Exam (elaborations)
Mark Klimek Lecture 1 (1).
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Mark Klimek Lecture 1 (1).
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If the pH and the BiCarb are both in the same direction then it is? - ANS-MetabolicIf the pH is up it is? - ANS-Alkalosis
If the pH is down it is? - ANS-Acidosis
As the pH goes so goes my patient except for? - ANS-Potassium
If the pH is up my patient with show signs and symptoms of? - ANS-Increase... like
tachycardia,diarrhea and borborygmi
If the pH is down my patient will show signs and symtoms of? - ANS-Decrease... like
decreased output, bradycardia and constipation
If my pH is up my potassium (K+) is ? - ANS-Down
If my pH is down my potassium (K+) is? - ANS-Up
If my patient is overventilating I should choose?
which acid base wld this be - ANS-Respiratory Alkalosis
If my patient is underventilating I should choose? which acid base wld this be? -
ANS-Respiratory Acidosis
If my patient has prolonged gastric vomiting or suction I choose? - ANS-Metabolic
Alkalosis
If it is not lung or prolonged vomiting or suctioning I choose? - ANS-Metabolic Acidosis
what does Mackussmals mean - ANS-Metabolic Acidosis-kussmals breathing
High pressure alarms in ventilators are triggered when? - ANS-increase resistance to air
flow.(in other words the machine is having to push too hard to get the air pushed into
the lung) when this happens the machine will go off.
High pressure alarms are caused by what three types of obstructions? - ANS-Kinking,
Water condensing in the dependant loops and mucus secretion in the airway.
in high pressure alarm If kinking in the tube is present you would? - ANS-Unkink
,in high pressure alarm. If water is condensing in the dependent loops, you would? -
ANS-Open system and empty water.
in high pressure alarm, If mucus secretion is present you would? - ANS-Turn them,
cough and have them deep breath first. If ineffective you then suction.
Low pressure alarms are triggered when? - ANS-Decreased resistance to airflow. (It is
to easy to push air in)
Low pressure alarms are normally caused by? - ANS-Disconnection
In Low pressure alarms, If the tubing is disconnected you would? - ANS-Reconnect
In Low pressure alarms, If O2 sensor line is disconnected you would? - ANS-Reconnect
In a vented client respiratory alkalosis means the vent setting may be too? - ANS-High
In a vented client respiratory acidosis means the vent may be too? - ANS-Low
What do you do if the patients disconnected tube is on the floor? - ANS-Bag them, (call
for help) get new tube and then reconnect.
What do you do if the patients disconnected tube is on the chest? - ANS-Reconnect ... if
its above the waist its ok.
What is the biggest problem in abuse? - ANS-Denial
What is definition of denial - ANS-refusal to accept reality of a problem
To treat denial you need to? - ANS-Confront
How do you confront? - ANS-Point out the difference between what they say and what
they do.
What is the one circumstance that you as a nurse would support denial? - ANS-Loss
and Grief
What is dependency? - ANS-When the abuser gets a significant other so make
decisions for them or do thing for them.
,What is codependency? - ANS-When the significant other gets positive self esteem
from doing things or making decisions for an abuser.
To treat dependency/codependency you ? - ANS-Set limits and enforce them. You also
need to work or the self estreem of the codependent.
What is manipulation? - ANS-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.
How do you treat manipulation? - ANS-Set limits and enforce.
Why is manipulation easier to treat then dependency/codependency? - ANS-Because
no one likes being manipulated.
What is Wernickes (Korsakoffs) Syndrome?
(wernickes is a encephalopathy and Korsakoffs is a pyschosis but they tend to go
together) - ANS-Psychosis induced by vitamin B1 (Thiamine) deficiency (pts loose in
touch with reality and go insane).
Wernicke Korsakoff syndrome is usually found in - ANS-Alcoholics
Primary symptom of Wernickes? - ANS-Amnesia(memory loss) with confabulation
(making up stories and they believe it ).
When a person has Wernicke Korsakoff syndrome, And they talk crazy how do you
approch them - ANS-You redirect patients and dont present reality(because presenting
reality is for pts who can learn it. and these people cannot learn it)
Is Wernickes preventable? how - ANS-Yes; Take vitamin B1-because B1 helps
breakdown alcohol
Is Wernickes arrestable(stop from getting worse)? - ANS-Yes by taking B1
Is Wernickes reversible? - ANS-No
What are 2 drugs that have to do with alcohol - ANS-Antabuse(Disulfiram) and
Revia(Naltrexone)
Disulfiram and Naltrexone is what type of Therapy? - ANS-Aversion Therapy
, What is aversion therapy? - ANS-When you try and make the patient do something and
they have a gut hatred for that particular thing. In this case it will be alcohol-MAKES
YOU DEATHLY ILL
Disulfiram onset and duration is? - ANS-2 weeks- so they have to be ON the drug for 2
wks for it work and they have to be OFF the drug before they can safely drink again and
not get sick-2wks
Teach a patient taking Antabuse to avoid what? - ANS-ALL forms of alcohol-to avoid
N/V and possibly death
On top of alcohol a patient taking Antabuse should also avoid what other 7 things? -
ANS-any over the counter that ends in-Elixirs, Aftershave/Perfumes, Alcohol based
hand sanitizer, Insect repellant, Mouthwash and uncooked icing because it has vanilla
extract.
They can HAVE red wine vinegarret
What are the five uppers? - ANS-Caffeine, Cocaine, Methamphetamines,
PCP/LSD(hallucinogens) and Aderol(ADD drug)
Downers are? - ANS-Everything other then the five uppers.
S/S of upper use? - ANS-Everything goes up...Tachycardia, increased BP etc.
S/S of downer use? - ANS-Everything goes down...Bradycardia, decreased BP etc.
Overdose/intoxication(too much) of a downer causes everything to go? - ANS-Down
Overdose/intoxication (too much) of an upper causes everything to go? - ANS-Up
Withdrawal(not enough) of an upper causes everything to go? - ANS-Down
Withdrawal(not enough) of a downer causes everything to go? - ANS-Up
At birth if the mother was addicted to a substance always assume the newborn is in?
and dont assume___? - ANS-Intoxication
dont assume withrdrawal
If 24 hours after birth assume the baby is in? - ANS-Withdrawal
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