Mark Klimek Yellow Book

Mark Klimek Yellow Book

If the pH and the BiCarb are both in the same direction then it is?Metabolc If the pH is up it is?Alkalosis As the pH goes so goes my patient except for?Potassium If the pH is down it is?Acidosis 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 Kussmal Respirations Metabolic Acidosis ( Remember MacKussmal Before measuing ABGs you should check what?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 PH is normal! It is never compensated if it is abnormal.If PH normal 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 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 Metabolic Acidosis If in doubt in ABGs, always pick Headache, nausea, weakness & numbness+ tingling. It can be either up or down.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.Don't suction unless Coughing & deep breathing is deemed inappropriate.In order to suction, you must be able to hear Mucus in the lung 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.First question to ask if the low pressure alarm sounds Where is the tubing?!

HOLD

H- High Pressure O- Obstruction L- Low D- Disconnections Never put anything in YOUR scope of practice On anyone else Make sure your answer is

PATIENT FOCUSED.

TAKE CARE OF YOUR PATIENT!

Don't answer based on staff, building, machine, etc.

PATIENT FIRST.

What does wean mean?Decrease Gradually What do you do if the patients disconnected tube is on the chest?Reconnect ... if its above the waist its ok.Remember is PSYCH if you are asked to Prioritize, Don't forget

MASLOW!

• Physiological
• Safety
• Comfort - Includes pain
• Psychological
• Social
• Spiritual

When prioritizing, always use Maslow + ABCs For one patient. Don't if you have more than one patient.What is the biggest problem in abuse?Denial To treat denial you need to?Confront them.Definition of Denial