MARK KLIMEK NCLEX STUDY GUIDE NOTES 2023 Updated MARK KLIMEK NCLEX STUDY GUIDE NOTES 2023 UpdatedMARK KLIMEK NCLEX STUDY GUIDE NOTES 2023 UpdatedMARK KLIMEK NCLEX STUDY GUIDE NOTES 2023 Updated
lOMoAR cPSD|22689903 Downloaded by Victor Muia (vmuia463@gmail.com) lOMoAR cPSD|22689903 MARK K LIMEK NCLEX STUDY GUIDE NOTES 2023 Updated Mz.ANTICHOLINERGIC vs. CHOLINERGIC EFFECTS ANTICHOLINERGIC CHOLINERGIC lOMoAR cPSD|22689903 Downloaded by Victor Muia (vmuia463@gmail.com) • ↓ Mucus • Bronchorrhea (large amounts of mucus in • Bronchodilation airway) • Dry mouth • Bronchoconstriction • Dry eyes • Salivation • Urinary retention • LacrimatingUrination • Dry skin •• Diaphoresis/Diarrhea • Constipation • GI Upset • Shut down GI • Emesis • Prevents V when trying to intubate ACID BASE GASES A. ABG Interpretation a. Rule of the B’s i. If the pH and the BICARB (HCO3) ii. Are BOTH in the same direction, iii. Then it is METABOLIC b. ↓ pH = acidosis c. ↑ pH= alkaline B. Values a. Normal pH = 7.35 – 7.45 b. Normal Bicarb= 22 -26 c. PaO2= 80 -100 mmHg d. PaCO2= 35 -45 mmHg e. SaO2= 95 -100% C. Signs & Symptoms of Acid -Base Imbalance a. As the pH goes, so goes the patient except for Potassium (bc it will try to compensate) pH UP ↑ K↓ [ALKALOSIS] pH DOWN ↓ K↑ [ACIDOSIS] lOMoAR cPSD|22689903 Downloaded by Victor Muia (vmuia463@gmail.com) • • • • • • • Tachycardia Tachypnea Diarrhea Tremors Seizure Hyperreflexia Agitated • • • • • • • Bradycardia Bradypnea Hypotension ↓ lucidity anorexia coma lethargy • • • • • • Borborygmi ( ↑ bowel sounds) Hypertension Palpitations Tetany Anxiety/Panic Poly • • cardia arrest suppressed, decreased, falling D. Causes of Acid -Base Imbalance a. First ask, “Is it Lung?” i. If YES - then it is Respiratory b. Then ask yourself: i. Are they Overventilating or Underventilating? 1. If Overventilating pick Alkalosis 2. If Underventilating pick Acidosis c. If not lung, then it’s Metabolic i. If the pat ient has prolonged gastric vomiting or suction, pick Metabolic Alkalosis ii. For everything else that isn’t lung, pick Metabolic Acidosis 1. Also, if you don’t know what to pick choose Metabolic Acidosis VENTILATOR ALARMS 1. High Pressure Alarms are triggered by ↑ resistance to air flow and can be caused by obstructions of three types: lOMoAR cPSD|22689903 Downloaded by Victor Muia (vmuia463@gmail.com) a. Kinked Tube i. NRS ACTION: Unkink it b. Water in tubing (caused by condensation) i. NRS ACTION : Empty it/Remove H2O c. Mucus in airway i. NRS ACTION: Turn, C&DB; only use suction if C&DB fails, as a last resort 2. Low Pressure Alarms are triggered by ↓ resistance to air flow and can be caused by disconnections of the: a. Tubing i. NRS ACTION: Pay attention to where tubing is…(contamination) ii. If on floor, change out iii. If on chest, clean with alcohol then put back on 3. Respiratory Alkalosis (Overventilation) means ventilator settings may be too HIGH. 4. Respiratory Acidosis (Underventilation) means ventilator settings may be too LOW. 5. To “Wean” To gradually and incrementally decrease with the goal of ridding all together ALCOHOLISM Note: Remember in a psych question if you are asked to prioritize DO NOT forget Maslow! Use the following priorities: 1. Physiological
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