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Medicine > Floor management knowledge > Flashcards

Floor management knowledge Flashcards

1
Q

Concerning UOP…

A

Less than 0.5 ml/kg/hr

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2
Q

How to replete phos

A

drug is phos-lo. Give orally.

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3
Q

hemoperitoneum presentation

A

low-grade fever, abdominal pain, drop in crib, tachycardia

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4
Q

How to manage a transfusion reaction…

A

If mild, stop transfusing, give tylenol and benadryl. Wait and restart.

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5
Q

How much would you expect platelets to respond to transfusion?

A

Should go up by 10 units per pack.

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6
Q

When would you use a dobhoff for feeding?

A

long term

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7
Q

What is fioricet?

A

tylenol + caffeine + barbiturate

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8
Q

name of permanent drain for pulmonary effusion?

A

pleurX

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9
Q

decent alternative to vanc?

A

Doxy, but weak MRSA coverage.

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10
Q

what is a vesicant?

A

agent that causes chemical burns and blisters

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11
Q

threshold for a concerning UOP?

A

0.5 ml/kg/hr in any patient

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12
Q

what will happen with extended resuscitation with NaCl?

A

Plasma sodium content will increase and you may get hypernatremic

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13
Q

how to keep someone’s sodium constant?

A

half normal saline

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14
Q

when to worry about 0 UOP after catheter being pulled

A

6 hours

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15
Q

problems with insulin drips

A

1) takes a while to get off. discharge barrier.

2) requires constant hourly checks

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16
Q

lovenox

A

enoxaparin

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17
Q

DVT treatment

A

lovenox

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18
Q

how to replace B12

A

IV cyanocobalamin

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19
Q

how to replace calcium

A
  • IV if severe/sympamtic

- oral if mild

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20
Q

calculating maintenance fluids

A

4 ml/kg/h for first 10 kg
2 ml/kg/h for second 10 kg
1 ml/kg/h for every additional kg

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21
Q

fluids to replace GI fluid losses

A

LR + NS

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22
Q

hyperkalemia on EKG management

A

exogenous sources of potassium, administration of a source of calcium ions (which will immediately oppose the myocardial effects of potassium), and administration of sodium bicarbonate (which, by producing a mild alkalosis, will shift potassium into cells)

23
Q

normal bicarb

A

22-28

24
Q

what to always think about with GI fluid loss

A

GI loss of bicarbonate

25
Q

concern with large ileostomy output

A

at risk for dehydration with hyponatremia + hypokalemia + non gap metabolic acidosis

26
Q

treatment of metabolic acidosis from GI fluid losses

A

fluid replacement

27
Q

treatment of hemolytic transfusion reactions

A

need to correct hypotension and oliguria with fluids and mannitol (need to prevent glomerular damage from hemolyzed red cell membranes)

28
Q

lassitude

A

fatigue

29
Q

management of ongoing bleeding from trach

A

1) reintubate with ETT + pull tract and compress innominate artery

30
Q

predictors of successful extubation

A

1) rapid shallow breathing index between 60 and 105
2) patient should be weaned to 5 cm H2) PEEP
3) RR less than 20
4) minute ventilation less than 10
5) negative inspiratory force at least greater than -20

31
Q

gas that can worsen abdominal distention

A

NO (causes progressive distention of air-filled spaces during prolonged anesthesia because it is only anesthetic less dense than air)

32
Q

ARDS diagnosis

A 
1) bilateral pulmonary infiltrates on CXR
OR 
PaO2/FiO2 less than 200
OR 
wedge pressure less than 18 mm Hg
33
Q

dopamine effects

A

1) increases coronary flow at all doses
low dose – dilation of renal and mesenteric vasculature, reducing blood flow to kidneys and bowel
moderate dose – B1 dominates + inotropic effect
high dose – alpha stimulation causes peripheral vasoconstriction

34
Q

respiratory distress following transufsion

A

TRALI

35
Q

TRALI presentation

A

respiratory distress + hypoxemia + bilateral pulmonary infiltrates

36
Q

treatment for TACO

A

diuretics

37
Q

treatment of TRALI

A

respiratory support, mechanical ventilation as needed

38
Q

treatment of cardiogenic shock secondary to MI?

A

positive isotropy with dobutamine (minimal chronotropic effect so only marginally increases myocardial O2 demand)

39
Q

acalculous cholecystitis pathophys

A

probably ischemia

40
Q

acalculous cholecystitis treatment

A

percutaneous drainage of the gallbladder

41
Q

pulsus paradoxus

A

decrease in SYSTOLIC BP by more than 10 mm Hg at the end of the INSPIRATORY phase of respiration

42
Q

major predictors of cardiac events

A 
Unstable angina
Recent MI
decompensated CHF
significant arrhythmias
severe valvular disease
43
Q

initial treatment of neurogenic shock

A
  • fluid resuscitation first

- vasoconstrictors (dopamine or phenylephrine)

44
Q

vitals with neurogenic shock

A

bradycardia (pts loss reflex increase in HR in response to hypotension)

45
Q

management of air embolism during central line placement

A

1) put patient in left lateral decubitus trendelenburg

2) aspirate central venous catheter

46
Q

pseudocholinesterase deficiency presentation

A

FH of prolonged effects of succinylcholine. Also happens with mivacurium.

47
Q

pre albumin vs. albumin

A
  • albumin has a long half-life so is a better indicator of long term nutritional depletion
  • pre albumin has a short half life so is a better indicator of short-term nutritional status
48
Q

respiratory quotient (RQ) tells you

A
  • composition of nutritional support
49
Q

rare but deadly complication of tracheostomy

A

tracheoinnominate artery fistula (TIAF)

50
Q

ddx of tracheoinnominate artery fistula (TIAF)

A
  • bronchoscopy in OR under anesthesia
51
Q

preop management of VW deficiency

A

give patient cryoprecipitate

52
Q

fioricet use

A

headaches (migraine and tension type)

53
Q

Xa inhibitors

A

Rivaroxaban

Fondaparinux

Medicine (71 decks)

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