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2nd Year PCP > Midterm Lab Testing > Flashcards

Midterm Lab Testing Flashcards

1
Q

Epinepherine Conditions (Bronchoconstriction)

A

RR: BVM ventilation
Other: Hx of asthma

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2
Q

Epinepherine Contraindications (Bronchoconstriction)

A

Allergy or sensitivity to epinepherine

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3
Q

Epinepherine Treatment (Bronchoconstriction)

A

Route: IM
Concentration: 1mg/ml=1:1000
Dose: 0.01mg/kg
Max Single Dose: 0.5mg
Max # of Doses: 1

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4
Q

Epinepherine Conditions (Allergic Reaction)

A

For anaphylaxis only

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5
Q

Epinepherine Contraindications (Allergic Reaction)

A

Allergy or sensitivity to epinepherine

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6
Q

Epinepherine Treatment (Allergic Reaction)

A

Route: IM
Concentration: 1mg/m=1:1000
Dose: 0.01mg/kg
Max Single Dose: 0.5mg
Dosing Interval: minimum 5 min
Max # of Doses: 2

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7
Q

Indications for Bronchoconstriction MD

A

Respiratory Distress and Suspected Bronchoconstriction

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8
Q

Indications for Moderate to Severe Allergic Reaction

A

Exposure to a probable allergen
AND
Signs and/or symptoms of a moderate to severe allergic reaction (including anaphylaxis)

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9
Q

Diphenhydramine Conditions (Allergic Reaction)

A

Weight: > or equal to 25kg

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10
Q

Diphenhydramine Contraindications (Allergic Reaction)

A

Allergy or sensativity to diphenhydramine

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11
Q

Diphenhydramine Treatment (Allergic Reaction) > or equal to 25kg and <50kg

A

Route: IV/IM
Dose: 25mg
Max Single Dose: 25mg
Max # of Doses: 1

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12
Q

Diphenhydramine Treatment (Allergic Reaction) > or equal to 50kg

A

Route: IV/IM
Dose: 50mg
Max Single Dose: 50mg
Max # of Doses: 1

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13
Q

Indications for Analgesia MD

A

Pain

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14
Q

Ketorolac Conditions (Analgesia)

A

Age: > or equal to 12 years
LOA: Unaltered
SBP: Normotension

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15
Q

Ketorolac Treatment (Analgesia)

A

Route: IM/IV
Dose: 10-15mg
Max Single Dose: 15mg
Max # of Doses: 1

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16
Q

Indications for Nausea/Vomiting MD

A

Nausea OR Vomiting

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17
Q

Dimenhydrinate Conditions (Nausea/Vomiting)

A

Age: <65 years
Weight: > or equal to 25kg
LOA: Unaltered

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18
Q

Dimenhydrinate Contraindications
(Nausea/Vomiting)

A

Allergy or sensitivity to dimenhydrinate or other antihistamines
Overdose on antihistamines or anticholinergics or tryclic antidepressants
Co-administration of diphenhydramine

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19
Q

Dimenhydrinate Treatment (Nausea/Vomiting) > or equal to 25kg to <50kg

A

Route: IV/IM
Dose: 25mg
Max Single Dose: 25mg
Max # of Doses: 1

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20
Q

Dimenhydrinate Treatment (Nausea/Vomiting) > or equal to 50kg

A

Route: IV/IM
Dose: 50mg
Max Single Dose: 50mg
Max # of Doses: 1

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21
Q

Indications for Opioid Toxicity MD

A

Altered LOC
AND
Respiratory depression
AND
Inability to adequately ventilate OR persistent need to ventilate
AND
Suspected opioid overdose

22
Q

Naloxone Conditions (Opioid Toxicity)

A

Age: > or equal to 24 hours
LOA: altered
RR: <10 breaths/min

23
Q

Naloxone Contraindications (Opioid Toxicity)

A

Allergy or sensitivity to naloxone

24
Q

Naloxone Treatment (Opioid Toxicity)

A

SAME DOSING INTERVAL AND MAX # OF DOSES FOR ALL ROUTES, 5 MIN INTERVAL CAN GIVE 3 TIMES

Route: IV
Dose: Up to 0.4mg
Max Single Dose: 0.4mg

Route: IM
Dose: 0.4mg
Max single Dose: 0.4mg

Route: IN
Dose: 2-4mg
Max Single Dose: 2-4mg

Route: SQ
Dose: 0.8mg
Max Single Dose: 0.8mg

25
Q

How do you position patient in a breech delivery?

A

To allow gravity to birth the baby.
- upright or supported squat position
- Bring buttocks to edge of bed, place feet on chair ( if possible)

26
Q

How do we manually deliver legs in a breech delivery

A
  • Apply pressure to the popliteal fossa once visible AND
  • Gently sweep foot down and out
27
Q

How much time do you have from the umbilicus in a breech delivery?

A

4 minutes to complete delivery of the head

28
Q

How do we manually deliver arms in breech delivery?

A
  • If hand or elbow on fetal chest
  • Gently sweep hand down and out
29
Q

How do we do Mauriceau-Smellie-Veit Manoeuvre?

A
  • Discourage patient from pushing
  • Support baby with forearm, palm supporting chest
  • Place second and fourth fingers on the cheekbones
  • Exert pressure on cheekbones to increase flexion of the neck
  • Place other hand on babys back with two middle fingers hooked over the shoulders
  • Middle finger pushes occiput to aid flexion
  • Life body in an arc and assist head to pivot around symphysis pubis
30
Q

When do we do Mauriceau-Smellie-Veit Manoeuvre?

A

In breech deliveries when…
Hairline/nape of neck is visible
OR
If head does not delivery within 3 minutes after umbilicus

31
Q

How long do you have after babys head delivered in shoulder dystocia?

A

8 minutes

32
Q

What is the first A in ALARM?

A

Ask for assistance
- Ask patient to lay flat on firm surface
- Ask spouse/family/other healthcare professionals to assist during ALARM
- Call for second crew if not done

33
Q

What is the L in ALARM

A

Legs abduction (McRobert’s Manoeuver)
- Hyperflex hips by lifting legs and knees
- Aim to bring knees to ears and form squatting position

34
Q

What is the second A in ALARM

A

Adduct shoulder (Suprapubic Pressure)
- Apply suprapubic pressure before the next contraction
- Maintain throughout entire contraction
- Instruct patient to push
- Apply gentle downward lateral flexion of the head

35
Q

What is the R in ALARM?

A

Roll over (Gaskins Maneouver)
- Ask patient to roll over onto hands and knees
- Apply upward lateral flexion of baby’s head to facilitate delivery of the body

36
Q

What is the M in ALARM?

A

Manually release posterior arm
- If hand is visible…
- Follow humorous
- Sweep arm across fetal chest and out

37
Q

How do we deliver the placenta

A

Guard the uterus and use gentle controlled cord traction during contraction with the patient pushing

38
Q

What do you do if delivery of placenta is unsuccessful and exhibiting signs of post-partum hemorrhage?

A

Ensure resuscitative measures are in place and perform external bimanual compression

39
Q

How do we perform external bimanual compression?

A

Place one hand on the lower portion of the abdomen, at symphysis pubis; cup hand, supporting lower portion of uterus.
Place the other hand at the top of the uterine fundus
Compress the uterus between each hand continuously until post-partum hemorrhage stops.

40
Q

When do we perform external uterine massage?

A

Once placenta has been delivered if fundus remains soft/boggy or there is continuous bleeding.

41
Q

How do we perform external uterine massage?

A

Place one hand on lower portion of abdomen, at the level of symphysis pubis in cupped position supporting lower portion of uterus.
Place one hand at the top of the uterine fundus. The uterus should now be palpable between hands.
Begin massaging with upper hand using a circular motion, lower hand remains still. Continue until bleeding stops.

42
Q

What are the things we assess a neonate for?

A

term gestation, breathing, crying, good muscle tone.

43
Q

What do we do if the neonate is not breathing or crying and does not have good muscle tone?

A

For 30 SECONDS, provide warmth, position/clear airway, dry, stimulate, reposition.

44
Q

What do we do if breathing and HR are not > or equal to 100

A

PPV for 30 SECONDS

45
Q

What do we do if heart rate is not > or equal to 60

A

Start CPR and connect the BVM to oxygen.

46
Q

Indications for Emergency Childbirth MD

A

Pregnant patient experiencing labour
OR
Post-partum patient immediately following delivery and/or placenta

47
Q

Delivery Conditions (Emergency Childbirth)

A

Age: Childbearing years
Other: Second stage labour
AND/OR
Imminent birth
AND/OR
Shoulder Dystocia
AND/OR
Breech Delivery
AND/OR
Prolapsed cord

48
Q

Umbilical Cord Management Conditions (Emergency Childbirth)

A

Age: Childbearing years
Other: Cord complications
OR
if neonate or maternal resuscitation is required
OR
due to transport considerations

49
Q

External Uterine Massage (Emergency Childbirth)

A

Age: Childbearing years
Other: Post placental delivery

50
Q

Oxytocin Conditions (Emergency Childbirth)

A

Age: Childbearing years
SBP: < or equal to 160 mmHg
Other: Postpartum delivery
AND/OR
Placental delivery

51
Q

Contraindications of External Uterine Massage (Emergency Childbirth)

A

Placenta not delivered

52
Q

Contraindications of Oxytocin (Emergency Childbirth)

A

Allergy or sensitivity to oxytocin
Undelivered fetus
Suspected or known pre-eclampsia with current pregnancy
Eclampsia (seizures) with current pregnancy
>4 hours post placenta delivery

2nd Year PCP (10 decks)

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