Mock Exam Part 1, #1-15 Reviewer Flashcards
primary indication for temporary transcutaneous pacing
bradycardia with hemodynamic compromise
until a more definitive pacing method can be established
indication for temporary transvenous pacemaker placement (not transcutaneous)
asystole
overdrive pacing in unresponsive VTach
Unresponsive recurrent sinus pauses (>3 s)
alternating bundle branch block
consider in RBBB with anterior or posterior hemiblock
when performing synchronized cardioversion, at which phase of the QRS complex should the shock be delivered?
on the R wave
“peak of the QRS complex”, “highest point of the R-wave”
synchronized cardioversion for atrial flutter
may require as little as 25-50 J
synchronized cardioversion for atrial fibrillation
150-200 J
(or 120-200 J)
A fib is narrow-complex, irregular.
But if narrow-complex, regular (SVT): 50-100 J
MOA of adenosine
inhibition of the conduction through the AV node, interrupting the reentry circuit responsible for SVT
6 mg - 12 mg - 12 mg
other drugs that block AV nodal conduction
verapamil, diltiazem
esmolol, metoprolol, propranolol
(table 18-2)
antiarrhythmic of choice for the stable wide-complex tachycardia
procainamide
if unstable –> electrical cardioversion, start at 100 J
preferred acute pain management for the patient with severe abdominal pain due to suspected kidney stones
ketorolac
“Agents such as NSAIDs should be considered for mild to moderate pain or when targeting severe pain originating from smooth muscle spasm such as renal or biliary colic
In specific instances such as renal and biliary colic, although parenteral NSAIDs may control severe pain, combination therapy with an opioid is usually superior.
before administering procedural sedation, what is the most important aspect to assess in the patient
allergies to medications
TRUE or FALSE
don’t give propofol in those with soy allergies
FALSE
“Propofol’s only TRUE immunologic contraindication is an allergy to the drug itself.”
A pediatric patient requires procedural sedation. What medicaiton is preferred for procedural sedation in children due to its safety profile and rapid onset
ketamine
- also the combination of anesthesia, analgesia, and amnesia is suitable for kids
almost universally preferred anxiolytic for minor procedures in children
midazolam, because of its rapid onset and short duration of action
sedative that can cause hallucinations and dissociation
ketamine
- derivative of the drug phencyclidine and is an NMDA glutamate receptor antagonist
critical dosing threshold of ketamine, above which characteristic dissociative state appears
1.0 to 1.5 mg/kg IV
or 3 to 4 mg/kg IM
no observable increased levels of depth beyond threshold, just increased duration of dissociative state
