Mark klimek, Mark Klimek, Mark Klimek Lecture Outline NCLEX, Mark Klimek, Mark Klimek NCLEX Pharm, mark klimek review tips

Mark klimek, Mark Klimek, Mark Klimek Lecture Outline NCLEX, Mark Klimek, Mark Klimek NCLEX Pharm, mark klimek review tips Rule of B's for ABGs - if the pH and the Bicarb are Both in the same direction it is metaBolic normal pH normal Bicarb - pH: 7.35-7.45 Bicarb: 22-26 Kussmul respirations - MACkussmul= metabolic acidosis S&S of acid-base imbalance - as the pH goes, so goes my patient except for potassium UP: (alkolosis):decreased K+, highest risk for seizures DOWN: (acidosis): increased K+, highest risk for respiratory arrest causes of respiratory acid-base imbalance - lung=respiratory overvent or undervent overvent= alkolosis undervent=acidosis causes of metabolic acid-base imbalance - not lung=metabolic prolonged gastric vomiting or suction=metabolic alkolosis (losing acid) everything else=metabolic acidosis high pressured ventilator alarms - triggered by increase resistance to air flow and can be caused by obstruction of three types: kinked tube: unkink it water in tube: empty it mucus in airway: turn, cough, deep breathe low pressured ventilator alarams - triggered by decreased resistance to air flow and can be caused by disconnections: tubing: reconnect if not contaminate if contaminated (below bed level): call first, then bag, reconnect respiratory alkalosis vs acidosis - alkalosis: ventilator setting may be too high (overvent) acidosis: ventilator setting may too low (undervent) HOLD - high pressured alarms obstruction low pressured alarms disconnection Maslow - 1. physiological 2. safety 3. comfort 4. psychological 5. social 6. spiritual #1 problem in substance abuse - denial: refusal to accept the reality of their problem treatment: confront it by pointing out to the person the difference between what they say and what they do. however, in grief and loss support denial dependency/codependency - dependency: when abuser gets SO to do things for them or make decisions for them codependency: when the SO derives positive self-esteem from doing things for or making decisions for the abuser treating dependency/codenpendency - set limits and enforce them. agree in advance what requests are allowed then enforce the agreement work on the self-esteem of the codependent person manipulation - when abuser gets the SO to do things for him/her that are no in the best interest of the SO. nature of the act is dangerous or harmful to SO treatment of manipulation - set limits and enforce them easier to treat than dependency/codependency because no body likes being manipulated wenicke's korsakoff syndrome - psychosis caused by a lack of B1 (thiamine) deficiency primary symptom: amnesia with confabulation -preventable -arrestable -irreversible antabuse/revia (disulfiram) - aversion therapy onset/duration of effectiveness: 2 weeks pt teaching: avoid all forms of alcohol to avoid nausea, vomiting, death uppers - cocaine, caffeine, PCP/LSD, methamphedimines, ADHD meds (amphetimines), bath salts S&S: increase everything, pupils dilate (mydriasis), seizures downers - codeine, heroin, alcohol, marijuana S&S: decrease everything, pupils constrict (miosis), respiratory arrest overdose vs withdrawal - upper overdose: everything is high upper withdrawal: everything is low