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U world all subjects 6-1-21 NOTES

Levetiracetam used to Prevent & treat seizures Often preferred over phenytoin, due to minimal drug to drug interactions. CNS depressant - LOW & SLOW body drowsiness & fatigue. MAJOR ADVERSE Suicidal thoughts Just like Phenytoin - Stevens-Johnson. Report: New anxiety, agitation, depression, mood changes. Report: Rash, blistering, muscle/joint pain. Key POINTS Driving must Get permission from HCP & follow transportation dept. guidelines.

Potentially Life Threatening:

 V-Tach- Pt has a pulse

Lethal Priority: Kills you in 8 mins or less

 Asystole- No pulse

 V-fib- No pulse

Treatment:

Supra Ventricular (Atrial) → ABCD’s

Adenocard (Adenosine):

 Push in less then 8 secs

 Don't worry about Asystole

 When it comes to IV push, when you don’t know go slow

Beta blockers (ending in “lol”)

 Just like CCB’s, same treatment, same side effects

Calcium channel blockers

 Better for asthmatics

Digoxin/Digitalis (Lanoxin)

V-fib → D-fib

Asystole → Epinephrine & Atropine (In that order if Epi doesn’t work)

PVC’s & V-Tach → Use Amiodarone for Ventricular

U world Cardiac and leadership 2

Fluid Volume Deficit

Cardiovascular

• Thready, increased pulse rate, decreased blood pressure and orthostatic

hypotension, flat neck and hand in veins in dependent positions, diminished

peripheral pulses, decreased central venous pressure, dysrhythmias

Respiratory

• Increased rate and depth of respirations, dyspnea

Neuromuscular

• Decreased central nervous system activity, from lethargy to coma, fever,

depending on the amount of fluid loss, skeletal muscle weakness

Renal

• Decreased urine output

Integumentary

• Dry skin, poor turgor, tenting, dry mouth

Gastrointestinal

• Decreased motility and diminished bowel sounds, constipation, thirst,

decreased body weight

Serum Blood Lab Findings

• Increased serum osmolality, increased hematocrit

• Increased blood urea nitrogen (BUN)

• Increased serum sodium level

• Increased urinary specific gravity

Memory Trick:

• If Osmolality is HIGH = Body is DRY

• If Specific gravity is HIGH = Body is DRY

Fluid Volume Excess

Cardiovascular

• Bouding, increased pulse rate, elevated blood pressure, distended neck

and hand veins, elevated central venous pressure, dysrhythmias

Respiratory

• Increased respiratory rate (shallow respirations), dyspnea, moist crackles

on auscultation

Neuromuscular

• Altered level of consciousness, headache, visual disturbances, skeletal

muscle weakness, paresthesias

Renal & Urinary

• Increased urine output if kidneys cannot compensate

• Decreased urine output if kidney damage is the cause

Integumentary

• Pitting edema in independent areas, pale cool skin

Gastrointestinal

• Increased motility in gastrointestinal tract, diarrhea

• Increased body weight, liver enlargement, ascites

Serum Blood Lab Findings

• Decreased serum osmolality, decreased hematocrit, decreased BUN level

• Decreased serum sodium level

• Decreased urine specific gravity

Memory Trick:

• If Osmolality is Low = Body is Liquidy

• If Specific gravity is Low = Body is Liquidy

End notes