Exam 3 Study Guide Ch 10-13

Question 1

What happens during Ventilation/Perfusion mismatch?

Answer 1

Lungs receive Oxygen without blood flow or you have blood flow without it receiving oxygen.

Question 2

What are indications and contradictions for OPA?

Answer 2

Indications.
Unresponsive patient without a gag reflex.
Any apneic patient being ventilated with a BVM.

Contraindications.
Conscious patients.
Any patient who has a gag reflex.

Question 3

What are the indications and contradictions for a NPA?

Answer 3

Indications.
Semiconscious or unconscious patient with a intact gag reflex.
Patients who otherwise will not tolerate an oropharyngeal airway.

Contraindications.
Severe head injury with blood draining from nose.
History of fractured nasal bone.

Question 4

What is insertion procedure for NPA and OPA?

Answer 4

NPA.
measure from nose to earlobe.
Place in larger nostril.
If useing right nare, bevel to septum.
If useing left nare, tip of airway pointing up.
Insert until you feel resistance, then rotate 180⁰
Rotation not required for right nostril.
Flange should rest against nostril.

OPA
Measure from earlobe to corner of mouth.
Open mouth with ceoss finger technique.
Insert with tip facing roof of mouth.
Rotate 180⁰
Flange rest on lips and teeth.

Question 5

What is a Surfactant?

Answer 5

Reduces surface tension within the alveoli and keeps them expanded, thus making it easier for gas exchange to take place.

A liquid protein substance that coats the alveoli in the lungs, decreases alveolar surface tension, and keeps the alveoli expanded, a low level in a premature infant contributes to respiratory distress syndrome.

Question 6

What is hypoxic drive?

Answer 6

A condition in which chronically low levels of oxygen in the blood stimulate the respiratory drive, see in patients with chronic lung disease.

Question 7

What is the Phrenic Nerve?

Answer 7

Nerve that innervates the diaphragm muscle allowing it to contract, necessary for adequate breathing to occure.

Question 8

Define Intrapulmonary Shunting?

Answer 8

The Bypassing of oxygenpoor blood past the nonfunctional alveoli to the left side of the heart.

Basically blood doesn’t get oxygenated and still gets circulated to the left side of the heart, to be circulated.

Question 9

Define process of inhalation and exhalation and what the diaphragm and intercostal muscles are doing during each phase?

Answer 9

When a person in inhales, the diaphragm and intercostal muscles contract, allowing air to enter body and travel to the lungs. When it contracts, the diaphragm moves down slightly, enlarging the thoracic cage from top to bottom. When the intercoastal muscles contract, they lift the ribs up and out. The combined actions of these structures enlarge the thorax in all directions.

During exhalation, the diaphragm and the intercostal muscles relax. In response, the thorax decreases in size, and the ribs and muscles assume a normal resting position.

Question 10

What happens during aerobic and anaerobic metabolism?

Answer 10

During aerobic metabolism, with oxygen, cells convert glucose into energy.
Anaerobic metabolism is without adequate oxygen the cells cant completely convert glucose into energy, Lactic acid and other toxins accumulate in the cell.

Question 11

What is the Partial Pressure of O2 in Alveoli?

Answer 11

104 mm of Hg

Question 12

What is the Partial Pressure of CO2 in Alveoli?

Answer 12

40 mm of Hg

Question 13

What is the process of breathing fresh air into the respiratory system and exchanging oxygen and carbon dioxide Alveoli in the blood in the pulmonary capillaries?

Answer 13

External Respiration

Question 14

What is this exchange of oxygen and carbon dioxide between the systemic circulatory system and the cells of the body

Answer 14

Internal Respiration

Question 15

How much inspired Oxygen will a Non Rebreather mask provide?

Answer 15

90%

Question 16

How much Inspired Oxygen can a Nasal Cannula provide?

Answer 16

24-44% 1-6L/min

Question 17

Indications and Contradictions for CPAP

Answer 17

Indications
Patients experiencing respiratory distress in which there own compensatory mechanisms are not enough to keep up with there oxygen demand.

Contraindications
Patient in respiratory arrest
Signs or symptoms of pneumothorax or chest trama
Patient with a tracheotomy
Active GI bleed or vomiting
Patient unable to follow verbal commands1

Question 18

What is Ventilation?

Answer 18

The physical act of moving air into and out of the lungs.

Question 19

What are the Ventilation Rates for Adult, child, and infant?

Answer 19

5 to 6 seconds
3 to 5
3 to 5

Question 20

What is the respiratory rate for Adults, children, and infants?

Answer 20

12-20
15-30
25-50

Question 21

What is the Volume Capabilities of BVM for Adult, Pediatric, and infant?

Answer 21

1200-1600
500-700
150-240

Question 22

When does Gastric Distention occur?

Answer 22

Most likely to occur when you ventilate too forcefully or too rapidly with a BVM or Pocket mask.
May also occur when airway is obstructed by foreign body or improper head position.

Question 23

What is the only flow meter not affected by gravity?

Answer 23

Bordon Flow Meter

Question 24

What is Absorption?

Answer 24

Process in which medications travel through the body tissues until they reach the bloodstream.

Question 25

What is Adsorption?

Answer 25

To bind or stick to a surface

Question 26

What is a oral medication that binds and adsorbs ingested toxins in the Gastrointestinal tract for treatment of some poisonings and medical overdoses.

Answer 26

Activated Charcoal

Question 27

What is the dosage of Activated Charcoal?

Answer 27

1-2 g/ kg of body weight

Question 28

How do you convert kilos to pounds?

Answer 28

Pounds divided by 2.2 1kg=2.2lbs Or divide by 2 then subtract 10% of that

Question 29

Whats the difference between Intraosseous and Intravenous?

Answer 29

Intraosseous is into the bone | Intravenous is into the vein

Question 30

What does a Pulse Oximetry do and explain falso positives?

Answer 30

A assessment tool that measures oxygen saturation of hemoglobin in the capillary beds. Hypovolemia Severe peripheral vasoconstriction (chronic hypoxia, smoking, hypothermia) Time delay in detecting respiratory insufficiency Dark or metallic polish Dirty fingers Carbon monoxide poisoning

Question 31

What is a fast acting MDI for acute attack of shortness of breath?

Answer 31

albuterol (Proventil, Ventolin)

Question 32

Alupent is also?

Answer 32

Metaproterenol and Metaprel

Question 33

What are the Vital Sign changes when a patient changes from compensated shock to decompensated shock?

Answer 33

Falling blood Pressure 90mm Hg or lower in a adult

Question 34

What is Nerogenic Shock, what does it affect and what vital signs changes will you see with it?

Answer 34

Damage to the cervical spine, causing widespread blood vessel dilation. Bradycardia (slow pulse) Low blood pressure Signs of neck injury

Question 35

What is shock due to spinal cord damage?

Answer 35

Neurogenic

Question 36

Define Septic Shock?

Answer 36

Severe bacteria infection Toxins damage the vessel walls, causing increased cellular permeability. The vessel walls leak and are unable to contract well.

Question 37

What is the O2 percentage of the Nasal Cannula and NRB?

Answer 37

24-44% 1-6L/min | 90-100% 10-15L/min

Question 38

Whats the difference between Trade name and Generic name?

Answer 38

Trade name is brand name a manufacturer gives a medication and will be Capitalized. Generic name is the original chemical name of a medication and wont be capitalized

Question 39

What are the 6 Rights of medications?

Answer 39

``` Right Patient Right Medication Right Dose Right Route Right Time Right Documentation ```

Question 40

What are capsules?

Answer 40

A gelatin shells filled with powder or liquid medication

Question 41

What are tablets?

Answer 41

Medications are compressed under high pressure. | Tablets often contain other materials that are mixed with the medication.

Question 42

What is a Solution?

Answer 42

A liquid mixture of one or more substances that cannot be separated by filtering or allowing the mixture to stand. Can be given in almost any route.

Question 43

What is a suspension?

Answer 43

Medications ground into fine particles and evenly distributed throughout a liquid by shaking or stirring. Suspensions will separate if they stand or filtered.

Question 44

Difference between lotions and ointments?

Answer 44

Lotions are absorbed rapidly and contain mostly water. Topical medications. Ointments are absorbed most slowly. Neosporin, triple antibiotic

Question 45

What is the dosage of Epi pen for anaphylaxis? And where do you apply it?

Answer 45

.3mg IM | Anterior lateral thigh

Question 46

Where do you give Oral Glucose?

Answer 46

Between cheek and gum on conscious patient only

Question 47

What is transdermal?

Answer 47

Transcutaneous or route of meditation over the skin

Question 48

What are causes of shock?

Answer 48

``` Pump failure (heart) Container, poor vessel function Fluid problem (content low blood volume) ```

Question 49

What is cardiac output?

Answer 49

Amount of blood ejected in 1 min

Question 50

What is Preload?

Answer 50

The precontraction pressure in the heart as the volume of blood builds up

Question 51

What is Afterload?

Answer 51

The force or resistance against which the heart pumps

Question 52

What is Pulmonary Embolism?

Answer 52

A blood clot that breaks off from a large vein and travels to the blood vessels of the long, causing an obstruction of blood flow Obstructive shock

Question 53

What is Cardiac Tamponade?

Answer 53

Compression of the heart as the result of buildup of blood or other fluid and the precardial sack, leading to decreased cardiac output Obstructive shock

Question 54

What is Tension Pneumothorax?

Answer 54

A life threatening collection of air within the pleura space, the volume and pressure have both collapsed the involved lung and caused a shift of the mediastinal structures to the opposite side Obstructive shock

Question 55

What is High Flow O2?

Answer 55

NRB 15 L/min

Question 56

Whats the difference between Obstructive Shock and Distributed Shock?

Answer 56

Obstructive shock is something that occurs when there is a block to blood flow in the heart and great vessels, causing an insufficient blood supply to the body's tissues Distributive shock is a condition that occurs when there is widespread dilation of the small he atrioles, small venules, or both.

Question 57

What does Aspirin do?

Answer 57

Prevents platelet aggregation and can help prevent | Myocardial infarction

Question 58

Systolic needs to be over____ for you to give Nitroglycerin.

Answer 58

100

Question 59

Nitroglycerin can not be given if _____ was taken within 24 hrs.

Answer 59

Viagra

Question 60

When can a EMT administer medication?

Answer 60

Peer-assisted medication Patient-assisted medication EMT-Administered medication

Question 61

What is the lowest portion of the Pharynx?

Answer 61

Laryngopharynx

Question 62

What warms and humidifiers air as it enters the body?

Answer 62

Mucus Membrane

Question 63

What folds over to prevent aspiration of contents into the Trachea when swallowing?

Answer 63

Epiglottis

Question 64

The(______) is a shield-shaped structure formed by two plates that join In a V shape anteriorly to form the (___________) known as the Adam's Apple.

Answer 64

Thyroid Cartilage | Laryngeal prominence

Question 65

What level does the Trachea divide at into the two main stem Bronchi?

Answer 65

Carina

Question 66

What is the thin slippery outer membrane that covers the lung tissue?

Answer 66

Visceral Pleura

Question 67

What lines the inside of the Thoracic Cavity?

Answer 67

Parietal Pleura

Question 68

What are the Thin, Hollow tubes made of smooth muscle?

Answer 68

Bronchioles

Question 69

What is the conduit for air entry into the lungs?

Answer 69

Trachea, or Windpipe

Question 70

What are the balloon like sacs that serve as the functional site for the exchange of oxygen and carbon dioxide?

Answer 70

Alveoli

Question 71

What is the space between the lungs called?

Answer 71

Mediastinum

Question 72

Deoxygenated blood enter the heart through the?

Answer 72

Right Atrium

Question 73

What pumps Oxygenated blood to the rest of the body?

Answer 73

Left Ventricle

Question 74

What pumps the blood from the heart to the lungs for Oxygenation and removal of carbon dioxide?

Answer 74

Right ventricle

Question 75

Where does Oxygenated blood enter the Heart?

Answer 75

Left Atrium

Question 76

What is the muscular part of breathing called?

Answer 76

Inhilation

Question 77

What is the process of moving air into and out of the lungs?

Answer 77

Pulmonary Ventilation

Question 78

What is Partial Pressure measured in?

Answer 78

mm Hg

Question 79

What is Albuteral, when, how?

Answer 79

If the have Asthma or difficulty breathing It stimulates nervous system causing bronchodilation 1-2 inhilations and wait 5 min before repeating dose

Question 80

What is cardiac output?

Answer 80

Amount of blood ejected by the left ventrical in 1 min

Question 81

What is a device that is used to change a liquid medication into a spray and push it into a nostril?

Answer 81

Mucosa Atomizer Device MAD

Question 82

How is Nitro administered and how does it affect the body?

Answer 82

SL tablet or Spray | Dilates blood vessels

Question 83

Why would you use Naloxone(Narcan) and how do you use it?

Answer 83

Reverses respiratory depression secondary to opioid overdose | IM and IN

Question 84

What are the side effects and Contraindications For Naloxone(Narcan)?

Answer 84

Nausea, Vomiting | Contraindication is Hypersensitivity

Question 85

How much Naloxone(Narcan) is in each Dose?

Answer 85

0.4 mg autoinjector or | 2 mg IN