Critical Care Drugs
You CIWA patient begins to seize. What medication are you emergently pulling for this break through seizure?
What is Lorazepam (Ativan)
This common saying is helpful when evaluating the severity of a patient's GCS: "Less than ___, intubate."
What is 8
First step when your patient is found unresponsive:
What is check for a pulse.
Your patient is in respiratory distress and the plan is to intubate. Name one of the many safety checks you as the nurse need to perform prior to starting this procedure:
What is:
1. Have working suction
2. Check patency of the IV
3. Have a crash cart nearby
4. Have Oxygen ready with a BVM
5. Have extra airway supplies
6. Have proper sedation/paralytic drugs
My heart failure patient had too much ham on Easter! I anticipate the provider ordering this lab, checking to see how much fluid they may be holding on to:
What is BNP
This drug may be given in hypertensive emergencies and needs close, frequent monitoring of the patient's blood pressure. Can I get an art line!
What is IV Nitroglycerin or Nitroprusside
This is an early sign of increased intracranial pressure.
What is decrease in LOC, confusion, restlessness, vision changes
Gasp! Your patient has no pulse and CPR is started. Upon the first pulse check, the patient is noted to be in Ventricular Fibrillation. What is your next step?
What is shock the patient.
What is disconnect the ventilator and bag the patient
"Ouch! My chest keeps hurting!" yells your patient. I anticipate obtaining this lab emergently to check for myocardial ischemia.
What is troponin
ACLS Drug used for the treatment of Hyperkalemia.
What is Calcium Gluconate
You receive this report from EMS. What is missing?
"Coming in for stroke like symptoms. Facial droop and right sided weakness. VSS, GCS 14. Be there in 7 minutes".
What is last known well.
If you're watching Grey's Anatomy, you will be pushing one of _____ constantly. Also, your go to drug in a cardiac arrest.
What is Epinephrine
It's time to intubate your patient! We want to make sure we push this type of drug prior to the paralytic!
What is a sedative. (Etomidate, ketamine)
"Help! I can't breathe!" A stat ABG is order and this is the result. What type of blood case is it and what are you going to do:
pH: 7.18
CO2: 57
HCO3: 24
PO2: 64
What is Respiratory Acidosis. Provide oxygen!
That's not milk hanging on your patient's IV pole, this drugs is commonly used to sedate patients. Make sure you watch their triglycerides!
What is Propofol
You are administering Alteplase to a patient when you notice the patient complains of a new headache. What is your first step?
Don't be spoofed: it looks like normal sinus rhythm on the monitor, but there is not a pulse. What rhythm is it?
What is PEA. Pulseless Electrical Activity.
Name two indications your intubated patient needs suctioning:
•Visible secretions in ET tube
•Sudden onset of respiratory distress
•Suspected aspiration of secretions
•↑ Peak airway pressures
•Adventitious breath sounds
•Respiratory rate and/or coughing
•↓ in PaO2 and/or SpO2
"Help me! I can't breathe and I've missed my last three dialysis appointments!". With this information, what electrolyte are you concerned with being high?
BONUS: Name one of the drugs you'd give in this situation!
BONUS BONUS: What EKG change do you anticipate?
What is Potassium
What is insulin & glucose, calcium gluconate, kayexalate (when more stable)
This drug is given to decrease ICP. Always make sure you place a foley catheter first!
What is Mannitol
List three things for seizure precautions:
What is:
•Padded side rails
•Airway at the bedside
•Suction available at the bedside
•Oxygen Flow meter at the bedside
•Maintain a patent IV site
What is Amiodarone
The patient is successfully intubated (hooray!). Name three ways to confirm tube placement.
What is:
1. Auscultation of lung sounds
2. End-tidal CO2 detector
3. Chest x-ray
List the normal ranges for these important electrolytes:
Sodium
Potassium
Calcium
Magnesium
What is:
Sodium 135-145
Potassium 3.5-5
Calcium: 8.5-10.2
Magnesium 1.3-2.2