Mark K Lecture #1

Metabolic

When the pH and bicarb (HCO3) are in the same direction it is what?

pH

7.35-7.45

HCO3

22-26

PaCo2

45-35

acidosis/alkalosis

what is based off of the pH?

the body gets more irritable/hyperexcitable

as the pH goes up, so does my patient, except for potassium

the body systems start to shut down

as the pH goes down, so does my patient, except for potassium

potassium goes up

when pH goes down

potassium goes down

when pH goes up

alkalosis signs & symptoms (things go up)

seizure

irritability

hyperreflexia (+3/+4)

tachypnea/tachycardia

borborgymi (increased bowel sounds)

acidosis signs & symptoms (things go down)

coma

bradycardia

paralytic ileus

hyporeflexia (0/+1)

lethargic/obtunded

seizures, have a suction at bedside

alkalosis patient's are more prone to what?

coma/respiratory arrest (have ambu bag at bedside)

acidosis patient's are more prone to what?

kussmaul respirations

metabolic acidosis patient's have what?

is it dealing with the lungs?

respiratory

is the client overventilating?

alkalosis

is the client underventilating?

acidosis

overventilating

respiratory alkalosis

underventilating

respiratory acidosis

ventilation deals with what?

gas exchange

if it isn't the lungs

metabolic

prolonged gastric vomiting/suctioning

metabolic alkalosis

losing acid becomes alkalosis

for everything else that isn't lung choose what?

metabolic acidosis

high pressure alarms

triggered by increased resistance to air flow (due to obstruction)

kinks in tubing > release kinks

water condesending in tube > empty water

mucus buildup in airway > turn, cough, deep breathe, suction

suction

as needed, if the patient cannot mobilize secretions by turning, coughing, deep breathing

low pressure alarms

triggered by decrease resistance to air flow (due to disconnections)

main tubing > reconnect it

oxygen sensor tube > reconnect it