KEEP CALM
and
PASS NCLEX
with
MARK KLIMEK
Review
1.1.
Acid-base balance/ventilators
Rule of the B’s.. If the pH & the bicarb are both in the same direction = metabolic
If they are in different directions = respiratory
pH = 7.35-7.45 acidosis/alkalosis
HCO3 (bicarb) = 22-26 (2+2+2 = 6)
...
Rule of the BB’s..
’s.. If the pH & the bbicarb
icarb are both in the same direction = metab
bolic
olic
If they are in different directions
directions = respiratory
Kussmaul breathing is a deep and labored breathing pattern often associated
metabolic acidosis, particularly diabetic ketoacidosis (DKA) but also kidney failure…
Kussmaul!!
M: metabolic
AC: acidosis
ex:
pT has respiratory acidosis…
acidosis… (select all that apply)..
+1 reflexes
diarhhea
adynamic ileus
spasm
urinary retention
tachycardia
2nd degree mobits type 2 heart block
hypokalemia
SATA questions: *never only 1… never all of them*
diarhhea will cause a metabolic acidosis.. but once you get acidodic, it will shut yo
down = paralytic ileus
…with scenarios.. always ask first “is it lung?” = respiratory
…then ask if the pt is over-ventilating or under-ventilating
under-ventilating??
over-ventilating
over-ventila ting = alkalosis
under-ventilating
under-vent ilating = acidosis
…it’s about the SaO2!!!
SaO2!!! (pay attention!!)
if it isn’t lung = metabolic
metabolic..
..
if pt has prolonged gastric vomiting or suctioning…
suctioning… it’s always metabolic alka
why? losing acid = becomes basic..
,
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