Mark Klimek NCLEX Review- Lecture/Yellow Book

Rule of the B's: If the ____ and the _____ are ______ in the same direction then it is meta_____ pH, Bicarb, Both, Bolic pH 7.30_______ HCO3 20_______ ↓= acidosis; ↓= metabolic 00:03 01:17 pH 7.58_______ HCO3 32_______ ↑= alkalosis; ↑= metabolic pH 7.22_______ HCO3 30_______ ↓= acidosis; ↑= respiratory You are providing care to a client with the following blood gas results: pH 7.32, CO2 49, HCO3 29, PO2 80, and SaO2 90%. Based on these results, the client is experiencing: ↓= acidosis; ↑= respiratory MacKussmaul The only acid base to cause Kussmaul respirations is Metabolic ACidosis As the _______ goes, so goes _______ except for _______ pH, my patient, Potassium Up hyokalemia, alkalosis, HTN, Tachycardia, Tachypnea, Seizures, Irritability, Spastic, Diarrhea, Borborygme, hyperreflexia, etc Down hyperkalemia, acidosis, htn, bradycardia, constipation, absent bowel sounds, flacid, bradypnea Causes of acid-base imbalances: First ask yourself, "Is it _______?" If yes, then it's _______. Then ask yourself: "Are they _______ or _______. If _______, pick _______. If _______, pick _______ lung, respiratory, overventilating, underventilating, overventilating, alkalosis, underventilating, acidosis Causes of acid-base imbalances: If it's not lung, then it's _______. If the patient has _______ _______ vomiting or suction, pick _______. For everything else that isn't lung, pick _______ _______. When you don't know what to pick, choose _______ _______ metabolic, prolonged gastric, alkalosis, metabolic acidosis, metabolic acidosis High pressure alarms are triggered by _______ resistance to air flow. increased High pressure alarms are triggered by increased resistance to airflow and can be caused by obstructions of three types: _______ action, _______ action, _______ action (kinked tube) unkink, (water in tube) empty, (mucus in airway) cough and deep breathe Low pressure alarms are triggered by _______ resistance to airflow. decreased Low pressure alarms are triggered by decreased resistance to airflow and can be caused by disconnections of the _______ or _______ tubing (reconnect it), oxygen sensor tube (reconnect it UNLESS tube is on the floor- bag them and call RT if this happens) Respiratory alkalosis means ventilator settings may be too _______ high Respiratory acidosis means ventilator settings may be too _______ low What does "wean" mean? gradually decrease with the goal of getting off altogether What is Maslow's highest priority to lowest priority? 1. Physiological 2. Safety 3. Comfort 4. Psychological (problems within the person) 5. Social (problems with other people) 6. Spiritual Arrange from highest to lowest priority using Maslow's: Denial Spiritual Distress Pain in Elbow Fall Risk Pathological Family Dynamics Electrolyte Imbalance Electrolyte Imbalance (Physiological) Fall Risk (Safety) Pain in Elbow (Comfort) Denial (Psychological) Pathological Family Dynamics (Social) Spiritual Distress (Spiritual) What are the 5 stages of grief? Denial Anger Bargain Depression Acceptance