NCLEX with MARK KLIMEK Review

KEEP CALM and PASS NCLEX with MARK KLIMEK Review 1. Acid-base balance/ventilators Rule of the B’s.. If the pH & the bicarb are both in the same direction = meta bolic If they are in different directions = respiratory pH = 7.35-7.45 acidosis/alkalosis HCO3 (bicarb) = 22-26 (2+2+2 = 6) CO2 = 45-35 ex: pH: 7.30 = bicarb: 20 = = metabolic acidosis ex: pH: 7.58 = bicarb: 32 = = metabolic alkalosis ex: pH: 7.22 = bicarb: 30 = = respiratory acidosis ex: You are providing care to a client with the following blood gas results: pH 7.32, CO2 49, HCO3 29, PO2 80 & SaO2 90%. Based on the results, the client is experiencing: = acidosis, = respiratory -opioid: CNS depressant.. know the symptoms (sedation, respiratory depression, etc).. *principle: acid base signs/symptoms.. as the pH goes… so goes my patient!!! -when pH goes up; patient goes up.. (everything gets irritable!) -when pH goes down; patient goes down! (systems in your body shut down) …except with potassium: when pH goes up; potassium goes down… when pH goes down; potassium goes up! (up) alkalosis: irritibility, hyper-reflexia (3 & 4), tachypnea, tachycardia, borborygmi (increased bowel sounds), seizure, aspirate.. (down) acidosis: hypo-reflexia, bradycardia, lethergy (obtunded), paralytic ileus (decreased bowel sounds), coma, respiratory arrest (ambu-bag!!) Kussmaul breathing is a deep and labored breathing pattern often associated with severe metabolic acidosis, particularly diabetic ketoacidosis (DKA) but also kidney failure… MAC Kussmaul! ! M: metabolic AC: acidosis ex: pT has respiratory acidosis… (select all that apply).. +1 reflexes ..........................................continued..........................................