ACPE, Croup, Allergic Reactions, Bronchoconstriction Flashcards
Can nitroglycerin be administered for an isolated posterior MI?
Yes
List some examples of Phosphodiesterase Inhibitors
Viagra, Levitra, Cialis, Revatio, Sildenafil, Tadalafil, Vardenafil, Udenafil, Lodenafil, Zaprinast, Icariin
You respond to a call - patient has CHF. Family member says they took a BP with their machine 5 minutes ago and was 88/58. Upon asking your partner to take vitals, their BP is now 105/62. Can you administer nitroglycerin?
No. Although they’re normotensive in that given moment, they’re at risk for recurrent decompensation (hypotension); contraindication for nitroglycerin conditions.
A patient is complaining of chest pain and also has CHF. Because of patient presentation, you must refer to the ACPE and Cardiac Ischemia MD’s. You are considering nitroglycerin (which falls under both directives). Pt is non-STEMI. How many times can you administer nitroglycerin?
6 MAXIMUM. Doesn’t matter if it’s under two separate directives. Per companion document:
“Pt may NOT receive 6 doses for pulmonary edema and 6 more doses for cardiac ischemia symptoms should they co-exist.”
Is a 12 or 15 lead acquisition and interpretation required for nitro administration UNDER THE ACPE MD?
No. RVI’s normally don’t present with acute pulmonary edema. HOWEVER, whenever practical and possible, it’s still recommended to take one.
You perform a 12-lead on a patient with chest pain. You perform an V4R. You see elevation. Can you administer nitro?
Hell no
You give nitro to a patient experiencing ACPE (auscultated, heard crackles). Their SBP drops one-third and they are now hypotensive. Can you administer a fluid bolus? (Be mindful of fluid overload)
Yes, but once pt is normotensive, discontinue fluid bolus and withhold further doses of nitro.
Symptoms of Bronchoconstriction?
Wheezing, coughing, dyspnea, decreased air entry and silent chest.
What should your intent be when administering salbutamol MDI?
To deliver all 6 (pediatric) or 8 (adult) sprays to complete a dose.
1 dose = 6 puffs or 8 puffs (if MDI)
OR 2.5 mg or 5.0 mg (if NEB)
What is preferred for bronchoconstriction? MDI or NEB?
MDI. NEB can be considered if pt is unable to accept, or uncooperative. Also use PPE if using NEB.
Is urticaria enough as an indication for you to administer Epi IM as per the Moderate to Severe Allergic Reaction MD?
No. Patient MUST present with at least one other sign or symptom involving another organ system
OR
a severe symptom (i.e anaphylaxis)
Should you always administer diphenhydramine after epi administration?
Yes
Body System Involvement (Integumentary)
Hives, itching, flushing, swelling, angioedema
Body System Involvement (Cardiovascular)
Increased HR, decreased BP, syncope, hypoxemia, decreased LOC
Body System Involvement (Respiratory)
SOB, wheeze, cough, stridor
