Mark Klimek Lecture Outlines
If the pH and the BiCarb are both in the same direction then it is? - ANS-Metabolic
If the pH is up it is? - ANS-Alkalosis
If the pH is down it is? - ANS-Acidosis
As the pH goes so goes my patient except for? - ANS-Potassium
If the pH is up my patient with show signs and symptoms of? - ANS-Increase... like
tachycardia,diarrhea and borborygmi
If the pH is down my patient will show signs and symtoms of? - ANS-Decrease... like
decreased output, bradycardia and constipation
If my pH is up my potassium (K+) is ? - ANS-Down
If my pH is down my potassium (K+) is? - ANS-Up
If my patient is overventilating I should choose? - ANS-Respiratory Alkalosis
If my patient is underventilating I should choose? - ANS-Respiratory Acidosis
If my patient has prolonged gastric vomiting or suction I choose? - ANS-Metabolic
Alkalosis
If it is not lung or prolonged vomiting or suctioning I choose? - ANS-Metabolic Acidosis
High pressure alarms are triggered when? - ANS-They cannot push air in
High pressure alarms are caused by what three types of obstructions? - ANS-Kinking,
Water in dependant loops and mucus in the airway.
If kinking in the tube is present you? - ANS-Unkink
If water is present in the dependant loops you? - ANS-Open system and empty water.
,If mucus is present you? - ANS-Turn them, cough and have them deeo breath first. If
ineffective you then suction.
Low pressure alarms are triggered when? - ANS-It is to easy to push air in.
Low pressure alarms are normally caused by? - ANS-Disconnection
If the tubing is disconnected you? - ANS-Reconnect
If O2 sensor line is disconnected you? - ANS-Reconnect
In a vented client respiratory alkalosis means the vent setting may be too? - ANS-High
In a vented client respiratory acidosis means the vent may be too? - ANS-Low
What do you do if the patients disconnected tube is on the floor? - ANS-Bag them, (call
for help) get new tube and then reconnect.
What do you do if the patients disconnected tube is on the chest? - ANS-Reconnect ... if
its above the waist its ok.
What is the biggest problem in abuse? - ANS-Denial
To treat denial you need to? - ANS-Confront
How do you confront? - ANS-Point out the difference between what they say and what
they do.
What is the one circumstance that you as a nurse would support denial? - ANS-Loss
and Grief
What is dependency? - ANS-When the abuser gets a significant other so make
decisions for them or do thing for them.
What is codependency? - ANS-When the significant other gets positive self esteem
from doing things or making decisions for an abuser.
To treat dependency/codependency you ? - ANS-Set limits and enforce them. You also
need to work or the self estreem of the codependent.
,What is manipulation? - ANS-When the abuser gets the significant other fo do things for
them that is not in the best interest of the significant other. This can be dangerous and
harmful to the significant other.
How do you treat manipulation? - ANS-Set limits and enforce.
Why is manipulation easier to treat then dependency/codependency? - ANS-Because
no one likes being manipulated.
What is Wernickes (Korsakoffs) Syndrome? - ANS-Psychosis induced by vitamin B1
(Thiamine) deficiency.
Vitamin B1 helps breakdown? - ANS-Alcohol
Primary symptom of Wernickes? - ANS-Amnesia with confabulation (making up stories).
Is Wernickes preventable? - ANS-Yes
Is Wernickes arrestable? - ANS-Yes
Is Wernickes reversible? - ANS-No
What is aversion therapy? - ANS-When you try and make the patient hate something.
Antabuse onset and duration is? - ANS-2 weeks
Teach a patient taking Antabuse to avoid what? - ANS-Alochol
On top of alcohol a patient taking Antabuse should also avoid what other 7 things? -
ANS-Elixirs, Vanilla Extract, Aftershave/Perfumes, Alcohol based hand sanitizer, Insect
repellant, Mouthwash and Vinagerette.
What are the five uppers? - ANS-Caffeine, Cocaine, Methamphetamines, PCP/LSD and
ADHD Meds
Downers are? - ANS-Everything other then the five uppers.
S/S of upper use? - ANS-Everything goes up...Tachycardia, increased BP etc.
S/S of downer use? - ANS-Everything goes down...Bradycardia, decreased BP etc.
, Overdose of a downer causes everything to go? - ANS-Down
Overdose of an upper causes everything to go? - ANS-Up
Withdrawal of an upper causes everything to go? - ANS-Down
Withdrawal of a downer causes everything to go? - ANS-Up
At birth if the mother was addicted to a substance always assume the newborn is in? -
ANS-Intoxication
If 24 hours after birth assume the baby is in? - ANS-Withdrawal
Every alcoholic goes through what withing 24 hours after cessation? - ANS-Withdrawal
syndrome
After 72 hours of alochol withdrawal a small minority may get? - ANS-Delirium Tremens
Can Delirium Tremens kill you? - ANS-Yes
Can Alcohol Withdrawal Syndrome kill you? - ANS-No
Are patients with Alcohol Withdrawal Syndrome a danger to themselves or others? -
ANS-No
Are patients with Delirium Tremens a danger to themselves or others? - ANS-Yes
N/I for Delirium Tremens? - ANS-Private room near nurses station, NPO/Clear liquids,
Restricted bed rest, restraints, tranquilizer, multivitamin (B1 vit.) and antihypertensive.
N/I for Alcohol Withdrawal Syndrome? - ANS-Semi-private room anywhere, regular diet,
up and ad-lib, no restraint, tranquilizer, multivitamin (B1) and antihypertensive.
A two point restraint is? - ANS-One arm and the opposite leg.
N/I for restraints? - ANS-Check Q15min. and rotate sites Q2H
All aminoglycosides end in? - ANS-"mycin" Vancomycin
If the pH and the BiCarb are both in the same direction then it is? - ANS-Metabolic
If the pH is up it is? - ANS-Alkalosis
If the pH is down it is? - ANS-Acidosis
As the pH goes so goes my patient except for? - ANS-Potassium
If the pH is up my patient with show signs and symptoms of? - ANS-Increase... like
tachycardia,diarrhea and borborygmi
If the pH is down my patient will show signs and symtoms of? - ANS-Decrease... like
decreased output, bradycardia and constipation
If my pH is up my potassium (K+) is ? - ANS-Down
If my pH is down my potassium (K+) is? - ANS-Up
If my patient is overventilating I should choose? - ANS-Respiratory Alkalosis
If my patient is underventilating I should choose? - ANS-Respiratory Acidosis
If my patient has prolonged gastric vomiting or suction I choose? - ANS-Metabolic
Alkalosis
If it is not lung or prolonged vomiting or suctioning I choose? - ANS-Metabolic Acidosis
High pressure alarms are triggered when? - ANS-They cannot push air in
High pressure alarms are caused by what three types of obstructions? - ANS-Kinking,
Water in dependant loops and mucus in the airway.
If kinking in the tube is present you? - ANS-Unkink
If water is present in the dependant loops you? - ANS-Open system and empty water.
,If mucus is present you? - ANS-Turn them, cough and have them deeo breath first. If
ineffective you then suction.
Low pressure alarms are triggered when? - ANS-It is to easy to push air in.
Low pressure alarms are normally caused by? - ANS-Disconnection
If the tubing is disconnected you? - ANS-Reconnect
If O2 sensor line is disconnected you? - ANS-Reconnect
In a vented client respiratory alkalosis means the vent setting may be too? - ANS-High
In a vented client respiratory acidosis means the vent may be too? - ANS-Low
What do you do if the patients disconnected tube is on the floor? - ANS-Bag them, (call
for help) get new tube and then reconnect.
What do you do if the patients disconnected tube is on the chest? - ANS-Reconnect ... if
its above the waist its ok.
What is the biggest problem in abuse? - ANS-Denial
To treat denial you need to? - ANS-Confront
How do you confront? - ANS-Point out the difference between what they say and what
they do.
What is the one circumstance that you as a nurse would support denial? - ANS-Loss
and Grief
What is dependency? - ANS-When the abuser gets a significant other so make
decisions for them or do thing for them.
What is codependency? - ANS-When the significant other gets positive self esteem
from doing things or making decisions for an abuser.
To treat dependency/codependency you ? - ANS-Set limits and enforce them. You also
need to work or the self estreem of the codependent.
,What is manipulation? - ANS-When the abuser gets the significant other fo do things for
them that is not in the best interest of the significant other. This can be dangerous and
harmful to the significant other.
How do you treat manipulation? - ANS-Set limits and enforce.
Why is manipulation easier to treat then dependency/codependency? - ANS-Because
no one likes being manipulated.
What is Wernickes (Korsakoffs) Syndrome? - ANS-Psychosis induced by vitamin B1
(Thiamine) deficiency.
Vitamin B1 helps breakdown? - ANS-Alcohol
Primary symptom of Wernickes? - ANS-Amnesia with confabulation (making up stories).
Is Wernickes preventable? - ANS-Yes
Is Wernickes arrestable? - ANS-Yes
Is Wernickes reversible? - ANS-No
What is aversion therapy? - ANS-When you try and make the patient hate something.
Antabuse onset and duration is? - ANS-2 weeks
Teach a patient taking Antabuse to avoid what? - ANS-Alochol
On top of alcohol a patient taking Antabuse should also avoid what other 7 things? -
ANS-Elixirs, Vanilla Extract, Aftershave/Perfumes, Alcohol based hand sanitizer, Insect
repellant, Mouthwash and Vinagerette.
What are the five uppers? - ANS-Caffeine, Cocaine, Methamphetamines, PCP/LSD and
ADHD Meds
Downers are? - ANS-Everything other then the five uppers.
S/S of upper use? - ANS-Everything goes up...Tachycardia, increased BP etc.
S/S of downer use? - ANS-Everything goes down...Bradycardia, decreased BP etc.
, Overdose of a downer causes everything to go? - ANS-Down
Overdose of an upper causes everything to go? - ANS-Up
Withdrawal of an upper causes everything to go? - ANS-Down
Withdrawal of a downer causes everything to go? - ANS-Up
At birth if the mother was addicted to a substance always assume the newborn is in? -
ANS-Intoxication
If 24 hours after birth assume the baby is in? - ANS-Withdrawal
Every alcoholic goes through what withing 24 hours after cessation? - ANS-Withdrawal
syndrome
After 72 hours of alochol withdrawal a small minority may get? - ANS-Delirium Tremens
Can Delirium Tremens kill you? - ANS-Yes
Can Alcohol Withdrawal Syndrome kill you? - ANS-No
Are patients with Alcohol Withdrawal Syndrome a danger to themselves or others? -
ANS-No
Are patients with Delirium Tremens a danger to themselves or others? - ANS-Yes
N/I for Delirium Tremens? - ANS-Private room near nurses station, NPO/Clear liquids,
Restricted bed rest, restraints, tranquilizer, multivitamin (B1 vit.) and antihypertensive.
N/I for Alcohol Withdrawal Syndrome? - ANS-Semi-private room anywhere, regular diet,
up and ad-lib, no restraint, tranquilizer, multivitamin (B1) and antihypertensive.
A two point restraint is? - ANS-One arm and the opposite leg.
N/I for restraints? - ANS-Check Q15min. and rotate sites Q2H
All aminoglycosides end in? - ANS-"mycin" Vancomycin
