Medical Mystery: Midnight Meltdown

Question 1

What is the typical starting dosing for IV Naloxone?

Accepted Answer

0.2-0.4mg

Question 2

What is one piece of data missing that needs to be included in the your rapid assessment?

Accepted Answer

CBG

Question 3

Now that that crisis is over, is there anything from the original assessment you want to look into?

Accepted Answer

Urine output

Question 4

Al wakes up and is confused and is pulling at his IV. What state of delirium is this patient exhibiting?

Accepted Answer

Hyperactive Delirium

Question 5

You tell him your main priorities now are?(SATA)

Accepted Answer

Preparing for additional doses, 1:1 with patient x1 hour, Continuous O2 sat monitoring

Question 6

What are some things you can predict after administering naloxone? SATA

Accepted Answer

Combative, Pain Crisis, Confusion

Question 7

This is sufficient information for a hand-over report

Accepted Answer

False

Question 8

What are your first three actions at this point? (sata)

Accepted Answer

Check IV patency/Start IV, Place patient on oxygen, Call for help from colleagues

Question 9

You call the doctor, you tell him you suspect a post surgical acute kidney injury. he asks "is that bad?". You reply:

Accepted Answer

Yes, AKI is dangerous

Question 10

Why is Chlorhexadine not an ideal choice for CBG's?

Accepted Answer

Gluconate

Question 11

He states: "Oh... What should we do then?". You reply " I would suggest...

Accepted Answer

Give him an IV bolus and maintenance fluids

Question 12

What would your next steps be?

Accepted Answer

Call the doctor

Question 13

What are is a non-invasive test you can perform for urinary output vs retention

Accepted Answer

US/Bladder Scan

Question 14

What are some ways you can verify how much morphine was given?

Accepted Answer

Check ADC for last dose pulled

Question 15

If a bladder scan shows 400cc but that patient doesn't have the urge to urinate, this is considered Acute Kidney Injury

Accepted Answer

False

Question 16

Doc states "Why would I want to give him so much fluid?" You tell him:

Accepted Answer

To help kick start the kidneys

Question 17

What blood work would you want to look into?

Accepted Answer

BUN, Cr, eGFR

Question 18

What medication do you anticipate you will need to administer?

Accepted Answer

Naloxone

Question 19

You scan Mr. Bumen's bladder and it shows 20mL, what does this lead you to investigate?

Accepted Answer

Possible acute kidney injury

Question 20

The Mystery of the Midnight Meltdown. Are you ready?

Accepted Answer

Yes

Questions 20