Labeled MAARK K

ABG

If the pH and the BiCarb are both in the same direction then it is?

Metabolic (rule of the Bs)

ABG

Do you ever choose "Compensated" if the pH is abnormal?

NEVER

ABG

If all three (pH, Bicarb, Co2) are abnormal then what is it?

Partially compensated

ABG

If the pH is up it is?

Alkalosis

ABG If the pH is down it is?

Acidosis

ABG As the pH goes so goes my patient except for?

Potassium

ABG If the pH is up my patient with show signs and symptoms of?

Increase... like tachycardia,diarrhea and borborygmi

ABG If the pH is down my patient will show signs and symtoms of?

Decrease... like decreased output, bradycardia and constipation

ABG If my pH is up my potassium (K+) is ?

Down

ABG If my pH is down my potassium (K+) is?

Up

ABG If my patient is experiencing Kussmaul Respirations what do they have?

Metabolic Acidosis

think! MAC KUSSMAUL

ABG Is it a lung problem?, if yes then what is it

Respiratory

ABG
If my patient is overventilating I should choose?

Respiratory Alkalosis

ABG If my patient is underventilating I should choose?

Respiratory Acidosis

ABG

If my patient has prolonged gastric vomiting or suction I choose?

Metabolic Alkalosis

ABG If it is not lung or prolonged vomiting or suctioning I choose?

Metabolic Acidosis

ABG What is the go to answer when you dont know what it is?

Metabolic Acidosis

Ventilator Alarms High pressure alarms are triggered when?

there is increased resistance to air flow, caused by obstructions

Ventilator Alarms High pressure alarms are caused by what three types of obstructions?

Kinking, Water in dependant loops and mucus in the airway.

Ventilator Alarms If kinking in the tube is present you...?

Unkink the tubing, DUH

Ventilator Alarms If water is present in the dependant loops you...?

Open system and empty water.

Ventilator Alarms If mucus is present you...?

Turn them, cough and have them deeo breath first. If ineffective you then suction.

Ventilator Alarms Low pressure alarms are triggered when?

there is decreased resistance to air flow, caused by disocnnections

Ventilator Alarma Low pressure alarms are normally caused by?

Disconnection

• main tubings or

• oxygen sensor tubing

Ventilator Alarms If the tubing is disconnected you?

Reconnect

Ventilator Alarms If O2 sensor line is disconnected you?

Reconnect

Ventilator Alarms In a vented client respiratory alkalosis means the vent setting may be too?

High

Ventilator Alarms
In a vented client respiratory acidosis means the vent may be too?

Low

Ventilator Alarms What do you do if the patients disconnected tube is on the floor?

Bag them, (call for help) get new tube and then reconnect.

Ventilator Alarms What do you do if the patients disconnected tube is on the chest?

Reconnect ... if its above the waist its ok.

Alcoholism What is the biggest problem in abuse?

Denial

Alcoholism How do you prioritize?

use Maslows hierarchy

1. physiological

2. safety

3. comfort

4. psychological

5. social

6. spiritual

Alcoholism To treat denial you need to?

Confront

Alcoholism How do you confront?

Point out the difference between what they say and what they do.

Alcoholism What is the one circumstance that you as a nurse would support denial?

Loss and Grief

Alcoholism What is dependency?

When the abuser gets a significant other so make decisions for them or do thing for them.

Alcoholism What is codependency?

When the significant other gets positive self esteem from doing things or making decisions for an abuser.

Alcholism To treat dependency/codependency you ?

Set limits and enforce them. You also need to work or the self estreem of the codependent.

Alcoholism What is manipulation?

When the abuser gets the significant other fo do things for them that is not in the best interest of the significant other. This can be dangerous and harmful to the significant other.

Alcoholism How do you treat manipulation?

Set limits and enforce.

Alcoholism Why is manipulation easier to treat then dependency/codependency?

Because no one likes being manipulated.

Alcholism What is Wernickes (Korsakoffs) Syndrome?

Psychosis induced by vitamin B1 (Thiamine) deficiency.

Alcoholism What is the primary symtpom for Wernickes

amnesia with comfabulation

• make stuff up and truly believe it

Alcoholism Vitamin B1 helps breakdown?

Alcohol

Alcoholism Primary symptom of Wernickes?

Amnesia with confabulation (making up stories).

Alcoholism is Wernickes preventable?

Yes take b1

Alcoholism Is Wernickes arrestable?

Yes you can stop it from geting worse

Alcoholism Is Wernickes reversible?

No

Alcoholism What is aversion therapy?

When you try and make the patient hate something.

Alcoholism What drugs are used in aversion therapy

Antabuse (disulfiram) and revia (naltrexone)

Alcoholism Antabuse onset and duration is?

2 weeks

Alcoholism Teach a patient taking Antabuse to avoid what?

Alochol

Alcoholism On top of alcohol a patient taking Antabuse should also avoid what other 7 things?

Elixirs, Vanilla Extract, Aftershave/Perfumes, Alcohol based hand sanitizer, Insect repellant, Mouthwash

RED WINE vinegrette is OKAY

Overdose vs. Withdrawal Every abused drug is either... or ....?

upper or downer

Overdose vs. Withdrawal What are the five uppers?

Caffeine, Cocaine, Methamphetamines, PCP/LSD and ADHD Meds

Overdose vs. Withdrawal Downers are?

Everything other then the five uppers.

Overdose vs. Withdrawal S/S of upper use?

Everything goes up...Tachycardia, increased BP etc.

Overdose vs. Withdrawal S/S of downer use?

Everything goes down...Bradycardia, decreased BP etc.

Overdose vs. Withdrawal Overdose of a downer causes everything to go?

Down

Overdose vs. Withdrawal

Overdose of an upper causes everything to go?

Up

Overdose vs. Withdrawal Withdrawal of an upper causes everything to go?

Down

Overdose vs. Withdrawal Withdrawal of a downer causes everything to go?

Up

Overdose vs. Withdrawal At birth if the mother was addicted to a substance always assume the newborn is in?

Intoxication

Overdose vs. Withdrawal If 24 hours after birth assume the baby is in?

Withdrawal

Overdose vs. Withdrawal
Every alcoholic goes through what within 24 hours after cessation?

Withdrawal syndrome

Overdose vs. Withdrawal After 72 hours of alochol withdrawal a small minority may get?

Delirium Tremens

Overdose vs. Withdrawal Can Delirium Tremens kill you?

Yes

Overdose vs. Withdrawal Can Alcohol Withdrawal Syndrome kill you?

No

Overdose vs. Withdrawal Are patients with Alcohol Withdrawal Syndrome a danger to themselves or others?

No

Overdose vs. Withdrawal Are patients with Delirium Tremens a danger to themselves or others?

Yes

Overdose vs. Withdrawal N/I for Delirium Tremens?

Private room near nurses station, NPO/Clear liquids, Restricted bed rest, restraints(2 point locked leahthers, or vest), tranquilizer, multivitamin (B1 vit.) and antihypertensive.

Overdose vs. Withdrawal N/I for Alcohol Withdrawal Syndrome?

Semi-private room anywhere, regular diet, up and ad-lib, no restraint, tranquilizer, multivitamin (B1) and antihypertensive.

Overdose vs. Withdrawal What do you do for both AWS and Dt's

give anti hypertensives, tranquilizers, and multivitamin (containing B1)

Overdose vs. Withdrawal A two point restraint is?

One arm and the opposite leg.

Overdose vs. Withdrawal N/I for restraints?

Check Q15min. and rotate sites Q2H

Aminoglycosides All aminoglycosides end in?

"mycin" Vancomycin

Aminoglycosides What do you think of

A mean old mycin, for mean old infections

Aminoglycosides If it has "thro" in it you?

Throw it out...Zithromycin

Aminoglycosides Toxic effects of aminoglycosides?

Ototoxicity

• think MICE --> ears nephrotoxicity

• ears are shaped like kidneys Cranial nerve 8 (vestibulocochlear nerve) which senses sound.

• 8 can be drawn in the ear

Aminoglycosides In aminoglycoside use monitor?

Hearing, balance, tinnitus & creatinine (best indicator of renal function)

Aminoglycosides Frequency of administration for aminoglycosides?

Q8H

Aminoglycosides Aminoglycoside route of administration?

Im or IV

Aminoglycosides Aminoglycosides are given PO for what two reasons?

Hepatic Encephalopathy and Pre-op bowel surgery.

Aminoglycosides
Neomycin and Kanmycin are used for what?

Bowel sterilzation

Aminoglycosides Who can sterilize my bowel?

"Neo" "Kan"

Aminoglycosides Hepatic Encephalopathy is caused by?

High ammonia levels

Aminoglycosides What raises ammonia levels the most?

Ecoli in the gut

Aminoglycosides When do you draw a trough level?

30 minutes before the next scheduled dose.

Aminoglycosides When do you draw a sublingual peak level?

5-10 minutes after it is dissolved.

Aminoglycosides When do you draw a IV peak level?

15-30 minutes after dose is finished.

Aminoglycosides When do you draw a IM peak level?

30-60 minutes after given

Aminoglycosides Drugs DON't determine peak and trough times, the ROUTE does.

...

Calcium Channel Blockers Calcium Channel Blockers are like what for the heart?

Valium

Calcium Channel Blockers Calcium Channel Blockers treat what? (the 6 A's)

Antihypertensive, Anti-Anginal, Anti Atrial Arrythmia and SVTS

Calcium Channel Blockers Calcium Channel Blocker side effects? (the 2 H's)

Headache and Hypotension and bradycardia

Calcium Channel Blockers What do inotropic drugs control?

Strength of heartbeat

Calcium Channel Blockers What dromotropic drugs control?

conductivity