BKAT ICU Post Test questions and answers with verified content

BKAT ICU Post Test questions and answers with verified content Nitroprusside purpose decreases preload and afterload by vasodilation (mainly afterload) Dobutamine mechanism of action contractility Dopamine at a low-end dose "renal dose" 0.5-4mcg/kg/min increases renal and mesentric perfusion Dopamine at a mid-range dose 4-10mcg/kg/min increases contractility and heart rate Dopamine at a high-range dose greater than 10mcg/kg/min vasoconstriction and increases BP Dopamine and Levophed infiltration leads to tissue necrosis Dopamine antidote regitine (phentolamine) TpA monitor for bleeding-hemorrhagic CVA diltiazem (cardizem) works by? (calcium channel blocker) slows ventricular rate by slowing conduction through the SA and AV node Diltazem (cardizem) biggest effect on which hemodynamic hypotension diltazem is used for patients with a-fib or a-flutter amiodarone (Cordarone) is a antiarrythmic prolongs the cardiac duration You MUST use a __________ when using amiodarone infusion 0.22 micron filter Watch out for ____________ in patients on a amiodarone infusion hypotension, prolongation of QT interval and bradycardia amiodarone is used for patients with a-fib, a-flutter and VT how much amiodarone is given to a stable VT with a pulse and a unstable pulseless VT/VF? 150mg over 10min for VT with pulse 300mg push; repeat x1 at 150mg Epinephrine has what effect on the body? increases HR, BP, and contractility what is the first line drug for pulseless arrest? Epinephrine What rhythms are considered fatal? V-fib, Vtach (pulseless), and asystole Epinephrine is also given for? anaphylaxis and as a vasopressor for hypotension Heparin is used for? Antidote is? anticoagulant Protamine Sulfate What is the osmotic diuretic of choice to decrease intracranial pressure? mannitol How does mannitol work? pulls fluids into intravascular space to be excreted by the kidneys to reduce intracranial pressure what insulin is given IV? What is the peak? Regular insulin can only be given IV 2-4 hr peak time Which insulin has a peak of 8-14 hrs? NPH Atropine is ineffective in which heart rhythms types? high degree AV blocks: 2nd degree type2 and 3rd degree Atropine works by? increasing heart rate-increasing conduction through SA node Atropine is given to treat? symptomatic bradycardia Dilantin is given to treat seizure disorders DO NOT give __________ with dilantin because ________ will happen. DO NOT give with dextrose containing solutions because it will crystalize Which corticosteroid is usually given in insufficient adrenal activity or hypersensitivity/inflammation reactions? Cortisone If chronically using cortisone be sure to _____ to prevent _____. If chronically using cortisone be sure to taper the medications to prevent acute adrenal insufficiency This medication is a cardiac glycoside that increases contractility. Digoxin Digoxin increases contractility by slowing the heart rate which decreases conduction through the AV node What should be monitored in patients taking Digoxin? hypotension, bradycardia, and symptoms of toxicity Signs/Symptoms of Digoxin toxicity nausea, yellow vision/halo, paroxysmal atrial tachycardia (PAT with block). True/Flase: Digoxin WILL NOT cause rapid AV conduction or hypertension True what medication is a antiarrhythmic that suppresses automaticity and depolarization? lidocaine Lidocaine is used to treat? ventricular dysrhythmias lidocaine toxicity sign mental confusion/change in LOC Monitor serum levels with _________ Lidocaine DO NOT give _______ medications to patients with suppressed respirations Narcotics (morphine, dilaudid) What changes on a EKG would you expect to see on a patient with a acute MI? ST elevation normal QRS: Prolonged QRS indicates: 0.12 seconds is normal QRS prolonged QRS indicates intraventricular conduction defect, typically a bundle branch block Distinguishing V-fib fibrillatory waves with no recognizable pattern Defib the Vfib Distinguishing V-Tach atrial rhythm and rate cannot be identified "Tombstones" First degree block interpretation looks like sinus rhythm but the PR is longer than normal. there will be 1 p for every qrs, but the PR interval will be greater than 0.20 sec Type 1 second degree block interpretation "Wenckebach" "Longer, Longer... drop" prolonged PR intervals and the missing QRS Type 2 second degree block interpretation PR interval is constant...QRS is missing "2 small p waves right after each other" give atropine, dopamine, or epi to increase HR is symptomatic bradycardic Third degree AV block interpretation a strip of p-waves laid independently over a strip of QRS complexes. Note that the p wave doesn't conduct the QRS complex that follows it.