Exam Review Notes

Dementia

  • Loss of body function is a late sign of dementia.
  • Other signs occur earlier.
  • Dementia is a chronic, progressive disease that worsens over time.

Increased Intracranial Pressure (ICP)

  • Manifestations of increased ICP:
    • Changes in level of consciousness.
    • Pupillary changes.
    • Motor dysfunction.
    • Headache.
    • Seizures.
  • Cushing's triad:
    • High blood pressure.
    • Low heart rate.
    • Low respiratory rate.
    • Increased widening pulse pressure (high top number, low bottom number).
  • Many diseases can cause increased ICP simultaneously or trigger each other.

Seizures

  • During a seizure, the nurse should NOT apply restraints.
    • Applying restraints can cause bone fractures or more harm due to the patient's uncontrolled movements.
  • Goals during a seizure:
    • Protect the patient and ensure safety.
    • Turn the patient to the side to prevent aspiration.
    • Time and record the seizure.
    • Do not put anything in the patient's mouth.
    • Avoid restraining the patient.

Respiratory Acidosis

  • Causes/risk factors for respiratory acidosis:
    • COPD.
    • Emphysema.
    • Diabetic ketoacidosis.
    • Drug overdose.
  • In respiratory acidosis:
    • pH is low (acidic).
    • CO_2 is high (more acid).
  • COPD and emphysema:
    • Patients might breathe fast, but not effectively, leading to CO_2 retention.

Metabolic Acidosis

  • A client with diarrhea is at risk for metabolic acidosis.
    • Diarrhea causes loss of bicarb (a base).
  • In metabolic acidosis:
    • pH is low (acidic).
    • CO_2 is normal (lungs not involved).
    • Bicarb is low (less base).

Physiological Dependence

  • A client prescribed oxycodone for chronic pain reports feeling shaky and sweaty when they run out:
    • This indicates physiological dependence (physical manifestation of withdrawal).
  • Terms to review:
    • Habit.
    • Psychological dependence.
    • Physiological dependence.
    • Tolerance.
    • Addiction.
  • Oxycodone is an opioid (depressant).
    • Opioid overdoses can cause respiratory depression, leading to death.
    • Respiratory depression results in respiratory acidosis (due to CO_2 retention).

Studying Electrolytes

  • There is no perfect way to study electrolytes; it takes time.
  • Do not forget to study other subjects as electrolyte imbalances manifest in diverse ways.
  • Electrolytes are historically one of the hardest topics to study.
  • Tips for studying electrolytes:
    • Active recall.
    • Practice questions.
    • Use fluid electrolyte acid base comparison charts.
    • Understand how electrolytes enter and exit the body.
    • Focus on how electrolytes are excreted (e.g., renal excretion of potassium).
    • Use mnemonics (e.g., respiratory opposite, metabolic equal).
  • Electrolytes involve some memorization, but understanding the underlying mechanisms is crucial.
  • When quizzing yourself, have notes available, but refer to textbooks or VDAP resources when stuck.
  • Use coach ally in Canvas to ask questions.
  • Consult Mark K lectures for thorough explanations of electrolyte balance.
  • Look for patterns and memory tips (e.g., symptoms often match the prefix - hyper/hypo).
  • Buddy up with a partner and quiz each other to reinforce understanding.