Term
| Amiodarone with Coumadin and digoxin |
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Definition
| Amniodarone increases Coumadin and Dig! (Lower Coumadin and Dig by 50% when taking amnio) |
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Term
| Treatment for Bradycardia |
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Definition
Atropine 0.5 mg IV/SQ (Also IM/ETT)
Epinephrine 2-10 mcg/min til cows come home |
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Term
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Definition
1-2 sec IV bolus, must immediately flush line w/ NS
Need 2 nurses by the line! |
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Term
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Definition
| Delays repolarization/extends refractory period (K channel blocker) |
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Term
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Definition
Sodium channel blockers (Lidocaine/Quinidine)
Beta blockers (-olol)
Potassium channel blockers (Amnio)
Calcium channel blockers (Cardizem)
Covert |
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Term
| ACLS pathway = Lidocaine dosage/parameters |
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Definition
| Give this antiarrhythmic during CPR: Lidocaine: 1-1.5 mg/kg first dose, then 0.5-.75, max 3 doses (3mg/kg) |
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Term
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Definition
| Clot/stroke, heart failure |
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Term
| Dextran effectiveness/management |
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Definition
2g/min large bore IV
Lowers viscosity
Caution in renal problems
Watch for anaphylaxis and fluid overload |
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Term
| IV fluids that shift fluid |
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Definition
| Colloids (Albumin, Plasma Proteins, Dextran, Hetastarch) |
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Term
| NE administration considerations |
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Definition
Correct hypovolemia 1st
HRF extravasation
Duration 1-2 min
OD: Photophobia, blurry vision
Beta blockers and TCA's lower NE |
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Term
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Definition
Increases PT/PTT
Flu-like s/s 3-5 days post-tx
HRF fluid overload and anaphylaxis |
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Term
| Dopamine administration considerations |
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Definition
Low dose: 2-3 mcg/kg/min (renal)
High dose: 5-10 mcg/kg/min (contract)
HRF dysrhythmia, HTN, ensure patent IV
Want CO and UOP to increase |
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Term
| Sepsis protocol (how to recognize, nurse actions if recognized from ED protocol) |
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Definition
SIRS: >2 of: >38/<36, <90 BPM, >20 RR, WBC >12000/<4000, >10%
Sepsis: SIRS w/ confirmed cause
Severe Sepsis: Sepsis + >1 s/s organ dysfunction, low BP, poor perfusion |
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Term
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Definition
Should see increased CO/UOP for cardiogenic shock
Might cause sinus tach |
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Term
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Definition
For Dopamine/NE extravasation
Give SQ all around the site 5-10mg + 10-15 mg NS |
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Term
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Definition
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Term
| Meds to prevent MI, angina, CVA |
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Definition
Prevent: Antiplatelet/anticoag, antihypertensive
In progress: Thrombolytics |
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Term
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Definition
Thombolytic w/in 3 h
(w/in 6h of an MI) |
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Term
| ACS protocol- med parameters, nurse actions |
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Definition
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Term
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Definition
| Contra with: Allergy, ED drugs, hypoTN, bradycardia, HF |
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Term
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Definition
10 mcg/min drip
Titrate 10 mcg/min q5min until pain-free, SBP <90 |
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Term
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Definition
| 1 in to wall 1 time if pain stops after SL. NO HAIRY CHESTS! |
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Term
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Definition
| Remember that it's in units |
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Term
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Definition
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Term
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Definition
| Vitamin K (6h) or Arixtra |
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Term
| INR, PT, aPTT (norms, assessments, mgmt if above/below therapeutic) |
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Definition
PT (12-15s) 1.5-2x
aPTT (21-35s) 1.5-2.5x
INR (2-3s) 3-4.5 if valve probs
If the times are low: Watch out for clots (DVT, SOB, doom)
If the times are very high: Watch out for bleed (Hematoma, LOC) |
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Term
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Definition
SQ love handles or 1-2 in. from umbilicus
Leave bubble, 3/8 in, 90 degrees, NO PORK ALLERGIES |
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Term
| Concern w/ switching from hep to coumadin |
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Definition
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Term
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Definition
| HRF bleed! CBC, HH, cerebral hemorrhage (LOC), dysrhythmias post-MI |
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Term
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Definition
Cerebral hemorrhage (LOC)
Dysrhythmias post-MI
Bleeding |
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Term
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Definition
Cranial hemorrhage
Aneurysm
BAD HTN
W/in 14 days trauma/sx
W/in 3 mo MI
W/in 21 days GI bleed
Glucose <40 or >400 |
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Term
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Definition
| Aspirin, Plavix, Repro, Integrelin |
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Term
| -statins (timing, side fx, contraindications, effectiveness) |
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Definition
Timing: Bedtime when chol is high (except Lipitor), take w/ food
Sfx: Renal fail d/t rhabdo, myalgia, myopathy. Increase fluids
Contra: Pregnancy, liver problems, grapefruit
Effective: Lowers LDL |
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Term
| Questran (Side fx, timing) |
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Definition
Timing: 1h b4 or 4-6h after other meds
Side fx: Constipation, osteoporosis, bleeding d/o, ADEK
*COMPLETELY mix powder |
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Term
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Definition
Low dose: 25 mg/d (Vit. B)
High dose: 2-3 g/d (lower chol)
Side fx: Hot flash/flush (pre-tx w/ ASA/Benadryl), hyperglycemia, hyperuricemia, hepatotoxicity |
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Term
| Fish oil (effectiveness, concerns) |
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Definition
Lowers trigs
Increases bleeding times
May actually increase LDL/VLDL |
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Term
| ACLS Pathway: Box about chest compressions |
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Definition
Push 100 BPM, full chest recoil
1 cycle: 30 compressions then 2 breaths
Rotate compressors q2min w/ rhythm checks
After an advanced airway is present, just do continuous chest compressions 8-10 breaths/min |
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Term
| ACLS Pathway: Box about epinephrine (Asystole/PEA) |
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Definition
Asystole/PEA: CPR 5 cycles
When IV/IO avaiable, give Epi 1 mg q 3-5 min
(May replace w/ Vasopressin 1 40U dose) |
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Term
| ACLS Pathway: Box about vasopressors |
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Definition
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Term
| ACLS Pathway: Box about epinephrine (VF/VT) |
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Definition
VF/VT: Do CPR then 1 shock, resume CPR and give Epi 1 mg IV/IO q 3-5 min when available
(May replace w/ Vasopressin 1 40U dose) |
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Term
| Sepsis protocol (how to recognize, nurse actions if recognized from ED protocol) |
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Definition
Early shock: Trendelenberg, 14-16g IV, NS, type/cross, O2
Late shock: Continue phase 1. Crystalloids, colloids, blood products |
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