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.