Want to create interactive content? It’s easy in Genially!
WNCVAHCS Phenobarbital Protocol 2024
Naomi Roster-Romero
Created on February 6, 2024
Start designing with a free template
Discover more than 1500 professional designs like these:
Transcript
Utilizing the current phenobarbital protocol, complete the following questions
2024 Ongoing competency
treating alcohol withdrawal with phenobarbital protocol
antiepileptic
A relative contraindication to phenobarbital in the treatment of alcohol withdrawal includes chronic use of phenobarbal as an _____________ agent .
consumption
Verify alcohol related history and most recent _____________ and quantity to determine risk for withdrawal.
FILL IN THE BLANKS GAME
antipsychotic
treatment
blood alcohol levels
antiepileptic
pain management
consumption
Provider will admit to the appropriate level of care (refer to Appendix _____________ and initiate the protocol.
Type & Screen
Which of these lab studies DO NOT necessarily need to be ordered per this protocol? _____________ .
FILL IN THE BLANKS GAME
Liver Function Test
CBC
Type & Screen
-1
RASS score must be at _________________ or greater to receive IV phenobarbital loading dose.
10mg/kg
When dosing phenobarbital, a loading dose of ____________ of ideal body weight should be infused over 30 minutes.
Addtionally, thiamine should be supplemented 100mg daily for _____________ days .
FILL IN THE BLANKS GAME
250
10mg/kg
+1
-1
5mg/kg
200
100
20mg/kg
100
Thiamine should be supplemented with _____________ mg orally ASAP.
15-30
Addtional dosing for RASS >0 after inital load dose include: 130mg IVP every _________________ minutes.
130 or 260
If Veteran does not meet 10mg/kg dosing criteria, consider administer a smaller dose of ____________ mg slow IV push, depending on severity of symptoms.
0 and -1
Goal RASS: Between _____________ .
FILL IN THE BLANKS GAME
60
130 or 260
+1 and 0
30-60
15-30
0 and -1
100 or 150
15
-1 and -2
20-30
30
150 or 200
30
Assess and document the RASS score prior to and _____________ minutes post administation to determine the need for additioanl dosing.
once per shift
Nursing to assess for signs and symptoms of delirium tremens utilizing CIWA-Ar at minimum of _____________ .
intramuscular
Oral or _____________ phenobarbital may be substituted if necessary. Follow protocol route dosing recommendations.
FILL IN THE BLANKS GAME
q 8 hrs
SQ
buccal
once per shift
q 4 hrs
intramuscular
30
Providers should NOT exceed _____________ mg/kg without critical care consultation.
20-30
Typical cumulative dose for treatment is between _____________ mg/kg of IDEAL BODY WEIGHT .
FILL IN THE BLANKS GAME
40
30-40
10-20
30
50
20-30
The CIWA-Ar Scoring Guidelinees can be found in Appendix _________________ of the current Phenobarbital Protocol PRO-NUR-07. I
+4 to -5
The Richmond Agitation Sedation Scale (RASS) ranges from ____________.
alternative etiologies
Veterans with persistent symptoms despite receiving maximum dosing should be evaluated for _____________ .
FILL IN THE BLANKS GAME
SSRI
+4 to -5
dementia
alternative etiologies
+2 to -2
H2 Blocker
schizophrenia
benzodiazepine
+5 to -5
benzodiazepine
Concurrent _____________ therapy is not recommended and may result in pardoxical agitation and/or delirium .