Schickling Shared "NURS 364 Week 1" - 24 Picmonics
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NURS 364 Week 1
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
How to Use Prioritization in Exam Questions
- Prioritize First
- Airway
- Breathing
- Circulation
- Prioritize Second
- Change in LOC (Altered Mental Status)
- Sepsis
- Acute Pain
- Untreated Medical Problems
- Prioritize Third
- Education
- Feelings
- Patient Waiting to be Discharged
- Test-taking Strategies
- Maslow’s Hierarchy of Needs
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
Airway, Breathing, Circulation (ABC's)
- Airway Assessment
- Changed Sound of Voice
- "See-saw" Respirations
- Stridor
- Breathing Assessment
- Normal Respiratory Rate: 12–20 Breaths/Min
- Use of Accessory Muscles in Respiration
- Cyanosis
- Circulation Assessment
- Color of Hands and Digits
- Normal Capillary Refill Time (CRT): 2 Seconds
- Decreased LOC
- Considerations
- Initial ‘Look, Listen and Feel” Assessment
- Emergency Treatment
- Prioritization in Exam Questions
5 mins
Alveolar Gas Exchange
- Characteristics
- Pulmonary Artery Blood is O2-Poor, CO2-Rich
- Two-Cell Thick Air-Blood Barrier
- CO2 Diffuses Into Air
- O2 Diffuses Into Blood
- Gases Equilibrate
- Pulmonary Vein is O2-Rich, CO2-Poor
- Thermoregulation
2 mins
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
Guidelines for Prioritizing
- First-level priority problems
- Airway, Breathing, Circulation (ABCs)
- Second-level Priority Problems
- MAA-U-AR
- Mental Status Change
- Acute Pain
- Acute Urinary Elimination Problems
- Untreated Medical Problems
- Abnormal Laboratory Values
- Risk of Infection, Safety or Security
- Third-Level Priority Problems
- Long-Term Treatments
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
How to Use ADPIE for Exam Questions
- ASSESSMENT QUESTIONS
- Data Collection
- NURSING DIAGNOSIS QUESTIONS
- Data Analysis
- PLANNING QUESTIONS
- Plan of Care
- INTERVENTION QUESTIONS
- Action or Intervening
- EVALUATION QUESTIONS
- Outcomes of Care
- STEPS
- Read Entire Question
- Identify Step in the Nursing Process
- Eliminate Answer Choices; Choose the Best Answer
3 mins
Hypoxia (Early Symptoms)
- Diaphoresis
- Restlessness
- Tachypnea
- Dyspnea on Exertion
- Tachycardia
- Hypertension
- Arrhythmias
- Decreased Urine Output
- Unexplained Fatigue
1 min
Hypoxia (Late Symptoms)
- Cyanosis
- Cool, Clammy Skin
- Use of Accessory Muscles
- Retractions
- Hypotension
- Arrhythmias
2 mins
Lung Sounds - Pleural Friction Rub
- Location
- Anterior Lateral Lung
- Description
- Dry, Rubbing, or Squeaking
- Sounds Like
- Rubbing a Balloon with Finger
- Cause
- Inflamed Pleura
50 secs
Lung Sounds - Rhonchi
- Location
- Trachea and Bronchi
- Description
- Low Pitched Rumbling
- Sounds Like
- Gurgling
- Cause
- Narrowed Airway
- Secretions or Bronchospasm
49 secs
Lung Sounds - Wheezes
- Location
- Throughout Lung
- Description
- High Pitched
- Sounds Like
- Musical
- Cause
- Air Moving through Narrowed Airways
38 secs
Maslow's Hierarchy of Needs
- Physiological Needs
- Oxygen, Water, Nutrition
- Body temperature, Elimination, Shelter, Sexual Expression
- Safety and Security
- Physical Safety
- Physiological Safety
- Love and Belonging
- Affection and Companionship
- Esteem
- Self Respect and Respect for Others
- Self Actualization
- Fulfillment
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 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
pH - Blood and Urine Lab Value
- Blood
- 7.35 - 7.45
- Urine
- 4.0 - 8.0
1 min
Physiologic Dead Space (VD)
- Tidal Volume (Vt)
- Partial Pressure of Arterial CO2 (PaCO2)
- Partial Pressure of CO2 in Expired Air (PECO2)
- VD = VT x (PaCO2-PECO2) / PaCO2
2 mins
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