Podcast
Questions and Answers
What is the characteristic sputum production in Heart Failure?
What is the characteristic sputum production in Heart Failure?
- Yellow/green
- Frothy (pink) (correct)
- Blood-tinged
- Clear
Which of the following is a risk factor for both Heart Failure and Acute Myocardial Infarction?
Which of the following is a risk factor for both Heart Failure and Acute Myocardial Infarction?
- COPD
- Hypertension (correct)
- CAD
- Pneumonia
What is the typical chest pain duration in Acute Myocardial Infarction?
What is the typical chest pain duration in Acute Myocardial Infarction?
- Usually more than 20 minutes (correct)
- Constant
- Less than 20 minutes
- Gradually worsening
What is the characteristic air entry pattern in Pneumonia?
What is the characteristic air entry pattern in Pneumonia?
What is the characteristic temperature pattern in Pneumonia?
What is the characteristic temperature pattern in Pneumonia?
What is the characteristic crackle pattern in Heart Failure?
What is the characteristic crackle pattern in Heart Failure?
What is the typical blood pressure pattern in severe shortness of breath?
What is the typical blood pressure pattern in severe shortness of breath?
What is the characteristic wheezing pattern in COPD?
What is the characteristic wheezing pattern in COPD?
Which of the following is NOT a primary function of non-invasive positive pressure ventilation (NIPPV) / CPAP?
Which of the following is NOT a primary function of non-invasive positive pressure ventilation (NIPPV) / CPAP?
Which of the following clinical findings suggests the potential need for NIPPV/CPAP in a patient with respiratory distress?
Which of the following clinical findings suggests the potential need for NIPPV/CPAP in a patient with respiratory distress?
How does NIPPV/CPAP help improve alveolar aeration?
How does NIPPV/CPAP help improve alveolar aeration?
Which of the following is NOT a potential benefit of NIPPV/CPAP in patients with respiratory distress?
Which of the following is NOT a potential benefit of NIPPV/CPAP in patients with respiratory distress?
How does NIPPV/CPAP affect afterload?
How does NIPPV/CPAP affect afterload?
Which of the following describes the mechanism by which NIPPV/CPAP improves pulmonary compliance?
Which of the following describes the mechanism by which NIPPV/CPAP improves pulmonary compliance?
Which of the following is a key characteristic of NIPPV/CPAP that distinguishes it from other forms of ventilation?
Which of the following is a key characteristic of NIPPV/CPAP that distinguishes it from other forms of ventilation?
Which of the following would be a contraindication to the use of NIPPV/CPAP?
Which of the following would be a contraindication to the use of NIPPV/CPAP?
What is the significance of a concordant ST elevation ≥ 1 mm in terms of scoring?
What is the significance of a concordant ST elevation ≥ 1 mm in terms of scoring?
According to the updated Smith criteria, what happens if the ST-QRS ratio is greater than 0.25?
According to the updated Smith criteria, what happens if the ST-QRS ratio is greater than 0.25?
What does excessive discordant ST elevation ≥ 5 mm suggest in the context of the QRS complex?
What does excessive discordant ST elevation ≥ 5 mm suggest in the context of the QRS complex?
How does the Smith criteria differ from the Sgarbossa’s criteria regarding point allocation?
How does the Smith criteria differ from the Sgarbossa’s criteria regarding point allocation?
Which of the following is an indicator of Left Main Disease?
Which of the following is an indicator of Left Main Disease?
In the context of diagnosing myocardial infarction in patients with known LBBB, what is the sensitivity and specificity of having any single criterion present?
In the context of diagnosing myocardial infarction in patients with known LBBB, what is the sensitivity and specificity of having any single criterion present?
Which dosage of Acetaminophen IV should be administered for a child weighing 15.4 lbs (7 kg)?
Which dosage of Acetaminophen IV should be administered for a child weighing 15.4 lbs (7 kg)?
What is the maximum total dose of Acetaminophen IV that can be given in a single day?
What is the maximum total dose of Acetaminophen IV that can be given in a single day?
For a child weighing 22 lbs (10 kg), how much Epinephrine IV should be administered?
For a child weighing 22 lbs (10 kg), how much Epinephrine IV should be administered?
What defines a posterior STEMI based on the content provided?
What defines a posterior STEMI based on the content provided?
What is the dose of Midazolam to be given to a child weighing 30 lbs (14 kg)?
What is the dose of Midazolam to be given to a child weighing 30 lbs (14 kg)?
How should Fentanyl be administered for a child weighing 9 kg?
How should Fentanyl be administered for a child weighing 9 kg?
What is the minimum dose of Diphenhydramine that can be administered to a child?
What is the minimum dose of Diphenhydramine that can be administered to a child?
In the context of cardiac conditions, which ST elevation criteria applies to women?
In the context of cardiac conditions, which ST elevation criteria applies to women?
What is the maximum single dose of Midazolam that can be given?
What is the maximum single dose of Midazolam that can be given?
How much Naloxone should be administered for a child with a weight of 40 lbs (18 kg)?
How much Naloxone should be administered for a child with a weight of 40 lbs (18 kg)?
A patient has a fractured proximal humerus. Which route of medication administration is contraindicated?
A patient has a fractured proximal humerus. Which route of medication administration is contraindicated?
Which of the following is NOT a contraindication for IO access?
Which of the following is NOT a contraindication for IO access?
When administering a medication intranasally, what should be done if the total volume exceeds 0.4 mL?
When administering a medication intranasally, what should be done if the total volume exceeds 0.4 mL?
Which of the following is a critical step to take before administering a medication intravenously?
Which of the following is a critical step to take before administering a medication intravenously?
In which situation would an intramuscular (IM) injection be preferred over an intranasal (IN) injection?
In which situation would an intramuscular (IM) injection be preferred over an intranasal (IN) injection?
What is the purpose of the Medication Administration Cross-Check Procedure (MACC)?
What is the purpose of the Medication Administration Cross-Check Procedure (MACC)?
What is the recommended site for an intramuscular injection in adults?
What is the recommended site for an intramuscular injection in adults?
Which of the following routes of medication administration is most likely to be associated with rapid onset of action?
Which of the following routes of medication administration is most likely to be associated with rapid onset of action?
Study Notes
Drug Routes
- IN route is generally preferred over IM unless contraindicated
- IN or NAS routes: use nostrils for secretions/obstructions, suction, and remove NPA; max 1 mL/nostril
- IM preferred site: Vastus Lateralus muscle in mid-anterolateral thigh
- IO approved sites: Proximal humerus, proximal tibia, distal tibia, and distal femur (depending on age)
- IV selection: based on vein condition, purpose (fluid/drugs to be infused), patient age/size, clinical status, and presence of special vein & skin problems
7 RIGHTS of Medication Administration
- RIGHT Patient: Confirm absence of allergy
- RIGHT Drug: Check package/drug container for name, concentration, integrity/sterility of parenteral medication, and expiration date
- RIGHT Dose: Prepare dose in compliance with SOP/OLMC, with consideration for controlled substances, IV inopressors, and high-risk meds
- RIGHT Route: Verify correct route of administration
- RIGHT Time: Verify correct time of administration
- RIGHT Response: Monitor for desired response and side effects
- RIGHT Documentation: Accurately document medication administration
Medication Doses for Pediatrics
- Acetaminophen IV: 15 mg/kg, max dose 750 mg, max daily dose 3750 mg
- Adenosine: 0.1 mg/kg, max 6 mg
- Amiodarone: 5 mg/kg
- Atropine: 0.02 mg/kg
- Diphhenhydramine: 1 mg/kg, max 50 mg
- Epinephrine: 0.01 mg/kg IM/IN, max 0.3 mg
ECG Interpretation
- STEMI:
- Men < 40: 2.5 mm STE in V2 or V3, 1 mm in any other lead
- Men ≥ 40: 2 mm STE in V2 or V3, 1 mm in any other lead
- Women: ≥ 1.5 mm STE in V2 or V3, 1 mm in any other lead
- Posterior STEMI:
- ST depression in leads V1, V2, V3 (V4?)
- Tall, broad R waves (dominant in V2)
- Upright T waves
- LBBB:
- Smith criteria:
- Concordance: ST segment is in the same direction as the QRS
- Discordance: ST segment is in the opposite direction to the QRS
- Appropriate discordance: ST segments in all leads should be discordant to the majority direction of the QRS
- Smith criteria:
Differential Diagnosis for SOB
- HF/PE:
- S&S: SOB, cough, sputum, fever, sweats, chest pain
- Sputum: Frothy (pink)
- Chest pain duration: Variable
- Hypertension: + Risk
- AMI:
- S&S: SOB, cough, sputum, fever, sweats, chest pain
- Chest pain duration: Usually > 20 min
- Hypertension: + Risk
- COPD:
- S&S: SOB, cough, sputum, wheezing, cyanosis
- Sputum: Clear
- Chest pain: -
- Hypertension: -
- Pneumonia:
- S&S: SOB, cough, sputum, fever, sweats, chest pain
- Sputum: Yellow/green
- Chest pain duration: Gradually worsening
- Hypertension: -
Non-Invasive Positive-Pressure Ventilation (NIPPV) / CPAP
- Primary functions:
- Provides high flow O2 and constant positive airway pressures throughout inspiration and expiration
- Improves pulmonary compliance and keeps distal airways open longer
- Recruits and stabilizes collapsed alveoli
- Reduces inspiratory work and relieves respiratory muscle fatigue
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Description
This quiz covers the different routes of medication administration, including intranasal, intramuscular, and intravenous routes, highlighting important considerations and contraindications.
