Mark Klimek Lecture Outlines 2023
Questions and Answers.
-If the pH and the BiCarb are both in the same direction then it is? - -Metabolic
-If the pH is up it is? - -Alkalosis
-If the pH is down it is? - -Acidosis
-As the pH goes so goes my patient except for? - -Potassium
-If the pH is up my patient with show signs and symptoms of? - -Increase... like
tachycardia,diarrhea and borborygmi
-If the pH is down my patient will show signs and symtoms of? - -Decrease... like
decreased output, bradycardia and constipation
-If my pH is up my potassium (K+) is ? - -Down
-If my pH is down my potassium (K+) is? - -Up
-If my patient is overventilating I should choose? - -Respiratory Alkalosis
-If my patient is underventilating I should choose? - -Respiratory Acidosis
-If my patient has prolonged gastric vomiting or suction I choose? - -Metabolic
Alkalosis
-If it is not lung or prolonged vomiting or suctioning I choose? - -Metabolic Acidosis
-High pressure alarms are triggered when? - -They cannot push air in
-High pressure alarms are caused by what three types of obstructions? - -Kinking,
Water in dependant loops and mucus in the airway.
-If kinking in the tube is present you? - -Unkink
-If water is present in the dependant loops you? - -Open system and empty water.
-If mucus is present you? - -Turn them, cough and have them deeo breath first. If
ineffective you then suction.
-Low pressure alarms are triggered when? - -It is to easy to push air in.
-Low pressure alarms are normally caused by? - -Disconnection
,-If the tubing is disconnected you? - -Reconnect
-If O2 sensor line is disconnected you? - -Reconnect
-In a vented client respiratory alkalosis means the vent setting may be too? - -High
-In a vented client respiratory acidosis means the vent may be too? - -Low
-What do you do if the patients disconnected tube is on the floor? - -Bag them, (call for
help) get new tube and then reconnect.
-What do you do if the patients disconnected tube is on the chest? - -Reconnect ... if its
above the waist its ok.
-What is the biggest problem in abuse? - -Denial
-To treat denial you need to? - -Confront
-How do you confront? - -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? - -Loss and
Grief
-What is dependency? - -When the abuser gets a significant other so make decisions for
them or do thing for them.
-What is codependency? - -When the significant other gets positive self esteem from
doing things or making decisions for an abuser.
-To treat dependency/codependency you ? - -Set limits and enforce them. You also
need to work or the self estreem of the codependent.
-What is manipulation? - -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? - -Set limits and enforce.
-Why is manipulation easier to treat then dependency/codependency? - -Because no
one likes being manipulated.
-What is Wernickes (Korsakoffs) Syndrome? - -Psychosis induced by vitamin B1
(Thiamine) deficiency.
-Vitamin B1 helps breakdown? - -Alcohol
,-Primary symptom of Wernickes? - -Amnesia with confabulation (making up stories).
-Is Wernickes preventable? - -Yes
-Is Wernickes arrestable? - -Yes
-Is Wernickes reversible? - -No
-What is aversion therapy? - -When you try and make the patient hate something.
-Antabuse onset and duration is? - -2 weeks
-Teach a patient taking Antabuse to avoid what? - -Alochol
-On top of alcohol a patient taking Antabuse should also avoid what other 7 things? - -
Elixirs, Vanilla Extract, Aftershave/Perfumes, Alcohol based hand sanitizer, Insect
repellant, Mouthwash and Vinagerette.
-What are the five uppers? - -Caffeine, Cocaine, Methamphetamines, PCP/LSD and
ADHD Meds
-Downers are? - -Everything other then the five uppers.
-S/S of upper use? - -Everything goes up...Tachycardia, increased BP etc.
-S/S of downer use? - -Everything goes down...Bradycardia, decreased BP etc.
-Overdose of a downer causes everything to go? - -Down
-Overdose of an upper causes everything to go? - -Up
-Withdrawal of an upper causes everything to go? - -Down
-Withdrawal of a downer causes everything to go? - -Up
-At birth if the mother was addicted to a substance always assume the newborn is in? -
-Intoxication
-If 24 hours after birth assume the baby is in? - -Withdrawal
-Every alcoholic goes through what withing 24 hours after cessation? - -Withdrawal
syndrome
-After 72 hours of alochol withdrawal a small minority may get? - -Delirium Tremens
-Can Delirium Tremens kill you? - -Yes
, -Can Alcohol Withdrawal Syndrome kill you? - -No
-Are patients with Alcohol Withdrawal Syndrome a danger to themselves or others? - -
No
-Are patients with Delirium Tremens a danger to themselves or others? - -Yes
-N/I for Delirium Tremens? - -Private room near nurses station, NPO/Clear liquids,
Restricted bed rest, restraints, tranquilizer, multivitamin (B1 vit.) and antihypertensive.
-N/I for Alcohol Withdrawal Syndrome? - -Semi-private room anywhere, regular diet,
up and ad-lib, no restraint, tranquilizer, multivitamin (B1) and antihypertensive.
-A two point restraint is? - -One arm and the opposite leg.
-N/I for restraints? - -Check Q15min. and rotate sites Q2H
-All aminoglycosides end in? - -"mycin" Vancomycin
-If it has "thro" in it you? - -Throw it out...Zithromycin
-Toxic effects of aminoglycosides? - -Ototoxicity, nephrotoxicity and cranial nerve 8
(vestibulocochlear nerve) which senses sound.
-In aminoglycoside use monitor? - -Hearing, balance, tinnitus & creatinine (best
indicator of renal function)
-Frequency of administration for aminoglycosides? - -Q8H
-Aminoglycoside route of administration? - -Im or IV
-Aminoglycosides are given PO for what two reasons? - -Hepatic Encephalopathy and
Pre-op bowel surgery.
-Neomycin and Kanmycin are used for what? - -Bowel sterilzation?
-Who can sterilize my bowel? - -"Neo" "Kan"
-Hepatic Encephalopathy is caused by? - -High ammonia levels
-What raises ammonia levels the most? - -Ecoli in the gut
-When do you draw a trough level? - -30 minutes before the next scheduled dose.
-When do you draw a sublingual peak level? - -5-10 minutes after it is dissolved.
-When do you draw a IV peak level? - -15-30 minutes after dose is finished.
Questions and Answers.
-If the pH and the BiCarb are both in the same direction then it is? - -Metabolic
-If the pH is up it is? - -Alkalosis
-If the pH is down it is? - -Acidosis
-As the pH goes so goes my patient except for? - -Potassium
-If the pH is up my patient with show signs and symptoms of? - -Increase... like
tachycardia,diarrhea and borborygmi
-If the pH is down my patient will show signs and symtoms of? - -Decrease... like
decreased output, bradycardia and constipation
-If my pH is up my potassium (K+) is ? - -Down
-If my pH is down my potassium (K+) is? - -Up
-If my patient is overventilating I should choose? - -Respiratory Alkalosis
-If my patient is underventilating I should choose? - -Respiratory Acidosis
-If my patient has prolonged gastric vomiting or suction I choose? - -Metabolic
Alkalosis
-If it is not lung or prolonged vomiting or suctioning I choose? - -Metabolic Acidosis
-High pressure alarms are triggered when? - -They cannot push air in
-High pressure alarms are caused by what three types of obstructions? - -Kinking,
Water in dependant loops and mucus in the airway.
-If kinking in the tube is present you? - -Unkink
-If water is present in the dependant loops you? - -Open system and empty water.
-If mucus is present you? - -Turn them, cough and have them deeo breath first. If
ineffective you then suction.
-Low pressure alarms are triggered when? - -It is to easy to push air in.
-Low pressure alarms are normally caused by? - -Disconnection
,-If the tubing is disconnected you? - -Reconnect
-If O2 sensor line is disconnected you? - -Reconnect
-In a vented client respiratory alkalosis means the vent setting may be too? - -High
-In a vented client respiratory acidosis means the vent may be too? - -Low
-What do you do if the patients disconnected tube is on the floor? - -Bag them, (call for
help) get new tube and then reconnect.
-What do you do if the patients disconnected tube is on the chest? - -Reconnect ... if its
above the waist its ok.
-What is the biggest problem in abuse? - -Denial
-To treat denial you need to? - -Confront
-How do you confront? - -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? - -Loss and
Grief
-What is dependency? - -When the abuser gets a significant other so make decisions for
them or do thing for them.
-What is codependency? - -When the significant other gets positive self esteem from
doing things or making decisions for an abuser.
-To treat dependency/codependency you ? - -Set limits and enforce them. You also
need to work or the self estreem of the codependent.
-What is manipulation? - -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? - -Set limits and enforce.
-Why is manipulation easier to treat then dependency/codependency? - -Because no
one likes being manipulated.
-What is Wernickes (Korsakoffs) Syndrome? - -Psychosis induced by vitamin B1
(Thiamine) deficiency.
-Vitamin B1 helps breakdown? - -Alcohol
,-Primary symptom of Wernickes? - -Amnesia with confabulation (making up stories).
-Is Wernickes preventable? - -Yes
-Is Wernickes arrestable? - -Yes
-Is Wernickes reversible? - -No
-What is aversion therapy? - -When you try and make the patient hate something.
-Antabuse onset and duration is? - -2 weeks
-Teach a patient taking Antabuse to avoid what? - -Alochol
-On top of alcohol a patient taking Antabuse should also avoid what other 7 things? - -
Elixirs, Vanilla Extract, Aftershave/Perfumes, Alcohol based hand sanitizer, Insect
repellant, Mouthwash and Vinagerette.
-What are the five uppers? - -Caffeine, Cocaine, Methamphetamines, PCP/LSD and
ADHD Meds
-Downers are? - -Everything other then the five uppers.
-S/S of upper use? - -Everything goes up...Tachycardia, increased BP etc.
-S/S of downer use? - -Everything goes down...Bradycardia, decreased BP etc.
-Overdose of a downer causes everything to go? - -Down
-Overdose of an upper causes everything to go? - -Up
-Withdrawal of an upper causes everything to go? - -Down
-Withdrawal of a downer causes everything to go? - -Up
-At birth if the mother was addicted to a substance always assume the newborn is in? -
-Intoxication
-If 24 hours after birth assume the baby is in? - -Withdrawal
-Every alcoholic goes through what withing 24 hours after cessation? - -Withdrawal
syndrome
-After 72 hours of alochol withdrawal a small minority may get? - -Delirium Tremens
-Can Delirium Tremens kill you? - -Yes
, -Can Alcohol Withdrawal Syndrome kill you? - -No
-Are patients with Alcohol Withdrawal Syndrome a danger to themselves or others? - -
No
-Are patients with Delirium Tremens a danger to themselves or others? - -Yes
-N/I for Delirium Tremens? - -Private room near nurses station, NPO/Clear liquids,
Restricted bed rest, restraints, tranquilizer, multivitamin (B1 vit.) and antihypertensive.
-N/I for Alcohol Withdrawal Syndrome? - -Semi-private room anywhere, regular diet,
up and ad-lib, no restraint, tranquilizer, multivitamin (B1) and antihypertensive.
-A two point restraint is? - -One arm and the opposite leg.
-N/I for restraints? - -Check Q15min. and rotate sites Q2H
-All aminoglycosides end in? - -"mycin" Vancomycin
-If it has "thro" in it you? - -Throw it out...Zithromycin
-Toxic effects of aminoglycosides? - -Ototoxicity, nephrotoxicity and cranial nerve 8
(vestibulocochlear nerve) which senses sound.
-In aminoglycoside use monitor? - -Hearing, balance, tinnitus & creatinine (best
indicator of renal function)
-Frequency of administration for aminoglycosides? - -Q8H
-Aminoglycoside route of administration? - -Im or IV
-Aminoglycosides are given PO for what two reasons? - -Hepatic Encephalopathy and
Pre-op bowel surgery.
-Neomycin and Kanmycin are used for what? - -Bowel sterilzation?
-Who can sterilize my bowel? - -"Neo" "Kan"
-Hepatic Encephalopathy is caused by? - -High ammonia levels
-What raises ammonia levels the most? - -Ecoli in the gut
-When do you draw a trough level? - -30 minutes before the next scheduled dose.
-When do you draw a sublingual peak level? - -5-10 minutes after it is dissolved.
-When do you draw a IV peak level? - -15-30 minutes after dose is finished.
