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Pharm 2 > Sedation IV > Flashcards

Sedation IV Flashcards

1
Q

IV drug administration types needles

A

Hollow Metal Needles
Scalp Vein Infusion Needles
Indwelling Catheters

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2
Q

Needle Gauge

A

The # of needles that can be placed into a 1 in circle

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3
Q

Needle gauges to use

A

18 - GA
20-23 Sedation, IM injections
25-27 LA
30 Accupuncture

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4
Q

Fluids used for IV drugs

A

LR lactated ringers
NS sodium chloride
5% dextrose in water
Sterile water for injection

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5
Q

Infusion rate for adults

A

10 drops = 1 ml

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6
Q

Infusion rate for pediatric

A

60 drops = 1 ml

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7
Q

Precaution to take with rigid IV needles

A

Immobilize the elbow

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8
Q

Complications: Venospasm

A

Vein disappear or collapses

Heat may help vein reappear

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9
Q

Complications: Hematoma

A

Extravasation of blood into surrounding tissues
Painless bluish discoloration
If happens: remove tourniquet, apply firm pressure, and then ice

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10
Q

Complications: Embolism

A

Pt can tolerate up to 1ml/kg of air
Eliminate air bubbles from tubing to prevent
Have pt head down and lying on left side

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11
Q

Complications: Over-hydration

A

Significant for CHF pts and children
Can cause pulmonary edema, tachycardia, inc BP
Prevent by calculated fluid deficit

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12
Q

Complications: Extravasation of drugs

A

Will have pain, delayed drug absoprtion, possibly tissue damage
Mgmt: remove needle, apply pressure
If gave > 2mL, inject 1% procaine

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13
Q

Complications: Intra-arterial Injection

A

Respond aggressively!!
Chemical insult–> spasm that compromises distal circulation
Best way to avoid is prevention
Assess blood color- bright cherry red vs dark red

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14
Q

Complications: Intra-arterial injection - MGMT:

A 
Leave needle in place, give 1% procaine
Hospitalize pt
Surgical endareterctomy
Heparinzation
Amputation of gangrenous limb is txt fails
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15
Q

Complications: Phlebitis and Thromboplebitis

A

Pain, edema, delayed onset
Mgmt: sling to limit limb activity
Elevate and heat limb
NSAIDs

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16
Q

Complications: Nausea

A

Tx w/ O2 and IV antiemetic

17
Q

Complications: Vomiting

A

Stop txt immediately and put pt on RIGHT side
IV antiemetic
Suction

18
Q

Complications: Emergence Delirium

A

Treat w/ scopolamine

19
Q

Emergency Scenarios: Airway Obstruction

A

Most common cause: Prolapsed tongue
MGMT: Head tilt chin lift if from prolapsed tongue
Remove debris if not from tongue
If pt is not breathing - THEN you have to breath for them

20
Q

Airways to fix airway obstruction

A 
Laryngeal Mask Airway
Combitube
King tube
Tracheal intubation
Surgical airway cricothyroidotomy
21
Q

LMA Indication

A

Alternative airway, difficult airway,
Can’t ventilate
Failed intubation
No laryngoscope

22
Q

LMA Advantages

A

Minimal training
Can use in peds
Least amount of tissue trauma
Can use to intubate

23
Q

Laryngospasm

A

Partial or complete closure of vocal cords due to irritation by foreign matter

24
Q

Crowing noise

A

Laryngospasm

25
Q

Laryngospasm mgmt

A 
Stop procedure
Deliver 100% O2
Position head
Protrude tongue and suction oro, naso, and hypo pharynx
Push on chest, listen for rush of air
Positive pressure O2
Succinylcholine if still unsuccessful
26
Q

Hypoglycemia

A

at 50-70 mg/dl –> CNS becomes excitable, nervousness, sweating, trembling
at 20-50 mg/dl –> convulsions, loss of consciousness, shock

27
Q

Hypoglycemia mgmt

A

If conscious- oral carbs, monitor, IV 50% dextrose if no response to oral carbs
If unconscious - get help, BLS, O2, administer carb, 50% dectros IV and Glucagon 1mg IM

28
Q

Allergy

A

Heightened response of the immune system
Broad range of onset
Affects multiple organ systes
If hypotension is involved– anaphylactic shock

29
Q

Commonly used drugs w/ allergic potential

A

Antibiotics
Antianxiety meds
Analgesics
LA

30
Q

Allergy: Clinical manifestations

A

CVS - pallor, lightheadedness, hypotension, tachycardia, loss of consciousness
GI - nausea, vomiting, severe abdominal cramping, diarrhea
Skin- urticaria, erythema, angioedema
Respiratory - follow skin but precedes CVS- Bronchospasm, angioedema of the larynx

31
Q 
Progressive respiratory and circulatory failure
Itching of nose and hands
Flushing of face
Labored breathing
Sudden hypotension
Cyanosis
Swelling of tongue, lips
A

Anaphylactic Shock

32
Q

Anaphylactic Shock mgmt

A

Epinephrine 0.1 mg IV
Antihistamine and steroid IM/IV
Transfer to hospital

33
Q

Asthma mgmt

A

position pt, administer bronchodilator
100% O2 by facemask
If not responsive, epi

34
Q

Opioid overdose mgmt

A

Naloxone - 0.4 mg/ml add 3 ml of saline = 0.1 mg/ml initial dose - fast acting but short lasting

35
Q

Benzodiazepine overdose mgmt

A

Flumazenil - 0.1 mg/ml- give initial dose of 0.2 mg

36
Q

Angina during procedure - mgmt

A

Terminate procedure
Position pt
supplemental O2
Administer nitroglycerine

37
Q

Myocardial Infarction mgmt

A 
Terminate procedure
Initiate EMS
Establish IV access
MONA
Be ready to do CPR
38
Q

MONA

A

Morphine for pain (nitrous can work too)
Oxygen
Nitroglycerine
Aspirin

Pharm 2 (11 decks)

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