Med Surge III Exam 1
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Mix with 120 mL water or juice
Don't crush/chew
Take after meals initially, then before meals if no n/v
Potassium administration Don't suddenly stop taking it
Don't use salt substitutes
Recognize S/S of hypo/hyperkalemia
Never give undiluted by IV or IV push
Slow pulse, fatigue, SOB
S/S hyperkalemia
*both hypo & hyper have palpitations, confusion, and muscle weakness
Dizziness, abdominal distension, frequent voiding
S/S hypokalemia
*both hypo & hyper have palpitations, confusion, and muscle weakness
Activated charcoal
Antidote for ingested poisons Decreases poison absorption
Give within first hour for effectiveness
Priority: airway stabilization
Control of airway, ventilation, and oxygen
Determine what was ingested, time since ingestion, S/S (pain, burning sensation,
Management of ingested poisons redness/burn in mouth, throat, pain on swallowing or inability to swallow,
vomiting, drooling)
Age & weight of patient
Pertinent health history
Headache, dizziness, confusion, palpitations, muscle weakness, intoxication -->
S/S carbon monoxide poisoning
coma, death
Priority - assess carboxyhemoglobin levels
Management of carbon monoxide
Treat with 100% O2
poisoning
May need hyperbaric chamber
Med Surge III Exam 1 ? Faster study and Med
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Activated charcoal ("universal" antidote)
Acetylcysteine for acetaminophen
Benzos for alcohol withdrawal/delirium tremens
Atropine for cholinergic drugs (rivastigmine, polocarpine, donepezil, neostigmine,
Meds to treat overdose
etc)
No longer used: Ipecac-induced vomiting or gastric lavage (minimal effectiveness
& potential complications)
Sedate with benzos (reduce agitation, exhaustion, seizures, promotes sleep)
Calm environment
Alcohol withdrawal treatments Physical exam to identify pre-existing illness/injury
Drug history
Baseline BP
Refer to resources
Try to separate them
Treatment of Intimate Partner Violence
Can't report unless child/elderly
Document wounds
Use ESI (emergency severity index) tool
Responsibilities of triage nurse:
Triage patients in the ED
Assess, reassess, initiate treatment, manage and
communicate, educate, sort patients, transport
them
Prophylaxis for gonorrhea
Ceftriaxone + 1% lidocaine
Prophylaxis for syphilis and chlamydia:
Single dose metronidazole
Single dose azithromycin
Meds for managing sexual assault
7-day oral regimen doxycycline
Anti-pregnancy:
Levonorgestrel and ethinyl estradiol
Give within 12-24 hours, no more than 72 hours post-intercourse
Antiemetic for side effects
Immediate needle decompression
Followed by chest tube insertion
Tension pneumothorax care S/S: chest pain, dyspnea, tachycardia, anxiety, air hunger, increased use of
accessory muscles, decreased/absent breath sounds on affected side, deviated
trachea to unaffected side
Leaked air pockets under skin, feels like "rice crispies"
Part of spontaneous pneumothorax
Not usually serious
Subcutaneous emphysema care
Report to provider
Monitor airway
Absorbs once pneumothorax is treated
Risk for hemorrhage - monitor for shock
Liver - right shoulder pain
Spleen - left shoulder pain
Intra-abdominal injury care If stable --> CT
If unstable --> FAST exam (focused assessment with sonography for trauma)
Management: ABCs, C-spine precautions, NPO, antibiotics/tetanus, monitoring,
surgery PRN
Med Surge III Exam 1 ? Faster study and Med
examSurge
readiness:
III Exam
Page
1.pdf
2 of: ?7 Complete solutions and rationales for rapid review.