NCLEX MARK KLIMEK EXAM REVIEW FROM

NCLEX MARK KLIMEK EXAM REVIEW FROM

LECTURE/YELLOW BOOK

Rule of the B's: If the ____ and the _____ are ______ in the same direction then it is meta_____ Answer - pH, Bicarb, Both, Bolic

pH 7.30_______ HCO3 20_______ Answer - ↓= acidosis; ↓= metabolic

pH 7.58_______ HCO3 32_______ Answer - ↑= alkalosis; ↑= metabolic

pH 7.22_______ HCO3 30_______ Answer - ↓= acidosis; ↑= respiratory

You are providing care to a client with the following blood gas results: pH 7.32, CO2 49, HCO3 29, PO2 80, and SaO2 90%. Based on these results, the client is experiencing: Answer - ↓= acidosis; ↑= respiratory

MacKussmaul Answer - The only acid base to cause Kussmaul respirations is Metabolic ACidosis

As the _______ goes, so goes _______ except for _______ Answer - pH, my patient, Potassium

Up Answer - hyokalemia, alkalosis, HTN, Tachycardia, Tachypnea, Seizures, Irritability, Spastic, Diarrhea, Borborygme, hyperreflexia, etc

Down Answer - hyperkalemia, acidosis, htn, bradycardia, constipation, absent bowel sounds, flacid, bradypnea

Causes of acid-base imbalances: First ask yourself, "Is it _______?" If yes, then it's _______. Then ask yourself: "Are they _______ or _______. If _______, pick _______.If _______, pick _______ Answer - lung, respiratory, overventilating, underventilating, overventilating, alkalosis, underventilating, acidosis

Causes of acid-base imbalances: If it's not lung, then it's _______. If the patient has _______ _______ vomiting or suction, pick _______. For everything else that isn't lung, pick _______ _______. When you don't know what to pick, choose _______ _______ Answer - metabolic, prolonged gastric, alkalosis, metabolic acidosis, metabolic acidosis

High pressure alarms are triggered by _______ resistance to air flow. Answer - increased

High pressure alarms are triggered by increased resistance to airflow and can be caused by obstructions of three types: _______ action, _______ action, _______ action

Answer - (kinked tube) unkink, (water in tube) empty, (mucus in airway) cough and deep breathe

Low pressure alarms are triggered by _______ resistance to airflow. Answer - decreased

Low pressure alarms are triggered by decreased resistance to airflow and can be caused by disconnections of the _______ or _______ Answer - tubing (reconnect it), oxygen sensor tube (reconnect it UNLESS tube is on the floor- bag them and call RT if this happens)

Respiratory alkalosis means ventilator settings may be too _______ Answer - high

Respiratory acidosis means ventilator settings may be too _______ Answer - low

What does "wean" mean? Answer - gradually decrease with the goal of getting off altogether

What is Maslow's highest priority to lowest priority? Answer - 1. Physiological

• Safety
• Comfort
• Psychological (problems within the person)
• Social (problems with other people)
• Spiritual

Arrange from highest to lowest priority using Maslow's:

Denial Spiritual Distress Pain in Elbow Fall Risk Pathological Family Dynamics Electrolyte Imbalance Answer - Electrolyte Imbalance (Physiological) Fall Risk (Safety) Pain in Elbow (Comfort) Denial (Psychological) Pathological Family Dynamics (Social) Spiritual Distress (Spiritual)

What are the 5 stages of grief? Answer - Denial Anger Bargain Depression Acceptance

The #1 problem in abuse is _______ Answer - denial

Denial is the _______ to accept the _______ of their problem Answer - refusal, reality

Treating denial: _______ it by pointing out to the person the difference between what they _______ and what they _______. In contrast, _______ the denial of loss and grief Answer - confront, say, do, support

Dependency: When the _______ gets the Significant Other to do things for them or make decisions for them Answer - abuser

Codependency: When the _______ _______ derives positive _______ from doing

things for or making decisions for the _______ Answer - Significant Other, self- esteem, abuser

When treating dependency/codependency: Set _______ and _______ them. Agree in

advance on what requests are allowed, then enforce the agreement Answer - limits, enforce

When treating dependency/codependency: Work on the _______ of the codependent

person Answer - self-esteem

Manipulation: when the _______ gets the _______ _______ to do things for him/her that are not in the _______ _______ of the _______ _______. The nature of the act is _______ or _______ to the _______ _______ Answer - abuser, significant other, interest, significant other, harmful, dangerous, significant other

Treating manipulation: set _______ and _______ Answer - limits, enforce

Wernicke's (Korsakoff's) Syndrome: _______ induced by Vitamin _______(thiamine)

deficiency Answer - Psychosis, B1

Primary symptoms of Wernicke's (Korsakoff's) Syndrome: _______ with _______

Answer - amnesia (memory loss), confabulation (make up stuff)

Characteristics of Wernicke's (Korsakoff's) Syndrome:

1. _______

2. _______

• _______ Answer - preventable (take vitamin)

arrestable (take vitamin) irreversible (kills brain cells)

Antabuse/Revia is aka _______ Therapy Answer - Aversion

Onset and duration of effectiveness of Antabuse/Revia: _______ Answer - 2 weeks

Patient teaching with Antabuse/Revia: Avoid _______ forms of _______ to avoid

_______, _______, _______ Answer - all, alcohol, nausea, vomiting, death

What are examples of products that contain alcohol? Answer - mouth wash, cologne, perfume, aftershave, elixir, most OTC liquid medicines, insect repellant, vanilla extract, vinagerettes, hand sanitizer

Every alcoholic goes through _______. Only a minority get _______ Answer - Alcohol Withdrawal Syndrome, Delirium Tremens

_______ is not life-threatening. _______ an kill you Answer - Alcohol Withdrawal Syndrome, Delirium Tremens

Patients with _______ are not a danger to themselves or others. Patients with ________ are dangerous to self and others Answer - Alcohol Withdrawal Syndrome, Delirium Tremens

AWS or DT: semiprivate room, any location Answer - AWS

AWS or DT: private room near the nurse's station Answer - DT

AWS or DT: Regular diet Answer - AWS

AWS or DT: Clear liquid or NPO diet (risk for aspiration) Answer - DT

AWS or DT: Up at liberty Answer - AWS

AWS or DT: Restricted to bedrest with no bathroom privileges Answer - DT

AWS or DT: No restraints Answer - AWS

AWS or DT: Usually restrained with either vest or 2 point (1 arm and 1 leg) Answer - DT

AWS or DT: Give anti-HTN medication Answer - Both

AWS or DT: Give tranquilizer Answer - Both

AWS or DT: Give multivitamin to prevent Wernicke's Answer - Both

For Aminoglycosides, think " __ ____ ___ _____" Answer - a mean old mycin

When are antibiotics/aminoglycosides used? Answer - to treat serious, life- threatening, resistant infections