EXAM 3 Flashcards
1
Q
If a patient has a weak or rapid pulse or has pale, cool, or diaphoretic skin, or is losing consciousness, what position should they be placed in?
A
supine
2
Q
What are jugular vein distention, subcutaneous emphysema, and unilateral/decreased/or absent breath sounds indicative of?
A
obstructive shock
3
Q
When would abruptio placenta be a prime suspect in a pregnant patient with vaginal bleeding?
A
in the later stages of pregnancy
4
Q
How should physically uncooperative patients be restrained?
A
in the lateral decubitus position with one arm above the head and the other below the waist
5
Q
What two things are especially important to alert to during the secondary assessment of a pregnant patient?
A
tachycardia and hypotension which could mean hemorrhage or compression of the vena cava
6
Q
What kinds of shock result from container (vessel) complications?
A
distributive
7
Q
What is the principal symptom of gastroenteritis?
A
diarrhea
8
Q
What happens in the duodenum?
A
digestive juices from the pancreas and liver mix
9
Q
What is cholecystitis?
A
inflammation of the gallbladder
10
Q
What is limb presentation?
A
born limb first; nothing you can do, TRANSPORT IMMEDIATELY!!!
11
Q
How do you do CPR on a newborn?
A
ventilate after every three compressions
12
Q
What dose of activated charcoal is given?
A
1 gram for every kilogram of the patient’s weight
13
Q
What are the symptoms of a sympathomimetic overdose? (like coke)
A
everything ramps up, agitation or seizures, dilated pupils
14
Q
What is wheezing often a sign of?
A
anaphylaxis
15
Q
What is diverticulitis?
A
Inflammation of small pockets at weak areas in the muscle walls
16
Q
What is often one of the earliest and most prominent signs of shock?
A
increased respiratory rate/heart rate
17
Q
What are the main causes of obstructive shock?
A
tension pneumothorax, cardiac tamponade, and pulmonary embolism
18
Q
What are the symptoms of a cholinergic overdose?
A
airway compromise and SLUDGEM
19
Q
How long should poisoned external areas of the body be washed?
A
15 to 20 minutes
20
Q
What are some causes of hypovolemic shock?
A
excessive bleeding, vomiting, and diarrhea; thermal burns, and dehydration
21
Q
What is preeclampsia and what are the signs and symptoms?
A
pregnancy-induced hypertension; signs/symptoms are severe hypertension, severe or persistent headache, visual abnormalities (including sensitivity to light), edema in hands/feet, and anxiety
22
Q
What is psychosis?
A
a state of delusion in which the person is out of touch with reality
23
Q
What are the four routes to consider during a poisoning?
A
ingestion, inhalation, injection, absorption
24
Q
What is the endometrium?
A
the lining of the inside of the uterus that is shed during a woman’s period
25
In every form of shock except what is the pulse often fast?
neurogenic; brain doesn't get signal to compensate
26
If central cyanosis is present or the oxygen saturation in a poorly perfused newborn does not improve, what should be done immediately?
administer blow-by oxygen at 5 LPM
27
What is a special consideration when treating patients with cholinergic overdose?
managing oral secretions so patient does not suffocate
28
What are the symptoms of a sedative-hypnotics overdose?
slurred speech, sedation or coma, hypoventilation, hypotension
29
What causes pancreatitis?
obstructing gallstone, alcohol abuse, or other diseases
30
What changes occur in the female body during pregnancy?
overall blood volume increases (up to 50%), increased respiratory rates with lower minute volume due to uterus pushing on diaphragm, higher demand for oxygen, heart rate increases (up to 20%), increased risk of vomiting and nausea following trauma
31
What is a treatment specific to neurogenic shock?
need for spinal immobilization
32
What do you do if the newborns HR is less than 60 bpm?
assist ventilation with BVM and 100% oxygen and begin chest compressions; reassess HR every 90 sec until HR and respirations are normal
33
In what position should you transport psychiatric patients?
Fowler's or high Fowler's
34
What is a treatment specific to anaphylactic shock?
assist with administration of epinephrine
35
What are the main signs of hypoperfusion?
rapid pulse rate; pale, cool, cyanotic or red, moist skin; delayed capillary refill
36
What drugs are people typically allergic to?
particular antibiotics and NSAIDs
37
What are the most common causes of abruptio placenta?
hypertension and trauma
38
What is the most common presenting sign of PID?
generalized lower abdominal pain
39
What do you do if the newborn's HR is 60 to 100 bpm?
assist ventilation with BVM and room air, reassess HR after 90 sec and move to ventilation using 100% oxygen if no improvement
40
What kinds of shock result from a pump failure?
cardiogenic and obstructive
41
What are the symptoms of an anticholinergic overdose?
everything ramped up like in sympathomimetics except they are Hot as a hare, blind as a bat, dry as a bone, red as a beet, and mad as a hatter
42
What does SLUDGEM stand for?
Salvation/Sweating, Lacrimation (tearing up), Urination, Defecation/drooling/diarrhea, Gastric upset/cramps, Emesis (vomiting), Muscle twitching
43
What is the emergency treatment for a typical contact poisoning?
avoid personal contamination and safely remove the corrosive substance as fast as possible then rapidly transport
44
What happens during a woman's period?
the endometrium is shed and blood is discharged
45
What is a major effect of cardiogenic shock?
blood backup into the lungs causing pulmonary edema
46
What happens in esophageal varices?
Capillary network in the esophagus leaks.
| Fatigue, weight loss, jaundice, anorexia, edema, abdominal pain
47
What is a wheal?
an itchy, raised, swollen area on the skin due to an allergic reaction
48
What are the different types of distributive shock?
septic, neurogenic, anaphylactic, and psychogenic
49
What is breech presentation?
born butt first, can usually transport cuz it takes longer but must deliver if butt has already exited the vagina
50
When would miscarriage be a prime suspect in a pregnant patient with vaginal bleeding?
early in the pregnancy
51
How do you treat a patient having seizures caused by eclampsia?
lay patient on her left side, maintain airway, and administer supplemental oxygen if necessary; if vomiting occurs suction airway; transport rapidly
52
What is the order of operation when approaching a patient?
SNNAC before walking in, then identify yourself and ask chief complaint, assess & treat ABC's immediately, then assess LOC using the 4 questions and asking name/age, then determine whether to transport now or after secondary, then get SAMPLE while partners get vitals, then ask more specifically about complaint and go through OPQRST, then call med control if you didn't do it already if they needed to be transported earlier
53
What are important things to ask a pregnant patient during history taking in addition to SAMPLE?
due date, any complications she's aware of, and if she's had any prenatal care
54
What PPE is necessary for an ongoing delivery?
gloves, eye and face protection, and a gown if time permits
55
What may happen in patients experiencing alcohol withdrawals?
they may experience delirium tremens (DTs) in which they hallucinate
56
What is the onset of the menstrual cycle called?
menarche
57
What is vertex presentation?
born head first, normal
58
When does PID typically start to cause pain?
during or after normal menstruation so ask when last menstruation is. walking can also make it worse so patients often shuffle
59
What does the Jejunum do?
Absorbs digestive products
| Does most of the work
60
Should patients in cardiogenic shock receive nitroglycerin to treat their chest pain?
hell no they are hypotensive
61
How much fluid is typically contained in the amniotic sac?
half a liter to a liter
62
What is gestational diabetes?
diabetes that arises as a result of pregnancy but usually resolves after; have the same treatment as other diabetics
63
in general, emergency medical conditions related to opioids are caused by what?
respiratory depression
64
What physical symptoms commonly accompany excited delirium?
tachycardia, hypertension, diaphoresis, and dilated pupils
65
What carries oxygenated blood from the placenta to the fetus?
umbilical vein
66
How do you immediately treat for shock?
apply oxygen, cover patient to keep warm, and position them supine, transporting immediately
67
What causes supine hypotensive syndrome?
uterus of pregnant patient squashes the inferior vena cava
68
What is the basic treatment for all of the kinds of shock?
position comfortably, administer high-flow oxygen, assist ventilations, keep patient warm, rapid transport
69
In what position should you place a patient who is having anaphylaxis?
high-fowler's to maximize ventilations
70
What are the expected respiratory and cardiovascular responses of the fetus immediately after birth?
breathes on its own 15 to 30 seconds after delivery and pulse is 120 bpm or higher
71
A pulse pressure of what may be seen in patients with shock?
less than 25 mm Hg
72
What is to be done for most overdoses?
monitor mental status and ABC's, provide supplemental oxygen and transport promptly; be ready to suction the airway
73
When should you consider the possibility of an ectopic pregnancy in a patient?
woman who has missed a menstrual cycle and reports sudden, severe, usually unilateral pain in the lower abdomen; history of PID, or previous ectopic pregnancies heighten suspicion
74
What kinds of shock result from lack of blood volume?
hypovolemic
75
What is urticaria?
hives
76
What two chemicals largely contribute to the body's allergic reaction?
histamines and leukotrienes
77
What is neurogenic shock usually a result of and what happens in it?
high spinal cord injury; all blood vessels below injury are cut off from sympathetic nerve impulses to contract so they all dilate
78
What is psychogenic shock?
Caused by a sudden reaction of the nervous system and Produces temporary, generalized vascular dilation; Results in fainting (syncope)
79
What happens in Mallory-Weiss syndrome?
Junction between esophagus and stomach tears; Principal symptom: vomiting
80
What are irregular pulse, weak pulse, pulmonary edema, crackles (rales) and chest pain indicative of?
cardiogenic shock
81
What do you do in the event of a prolapsed cord?
position the head away from the cord and transport immediately; place woman in supine position with foot end of cot raised 12 inches and hips elevated
82
How long is considered a full term pregnancy?
between 39 weeks and 40 weeks, 6 days; called term gestation
83
What kind of questions should you ask to determine if delivery is imminent?
when are you due? are you having contractions, and if so, how far apart and long? has your water broken? do you feel need to push?
84
What are the symptoms of an opiate overdose?
everything slows down or gets weaker, pupils constrict heavily
85
What processes take place in anaphylactic shock?
widespread vascular dilation, increased permeability, and bronchoconstriction
86
What does the ileum do and where is it located?
Absorbs nutrients that were not absorbed earlier; Absorbs bile acids so they can be returned to the liver for future use and vitamin B12 for making nerve cells and red blood cells
87
What are treatments for inhaled poison?
move to clean air and administer oxygen, may need to call HazMat team
88
What happens in bacterial vaginosis and what are the symptoms?
normal bacteria are overtaken by other kinds; symptoms are itching, burning, or pain and may be accompanied by a fishy smelling discharge
89
What produces referred pain in the abdomen?
the nerves of the visceral peritoneum is supplied by the autonomic nervous system which causes referred pain
90
When a patient is in shock, can we give them water or food if they ask?
NOOOO
91
What are the types of hypovolemic shock?
hemorrhagic and non-hemorrhagic
92
What happens in placenta previa?
the placenta develops over and covers the cervix; when early labor begins and the cervix begins to dilate, the pregnant woman may experience heavy vaginal bleeding often without much pain; RAPID TRANSPORT
93
What kind of questions should you ask to help determine any potential complications with a delivery?
have you had a c-section? have you had any problems in this or past pregnancies? do you use drugs or drink alcohol? are you only expecting one child?
94
What is ileus?
Paralysis of muscular contractions; Retained gas and feces cause distention; Stomach empties by emesis (vomiting)
95
What is eclampsia?
seizures that occur as a result of hypertension
96
If only assisted ventilation is needed in a newborn, at what rate should they be given?
40-60 breaths per min
97
What are important questions to ask during an allergic reaction or in addition to SAMPLE and OPQRST?
Have any interventions already been completed? Has the patient experienced a severe allergic reaction in the past? Did you just eat and if so what was it?
98
What happens in abruptio placenta?
the placenta separates prematurely from the wall of the uterus; RAPID TRANSPORT
99
How do you treat spina bifida in the field?
cover spinal protrusion with occlusive dressing
100
What PPE is necessary when there is significant blood or bodily fluid?
gloves, eye protection, and a mask
101
What is angioedema?
areas of localized swelling
102
What is cystitis and what are the symptoms?
UTI, caused by bacterial infection; serious if it spreads to kidneys
103
What is a complication often seen in postpartum patients?
embolism
