NRNP6566 KNOWLEDGE CHECK WEEK 8

NRNP6566 KNOWLEDGE CHECK WEEK 8 QUESTION 1 1. A 77 year old man fell and suffered a laceration across his upper right lip. The APRN decides to utilize a block for pain control which suturing the laceration. What type of block and what medication would be appropriate for this patient? For upper lip laceration, an infraorbital nerve block can be used. The anesthetic of choice is plain lidocaine but if there are profuse bleeding externally, epinephrine can be added for better hemodynamic control. Once anesthesia is achieved, irrigate the area with saline. Lidocaine 2% should be used as nerve blocks for intraoral and superficial procedures. Adding epinephrine produces vasoconstriction. The dose for lidocaine with epinephrine is 7mg/kg with a maximum dose of 500 mg QUESTION 2 1. A 13 year old girl is evaluated in urgent care for a large wound on her left forearm. She complains of severe pain, is crying, and is rocking on the bed due to pain. The APRN is planning on how to repair the laceration and is considering utilizing ketamine for procedural sedation. What are the benefits and risks of this drug? What monitoring would be indicated if utilized? QUESTION 3 1. A 66 year old women in the ICU is diagnosed with delirium. What would be the best approach to treating her delirium? NRNP6566 KNOWLEDGE CHECK WEEK 8 Ketamine has several advantages over other sedatives for procedural sedation. According to Buck (2016), the use of ketamine results in only minimal respiratory depression with preserved or exaggerated pharyngeal and laryngeal reflexes. It also results to normal or slightly increased muscle tone with minor increase in BP, heart rate and cardiac output (Buck, 2016). Additionally, it is rapid acting as an anesthetic with analgesic properties. Some potentially life-threatening adverse effects have been associated with ketamine, although rare. These include laryngospasm, apnea, impaired cardiac function, increased intracranial pressure and diabetes insipidus so the patients should be carefully monitored for these (Buck, 2016). Reference Buck, M. L. (2016). Ketamine infusions for pediatric sedation and analgesia. Pediatric Pharmacotherapy, 22(6). content/uploads/sites/237/2015/12/June16_Ketamine_PedP