Electrolytes

Question 0

Calcium Chloride

Indications

Answer 0

Mag antidote
CaChannel blocker OD
Acute hyperK (no dig)
Acute hypoCa
2nd choice--Beta blocker OD
Pretreat for CCB therapy
CA Renal failure

Question 1

Calcium Chloride

P-Dyn

Answer 1

Stabilizes myocardial cell membrane
Essential for contractility/coag
Increased squish
!!Mag antidote!!

Question 2

Calcium Chloride

A/S

Answer 2

Brady/blocks
Asystole
Hypotension

Question 3

Calcium Chloride

Contraindications

Answer 3

VF-Relative (yes hyperK/renal)
Dig toxicity
HyperCa
Renal/cardiac disease

Question 4

Calcium Chloride

Precautions

Answer 4

Extravasation=necrosis
Maybe vasospasm in coronary/cerebral arteries
SLOW IV push 100 mg/1 min
No scalp veins in peds

Question 5

Calcium Chloride

Interactions

Answer 5

Dig-Increased arrhythmias
Precipitate with Bicarb
Blunts CC blockers

Question 6

Calcium Chloride

Dose

Answer 6

500-1000 mg IV may repeat PRN q10

2-4 mg/kg may repeat PRN (pretreat for CCB therapy)

Question 7

Calcium Chloride

Peds Dose

Answer 7

20 mg/kg repeat q10 if indications persist

Question 8

Mag Sulfate

Class

Answer 8

Antiarrythmic
Anticonvulsant
Electrolyte

Question 9

Mag Sulfate

P-Dyn

Answer 9

Essential in ion movement
Decreased Acth release
Depresses smooth/skeletal/cardiac
Stabilizes excitable cell membranes
CNS depressant
Ca antidote

Question 10

Mag Sulfate

Indications

Answer 10

Torsades
Dig caused V-arrhythmias
Eclampsia seizures
Unresponsive status asthmaticus/severe COPD

Question 11

Mag Sulfate

A/S

Answer 11

CNS/resp depression
Brady/blocks
Decreased BP
Hypothermia
Flushing

Question 12

Mag Sulfate

Contraindications

Answer 12

Resp depression
Blocks
Shock
HypoCa
HyperMag

Question 13

Mag Sulfate

Precautions

Answer 13

Dilute, caustic to veins
Impaired renal function
Pt on dig

Question 14

Mag Sulfate

Interactions

Answer 14

Increased effects of CNS depressants

Digitalis

Question 15

Mag Sulfate

Dose

Answer 15

Arrest 1-2 g/10 mL
Non-arrest 1-2 g/50-100 mL over 5-60
Eclampsia 2-4 g/50-100 mL over 2-5
Or 2-4 g IM divided doses
DIB 1-2 g over 20 min

Question 16

Mag Sulfate

Peds Dose

Answer 16

25-50 mg/kg (max 2g) IV/IO over 10-20

TdP
Hypomag
Asthma (rare)

Question 17

Sodium Bicarbonate

Class

Answer 17

Alkalinizing agent
Buffer
Electrolyte

Question 18

Sodium Bicarbonate

P-Dyn

Answer 18

Reacts with hydrogen to form water and CO2

Raises blood pH

Question 19

Sodium Bicarbonate

Indications

Answer 19

2ndary in HyperK to/with CC
TCA/ASA/Procainamide OD
DKA
Late/never in CA

In conjunction with CC in Ca/renal

Question 20

Sodium Bicarbonate

A/S

Answer 20

Alkalosis
Paradoxical acidosis (cerebral/cardiac depression)
Hypoxia
Electrolyte imbalance
Seizures

Question 21

Sodium Bicarbonate

Contraindications

Answer 21

Rare in emergencies

Alkalosis

Question 22

Sodium Bicarbonate

Interactions

Answer 22

Deactivates catecholamines/vasopressors

Precipitates with calcium

Question 23

Sodium Bicarbonate

Dose

Answer 23

1 mEq/kg

Repeat 0.5 mEq/kg q 10

Question 24

Sodium Bicarbonate

Peds Dose

Answer 24

1 mEq/kg

0.5 mEq/kg q 10

Question 25

Hypercalcemia-ECG

Answer 25

Shortened QT interval
Inc PRI, QRS
T wave flattening
AV blocks/BBB

Question 26

Hypercalcemia-ECG

Answer 26

Inc QT interval

Inc R on T probability

Question 27

Hypermag-ECG

Answer 27

Inc PRI/QRS
Elevated T waves
3rd degree block
Asystole

Question 28

Hypomag-ECG

Answer 28

Diminished amplitude of P and QRS
Inc PRI/QRS/QT
ST changes
Flat/wide T waves
U wave presence

Question 29

HypoK-ECG

Answer 29

Decreased/flat T waves
U waves
ST depression
Inc PRI/QRS/QT interval
Bradydysrhythmias
AV block/disassociation
VT

Question 30

HyperK-ECG

Answer 30

Changes correlate with degree
Tall/peaked T waves
Inc PRI/QT interval
Flat P and ST
Wide QRS
VF, asystole