Mark Klimek CHAPTER 1, 2, 3!! Questions with Complete Solutions Rated A+

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 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 when the PH is Up you see what? - hyokalemia, alkalosis, HTN, Tachycardia, Tachypnea, Seizures, Irritability, Spastic, Diarrhea, Borborygmi i.e increased bowel sound, hyperreflexia, etc when the PH IS Down you see what?c - hyperkalemia, acidosis, htn, bradycardia, constipation, absent bowel sounds, flacid, bradypnea, resp arrest 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 what? - increased resistance to airflow caused by Kinked tube- unkink it Water in tube- empty it Mucus in airway- cough and deep breathe 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) 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 NOTE- if the O2 is on the floor then you bag them and call RT if this happens 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? - 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 The #1 problem in abuse is _______ - denial Denial is what? - it is the refusal to accept the , reality of the problem Treating denial: _______ it by pointing out to the person the difference between what they _______ and what they _______. In contrast, _______ the denial of loss and grief - confront, say, do, support Dependency is what? - it is when the abuser gets the significant other to do things for them or make decisions for them. Codependency: When the _______ _______ derives positive _______ from doing things for or making decisions for the _______ - Significant Other, self-esteem, abuser When treating dependency/codependency: Set _______ and _______ them. Agree in advance on what requests are allowed, then enforce the agreement - limits, enforce When treating dependency/codependency what do you do? - You work on the self-esteem of the codependent person. What is manipulation? - it is when the abuser gets the significant other to do things for him/her that are not in the interest, significant other. The nature of the act is harmful or dangerous to the, significant other How do you Treating manipulation?: - setting limits and enforce Wernicke's (Korsakoff's) Syndrome is what? - Psychosis induced by vitamin B1 deficiency Primary symptoms of Wernicke's (Korsakoff's) Syndrome? - amnesia (memory loss), confabulation (make up stuff) Characteristics of Wernicke's (Korsakoff's) Syndrome includes the following: - preventable (take vitamin) arrestable i.e is you can stop it from getting worse (take vitamin) irreversible (kills brain cells) Antabuse/Revia is aka - it is a form of Aversion therapy THIS IS A GUT HATRED OF SOMETHING. Onset and duration of effectiveness of Antabuse/Revia: _______ - 2 weeks Patient teaching with Antabuse/Revia. - Teach patient to avoid all form of alcohol and avoid all, alcohol eg mouth wash, hand sanitizer, after shave, perfume and colognes, insect repellant, ANY over counter than ends in ELIXIR, uncooked icings.. THis is becasue patient can have nausea, vomiting, death What are examples of products that contain alcohol? - mouth wash, cologne, perfume, aftershave, elixir, most OTC liquid medicines, insect repellant, vanilla extract, vinagerettes, hand sanitizer Every abused drug is either a what? - upper or downer. UPPER ARE WHAT? - caffeine, cocaine, PPC/SSD, METHEMPHETAMINES Signs and sympotms OF UPPER? - euphoria, restessless, irritability, borborygmi, Note when a drug addicted mother gives birth what does the baby have? - The baby is intoxicated Every alcoholic goes through what? - Alcohol Withdrawal Syndrome 24hrs after they stop drinking. However only a minority gets Delirium Tremens. Note alcohol withdrawal always preceds delirium tremens but delirium tremes dosent. what time frame do you go into delirium tremens? - 72hrs what is not life-threatening? .And what can kill you? - Alcohol Withdrawal Syndrome, Delirium Tremens Patients with _______ are not a danger to themselves or others. Patients with ________ are dangerous to self and others? - Alcohol Withdrawal Syndrome, Delirium Tremens which between AWS or DT need semiprivate room, any location? - AWS which between AWS or DT needs a private room near the nurse's station? - DT which between AWS or DT need Regular diet? - AWS which between AWS or DT need Clear liquid or NPO diet (risk for aspiration) - DT which AWS or DT are Up at liberty? - AWS which AWS or DT need Restricted bedrest with no bathroom privileges - DT which AWS or DT require No restraints? - AWS which AWS or DT are Usually restrained with either vest or 2 point (i.e 1 arm and 1 leg) - DT