Nursing Chapter on Respiratory and Mental Health

If the pH and the Bicarbonate (HCO3) are both changing in the same direction, then it is metabolic

Acidosis (pH too low) and metabolic (involves bicarbonate)

Alkalosis (pH too high) and metabolic (involves bicarbonate)

Acidosis (pH too low) and respiratory (involves CO2)

A condition involving an imbalance in the body's acid-base balance marked by a lowered pH and decreased bicarbonate.

Deep, rapid breathing, often a sign of metabolic acidosis.

Increased pH and increased bicarbonate suggest a metabolic imbalance.

Imbalances arising from either respiratory or metabolic causes.

Triggered by increased resistance to airflow.

Kinked tubing, water in the tubing or mucus.

Triggered by decreased resistance to airflow.

Disconnected tubing or oxygen sensor tubing

Ventilator settings may be too high

Ventilator settings may be too low

Gradually decreasing ventilator support to eventually discontinue it.

A prioritized model of human needs: Physiological, Safety, Comfort, Psychological, Social, and Spiritual

A physiological need, at the base of Maslow's Hierarchy

A safety need, in Maslow's Hierarchy, following physiological needs.

A comfort need, in Maslow's Hierarchy, following physiological and safety needs.

A psychological need, in Maslow's Hierarchy, following physiological, safety, and comfort needs.

A social need, in Maslow's Hierarchy, following lower order needs.

A spiritual need, at the top of Maslow's Hierarchy.

Denial, Anger, Bargaining, Depression, Acceptance

Denial

Refusal to accept reality of their problems.

Confronting the discrepancies between what they say and do. Support, not confrontation.

When the abuser gets others to meet their needs or make decisions for them.

When the significant other derives self-esteem from helping the abuser.

Set limits and enforce them. Agree on allowed requests and make sure the agreements are followed.

Working on the self-esteem of the person with codependency

When the abuser gets the significant other to do things not in their best interests, often harmful or dangerous

Set limits and enforce them.

A psychological condition caused by Vitamin B1 (thiamine) deficiency.

Amnesia (memory loss) and confabulation (making up stories).

Alcohol use disorder (AUD) that can be prevented by taking vitamins.

Permanent damage to brain cells, often from excessive alcohol consumption, leading to irreversible issues.

Medication used for aversive therapy for alcohol addiction.

Antabuse/Revia's effectiveness takes roughly 2 weeks to develop.

Patients should avoid all forms of alcohol to avoid nausea, vomiting, and death.

Examples include mouthwash, cologne, perfume, aftershave, elixirs, OTC liquid medicines, insect repellent, vanilla extract, and vinaigrettes.

A set of symptoms that can occur after stopping or significantly reducing alcohol consumption.

A serious and potentially life-threatening complication of alcohol withdrawal.

Patients experiencing AWS are not a danger to themselves or others.

Patients experiencing DT are a danger to themselves and others.

Semi-private room is an appropriate option for AWS.

Private room near nurses' station is recommended for DT patients.

Patients experiencing AWS can follow a regular diet.

Patients experiencing DT usually require a clear liquid or nothing-by-mouth (NPO) diet due to aspiration risk.

Patients experiencing AWS can typically be up and moving with lesser restrictions.

Patients experiencing DT often require bedrest and restricted bathroom access.

No restraints are required for AWS patients

Patients experiencing DT often require restraints, typically vests or 2-point (one arm and one leg).

Both AWS and DT patients may require anti-hypertensive medications and tranquilizers.

Both conditions may benefit from multivitamins, especially to prevent Wernicke's encephalopathy.

A group of antibiotics, pronounced as 'a mean old mycin'.

Used to treat serious, life-threatening, or resistant infections.

They commonly end in '-mycin', while not all '-mycin' drugs are aminoglycosides.

e.g., Streptomycin, Gentamicin, Tobramycin, Clindamycin

Aminoglycosides can be ototoxic (affect hearing, balance, or cause tinnitus) and nephrotoxic (impact kidneys). Regularly monitor these.

A temporary, episodic, and severe loss of reality due to chemical imbalances (e.g., UTI, thyroid, electrolyte).

Acknowledge feelings, reassure safety and temporary nature.

Disorganized thoughts, unconnected or tangential ideas; they seem to jump from one thought to another.

Rapid, continuous speech, with loosely associated phrases.

Randomly strung words with no meaning.

Making up new words or phrases.

Psychotic refusing to change clothes or leave the room.

Believing that everyone is talking about you.

Memory loss and inability to learn.

The cranial nerve associated with hearing and balance, usually administered every 8 hours (Q8H).

Crucial step in interacting with someone experiencing psychotic episodes.

Oral administration of aminoglycosides is generally avoided except in cases of hepatic encephalopathy (high ammonia levels) or before surgery.

Reaassure, Redirect, and Establish Reality.

A serious condition caused by liver failure, characterized by brain dysfunction due to high ammonia levels.

Imbalance in glucose metabolism.

Dehydration, excessive thirst, and frequent urination.

A blood sample drawn 30 minutes before the next medication dose.

Insulin-dependent; body doesn't produce insulin.

Blood sample taken 5-10 minutes after the drug dissolves.

Blood sample taken 15-30 minutes after completing the medication infusion.

Non-insulin dependent; body resists insulin.

Frequent urination, excessive thirst, and increased appetite.

Blood sample collected 30-60 minutes after injection.

Insulin, diet, and exercise.

Blood sample time depends on the type of insulin.

Blood sample not generally necessary for oral medication.

Diet, exercise, and sometimes oral hypoglycemics.

High-priority agents with high mortality rates and easily transmitted.

Second-highest priority agents, less easily transmitted and lethal.

Third-lowest priority with emerging infectious diseases using easily available organisms.

Inhaled transmission via airborne precautions. No specific treatment. Skin rash begins around mouth.

Characterized by chest symptoms and respiratory failure. Treated with streptomycin.

Inhaled. Flu-like symptoms and respiratory failure. Treated with ciprofloxacin, penicillin, and streptomycin.

Inhaled spread resulting in hemoptysis, hematemesis, and hematochezia, followed by respiratory failure and DIC. Treatable within 48 hours. Treated with doxycycline and mciin.

Spotting and bruising are prominent symptoms, with a high fatality rate.

Ingestion, with descending paralysis, fever, and alertness, leading to respiratory arrest.

Mustard gas, cyanide, phosgene, chlorine, and sarin are examples.

Blisters are the primary symptom of mustard gas.

Cyanide causes cyanide poisoning with prominent symptoms and requires specific treatment.

Use the unaffected side of the body for support when using an advance cane.

Don't attach belongings to the front of a walker.

Hold the chair, stand up, and then grasp the walker to support yourself.

Non-psychotic individuals have insight (aware of illness) and are reality-based. Psychotic individuals lack insight and aren't reality-based.

A false, fixed belief, idea, or thought. No sensory component.

Paranoid/ persecutory, grandiose, and somatic.

A false, fixed belief that people are harming you.

A false, fixed belief of superiority.

A false, fixed belief about a part of the body.

A false, fixed sensory experience.

Auditory (hearing), tactile (feeling), visual (seeing), gustatory (tasting), and olfactory (smelling).

A misinterpretation of reality; a sensory experience with a referent in reality.

Illusions have a real-world basis; hallucinations do not.

First ask yourself what the underlying problem might be: is it functional psychosis, psychosis of dementia, or psychotic delirium?

Schizophrenia, schizoaffective (mood disorder, thought process), major depression, and mania.

Acknowledge feelings, present reality positively and negatively, set limits, and enforce limits.

Affects patients with Alzheimer's, Wernicke's, organic brain syndrome, and dementia; brain destruction prevents learning.

Acknowledge feelings, and...