NU340 Dose Calculations Quiz & Critical Care Infusions Quiz Review

NU340 Dose Calculations Quiz & Critical Care Infusions Quiz Review 1/ (x) kg if looking for mg/kg/hr (or something similar), write equation as _____ (x) kg / 1 if looking for mL/hr (or something similar), write equation as _____ mcg / (kg x min) if mcg/kg/min (or something similar), then write equation as mcg _____ Morphine Sulfate which medication? - opioid agonist, schedule II, high alert - Onset: route-dependent (SC = 20 min; IM = 10-30 min; IV = rapid) - Function/Mechanism of Action: analgesia (binds to opioid receptors in CNS; alters perception & response to painful stimuli while producing generalized CNS depression) - Administration: PO, SC, IM, IV, rectal // dilute IVP with 5 mL NS // administer over 5 min - Adverse Effects: respiratory depression, prolonged sedation, confusion, hypotension, n/v, constipation - Other Considerations/Monitoring: Naloxone (Narcan) = reversal agent; use cautiously with head trauma; monitor pain, LOC, RR, HR, BP Fentanyl (Sublimaze) which medication? - opioid agonist, schedule II, high alert - Onset: route-dependent (IM = 15 min; IV = 1-2 min) - Function/Mechanism of Action: analgesia, supplemententation of anesthesia/sedation (binds to opioid receptors in CNS; alters perception & response to painful stimuli while producing generalized CNS depression) - Administration: IM, IV, transdermal // administer over 1-3 min - Adverse Effects: respiratory depression, apnea, laryngospasm, sedation, confusion, hypotension, bradycardia, constipation, muscle rigidity - Other Considerations/Monitoring: Naloxone (Narcan) = reversal agent; avoid if had MAOIs in last 14 days; monitor pain, LOC, RR, HR, BP Oxycodone which medication? - opioid agonist, schedule II, high alert - Onset: route-dependent (PO = 10-15 min) - Function/Mechanism of Action: analgesia (binds to opioid receptors in CNS; alters perception & response to painful stimuli while producing generalized CNS depression) - Administration: PO, rectal - Adverse Effects: respiratory depression, sedation, confusion, constipation - Other Considerations/Monitoring: Naloxone (Narcan) = reversal agent; monitor pain, LOC, RR, HR, BP Hydromorphone (Dilaudid) which medication? - opioid agonist, schedule II, high alert - Onset: route-dependent (PO = 30 min; IM = 15 min; IV = 10-15 min) - Function/Mechanism of Action: analgesia (binds to opioid receptors in CNS; alters perception & response to painful stimuli while producing generalized CNS depression), antitussive (suppresses cough reflex via direct central action) - Administration: PO, IM, IV - Adverse Effects: respiratory depression, sedation, confusion, constipation, hypotension - Other Considerations/Monitoring: Naloxone (Narcan) = reversal agent; avoid if had MAOIs in last 14 days; monitor pain, LOC, RR, HR, BP Propofol (Diprivan) which medication? - NMDA receptor agonist, sedative - Onset: rapid (~40-60 secs) // very short half life - Function/Mechanism of Action: intubation, procedural sedation, continuous sedation, antiemetic effects // no analgesic properties (not effective in helping manage pain) - Administration: IV // titrated to patient response - Adverse Effects: allergic reactions (soybean & egg products), respiratory depression, apnea, hypotension; pain, burning, stinging of site - Other Considerations/Monitoring: propofol infusion syndrome (collection of metabolic abnormalities & organ system failures; tends to happen in patients on high doses for > 48 hrs & on vasopressors; sends patient into sudden cardiac failure (cardiogenic shock, metabolic acidosis, hepatic failure, renal failure, rhabdomyolysis); supportive therapy is tx); change IV tubing q 12 hrs (contains lots of lipids & calories, which increase risk of infection); monitor RR, HR, BP, triglyceride levels; maintain patient airway & adequate ventilation; patient must be intubated if infusion is running (causes respiratory depression) Dexmedetomidine (Precedex) which medication? - sedative, hypnotic, anxiolytic, anesthesia - Onset: rapid - Function/Mechanism of Action: selective alpha adrenergic agonist with sedative properties; sedates initially-intubated & mechanically ventilated - Administration: IV - Adverse Effects: hypotension, bradycardia, sinus arrest, AV blocks, ventricular dysfunction // doesn't cause respiratory depression (patients don't need to be on ventilator) - Other Considerations/Monitoring: contraindicated with chemotherapy; monitor HR, BP, ECG Midazolam (Versed) which medication? - antianxiety, anticonvulsant, sedative/hypnotic, high alert - Onset: route-dependent (IN = 5 min, IM = 15 min, IV = 1.5-5 min) - Function/Mechanism of Action: produces generalized CNS depression (such as short-term sedation, postoperative amnesia, termination of seizure activity); effects can