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What is the "classic" sign of pulmonary edema?
Frothy pink sputum
When the left ventricle begins to fail, blood backs up into the pulmonary circulation, causing pulmonary ______.
edema
You are going to be giving a patient midazolam. Which reversal agent do you need available?
Flumazenil
Vecuronium may be used to facilitate easy tracheal intubation and mechanical ventilation by relaxing the vocal cords, jaw, and associated respiratory muscles. True or False
True
What is the "train of four" test?
4 consecutive stimuli delivered along path of a nerve and response of muscle is measured. 4 equal muscle contractions = no neuromuscular blockade. absence=block
Positioning is important for the patient with ARDS. Oxygenation is sometimes improved in patients with ARDS when in which position?
Prone
Idarucizumab is the antidote for ______.
Dabigatran (Pradaxa)
Garlic can increase the effects of heparin. True or False?
True (garlic supplement or excessive garlic intake)
Rivaroxaban is safe to use for those with renal disease. True or False
False- avoid if creatinine clearance of less than 15mL/min
Dabigatran is safe to use in older adults. True or False
Both... alert: Beer Criteria: potentially inappropriate; Check Creatinine clearance. No dose adjustment if renal function ok.
What is the antidote to warfarin?
Vit K
How does warfarin work?
Acts in liver to prevent synthesis of vit-K dependent clotting factors. Similar to vit-K in structure, it acts as a competitive antagonist to hepatic use of K
Heparin is safe to use during pregnancy. True or False?
True- does not cross placental barrier and not secreted in breast milk
Why would a patient start both enoxaparin and warfarin at the same time?
enoxaparin acts right away. warfarin takes time to become therapeutic. Enoxaparin bridges until warfarin is therapeutic
How long should a patient expect to be on anticoagulation therapy after a PE?
10 days-3 months; Forever if high risk
What is a normal PTT? Therapeutic PTT?
25-35 seconds; 45-70 seconds (2-2.5 times normal)
What does an IVC filter do?
Provides a screen in the IVC- allows blood through while blocking or fragmenting emboli from pelvis or lower extremities
Your patient is diagnosed with a PE and a urinary catheter is ordered. Why?
Need to monitor I&O very closely. PE can lead to shock, etc.
What is the specific test to diagnose PE?
CT angiogram- Multidetector-row computed tomography angiography (MDCTA)
What is V/Q mismatch?
happens when part of your lung receives oxygen without blood flow or blood flow without oxygen.
List 3 risk factors for PE.
Recent surgery, pregnancy, HF, over 50yo, hypercoagulable state, prolonged immobility, OCPs, smoking
What is a VTE?
Venous Thromboembolism; DVT, PE


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