What meds would this PACU test cover?

[BluegrassRN]

I'm applying for a job in our PACU, and part of the application process is a pharmacology test. I've worked as a nurse for about 10 years on the medical floor of this hospital, so I have experience, but I'm still a little nervous about the test. I've never even seen a reference to a pharmacology test on any other job listing, so I have no clue about what would be on it.

I assume that pain medications (dosage, side effects) will be covered, but what else? What sort of meds do you routinely give in the PACU, or which meds would you expect to be on a pharmacology test specific to this department?

[meandragonbrett]

Specific to PACU: Propofol, Ketamine, Midazolam, Lorazepam, the inhalation anesthetics, Fentanyl, Dilaudid, Demerol, Decadrom, Zofran, Promethazine, Droperidol, Haldol, Benadryl, Metoprolol, Labetalol, Hydralazine, Nitro, Levophed, Dopamine, Dobutamine, Norepi, and Phenylepherine. Those are some to get you started.

[GHGoonette, BSN, RN]

Don't forget neostigmine, flumenazil (anexate) and norcuron. Also your anticholinergic substances like Robinul and Atropine. You'll need to know the difference between the different muscle relaxants, eg which is a depolarizing neuromuscular blocker (scoline) and what is the reversal agent (none - that would be a trick question). The others (Mivacron, Esmeron, sorry, for some reason I can only remember trade names :) ) are non-depolarizing and are reversed by neostigmine. It would be a good idea if you know the signs of non-reversal of muscle relaxants, ie uncoordinated movements, inadequate ventilation etc.

Norcuron, dosage and duration of action. Reasons why not to give Norcuron, eg severe pain after reversal of opiates. Alternative is to support breathing where necessary and monitor SpO2 and consciousness levels for at least 30 minutes on room air.

All those that MDB has pointed out are very important, especially the inhalation substances and their side effects. Also read up on malignant hyperthermia and its causes and the rescue drug Dantrium.

Storage and safekeeping of Schedule drugs and recordkeeping. Make sure you know your regulations.

I think between the two posts you've got most of what you need to know, but if you know any of the PACU nurses already working there, try picking her brains to find out what kind of stuff they're likely to ask. Good luck!

[BluegrassRN]

Thank you so much!

[GHGoonette, BSN, RN]

Oops, just re-read my post! Not Norcuron, that's another neuro muscular blocker! NALOXONE! Also known as Narcan, opiate reversal agent, but you should know that! Sorry for the blooper!