MARK KLIMEK YELLOW BOOK
Are they overventilating or underventilating?
If overventilating, pick ________
If underventilating, pick _______ alkalosis; acidosis
If the patient has _____ _______ vomiting or suction, pick _____ prolonged gastric; metabolic
alkalosis
Respiratory alkalosis means ventilator settings may be too ____ high
Respiratory acidosis means ventilator settings may be too ____ low
______ the denial in loss and grief. _______ the denial in abuse support; confront
What is Wernicke's/Korsakoff's Syndrome? form of dementia; psychosis induced by vitamin B1
(Thiamine) deficiency
Primary symptom of Wernicke's/Korsakoff's Syndrome? amnesia with confabulation (making up stories
to fill in memory gaps)
Characteristics of Wernicke's/Korsakoff's Syndrome? preventable (take vitamin B)
arrestable
irreversible
What is dementia? damage to the brain that is PERMANENT
i.e. NEVER PICK increase function, improve, cure
What is disulfiram? aversion therapy
What is the onset and duration of disulfiram? 2 weeks (takes 2 weeks to get out of system)
What should you teach patients on disulfiram? Avoid all forms of alcohol to avoid N/V and possibly
death (i.e. insect repellants, mouthwashes, colognes and perfumes and aftershave, vanilla extract,
vingeretts, elixirs, hand sanitizers, tinctures (alcohol for wounds that contain meds for the skin), alcohol
prep pads)
What are the names of uppers? 1. cocaine
2. PCP/LSD
3. meth
,4. caffeine
5. ADHD drugs
6. bath salts
What are the sings and symptoms of uppers? 1. diarrhea
2. dilated pupils
3. tachycardia
4. hyperreflexia
5. +4 pulse
6. hypertension
Every alcoholic goes through _____ within ______ Alcohol Withdrawal Syndrome within 24 hours
of last drink
Only a minority of alcoholics get ______ within _______ Delirium tremens within 72 hours after last
drink
(AWS/DTs) can kill you DTs
Patients with (AWS/DTs) are not a danger to themselves or others AWS
Patients with (AWS/DTs) are a danger to themselves and others DTs
What type of room should an AWS patient have? semi private room; anywhere
What type of room should a DT patient have? private room near nurse's station
What type of diet should an AWS patient have? regular
What type of diet should a DTs patient have? Why? NPO or clear liquids; worried about aspiration
What type of activity order should an AWS patient have? up ad lib
What type of activity order should a DTs patient have? restricted bedrest; no BR privileges
You should restrain a (AWS/DTs) patient with ______. You should check them every _______. You
should rotate them ______. restrain DTs patient with vest or 2 point leather restraints; check every
15 minutes; rotate every 2 hours
Both AWS and DTs patients are on _______, ________, and _______. Antihypertensives (BP is up;
withdrawaling from a downer)
,Tranquilizers (AWS- benzos- pams and lams; DTs -zines)
Multivitamin
What are the toxic effects of aminoglycosides? ototoxicity and nephrotoxicity
What must you monitor with ototoxicity? hearing, balance, tinnitus (ringing in ears)
What must you monitor with nephrotoxicity? creatinine
What is the best indicator of fluid balance? weight
What is the best indicator of dehydration? BUN
When should you administer aminoglycosides? every 8 hours
What is the route of administration for aminoglycosides? Give IM or IV
When should you give PO aminoglycosides? 1. Hepatic encephalopathy (brain disease) aka Liver
coma, ammonia-induced encephalopathy
2. pre-op bowel surgery (neo- and kan-)
Who can sterilize my bowel? Neo- Kan- !
How do you draw trough and peak levels? trough level
administer med
peak level
Sublingual, IV, IM, SQ, and PO trough level 30 minutes before next dose
Why do you draw trough and peak levels? meds with narrow therapeutic window
When do you draw peak levels for sublingual med? 5-10 minutes after drug dissolves
When do you draw peak levels for IV med? 15-30 minutes after drug is FINISHED not hung
When do you draw peak levels for IM med? 30-60 minutes
When do you draw peak levels for PO med? don't even try!
What is Category A Biological Agents? STAPHB
Smallpox
Tularemia
Anthrax
, Hemorrhagic fevers
Botulism
What is Category B Biological Agents? everything that isn't Category A or C
What is Category C Biological Agents? Nipeh- Virus
Hanta- Virus
How is smallpox transmitted? What kind of precautions? inhaled transmission; on airborne
precautions
How do people die from smallpox? septicemia; there is no treatment (early detection and isolation
is crucial)
What to look for in smallpox? rash starts around the mouth first
How is tularemia transmitted? What kind of precautions? inhaled transmission; on airborne
precautions
How do people die from tularemia? die from respiratory failure
How is tularemia treated? streptomycin
How is anthrax transmitted? What kind of precautions? inhaled transmission; on airborne precautions
What does anthrax look like? respiratory flu
How do people die from anthrax contamination? respiratory failure
How do you treat anthrax contamination? cipro
PCN
streptomycin
How is plague transmitted? What kind of precautions? inhaled transmission; on airborne precautions
What are signs and symptoms of the plague infected client? Hemoptysis: coughing up blood
Hematemesis: vomiting blood
Hematochezia: bright red diarrhea
How do people die from plague? respiratory failure and blood loss (DIC)
How do you treat the plague? doxycycline
-mycins
Are they overventilating or underventilating?
If overventilating, pick ________
If underventilating, pick _______ alkalosis; acidosis
If the patient has _____ _______ vomiting or suction, pick _____ prolonged gastric; metabolic
alkalosis
Respiratory alkalosis means ventilator settings may be too ____ high
Respiratory acidosis means ventilator settings may be too ____ low
______ the denial in loss and grief. _______ the denial in abuse support; confront
What is Wernicke's/Korsakoff's Syndrome? form of dementia; psychosis induced by vitamin B1
(Thiamine) deficiency
Primary symptom of Wernicke's/Korsakoff's Syndrome? amnesia with confabulation (making up stories
to fill in memory gaps)
Characteristics of Wernicke's/Korsakoff's Syndrome? preventable (take vitamin B)
arrestable
irreversible
What is dementia? damage to the brain that is PERMANENT
i.e. NEVER PICK increase function, improve, cure
What is disulfiram? aversion therapy
What is the onset and duration of disulfiram? 2 weeks (takes 2 weeks to get out of system)
What should you teach patients on disulfiram? Avoid all forms of alcohol to avoid N/V and possibly
death (i.e. insect repellants, mouthwashes, colognes and perfumes and aftershave, vanilla extract,
vingeretts, elixirs, hand sanitizers, tinctures (alcohol for wounds that contain meds for the skin), alcohol
prep pads)
What are the names of uppers? 1. cocaine
2. PCP/LSD
3. meth
,4. caffeine
5. ADHD drugs
6. bath salts
What are the sings and symptoms of uppers? 1. diarrhea
2. dilated pupils
3. tachycardia
4. hyperreflexia
5. +4 pulse
6. hypertension
Every alcoholic goes through _____ within ______ Alcohol Withdrawal Syndrome within 24 hours
of last drink
Only a minority of alcoholics get ______ within _______ Delirium tremens within 72 hours after last
drink
(AWS/DTs) can kill you DTs
Patients with (AWS/DTs) are not a danger to themselves or others AWS
Patients with (AWS/DTs) are a danger to themselves and others DTs
What type of room should an AWS patient have? semi private room; anywhere
What type of room should a DT patient have? private room near nurse's station
What type of diet should an AWS patient have? regular
What type of diet should a DTs patient have? Why? NPO or clear liquids; worried about aspiration
What type of activity order should an AWS patient have? up ad lib
What type of activity order should a DTs patient have? restricted bedrest; no BR privileges
You should restrain a (AWS/DTs) patient with ______. You should check them every _______. You
should rotate them ______. restrain DTs patient with vest or 2 point leather restraints; check every
15 minutes; rotate every 2 hours
Both AWS and DTs patients are on _______, ________, and _______. Antihypertensives (BP is up;
withdrawaling from a downer)
,Tranquilizers (AWS- benzos- pams and lams; DTs -zines)
Multivitamin
What are the toxic effects of aminoglycosides? ototoxicity and nephrotoxicity
What must you monitor with ototoxicity? hearing, balance, tinnitus (ringing in ears)
What must you monitor with nephrotoxicity? creatinine
What is the best indicator of fluid balance? weight
What is the best indicator of dehydration? BUN
When should you administer aminoglycosides? every 8 hours
What is the route of administration for aminoglycosides? Give IM or IV
When should you give PO aminoglycosides? 1. Hepatic encephalopathy (brain disease) aka Liver
coma, ammonia-induced encephalopathy
2. pre-op bowel surgery (neo- and kan-)
Who can sterilize my bowel? Neo- Kan- !
How do you draw trough and peak levels? trough level
administer med
peak level
Sublingual, IV, IM, SQ, and PO trough level 30 minutes before next dose
Why do you draw trough and peak levels? meds with narrow therapeutic window
When do you draw peak levels for sublingual med? 5-10 minutes after drug dissolves
When do you draw peak levels for IV med? 15-30 minutes after drug is FINISHED not hung
When do you draw peak levels for IM med? 30-60 minutes
When do you draw peak levels for PO med? don't even try!
What is Category A Biological Agents? STAPHB
Smallpox
Tularemia
Anthrax
, Hemorrhagic fevers
Botulism
What is Category B Biological Agents? everything that isn't Category A or C
What is Category C Biological Agents? Nipeh- Virus
Hanta- Virus
How is smallpox transmitted? What kind of precautions? inhaled transmission; on airborne
precautions
How do people die from smallpox? septicemia; there is no treatment (early detection and isolation
is crucial)
What to look for in smallpox? rash starts around the mouth first
How is tularemia transmitted? What kind of precautions? inhaled transmission; on airborne
precautions
How do people die from tularemia? die from respiratory failure
How is tularemia treated? streptomycin
How is anthrax transmitted? What kind of precautions? inhaled transmission; on airborne precautions
What does anthrax look like? respiratory flu
How do people die from anthrax contamination? respiratory failure
How do you treat anthrax contamination? cipro
PCN
streptomycin
How is plague transmitted? What kind of precautions? inhaled transmission; on airborne precautions
What are signs and symptoms of the plague infected client? Hemoptysis: coughing up blood
Hematemesis: vomiting blood
Hematochezia: bright red diarrhea
How do people die from plague? respiratory failure and blood loss (DIC)
How do you treat the plague? doxycycline
-mycins
