ICU meds

Question 1

Ketamine indications. SE. Nursing Considerations?

Answer 1

Indications: Anesthesia with profound analgesia, minimal respiratory depression, and minimal skeletal muscle relaxation.
SE: HTN (cardiovascular stimulant)
Nursing: Give with benzo to prevent emergnce phenomenon (psychomotor agitation when emerging from sedation)

Question 2

Succhcholyine indications. SE. Nursing Considerations?

Answer 2

Indication - neuromuscular blockade - induces skeletak relaxation.
SE: Resp depression, hypoxia, apnea, bradycardia, hyperk, malignant hypothermia
Nursing: Analgesia and sedation first, for kidney failure pts

Question 3

Midazolam indications. SE. Nursing Considerations?

Answer 3

Indication: benzo sedative
SE: severe HypoTN, bradycardia, resp depression and cardiac arrest
Nursing: Monitor BP closely

Question 4

Fentanyl indications. SE. Nursing Considerations?

Answer 4

Indication: narcotic/ analgesia
SE: Resp, circulatory depression, tachy/brady, hypo/hyperTN
Nursing: Fast acting, met via liver

Question 5

Rocuronium ndications. SE. Nursing Considerations?

Answer 5

Indication: skeletal muscle paralysis
SE: anaphylaxis
NC: keep in fridge

Question 6

Phenylephrine indications. SE. Nursing Considerations?

Answer 6

I: alpha adrenergic agonist (vasoconstriction) during anesthesia. Overcome peripheral vascular failure
NC: DO NOT give to hypovolemic pts. Peripheral/visceral vasoconstriction decreases blood to vital organs’ kidneys

Question 7

Halidol indications. Mechanism of action. SE. Nursing Considerations?

Answer 7

I - aggression/agitation, schitzophrenia, unresolved post-surgical nausea
M: anticholinergic/ alpha blocking properties/ changes dopamine receptors
SE: hypoTN, resp depression, vent dysrhythmias, QT enlongation
NC: Monitor for development of neuroleptic malignant syndrome (fever, respiratory distress, tachycardia, seizures, diaphoresis, hypertension or hypotension, pallor, tiredness, severe muscle stiffness, loss of bladder control)

Question 8

Nozinan indications. Mechanism of action. SE. Nursing Considerations?

Answer 8

I: sedative/anti-psychotic
M - alters effects of dopamine, alpha adrenergic antagonist (causes hypoTN)
SE: seizures, hypoTN, drowsiness
NC - Risk of orthostatic hypoTN

Question 9

Propofol indications. Mechanism of action. SE. Nursing Considerations?

Answer 9

I - Induction and maintenance of anesthesia.
M - unknown
SE: apnea, bradycardia, hypoTN,
NC - Assess respiratory status, pulse, and BP continuously throughout propofol therapy. Frequently causes apnea lasting ≥60 sec.
Monitor for propofol infusion syndrome (severe metabolic acidosis, hyperkalemia, lipemia, rhabdomyolysis, hepatomegaly, cardiac and renal failure)
Only good for 12 hrs
Subtract dose from lipids received

Question 10

isosorbide dinitrate indications. Mechanism of action. SE. Nursing Considerations?

Answer 10

I - nitrate for CHF/ anginal pain
M - venous dilation (increrases venous capacitance). Increases coronary blood flow
SE: dizziness, hypoTN, tachycardia
NC - none

Question 11

Spironalactone indications. Mechanism of action. SE. Nursing Considerations?

Answer 11

I - K sparing diuretic. Anti-aldosterone. Increases survival with CHF
M - Causes loss of sodium bicarbonate and calcium while saving potassium and hydrogen ions by antagonizing aldosterone.
SE: hyperK
NC: monitor weight daily