Emergency medication for shock, cardiac arrest, and anaphylaxis

Question 1

Norepinephrine

Adverse effects

Answer 1

Headache, palpitations, nervousness, epigastric distress

Angina, HTN, tissue necrosis with extravasation

Question 2

Norepinephrine

Nursing considerations

Answer 2

Vasoconstrictor to inc. BP and cardiac output. Monitor BP.
Reflex bradycardia may occur with rise in BP. Client should be attended at all times. Monitor urinary output. Infuse w dextrose solution, not saline. Protect medication from light.

Question 3

Dopamine

Adverse effects

Answer 3

Increased ocular pressure, ectopic beats, nausea. Tachycardia, chest pain, dysrhythmias.

Question 4

Dopamine

Nursing Considerations

Answer 4

Low dose dilates renal and coronary arteries. High dose vasoconstrictor, increases myocardial oxygen consumption. Headache is an early symptom of drug excess. Monitor BP, peripheral pulses, urinary output. Use infusion pump.

Question 5

Epinephrine

Adverse Effects

Answer 5

Nervousness, restlessness, dizziness, local necrosis of skin

Question 6

Epinephrine

Nursing considerations

Answer 6

Stimulates alpha and beta adrenergic receptors. Monitor BP. Carefully aspirate syringe before IM & SC doses; inadvertent. IV admin can be harmful. Always check strength, 1:100 only for inhalation, 1:1000 for parenteral admin (SC or IM). Ensure adequate hydration.

Question 7

Isoproterenol

Adverse effects

Answer 7

Headache, palpitations, tachycardia, changes in BP, angina, bronchial asthma, pulmonary edema.

Question 8

Isoproterenol

Nursing Considerations

Answer 8

Stimulates beta 1 & beta 2 adrenergic receptors
Used for Heart Block, Ventricular arrhythmias, and bradycardia. Bronchodilator used for asthma and bronchospasms. Don’t give at hs( @ bedtime)- interrupts sleep patterns. MONITOR BP, PULSE

Question 9

Phenylephrine

Adverse Effects

Answer 9

Palpiations, Tachycardia, Hypertension, Dysrhythmia, angina, Tissue necrosis with extravasation

Question 10

Phenylephrine

Nursing Considerations

Answer 10

Potent alpha 1 agonist

Used to treat hypotension

Question 11

Dobutamine hydrochloride

Adverse Effects

Answer 11

Hypertension, PVCs, Asthmatic episodes, Headache

Question 12

Dobutamine hydrochloride

Nursing Considerations

Answer 12

Stimulates beta 1 receptors. Incompatible with alkaline solutions ( sodium carbonate). Administer through central venous catheter or large peripheral vein using an infusion pump.
DON’T infuse through line with other meds (incompatible). MONITOR EKG, BP, I & O, serum potassium

Question 13

Milrinone

Adverse Effects

Answer 13

Dysrhytmia, Thrombocytopenia, Jaundice

Question 14

Milrinone

Nursing Considerations

Answer 14

Positive inotropic agent

Smooth muscle relaxant used to treat severe heart failure

Question 15

Sodium nitroprusside

Adverse Effects

Answer 15

hypotension, Increased Intracranial pressure

Question 16

Sodium nitroprusside

Nursing Considerations

Answer 16

Dilates cardiac veins and arteries. Decreases preload and afterload. Increases myocardial perfusion. Keep medication in dark after fixed. Use infusion pump.

Question 17

Diphenhydramine HCl

Adverse Effects

Answer 17

Drowsiness, confusion, insomnia, headache, vertigo, photosensitivity

Question 18

Diphenhydramine HCl

Nursing Considerations

Answer 18

Blocks effects of histamine on bronchioles, GI tract, and blood vessels

Question 19

Emergency Medications for Shock, Cardiac Arrest, and Anaphylaxis

Answer 19

Actions: varies with med
Indications: Hypovolemic shock, cardiac arrest, anaphylaxis
Adverse effects: serious rebound effect may occur, balance between underdosing and overdosing
Nursing Considerations: Monitor vital signs, measure urine output, assess for extravasation, observe extremities for color and perfusion