Module 2 Discussion Flashcards
What are the 4 stages of alcohol withdrawal
minor withdrawal symptoms
hallucinosis
withdrawal seizures
tremens
when does minor withdrawal symptoms occur?
6-12 hours
what does minor alcohol withdrawal symptoms include
tremors, sweating, N/V, HTN, tachy, hypertehermia, tachypnea
when does alcholic hallucination occur or stage 2
12-24 hours
when does stage 3 seizures occur
24-48 hours
when does delirium trememns occur
48-72 hours
what is included in delirium trememns
delirium, psychosis, hallucinations, hypertehermia, malignant hypertension siezures and coma
what differentiates DTs from alcoholic hallucinsosi
presence of disorientation
out of lorazepam and diazepam which drug is favored for the elderly or pts with severe liver or respiratory failoure
lorazepam because it has fewer metabolites
what can prevent DTs
early intervention of EtOH withdrawal
what is the benefit of diazepam
longer duration
what is the LOU at minimum for acute withdarawl
potentially unstable
what is mortalitly from regarding DTs
hyperthermia
severe HTN
cardiac arrhythmias
seizure complications
what three things occur during anaphylaxis
capillary permeability
peripheral vasodilation
constricton of smooth muscles
how many systems must be included for anaphylaxis to be diagnosed
2
what is important regarding d/c of anaphylaxis patients
d/c teaching about possibility of reurrence of symptoms up to 3 days
what are biphasic reactions in anaplhylaxis
occur 1-8 huours after risk 20%
What effects does epinephrine have
alpah effects, beta 1 and 2
what is a chronotrope
increased HR
what is an inotrope
increased contractility
what alpha effects does epi have
incresed vasoconstriction and peripheral vascularar resistance
decreased mucosal edema
what beta one effects does epi have
increased HR and inotropic effects
what beta 2 effects does epi have
bronchodilation and decreased histamine release from the mast cells and basophils
where and how is epi administred
vastus lateralis (thigh) IM
what drugs are given in anaphylaxis
epi, antihistamines, corticosteroids,
why are antihistamines given in anaphylaxis
help treat cutaneous symtpoms - hives/itchiness
Interventions for sepsis
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
if sepsis is showing signs of cardiogenic shock which drug should eb given
dobutamine
when should a second lactate be done, which teim interval
within 30 mins repeat in 2-4 hours if intiial value greater or equal to 4mmol/L
what does a high CD4 count mean
high viral load
what CTAS score should be given witto a patient with a high CD4 coutn
2
