Therese Shared "HSIII Test 1" - 22 Picmonics
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HSIII Test 1
Blood Acid-Base Control
- Characteristics
- In a State of Acidemia
- Medullary Chemoreceptors Control Ventilation Rate
- Expulsion of CO2 through Lungs Increases pH
- Bicarbonate Reabsorption from the Kidney Increases pH
- Kidney Excretion of H+ Increases pH
2 mins
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 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
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
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
Metabolic Acidosis Interventions
- Interventions
- Raise Plasma pH > 7.20
- Treat Underlying Cause
- Sodium Bicarbonate
- Considerations
- Follow ABGs
- Continuously Monitor Patient
2 mins
Respiratory Acidosis Interventions
- Improve Respiration
- Pharmacologic Interventions
- Bronchodilators
- Respiratory Stimulants
- Drug Antagonists
- Nonpharmacologic Interventions
- Oxygen
- Assisted Ventilation
- Prevent Complications
1 min
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
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
Syndrome Of Inappropriate Antidiuretic Hormone (SIADH)
- Pathophysiology
- Hypersecretion of ADH
- Increased Sensitivity to ADH
- Signs & Symptoms
- Serum Hypoosmolality
- Coma and Seizure
- Dilutional Hyponatremia
- Cramps and Tremors
- Euvolemia
- Change in LOC
2 mins
Morphine
- Mechanism
- Opioid Receptor Agonist
- Indications
- Pain
- Myocardial Infarction
- Side Effects
- Nausea and Vomiting
- CNS Depression
- Biliary Colic
- Constipation
- Increased Intracranial Pressure (ICP)
- Pupillary Constriction
- Hypotension
2 mins
Naloxone (Narcan)
- Mechanism
- Competitive Opioid Receptor Antagonist
- Indications
- Opioid Induced CNS Depression
- Side Effects
- Severe Nausea and Vomiting
- Excitable State
- Opioid Withdrawal Symptoms
- Considerations
- Repeated Dosing Often Required
1 min
Oxycodone
- Mechanism of Action
- Opioid Receptor Agonist
- Indication
- Refractory Pain
- Side Effects
- Respiratory Depression
- Constipation
- CNS Depression
- Considerations
- Addiction
- Naloxone
2 mins
Fentanyl
- Mechanism of Action
- Opioid Receptor Agonist
- High Potency
- Indications
- Anesthesia Induction
- Chronic Pain
- Breakthrough Pain
- Side Effects
- CNS Depression
- Respiratory Depression
- Constipation
- Miosis
- Considerations
- Addiction
3 mins
Codeine
- Mechanism
- Opioid Receptor Agonist
- Indications
- Mild to Moderate Pain
- Cough Suppressant
- Side Effects
- Sedation
- Constipation
- Miosis
- Considerations
- Close Monitoring When Breast Feeding
- Often Combined with Non-Opioids
2 mins
Acetaminophen
- Indications
- Fever
- Pain
- Mechanism of Action
- Reversibly Inhibits COX
- Acts Primarily in CNS
- Side Effect
- Hepatic Necrosis
- N-acetylcysteine Antidote
51 secs
Acetaminophen Antidote
- Antidote
- N-Acetylcysteine
33 secs
Ibuprofen (Advil, Motrin)
- Mechanisms
- NSAID
- COX Inhibitor
- Indications
- General Pain
- Fever
- Inflammatory Conditions
- Side Effects
- GI Ulcers
- Nephrotoxicity
- Rash
- Considerations
- Avoid with Alcohol
- Risk of Thrombotic Event
2 mins
NSAIDs
- Indications
- Anti-inflammatory
- Analgesic
- Fever
- Closure of Patent Ductus Arteriosus
- Mechanism of Action
- Reversible Inhibition of COX-1 and COX-2
- Block Prostaglandin Synthesis
- Side Effects
- Interstitial Nephritis
- Gastric Ulcer
- Renal Ischemia
1 min
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