Siobhan Shared "NUR301" - 17 Picmonics
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NUR301
How to Interpret Acid Base Disorders
- pH, pCO₂, HCO₃ (Bicarbonate)
- Step 1
- pH
- Acidosis
- Alkalosis
- Step 2
- pCO₂
- Opposite Direction as pH
- Respiratory Acidosis
- Respiratory Alkalosis
- Step 3
- HCO₃ (Bicarbonate)
- Same Direction as pH
- Metabolic Acidosis
- Metabolic Alkalosis
3 mins
Respiratory Acidosis Assessment
- Assessment
- Decreased pH < 7.35
- Increased PaCO2 > 45
- Reduced Respirations
- Anxiety
- Change in LOC
- Tachycardia
- Cyanosis
- Increased Electrolytes
- ECG Changes
- Muscle Weakness
- Hyporeflexia
2 mins
Respiratory Acidosis Interventions
- Improve Respiration
- Pharmacologic Interventions
- Bronchodilators
- Respiratory Stimulants
- Drug Antagonists
- Nonpharmacologic Interventions
- Oxygen
- Assisted Ventilation
- Prevent Complications
1 min
Respiratory Alkalosis Assessment
- Assessment
- Increased pH > 7.45
- Decreased PaCO2 < 35 mmHg
- Hyperventilation
- Brainstem Stimulation
- Head Injury
- Shock
- Lightheadedness
- Tingling Lips or Fingers
- Trousseau's
- Chvostek's Sign
- Anxiety
2 mins
Respiratory Alkalosis Interventions
- Treat Underlying Cause
- Mechanically Ventilated Patients
- Decrease Tidal Volume and/or Respiratory Rate
- Give Adequate Pain Control and Sedation
- Hyperventilation Syndrome
- Sedatives
- Antidepressants
- Considerations
- Compensatory Drop in Serum Bicarbonate
- Calming Breathing Exercises
- Correct CO2 Slowly
2 mins
Metabolic Acidosis Assessment
- Characteristics
- Decreased pH < 7.35
- Decreased HCO3 < 22
- Signs & Symptoms
- Abdominal Pain
- CNS Depression
- Coma
- Hypotension
- Arrhythmias
- Increased Respirations
- Kussmaul Respirations
- Flushed, Warm, Dry Skin
- Muscle Weakness
2 mins
Metabolic Acidosis Interventions
- Interventions
- Raise Plasma pH > 7.20
- Treat Underlying Cause
- Sodium Bicarbonate
- Considerations
- Follow ABGs
- Continuously Monitor Patient
2 mins
Metabolic Alkalosis Assessment
- Signs and Symptoms
- Increased pH > 7.45
- Increased HCO3 > 26
- Excitable State
- Arrhythmias
- Paresthesias
- Muscle Cramps
- Muscle Weakness
- Decreased Respiratory Effort
1 min
Metabolic Alkalosis Interventions
- Interventions
- Treat Underlying Cause
- Stop Potassium (K+) Wasting Diuretics
- Spironolactone
- Acetazolamide
- IV Fluids
- Sodium Chloride
- Replace Potassium (K+)
- Considerations
- Monitor Respiratory Rate
- Monitor Heart Rate
- Seizure Precautions
2 mins
Peptic Ulcer Disease Assessment
- Mechanism/Cause
- Helicobacter Pylori
- NSAIDs
- Increased Stomach Acid
- Assessment
- Abdominal Pain
- Heartburn (Pyrosis)
- Melena
- Weight Changes
- GI Distress
- Considerations
- Most Commonly in Duodenum
- Duodenal: Pain Relieved by Eating
- Gastric: Pain Caused by Eating
2 mins
Peptic Ulcer Disease Interventions
- Combination Drug Therapy
- Two Antibiotics
- Proton Pump Inhibitor (PPI)
- Decrease Acid Secretion
- Avoid NSAIDs
- Diet and Lifestyle Changes
1 min
Gastroenteritis
- Cause/Mechanism
- Viruses
- Bacteria
- Food Intolerances
- Assessment
- Flu-Like Symptoms
- GI Distress
- Bloody Stool
- Interventions
- Oral Rehydration
- Considerations
- Self-Limiting
- Prevention
2 mins
Acute Gastritis
- Erosive
- Disruption of Mucosal Barrier
- Caused by Stress
- NSAIDs (Non-Steroidal Anti-Inflammatory Drugs)
- Alcohol
- Uremia
- Burns
- Curling's Ulcer
- Brain Injury
- Cushing Ulcer
- Increase H+ Production
1 min
Chronic Gastritis
- Type A
- Type A
- Fundus and Body
- Autoimmune
- Autoantibodies to Parietal Cells
- Pernicious Anemia
- Achlorhydria
- Type B
- Type B
- Most Common Type
- Helicobacter pylori
- Antrum
- Increased Risk of MALT Lymphoma
- Associations
- HIV/AIDS
- Crohn's Disease
3 mins
Helicobacter Pylori
- Characteristics
- Gram-Negative
- Bacilli
- Curved
- Polar Flagellum
- Catalase-Positive
- Oxidase-Positive
- Disease
- Gastric and Duodenal Ulcers
- Ammonia
- Neutral Environment
- Gastric Adenocarcinoma
- MALT lymphoma
- Diagnosis
- Serology IgG antibody
- Stool Antigen
- Urease Positive Breath Test
- Biopsy
- Treatment
- 2 ABX and PPI
2 mins
Helicobacter pylori Associations
- Gastritis
- Peptic Ulcer Disease
- Stomach Cancer
50 secs
Gastroesophageal Reflux Disease (GERD) Assessment
- Pathophysiology
- Relaxed Lower Esophageal Sphincter
- Signs and Symptoms
- Dyspepsia (Indigestion)
- Belching
- Nighttime Coughing
- Dysphagia
- Epigastric Pain
- Regurgitation
- Heartburn (Pyrosis)
- Globus
2 mins
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