Emma Shared "ICU" - 88 Picmonics
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ICU
Hyponatremia
- Assessment
- < 135 mEq Na+
- Nausea and Vomiting
- Decreased LOC
- Confusion / Lethargy
- Seizures
- Priority Interventions
- Assess Airway
- Reduce Diuretic Dosage
- Fluid Excess Hyponatremia
- Mannitol (Osmitrol)
- Fluid Restriction
- Fluid Deficit Hyponatremia
- Hypertonic Solution (3% or 5% NaCl)
2 mins
Hypernatremia
- Assessment
- > 145 mEq/L Na+
- Change in LOC
- Extreme Thirst
- Orthostatic Hypotension
- Dry Flushed Skin
- Muscle Twitching
- Seizures
- Priority Interventions
- Treat and Prevent Dehydration
- Hypotonic Solutions (0.225% or 0.45% NaCl)
- Sodium Restriction
- Diuretics
2 mins
Hypomagnesemia
- Assessment
- Confusion
- Increased Deep Tendon Reflexes (DTRs)
- Neuromuscular Irritability
- Seizures
- Muscle Cramps
- Tremors
- Insomnia
- Tachycardia
- Interventions
- Magnesium Sulfate
- Foods High in Magnesium
1 min
Hypermagnesemia
- Assessment
- Flushing
- Lethargy
- Muscle Weakness
- Decreased Deep Tendon Reflexes (DTRs)
- Decreased Respirations
- Bradycardia
- Hypotension
- Interventions
- Dialysis
- IV Calcium Gluconate
- Diuretics
- Avoid Antacids and Laxatives containing Mg2+
2 mins
Hypocalcemia
- Muscle Spasms
- Assessment
- < 8.5 mg/dL Ca2+
- Decreased Bone Density
- Tetany
- Chvostek's Sign
- Trousseau's Sign
- Increased DTR
- ECG Changes
- QT Prolongation
- Considerations
- Oral and IV Replacement of Ca2+
- Seizure Precautions
2 mins
Hypocalcemia Causes
- Hypoalbuminemia
- Hypomagnesemia (Less Common Hypermagnesemia)
- Hypovitaminosis D
- Hypoparathyroidism
- Medications
- Hyperphosphatemia
- Malnutrition
- Acute Pancreatitis
- Alkalosis
- Sepsis
- Chronic Kidney Disease
2 mins
Hypocalcemia Treatments
- Characteristics
- Treat Underlying Disorder
- Acute Treatments
- IV Calcium Gluconate
- Cardioprotective
- Chronic Treatments
- Calcium Carbonate
- Calcium Citrate
- Vitamin D Supplements
- Considerations
- Treat Hypomagnesemia
2 mins
Hypercalcemia
- Assessment
- > 10.5 mg/dL Ca2+
- Pathologic Fractures
- Lethargy
- Hypercoagulation
- Constipation
- ECG Changes
- QT Shortening
- Interventions
- No Calcium Intake
- Chelating Drugs
- Calcitonin
- Bisphosphonates
- Loop Diuretics instead of Thiazide Diuretics
- Considerations
- Increased Risk for Renal Calculi
- Increase Fluids
3 mins
Hypercalcemia Treatments
- Treat Underlying Disorder
- Hydration
- Dialysis
- Calcium Restriction
- Bisphosphonates
- Calcitonin
- Cinacalcet
- Glucocorticosteroids
- Denosumab
2 mins
Hypokalemia
- Assessment
- < 3.5 mEq/L
- Muscle Weakness
- Arrhythmia
- U Wave
- Ileus
- Hyporeflexia
- Interventions
- IV K+ Infusion at 5-10 mEq/hr
- Give Orally with Food
- Nursing Considerations
- Monitor Respiratory Status
3 mins
Hyperkalemia
- Assessment
- > 5.0 mEq/L K+
- Abdominal Cramps
- Muscle Weakness
- Diarrhea
- Arrhythmia
- Tall, Peaked T Waves
- Interventions
- IV Calcium
- Infusion of Glucose and Insulin
- Loop or Thiazide Diuretics
- Kayexalate
- Dialysis
- Prevention Education
2 mins
Potassium (K+) Lab Value
- 3.5 to 5.0 mEq/L
20 secs
Creatinine Lab Values
- Measures Renal Function
- 0.6 - 1.3 mg/dL
1 min
Meperidine (Demerol)
- Mechanism
- Opioid Receptor Agonist
- Indications
- Moderate to Severe Pain
- Post Anesthesia Shivering
- Side Effects
- Tremors
- Constipation
- CNS Depression
- Sedation
- Considerations
- Short Term Administration
- Increased Risk Serotonin Syndrome
- Does NOT cause Miosis
- Renal Failure Increases Toxicity Risk
2 mins
Calcium Channel Blockers (Verapamil and Diltiazem)
- Mechanism of Action
- Slows AV Conduction
- Indications
- Angina Pectoris
- Arrhythmias
- Essential Hypertension
- Side Effects
- Bradycardia
- Hypotension
- Constipation
- Peripheral Edema
- Gingival Hyperplasia
- Nursing Consideration
- Medication Education
2 mins
Phenytoin
- Indications
- Status Epilepticus
- Tonic-Clonic Seizures
- Mechanism of Action
- Blocks Na+ Channel Activation
- Inhibition of Glutamate Release
- Class IB Antiarrhythmic
- Side Effects
- Teratogenic
- Macrocytic Megaloblastic Anemia
- Induce Cytochrome P450
- Drug-induced Lupus
- Neuropathy
- Hirsutism
- Gingival Hyperplasia
1 min
Rifampin
- Tuberculosis (TB)
- Blocks RNA Polymerization
- Haemophilus influenzae Type B
- Leprosy
- Meningitis
- P450 inducer
- Red-orange urine
55 secs
P450 Inducer
- Griseofulvin
- Phenytoin
- Carbamazepine
- Rifampin
- Barbiturates
- Chronic Alcohol Use
- St. John's Wort
51 secs
Fluoroquinolones
- End in "-floxacin"
- Mechanism of Action
- Bactericidal
- Indications
- Variety of Infections
- Side Effects
- GI Distress
- Photosensitivity
- Achilles Tendon Rupture
- Contraindications
- Pregnancy
- Children
- Myasthenia Gravis
- Considerations
- Avoid Milk Products or Antacids
- Slow IV Infusion
2 mins
Aminoglycosides
- Drug Names
- Gentamicin
- Neomycin for Bowel Surgery Prep
- Amikacin
- Tobramycin
- Streptomycin
- Mechanism of Action
- Bactericidal
- Inhibit Formation of Initiation Complex
- Cause Misreading of mRNA
- Require O2 for Uptake
- Resistance
- Resistance by Transferase Enzymes
- Acetylation
- Phosphorylation
- Adenylation
- Indications
- Gram-Negative Rod Infections
- Synergistic with B-Lactam Antibiotics
- Side Effects
- Nephrotoxicity Especially When Used with Cephalosporins
- Ototoxicity Especially When Used with Loop Diuretics
- Teratogen
5 mins
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