lOMoARcPSD|40307388
Mark Klimek Bundle - Mark K NCLEX lecture.
NCLEX-PN Review (South Texas College)
Scan to open on Studocu
Studocu is not sponsored or endorsed by any college or university
Downloaded by Morris Muthii ()
, lOMoARcPSD|40307388
Lecture 1: Acid & Bases
As the pH goes, so does my patient, except for K
pH = irritable, hyper-excitable, mummy
borborygmi*. ( hyperactivebowel sounds) K+ down -
I
>
pH , = body shuts down, HR/RR down, lethargy, K+ up
* ASKYOURSEIF #
,i¥÷¥É¥É¥§
I If it is NOT caused by the lungs, the answer is
Is it the lungs? METABOLIC
Yes No
Over ventilating & Under ventilating Prolonged vomiting/ suctioning Everything Else
Respiratory alkalosis↑ Respiratory Acidosis te Metabolic alkalosis Metabolic acidosis
w w
mackussmaul
(Ventilation means gas exchange "
"
* "
" " " """ *
Quick Notes:
There’s a difference between s/s of acid base imbalances vs. causes of acid
base imbalances
Resp. rate doesn't matter, Sao2 matters. d- brent -_
tepltlaad)
÷⇐;€}
¥
Modifying phrase trumps original noun [Questions]
Ex. “An ocd pt who is now psychotic” (look @ psychotic) When would you want suction at bedside? for a patient
“A vomiting pt who is now dehydrated” (look @ dehydrated) with alkalosis bc of their risk for seizures!
If the pH and bicarb are in same direction, it’s metabolic When would you want an ambu bag at bedside? For
patient with acidosis bc of risk for resp depression!
Vent Alarms
High pressure alarm goes off: working too hard (obstruction)
1. Check for kinks → unkink
2. Water condensation in the tube → empty it
3. Mucus in the airway: turn/cough/deep breathe
(If that doesn't work then suction (last resort))
Low pressure alarm goes off: that was too easy (disconnection)
a. Main tubing: reconnect -
b. O2 sensor tubing (senses fio2 @ trachea area): reconnect
Translate respiratory alkalosis to ventilating over (settings are too high)
Respiratory acidosis to ventilating under (settings are too low) RNCLEX
Downloaded by Morris Muthii ()
-
, lOMoARcPSD|40307388
Lecture 2: Alcohol/Drugs
DENIAL is the #1 problem with abuse
Alcoholism
#1 problem psychologically is denial
CONFRONT THEM Point out the difference from what they say and what they do
SET LIMITS & SAY NO “I’m saying no because I’m a good person”
*±¥⇐
Dependency Co Dependency Manipulation
abuser gets to keep using Significant other feels positive self esteem Abuser gets significant other to do things
abuser is dependent on spouse to do things from supporting the alcoholism for him/her that's not in the best interest
for them Harder to treat because spouse feels good for the significant other
for helping “I am a wonderful spouse for The nature of the act is dangerous or
Ex. “Call my boss for me” calling your boss for you” harmful
SET LIMITS & SAY NO Manipulation is easier to treat than
dependency because there's no positive
self esteem issue with manipulation
Aversion Therapy
Wernicke Korsakoff- Psychosis induced by Vitamin B1/
Tm g
Antabuse (disufiram) & ReVia (naltrexone)
Thiamine deficiency
Makes you hate alcohol and if you drink it you’ll get deathly ill
S/s: Amnesia with confabulation (memory loss with making up stories)
Takes 2 weeks to get into the system
Don't confront them or present reality. THEY BELIEVE WHAT THEY
Need 2 weeks to get out of system to safely drink again
ARE SAYING! Redirect them.
To prevent/stop it from getting worse: Take vitamin B1.
AVOID ALL ALCOHOL PRODUCTS
They don't have to stop drinking, and it’s irreversible.
1. Mouthwash
www 2. Aftershave
3. Perfumes/Cologne
Quick Notes: 4. Insect repellent
With abuse you confront, with loss you support 5. Anything that ends in elixir
Neutral: dependency/codependency has 2 pts. 6. Alcohol based hand sanitizer
Negative: manipulation has 1 pt. 7. Unbaked icing (vanilla extract)
The most abused drug is laxatives **They can have red wine vinegarette!
* ASK YOURSELF *
Uppers (5): ↑ Downers: ↓ Is the drug an Upper or Downer?
Caffeine, Cocaine, PCP/LSD Heroin, Marijuana, Alcohol, Is the question asking about overdose or
(hallucinogens), Methamphetamines, Benzos (everything not an upper) withdrawal?
Adderral S/s: (things go down) Lethargy, Withdrawal in upper: everything goes down
S/s: (Things go up) euphoria, respiratory depression, Withdrawal in downer: everything goes up
tachycardia, tachypnea, restlessness, bradycardia, bradypnea,
irritability, borborygmi/diarrhea, *Resp. depression biggest risk in: downer
reflexes +3/+4 (spastic), seizure overdose and upper withdrawal*
Downloaded by Morris Muthii () RNCLEX
Mark Klimek Bundle - Mark K NCLEX lecture.
NCLEX-PN Review (South Texas College)
Scan to open on Studocu
Studocu is not sponsored or endorsed by any college or university
Downloaded by Morris Muthii ()
, lOMoARcPSD|40307388
Lecture 1: Acid & Bases
As the pH goes, so does my patient, except for K
pH = irritable, hyper-excitable, mummy
borborygmi*. ( hyperactivebowel sounds) K+ down -
I
>
pH , = body shuts down, HR/RR down, lethargy, K+ up
* ASKYOURSEIF #
,i¥÷¥É¥É¥§
I If it is NOT caused by the lungs, the answer is
Is it the lungs? METABOLIC
Yes No
Over ventilating & Under ventilating Prolonged vomiting/ suctioning Everything Else
Respiratory alkalosis↑ Respiratory Acidosis te Metabolic alkalosis Metabolic acidosis
w w
mackussmaul
(Ventilation means gas exchange "
"
* "
" " " """ *
Quick Notes:
There’s a difference between s/s of acid base imbalances vs. causes of acid
base imbalances
Resp. rate doesn't matter, Sao2 matters. d- brent -_
tepltlaad)
÷⇐;€}
¥
Modifying phrase trumps original noun [Questions]
Ex. “An ocd pt who is now psychotic” (look @ psychotic) When would you want suction at bedside? for a patient
“A vomiting pt who is now dehydrated” (look @ dehydrated) with alkalosis bc of their risk for seizures!
If the pH and bicarb are in same direction, it’s metabolic When would you want an ambu bag at bedside? For
patient with acidosis bc of risk for resp depression!
Vent Alarms
High pressure alarm goes off: working too hard (obstruction)
1. Check for kinks → unkink
2. Water condensation in the tube → empty it
3. Mucus in the airway: turn/cough/deep breathe
(If that doesn't work then suction (last resort))
Low pressure alarm goes off: that was too easy (disconnection)
a. Main tubing: reconnect -
b. O2 sensor tubing (senses fio2 @ trachea area): reconnect
Translate respiratory alkalosis to ventilating over (settings are too high)
Respiratory acidosis to ventilating under (settings are too low) RNCLEX
Downloaded by Morris Muthii ()
-
, lOMoARcPSD|40307388
Lecture 2: Alcohol/Drugs
DENIAL is the #1 problem with abuse
Alcoholism
#1 problem psychologically is denial
CONFRONT THEM Point out the difference from what they say and what they do
SET LIMITS & SAY NO “I’m saying no because I’m a good person”
*±¥⇐
Dependency Co Dependency Manipulation
abuser gets to keep using Significant other feels positive self esteem Abuser gets significant other to do things
abuser is dependent on spouse to do things from supporting the alcoholism for him/her that's not in the best interest
for them Harder to treat because spouse feels good for the significant other
for helping “I am a wonderful spouse for The nature of the act is dangerous or
Ex. “Call my boss for me” calling your boss for you” harmful
SET LIMITS & SAY NO Manipulation is easier to treat than
dependency because there's no positive
self esteem issue with manipulation
Aversion Therapy
Wernicke Korsakoff- Psychosis induced by Vitamin B1/
Tm g
Antabuse (disufiram) & ReVia (naltrexone)
Thiamine deficiency
Makes you hate alcohol and if you drink it you’ll get deathly ill
S/s: Amnesia with confabulation (memory loss with making up stories)
Takes 2 weeks to get into the system
Don't confront them or present reality. THEY BELIEVE WHAT THEY
Need 2 weeks to get out of system to safely drink again
ARE SAYING! Redirect them.
To prevent/stop it from getting worse: Take vitamin B1.
AVOID ALL ALCOHOL PRODUCTS
They don't have to stop drinking, and it’s irreversible.
1. Mouthwash
www 2. Aftershave
3. Perfumes/Cologne
Quick Notes: 4. Insect repellent
With abuse you confront, with loss you support 5. Anything that ends in elixir
Neutral: dependency/codependency has 2 pts. 6. Alcohol based hand sanitizer
Negative: manipulation has 1 pt. 7. Unbaked icing (vanilla extract)
The most abused drug is laxatives **They can have red wine vinegarette!
* ASK YOURSELF *
Uppers (5): ↑ Downers: ↓ Is the drug an Upper or Downer?
Caffeine, Cocaine, PCP/LSD Heroin, Marijuana, Alcohol, Is the question asking about overdose or
(hallucinogens), Methamphetamines, Benzos (everything not an upper) withdrawal?
Adderral S/s: (things go down) Lethargy, Withdrawal in upper: everything goes down
S/s: (Things go up) euphoria, respiratory depression, Withdrawal in downer: everything goes up
tachycardia, tachypnea, restlessness, bradycardia, bradypnea,
irritability, borborygmi/diarrhea, *Resp. depression biggest risk in: downer
reflexes +3/+4 (spastic), seizure overdose and upper withdrawal*
Downloaded by Morris Muthii () RNCLEX
