if pH over 7.45
ALKALOSIS -everything up -tachycardia, HTN, seizure, irrability, diarrhea, hyperreflexia, HYPOkalemia
intervention for pH over 7.45
suction patient because risk of seizure
if pH goes below 7.35
ACIDOSIS -everything goes down -bradycardia, constipation, obtunded, lethargic, low bp, hyporeflexia, HYPERkalemia
intervention for pH over 7.35
ventilate patient with ambu bag respiratory arrest
pick metabolic alkalosis
if the patiebnt has prolonged gastric emptying or suction
ventilator high pressure alarms causes
-kinks in tubing -condensed water in dependent tube-mucus plugs
ventilator low pressure alarms causes
-main tubing disconnection-02 sensor tube disconnection
alcoholism number one problem
DENIAL
how to treat/respond to denial?
- confront by pointing out the difference of what they say and do -start with "i" statements
when denial is okay
DABDA -denial-anger-bargaining-depression-acceptance
alcoholism second problem
codependency vs dependency
dependency definition
when they get the s/o to do things or make decisions for them
co dependency definition
when the significant other derive self esteem for doing things or making decisions for the abuser
manipulation definition
when the abuser gets the s/o to do things or make decisions that are not in the best interests of the s/o
how to deal with a manipulative person
set limits and enforce them
wernicke korsakoff syndrome
wernicke = encephalopathykorsakoff = psychosis
wernicke and korsafoff
-psychossis induced by vitamin b1, thiamine deficiency -pt looses touch with reality -primary s and s = amnesia and confabulation
amnesia
memory loss
confabulation
making up stories
how to deal with a patient with wernicke and korasfoff
redirect the patient to something he/she can do
antabuse
alcohol deterrent
revia
antidote for antabuse
onset and duration of antabuse
takes two weeks to work
patient teaching for antabuse
-avoid all forms of ETOH (not doing so will lead n/v)-avoid all items containing alcohol