Medications
Opioids common serious side effect to monitor
What is respiratory depression?
You enter a room and find:
Patient 1: HR 122, BP 92/54, reports feeling sleepy
Patient 2: BP 128/78, mild incision pain
Patient 3: BG 58, shaky and confused
Who do you assess first and why?
What is patient 3: hypoglycemia
Your body produces about 1–1.5 liters of this each day to aid digestion.
What is saliva?
Sodium is 122 and the patient is confused and lethargic
What is hyponatremia?
A diabetic patient becomes shaky, confused, and diaphoretic
What is hypoglycemia
Electrolyte effect to monitor on Furosemide
What is hypokalemia
A post-op patient has:
HR 130
BP 84/50
RR 28
Pale, cool skin
Urine output 10 mL/hr
Which system is most concerning?
What is the cardiovascular system?
The tiny bones in your ear are called the smallest bones in the body. Name one.
What is stapes, incus or malleus?
A patient’s WBC is 18,000 and they have a fever
What is infection/sepsis?
A patient suddenly has slurred speech and facial droop.
What is activate the stroke protocol?
A patient weighs 70 kg. Vancomycin is ordered at 15 mg/kg IV q12h. How many mg should you administer per dose?
What is 1050 mg per dose (70 x 15 )
A patient’s skin is pink, warm, and dry. Their capillary refill is <2 seconds. What does this indicate?
What is adequate perfusion?
Sneezes can travel this fast through the air.
What is 100 mph?
A patient’s potassium is 2.9. They complain of muscle weakness and palpitations.
What is hypokalemia with risk for cardiac dysrhythmia?
A post-op patient is restless, keeps removing their gown, respirations are 28/min, and pulse ox drops from 96% to 90%. They say, “I can’t catch my breath.”
What is access airway/breathing, apply O2 and call for help?
A patient is ordered Vancomycin 1 g IV over 90 minutes. The IV bag contains 1 g in 250 mL. What is the mL/hr infusion rate?
What is 167 ml/hr
Rate = 250 ÷ (90 ÷ 60) = 250 ÷ 1.5 = 167 mL/hr
A patient who is usually alert suddenly becomes lethargic and disoriented. Which assessment is most important first?
What is the assessment of neurological status (LOC, orientation, pupillary response)
Your taste buds only live for…
What is 10-14 days?
A patient on warfarin has an INR of 5.8 and reports a headache.
What is high bleeding risk/possible intracranial hemorrhage?
A post-op patient suddenly reports sharp chest pain and severe shortness of breath. They are anxious and tachycardic.
What is a pulmonary embolism?
A child weighs 18 kg. The order is Amoxicillin 40 mg/kg/day divided q8h. How many mg per dose?
What is 240 mg per dose
Total daily dose = 18 × 40 = 720 mg/day
Divided q8h = 720 ÷ 3 = 240 mg per dose
Mr. Alvarez is a 72-year-old post-op patient who is scheduled for IV morphine 2 mg PRN for pain. Before giving the medication, you assess:
Respirations: 8/min
O₂ saturation: 91% on 2 L NC
Heart rate: 70 bpm
BP: 118/72
Pain: 7/10.
What do you do next?
What is hold the dose & notify provider d/t respiratory depression
Humans shed up to this much skin each year without noticing
What is 1.5 lbs?
A patient’s labs return:
Potassium 6.1
Creatinine 2.8
BUN 48
Urine output 10 mL/hr
What is acute kidney failure?
A patient vomits dark, coffee-ground material and becomes pale and dizzy.
What is a GI bleed?