WITH CORRECT ANSWERS
(GRADED A)
What is the clinical use for neuromuscular blockades? - Answer-Generally they are
reserved for patients with severe, refractory, or life threatening hypoxemia who are not
responsive to other sedatives or analgesics
What is Succinylcholine? - Answer-It is a paralytic used during intubation with a rapid
onset (30-60 seconds) but a short duration (4-10 min)
What should be given before NMD's are given? - Answer-Make sure the patient gets
pain and sedation medication first! Side note: Dexmedetomidine should not be used for
sedation with NMD due to light sedative properties
Titrate dose of non depolerizing NMD agent to achieve how many twitches? - Answer-
1/4 or 2/4 which is 85%-90% if blocked receptors
Which pressor should be used to bridge the pressor before propofol is given? - Answer-
Phenylephrine
Which pressor is used first line for sepsis? - Answer-Norepinephrine
Which pressor is primarily used for right sided heart failure? (after-load reduction) -
Answer-Milrinone
Why should an extra dose of Flolan be with you while administering a dose and what is
its indication of use? - Answer-Flolan is used for pulmonary arterial hypertension and
you will need an extra dose because its half like is only 6 seconds
What is the greatest sign that a patient is deteriorating neurologically? - Answer-Loss of
consciousness
Which pressor does not have an immediate effect on heart rate? - Answer-
Norepinephrine
Is Epinephrine a positive or negative inotrope or chronotrope and what does that mean?
- Answer-Epinephrine is a positive inotrope which means that it straightens the hearts
contractility.
, ACE inhibitors, clavidepine and nipride are vasodilators that will decrease or increase
what? - Answer-Decrease after-load
Milrinone, Epinephrine, dopamine, and dobutamine act as inotropes or chronotropes for
what? - Answer-Inotropes for contractility
qSOFA will be positive if it has two or more of which criteria? - Answer-Increased
respiratory rate, altered mentation, and low blood pressure
Vasopressin is a vasodilator or vasoconstrictor? - Answer-Vasoconstrictor
Norepinephrine, phenylephrine, and dopamine dilate or constrict arteries to do what? -
Answer-They constrict arteries to increase afterload
What are a couple of ways to decrease preload? - Answer-Give nitroglycerin, give
diuretics, or start CRRT
What are a couple of ways to increase preload? - Answer-Give crystalloids, colloids or
blood products
Which way to SvO2 and Cardiac output trend? - Answer-They trend in the same
direction
How is MAP calculated? - Answer-Cardiac Output times Resistance
What is a normal SvO2 - Answer-60%-80%
How does hypovolemic shock effect preload and after-load?
What is the Physical assessment?
What is the treatment? - Answer-Decreases preload because patient is dehydrated,
veins are dilated. Increased after-load (SNS, RAAS)
Patient would be cool and clamped down, tachycardia, low urine output, thirsty, dry
mucus membranes, and narrowing pulse pressure
Treatment: includes giving a fluid bolus or blood and then the compensatory
mechanisms will reverse
How does distributive shock effect preload and after-load and contractility?
What is the Physical assessment?