NCLEX FINAL EXAM PREP

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NCLEX FINAL EXAM PREP

STUDY GUIDE

Fundamentals of nursing

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Mz.ANTICHOLINERGIC vs. CHOLINERGIC EFFECTS

ANTICHOLINERGIC CHOLINERGIC

• ↓ Mucus • Bronchodilation • Dry mouth • Dry eyes • Urinary retention • Dry skin • Constipation • Shut down GI • Prevents V when trying to intubate

• Bronchorrhea (large amounts of mucus in airway) • Bronchoconstriction • Salivation • Lacrimating • Urination • Diaphoresis/Diarrhea • GI Upset • Emesis

ACID BASE GASES

• ABG Interpretation
• Rule of the B’s
• If the pH and the BICARB (HCO3)

ii. Are BOTH in the same direction, iii. Then it is METABOLIC

• ↓ pH = acidosis
• ↑ pH= alkaline
• Values
• Normal pH = 7.35 – 7.45
• Normal Bicarb= 22-26
• PaO2= 80-100 mmHg

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• PaCO2= 35-45 mmHg
• SaO2= 95-100%
• Signs & Symptoms of Acid-Base Imbalance
• As the pH goes, so goes the patient except for Potassium (bc it will

try to compensate) pH UP ↑ K↓ [ALKALOSIS] pH DOWN ↓ K↑ [ACIDOSIS]

• • • •

• •

• Tachycardia Tachypnea Diarrhea Tremors Seizure Hyperreflexia Agitated • • • • • • • Bradycardia Bradypnea Hypotension ↓ lucidity anorexia coma lethargy

• • • •

• •

Borborygmi (↑ bowel sounds) Hypertension Palpitations Tetany Anxiety/Panic Poly • • cardia arrest suppressed, decreased, falling

• Causes of Acid-Base Imbalance
• First ask, “Is it Lung?”
• If YES- then it is Respiratory

b. Then ask yourself:

• Are they Overventilating or Underventilating?
• If Overventilating pick Alkalosis
• If Underventilating pick Acidosis
• If not lung, then it’s Metabolic

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• If the patient has prolonged gastric vomiting or suction, pick

Metabolic Alkalosis ii. For everything else that isn’t lung, pick Metabolic Acidosis

• Also, if you don’t know what to pick choose Metabolic

Acidosis

VENTILATOR ALARMS

• High Pressure Alarms are triggered by ↑ resistance to air flow and can be

caused by obstructions of three types:

• Kinked Tube

i. NRS ACTION: Unkink it

• Water in tubing (caused by condensation)

i. NRS ACTION: Empty it/Remove H2O

• Mucus in airway

i. NRS ACTION: Turn, C&DB; only use suction if C&DB fails,

as a last resort

• Low Pressure Alarms are triggered by ↓ resistance to air flow and can be

caused by disconnections of the:

• Tubing

i. NRS ACTION: Pay attention to where tubing

is…(contamination) ii. If on floor, change out iii. If on chest, clean with alcohol then put back on

• Respiratory Alkalosis (Overventilation) means ventilator settings may be

too HIGH.

• Respiratory Acidosis (Underventilation) means ventilator settings may be

too LOW.