Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

NAPLEX STUDY > Acute Care > Flashcards

Acute Care Flashcards

1
Q

Crystalloids

A

-D5W (free water)
-NS (volume resuscitation)
-LR (volume resuscitation)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

Colloids

A

-large molecules that remain in the intravascular space and increase oncotic pressure
-albumin (edema)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

hypotonic hypervolemic hyponatreia

A

-caused by fluid overload
-diuresis with fluid restriction

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

hypotonic isovolemic hyponatremia

A

-caused by SIADH
-diuresis, restricting fluids, and stopping drugs that can cause SIADH

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

hypotonic hypovolemic hyponatremia

A

-salt wasting, diuretics, adrenal insufficiency, blood loss, or vomiting/diarrhea
-stop hypotonic solutions
-severe symptoms/Na <120 can use hypertonic (3%) sodium

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

correcting hyponatremia

A

-should not be correct too fast (4-8 mEq/L/24h)
-correcting more rapidly than 12 mEq/L/24h can cause osmotic demyelination syndrome or central pontine myelinolysis which can cause paralysis, seizures, and death

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

Conivaptan and Tolvaptan

A

can be used to treat SIADH and hypervolemic hyponatremia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

Hypernatremia

A

-associated with a water deficit and hypertonicity
-hypovolemic: loss of fluids > replace with fluids
-hypervolemic: hypertonic fluids > diuresis
-isovolemic: DI > desmopressin

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

KCl

A

-peripheral line: max infusion rate < 10 mEq/hr and max concentration of 10 mEq/100 mL
-higher rates/concentration require a central line and cardiac monitoring
-DO NOT IV PUSH

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

Resistant hypokalemia

A

-serum magnesium should be checked as magnesium is necessary for potassium uptake
-magnesium should be replaced first when both are present

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

hypomagnesium

A

-IV, IM magnesium sulfate
-magnesium oxide (PO)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

hypophosphotemia

A

< 1 mg/dL treat with IV phosphorous

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

IVIG (Gammagard, Gamunex-C, Octagam, Privigen)

A

-slower infusion rate in renal and CV disease
-do not freeze, shake or heat
-Boxed Warnings: acute renal dysfunction, thrombosis
-infusion reaction (facial flushing), chest tightness, fever, chills, hypotension

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

Vasopressors

A

-most work by stimulating alpha receptors
-causes peripheral vasoconstriction and increasing systemic vascular resistance which in turn increases BP, HR, CO
-all are vesicants when administered IV –> treat extravasation with phentolamine
-arrhythmias, tachycardia, necrosis (gangrene), bradycardia (phenylephrine), hyperglycemia (epi)
-all should be administered via central line

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

Dopamine

A

-Low (renal) dose: 1-4 mcg/kg/min works at dopamine-1-agonist receptors
-medium dose: 5-10 mcg/kg/min works at beta-1-agonist receptors
-high dose: 10-20 mcg/kg/min works at alpha-1-agonist

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

epinephrine (Adrenaline)

A

-alpha-1, beta-1, beta-2 agonist
-IV push is 0.1 mg/mL (1:10,000 ratio strength)
-IM/compounding is 1 mg/mL (1:1,000)

17
Q

Norepinephrine (Levophed)

A

alpha-1 agonist activity is > beta-1-agonist

18
Q

phenylephrine (neosynephrine)

A

alpha-1 agonist

19
Q

Vasopressin (Vasostrict)

A

vasopressin receptor agonist

20
Q

Nitroprusside (Nipride)

A

-mixed (equal) arterial and venous vasodilator
-produces cyanide, excessive hypotension
-increased ICP
-headache, tachycardia, thiocyanate/cyanide toxicity (risk increases in renal and hepatic impairment)
-degradation color to blue means cyanide

21
Q

Nitroglycerin

A

-low dose: venous vasodilator
-high dose: arterial vasodilator
-Contraindications: SBP < 90 mmHg; PDE-5 inhibitors
-headache, tachycardia, tachyphylaxis
-requires non-PVC container

22
Q

Inotropes

A

-increase contractility of the heart
-dobutamine (beta-1 agonist with some beta-2 and alpha-1 agonism)
-milrinone (PDE-3 inhibitor)

23
Q

Hypovolemic shock

A

fluid resuscitation with crystalloids (if not caused by hemorrhage)
-then vasopressors after fluid resuscitation

24
Q

Septic Shock

A

-target MAP of > 65
-fill the tank: optimize preload with IV crystalloids (LR preferred)
-alpha-1 agonist activity (peripheral vasoconstriction) to incr SVR
-beta-1 agonist activity to increase myocardial contractility and CO
-norepi is the vasopressin of choice

25
Q

MAP

A

= [(2 x DBP) + SBP]/3

26
Q

VAP

A

pseudomonas (and a few other organisms) thrive in the moist air in the ventilator

27
Q

indwelling catheter

A

CAUTI

28
Q

Cardiogenic shock

A

pt presented with edema, JVD, or ascites are VOLUME OVERLOADED:
-loop diuretic, vasodilators (NTG, nitroprusside)

Pt with decreased renal fx, AMS, and/or cool extremities have HYPOPERFUSION:
-inotropes (dobutamine, milrinone)
-if hypotensive consider adding a vasopressor (dopamine, norepi, phenylephrine)

Some patients experience BOTH

29
Q

P.A.D.I.S

A

-Pain: IV morphine, dilaudid, fentanyl are first line options for analgesia
-Agitation: benzos, propofol, dexmedetomidine
-Delirium: no prevention - use of non-benzos may help reduce the incidence (quetiapine)
[RASS SCORE +4 combative | 0 calm/alert | -5 unarousable]

30
Q

Dexmedetomidine (Precedex)

A

-alpha-2 adrenergic agonist
-hypo/hypertension, bradycardia
-does not require refrigeration
-infusion should not exceed 24 hours
-approved for both intubated and not intubated patients`

31
Q

Propofol

A

hypotension, apnea, hypertriglyceridemia, green urine/hair/nail beds, propofol-related infusion syndrome (PRIS)
-bacterial growth, discard vial and tubing within 12 hours of use
-provides 1.1 kcal/mL

32
Q

lorazepam (Ativan)

A

propylene glycol toxicity (acute renal failure and metabolic acidosis)

33
Q

Stress ulcers

A

H2RAs and PPIs are recommended to prevent-stress related mucosal damage
-PPIs can increase the risk of GI infections, fractures, nosocomial pneumonia

34
Q

NMBA: depolarizing

A

Succinylcholine

35
Q

NMBA: non-depolarizing

A

-rocuronium, vecuronium, cisatracurium (hofmann elimination - independent of renal and hepatic function)
-flushing, bradycardia, hypotension, tachyphylaxis

36
Q

hemostatic agents

A

-inhibit fibrinolysis and enhancing coagulation
-Tranexamic acid (Cyklokapron inj, Lysteda tab)
-Recombinant Factor VIIa (NovoSeven RT)

NAPLEX STUDY (25 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions