Mark Klimek Nclex Review Nursing Notes

Mark Klimek Nclex Review Nursing Notes

Mark Klimek NCLEX Review

Acid Base Balance

Rule 1: If the pH & the HCO3 are in the same direction  METABOLIC if they are opposite direction  RESPIRATORY

Rule 2: pH determines Acidosis or Alkalosis

pH 7.35 – 7.45

HCO3 22 -- 26

CO2 45 – 35

Ventilators

↑pressure alarm: 1 st kink  2 nd condensation  3 rd mucus  fix kink, empty tube, reposition, suction – in that order

↓pressure alarm: there is a disconnection or a leak

Alcoholism/ALL Abuse

#1 ABUSERS PROBLEM IS DENIAL CONFRONT PROBLEM WO ATTACKING– STATE WHAT YOU SEE avoid “you answers”

#2 ABUSERS PROBLEM IS DEPENDENCY SET LIMITS & LEARN TO SAY NO! – WORK ON CODEPENDENT’S SELF ESTEEM

#3 ABUSERS PROBLEM IS MANIPULATION HARMFUL/DANGEROUS TO THE DEPENDENT

Wernike’s/Korsacoff Alcoholism

W = encephalopathy K = psychosis

- Preventable & Irreversible amnesia and confabulation (they believe what they are saying is true)

- LEARN TO REDIRECT NOT REORIENT

- TAKE B1 VITAMIN

- Antabuse/Disulfiram – eversion therapy (makes them hate ETOH & makes them sick if they drink it)

 Avoid ETOH of all kinds . . . mouthwash, aftershave, perfume, insect repellent, OTC that ends in

elixir, hand sanitizer, unbaked vanilla icing, vinaigrette

OVERDOSE/WITHDRAWAL

UPPERS  PCP/LSD, caffeine, cocaine, methamphetamines, Adderall

 OD = seizure

 WD = respiratory depression s/s

DOWNERS  everything else

 OD = respiratory depression s/s

 WD = seizure

Delirium Tremens

“DT’s” 72 hours after last drink…. Not everyone goes through this & can kill you.

o not stable, danger to self and others

o Private, near nurse’s station

o NPO or Clear liquid

o Restricted Bedrest- no getting up to go to the bathroom -- urinal and bedpan

o Restrained, vest or leather restraints, two point leather restraints.

o Antihypertensive, B1 vitamin

o Tranquilizer b/c withdrawal stage –major