Mark Klimek Audio Notes: Acid Base ABG’s. Lecture Notes.

As pH goes, so does my Pt! Except for K pH ↓ Pt goes ↓ (HR, RR, all vitals) K goes ↑ pH ↑ Pt goes ↑ K goes ↓ Except for K – it does the opposite pH ↑ : Alkalosis • Seizures, hyperactivity, borborgemy (↑BS) Kausmal breathing = MacKausamal (Metabolic Acidosis breathing) Lung: Respiratory Everything else: Metabolic When you don’t know: it’s probably metabolic acidosis (It’s super common) Ventilators High Pressure Alarm • Obstructed airflow • Having to use too much pressure • Kinks, water collection in tube, mucous • Turn, cough, deep breathe Low Pressure Alarm • ↓ Resistance – machine finding job too easy • Disconnected tube • 02 sensor disconnected If tube goes lower than pt level – contaminated Amino Glycosides A Mean Old Mycin Amino Glycosides only treat Mean old Infections! True mean old Mycins don’t have “Thro” If it has “Thro” – Thro it away! • Ex: Zithromycin Mean Old Mycins destroy ears (ototoxicity) and kidneys (nephrotoxicity) • Must check Creatinine for Nephrotoxicity – NOT urine output 8 Toxic to Cranial nerve 8 give q8h Mean Old Mycins do NOT get absorbed – they go in and out and sterilize/clean PO Mean Old Mycins are for bowel sterilizing • NeoMYCIN • KanoMYCIN Who can sterilize my bowel?? NEO KAN! Drawing TAP Levels (Peak and Trough) For drugs that have a narrow therapeutic level and are toxic Route determines TAP – Not the drug TROUGH PEAK IV 30 MIN BEFORE NEXT DOSE IV 15-30 min after its done IM 30 MIN BEFORE NEXT DOSE IM 30-60 min after its given SUB Q 30 MIN BEFORE NEXT DOSE Subling 5-10 min after its in the system PO 30 MIN BEFORE NEXT DOSE Heart Rhythms Ca Channel Blockers are chill pills for the heart • They end in DEPIM or ZEM Rhythms Asystole: No QRS – Lethal Flutter: Sawtooth Afib: Chaotic with QRS pattern Vfib: Chaotic without QRS pattern – Lethal Vent tachy: Wide bizarre QRS SVT: Narrow QRS PVC: random rhythm change – only concerned if > 6 or 6 in a row Change in rhythm: check pulse or BP for cardiac output Treat ventriculars with lidocaine • V → L Treat SVT (it’s actually an atrial) A denosine – puts you in asystole for 20 seconds B eta bockers – all end it “lol”