Critical Care Medications

Question 1

What is a Central Venous Access Device (CVAD)?

Answer 1

An IV catheter that administers meds / fluids directly to the Superior Vena Cava

Question 2

A CVAD can address blood and fluid volume needs, deliver meds, and improve or maintain-

Answer 2

Organ Perfusion

Question 3

Movement of oxygenated blood through the body to the tissues =

Answer 3

Perfusion

Question 4

Large volume IV bolus infusions are usually given as-

Answer 4

A one time prescription

Question 5

Large volume IV infusions on a continuous basis are administered for-

Answer 5

Fluid & Electrolyte Replacement + Administering Meds

Question 6

Volume of IV medication / fluid administered over a set period of time =

Answer 6

Intermittent IV Bolus Infusion

Question 7

An Intermittent IV Bolus Infusion can also be called-

Answer 7

IV Piggyback

Question 8

An Intermittent IV Bolus Infusion usually contains how much of a med?

Answer 8

50 - 250 mL of solution

Question 9

Involve a small amount of med, either concentrated or diluted, and are administered over a short time =

Answer 9

Small-Volume IV Bolus Infusion

Question 10

How long does it take to administer a Small-Volume IV Bolus Infusion?

Answer 10

About 1-5 min

Question 11

A Small-Volume IV Bolus Infusion can also be called an-

Answer 11

IV Push

Question 12

A condition of severe hypotension and decreased tissue perfusion =

Answer 12

Shock

Question 13

What’s a Hemorrhage?

Answer 13

A loss of blood, externally or internally

Question 14

During a fluid Bolus, what symptoms should be monitored for?

Answer 14

Wheezing, Dyspnea, or other indications of Fluid Overload

Question 15

When administering a Large Volume Bolus, what should be used to allow for rapid infusion of the fluid?

Answer 15

A Central Line or Large Gauge Angiocatheter

Question 16

What is an Angiocatheter?

Answer 16

A flexible tube inserted to a blood vessel to administer IV meds or fluids

Question 17

What are Continuous IV Med Infusions prescribed in?

Answer 17

Units/hr
Mg/hr
Mg/min
Mcg/kg/min

Question 18

What is Heparin?

Answer 18

A med that prevents the formation of blood clots

Question 19

How is Heparin administered?

Answer 19

Only available for SUBQ or IV injection

Question 20

What can be administered after the pt has an Acute Myocardial Infarction to prevent the formation of blood clots?

Answer 20

IV Heparin

Question 21

What can IV Heparin do for pt’s with Venous Thrombosis or a Pulmonary Embolism?

Answer 21

Helps prevent additional clot formation or the further development of existing clots

Question 22

What should always be available to prevent potential Heparin overdose?

Answer 22

Protamine Sulfate

Question 23

What does Magnesium Sulfate do?

Answer 23

Activates many intracellular enzymes + Helps regulate skeletal muscle contractility + Helps blood coagulation

Question 24

Magnesium Sulfate is important for the treatment of-

Answer 24

Seizures caused by Eclampsia, Acute Myocardial Infarction, Cardiac Arrest, Preterm Labor, Magnesium Deficiency

Question 25

What is Eclampsia?

Answer 25

A Hypertensive Disorder after the 20th week of Gestation that results in Seizures

Question 26

What should be monitored after administering Magnesium Sulfate?

Answer 26

Cardiac Status, Neuromuscular Status, Serum Magnesium Levels, Signs of Magnesium Toxicity

Question 27

What are the signs of Magnesium Toxicity?

Answer 27

Hypotension, Depressed Cardiac Function, Depressed / Absent Deep Tendon Reflexes, Respiratory Depression

Question 28

What should always be made available in case of a potential overdose of Magnesium Sulfate?

Answer 28

Calcium Gluconate

Question 29

What is Labetalol?

Answer 29

A 3rd Generation Beta Blocker (Has Alpha and Beta activity)

Question 30

What does a Alpha Blockade result in?

Answer 30

Vasodilation (Which Decreases Peripheral Resistance and Lowers BP)

Question 31

What does a Beta Blockade do?

Answer 31

Decreases HR, Myocardial Contractility, and the AV Node’s Conduction Rate

Question 32

Labetalol’s Vasodilation effect makes this med effective for-

Answer 32

Severe Hypertension

Question 33

What should be monitored when taking Labetalol (Non-Intravenously)?

Answer 33

Vital Signs and Cardiac Status

Question 34

What should be monitored when taking IV Labetalol?

Answer 34

Monitor for Hypotension, Bradycardia, Nausea, Dizziness, Pulmonary Edema, Sweating

Question 35

What is Dopamine?

Answer 35

An Alpha and Beta Adrenergic Agonist

Question 36

What do meds with an Adrenergic Affect mimic?

Answer 36

The Sympathetic Nervous System

Question 37

What receptors in the heart are affected by Dopamine?

Answer 37

Beta 1 Receptors

Question 38

What does Dopamine do to Cardiac Output?

Answer 38

Increases it

Question 39

How can Dopamine increase Tissue Perfusion?

Answer 39

Increased Cardiac Output = Increased Tissue Perfusion

Question 40

How does Dopamine affect the kidneys?

Answer 40

It activates Dopamine Receptors in the kidneys

Question 41

When the kidney’s Dopamine Receptors are activated, what occurs?

Answer 41

The Renal Vessels will Dilate, causing an Increased Glomerular Filtration Rate (GFR) and Urinary Output

Question 42

Dopamine’s effects on the kidneys (Increased GFR + Urinary Output) are good for treating-

Answer 42

Heart Failure, Cardiogenic Shock, and Septic Shock, where there’s a need for cardiac stimulation and Vasopressor action

Question 43

What’s a Vasopressor?

Answer 43

A med that stimulates contraction of blood vessels + Increased BP

Question 44

What should be frequently checked when administering Dopamine?

Answer 44

Vital Signs Continuously Monitor Cardiac Status (Observe for Tachycardia, Dysrhythmias, Angina Pectoris, and Myocardial Infarction) Monitor IV site closely for Extravasation

Question 45

What is Angina Pectoris?

Answer 45

A type of chest pain that occurs when the heart doesn’t get enough blood and oxygen

Question 46

What can high doses of Dopamine cause?

Answer 46

Alpha 1 Activation, leading to Local Vasoconstriction

Question 47

What is it called when you modify the volume of a fluid / med in order to maintain physiological parameters?

Answer 47

You are Titrating the substance

Question 48

What are some examples of Physiological Parameters?

Answer 48

BP + HR + Cardiac Output + Sedation Level

Question 49

You can Titrate an IV infusion of Dopamine to maintain a Systolic BP between-

Answer 49

110 - 130 mmHg

Question 50

Some of the meds that require Titrating include-

Answer 50

Heparin, Nitroprusside, Norepinephrine, Dobutamine, Nitroglycerin

Question 51

Meds should be Titrated in very small increments to avoid-

Answer 51

Extreme Fluctuations in Vital Signs

Question 52

What is Nitroprusside?

Answer 52

A non-nitrate Vasodilator that causes direct Vasodilation of both arteries and veins

Question 53

What does taking Nitroprusside do to you?

Answer 53

Causes rapid reduction of BP

Question 54

What is a Vasodilator?

Answer 54

A type of med that results in the Dilation (Widening) of blood vessels

Question 55

What things is Nitroprusside used to treat?

Answer 55

Hypertensive Crisis + Acute Heart Failure

Question 56

When do the effects of Nitroprusside take effect after administration?

Answer 56

Immediately

Question 57

What cardiac changes can Nitroprusside cause?

Answer 57

Bradycardia + Tachycardia + ECG Changes

Question 58

What things should be monitored when a pt takes Nitroprusside?

Answer 58

Vitals (Cardiac Status + BP) Signs of Thiocyanate Toxicity

Question 59

What are the signs of Thiocyanate Toxicity?

Answer 59

Blurred Vision, Tinnitus, Fatigue, Absent Reflexes, Changes in Mental Status

Question 60

What is important to keep in mind about Nitroprusside before administering?

Answer 60

It’s light sensitive, so the solution container has to be placed in an opaque wrapper and used within 24 hr

Question 61

What is Nitroglycerin?

Answer 61

An organic nitrate that causes direct Vasodilation of both arteries and veins

Question 62

What does taking Nitroglycerin result in?

Answer 62

Decreased BP + Decreased Veinous Return + Decreased Cardiac Oxygen Demand

Question 63

Nitroglycerin can be used to treat-

Answer 63

Acute Coronary Syndrome Angina Myocardial Infarction Hypertensive Crisis

Question 64

How can Nitroglycerin be administered?

Answer 64

Sublingually + as a Spray + Transmucosal Tablet + Tropical Ointment + Continuous IV Infusion

Question 65

What do Preloaded Mini-Injection Systems provide?

Answer 65

Easy access + quick delivery of a med during an emergency

Question 66

What are some meds that are available as a Mini-Injection System?

Answer 66

Atropine, Lidocaine, Sodium Bicarbonate, Epinephrine

Question 67

How much med does one Mini Injection System hold?

Answer 67

1 Adult Dose

Question 68

When using a Mini Injection System, what should be used if available?

Answer 68

A Central Line