Emergency Department IV Infusion Guidelines
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Questions and Answers

What is the recommended loading dose for this antiarrhythmic agent in cases of cardiac arrest?

  • 1 to 1.5 mg/kg (correct)
  • 4 mg/kg
  • 2 to 3 mg/kg
  • 0.5 to 0.75 mg/kg

    • What is the maximum cumulative dose for this antiarrhythmic agent?

  • 1 mg/kg
  • 4 mg/kg
  • 3 mg/kg (correct)
  • 2 mg/kg

    • In the case of severe toxicity from this antiarrhythmic agent, what is the available antidote?

  • Naloxone
  • IV lipid emulsion (Intralipid®) (correct)
  • Flumazenil
  • Activated charcoal

    • What potential side effect should be monitored for during administration?

    <p>Local thrombophlebitis</p> Signup and view all the answers

    Which of the following is a potential sign of CNS toxicity from this medication?

    <p>Circumoral numbness</p> Signup and view all the answers

    What is the typical onset time for labetalol after intravenous administration?

    <p>Within 5 minutes</p> Signup and view all the answers

    What is a potential cause of bradycardia?

    <p>Sinus pause</p> Signup and view all the answers

    What is the usual maximum cumulative IV dose of labetalol for severe hypertension?

    <p>300 mg</p> Signup and view all the answers

    In which situation should labetalol dosing be approached with caution?

    <p>In patients with hepatic dysfunction</p> Signup and view all the answers

    Which medication is used for inotropic support?

    <p>Dobutamine</p> Signup and view all the answers

    What is the recommended concentration for Dobutamine reconstitution?

    <p>12.5 mg/mL</p> Signup and view all the answers

    Which of the following is a recommended practice for continuous IV infusion of labetalol?

    <p>Monitor BP every 5 minutes at the beginning and with each dosage change</p> Signup and view all the answers

    What should be monitored before initiating Dobutamine if hypovolemia is present?

    <p>Fluid volume status</p> Signup and view all the answers

    What should be monitored regularly during the administration of labetalol?

    <p>Urine output and serum glucose</p> Signup and view all the answers

    What is the antidote available in case of Dobutamine extravasation?

    <p>Phentolamine</p> Signup and view all the answers

    What is the initial bolus dose of labetalol administered over 1-2 minutes for IV use?

    <p>10-20 mg</p> Signup and view all the answers

    What could a high-dose of labetalol potentially lead to?

    <p>Severe hypotension and bradycardia</p> Signup and view all the answers

    What is the initial dosing range for Dobutamine infusion?

    <p>0.5 to 5 mcg/kg/min</p> Signup and view all the answers

    What is a critical electrolyte disturbance to correct before using Dobutamine?

    <p>Hypokalemia</p> Signup and view all the answers

    What is the method of preparing a continuous infusion of labetalol?

    <p>Withdraw 10 mL from a 250 mL bag and add 60 mL of labetalol</p> Signup and view all the answers

    What is the onset time for Dobutamine after administration?

    <p>1-10 minutes</p> Signup and view all the answers

    What is the correct duration for the onset of immediate release PO diltiazem?

    <p>3 minutes</p> Signup and view all the answers

    What is the recommended frequency for monitoring blood pressure during a continuous IV infusion of diltiazem until hemodynamic stability is achieved?

    <p>Every 3 to 5 minutes for the first 15 minutes</p> Signup and view all the answers

    What is the appropriate action regarding fluid removal from the D5W or NS bag before preparing the continuous IV infusion of diltiazem?

    <p>No removal is required</p> Signup and view all the answers

    What is the maximum dose rate specified for continuous diltiazem IV administration as directed by a physician?

    <p>5-15 mg/h</p> Signup and view all the answers

    Which of the following is NOT a sign to observe for during diltiazem administration?

    <p>Frequent urination</p> Signup and view all the answers

    What is the maximum infusion rate for magnesium sulfate unless there is an urgent indication?

    <p>150 mg/min</p> Signup and view all the answers

    Which of the following conditions is a contraindication for administering anxiety medication?

    <p>Acute narrow-angle glaucoma</p> Signup and view all the answers

    What is the maximum allowable dose per hour for the administration of anxiety medication?

    <p>10 mg/h</p> Signup and view all the answers

    What potential side effect is linked to the rapid administration of magnesium sulfate?

    <p>Asystole</p> Signup and view all the answers

    What monitoring is recommended for direct IV administration of magnesium sulfate for ventricular arrhythmias?

    <p>Heart rate and ECG</p> Signup and view all the answers

    What is a potential effect of benzodiazepine therapy that should be considered before administration?

    <p>Anterograde amnesia</p> Signup and view all the answers

    How should the magnesium sulfate be administered for fluid-restricted patients?

    <p>IV over 1-5 hours</p> Signup and view all the answers

    What is the initial dose for continuous infusion of anxiety-reducing medication?

    <p>1-3 mg/h</p> Signup and view all the answers

    What is the maximum dose for the continuous IV infusion of Isoproterenol?

    <p>10 mcg/min</p> Signup and view all the answers

    What monitoring should be done every 5 minutes during the continuous IV infusion of Isoproterenol?

    <p>Blood pressure</p> Signup and view all the answers

    Which of the following is NOT recommended in the initial treatment of Isoproterenol?

    <p>Loading dose administration over 30 minutes</p> Signup and view all the answers

    When should the infusion site for Isoproterenol be monitored for extravasation?

    <p>Every 15 minutes</p> Signup and view all the answers

    What is the onset time for Isoproterenol administration?

    <p>Immediate</p> Signup and view all the answers

    What should be done if the patient has pre-existing ventricular arrhythmias?

    <p>Avoid administering Isoproterenol</p> Signup and view all the answers

    Which parameter should be monitored as per physician discretion during Isoproterenol treatment?

    <p>Serum potassium</p> Signup and view all the answers

    What is the recommended volume for the loading dose of Isoproterenol?

    <p>50 mL</p> Signup and view all the answers

    Study Notes

    Emergency Department Intravenous Infusion Guidelines

    • Initiation Time: Any infusion prepared on a nursing unit should be started within 1 hour of preparation and discarded 24 hours later for sterility reasons. Pharmacy-prepared infusions should be discarded according to label stability guidelines.

    Reconstitution, Concentration, and Doses for Common Indications in the ED

    • Drugs and Indications: Multiple medications are listed, each with specific reconstitution, concentration, and dosage information for various medical conditions, such as paroxysmal supraventricular tachycardia, pulmonary embolism, and others.
    • Preparation Instructions: Instructions detail how to prepare each medication (e.g., dilution techniques, syringe methods, use of transfer devices).
    • Comments/Considerations: Each drug includes essential information, precautions, and potential side effects (e.g., drug interactions, presence of propylene glycol, or potential for extravasation at administration site).
    • Monitoring Parameters: Detailed guidelines are given about the required monitoring for each medication (e.g., continuous 12-lead ECG, BP, HR, cardiac monitors, site monitoring for extravasation).
    • Contraindications: Specific contraindications for each medication based on patient conditions (e.g., AV block, symptomatic bradycardia, or heart transplant patients), are outlined.
    • Note: Includes crucial disclaimers regarding the provided information, emphasizing that more detailed information should be sought from qualified professionals such as pharmacists and physicians.

    Reconsitituion, Concentration, and Doses for Common Indications in the ED - Additional Notes for Specific Drugs

    • Drug name: Specific medications and their relevant information are listed.
    • Administration Route: (e.g., IV push, continuous infusion) for each medication is detailed.
    • Dose/concentration/reconstitution: Specific preparation techniques, concentrations, or dosages for the given conditions and medication are listed.
    • Comments/Considerations: Essential information, precautions, and potential adverse effects (drug interactions, extravasation, or toxicity).
    • Monitoring/Other Pertinent Information: Required monitoring procedures, additional information (such as baseline vital status monitoring frequencies, or specific monitoring based on the drug), and contraindications are given.

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    Related Documents

    Intravenous Infusion Guidelines 2024 (MUHC)

    Description

    This quiz covers essential guidelines for intravenous infusions in the Emergency Department, including initiation timelines, reconstitution, concentrations, and dosages for common medications. It also highlights critical preparation instructions and important precautions for various medical conditions.

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