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Mark K - Yellow book terms
Terms in this set (69)
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, C02 49, HC03 29, P02 80, and Sa02 90%. Based on these results, the client is experiencing:
The only acid base to cause Kussmaul respirations is Metabolic ACidosis
As the _______ goes, so goes _______ except for _______
pH, my patient, potassium
HYPOkalemia, alkalosis, HTN, Tachycardia, Tachypnea, Seizures, Irritability, Spastic, Diarrhea, Borborygme (increased bowel sounds), hyperreflexia, etc
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, over ventilating, under ventilating, over ventilating, alkalosis, under ventilating, 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.
Modifying phrase trumps original noun
High pressure alarms are triggered by _____ resistance to air flow.
(Machine is pushing too hard to deliver air)
High pressure alarms are triggered by increased resistance to airflow and can be caused by obstruction of three type: _____ 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.
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 ____
Respiratory acidosis means ventilator settings may be too ____
What does "wean" mean?
gradually decrease with the goal of getting off altogether.
What is Maslow's highest priority to lowest priority?
4. Psychological (problems within person)
5. Social (problems with other people)
Arrange from highest to lowest priority using Maslow's:
Pain in Elbow
Pathological Family Dynamics
Electrolyte imbalance (physiological)
Fall risk (safety)
Pain in elbow (comfort)
Pathological family dynamics (social)
Spiritual distress (spiritual)
What are the 5 stages of grief?
The #1 problem in abuse is ________
Denial is the _______ to accept the _______ of their problem
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
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
When treating dependency/codependency: Work on the _______ of the codependent person
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 _______
Wernicke's (Korsakoff's) Syndrome: _______ induced by Vitamin _______(thiamine) deficiency
Primary symptoms of Wernicke's (Korsakoff's) Syndrome: _____ with _____
Amnesia (memory loss), Confabulation (make up stuff)
Characteristics of Wernicke's (Korsakoff's) Syndrome:
Preventable (take vitamin B1)
Arrestable (take vitamin B1
Irreversible (kills brain cells)
Antabuse/Revia is aka _______ Therapy
Onset and duration of effectiveness of Antabuse/Revia: _______
Patient teaching with Antabuse/Revia: Avoid ____ forms of _____ to avoid ____,_____,_____
All, alcohol, nausea, vomiting, death
What are examples of products that contain alcohol?
mouth wash, cologne, perfume, aftershave, elixir, most OTC liquid medications, insect repellant, vanilla extract, hand sanitizer, already made frosting.
Every alcoholic goes through _______. Only a minority get _______
Alcohol withdrawal syndrome (AWS), Delirium Tremens (DT)
______ is not life threatening. _______ can kill you.
Patients with _______ are not a danger to themselves or others. Patients with ________ are dangerous to self and others
AWS or DT: semiprivate room, any location
AWS or DT: private room near the nurse's station
AWS or DT: Regular diet
AWS or DT: Clear liquid or NPO diet (risk for aspiration)
AWS or DT: Up at liberty
AWS or DT: Restricted to bedrest with no bathroom privileges
AWS or DT: No restraints
AWS or DT: Usually restrained with either vest or 2 point (1 arm and 1 leg)
AWS or DT: Give anti-HTN medication
AWS or DT: Give tranquilizer
AWS or DT: Give multivitamin to prevent Wernicke's
For Aminoglycosides, think:
"A Mean Old Mycin"
When are antibiotics/aminoglycosides used?
to treat serious, life-threatening, resistant infections
All aminoglycosides end in _______, but not all drugs that end in _______ are aminoglycosides.
What are some examples of wannabe mycins?
If it has 'THRO' throw it off of the list
What are some examples of aminoglycosides?
Streptomycin, Cleomycin, Tobramycin, Tobramycin, Gentamycin, Vancomycin, Clindamycin
When remembering toxic effects of mycin's think _______
What is the toxic effect of ahminoglycosides and what must you monitor?
ototoxicity; monitor hearing, balance, and tinnitus
The human ear is shaped like a ______ so another toxic effect of ahminoglycosides is _______ so monitor _______
kidney, nephrotoxicity, creatinine
The number "___" drawn inside the ear reminds you of cranial nerve ___ and frequency of administration ___
8, 8, 8 hours
Do not give aminoglycosides PO expect in these 2 cases:
1. _______ _______ (due to high _______ level)
2. Pre-op _______ surgery
Hepatic encephalopathy (liver coma, ammonia-induced encephalopathy) Ammonia
Who can sterilize my bowel?
What is the reason for drawing trough and peak levels?
Narrow therapeutic level
When do you ALWAYS draw the trough?
30 minutes before next dose
When do you draw the peak level of sublingual medications?
5-10 minutes after drug dissolves
When do you draw the Peak level of IV medications?
15-30 minutes after medication is finished
When do you draw the peak level of IM medications?
30-60 minutes after injecting it
When do you draw the peak level of SQ medications?
Depends on type of insulin
When do you draw the peak level of PO medications?
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