Patient may have ACPE.
What are the indications?
[[Severe respiratory distress, Wheezes, Asthma->Wrong1]]
[[Jugular Vein distension, Stridor at rest, Barking cough, Sore throat->Wrong1]]
[[Severe respiratory distress, suspected cardiogenic pulmonary edema->Wrong1]]
[[Moderate to Severe respiratory distress, suspected cardiogenic pulmonary edema->Correct1]]
WRONG!
[[Try again->Start]]
What drug would you like to administer?
[[Epinephrine->Wrong1]]
[[Salbutamol->Wrong1]]
[[Epinephrine Auto Injector->Wrong1]]
[[NaCL Fluid Bolus->Wrong1]]
[[Nitroglyercin->Correct2]]
[[ASA->Wrong1]]
[[Acetominophen->Wrong1]]
[[Ketorolac->Wrong1]]
[[Ibuprophen->Wrong1]]
[[Naloxone->Wrong1]]
What is the condition of your patient that clears you to use this drug?
[[Age: >=18 LOA: N/A HR: 60-159 BPM RR: N/A SBP: Normotension Other: Ascertain prior hisotry of Nitroglycerin use OR establish IV access->Correct3]]
[[Age: >=18 LOA: N/A HR: N/A BPM RR: N/A SBP: Normotension Other: Ascertain prior hisotry of Nitroglycerin->Wrong1]]
[[Age: N/A LOA: N/A HR: N/A BPM RR: N/A SBP: Normotension Other: Ascertain prior hisotry of Nitroglycerin use OR establish IV access->Wrong1]]
[[Age: >=16 LOA: Unaltered HR: 60-159 BPM RR: N/A SBP: 100-140 Other: Ascertain prior hisotry of Nitroglycerin use OR establish IV access->Wrong1]]
What is NOT a contraindication for this drug?
[[Allergy or sensitiviy to nitro->Wrong1]]
[[History of asthma->Correct4]]
[[Phosphodiasterase inhibitor use within the previous 48 hours->Wrong1]]
[[SBP drops by 1/3 or more of the initial value after nitroglycerin is administered->Wrong1]]
Systolic Blood Pressure is:
[[100 mmHG to < 140 mmHG]]
[[>= 140 mmHG]]
Concentration
[[1:5000 at 1 mg->Wrong1]]
[[1:10000 at 0.5 mg->Wrong1]]
[[1:1000 at 0.5 mg->Correct6]]
CORRECT!
Don't forget to consider a 12-lead ECG acquisition when possible.
Do you have IV access OR Hx of nitroglycerin use?
[[Yes->Lowcorrect1]]
[[No->DoNotAdminister]]
Do you have IV access OR Hx of nitroglycerin use?
[[Yes->Highcorrect1]]
[[No->Lowcorrect1]]
What is the correct route?
[[Buccal->Wrong1]]
[[IM->Wrong1]]
[[Sublingual->Lowcorrect2]]
[[PRN->Wrong1]]
[[NEB->Wrong1]]
DO NOT ADMINISTER THIS DRUG!
Dosage?
[[Dose: 0.3-0.4 mg per kilogram, Max Single Dose: 4 mg, Interval: 5 minutes, Max # of Doses: 6->Wrong1]]
[[Dose: 0.3-0.4 mg, Max Single Dose: 0.4 mg, Interval: 5 minutes, Max # of Doses: 6->Correct6]]
[[Dose: 0.5-1 mg per kilogram, Max Single Dose: 5 mg, Interval: 20 minutes, Max # of Doses: 6->Wrong1]]
[[Dose: 10 ml, Max Single Dose: 10 ml, Interval: 10 minutes, Max # of Doses: 3->Wrong1]]
What is the correct route?
[[Buccal->Wrong1]]
[[IM->Wrong1]]
[[Sublingual->Highcorrect2]]
[[PRN->Wrong1]]
[[NEB->Wrong1]]
Dosage?
[[Dose: 0.3-0.4 mg, Max Single Dose: 0.4 mg, Interval: 5 minutes, Max # of Doses: 6->Wrong1]]
[[Dose: 0.6-0.8 mg, Max Single Dose: 0.8 mg, Interval: 5 minutes, Max # of Doses: 6->Correct6]]
[[Dose: 0.5-1 mg per kilogram, Max Single Dose: 5 mg, Interval: 20 minutes, Max # of Doses: 6->Wrong1]]
[[Dose: 10 ml, Max Single Dose: 10 ml, Interval: 10 minutes, Max # of Doses: 3->Wrong1]]