ACLS Final Exam Prep| Questions and 100% Correct Verified Answers (2023/ 2024 Update)
QUESTION
When would the initial dose of adenosine be reduced to
... [Show More] 3 mg instead of 6mg?
Answer:
1. patients receiving dipyridamole or cabamazepine
2. heart transplant patients
3. if given via central venous access
QUESTION
Contraindications to adenosine
Answer:
second or third degree heart block, sick-sinus syndrome, known hypersensitivity to the drug
(use caution in patients with asthma)
QUESTION
Side effects of adenosine
Answer:
facial flushing, headache, SOB, dizziness, and nausea
QUESTION
half-life of adenosine
Answer:
<10 seconds
QUESTION
When is adenosine used?
Answer:
-stable narrow-complex SVT (terminates reentrant rhythms in SA or AV node)
-does NOT convert afib/flutter or VT but may be used as a diagnostic aid (slow rate down enough to diagnose)
QUESTION
Describe how to administer adenosine
Answer:
-connect drug and flush syringe(s) to patient
-give medication as rapid IV injection in the port closest to patient and hold plunger down
-immediately give 20mL NS IV flush
QUESTION
Persistent tachyarrhythmias causing these symptoms should undergo synchronized cardioversion ASAP (if regular and narrow, adenosine may also be considered)
Answer:
-hypotension
-acutely altered mental status
-signs of shock
-ischemic chest discomfort
-acute heart failure
QUESTION
If your patient is not experiencing decompensating symptomatic tachycardia (hypotension, AMS, etc.) and the QRS is NOT wide (0.12 seconds or more), what is/are the next step(s).
Answer:
-IV access and 12 lead EKG
-Vagal maneuvers
-Adenosine if regular
-BB or CCB
-Consider expert consultation
QUESTION
If your patient is not experiencing decompensating symptomatic tachycardia (hypotension, AMS, etc.) and the QRS is wide (0.12 seconds or more), what is/are the next step(s).
Answer:
-IV access and 12 lead EKG
-Consider adenosine only if regular and monomorphic
-consider antiarrhythmic infusion
-consider expert consultation
QUESTION
Antiarrhythmic infusion options in the tachycardia algorithm
Answer:
procainamide, amiodarone, sotalol
QUESTION
Dosing of procainamide in the tachycardia algorithm
Answer:
20-50mg/min until arrythmia suppressed, hypotension ensues, QRS duration increases >50%, or maximum dose of 17mg/kg is given
QUESTION
Maximum dose of procainamide in the tachycardia algorithm
Answer:
17mg/kg
QUESTION
rate of maintenance infusion of procainamide in the tachycardia algorithm
Answer:
1-4mg/min
QUESTION
If your patient has these underlying conditions, procainamide should be avoided in the setting of tachycardia
Answer:
prolonged QT or CHF
QUESTION
Dosing of amiodarone in the tachycardia algorithm
Answer:
first dose 150mg over 10 minutes, repeat PRN
QUESTION
After an amiodarone infusion has been given in the setting of tachycardia, it should be followed with a maintenance infusion of 1 mg/min for the first _____ hours
Answer:
6
QUESTION
Dosing of sotalol in the tachycardia algorithm
Answer: [Show Less]