Tabatha Shared "4th semester (test 2)" - 51 Picmonics

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4th semester (test 2)

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
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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
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2 mins
Pulmonary Embolism Assessment
Assessment
Shortness of Breath (SOB)
Pleuritic Chest Pain
Tachypnea
Hemoptysis
Hypoxemia
Considerations
Sudden Death
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51 secs
Lidocaine
Mechanism
Blocks Na+ Channels
Indications
Ventricular Arrhythmia
Anesthetic
Side Effects
Paresthesias
Seizures
Respiratory Depression
Drowsiness
Consideration
Anesthetic Effects Extended with Epinephrine
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1 min
Local Anesthetic Overview
Indications
Minor Procedures
Epidurals
Mechanism of Action
Blocks Na+ Channels
State Dependent
Combined with Vasoconstrictors
Infected Tissue Requires Higher Dose
Drugs
Esters
Amides
Side Effects
Arrhythmias
Cardiotoxicity
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1 min
IV Anesthetics
Barbiturates
Benzodiazepines
Respiratory Depression
Hypotension
Ketamine
NMDA Receptor Antagonist
Hallucinations
Opioids
Propofol
Potentiates GABA-A
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2 mins
Respiratory Acidosis Interventions
Improve Respiration
Pharmacologic Interventions
Bronchodilators
Respiratory Stimulants
Drug Antagonists
Nonpharmacologic Interventions
Oxygen
Assisted Ventilation
Prevent Complications
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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
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2 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
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2 mins
Anticholinergics Continued
Drugs
Glycopyrrolate
Reduces Airway Secretions
Ulcer Treatment
Ipratropium
Asthma and C.O.P.D
Dicyclomine
Hyoscyamine
Irritable Bowel Syndrome
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1 min
Metabolic Acidosis Interventions
Interventions
Raise Plasma pH > 7.20
Treat Underlying Cause
Sodium Bicarbonate
Considerations
Follow ABGs
Continuously Monitor Patient
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2 mins
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
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2 mins
Metabolic Syndrome
Assessment
Dyslipidemia
Central Obesity
Insulin Resistance
Hypertension
Increased C-Reactive Protein (CRP)
Increased Fibrinogen
Considerations
Increased Risk Cardiovascular Disease
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1 min
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
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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
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3 mins
Respiratory Acidosis
Hypoventilation
Increased PaCO2 > 45
Barbiturates Depress Central Respiratory Center of Brain
Opioids Depress Central Respiratory Center of the Brain
Airway Obstruction
Respiratory Muscle Weakness/Paralysis
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3 mins
Acute Respiratory Distress Syndrome (ARDS) Interventions
Interventions
Closely Monitor Patient
ABG's (Arterial Blood Gases)
Oxygen
Assess for O2 Toxicity
Mechanical Ventilation
PEEP
Assess for Pneumothorax
Permissive Hypercapnia
Considerations
High Mortality Rate
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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
Rebreathing into Paper Bag
Sedatives
Antidepressants
Considerations
Compensatory Drop in Serum Bicarbonate
Correct CO2 Slowly
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2 mins
Hypokalemia
Assessment
< 3.5 mEq/L
Muscle Weakness
Arrhythmia
U Wave
Ileus
Hyporeflexia
Interventions
IV K+ Infusion at 5-10 mEq/hr
Give Orally with Food
Nursing Considerations
Monitor Respiratory Status
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3 mins
Hyperkalemia
Assessment
> 5.0 mEq/L K+
Abdominal Cramps
Muscle Weakness
Diarrhea
Arrhythmia
Tall, Peaked T Waves
Interventions
IV Calcium
Infusion of Glucose and Insulin
Loop or Thiazide Diuretics
Kayexalate
Dialysis
Prevention Education
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2 mins

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