Mark Klimek ALL Lectures Reviews GRADED A+ 2025 EXAMS
Preparation
Rule of the B's: If the ____ and the _____ are ______ in the same direction then it is ___ - pH, Bicarb
(HCO3), Metabolic
Normal pH value is - 7.35-7.45
If the pH is greater than 7.45, it is - alkalosis
As the pH goes __ so goes my patient except for? - Potassium
What symptoms occur when your pH is low? - hyporeflexia (0, +1), obtundent, paralytic ileus,
bradycardia, bradypnea, respiratory arrest, hyperkalemia
What symptoms occur when your pH is high - hyperreflexia (+3, +4), irritability, borborygmi, seizures,
tachycardia, tachypnea, hypokalemia
What is a nursing intervention for when the patient is acidotic - ambubag + ventilation
What is a nursing intervention for when the patient is alkalotic - seizure precautions + suctioning
What Acid-Base imbalance would you see Kussmaul Respirations? - "MAC Kussmaul" - Metabolic
Acidosis
A patient is drowning. Which Acid Base imbalance will they be experiencing - Respiratory acidosis. The
patient is having to hold their breath and therefore their lungs are affected = Respiratory. Additionally,
the patient is UNDERventilating = Acidosis
A patient is severely vomiting and needs prolonged suctioning. Which Acid Base imbalance will they be
experiencing - Metabolic alkalosis. The patient is losing acids through their vomit = alkalosis. Additionally
the problem has nothing to do with the lungs = Metabolic
,if the patient is not having respiratory issues and is not vomiting, which Acid Base imbalance are they
experiencing? - Metabolic acidosis
What will trigger a high pressure alarm on a ventilator? - OBSTRUCTIONS: (1) kinks - unkink it (2)
condensed water - empty it (3) mucous plugs - turn the patient and ask them to cough and deep
breathe. Only suction PRN
What will trigger a low pressure alarm on a ventilator - (1) The main tubing has disconnected - re-attach
(2) O2 sensor disconnection
If a patient on ventilation is experiencing Respiratory Alkalosis, is the pressure too high or low? - The
pressure is too high and they are being over ventilated
If a patient on ventilation is experiencing Respiratory Acidosis, is the pressure too high or too low? - The
pressure is too low and they are being under ventilated
What is the #1 psychological problem in alcoholism - Denial
How do you approach an alcoholic who is in denial? - Through confrontation
What is the 2nd psychological problem in alcoholics - Codependency (victim) vs dependency (abuser)
How do we approach codependents and dependents? - Confront the dependent and teach the
codependent how to set boundaries and limits
Wernicke's Korsakoff Syndrome - When one loses touch with reality (psychosis) due to a Vitamin B1
(Thiamine) deficiency
Wernicke's Korsakoff Syndrome signs and symptoms - Amnesia and confabulation
, Nursing intervention for someone with Wernicke's Korsakoff Syndrome? - Redirect the patient to
something they can do
Treatment for Wernicke's Korsakoff Syndrome - Taking supplemental Vit B1.
What medication is given to treat Alcohol use disorder - Disulfiram (antabuse) - works by producing
unpleasant side effects when alcohol enters the body
Patient teaching for a patient with Alcohol use disorder who is taking Disulfiram? - No alcohol containing
products - mouth wash, aftershave, vanilla extract (cupcake icing), insect repellant, medications that end
in "elixir"
Which drugs are UPPERS - caffeine, cocaine, LSD, Adderall, Methamphetamines (every other drugs listed
will be a downer)
What signs and symptoms will you see with UPPER drugs (Caffeine, Cocaine, LSD, Adderall and
Methamphetamines)? - Uppers --> Make you go UP: Euphoria, Tachycardia, borborygmi, irritability,
hyperreflexia, diarrhea
What signs and symptoms will you see with DOWNER drugs? - Downers --> Make you go DOWN:
paralytic ileus, constipation, brady, comatose/obtundent, hyporeflexia,
If you overdose on an UPPER, do you go up or down? - You go UP because now you have too much
If you withdraw from an UPPER, do you go up or down? - You go DOWN because now you have too little
If you overdose from a DOWNER, do you go up or down? - You go DOWN because you have too much
DOWNER
If you withdraw from a DOWNER, do you go up or down? - You go UP because now you have too little
DOWNER and are UP
Preparation
Rule of the B's: If the ____ and the _____ are ______ in the same direction then it is ___ - pH, Bicarb
(HCO3), Metabolic
Normal pH value is - 7.35-7.45
If the pH is greater than 7.45, it is - alkalosis
As the pH goes __ so goes my patient except for? - Potassium
What symptoms occur when your pH is low? - hyporeflexia (0, +1), obtundent, paralytic ileus,
bradycardia, bradypnea, respiratory arrest, hyperkalemia
What symptoms occur when your pH is high - hyperreflexia (+3, +4), irritability, borborygmi, seizures,
tachycardia, tachypnea, hypokalemia
What is a nursing intervention for when the patient is acidotic - ambubag + ventilation
What is a nursing intervention for when the patient is alkalotic - seizure precautions + suctioning
What Acid-Base imbalance would you see Kussmaul Respirations? - "MAC Kussmaul" - Metabolic
Acidosis
A patient is drowning. Which Acid Base imbalance will they be experiencing - Respiratory acidosis. The
patient is having to hold their breath and therefore their lungs are affected = Respiratory. Additionally,
the patient is UNDERventilating = Acidosis
A patient is severely vomiting and needs prolonged suctioning. Which Acid Base imbalance will they be
experiencing - Metabolic alkalosis. The patient is losing acids through their vomit = alkalosis. Additionally
the problem has nothing to do with the lungs = Metabolic
,if the patient is not having respiratory issues and is not vomiting, which Acid Base imbalance are they
experiencing? - Metabolic acidosis
What will trigger a high pressure alarm on a ventilator? - OBSTRUCTIONS: (1) kinks - unkink it (2)
condensed water - empty it (3) mucous plugs - turn the patient and ask them to cough and deep
breathe. Only suction PRN
What will trigger a low pressure alarm on a ventilator - (1) The main tubing has disconnected - re-attach
(2) O2 sensor disconnection
If a patient on ventilation is experiencing Respiratory Alkalosis, is the pressure too high or low? - The
pressure is too high and they are being over ventilated
If a patient on ventilation is experiencing Respiratory Acidosis, is the pressure too high or too low? - The
pressure is too low and they are being under ventilated
What is the #1 psychological problem in alcoholism - Denial
How do you approach an alcoholic who is in denial? - Through confrontation
What is the 2nd psychological problem in alcoholics - Codependency (victim) vs dependency (abuser)
How do we approach codependents and dependents? - Confront the dependent and teach the
codependent how to set boundaries and limits
Wernicke's Korsakoff Syndrome - When one loses touch with reality (psychosis) due to a Vitamin B1
(Thiamine) deficiency
Wernicke's Korsakoff Syndrome signs and symptoms - Amnesia and confabulation
, Nursing intervention for someone with Wernicke's Korsakoff Syndrome? - Redirect the patient to
something they can do
Treatment for Wernicke's Korsakoff Syndrome - Taking supplemental Vit B1.
What medication is given to treat Alcohol use disorder - Disulfiram (antabuse) - works by producing
unpleasant side effects when alcohol enters the body
Patient teaching for a patient with Alcohol use disorder who is taking Disulfiram? - No alcohol containing
products - mouth wash, aftershave, vanilla extract (cupcake icing), insect repellant, medications that end
in "elixir"
Which drugs are UPPERS - caffeine, cocaine, LSD, Adderall, Methamphetamines (every other drugs listed
will be a downer)
What signs and symptoms will you see with UPPER drugs (Caffeine, Cocaine, LSD, Adderall and
Methamphetamines)? - Uppers --> Make you go UP: Euphoria, Tachycardia, borborygmi, irritability,
hyperreflexia, diarrhea
What signs and symptoms will you see with DOWNER drugs? - Downers --> Make you go DOWN:
paralytic ileus, constipation, brady, comatose/obtundent, hyporeflexia,
If you overdose on an UPPER, do you go up or down? - You go UP because now you have too much
If you withdraw from an UPPER, do you go up or down? - You go DOWN because now you have too little
If you overdose from a DOWNER, do you go up or down? - You go DOWN because you have too much
DOWNER
If you withdraw from a DOWNER, do you go up or down? - You go UP because now you have too little
DOWNER and are UP
