Mark Klimek NCLEX Review - Lecture
Notes
• ABGs (identifying & cause)
•••••••••••••••••••••••••••••••••••••••••••••••••••••
Rule of the B's: If the ____ and the _____ are ______ in the same direction then it is meta_____
pH, Bicarb, Both, Bolic
Brainpower
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Compensated v.s. Partially Compensated
COMPENSATED: pH will be within the normal range (body has corrected the problem)
PARTIALLY COMPENSATED: pH is not normal. Look at the system that is supposed to fix the
problem (if you have a respiratory problem, the metabolic system will try to compensate and
vice versa) and see if it is abnormal, which means it is trying to compensate
• If YES, then you have PARTIAL compensation
• If NO, then you have UNCOMPENSATION
As the _______ goes, so goes _______ except for _______
,pH, my patient, potassium
Up (alkalosis)
Hyperkalemia, Hypertension, Tachycardia, Tachypnea, Diarrhea, Seizures, Irritability, Spastic,
Tentany, Borborygme, Hyperreflexia, etc.
Down (acid)
Hyperkalemia, Hypotension, Bradycardia, Bradypnea, Constipation, Coma, - Arrest, Lethargic,
Absent bowel sounds, Flacid, etc.
MAC Kussmaul
The only acid base to cause Kussmaul respirations is Metabolic ACidosis
(Note: does not follow rule as it is not a symptom but a compensation mechanism.)
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 or underventilating
overventilating = alkalosis
underventilating = acidosis
(Note: generally respiration rate does not correlate to ventilation but SaO2 DOES.)
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 ______ ______.
not lungs = metabolic
prolonged gastric vomiting or suction = alkalosis
metabolic acidosis
metabolic acidosis
Ventilator Alarms - HIGH pressure:
Triggered by _______ resistance to air flow.
Caused obstructions of three types:
1. _______ [action]
2. _______ [action]
3. _______ [action]
increased
1. kinked tube [unkink]
2. water in tube [empty]
3. mucus in airway [cough + deep breathe]
Ventilator Alarms - LOW pressure:
Triggered by _______ resistance to air flow.
Caused by disconnections:
1. _______ [action]
2. _______ [action]
decreased
1. tubing [reconnect it]
2. oxygen sensor tube [reconnect, UNLESS tube is on the floor or below bed then bag them &
call RT]
Respiratory alkalosis means ventilator settings may be too _______.
Respiratory acidosis means ventilator settings may be too _______.
Notes
• ABGs (identifying & cause)
•••••••••••••••••••••••••••••••••••••••••••••••••••••
Rule of the B's: If the ____ and the _____ are ______ in the same direction then it is meta_____
pH, Bicarb, Both, Bolic
Brainpower
Read More
Previous
Play
Next
Rewind 10 seconds
Move forward 10 seconds
Unmute
0:03
/
0:15
Full screen
Compensated v.s. Partially Compensated
COMPENSATED: pH will be within the normal range (body has corrected the problem)
PARTIALLY COMPENSATED: pH is not normal. Look at the system that is supposed to fix the
problem (if you have a respiratory problem, the metabolic system will try to compensate and
vice versa) and see if it is abnormal, which means it is trying to compensate
• If YES, then you have PARTIAL compensation
• If NO, then you have UNCOMPENSATION
As the _______ goes, so goes _______ except for _______
,pH, my patient, potassium
Up (alkalosis)
Hyperkalemia, Hypertension, Tachycardia, Tachypnea, Diarrhea, Seizures, Irritability, Spastic,
Tentany, Borborygme, Hyperreflexia, etc.
Down (acid)
Hyperkalemia, Hypotension, Bradycardia, Bradypnea, Constipation, Coma, - Arrest, Lethargic,
Absent bowel sounds, Flacid, etc.
MAC Kussmaul
The only acid base to cause Kussmaul respirations is Metabolic ACidosis
(Note: does not follow rule as it is not a symptom but a compensation mechanism.)
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 or underventilating
overventilating = alkalosis
underventilating = acidosis
(Note: generally respiration rate does not correlate to ventilation but SaO2 DOES.)
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 ______ ______.
not lungs = metabolic
prolonged gastric vomiting or suction = alkalosis
metabolic acidosis
metabolic acidosis
Ventilator Alarms - HIGH pressure:
Triggered by _______ resistance to air flow.
Caused obstructions of three types:
1. _______ [action]
2. _______ [action]
3. _______ [action]
increased
1. kinked tube [unkink]
2. water in tube [empty]
3. mucus in airway [cough + deep breathe]
Ventilator Alarms - LOW pressure:
Triggered by _______ resistance to air flow.
Caused by disconnections:
1. _______ [action]
2. _______ [action]
decreased
1. tubing [reconnect it]
2. oxygen sensor tube [reconnect, UNLESS tube is on the floor or below bed then bag them &
call RT]
Respiratory alkalosis means ventilator settings may be too _______.
Respiratory acidosis means ventilator settings may be too _______.
