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level: Level 5

Questions and Answers List

Identifying complications and treating them:

level questions: Level 5

QuestionAnswer
→ If a patient is vomiting or sweating excessively or passing large quantities of urine, it should be given fluids intravenously to replace GI, dermal, and renal losses = leads to __metabolic acidosis or alkalosis.
1 → Drugs cause metabolic acidosis 2 → Treatment:1 carbon monoxide, cocaine, cyanide, ethanol, methanol, iron, paracetamol, tricyclic antidepressant 2 administration of sodium bicarbonate 50-100 ml as bolus dose.
→ Can be caused by ingestion of salts → It is a well-recognized effect as a non-accidental injury. → Can be seen on patients who took MDMA. → GIVE THE TREATMENT:Hypernatremia Treatment: restricting the amount of fluid given to patients
→ Low potassium → Treated by __Hypokalemia Treated by infusing potassium
Hypoglycemia → Treated by __infusing 10% dextrose
→ We can give antibacterial ointments. → Unconscious patients should be turned at least every 2 hours. Bullous lesions should be left intact until they burst, to reduce the risk of infection. → Usual in bedridden patients.Skin blisters
Convulsions Treatment:→ Give diazepam 10-20 mg IV, Lorazepam 4 mg IV
it can cause hypoxia, brain damage. Treatment: __Persistent convulsion Treatment: Phenytoin 18 mg/kg IV at a rate not more than 50mg per minute. - ECG monitoring
→ If the convulsion is caused by __ poisoning, do not give phenytoin. → It can stimulate the sodium channel blockade and increase the risk of cardiac arrhythmia.tricyclic antidepressant
→ Dissolution of striated muscle fibers with leakage of muscle cell contents that results from the death of muscle fibers and eventually released in the bloodstream → In serious complications, too much release of muscle contents, mainly proteins – can lead to renal failure. → Too much protein that needs to be filtered out of our kidneys.Rhabdomyolysis
→ cannot participate in oxygen transport. → Excess __ can cause tissue hypoxia– because of incapable binding to oxygen. Treatment:Methemoglobinemia - ferrous hemoglobin iron oxidized → ferric ion Treatment: →high flow oxygen (conc. greater than 30%) to symptomatic patients with methemoglobinemia to maximize oxygen saturation on the residual normal ferrous hemoglobin → concentrations greater than 30%, methylthioninium chloride (Methylene Blue) 2 mg/kg − intravenously over 5–10 minutes as a 1% solution.
1) 1 IF the patient is anemic - it can be a cause of high level of methaemoglobinaemia and not due to poisoning 2 IF px has severe renal impairment What is the course of action? 2 → If there are evidence of continuing chemical absorption or prolonged Methaemoglobinaemia formation1 do not give methylene blue. 2 give a second dose of methylene blue 1-2 mg/kg - more than that can cause severe intravascular hemolysis.
→ Altered mental status, neuromuscular hyperactivity, autonomic instability → Benzodiazepine, diazepam, clonazepamSerotonin syndrome