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PDC NEW (QUESTIONS & ANSWERS) SOLVED 100% CORRECT!!
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PDC NEW (QUESTIONS & ANSWERS)SOLVED 100% CORRECT!!
Poison Control centers number? Answer- 1-800-222-1222
Why is it necessary to limit the amount of fluids given to an overdose patient? pg.
101 Answer- Many medications depress myocardial contractility and heart rate,
which predisposes the patient to heart failure.
Beta blocker overdose- signs and symptoms Answer- Hypotension, hypoglycemia,
hypothermia, bradycardia, cardiac arrhythmia, seizure
Treatment for Beta blocker overdose. adult and pediatric Answer- adult- Normal
saline 1L IV/ IO may repeat 1x prn
pediatric- 20ml/kg IV/IO may repeat 2x prn
Common Beta Blockers Answer- Atenolol,
carvedilol,
metoprolol,
nebivolol,
propranolol
Calcium Channel Blockers overdose- Signs and symptoms Answer- bradycardia,
AMS,
Syncope,
Seizures,
Hypotension,
Non- cariogenic pulmonary edema
common calcium channel blockers Answer- Amlodipine
Felodipine
Nifedipine
Verapamil
Nicardipine
Diltiazem
Calcium channel blocker overdose- Patient presenting with hypotension and
bradycardia or not responding to treatment do what? Answer- Refer to the
bradycardia protocol
,Calcium Channel Blockers treatment- with hypotension Answer- Calcium Chloride
1g IV/IO over 2 minutes
Normal Saline 1L IV/IO may repeat 1x prn
Calcium Channel Blockers treatment- with hypotension in pediatrics Answer-
Calcium Chloride 20mg/kg IV/IO over 2 minutes may repeat in 10 minutes.
Normal Saline 20mg/kg IV/IO may repeat 2x prn
Cocaine Overdose Signs and symptoms Answer- Chest Pain
Hypertension
Excited delirium
Seizures
Tachycardia
Hyperthermia
Supra-ventricular and ventricular cardiac arrhythmia
Cocaine overdose- Patient presenting with stable SVT, WCT, Chest pain, HTN, or
Seizure Answer- Versed 5mg IV/IO/IN/IM
May repeat 1x prn in 5 minutes
Cocaine overdose- contraindication of Versed Answer- hypotension
Cocaine overdose Pediatric- Patient presenting with stable SVT, WCT, Chest pain,
HTN, or Seizure Answer- Versed 0.1 mg/kg IV/IO
Versed 0.2 mg/kg IN/IM
May repeat either route 1x prn
Precaution for Versed Answer- Monitor for respiratory depression
Narcotic Overdose- Narcan is to be used PRN to improve ____________,
_____________, and _____________ Answer- Intrinsic airway patency, ventilation,
and oxygenation
Narcotic overdose- Narcan Infusion IV/IO dose Answer- Dilute 0.5mg of narcan into
a 50 ml bag of normal saline. Use a 60 gtts run wide open. Reassess vitals after
25ml has been administered.
May repeat in 2 minutes for a max total dose of 4 mg.
Narcotic overdose- Narcan prefilled syringe w/MAD dose (Adult and PED) Answer-
Adult- 2mg IN
Pediatric - 1mg IN
Both can be repeated in 5 minutes. Max dose 8mg
Narcotic overdose- Narcan IM dose (Adult and PED) Answer- Adult- 2mg IM
Pediatric- 1mg IM
Both can be repeated in 5 minutes. Max dose 4mg
Opioid Withdrawals- COWS scale stands for? Answer- Clinical Opiate Withdrawal
Scale
,Opioid withdrawal exclusion criteria? Answer- AMS/ no capacity
Unwilling to give name, DOB, and phone number
Unwilling to be transported to hospital
Pregnant
Taken methadone within the past 48 hours
Opioid withdrawals- COWS score <5 Answer- Monitor and transport
Opioid withdrawals- COWS score >5 Answer- attempt verbal consent for Suboxone
Dose and Contraindications for Suboxone sublingual Answer- 16mg SL (2 films) If
no response in 15 minutes, repeat with 8mg SL (1 film).
Contraindication- Hypersensitivity to Buprenorphine or Naloxone
Review COWS scale page 107 Answer- Review COWS scale page 107
TCA overdose- signs and symptoms Answer- Mad as a hatter
Red as a beat
Hot as Hell
Dry as a bone
Blind as a bat
Coma
Seizure
Cardiac arrhythmia
Acidosis
Common TCA drugs Answer- Amitriptyline
Desipramine
Doxepin
TCA overdose- Patient presenting with a Wide QRS Complex (>.12 seconds or 3
small boxes) treatment Answer- Sodium Bicarb.- 100mEq, over 2 minutes.
If no change in 5 minutes- 50mEq, over 2 minutes
Max dose 150mEq
TCA overdose- Isolated hypotension only treatment Answer- Normal Saline 1L IV/IO
May repeat 1x prn
Precaution for sodium bicarbonate in TCA overdose Answer- Discontinue treatment
when QRS complex are <.12 seconds (3 small boxes)
TCA overdose- Pediatric treatment with a wide QRS complex >0.08 (2 small boxes)
Answer- Sodium bicarb.- 1mEq/kg IV/IO over two minutes. Max single dose of
50mEq.
May repeat 2x prn in 5 minutes.
Behavioral Emergencies- Mild definition Answer- Agitated, confused, and/ or scared
but cooperative
conversational and easily calmed
, Behavioral Emergencies- Moderate definition Answer- Agitated but without
immediate danger to self or others
Able to have a conversation, even if brief. Loud and destructive but distractible.
Behavioral Emergencies- Severe definition Answer- Immediately dangerous to self
or others.
Uncooperative, aggressive, bizarre behavior and can not be calmed.
Behavioral emergency treatment for mild Answer- Monitor and transport
Behavioral Emergency treatment for moderate and/ or severe patients who are
_________, >____ years old, ___________________, or any ketamine
contraindication Answer- pregnant,
>65 years old,
known coronary artery disease
pg. 111
Behavioral Emergency- treatment for moderate and/ or severe patients who are
pregnant, >65 years old, known coronary heart disease, or any ketamine
contraindication Answer- Droperidol- 5mg IV/IO/IM
Onset time: 5-10 minutes
may repeat 1x prn in 10 minutes
Precaution for Droperidol Answer- Use with caution for patients already taking other
sedatives.
Behavioral Emergency- Severe- Special populations is defined as Answer- Head
trauma
<50kg
Neuro- developmental disorder
Already taken other sedatives
Behavioral Emergency- Severe special population Ketamine dose Answer- 200mg
IM
May repeat 3x prn, in 5 minute intervals to gain control of the patient
Contraindications for Ketamine Answer- Pregnant
Penetrating eye injury
Non-traumatic chest pain
Precautions for Ketamine Answer- Be prepared for advanced airway management.
Rapid IV administration is associated with respiratory depression, apnea, and higher
then usual blood pressure.
May increase schizophrenic symptoms.
Behavioral emergency- Ketamine dose Answer- 400mg IM
May repeat 1x prn in 5 minutes
Pediatric Moderate or Severe Behavioral Emergency Answer- Droperidol 0.1mg/kg
IV/IO/IM
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