Mark Klimek NCLEX Review- Lecture/Yellow Book Questions with 100% Correct Solutions

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 Up - hyokalemia, alkalosis, HTN, Tachycardia, Tachypnea, Seizures, Irritability, Spastic, Diarrhea, Borborygme, hyperreflexia, etc Down - hyperkalemia, acidosis, htn, bradycardia, constipation, absent bowel sounds, flacid, bradypnea 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 _______ resistance to air flow. - increased High pressure alarms are triggered by increased resistance to airflow and can be caused by obstructions of three types: _______ action, _______ action, _______ action - (kinked tube) unkink, (water in tube) empty, (mucus in airway) cough and deep breathe Low pressure alarms are triggered by _______ resistance to airflow. - decreased 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) Respiratory alkalosis means ventilator settings may be too _______ - high 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: Denial Spiritual Distress Pain in Elbow Fall Risk Pathological Family Dynamics Electrolyte Imbalance - 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 the _______ to accept the _______ of their problem - refusal, reality 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: When the _______ gets the Significant Other to do things for them or make decisions for them - abuser 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: Work on the _______ of the codependent person - self-esteem Manipulation: when the _______ gets the _______ _______ to do things for him/her that are not in the _______ _______ of the _______ _______. The nature of the act is _______ or _______ to the _______ _______ - abuser, significant other, interest, significant other, harmful, dangerous, significant other Treating manipulation: set _______ and _______ - limits, enforce Wernicke's (Korsakoff's) Syndrome: _______ induced by Vitamin _______(thiamine) deficiency - Psychosis, B1 Primary symptoms of Wernicke's (Korsakoff's) Syndrome: _______ with _______ - amnesia (memory loss), confabulation (make up stuff) Characteristics of Wernicke's (Korsakoff's) Syndrome: 1. _______ 2. _______ 3. _______ - preventable (take vitamin) arrestable (take vitamin) irreversible (kills brain cells)