Mark Klimek Lecture Outlines Edited 2022
If the pH and the BiCarb are both in the same direction then it is? Correct Answer: Metabolc
If the pH is up it is? Correct Answer: Alkalosis
As the pH goes so goes my patient except for? Correct Answer: Potassium
If the pH is down it is? Correct Answer: Acidosis
If the pH is up my patient with show signs and symptoms of? Correct Answer: Increase... like
tachycardia,diarrhea and borborygmi
If the pH is down my patient will show signs and symtoms of? Correct Answer: Decrease... like
decreased output, bradycardia and constipation
If my pH is up my potassium (K+) is ? Correct Answer: Down
If my pH is down my potassium (K+) is? Correct Answer: Up
If my patient is overventilating I should choose? Correct Answer: Respiratory Alkalosis
If my patient is underventilating I should choose? Correct Answer: Respiratory Acidosis
If my patient has prolonged gastric vomiting or suction I choose? Correct Answer: Metabolic
Alkalosis
If it is not lung or prolonged vomiting or suctioning I choose? Correct Answer: Metabolic
Acidosis
Kussmal Respirations Correct Answer: Metabolic Acidosis ( Remember MacKussmal
Before measuing ABGs you should check what? Correct Answer: Allen's test. Should be
positive. Pt makes a fist and pressure is applied to the ulnar and the radial arteries Ulnar pressure
is released and color should return in 7 seconds (means it's positive and OK to take ABG's).
Definition of Compensation Correct Answer: PH is normal! It is never compensated if it is
abnormal.
If PH normal Correct Answer: look in the direction it is going. Closer to Acidic? (7.35) acidosis.
Then look at Bicarb & figure out which is abnormal. If Bicarb is out of range, it's metabolic
acidosis.
If C02 is abnormal, it's Respiratory Acidosis :)
,If your pt is acidotic and you need to pick a symptom Correct Answer: Pick the symptom where
everything is DOWN. ( And vice Versa)
Ex: 2 degree Morbitz Type 2 BLOCK. <---- Down direction
If you don't know what causes an acid base balance, pick Correct Answer: Metabolic Acidosis
If in doubt in ABGs, always pick Correct Answer: Headache, nausea, weakness & numbness+
tingling. It can be either up or down.
High pressure alarms are triggered when? Correct Answer: They cannot push air in
High pressure alarms are caused by what three types of obstructions? Correct Answer: Kinking,
Water in dependant loops and mucus in the airway.
If kinking in the tube is present you? Correct Answer: Unkink
If water is present in the dependant loops you? Correct Answer: Open system and empty water.
If mucus is present you? Correct Answer: Turn them, cough and have them deeo breath first. If
ineffective you then suction.
Don't suction unless Correct Answer: Coughing & deep breathing is deemed inappropriate.
In order to suction, you must be able to hear Correct Answer: Mucus in the lung
Low pressure alarms are triggered when? Correct Answer: It is to easy to push air in.
Low pressure alarms are normally caused by? Correct Answer: Disconnection
If the tubing is disconnected you? Correct Answer: Reconnect
If O2 sensor line is disconnected you? Correct Answer: Reconnect
In a vented client respiratory alkalosis means the vent setting may be too? Correct Answer: High
In a vented client respiratory acidosis means the vent may be too? Correct Answer: Low
What do you do if the patients disconnected tube is on the floor? Correct Answer: Bag them,
(call for help) get new tube and then reconnect.
First question to ask if the low pressure alarm sounds Correct Answer: Where is the tubing?!
HOLD Correct Answer: H- High Pressure
O- Obstruction
L- Low
,D- Disconnections
Never put anything in YOUR scope of practice Correct Answer: On anyone else
Make sure your answer is Correct Answer: PATIENT FOCUSED.
TAKE CARE OF YOUR PATIENT!
Don't answer based on staff, building, machine, etc.
PATIENT FIRST.
What does wean mean? Correct Answer: Decrease Gradually
What do you do if the patients disconnected tube is on the chest? Correct Answer: Reconnect ...
if its above the waist its ok.
Remember is PSYCH if you are asked to Prioritize, Don't forget Correct Answer: MASLOW!
1. Physiological
2. Safety
3. Comfort - Includes pain
4. Psychological
5. Social
6. Spiritual
When prioritizing, always use Maslow + ABCs Correct Answer: For one patient. Don't if you
have more than one patient.
What is the biggest problem in abuse? Correct Answer: Denial
To treat denial you need to? Correct Answer: Confront them.
Definition of Denial Correct Answer: Refusal to accept reality of their problem
How do you confront? Correct Answer: 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? Correct Answer: Loss
and Grief
Always go Correct Answer: Med surg first. Then Psych
What is dependency? Correct Answer: When the abuser gets a significant other so make
decisions for them or do thing for them.
What is codependency? Correct Answer: When the significant other gets positive self esteem
from doing things or making decisions for an abuser.
To treat dependency/codependency you ? Correct Answer: Set limits and enforce them.
, Say NO and follow through.
Agree in advance on what requests are allowed, then enforce the agreement.
You also need to work or the self esteem of the codependent.
What is manipulation? Correct Answer: 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? Correct Answer: Set limits and enforce.
Why is manipulation easier to treat then dependency/codependency? Correct Answer: Because
no one likes being manipulated.
DABDA Correct Answer: D- Denial
A- Anger
B- Bargaining
D- Depression
A- Acceptance
Psych Needs, In order Correct Answer: Denial
Depend
Manipulation
To address a patient's psychological needs, they must be: Correct Answer: STABLE, safe,
comfortable.
Pain Correct Answer: Never killed anyone. Definitely NOT the top priority, especially if there
are physiological needs in the question that make the patient unstable.
What is Wernickes (Korsakoffs) Syndrome? Correct Answer: Psychosis induced by vitamin B1
(Thiamine) deficiency.
Symptom of Wernickes Korsakoffs syndrome? Correct Answer: Amnesia with confabulation.
= Loss of memory with making up stories to fill in the gaps.
Vitamin B1 helps breakdown? Correct Answer: Alcohol
So without B1 what happens? Correct Answer: Alcohol isn't metabolized correctly goes to the
brain and causes Wernickes
If the pH and the BiCarb are both in the same direction then it is? Correct Answer: Metabolc
If the pH is up it is? Correct Answer: Alkalosis
As the pH goes so goes my patient except for? Correct Answer: Potassium
If the pH is down it is? Correct Answer: Acidosis
If the pH is up my patient with show signs and symptoms of? Correct Answer: Increase... like
tachycardia,diarrhea and borborygmi
If the pH is down my patient will show signs and symtoms of? Correct Answer: Decrease... like
decreased output, bradycardia and constipation
If my pH is up my potassium (K+) is ? Correct Answer: Down
If my pH is down my potassium (K+) is? Correct Answer: Up
If my patient is overventilating I should choose? Correct Answer: Respiratory Alkalosis
If my patient is underventilating I should choose? Correct Answer: Respiratory Acidosis
If my patient has prolonged gastric vomiting or suction I choose? Correct Answer: Metabolic
Alkalosis
If it is not lung or prolonged vomiting or suctioning I choose? Correct Answer: Metabolic
Acidosis
Kussmal Respirations Correct Answer: Metabolic Acidosis ( Remember MacKussmal
Before measuing ABGs you should check what? Correct Answer: Allen's test. Should be
positive. Pt makes a fist and pressure is applied to the ulnar and the radial arteries Ulnar pressure
is released and color should return in 7 seconds (means it's positive and OK to take ABG's).
Definition of Compensation Correct Answer: PH is normal! It is never compensated if it is
abnormal.
If PH normal Correct Answer: look in the direction it is going. Closer to Acidic? (7.35) acidosis.
Then look at Bicarb & figure out which is abnormal. If Bicarb is out of range, it's metabolic
acidosis.
If C02 is abnormal, it's Respiratory Acidosis :)
,If your pt is acidotic and you need to pick a symptom Correct Answer: Pick the symptom where
everything is DOWN. ( And vice Versa)
Ex: 2 degree Morbitz Type 2 BLOCK. <---- Down direction
If you don't know what causes an acid base balance, pick Correct Answer: Metabolic Acidosis
If in doubt in ABGs, always pick Correct Answer: Headache, nausea, weakness & numbness+
tingling. It can be either up or down.
High pressure alarms are triggered when? Correct Answer: They cannot push air in
High pressure alarms are caused by what three types of obstructions? Correct Answer: Kinking,
Water in dependant loops and mucus in the airway.
If kinking in the tube is present you? Correct Answer: Unkink
If water is present in the dependant loops you? Correct Answer: Open system and empty water.
If mucus is present you? Correct Answer: Turn them, cough and have them deeo breath first. If
ineffective you then suction.
Don't suction unless Correct Answer: Coughing & deep breathing is deemed inappropriate.
In order to suction, you must be able to hear Correct Answer: Mucus in the lung
Low pressure alarms are triggered when? Correct Answer: It is to easy to push air in.
Low pressure alarms are normally caused by? Correct Answer: Disconnection
If the tubing is disconnected you? Correct Answer: Reconnect
If O2 sensor line is disconnected you? Correct Answer: Reconnect
In a vented client respiratory alkalosis means the vent setting may be too? Correct Answer: High
In a vented client respiratory acidosis means the vent may be too? Correct Answer: Low
What do you do if the patients disconnected tube is on the floor? Correct Answer: Bag them,
(call for help) get new tube and then reconnect.
First question to ask if the low pressure alarm sounds Correct Answer: Where is the tubing?!
HOLD Correct Answer: H- High Pressure
O- Obstruction
L- Low
,D- Disconnections
Never put anything in YOUR scope of practice Correct Answer: On anyone else
Make sure your answer is Correct Answer: PATIENT FOCUSED.
TAKE CARE OF YOUR PATIENT!
Don't answer based on staff, building, machine, etc.
PATIENT FIRST.
What does wean mean? Correct Answer: Decrease Gradually
What do you do if the patients disconnected tube is on the chest? Correct Answer: Reconnect ...
if its above the waist its ok.
Remember is PSYCH if you are asked to Prioritize, Don't forget Correct Answer: MASLOW!
1. Physiological
2. Safety
3. Comfort - Includes pain
4. Psychological
5. Social
6. Spiritual
When prioritizing, always use Maslow + ABCs Correct Answer: For one patient. Don't if you
have more than one patient.
What is the biggest problem in abuse? Correct Answer: Denial
To treat denial you need to? Correct Answer: Confront them.
Definition of Denial Correct Answer: Refusal to accept reality of their problem
How do you confront? Correct Answer: 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? Correct Answer: Loss
and Grief
Always go Correct Answer: Med surg first. Then Psych
What is dependency? Correct Answer: When the abuser gets a significant other so make
decisions for them or do thing for them.
What is codependency? Correct Answer: When the significant other gets positive self esteem
from doing things or making decisions for an abuser.
To treat dependency/codependency you ? Correct Answer: Set limits and enforce them.
, Say NO and follow through.
Agree in advance on what requests are allowed, then enforce the agreement.
You also need to work or the self esteem of the codependent.
What is manipulation? Correct Answer: 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? Correct Answer: Set limits and enforce.
Why is manipulation easier to treat then dependency/codependency? Correct Answer: Because
no one likes being manipulated.
DABDA Correct Answer: D- Denial
A- Anger
B- Bargaining
D- Depression
A- Acceptance
Psych Needs, In order Correct Answer: Denial
Depend
Manipulation
To address a patient's psychological needs, they must be: Correct Answer: STABLE, safe,
comfortable.
Pain Correct Answer: Never killed anyone. Definitely NOT the top priority, especially if there
are physiological needs in the question that make the patient unstable.
What is Wernickes (Korsakoffs) Syndrome? Correct Answer: Psychosis induced by vitamin B1
(Thiamine) deficiency.
Symptom of Wernickes Korsakoffs syndrome? Correct Answer: Amnesia with confabulation.
= Loss of memory with making up stories to fill in the gaps.
Vitamin B1 helps breakdown? Correct Answer: Alcohol
So without B1 what happens? Correct Answer: Alcohol isn't metabolized correctly goes to the
brain and causes Wernickes
