WEEK 9

Sniffles… The BodPod was down; so I couldn’t get the 6 wks eval. Got the results yesterday for week 9 and upset with myself TT^TT
Current weight: 162.447 lbs ( pre-FD 176.6 )
Current waist girth: 34.25 in ( pre-FD 37.5 )
Current Body Fat: 37.6 % ( pre-FD 40.4)
I was using the handheld BF reader and for the longest time I was writing 35% on our progress pictures. That’s the reason why I’m quite heartbroken somewhat… I care more for that number bec of the visceral/cancerous type of fat/cortisol/etc bad junk in my body and health risks “I’ve put myself in.”
I did gain 0.361 lbs of lean body mass and lost 7.287 lbs of FAT smile emoticon
I haven’t fully started the BB challenge; rather, reading more/prepping more and finishing the SS first. I’m ready for the next reading in 6 wks to give me a better results. I hate this feeling I’m feeling and I am using that number as my NEMESIS & motivation to push harder. Sigh… I need a goosegump hug…

#FIGHTERDIET

https://www.facebook.com/iloveluisa/videos/941499742548551/ <<< I want to prove this comedian wrong that having a flabby gut like mine and unhealthy body is not something to laugh about or give others reason to justify why feeding yourself junk is ok. I'm tired of my gut and my underwear rolling down on me when I sit down. I want this ebook. No… I NEED this ebook. I don't want to do the Jane Fonda calisthenics latest fad that we've all tried but not worked. I refuse to feed my brain that junk, too. I want a stronger core just like Pauline. I know it's in there, as long as I keep eating clean like I've been with this challenge =) and keep working on becoming lean.

in response to: http://fighterdiet.com/blog/athletes/fighter-diet-belly-fat/

FIGHTER DIET

Yesterday was shift 3 of 6 for me and I started it w/ chest compressions/Code Blue on a person the same age as I for over an hour =( There’s 4-5 of us rotating CPR while I was pushing meds, etc. Afterwards, had to change into a different pair of scrubs since we were all covered in sweat (and it’s my SHARK week, TMI). My cohort who wears a fitbit said he burned 1100+ cals; I use a polar watch w/HR only when I WOD. I know I can’t go by his numbers but rest of my 12.5 hrs shift had me losing more cals for the rest of the day 0.o~
I’m sharing because: 1) with FD, I’m a better nurse. I had more energy & focus and noticed the processed-sugar-cloud lifted off my brain. Meal #1 was enough to get me thru while I could see others struggling, the ones who only drink coffee/eat donuts for breakfast or skip breakfast. THAT was me before FD. 2) I didn’t join them with the usual celebratory “justified” croissant or treats afterwards. I didn’t want to cheat and FD’s Mind Power reads kept echoing in my head. 3) The most important reason why I decided to get truly serious with my FITness: I will live like this (FD Diet & WODs) so I may live like that (ex. Pauline Nordin​). I want to upgrade myself to a nurse who physically mirrors her passion for her calling, advocates for health, and lives her profession & oath to care for others. I don’t want to tell my patients “you are obese/chol & BP are to high/etc” while mine is the same. I don’t want to be the wife/daughter telling my loved ones “I wish I loved myself enough to eat healthy & workout every day” so that I won’t die of a stroke/heart attack. I want to be the mother who will impart her FD knowledge & practice to her children; so, they too will live a lean life.
Y’all are doing not only yourselves the RIGHT thing & inspiring others. When you struggle with the sweets/cheat cravings, remind yourself of the bigger picture. We are living like this (eating 900 g of green beans, farts, veggie belly, ridding of sabotaging bf/gf’s, insert complaints here) so you may LIVE and not end up on the Code table.

NURSING

Here is a basic way to read arterial blood gases.

1.  First look at the disease of your patient.  That will give you valuable information on whether it is a respiratory or metabolic problem.

2.  Look at the pH.  Normal is 7.35-7.45.  If it is high, then the problem is alkalosis.  If it is low, the problem is acidosis.

3.  Look at the PaCO2 .  Normal is 35-45.  If the PaCO2 is high and the pH is low, then the patient probably has respiratory acidosis.  Go back to the patient history to check.  If the PaCO2 is low and the pH is high, then it might be respiratory alkalosis.  Again go back to the patient history.

4.  Look at the HCO3.  Normal is 22-26.  If the HCO3 is high and the pH is high, then the patient probably has metabolic alkalosis. Go back to the patient history.  If the HCO3 is low and the  pH is low, then the patient probably has metabolic acidosis.  Again go back to the patient history.

So why do yo keep going back to the patient history?  As the patient begins to compensate, the values of the opposite side will change.  For example if the patient has respiratory acidosis over a long period of time, the body will compensate by increasing HCO3 levels.  The final step is to determine if the body is compensating for the disorder.  Another example of compensation- metabolic acidosis in a diabetic patient.  The patient’s respiratory rate will increase and depth of respirations will increase in an attempt to blow off more CO2.  So the HCO3 is low due to the diabetic acidosis,then CO2 will lower as the body tries to compensate.

For this class, know how to do the basic analysis.  I won’t ask you about compensation- partial or full.

 

ACID-BASE BALANCE

I. Hydrogen ion balance CO2 + H2O <——> H2CO3 <——> H+ + HCO3-

A. Chemical buffer system- proteins, HCO3-, Hgb, immediate

B. Respiratory system- CO2 + H2O —–> H2CO3, rapid

C. Renal system- H2CO3 ——-> H+ + HCO3-, slow

II. Respiratory acidosis- basic cause hypoventilation

A. Causes-

1. Inhibition of respiratory center- drugs, oxygen therapy in chronic hypercapnia, cardiac arrest, sleep apnea

2. Disorders of the respiratory muscles and chest wall- neuromuscular diseases, chest cage deformity- kyphoscoliosis, extreme obesity, chest wall injury- fractured ribs.

3. Disorders of gas exchange- COPD, severe pneumonia, asthma, acute pulmonary edema, pneumothorax

4. Acute upper airway obstruction- aspiration of a foreign body or vomitus, laryngospasms

B. Clinical manifestations- dyspnea, disorientation, coma, dysrhythmias, hyperkalemia, hypoxemia, tremor, increased intracranial pressure.

C. Medical management- increase ventilation. Caution in giving O2 to patients with chronic hypercapnia.

III. Respiratory alkalosis- basic cause hyperventilation

A. Causes-

1. Cerebral stimulation of respiration- psychogenic, hypermetabolic states such as fever, CNS disorders, head trauma, brain tumor, Salicylate intoxication- early

2. Hypoxia- pneumonia, asthma, pulmonary edema, congestive heart     failure, pulmonary fibrosis, high altitude residence

3. Excessive mechanical ventilation

4. Gram negative sepsis, cirrhosis, exercise

B. Clinical manifestations- yawning, A light  headedness, circumoral paresthesia, numbness, tingling of fingers and toes, carpopedal spasms, chronic exhaustion, palpitations, anxiety, dry mouth, sleeplessness, cold and clammy hands and feet, inability to concentrate, mental confusion, syncope, hypokalemia

C. Medical management- treat underlying cause, paper bag, sedation

IV. Metabolic acidosis

A. Causes

1. Bicarbonate loss- GI- diarrhea, ileostomy; renal loss- hypoaldosteronism

2. Increased acid load- hyperalimentation

3. Rapid infusion of saline solution

4. Increased acid production- lactic acid, diabetic ketoacidosis, starvation, alcohol intoxication

5. Ingestion of toxic substances- salicylate overdose, methanol, antifreeze

6. Failure of acid secretion- renal failure

B. Clinical manifestations- Kussmal breathing (deep, rapid respirations), peripheral vasodilation, hypotension, cardiac dysrhythmia, lethargy, coma, nausea, vomiting, growth failure, bone disorders, headache

C. Medical management- treat underlying cause, IV lactated ringer’s solution, if severe- NaHCO3.

V. Metabolic alkalosis- increase in plasma bicarbonate

A. Causes-

1. GI loss- vomiting, chloride losing diarrhea

2. Renal loss- diuretics, mineralcorticosteroid excess- hyperaldosteronism, Cushing syndrome, excess licorice intake, carbenicillin or penicillin

3. Hypokalemia

4. Excess NaHCO3 administration

5. Antacids, milk, milk-alkali syndrome

6. Massive citrated blood transfusion

B. Clinical manifestations- signs of hypokalemia, hypoventilation, dysrhythmias

C. Medical management- mild chloride responsive metabolic alkalosis- parenteral isotonic saline with KCl, treat underlying condition, IV HCl if life threatening

VI. Arterial blood gases