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l T-Mobile 7:10 PM @イ 4496 @ D Done Psych Case Study.docx 4.. Donald's respiratory rate is 8 and shallow. The respiratory therapist intubates her and continues to ventilate her manually. You attach ECG leads to her chest and find the results shown in the figure. What is your interpretation of Donald's rhythm? Case Study Progress Donald is given an ampule of 50 mL DsoW, 1 mg naloxone (Narcan), and 0.5 mg atropine IV push. Her respirations improve slightly, and her pulse increases to 56 beats/min. She is transported to the ED 5. Describe the purpose of administering the combination of D50W, atropine, and naloxone. 6. What treatment will Donald require in the ED? 7. Within 30 minutes of receiving the naloxone, Z.H. is starting to respond. Why do you need to continue to observe her closely? Select all that apply. Explain the rational for the answers a. Z.H. may develop pulmonary edema after receiving naloxone b. A common adverse effect of naloxone is the onset of atrial ibrillation. c. The duration of action of the drugs taken may exceed that of naloxone. d. The risk of developing diabetie ketoacidosis is high after receiving naloxone and D50W e. Rapidly reversing the effects of the drug overdose will cause a rebound decline in level of

Answer 1

Answer :

4) ECG is a diagnostic test which measure the heart electrical activity.

Normal ECG consists of p,q,r,s,t waves

P wave indicates contraction of atria leading to pumping of blood inside the ventricles .

This wave is followed by a short PR interval,since the atrioventricular node slows the electrical depolarisation.

After this ,QRS complex is observed,with short down ward deflection ,which is denoted by Q,a high peak R followed by S wave .

QRS complex represents contraction and ventricual depolarization and last T wave represents ventricular repolarization.

Here Z.H .has irregular rhythm ,this irregularity is may be due to heart attack ,leading to sinoatrial block or sinus arrest.

5) D 50w is also called as dextrose 50% in water .this solution is an immediate source of glucose and water to hypoglycemic patients .it restores blood glucose levels and increases the blood circulation level in the patient .

When some one present with a decreased level of consciousness without an identifiable cause ,you must consider the possibility of ingestion of or exposure to toxic agent .because of her presentation ,she is treated preemptively with naloxone ,an opiod antagonist and atropine was given to reverse the bradycardia

6) answer :

After administration of combination of dextrose ,naloxone ,atropine , her respirations improves slowly and pulse increases.

In emergency department , after administration of additional dose of naloxone 0.4 mg ,Z.H level of consciousness improves and she is able to be exubated.

After stabilization , she is transferred to ICU for forther management

7) answer:

A)the pulmonary edema likely caused by an adrenergic response from a large increase in centrally mediated catecholamines following naloxone administration.

B) abrupt reversal of opiod depression may result in atrial fibrillation.

C) some may exceed due to naloxone activity

D) yes ,due to taking of high amount of dextrose .

E) this has no effect on level of consciousness.