

To

Do Not Start Insulin if K+ Very Low

From

DKA Potassium Monitoring

Strength

strong

Relationship

Insulin drives potassium into cells; if total-body potassium is already depleted, insulin without K+ replacement causes dangerous hypokalemia

To

All Medical Emergencies

From

Recognition and Speed

Strength

strong

Relationship

The unifying principle across all medical emergencies is early recognition of the pattern and speed of priority intervention before deterioration

To

Intervention Escalation

From

Continuous Reassessment

Strength

moderate

Relationship

After every intervention, reassess the patient and escalate support if not improving (e.g., from nasal cannula to NIPPV to intubation in respiratory failure)

To

Scope of Nursing in Medical Emergencies

From

RA 9173 Philippine Nursing Practice

Strength

moderate

Relationship

Under RA 9173, nurses in emergency settings practice at advanced levels (NCM III-IV) including pharmacologic interventions and critical procedures

To

Triage Priority in Medical Emergencies

From

Maslow Hierarchy

Strength

moderate

Relationship

Physiologic needs (breathing, circulation, neurologic function) take highest priority; medical emergencies threaten these fundamental needs