AG-ACNP - COMMON PROBLEMS IN ACUTE CARE/ ACNP BOARD
REVIEW WITH COMPLETE SOLUTION A+ 2026 GUARANTEED PASS
Ipecac indications
At home, immediate forced emesis of SOLID ingestants
Acetaminophen toxicity s/s
24-48 hrs - nausea, vomiting
RUQ pain
Hepatoxicity - jaundice, elevated lfts
Acetaminophen toxicity management
GI lavage
Activated charcoal 1 gm/kg q4 hrs
N-Acetylcysteine (Mucomyst) PO PRN
Hyperkalemia causes
MACHINE
Meds - NSAIDS, ACE Inhibitors
Acidosis
Cellular destruction, death - trauma, burns
,Hypoaldosertonism
Intake increase
Nephron damage; renal failure
Excretion impaired
Hyperkalemia s/s
MURDER
Muscle weakness, flaccid paralysis
Urine output decrease
Respiratory distress
Diarrhea, decreased FOC
EKG changes - tall, peaked T waves, bradycardia
Reflexes increased
Hyperkalemia moderate management
Kaexalate - exchange resins
Hyperkalemia severe >6.5 meq/L or flaccid paralysis
Insulin 10 U with one amp D50 - pushes K back into cell
,Calcium
Mediator of neuromuscular and cardiac function
Normal total calcium level
8.5-10.5 mg/dl
Normal Ionized calcium level
4.5-5.5 mg/dl
Calcium to monitor when albumin is out of normal range
Ionized calcium - does not vary with the albumin level
Total calcium is 50% bound to albumin - normal calcium level in
hypoalbuminemia = HYPERCALCEMIA
Acidemia and calcium
Acidemia INCREASES calcium
Alkalemia and calcium
Alkalemia DECREASES calcium
, Hypocalcemia causes
Hypomag
Hypoparathyroidism
PANCREATITIS
Renal failure
Trauma
Hypocalcemia s/s
CATS go numb - NOT ENOUGH SEDATIVE
Convulsions
Arrythmias - >QT prolongation
Tetany - Trousseau, Chvostek (cheek)
Seizures
Numbness, tingling
Hypocalcemia treatment
Acute hypocalcemia
IV calcium gluconate
Chronic
Vitamin D
Calcium supplements
REVIEW WITH COMPLETE SOLUTION A+ 2026 GUARANTEED PASS
Ipecac indications
At home, immediate forced emesis of SOLID ingestants
Acetaminophen toxicity s/s
24-48 hrs - nausea, vomiting
RUQ pain
Hepatoxicity - jaundice, elevated lfts
Acetaminophen toxicity management
GI lavage
Activated charcoal 1 gm/kg q4 hrs
N-Acetylcysteine (Mucomyst) PO PRN
Hyperkalemia causes
MACHINE
Meds - NSAIDS, ACE Inhibitors
Acidosis
Cellular destruction, death - trauma, burns
,Hypoaldosertonism
Intake increase
Nephron damage; renal failure
Excretion impaired
Hyperkalemia s/s
MURDER
Muscle weakness, flaccid paralysis
Urine output decrease
Respiratory distress
Diarrhea, decreased FOC
EKG changes - tall, peaked T waves, bradycardia
Reflexes increased
Hyperkalemia moderate management
Kaexalate - exchange resins
Hyperkalemia severe >6.5 meq/L or flaccid paralysis
Insulin 10 U with one amp D50 - pushes K back into cell
,Calcium
Mediator of neuromuscular and cardiac function
Normal total calcium level
8.5-10.5 mg/dl
Normal Ionized calcium level
4.5-5.5 mg/dl
Calcium to monitor when albumin is out of normal range
Ionized calcium - does not vary with the albumin level
Total calcium is 50% bound to albumin - normal calcium level in
hypoalbuminemia = HYPERCALCEMIA
Acidemia and calcium
Acidemia INCREASES calcium
Alkalemia and calcium
Alkalemia DECREASES calcium
, Hypocalcemia causes
Hypomag
Hypoparathyroidism
PANCREATITIS
Renal failure
Trauma
Hypocalcemia s/s
CATS go numb - NOT ENOUGH SEDATIVE
Convulsions
Arrythmias - >QT prolongation
Tetany - Trousseau, Chvostek (cheek)
Seizures
Numbness, tingling
Hypocalcemia treatment
Acute hypocalcemia
IV calcium gluconate
Chronic
Vitamin D
Calcium supplements
