NCLEX Final Exam Study Guide (2021)

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Mz.ANTICHOLINERGIC vs. CHOLINERGIC EFFECTS ANTICHOLINERGIC CHOLINERGIC • ↓ Mucus • Bronchodilation • Dry mouth • Dry eyes • Urinary retention • Dry skin • Const... ipation • Shut down GI • Prevents V when trying to intubate • Bronchorrhea (large amounts of mucus in airway) • Bronchoconstriction • Salivation • Lacrimating • Urination • Diaphoresis/Diarrhea • GI Upset • Emesis ACID BASE GASES A. ABG Interpretation a. Rule of the B’s i. If the pH and the BICARB (HCO3) ii. Are BOTH in the same direction, iii. Then it is METABOLIC b. ↓ pH = acidosis c. ↑ pH= alkaline B. Values a. Normal pH = 7.35 – 7.45 b. Normal Bicarb= 22-26 c. PaO2= 80-100 mmHg d. PaCO2= 35-45 mmHg e. SaO2= 95-100% C. Signs & Symptoms of Acid-Base Imbalance a. As the pH goes, so goes the patient except for Potassium (bc it will try to compensate) pH UP ↑ K↓ [ALKALOSIS] pH DOWN ↓ K↑ [ACIDOSIS] • • • • • • • Tachycardia Tachypnea Diarrhea Tremors Seizure Hyperreflexia Agitated • • • • • • • Bradycardia Bradypnea Hypotension ↓ lucidity anorexia coma lethargy • • • • • • Borborygmi (↑ bowel sounds) Hypertension Palpitations Tetany Anxiety/Panic Poly • • cardia arrest suppressed, decreased, falling D. Causes of Acid-Base Imbalance a. First ask, “Is it Lung?” i. If YES-! then it is Respiratory b. Then ask yourself: i. Are they Overventilating or Underventilating? 1. If Overventilating ! pick Alkalosis 2. If Underventilating ! pick Acidosis c. If not lung, then it’s Metabolic i. If the patient has prolonged gastric vomiting or suction, pick Metabolic Alkalosis ii. For everything else that isn’t lung, pick Metabolic Acidosis 1. Also, if you don’t know what to pick choose Metabolic Acidosis [Show More]

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