Module 2 Discussion

Question 1

What are the 4 stages of alcohol withdrawal

Answer 1

minor withdrawal symptoms
hallucinosis
withdrawal seizures
tremens

Question 2

when does minor withdrawal symptoms occur?

Answer 2

6-12 hours

Question 3

what does minor alcohol withdrawal symptoms include

Answer 3

tremors, sweating, N/V, HTN, tachy, hypertehermia, tachypnea

Question 4

when does alcholic hallucination occur or stage 2

Answer 4

12-24 hours

Question 5

when does stage 3 seizures occur

Answer 5

24-48 hours

Question 6

when does delirium trememns occur

Answer 6

48-72 hours

Question 7

what is included in delirium trememns

Answer 7

delirium, psychosis, hallucinations, hypertehermia, malignant hypertension siezures and coma

Question 8

what differentiates DTs from alcoholic hallucinsosi

Answer 8

presence of disorientation

Question 9

out of lorazepam and diazepam which drug is favored for the elderly or pts with severe liver or respiratory failoure

Answer 9

lorazepam because it has fewer metabolites

Question 10

what can prevent DTs

Answer 10

early intervention of EtOH withdrawal

Question 11

what is the benefit of diazepam

Answer 11

longer duration

Question 12

what is the LOU at minimum for acute withdarawl

Answer 12

potentially unstable

Question 13

what is mortalitly from regarding DTs

Answer 13

hyperthermia
severe HTN
cardiac arrhythmias
seizure complications

Question 14

what three things occur during anaphylaxis

Answer 14

capillary permeability
peripheral vasodilation
constricton of smooth muscles

Question 15

how many systems must be included for anaphylaxis to be diagnosed

Answer 15

2

Question 16

what is important regarding d/c of anaphylaxis patients

Answer 16

d/c teaching about possibility of reurrence of symptoms up to 3 days

Question 17

what are biphasic reactions in anaplhylaxis

Answer 17

occur 1-8 huours after risk 20%

Question 18

What effects does epinephrine have

Answer 18

alpah effects, beta 1 and 2

Question 19

what is a chronotrope

Answer 19

increased HR

Question 20

what is an inotrope

Answer 20

increased contractility

Question 21

what alpha effects does epi have

Answer 21

incresed vasoconstriction and peripheral vascularar resistance
decreased mucosal edema

Question 22

what beta one effects does epi have

Answer 22

increased HR and inotropic effects

Question 23

what beta 2 effects does epi have

Answer 23

bronchodilation and decreased histamine release from the mast cells and basophils

Question 24

where and how is epi administred

Answer 24

vastus lateralis (thigh)
IM

Question 25

what drugs are given in anaphylaxis

Answer 25

epi, antihistamines, corticosteroids,

Question 26

why are antihistamines given in anaphylaxis

Answer 26

help treat cutaneous symtpoms - hives/itchiness

Question 27

Interventions for sepsis

Answer 27

preload mamangement - 30cc.kg in first 3 hours
inotrope - norepi is first line amintain MAP above 65
cardiac monitor for dsyrhtmias associated with acidosis and shock
IV abx within 1 hour
high flow O2
frequent ABG
ecntral and arterial line
oactate within 30 mins

Question 28

if sepsis is showing signs of cardiogenic shock which drug should eb given

Answer 28

dobutamine

Question 29

when should a second lactate be done, which teim interval

Answer 29

within 30 mins repeat in 2-4 hours if intiial value greater or equal to 4mmol/L

Question 30

what does a high CD4 count mean

Answer 30

high viral load

Question 31

what CTAS score should be given witto a patient with a high CD4 coutn

Answer 31

2