Mark K Lectures 1-3 Flashcards
Normal pH range
3.5-4.5
Normal Bicarb range
22-26
If pH and bicarb go in same direction
Metabolic
If pH and bicarb go in opposite directions
Respiratory
If ph goes down =
Acidosis
If ph goes up =
Alkalosis
What happens to pt’s body systems when ph goes up?
All body systems go up (except potassium)
What happens to pt’s body systems if ph goes down?
Body systems go down (except for potassium)
Which acid base imbalance do Kussmaul respirations occur with?
Metabolic acidosis
(MacKussmaul)
What is Wernicke-Korsakoff Syndrome?
Psychosis from vit B1 deficiency (alcoholism)
What is disulfiram used for?
Aversion therapy for alcoholic
Pt teaching for disulfiram
Onset and duration are both 2 weeks
No alcohol
What happens to body systems with withdrawl from uppers?
Body systems decrease
What happens to body systems with withdrawl from downers?
Body systems increase
What happens to a drug dependent newborn?
Withdrawal starts in 24 hours
Body systems go up
What happens with alcohol withdrawl?
What type of diet?
Starts in 24 hr (not life threatening)
Delirium tremons may start in 72 hrs (can be fatal, threat to others, must be restrained)
Both pts need to be on clear liquid diet due to risk of seizures (bc body systems are up)
What are aminoglycosides and what do they end with?
Strong antibiotics
-mycin (mean old mycin)
Not -thromycin
Side effects of aminoglycosides
Ears (mickey mouse): ototoxic (hearing, tinnitus, vertigo)
Monitor creatinine (ear looks like kidney)
Administration of aminoglycosides
Administered q8h (CN 8 = auditory)
Routes for aminoglycosides
IM or IV
PO only to sterilize bowel
Aminoglycosides used to sterilize bowel
Neomycin and Canamycin
(Neo Can sterilize my bowel)
When is trough drawn?
30 min prior to next dose for all routes
Sublingual peak
5-10 min after drug is dissolved
IV peak
15-30 min after drug is finished running
IM peak
30-60 min
How to tell if a medication is a CCB?
Ends in -dipine (dipping in calcium channel)
Plus Verapamil and Cardizem
Nursing considerations for Cardizem
(CCB)
Can be given continuous IV
Must continuously monitor BP and take BP before administering
If BP < 100 must be titrated
Hold if systolic is <100
Which are the lethal heart rhythms?
ASystole
Vfib
Treatment for PVCs?
Amioderone
(For ventricular use amioderone)
Treatment for Vtach?
Amioderone
(For ventricular use amioderone)
Treatment for atrial/supraventricular heart rhythms?
(Atrial use A, B, C, D)
Adenosine
Beta blockers (-lol)
CCB
Digitalis/digoxin/Lanoxin
Treatment for Vfib
Defibrillation
Treatment for asystole
Epi
Then atropine if epi doesnt work
(t in atropine looks like a cross - better pray it works)
What should you do if there is a breakage in a chest tube?
Clamp
Cut tube away from device
Put end in sterile water
Unclamp tube
When is bubbling in a chest tube good / bad?
Water seal intermittent = good
Water seal continuous = bad
Suction control intermittent = bad
Suction control continuous = good
(Want continuous suction)
Which congenital heart defects must be treated right away?
(TRouBLe)
Right to left shunt
Blue = cyanotic
Tetralogy of fallout, trunkus arteriosis, TaPV, etc (all starting with T)
What will all congenital heart defects have?
Murmur
And will have echocardiogram done
What are the 4 defects of tetralogy of fallot?
(Varied pictures of a ranch)
VD = ventricular defects
PS = pulmonary stenosis
OA = overriding aorta
RH = right hypertrophy
What are the 4 defects of tetralogy of fallout?
(Varied pictures of a ranch)
What situations would a pt be under contact precautions?
Anything intestinal
Staph infections
RSV (1-2 yr olds, is droplet but they put things in mouth)
Herpes
Requirements for contact precautions
Private room or cohort
Gloves & gown
Disposable supplies or dedicated equipment
Which situations would a pt be under droplet precautions?
All meningitis
H flu (epiglottitis)
Requirements for droplet precautions
Private room or cohort
Mask & gloves
Pt wear mask when not in room
Disposable supplies or dedicated equipment
Which situations would a pt be on airborne precautions?
Measles, mumps, rubella
TB
Varicella chicken pox
Requirements for a pt on airborne precautions
Private room required unless cohorting
Mask & gloves
Pt wear mask when not in room
Negative airflow room
Order of taking off PPE
Gloves
Goggles
Gown
Mask
Alphabetical order
Order to put on PPE
Gown
Mask
Goggles
Gloves
put on in reverse alphabetical order but mask is 2nd
