Mark-Klimek- Audio Notes

Mark-Klimek-Notes|Mark-Klimek-Notes ...................VENTILATORS 1. High pressure alarms are triggered by increased resistance to air flow. 2. High pressure alarms are triggered by resistance to airflow and can be caused by obstructions of 3 types: kinked tube, (unkink) action, water in tube (empty) action, mucus in airway (turn, cough and deep breathe) action. Lastly suction 3. Low pressure alarms are triggered by decrease resistance to airflow and can be caused by disconnections of the tubing (reconnect it) or oxygen sensor tube (reconnect it UNLESS tube is on the floor- bag them and call RT if this happens) (black coated wirey tubing that piggy backs the tubing, measure FiO2) 4. Respiratory alkalosis means the ventilator settings may be too high. 5. Respiratory acidosis means the ventilator settings may be too low. 6. What does “wean” mean? Gradually decrease with the goal of getting off altogether Mark Klimek Audio Tape 2 ALCOHOLISM/ ABUSE 1. #1 Psychological problem is denial. (1 patient) a. Denial is the refusal to accept the reality of their problem. b. Treating denial: confront it by pointing out to the person the difference between what they say and what they do. In contrast, support the denial of loss and grief. i. Abuse vs. Loss ii. Denial and Loss and Greif Stages; DABDA 1. Denial- healthy normal 1st action therefore you support 2. Anger 3. Bargaining 4. Depression 5. Acceptance c. When dealing with a psychodynamic problem between staff use the word I not the word you. ex. I seem to be frustrating you vs. Why do you not like me. 2. #2 Psychological problem is Dependency/ Codependency (2 patients) a. Dependency: When the abuser gets the Significant Other to do things for them or make decisions for them b. Codependency: When the Significant Other derives positive self- esteem from doing things for or making decisions for the abuser c. When treating dependency/codependency: Set limits and enforce them. Agree in advance on what requests are allowed, then enforce the agreement. 3. Manipulation: (1 patient) when the abuser gets the significant other to do things for him/her that are not in the best interest of the significant other. The nature of the act is harmful or dangerous to the significant other. a. Treating manipulation: set limits and enforce. i. Easier to treat 4. Alcoholism a. Wernicke’s (Korsakoff’s) Syndrome: psychosis induced by Vitamin B1 (thiamine) deficiency b. Primary symptoms of Wernicke’s (Korsakoff’s) Syndrome: amnesia (memory loss) with confabulation (make up stuff) c. Characteristics of Wernicke’s (Korsakoff’s) Syndrome i. Preventable (take vitamin) ii. Arrestable (take vitamin) iii. Irreversible (kills brain cells) d. Disulfaram (Antabuse/Revia) is aka Aversion Therapy e. Onset and duration of effectiveness of Disulfaram (Antabuse/Revia): 2 weeks .....................