CMN 577 Exam 3: Poisoning Questions
What drug may reverse benzodiazepine-induced coma? - CORRECT
ANSWER-Flumazenil
Flumazenil should not be used in patients? - CORRECT ANSWER-- Congested
a potential convulsant drug
- A user of high-dose benzo's
- Has a seizure disorder
-- Its use may precipitate seizures
How long after taking extended release bupropion overdose may the onset of
seizures occur? - CORRECT ANSWER-18-24 hours
What is the antidote for acetaminophen overdose? - CORRECT
ANSWER-Acetylcysteine (Mucomyst)
What lab tests are indicated in the overdose patient? - CORRECT ANSWER--
Measured serum osmolality and Osmal gap
- Electrolytes
- Anion gap
- Glucose
- Creatinine, BUN, creatinine kinase
- UA, and EKG
Charcoal can be given within what timeframe for acetaminophen overdose? -
CORRECT ANSWER-Within 1-2 hours of ingestion
A patient comes into the ER with severe agitation, psychosis, and starts having a
seizure.
What do you suspect and what is the initial treatment? - CORRECT ANSWER--
Suspect a drug overdose (amphetamines/cocaine).
- Tx w/ a benzo (diazepam, lorazepam)
Your amphetamine/cocaine overdose patient now has HTN. The nurse suggests
that you order a beta-blocker to treat the HTN.
, What do you as the provider tell the nurse? - CORRECT ANSWER-A
beta-blocker is not appropriate treatment in this case, as it may result in
paradoxical worsening of the HTN as a result of unopposed alpha-adrenergic
effects
What should be done immediately for a digitalis. Or another cardiac glycoside
overdose? - CORRECT ANSWER-- Administer activated charcoal, monitor
potassium levels and cardiac rhythm.
- Treat bradycardia initially with atropine
Iron overdose leads to hypotension. What can be done immediately to treat the
hypotension? - CORRECT ANSWER-IV crystalloid administration (NS or LR)
How long should a patient with seafood poisoning be observed, minimally? -
CORRECT ANSWER-4-6 hours
What are emergency measures that you would NOT do in a snake bite victim? -
CORRECT ANSWER-Do NOT give alcoholic beverages or stimulants, do NOT
apply ice, do not apply a tourniquet
What kind of spider bite can cause progressive local necrosis as well as
hemolytic reactions? - CORRECT ANSWER-Brown Recluse
When is it appropriate to treat HTN due to poisoning? - CORRECT
ANSWER-When patient is symptomatic, or their diastolic pressure is higher than
105-110
Hypotensive patients, due to poisoning, are best treated with immediate? -
CORRECT ANSWER-NS 200mL blouses, repeatedly. If not adequate, give
dopamine or norepinephrine
Hypotension caused by overdose of TCA's or sodium channel blockers,
administer? - CORRECT ANSWER-Sodium Bicarbonate
In hypotension d/t B.B. overdose, give? - CORRECT ANSWER-Glucagon
What drug may reverse benzodiazepine-induced coma? - CORRECT
ANSWER-Flumazenil
Flumazenil should not be used in patients? - CORRECT ANSWER-- Congested
a potential convulsant drug
- A user of high-dose benzo's
- Has a seizure disorder
-- Its use may precipitate seizures
How long after taking extended release bupropion overdose may the onset of
seizures occur? - CORRECT ANSWER-18-24 hours
What is the antidote for acetaminophen overdose? - CORRECT
ANSWER-Acetylcysteine (Mucomyst)
What lab tests are indicated in the overdose patient? - CORRECT ANSWER--
Measured serum osmolality and Osmal gap
- Electrolytes
- Anion gap
- Glucose
- Creatinine, BUN, creatinine kinase
- UA, and EKG
Charcoal can be given within what timeframe for acetaminophen overdose? -
CORRECT ANSWER-Within 1-2 hours of ingestion
A patient comes into the ER with severe agitation, psychosis, and starts having a
seizure.
What do you suspect and what is the initial treatment? - CORRECT ANSWER--
Suspect a drug overdose (amphetamines/cocaine).
- Tx w/ a benzo (diazepam, lorazepam)
Your amphetamine/cocaine overdose patient now has HTN. The nurse suggests
that you order a beta-blocker to treat the HTN.
, What do you as the provider tell the nurse? - CORRECT ANSWER-A
beta-blocker is not appropriate treatment in this case, as it may result in
paradoxical worsening of the HTN as a result of unopposed alpha-adrenergic
effects
What should be done immediately for a digitalis. Or another cardiac glycoside
overdose? - CORRECT ANSWER-- Administer activated charcoal, monitor
potassium levels and cardiac rhythm.
- Treat bradycardia initially with atropine
Iron overdose leads to hypotension. What can be done immediately to treat the
hypotension? - CORRECT ANSWER-IV crystalloid administration (NS or LR)
How long should a patient with seafood poisoning be observed, minimally? -
CORRECT ANSWER-4-6 hours
What are emergency measures that you would NOT do in a snake bite victim? -
CORRECT ANSWER-Do NOT give alcoholic beverages or stimulants, do NOT
apply ice, do not apply a tourniquet
What kind of spider bite can cause progressive local necrosis as well as
hemolytic reactions? - CORRECT ANSWER-Brown Recluse
When is it appropriate to treat HTN due to poisoning? - CORRECT
ANSWER-When patient is symptomatic, or their diastolic pressure is higher than
105-110
Hypotensive patients, due to poisoning, are best treated with immediate? -
CORRECT ANSWER-NS 200mL blouses, repeatedly. If not adequate, give
dopamine or norepinephrine
Hypotension caused by overdose of TCA's or sodium channel blockers,
administer? - CORRECT ANSWER-Sodium Bicarbonate
In hypotension d/t B.B. overdose, give? - CORRECT ANSWER-Glucagon
