On-Call pearls Flashcards
1
Q
on-call
Constipation
A
- Lactulose 30 ml PO qD
- Dulcolax
- Milk of magnesia 60ml PO
- Docusate 50-100 mg dD
2
Q
on-call
Diarrhea
A
- Lomotil 10 ml PO qD
- Imodium 4 mg PO x1
- —–Then 2 mg after each episode (16 mg/d max)
3
Q
on-call
Nausea/vomiting
A
- Phenergan 12.5 /25 mg PO/IV q6h, 4 mg IVP
- Ondansetron 4 mg IV over 2-5 mins, or 4 mg IM
4
Q
on-call
Dry eyes
A
natural Tears 1-2 drops QHS TID or QID
5
Q
on-call
Hypotension
A
- stop HTN meds
- NS or LR 250 ml-500ml bolus
- STAT H/H
- type and screen 2 units if unsure
- type and cross 2 units if sure
- –tylenol 650 mg 30 mins before transfussion
- –benadryl 25 mg PO 30 mins before transfusion
- –post-transfusion CBC in 6 hours
6
Q
on-call
Shock
A
- EKG + CXR + H/H
- pressor Dopamine 5 mcg/kg/min
- –Titrate to systolic >100 MAP>60, max of 20 mc/km/mim
- Levophed 8-12 mcg/min. Maintanance 2-4 mcg/min
7
Q
on-call
Hematuria
A
- clots?/pink?
- Stop Heparin, NOT Coumadin
- PT/PTT/INR
- 3-way Foley
- Continuous Bladder irrigation with 3 L free H2O
8
Q
on-call
Agitation
A
- Access reason, telemetry monitor?
- Orient
- Ativan 1 mg IV x 1
- Haldol 5 mg IM q4h PRN (geriatrics)
9
Q
on-call
Pain
A
- Lorbat 5-10 mg PO
- Percocet 5-10 mgPO
- Morphine 2-4 mg IV x 1
- Dilaudid 1 mg IV x 1 (0.5 if pt is frail)
10
Q
on-call
SOB
A
- Sats? Liters?
- Titrate nasal cannula 5-6 liters to >90%
- Nasal canula
- ventimask
- Non-rebreather
- Bipap (CHF/COPD): 50% 02, 12 Inspir and 6 Expir cm H2O
- Albuterol and Atrovert nebs=Duonebs
- Xopenex if pt has persistant tachycardia
- Lasix if wet (double dose of PO as IV form)
- —–get CXR, ABG, EKG, CBC/BMP
- if sudden aspiration, ask resp. Therapy to deep suction
11
Q
on-call
Post-Op-Fever
A
- Expect post-op fever in pt’s s/p Ortho procedures
- dont draw cultures, give Tylenol, unless POD>7
12
Q
on-call
HTN
A
- clonidine 0.2 mg PO x 1
- —PO q4h PRN SBP>160 DBP>100
- —Max. 0.5-0.7/day
- Lopressor 5 mg IV x 1
- Labetalol IV 10-20 mg x 1 (if they dont tolerate PO)
- ——-cardiac monitor
- Nitropaste 2 in to anterior chest wall
- Hydralazine 5 mg IVP x 1
13
Q
on-call
Hypokalemia
A
- KCL 40 meq PO (K Dur)
- KCL 40 meq + 250 ml NS over 4 hours (aka K ryder)
- Never >10 meq/h-it burns
- if K+ <3, K-Dur 40 meq PO+ Ryder 40 meq IV
- Each 10 meq increases K+ by 0.1
14
Q
on-call
Hypomagnesemia
A
- MagOx x TID iflow Mg
- Magnesium 2 g IV over 1 hour
15
Q
on-call
Hyperkalemia
A
- Kayexalate 60 g PO q 6h PRN
- calcium gluconate 1 amp
- Insulin 10 units + D50 1 amp
