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The Use of Ketamine for the Management of Acute Pain in the Emergency Department

The Use of Ketamine for the Management of Acute Pain in the Emergency Department EARN CE CREDIT ONLINE Go to http://www.nursingcenter.com/CE/AENJ and receive a certificate within minutes. CE Test The Use of Ketamine for the Management of Acute Pain in the Emergency Department Test Instructions Registration deadline is March 5, 2021. approved provider of continuing nursing education by Read the article. The test for this CE activity can only be the District of Columbia, Georgia, and Florida CE Broker taken online at http://www.nursingcenter.com/CE/AENJ. #50-1223. Provider Accreditation Tests can no longer be mailed or faxed. The ANCC’s accreditation status of Lippincott Pro- Lippincott Professional Development will award 1.5 con- You will need to create (its free!) and login to your fessional Development refers only to its continuing nurs- tact hours for this continuing nursing education activ- personal CE Planner account before taking online tests. ing educational activities and does not imply Commission ity. This activity has been assigned 1.5 pharmacology Your planner will keep track of all your Lippincott Pro- on Accreditation approval or endorsement of any com- credits. fessional Development online CE activities for you. mercial product. Lippincott Professional Development is accredited There is only one correct answer for each question. Payment: The registration fee for this test is $17.95. as a provider of continuing nursing education by the A passing score for this test is 13 correct answers. If American Nurses Credentialing Center’s Commission on you pass, you can print your certificate of earned contact Disclosure Statement Accreditation. hours and access the answer key. If you fail, you have The authors and planners have disclosed that they have This activity is also provider approved by the the option of taking the test again at no additional cost. no significant relationship with or financial interest in any California Board of Registered Nursing, Provider Num- For questions, contact Lippincott Professional De- commercial companies that pertain to this educational ber CEP 11749 for 1.5 contact hours. LPD is also an velopment: 1-800-787-8985. activity. AENJ0419A CE TEST QUESTIONS General Purpose: To examine the use of ketamine 6. Compared with the morphine group in 13. Among the most commonly reported to manage pain in emergency department patients, in- a study by Beaudoin et al., patients in adverse effects of ketamine is cluding its pharmacology, indications, adverse effects, the ketamine group reported a. dry mouth. and contraindications, while also discussing new guide- a. less intense pain at 2 hr. b. dizziness. c. edema. lines for the use of this analgesic medication. b. more vertigo and sweating. Learning Objectives/Outcomes: After com- c. needing more rescue analgesia. 14. Which of the following medications is 7. Which of the following is an abso- recommended as an adjunctive agent pleting this continuing education activity, you should be able to: lute contraindication for the use of ke- to help ameliorate nausea due to ke- tamine? tamine administration? 1. List the indications and contraindications for the use of ketamine in managing acute pain in the emer- a. heart failure a. ondansetron b. suicidal ideation b. midazolam gency department. 2. Review the various adverse effects of ketamine. c. hypertensive emergency c. atropine 8. Which of the following is a relative 15. At nondissociative doses, ketamine 3. Describe the current guidelines for administering ke- tamine to manage acute pain and counteract its ad- contraindication for the use of ke- often results in transient verse effects. tamine? a. hypoxia. 1. Ketamine is unique in that, at thera- a. acute alcohol intoxication b. hypotension. peutic doses administered according b. renal dysfunction c. tachycardia. to preestablished guidelines, it does c. hypersensitivity 16. Which of the following medications not cause 9. The use of ketamine increases the has been proposed as a potential a. bradycardia. risk of laryngospasm for patients un- agent to counteract both the cardio- b. respiratory depression. dergoing vascular stimulatory effects and the c. a loss of sensory perception. a. esophageal foreign body removal. undesirable psychedelic effects of 2. Because of its potential for abuse, b. intraoral laceration repair. ketamine? c. endoscopy. a. metoprolol dependence, and diversion, ketamine is a controlled substance listed as 10. Compared with administering ke- b. clonidine tamine intravenously, administering it c. diltiazem Schedule a. I. intramuscularly increases the risk of 17. The Consensus Guidelines on the a. headache. Use of Intravenous Ketamine Infu- b. II. c. III. b. vomiting. sions for Acute Pain Management c. tremors. recommends 3. Ketamine can be administered via several routes 11. Ketamine can cause emergence reac- a. bolus dosing not to exceed 0.15 mg/kg. a. and is water- and lipid-soluble. tion symptoms, such as b. bolus dosing between 0.4 and 0.5 mg/kg. b. but does not cross the blood–brain barrier. a. agitation. c. infusions not to exceed 1 mg/kg/hr. c. and initially distributes to peripheral soft-tissue b. lethargy. 18. Compared with monitoring after the sites. c. seizures. administration of typical analgesics 4. When administered intravenously, its 12. The use of which of the following such as morphine, the American onset of action is within medications can help reduce the inci- College of Emergency Physicians a. 5–10 sec. dence of adverse psychomimetic ef- recommends b. 10–30 sec. fects with no increase in recovery a. less routine or special monitoring. c. 30–60 sec. time or other adverse effects? b. the same level of monitoring. a. cyclobenzaprine c. more intensive monitoring. 5. Numerous case reports suggest that ketamine lessens traumatic pain and b. escitalopram c. diazepam can also reduce a. confusion. b. opioid consumption. c. visual hallucinations. E1 http://www.deepdyve.com/assets/images/DeepDyve-Logo-lg.png Advanced Emergency Nursing Journal Wolters Kluwer Health

The Use of Ketamine for the Management of Acute Pain in the Emergency Department

Advanced Emergency Nursing Journal , Volume 41 (2) – Apr 1, 2019

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Wolters Kluwer Health
Copyright
© 2019 Wolters Kluwer Health, Inc. All rights reserved.
ISSN
1931-4485
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1931-4493
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10.1097/TME.0000000000000246
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Abstract

EARN CE CREDIT ONLINE Go to http://www.nursingcenter.com/CE/AENJ and receive a certificate within minutes. CE Test The Use of Ketamine for the Management of Acute Pain in the Emergency Department Test Instructions Registration deadline is March 5, 2021. approved provider of continuing nursing education by Read the article. The test for this CE activity can only be the District of Columbia, Georgia, and Florida CE Broker taken online at http://www.nursingcenter.com/CE/AENJ. #50-1223. Provider Accreditation Tests can no longer be mailed or faxed. The ANCC’s accreditation status of Lippincott Pro- Lippincott Professional Development will award 1.5 con- You will need to create (its free!) and login to your fessional Development refers only to its continuing nurs- tact hours for this continuing nursing education activ- personal CE Planner account before taking online tests. ing educational activities and does not imply Commission ity. This activity has been assigned 1.5 pharmacology Your planner will keep track of all your Lippincott Pro- on Accreditation approval or endorsement of any com- credits. fessional Development online CE activities for you. mercial product. Lippincott Professional Development is accredited There is only one correct answer for each question. Payment: The registration fee for this test is $17.95. as a provider of continuing nursing education by the A passing score for this test is 13 correct answers. If American Nurses Credentialing Center’s Commission on you pass, you can print your certificate of earned contact Disclosure Statement Accreditation. hours and access the answer key. If you fail, you have The authors and planners have disclosed that they have This activity is also provider approved by the the option of taking the test again at no additional cost. no significant relationship with or financial interest in any California Board of Registered Nursing, Provider Num- For questions, contact Lippincott Professional De- commercial companies that pertain to this educational ber CEP 11749 for 1.5 contact hours. LPD is also an velopment: 1-800-787-8985. activity. AENJ0419A CE TEST QUESTIONS General Purpose: To examine the use of ketamine 6. Compared with the morphine group in 13. Among the most commonly reported to manage pain in emergency department patients, in- a study by Beaudoin et al., patients in adverse effects of ketamine is cluding its pharmacology, indications, adverse effects, the ketamine group reported a. dry mouth. and contraindications, while also discussing new guide- a. less intense pain at 2 hr. b. dizziness. c. edema. lines for the use of this analgesic medication. b. more vertigo and sweating. Learning Objectives/Outcomes: After com- c. needing more rescue analgesia. 14. Which of the following medications is 7. Which of the following is an abso- recommended as an adjunctive agent pleting this continuing education activity, you should be able to: lute contraindication for the use of ke- to help ameliorate nausea due to ke- tamine? tamine administration? 1. List the indications and contraindications for the use of ketamine in managing acute pain in the emer- a. heart failure a. ondansetron b. suicidal ideation b. midazolam gency department. 2. Review the various adverse effects of ketamine. c. hypertensive emergency c. atropine 8. Which of the following is a relative 15. At nondissociative doses, ketamine 3. Describe the current guidelines for administering ke- tamine to manage acute pain and counteract its ad- contraindication for the use of ke- often results in transient verse effects. tamine? a. hypoxia. 1. Ketamine is unique in that, at thera- a. acute alcohol intoxication b. hypotension. peutic doses administered according b. renal dysfunction c. tachycardia. to preestablished guidelines, it does c. hypersensitivity 16. Which of the following medications not cause 9. The use of ketamine increases the has been proposed as a potential a. bradycardia. risk of laryngospasm for patients un- agent to counteract both the cardio- b. respiratory depression. dergoing vascular stimulatory effects and the c. a loss of sensory perception. a. esophageal foreign body removal. undesirable psychedelic effects of 2. Because of its potential for abuse, b. intraoral laceration repair. ketamine? c. endoscopy. a. metoprolol dependence, and diversion, ketamine is a controlled substance listed as 10. Compared with administering ke- b. clonidine tamine intravenously, administering it c. diltiazem Schedule a. I. intramuscularly increases the risk of 17. The Consensus Guidelines on the a. headache. Use of Intravenous Ketamine Infu- b. II. c. III. b. vomiting. sions for Acute Pain Management c. tremors. recommends 3. Ketamine can be administered via several routes 11. Ketamine can cause emergence reac- a. bolus dosing not to exceed 0.15 mg/kg. a. and is water- and lipid-soluble. tion symptoms, such as b. bolus dosing between 0.4 and 0.5 mg/kg. b. but does not cross the blood–brain barrier. a. agitation. c. infusions not to exceed 1 mg/kg/hr. c. and initially distributes to peripheral soft-tissue b. lethargy. 18. Compared with monitoring after the sites. c. seizures. administration of typical analgesics 4. When administered intravenously, its 12. The use of which of the following such as morphine, the American onset of action is within medications can help reduce the inci- College of Emergency Physicians a. 5–10 sec. dence of adverse psychomimetic ef- recommends b. 10–30 sec. fects with no increase in recovery a. less routine or special monitoring. c. 30–60 sec. time or other adverse effects? b. the same level of monitoring. a. cyclobenzaprine c. more intensive monitoring. 5. Numerous case reports suggest that ketamine lessens traumatic pain and b. escitalopram c. diazepam can also reduce a. confusion. b. opioid consumption. c. visual hallucinations. E1

Journal

Advanced Emergency Nursing JournalWolters Kluwer Health

Published: Apr 1, 2019

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