A Quiz On Sodium Bicarbonate! Trivia

1.

What is the indication for Sodium Bicarbonate?

A.

Hyperkalemia
B.

Tricyclic and phenobarbital overdose
C.

Intubated patient with continued long arrest interval, pulseless electrical activity
D.

Pretreatment for a patient with decreased renal function that will be receiving IV contrast dye
E.

All of the above

Correct Answer
E. All of the above

Explanation
Sodium bicarbonate is indicated for various conditions. It is used for the treatment of hyperkalemia, as it helps in shifting potassium into the cells. It is also used in cases of tricyclic and phenobarbital overdose, as it can help in reversing the toxic effects of these drugs. In an intubated patient with a continued long arrest interval and pulseless electrical activity, sodium bicarbonate may be administered to correct acidosis and improve cardiac function. Additionally, sodium bicarbonate is given as a pretreatment to patients with decreased renal function who will be receiving IV contrast dye, as it can help prevent contrast-induced nephropathy. Therefore, the correct answer is "All of the above."

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2.

The contraindications for Sodium Bicarbonate is a pre-existing alkalosis.

A.

True
B.

False

Correct Answer
A. True

Explanation
The statement is true because Sodium Bicarbonate is an alkaline substance that increases the pH level in the body. Therefore, if a person already has a pre-existing alkalosis, which is a condition characterized by an elevated pH level in the blood, the use of Sodium Bicarbonate would further worsen the condition. It is important to avoid using Sodium Bicarbonate in such cases to prevent any potential harm or complications.

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3.

What are some adverse effects of Sodium Bicarbonate?

A.

Metabolic alkalosis
B.

Hypoxia
C.

Seizure
D.

Hyperosmolality
E.

Acute Hypokalemia
F.

May worsen CHF
G.

Rise in intracellular PCO2 and increased tissue acidosis

Correct Answer(s)
A. Metabolic alkalosis
B. Hypoxia
C. Seizure
D. Hyperosmolality
E. Acute Hypokalemia
F. May worsen CHF
G. Rise in intracellular PCO2 and increased tissue acidosis

Explanation
Sodium bicarbonate is a medication commonly used to treat acidosis. However, it can also have adverse effects. Metabolic alkalosis is a potential adverse effect, as sodium bicarbonate can increase the pH of the blood, leading to alkalosis. Hypoxia can occur because sodium bicarbonate can cause a shift in the oxygen-hemoglobin dissociation curve, impairing the release of oxygen to tissues. Seizures can occur in rare cases due to the alkalosis caused by sodium bicarbonate. Hyperosmolality refers to an increased concentration of solutes in the blood, which can occur with excessive sodium bicarbonate administration. Acute hypokalemia can occur as sodium bicarbonate can cause potassium to shift into cells, leading to low levels in the blood. Sodium bicarbonate may worsen congestive heart failure (CHF) as it can increase fluid volume. Finally, sodium bicarbonate can cause a rise in intracellular PCO2 and increased tissue acidosis due to its effects on carbon dioxide transport.

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4.

Medical consultation is required before administering Sodium Bicarbonate.

A.

True
B.

False

Correct Answer
A. True

Explanation
Sodium bicarbonate is a medication that is commonly used to treat conditions like acidosis or to relieve heartburn. However, it is important to consult with a medical professional before administering it. This is because sodium bicarbonate can interact with certain medications and medical conditions, and the dosage and administration need to be tailored to the individual's specific needs. Therefore, it is crucial to seek medical advice before using sodium bicarbonate to ensure its safe and appropriate use.

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5.

What is the adult dose for Sodium Bicarbonate?

A.

1 mEq/kg IV initially with 0.5 mEq/kg at 10 minute intervals
B.

10 mg/kg
C.

50 mg/kg
D.

1 mcg/kg IV initially with 0.5 mcg/kg at 10 minute intervals

Correct Answer
A. 1 mEq/kg IV initially with 0.5 mEq/kg at 10 minute intervals

Explanation
The correct answer is 1 mEq/kg IV initially with 0.5 mEq/kg at 10 minute intervals. This is the adult dose for Sodium Bicarbonate. It is administered intravenously at a rate of 1 mEq/kg initially, followed by 0.5 mEq/kg at 10-minute intervals. This dosing regimen is used to treat conditions such as metabolic acidosis or to correct electrolyte imbalances.

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6.

What is the pediatric dose for Sodium Bicarbonate for a patient less than 1-year-old?

A.

0.5 mEq/kg IV/IO
B.

1 mEq/kg IV/IO diluted (1:1) with LR
C.

1mcg/kg IV/IO
D.

Not indicate

Correct Answer
B. 1 mEq/kg IV/IO diluted (1:1) with LR

Explanation
The correct answer is 1 mEq/kg IV/IO diluted (1:1) with LR. This is the pediatric dose for Sodium Bicarbonate for a patient less than 1-year-old. It is administered intravenously or intraosseously, and it should be diluted in a 1:1 ratio with LR (Lactated Ringer's solution). This dosage is specific to pediatric patients and is used to treat conditions such as metabolic acidosis.

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7.

What is the adult dose for Sodium Bicarbonate for a hyperkalemic patient?

A.

50 mEq slow (over 5 minutes) IV then initiate a drip of 100 mEq Sodium Bicarbonate in 1000 mL LR to run over 30-60 minutes
B.

50 mcg/kg slow (over 5 minutes) IV then initiate a drip of 100 mcg Sodium Bicarbonate in 1000 mL LR to run over 30 minutes
C.

10 mg/kg IV/IO
D.

5 mg/kg IV/IO

Correct Answer
A. 50 mEq slow (over 5 minutes) IV then initiate a drip of 100 mEq Sodium Bicarbonate in 1000 mL LR to run over 30-60 minutes

Explanation
The correct answer is the first option, which states that the adult dose for Sodium Bicarbonate for a hyperkalemic patient is 50 mEq slow (over 5 minutes) IV, followed by initiating a drip of 100 mEq Sodium Bicarbonate in 1000 mL LR to run over 30-60 minutes. This answer provides the specific dosage and administration instructions for treating hyperkalemia with Sodium Bicarbonate.

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8.

What is the pediatric dose for Sodium Bicarbonate for a hyperkalemic patient?

A.

0.5 mcg/kg IV/IO
B.

1mcg/kg IV/IO
C.

1 mEq/kg (over 5 minutes) IV/IO. For patient less than 1, dilute (1:1) with LR
D.

0.5 mEq/kg IV/IO

Correct Answer
C. 1 mEq/kg (over 5 minutes) IV/IO. For patient less than 1, dilute (1:1) with LR

Explanation
The correct answer is 1 mEq/kg (over 5 minutes) IV/IO. For a hyperkalemic patient, sodium bicarbonate is used to help correct the acidosis caused by high levels of potassium in the blood. The dose of 1 mEq/kg is the recommended dose for pediatric patients. It is important to administer the medication slowly over 5 minutes to avoid any adverse effects. For patients less than 1 year old, the sodium bicarbonate should be diluted with an equal amount of lactated Ringer's solution (LR) before administration.

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9.

When administering Sodium Bicarbonate and other medication through the same IV line, the line should be flushed before and after administering Sodium Bicarbonate.

A.

True
B.

False

Correct Answer
A. True

Explanation
When administering Sodium Bicarbonate and other medications through the same IV line, it is important to flush the line before and after administering Sodium Bicarbonate. This is done to ensure that there are no residual medications or substances in the line that could potentially interact with or contaminate the Sodium Bicarbonate. Flushing the line helps to maintain the integrity and effectiveness of the medication being administered, reducing the risk of any adverse reactions or complications. Therefore, the statement is true.

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10.

Sodium Bicarbonate is in what class of drug?

A.

Buffer
B.

Alkalinizing agent
C.

Electrolyte supplement
D.

All of the above

Correct Answer
D. All of the above

Explanation
Sodium Bicarbonate is classified as all of the above because it is a versatile drug that acts as a buffer, an alkalinizing agent, and an electrolyte supplement. As a buffer, it helps maintain the pH balance in the body. As an alkalinizing agent, it increases the pH of the blood and urine. Additionally, it can be used as an electrolyte supplement to replenish sodium and bicarbonate levels in the body. Therefore, all three options accurately describe the class of drug that Sodium Bicarbonate belongs to.

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