Mz.ANTICHOLINERGIC vs. CHOLINERGIC EFFECTS
ANTICHOLINERGIC CHOLINERGIC
• ↓ Mucus
• Bronchodilation
• Dry mouth
• Dry eyes
• Urinary retention
• Dry skin
• Constipation
• Shut down GI
• Prevent
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Mz.ANTICHOLINERGIC vs. CHOLINERGIC EFFECTS
ANTICHOLINERGIC CHOLINERGIC
• ↓ Mucus
• Bronchodilation
• Dry mouth
• Dry eyes
• Urinary retention
• Dry skin
• Constipation
• 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
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