Cardio
Patient takes furosemide 40 mg PO daily at home. What oral dose of Bumetanide is equivalent?
Bumetanide 1 mg PO
Pt with K of 6.9 with peaked T waves on ECG. What medication should you give ASAP?
patient with asthma previously well controlled on albuterol inhaler therapy has been having exacerbations 3 times a week and has been waking up at night 3 times a month. What is the next best step?
Pt with aspiration pneumonia, no lung abscess or empyema. Do we need to add anaerobic coverage with metronidazole or clindamycin?
No.
DKA patient received fluids. Potassium is 2.9. what is the next best step?
Replace potassium to above 3.5
Why are IV loop diuretics preferred over oral in a patient with Acute decompensated HF?
ADHF can cause gut swelling, slow GI absorption of PO medications, IV bypasses the gut.
Hospitalized patients potassium remains low despite replacement. What to do next?
Check magnesium and replace magnesium along with potassium.
Targeted SpO2 for patient with Acute COPD exacerbation
88-92 percent
Patient has a Neutrophil count of 150. She developes neutropenic fever. No evidence of hypotension, pneumonia, catheter infection. (No signs of gram positive infection).
What is the next best step in treatment?
antipseudomonal beta lactams.
Patient on long term prednisone therapy comes on your unit is hypotensive. Labs indicate hyponatremia and hyperkalemia. What is the diagnosis?
Adrenal Crisis
They come in for volume overload.
What total daily IV furosemide range do you use for initial dose
80-200 mg IV per day.
Patient with Sodium of 112 has a seizure. what is the next best step?
3 percent hypertonic saline.
Patient with COPD exacerbation starts having increased dyspnea and cough with purulent sputum. What is indicated?
Add antibiotics
Elderly woman from nursing home has a positive urine culture growing E coli. She is afebrile. Denies urinary sx. What is the next best step in management?
BONUS: What if she was a 30 year old pregnant woman?
Nothing; you treat her with cephalexin or nitrofurantoin.
Patient on long term prednisone therapy comes on your unit is hypotensive. Labs indicate hyponatremia and hyperkalemia. What is the next best step?
IV hydrocortisone 100 mg and fluid resuscitation. Do not wait for labs.
patient with acute decompensated HF still has volume overload with JVD and peripheral edema, but is improving clinically with treatment with Diuretics.
Creatinine rises from 1.1-1.6. BP stable. Urine output WNR.
What is the next best step with the loop diuretic?
Continue treatment.
Cardiorenal vs AKI
Patient with metabolic alkalosis after several days of vomitting has a urine chloride of 8 mEq/L. Is this patient chloride responsive or chloride resistant? What is the treatment?
Patient comes in with severe asthma exacerbation. Monitoring her PaCO2, on admission it was 28 mmHg. 6 hours later, it is 48 mmHg. you notice the patient has decreased work of breathing. What are these findings suggesting?
Impending respiratory failure from ventilatory fatigue. Intubate?
patient has confirmed initial, nonfulminant C Diff infection. What is the preferred first line treatment?
Hospitalized Patient with Type 1 diabetes is made NPO for a procedure. What should you do with their insulin regimen?
Continue Basal Insulin.