Mark Klimek Audio Notes 1
Acid Base ABG’s
As pH goes, so does my Pt! Except for K
pH ↓ Pt goes ↓ (HR, RR, all vitals) K goes ↑
pH ↑ Pt goes ↑ K goes ↓
Except for K – it does the opposite
pH ↑ : Alkalosis
Seizures, hyperactivity, borborgemy (↑BS)
Kausmal breathing = MacKausamal (Metabolic Acidosis breathing)
Lung: Respiratory
Everything else: Metabolic
When you don’t know: it’s probably metabolic acidosis (It’s super common)
Ventilators
High Pressure Alarm
Obstructed airflow
Having to use too much pressure
Kinks, water collection in tube, mucous
Turn, cough, deep breathe
Low Pressure Alarm
↓ Resistance – machine finding job too easy
Disconnected tube
02 sensor disconnected
,Mark Klimek Audio Notes 2
If tube goes lower than pt level – contaminated
Amino Glycosides
A Mean Old Mycin
Amino Glycosides only treat Mean old Infections!
True mean old Mycins don’t have “Thro”
If it has “Thro” – Thro it away!
Ex: Zithromycin
Mean Old Mycins destroy ears (ototoxicity) and kidneys (nephrotoxicity)
Must check Creatinine for Nephrotoxicity – NOT urine output
8 Toxic to Cranial nerve 8 give q8h
Mean Old Mycins do NOT get absorbed – they go in and out and sterilize/clean
PO Mean Old Mycins are for bowel sterilizing
NeoMYCIN
KanoMYCIN
Who can sterilize my bowel?? NEO KAN!
Drawing TAP Levels (Peak and Trough)
For drugs that have a narrow therapeutic level and are toxic
, Mark Klimek Audio Notes 3
Route determines TAP – Not the drug
TROUGH PEAK
IV 30 MIN BEFORE NEXT DOSE IV 15-30 min after its done
IM 30 MIN BEFORE NEXT DOSE IM 30-60 min after its given
SUB Q 30 MIN BEFORE NEXT DOSE Subling 5-10 min after its in the system
PO 30 MIN BEFORE NEXT DOSE
Heart Rhythms
Ca Channel Blockers are chill pills for the heart
They end in DEPIM or ZEM
Rhythms
Asystole: No QRS – Lethal
Flutter: Sawtooth
Afib: Chaotic with QRS pattern
Vfib: Chaotic without QRS pattern – Lethal
Vent tachy: Wide bizarre QRS
SVT: Narrow QRS
PVC: random rhythm change – only concerned if > 6 or 6 in a row
Change in rhythm: check pulse or BP for cardiac output
Treat ventriculars with lidocaine
V→L
Treat SVT (it’s actually an atrial)
A denosine – puts you in asystole for 20 seconds
B eta bockers – all end it “lol”
C a channel blockers
D igitalis
Acid Base ABG’s
As pH goes, so does my Pt! Except for K
pH ↓ Pt goes ↓ (HR, RR, all vitals) K goes ↑
pH ↑ Pt goes ↑ K goes ↓
Except for K – it does the opposite
pH ↑ : Alkalosis
Seizures, hyperactivity, borborgemy (↑BS)
Kausmal breathing = MacKausamal (Metabolic Acidosis breathing)
Lung: Respiratory
Everything else: Metabolic
When you don’t know: it’s probably metabolic acidosis (It’s super common)
Ventilators
High Pressure Alarm
Obstructed airflow
Having to use too much pressure
Kinks, water collection in tube, mucous
Turn, cough, deep breathe
Low Pressure Alarm
↓ Resistance – machine finding job too easy
Disconnected tube
02 sensor disconnected
,Mark Klimek Audio Notes 2
If tube goes lower than pt level – contaminated
Amino Glycosides
A Mean Old Mycin
Amino Glycosides only treat Mean old Infections!
True mean old Mycins don’t have “Thro”
If it has “Thro” – Thro it away!
Ex: Zithromycin
Mean Old Mycins destroy ears (ototoxicity) and kidneys (nephrotoxicity)
Must check Creatinine for Nephrotoxicity – NOT urine output
8 Toxic to Cranial nerve 8 give q8h
Mean Old Mycins do NOT get absorbed – they go in and out and sterilize/clean
PO Mean Old Mycins are for bowel sterilizing
NeoMYCIN
KanoMYCIN
Who can sterilize my bowel?? NEO KAN!
Drawing TAP Levels (Peak and Trough)
For drugs that have a narrow therapeutic level and are toxic
, Mark Klimek Audio Notes 3
Route determines TAP – Not the drug
TROUGH PEAK
IV 30 MIN BEFORE NEXT DOSE IV 15-30 min after its done
IM 30 MIN BEFORE NEXT DOSE IM 30-60 min after its given
SUB Q 30 MIN BEFORE NEXT DOSE Subling 5-10 min after its in the system
PO 30 MIN BEFORE NEXT DOSE
Heart Rhythms
Ca Channel Blockers are chill pills for the heart
They end in DEPIM or ZEM
Rhythms
Asystole: No QRS – Lethal
Flutter: Sawtooth
Afib: Chaotic with QRS pattern
Vfib: Chaotic without QRS pattern – Lethal
Vent tachy: Wide bizarre QRS
SVT: Narrow QRS
PVC: random rhythm change – only concerned if > 6 or 6 in a row
Change in rhythm: check pulse or BP for cardiac output
Treat ventriculars with lidocaine
V→L
Treat SVT (it’s actually an atrial)
A denosine – puts you in asystole for 20 seconds
B eta bockers – all end it “lol”
C a channel blockers
D igitalis
