We often draw blood gasses looking for an ACIDosis, but what about when you discover an ALKAlosis?
In this episode, I share a story of a patient with a history of CHF, admitted for diuresis. She was initially improving but becames lethargic and difficult to arouse. We were surprised when her VBG showed alkalosis instead acidosis. Guest Sarah Lorenzini from the Rapid Response RN podcast, helped me make sense of our finding.
Listen in to learn about this rare acid base imbalance that can occur as a result of a very common intervention.
Check out Nicole Kupchik's exam reviews and practice questions at nicolekupchikconsulting.com. Use the promo code UPMYGAME20 to get 20% off all products.Do you need help with your resume, interviewing, or need career coaching? Check out Sarah at New Thing Nurse:

Get 15% off of her resume and cover letter templates using the promo code UPMYGAME

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Up My Nursing Game is partnering with VCU Health Continuing Education to offer FREE continuing education credits for registered nurses. Click here to obtain nursing credit.See the show notes at upmynursinggame.com.
The key moments in this episode are:00:02:32 - Patient background and presentation00:15:14 - Causes of metabolic alkalosis 00:20:18 - Treatment of diuretic induced metabolic alkalosis, 00:27:12 - Diagnostic reasoning, antibiotic stewardship

Metabolic Alkalosis: The Forgotten Acid-Base Imbalance

Up My Nursing Game is an educational nursing podcast for curious and driven acute, emergency, and critical care nurses who seek a deeper understanding of clinical subjects and want to broaden their understanding of patient care in the hospital setting. No boring lectures here! Join Annie, RN, as she delivers high-value content, including interviews with members across the healthcare team that address common clinical questions, share unique perspectives, and covers what was missed in nursing school.

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While the concept of hypovolemic shock may seem straightforward compared to the other types of shock, it's various causes and vastly different treatment approaches may catch you off guard. In this episode, flight nurse Nyssa from The Q Word Podcast vividly illustrates the key differences between fluid volume depletion and blood volume loss. You'll learn to spot the ominous clinical presentations of hemorrhagic shock. But most importantly, Nyssa equips you with the critical life-saving interventions for massive hemorrhage - from using tourniquets to transexamic acid. Whether you're an emergency nurse or just want to solidify your knowledge, this masterclass on managing hypovolemic shock's most high-stakes form will drastically elevate your nursing game.
This episode is part of Nurses' PodCrawl 2024. Check out other episodes from these excellent nurse podcasters:

Obstructive Shock: Critical Care Scenarios and Rapid Response RN


Distributive shock: Straight A Nursing and How Not to Kill Your Patient


Cardiogenic Shock: Nurse Dose Podcast and Up My Nursing Game



Check out Nicole Kupchik's exam reviews and practice questions at nicolekupchikconsulting.com. Use the promo code UPMYGAME20 to get 20% off all products.
Do you need help with your resume, interviewing, or need career coaching? Check out Sarah at New Thing Nurse:

Get 15% off of her resume and cover letter templates using the promo code UPMYGAME

Nursing students and new grad career services 

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Hypovolemic Shock with The Q Word Podcast's Lisa and Nyssa, RN

In this in-depth episode, cardiac nursing expert Sean from the Nurse Dose Podcast vividly illustrates how acute coronary syndromes, valve dysfunction, arrhythmias, and mechanical complications can all culminate in cardiogenic shock. You'll learn to spot the ominous signs like falling cardiac output, rising filling pressures, and poor end-organ perfusion. But most importantly, Sean equips you with the critical interventions - from revascularization to advanced circulatory support devices like balloon pumps and Impella pumps. Whether you're an ICU nurse or just want to solidify your knowledge of this high-stakes condition, this masterclass on cardiogenic shock is a must-listen.

This episode is part of Nurses' PodCrawl 2024. Check out other episodes from these excellent nurse podcasters:

Obstructive Shock: Critical Care Scenarios and Rapid Response RN


Distributive shock: Straight A Nursing and How Not to Kill Your Patient


Hypovolemic shock: The Q Word Podcast and Up My Nursing Game



From this episode:

Listen to the Nurse Dose Podcast


Check out Nurse Dose on IG! @NurseDosePodcast



Check out Nicole Kupchik's exam reviews and practice questions at nicolekupchikconsulting.com. Use the promo code UPMYGAME20 to get 20% off all products.
Do you need help with your resume, interviewing, or need career coaching? Check out Sarah at New Thing Nurse:

Get 15% off of her resume and cover letter templates using the promo code UPMYGAME

Nursing students and new grad career services 

Experienced RN career services

NP career services

Cardiogenic Shock with Sean from the Nurse Dose Podcast

Imagine being a nurse faced with a patient who has taken a fistful of someone else's medications, leading to a life-threatening allergic reaction. This was the reality Dave Dovell, a registered nurse and author, confronted in a fascinating case study he shares during this podcast episode. He takes listeners on a deep dive into the clinical presentation and management of anaphylaxis and offers insights into providing compassionate care. This powerful case study underscores the multifaceted challenges nurses face and the importance of prioritizing patient-centered care even in the most demanding situations.
Mentioned in this episode:


The New RN: A blog and more for new nurses and student nurses


Brand New Nurse, by Dave Dovell


Check out Nicole Kupchik's exam reviews and practice questions at nicolekupchikconsulting.com. Use the promo code UPMYGAME20 to get 20% off all products.
Do you need help with your resume, interviewing, or need career coaching? Check out Sarah at New Thing Nurse:

Get 15% off of her resume and cover letter templates using the promo code UPMYGAME

Nursing students and new grad career services 

Experienced RN career services

NP career services


See the show notes at upmynursinggame.com.

Anaphylaxis and Med Errors: A Case Study with Dave Dovell, RN

The emergency severity index, or ESI, is meant to swiftly triage patients based on urgency and resource needs. In this episode emergency nurse, Kevin MacFarlane, shares his techniques for determining ESI scores, from identifying true level one resuscitation cases to non-urgent level five medication refills. You'll gain a comprehensive understanding of how ESI goes beyond just categorizing medical emergencies to account for quality of life impacts. Kevin also offers a glimpse into the future role of AI in revolutionizing triage protocols - a must-listen for any nurse committed to providing the right care at the right time.
Mentioned in this episode:


The Art of Emergency Nursing Podcast


How Not to Kill Your Patient Podcast


Check out Nicole Kupchik's exam reviews and practice questions at nicolekupchikconsulting.com. Use the promo code UPMYGAME20 to get 20% off all products.
Do you need help with your resume, interviewing, or need career coaching? Check out Sarah at New Thing Nurse:

Get 15% off of her resume and cover letter templates using the promo code UPMYGAME

Nursing students and new grad career services 

Experienced RN career services

NP career services


See the show notes at upmynursinggame.com.

Triage Fundamentals: Emergency Severity Index (ESI)

Sedation and delirium can derail even the strongest patient's recovery in the ICU - but spontaneous awakening trials (SATs) can empower nurses to get ahead of this vicious cycle. In this candid episode, I pick the brain of Kali Dayton, an ICU nurse practitioner fervent about early mobility, pulls back the curtain on SATs, a tragically misunderstood intervention that involves stopping sedatives each day to reconnect with the patient. With a mix of hard data and bedside wisdom, Kali reveals SATs as a game-changer for bettering outcomes like delirium, ventilator days, and the chance of discharge to home. You'll hear practical tips on everything from managing agitated awakenings to recruiting family as awakening coaches. Whether you're routinely pawing through SAT policies or clueless about this critical care practice, this lively dialogue will upend assumptions about sedation and empower you to maximize your impact.
Mentioned in this episode: RASS survey
Check out Nicole Kupchik's exam reviews and practice questions at nicolekupchikconsulting.com. Use the promo code UPMYGAME20 to get 20% off all products.
Do you need help with your resume, interviewing, or need career coaching? Check out Sarah at New Thing Nurse:

Get 15% off of her resume and cover letter templates using the promo code UPMYGAME

Nursing students and new grad career services 

Experienced RN career services

NP career services


See the show notes at upmynursinggame.com.

Metabolic Alkalosis: The Forgotten Acid-Base Imbalance

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