critical care

Question 1

what is the typical goal correction for Na

Answer 1

4-6meq/L in 24 hrs

Question 2

how many meq should you not go over in 24 hrs

Answer 2

12 meq

Question 3

what can happen if going over 12 meq

Answer 3

ODS

Question 4

hyponatremia can be categorized in to what

Answer 4

hyper (fluid overload) and hypo (diuretics, vomiting) volemic

Question 5

what is the tx hypervol

Answer 5

diuresis w fluid restriction
arginine vaspressin

Question 6

what is the arginine vaso

Answer 6

tolvaptan
limit to 30 days bc of hepato
ONLy HOSP ADMIN

Question 7

what is the tx for hypovol

Answer 7

3% NaCl IV

Question 8

a drop of 1 meq of serum K equals to a deficit of how many meq in body

Answer 8

100-400

Question 9

potassium is usually admined via what line

Answer 9

peripheral

Question 10

you can do a central line for K when?

Answer 10

if its more aggreessive (rate of >10)

Question 11

what is the max rate of K with peri line

Answer 11

<10 meq/hr w max concen of 100meq/100mL

Question 12

what should you replace first if both mag and K is low

Answer 12

Mag

Question 13

hypomag occurs at what level

Answer 13

<1.3

Question 14

if mag is <1, w sx, what do you replace with

Answer 14

mag sulfate

Question 15

if mag is >1 but <1.5 then what can you replace w

Answer 15

oral mag oxide

Question 16

how long should you continue mag oxide for?

Answer 16

5 days

Question 17

hypophos occurs at what level

Answer 17

<1

Question 18

what should you replace hypophos with

Answer 18

IV phos

Question 19

how long does phos take to replace

Answer 19

1 week

Question 20

what are the ICU meds that target SNS

Answer 20

vasopressors (alpha receptors)
vasodilators

Question 21

vasopressors do what to BP

Answer 21

increase

Question 22

what agents are vasopressors

Answer 22

dopamine
epi
norepi
vasopressin

Question 23

dopamine is dose dependent, what is the dosing at different receptors

Answer 23

D1: 1-4 (renal)
B1: 5-10 (inc contract)
A1: 10-20

Question 24

what receptors does epi target

Answer 24

alpha 1
beta 1 and 2

Question 25

what receptors does norpei target

Answer 25

A1 > B2

Question 26

vasopressors are vesicants, if extravasation occurs what can you tx with?

Answer 26

phentolamine

Question 27

vasopressors are given via what line

Answer 27

central

Question 28

vasodilators do what to BP

Answer 28

decrease

Question 29

what are the agents that are VD

Answer 29

nitroglycerin nitroprusside

Question 30

nitroglycerin should not be used below what SBP

Answer 30

90

Question 31

at low dose, NG VD arteries or veins

Answer 31

veins

Question 32

at high dose, NG VD arteries or veins

Answer 32

arteries

Question 33

nitroprusside has a BW that the metabolite produces what

Answer 33

cyanide

Question 34

what soln should be used with NP

Answer 34

D5W

Question 35

what is used for cyanide toxicity

Answer 35

sodium thioosulfate

Question 36

intropess should be used when

Answer 36

heart is not pumping strong enough (inc contractility)

Question 37

what are the agents that are inotropes

Answer 37

dobutamine (beta 1) milrinone (PDE3)

Question 38

when dobumatine is oxidized it turnss what color

Answer 38

pink

Question 39

what are the types of shock

Answer 39

hypovolemic (hemorrhagic) distributive (septic) cardiogenic (post-MI)

Question 40

what is first line for hypovol

Answer 40

crystalloids

Question 41

what is the tx for septic shock

Answer 41

vasopressor (maintain MAP >65) broad spec abx + crystalloids

Question 42

what is the vasopressor of choice with septic shock

Answer 42

norepi

Question 43

what is the crystalloid of choice with septic shock

Answer 43

LR

Question 44

cardiogenic shock occurs when?

Answer 44

acute HF + HTN and hypoperfusion

Question 45

stop BB when what 2 factors out of the 3 are present

Answer 45

HTN and hypoperfus

Question 46

what is the tx for vol overload in cardiogenic shock

Answer 46

diuretics (loop) + VD

Question 47

what is the tx for hypoperefusion in cardio shock

Answer 47

inotropes

Question 48

what are the first line opioids for pain in ICU

Answer 48

morphine hydromorphone fent

Question 49

what is agitation mainly managed by iin ICU

Answer 49

benzos (loraze, midaz)

Question 50

what are the non benzo options for agitation in ICU

Answer 50

propofol dexmedetomidine (precedex) * used for sedation (better ICU outcomes)

Question 51

precedex is the only sedative approved for the use in what

Answer 51

intubated and nonintubated pt

Question 52

duration of precedex should not exceed what

Answer 52

24 hrs

Question 53

proprofol in CI in those with a hypersensitivty to what

Answer 53

egg

Question 54

what color can propofol turn your nail/hair/pee

Answer 54

green

Question 55

for delirium in ICU what should be used

Answer 55

quetiapine

Question 56

for stress ulcers in ICU, what is first line

Answer 56

H2Ra + PPI

Question 57

in what setting are NMDA used and what is used to faciltate

Answer 57

surgery and mechanical vent to tx muscle spasms

Question 58

NMDA cause paralysis of what

Answer 58

skeletal muscle

Question 59

NMDA has been given while on what

Answer 59

vent (need good sedation + analgesia before starting)

Question 60

what are NMDA agents

Answer 60

succinylcholine cisatcurium

Question 61

succ is depolar or non-depolar

Answer 61

depolar

Question 62

cisa is depolar or non-depolar

Answer 62

non

Question 63

what is used for secretions

Answer 63

glycopyrolate

Question 64

what agents add toxicity by enhancing NMDA

Answer 64

aminoglycosides polymyxins

Question 65

what are additional drugs used in ICU and OR

Answer 65

bupivicaine lidocaine/epi for local procedure

Question 66

what are common local anesthetic

Answer 66

lidocaine

Question 67

what are common inhaled anesthetic

Answer 67

desflurane sevloflurane

Question 68

what are common inj anesthetic

Answer 68

bupi ropi