Nursing ABGs, Substance Use, and Pharmacology Practice Flashcards

Flashcards covering arterial blood gas (ABG) values, acid-base imbalances, ventilator alarms, substance use disorders, and aminoglycoside pharmacology.

Normal pH range

$7.35-7.45$. Below $7.35$ indicates acidosis; above $7.45$ indicates alkalosis.

$$PaCO_2$$

Partial pressure of carbon dioxide in arterial blood. The normal range is $35-45\,mm\,Hg$. High values indicate acidity; low values indicate alkalinity.

$$HCO_3^-$$

Bicarbonate, the metabolic ABG value. The common interpretation range is $22-26\,mEq/L$, though some texts use $21-28\,mEq/L$. It acts as a base to buffer acid.

Respiratory Acidosis

An ABG pattern where pH is low and $PaCO_2$ is high. It is typically caused by underventilation or $CO_2$ retention.

Respiratory Alkalosis

An ABG pattern where pH is high and $PaCO_2$ is low. It is typically caused by overventilation where $CO_2$ is blown off.

Metabolic Acidosis

An ABG pattern where pH is low and $HCO_3^-$ is low. It is caused by too much acid in the body or a loss of base.

Metabolic Alkalosis

An ABG pattern where pH is high and $HCO_3^-$ is high. It is caused by too much base or a loss of acid (e.g., vomiting or NG suction).

Acidosis Body Pattern

A general "down" state characterized by bradycardia, bradypnea, hypotension, lethargy, hyporeflexia, and constipation. An exception is potassium ($K^+$), which tends to go up.

Alkalosis Body Pattern

A general "up" state characterized by tachycardia, tachypnea, hypertension, irritability, seizures, hyperreflexia, and borborygmi. An exception is potassium ($K^+$), which tends to go down.

Kussmaul respirations

Deep, rapid breathing that serves as a classic compensation for metabolic acidosis, specifically Diabetic Ketoacidosis (DKA).

Borborygmi

Loud, rumbling bowel sounds reflecting increased gastric motility.

Hyperreflexia

Overactive reflexes documented as $3+$ or $4+$. Seen in alkalosis, hypocalcemia, hypomagnesemia, and stimulant toxicity.

Hyporeflexia

Decreased reflexes documented as $0$ or $1+$. Seen in acidosis, hypermagnesemia, hypercalcemia, and depressant states.

High-pressure ventilator alarm

An alarm triggered by increased resistance or obstruction, such as kinks in the tubing, water accumulation, secretions, biting the tube, or bronchospasms.

Low-pressure ventilator alarm

An alarm triggered by decreased resistance, typically caused by leaks, tubing disconnection, or a cuff leak.

Denial

The refusal or inability to accept reality. In substance use, it should be confronted by pointing out discrepancies between words and actions using "I" statements.

Dependency

A situation where a client relies on another person to make decisions or perform tasks for them.

Co-dependency

A dynamic where a significant other derives self-esteem from rescuing or doing things for a dependent person.

Manipulation

Getting another person to perform actions that are not in that person's best interest, often involving harmful or dangerous requests.

Wernicke encephalopathy

An acute brain disorder caused by a thiamine ($B_1$) deficiency, often associated with alcohol misuse.

Korsakoff syndrome

A long-term memory disorder and psychosis linked to thiamine deficiency, characterized by amnesia and confabulation.

Confabulation

The act of making up stories to fill memory gaps without the intent to lie, seen in Korsakoff syndrome.

Disulfiram (Antabuse)

An alcohol deterrent medication that causes severe unpleasant reactions if alcohol is consumed. Patients must avoid all alcohol-containing products, including mouthwash and hand sanitizer.

Naltrexone (Revia)

An opioid antagonist used for the maintenance and treatment of alcohol and opioid use disorders; it is not the acute emergency reversal agent.

Naloxone (Narcan)

The emergency medication used for the reversal of acute opioid toxicity and respiratory depression.

Alcohol Withdrawal Syndrome

Symptoms such as tremors and anxiety that occur within about $24$ hours after stopping alcohol consumption.

Delirium tremens (DTs)

A life-threatening complication of alcohol withdrawal occurring $48-72$ hours after the last drink, involving autonomic instability and hallucinations.

Aminoglycosides

Powerful antibiotics (e.g., gentamicin, tobramycin, neomycin) used for serious gram-negative infections. They are notably ototoxic and nephrotoxic.

Ototoxicity

Ear toxicity that can cause tinnitus, hearing loss, and balance problems; it is a major side effect of aminoglycosides.

Nephrotoxicity

Kidney toxicity characterized by rising creatinine levels and decreased urine output; a major risk when administering aminoglycosides.

Trough level

The lowest concentration of a drug in the blood, measured immediately before the next dose to prevent toxicity.

Peak level

The highest concentration of a drug in the blood, measured after administration to ensure a therapeutic effect.