MARK KLIMEK NCLEX STUDY GUIDE
NOTES|| LATEST UPDATE 2026
Normal pH
7.35-7.45
Normal bicarb
22-26
As the pH goes...
so goes my patient, EXCEPT for Potassium!!!
Alkalosis S/S
*UP (higher, faster, elevated)*
-hyper-reflexia
-increased bowel sounds
-increased BP
-tachycardia
-diarrhea
-irritability
-seizures
-agitation
-HYPOKALEMIA
Acidosis S/S
**DOWN (suppressed, decreased, slower)
-decreased bowel sounds
,-hypotension
-decreased ST waves
-heart block
-constipation
-flaccidity
-bradycardia
-hypo-reflexia
-HYPERKALEMIA
Kussmaul respirations
hyperventilation state to blow off CO2 and compensate for metabolic acidosis
-"(MAC)Kussmaul respirations"
#1 problem in abuse
denial
Treating denial (abuse)
CONFRONT it by point out to the person the difference between what they SAY and
what they DO (support it in grief)
Dependency
When the abuser gets the significant other to do things for them or make decisions for
them
-**HARMLESS**
Codependency
When the significant other derives positive self-esteem from doing things for or making
decisions for the abuser
,Manipulation
When the abuser gets the significant other to do things for him/her that aren't in the best
interest of the significant other
-**the nature of the act is HARMFUL or dangerous to the significant other**
Wernicke's (Korsikoff's) Syndrome
-Dementia induced by Vitamin B1 (thiamine) deficiency
-primary symptom: memory loss with confabulation
(amnesia and making stuff up to cover for it)
Characteristics of Wernicke's
-it is preventable (daily vitamin), it is arrestable (can stop from worsening), it is
irreversible
Antabuse (disulfiram) / Revia (naltrexone)
-adjuvant therapy
-onset & duration of effectiveness: 2 weeks
-avoid ALL forms of alcohol
Why do patients need to avoid all forms of alcohol on Antabuse and Revia?
it will cause physiologic crisis (N/V, death)
What should pts avoid on Antabuse and Revia?
-mouthwash
-aftershave
-perfumes
-elixir
-insect repellent
, -vanilla extract
-vinaigrette dressings
-alcohol based hand sanitizers
-alcohol prep pads
Uppers
1. caffeine
2. cocaine
3. PCP/LSD
4. amphetamines
5. ADHD drugs
6. bath salts
S/S of uppers
-tachycardia
-HTN
-increased temp
-diarrhea
-hyper-reflexia (clonus)
-borborygmi (hyperactive bowel pounds)
-agitation
-seizures
-tremors
-dilated pupils
Downers
NOTES|| LATEST UPDATE 2026
Normal pH
7.35-7.45
Normal bicarb
22-26
As the pH goes...
so goes my patient, EXCEPT for Potassium!!!
Alkalosis S/S
*UP (higher, faster, elevated)*
-hyper-reflexia
-increased bowel sounds
-increased BP
-tachycardia
-diarrhea
-irritability
-seizures
-agitation
-HYPOKALEMIA
Acidosis S/S
**DOWN (suppressed, decreased, slower)
-decreased bowel sounds
,-hypotension
-decreased ST waves
-heart block
-constipation
-flaccidity
-bradycardia
-hypo-reflexia
-HYPERKALEMIA
Kussmaul respirations
hyperventilation state to blow off CO2 and compensate for metabolic acidosis
-"(MAC)Kussmaul respirations"
#1 problem in abuse
denial
Treating denial (abuse)
CONFRONT it by point out to the person the difference between what they SAY and
what they DO (support it in grief)
Dependency
When the abuser gets the significant other to do things for them or make decisions for
them
-**HARMLESS**
Codependency
When the significant other derives positive self-esteem from doing things for or making
decisions for the abuser
,Manipulation
When the abuser gets the significant other to do things for him/her that aren't in the best
interest of the significant other
-**the nature of the act is HARMFUL or dangerous to the significant other**
Wernicke's (Korsikoff's) Syndrome
-Dementia induced by Vitamin B1 (thiamine) deficiency
-primary symptom: memory loss with confabulation
(amnesia and making stuff up to cover for it)
Characteristics of Wernicke's
-it is preventable (daily vitamin), it is arrestable (can stop from worsening), it is
irreversible
Antabuse (disulfiram) / Revia (naltrexone)
-adjuvant therapy
-onset & duration of effectiveness: 2 weeks
-avoid ALL forms of alcohol
Why do patients need to avoid all forms of alcohol on Antabuse and Revia?
it will cause physiologic crisis (N/V, death)
What should pts avoid on Antabuse and Revia?
-mouthwash
-aftershave
-perfumes
-elixir
-insect repellent
, -vanilla extract
-vinaigrette dressings
-alcohol based hand sanitizers
-alcohol prep pads
Uppers
1. caffeine
2. cocaine
3. PCP/LSD
4. amphetamines
5. ADHD drugs
6. bath salts
S/S of uppers
-tachycardia
-HTN
-increased temp
-diarrhea
-hyper-reflexia (clonus)
-borborygmi (hyperactive bowel pounds)
-agitation
-seizures
-tremors
-dilated pupils
Downers
