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Flashcards in Final Deck (158):
1

Drugs for RSI

Lidocaine
Etomidate
Succinylcholine
Vecurium

2

Respiration

Inhalation and exhalation (act of breathing)

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Ventilation

Exchange of air between lungs and atmosphere (occurs in the alveoli)

4

Hypoxic drive

Respiratory drive in which the body uses oxygen chemoreceptors instead of C02 receptors to regulate respiratory cycle

5

Respiratory center of the brain

Medulla oblongata and pons (controls rate and depth or movement of diaphragm)

6

Paroxysmal nocturnal dyspnea (PND)

Attacks of severe SOB and coughing that occur at night and awakes the pt from sleep

7

Exacerbation of COPD

Sudden worsening of COPD (can be triggered by infections with bacteria or viruses)

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Pulsus paradoxus

large decrease in systolic BP on insparation

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CO2 normal range

5-6%

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EtCO2 normal range

35-35mmHg

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Hyperventilation

Rapid or deep breathing which causes hypocapnia (low CO2) leading to alkalosis

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Hypoventilation

Breathing at an abnormally slow rate which leads to hypercapnia causing respiratory acidosis

13

Boyle's law

States that a constant temp for a fixed mass, the absolute pressure and the volume of a gas are inversely proportional

14

Henry's law

States that a constant temperature, the amount of gas that dissolves in a liquid is directly proportional to the partial pressure of gas is equilibrium with liquid

15

COPD

A group of lung diseases that block airflow and make it difficult to breathe

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Bronchitis

Inflammation of the tracheobronchial tree caused by a virus

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S/S bronchitis

Soreness in chest and tight throat, congestion, wheezing, dyspnea and slight fever

18

Emphysema

Abnormal and permanent enlargement of air spaces within the lungs which progresses into airway collapse from alveoli forming into blebs

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S/S of emphysema

Wheezing, cough that wont go away, chest tightness or pain

20

Asthma

Inflammation of the airways and is characterized by hyper responsiveness of the tracheobronchial tree to various stimuli leading to edema and mucus secretion which contribute to airflow obstruction and bronchial reactivity

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S/S of asthma

Coughing, wheezing, chest tightness and SOB

22

Pulmonary embolism

One or more arteries in the lungs become blocked by a clot

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S/S of PE

Sudden SOB, chest pain (worsens when the y take a deep breath) sharp pin point pain, cough which may produce pink sputum

24

Pneumonia

Caused by inflammation of the lungs as a result of bacterial or viral infection (at risk: elderly, very young, and people with preexisting health problems [COPD, diabetes, CHF, sickle cell])

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Pneumonia S/S

Cough w/ green or yellow sputum, fever, shaking chills, SOB

26

Croup

An upper airway infection that blocks breathing and has a distinctive barking cough.

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Croup S/S

Stridor, barking cough (commonly occurs in infants and small children), fever

28

Wheezing

A high pitched whistling sound that is more prominent on exhalation but in very sick patients can be heard on inhalation. Suggest an obstruction of the lower airway. If unilateral suspect foreign body or infection, if bilateral suspect asthma. Other causes include inhaled chlorine or lung disease (asbestosis)

29

Rales

A moist crackling sound caused by air passing moisture. Suggest cardiac failure or infection

30

Rhonchi

A lower pitched rattling sound on exhalation that indicates fluid in the larger airways in the lungs. Indicates the presence of mucus in the lungs caused by infection (pneumonia) or inflammation (bronchitis). Also caused by aspiration of fluids. Patients often report a productive cough

31

Stridor

A brassy crowning sound on inhalation caused by the narrowing, swelling, or obstruction of the upper airway. Caused by bacterial epiglottitis, viral croup, swelling from upper airway burns, or a partial foreign body obstruction

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Pleural friction rubs

A squeaking or grating sound heard on inhalation and exhalation that occurs when the pleural linings rub together. Caused by the loss of lubrication due to inflammation of the pleura. Patient may complain of pain on inhalation

33

Left sided heart failure

Occurs when the left vent. Doesn’t pump efficiently. This prevents your body from getting enough 02 rich blood blood backs up into your lungs instead, which causes SOB and buildup of fluid

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Right sided heart failure

LVH can lead to RVH (by blocking blood supply to the right ventricle causing blood in right ventricle to flow back into the right atrium blood volume overload of the right ventricle

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MI

Heart attack, irreversible death of heart secondary to prolonged lack of )2 supply to the heart (blockage of blood flow to heart muscle)

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Angina

Chest pain

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Defibrillate

200j, 300j, 360j

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Synchronized cardioversion

Unstable narrow and wide complex tachyarrhythmias such as atrial fibrillation, atrial flutter and ventricular tachycardia with pulses and SVT
100j, 200j, 300j, 360j

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Transcutaneous pacing

Sinus bradycardia, junctional escape, any heart blocks. Start at 80 bpm, go up by 10 until capture, confirm mechanical capture, set 10 above

40

Coronary artery disease (CAD)

Occurs when there is a buildup of plaque inside the artery walls, overtime buildup may partially block artery and decrease blood flow to heart

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S/S of CAD

Chest pain, (crushing pain, heaviness radiation to arm or jaw), some may have indigestion and nausea

42

Cardiomyopathy

Effects how the heart muscle squeezes (thickening of heart muscle)

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S/S of Cardiomyopathy

SOB, Chest pain, Fainting, Palpitations, Dizziness

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Acute coronary syndrome (ACS)

Sudden reduced blood flow to the heart (ST elevation, Heart attack, Stemi)

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S/S of ACS

Chest pain, N&V, SOB, Diaphoretic, Dizziness, Fatigue

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Ectopic foci

Ectopic pacemaker is an excitable group of cells that causes a premature heartbeat outside the normally functioning SA node

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Frank Starling's law

States that stroke volume of the heart increases in response to an increase in the volume of blood filling in the heart (end diastolic volume)

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Inotropic

Affects the force of contraction

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Chronotropic

Affects the heart rate

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Dromotropic

Affects conduction velocity (electrical)

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Depolarization

Muscle fibers are stimulated to contract

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Repolarization

Closing of sodium and calcium channels stops inflow of ions. Next potassium channels open, allowing escape of potassium ions from cell

After potassium channels close, sodium-potassium pump helps move sodium and potassium back into respective locations

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Refractory period

The period when the cell is depolarized or in the process of repolarizing

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Preload

amount of blood returned to the heart to be pumped out and directly affecting the afterload

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Afterload

The pressure in the aorta or the peripheral vascular resistance, against which the left vent. must pump blood

56

Cardiac output

amount of blood that is pumped out by either ventricle

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Stroke volume

amount of blood pumped out by either ventricle in a single contraction

58

Dementia

Happens over time (memory loss/decreased brain function)

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Delirium

Acute state of mind (alcohol withdrawals)

60

Cardiogenic shock

Occurs when the heart cannot circulate enough blood to maintain adequate peripheral O2 delivery

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Obstructive shock

When blood flow becomes blocked in the heart or a great vessel

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Hypovolemic shock

Circulating blood volume is insufficient to deliver adequate O2 and nutrients to the body

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Distributive shock

Occurs when there is widespread dilation of the resistance vessels, the capacitance vessels or both (most common type anaphylactic, septic, neurogenic)

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Anaphylactic shock

Histamine and other vasodilator proteins are released on exposure to an allergen

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Septic shock

Occurs as a result of widespread infection

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Neurogenic shock

Usually results from spinal cord injuries

67

Abdominal aortic aneurysm (AAA)

Enlargement of the aorta, when ruptured is deadly

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Dissecting aortic aneurysm

tearing of the inner most layer of the aorta, massive bleeding.

69

Sympathetic nervous system

Fight or flight, smooth muscle contraction or relaxation of the blood vessels and bronchioles

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Parasympathetic nervous system

Feed and breed. Control of involuntary, vegetative functions, mediated by the vagus nerves through the chemical ACE

71

Bowel obstruction

Occurs when your small or large intestine is partially or completely blocked causes severe pain that comes and goes

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S/S of bowel obstruction

Cramping pain that comes and goes, vomiting, bloating, constipation, diarrhea

73

Diverticulitis

Occurs when diverticula form in the wall of the colon (if pouches get inflamed or infected, it’s called diverticulitis[can be very painful])

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S/S of diverticulitis

Abdominal pain, LL side worsens when you move (most common symptom), fever, chills, diarrhea, constipation, not feeling like eating)

75

Pulmonary edema

A condition caused by excess fluids in the lungs. Fluid collects in alveoli making it difficult to breath

76

S/S of pulmonary edema

Extreme SOB, dyspnea that worsens when lying flat, feeling of suffocating or drowning, wheezing or gasping for breath, anxiety, cough that produces frothy sputum, rapid or irregular heartbeat

77

Pharmacokinetics

How the drug moves throughout the body

78

Pharmacodynamics

How the drug effects the body and there MOA

79

Stroke

Damage to the brain from interruption of its blood supply

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S/S of stroke

Facial droop, arm drift , speech impediment

81

Addiction

Fact or condition of being addicted to a particular substance, thing or activity

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Habituation

The abnormal tolerance to adverse or therapeutic effects associated with the substance

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Withdrawal

A group of symptoms that occur upon the abrupt discontinuation or decrease intake of the substance

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Allergic reaction

An abnormal immune response the body develops when it has previously been exposed to a substance/ allergen effecting one body system (localized)

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S/S and treatment of allergic reaction

Hives, swelling, no respiratory involvement
-Tx: Benadryl 25-50mg IM/PO

86

Anaphylaxis

Is an extreme systemic response from an allergic reaction involving two or more body systems

87

S/S and treatment of Anaphylaxis

S/s: Pruritus(itching), swelling of the face and tongue(angioedema), urticaria, SOB from swelling of the airway (stridor/wheezing)
-Tx: O2, EPI 0.3-0.5mg 1:1000 IM/SC, Benadryl 25-50mg IV/IM, Albuterol 2.5-5mg in 3.0ml NS
-Anaphylactic shock: untreated anaphylaxis
-S/s: all of the above, hypotension, hypoxia
-Tx: O2, Epi 0.3-0.5mg 1:1000 IM/SC, Benadryl 25-50mg IV/IM, Fluid bolus 1-2L (up to 4L), Dopamine (if pt doesn’t respond to fluids and lungs are clear), Albuterol 2.5-5.0mg in 3.0ml NS, Glucagon if refractory to epinephrine

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Dehydration

Fluid bolus 20mL/kg and ABC

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Hemorrhoids

Swollen and inflamed veins in the rectum and anus discomfort and bleeding

90

Treatment for hemorrhoids

ABC, Fluids to maintain 90mmHg

91

Acute respiratory distress syndrome (ARDS)

Caused by diffuse damage to the alveoli, perhaps result of shock, aspiration of gastric contents, pulmonary edema or a hypoxic event

92

Treatment for ARDS

ABC, Monitor, treat vitals

93

Urinary tract infection (UTI)

Develop in the lower urinary tract, when normal flora enter the urethra and grow

94

Treatment for UTI

ABC, Monitor, Position of comfort, Analgesics if pain (caution for N&V)

95

Esophageal varices

Caused by pressure increases in the blood vessels that surround the esophagus and stomach

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Treatment for esophageal varices

ABC, Fluids as needed, position of comfort, transport

97

Meningitis

Inflammation of the membranes that cover the brain and spinal cord

98

S/S and treatment for meningitis

Sudden onset of fever, severe headache, stiff neck, Kernig sign (pt cannot extend his/her leg at the knee because of stiffness in the hamstring), Burdinznski sign (passive flexion of the leg on one side, causing similar movement to the other), pink rash that becomes purple.
-Tx: MASK UP, ABC, tx vitals, monitor, transport

99

Types of diffusion

Passive diffusion
Facilitated diffusion
Osmosis

100

Passive diffusion

Movement of biochemical and other atomic or molecular substances across cell membranes without need of energy

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Facilitated diffusion

Process of spontaneous passive transport of molecules or ions across a cell’s membrane via specific integral proteins

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Osmosis

Process in which molecules of a solvent pass through a semipermeable membrane from a less concentrated solution to a more concentrated one equalizing concentration on both sides of membrane

103

Pyrexia

Fever

104

Dystonic reactions

Reversible extrapyramidal effects that can occur after admin of a neuroleptic drug (sustained muscle contraction, twisting, repetitive movement, abnormal postures)

105

Barotrauma

Caused by increased air or water pressure (changes in pressure)

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Spontaneous pneumothorax

Formation of small sacs of air in the lung tissue that rupture, causing air to leak into the pleural space

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S/S for spontaneous pneumothorax

Sudden chest pain, sharp pain tightness in chest, SOB, rapid HR, rapid breathing, cough

108

Tension pneumothorax

Progressive build-up of air within the pleural space, usually due to lung lac

109

S/S and treatment for tension pneumothorax

Shock, JVD, reduced breath sounds on one side, deviated trachea
-Tx: Needle decompression 14-16 gauge needle, second intercostal space, above the third rib (midclavicular)

110

Types of heat emergencies

-Heat Cramps
-Heat Syncope
-Heat Exhaustion
-Heatstroke

111

Heat Cramps

Caused by perfuse sweating and subsequent sodium loss from sweating which leads to acute/involuntary/painful muscle spasms in the lower extremities and abdomen. Contributing factors include salt depletion, dehydration, and muscle fatigue.

112

Treatment for heat cramps

Move pt to a cool environment, have the pt drink a sports drink containing electrolytes and eat salty food (if not nauseated), if nauseated start an IV bolus of NS

113

Heat Syncope

An orthostatic syncopal or near-syncopal that occurs in non-acclimated who may be be under heat stress

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Treatment for heat syncope

Place pt in supine position and replace fluid deficits

115

Heat Exhaustion

An orthostatic syncopal or near-syncopal that occurs in non-acclimated who may be be under heat stress

116

S/S and treatment for heat exhaustion

-S/S: Core body temperature (CBT) elevated but less than 104 F, headache, fatigue, weakness, dizziness, nausea, vomiting, and sometimes abdominal cramping, pale/clammy skin, orthostatic VS from fluid loss, brown urine (Rhabdomyolysis)
-Tx: remove to cool environment, supine position, hand/forearm immersion in cold water, oral hydration with sport drinks (no nausea/vomiting), IV fluid boluses (if nauseous and vomiting), Monitor ECG, consider Zofan for nausea

117

Heatstroke

Caused by severe disturbance in the body’s thermoregulation. Can be caused by either extremely high environmental heat (Classic Heatstroke) or exercising in high temp. (Exertional Heatstroke)

118

S/S and treatment for heat stroke

-S/s: CBT above 104 F, ALOC (confused, delirious, or comatose), irritable/combative, hallucinations, seizures, constricted pupils, tachycardia, hyperventilation, low end-tidal CO2
-Tx: ABCs, move to cool environment, cool as rapidly as possible (ice immersion), IV boluses, check BG, monitor ECG, be prepared to treat seizure activity

119

Frostbite

An ischemic injury classified as superficial (“frostnip”) or deep depending on if tissue loss occurs

120

S/S and treatment for frostbite

-S/s: Superficial- numbness, tingling, burning, white/waxy/hard to the touch skin. Once thawing occurs: edema and a throbbing pain occurs for days-weeks. Deep: skin appears white, yellow-white, or mottled blue-white, and is hard/cold/without sensation. Once thawed: injured area turns purple and becomes extremely painful, gangrene (permanent cell death) may set in
-Tx: Move pt into warm environment, elevate affected areas, transport

121

Hypothermia

Defined as a decrease in CBT starting at 95F. 95-93.2 F is mild hypothermia, 86-93.2 F is moderate, below 86 is severe hypothermia

122

S/S and treatment for hypothermia

-S/s: slurred speech, impaired coordination, ataxia (loss of control of body movements)
-Tx: Mild hypothermia (93.2-95 F): passive rewarming
-Moderate (86-93.2 F): active external rewarming using warming blankets/hot packs
-Severe (below 86 F): active core rewarming using warm IV boluses

123

Drugs for crush injury

-Albuterol: 2.5-5.0mg in 3.0ml NS
-Sodium Bicarb: 1mEq/kg IV/IO
-Calcium chloride: 2-4mg/kg IV/IO

124

Treatment for high altitude sickness

ABC, CPAP, Monitor, Transport

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Nitrogen narcosis

A drowsy state induced by breathing air under higher than atmospheric pressure

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Treatment for nitrogen narcosis

ABC, intubate if needed, IV fluids if needed, transport

127

HGB

Type of protein found in RBC that transport 02 throughout the body

128

Drugs for seizures

-Versed 0.1mg/kg slow IV/IO/IN max: 5.0mg
-Eclamptic seizure: mag sulfate: 4-5g IV, 5g in each butt cheek (IM)

129

Meconium

infant poop, strong indicator of fetal distress, hypoxia, asphyxia

130

Ectopic pregnancy

A pregnancy in which the egg implants anywhere outside the uterus
Risk factors: abdominal surgery, PID, several abortions, smoking, endometriosis

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S/S and treatment for ectopic pregnancy

-S/s: sharp or stabbing pain in lower abdomen, vaginal bleeding (more than normal), weakness, dizziness, fainting (GREY TURNER/CULLEN SIGNS)
-Tx: treat for shock, left lateral postion, supportive care

132

Types of abortion

-Abortion
-Spontaneous abortion: (miscarriage) (Natural)
-Elective abortion
-Incomplete abortion

133

Abortion

-Expulsion of the fetus prior to the 20th week gestation

134

Spontaneous abortion

Miscarriage, natural

135

Elective abortion

Intentional

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Incomplete abortion

Abortion leaving any part of conception in the uterus (watch for infection)

137

Mittlelshmertz

Occurs mid ovulation cycle (two weeks before beginning of menses)

138

APGAR

Appearance, Pulse, Grimace, Activity, Respiration

139

Preeclampsia

Dangerous pregnancy condition causing hypertension

140

Eclampsia

Seizure that occurs during a woman’s pregnancy shortly after giving birth

141

Treatment for eclampsia

Mag sulfate: 4-5g IV, 5g IM each butt cheek

142

Pregnancy trimesters

1st trimester= 12th week
2nd trimester = 13-27 week
3rd trimester= 28-end weeks

143

Functions of placenta

Placenta provides 02 and nutrients to the growing baby and removes waste products from the baby’s blood

144

Antepartum risk factors

Any findings that suggest the pregnancy may have negative outcome, anything that effects nutrition and circulation, environment, woman weight less than 100lb or greater than 200lb, smoking, drugs, pre-existing cardiac issues, previous pregnancy, stillborn, habitual abortion, Rh or blood group sensation

145

Postpartum care

Stimulus, temperature management, airway

146

Endometriosis

Inflammation of the uterine lining

147

S/S and treatment for endometriosis

-S/S: fever, malaise, constipation
-Tx: supportive care, ABC, transport

148

Abruptio placenta

-Premature separation of placenta from wall of uterus, caused by maternal hypertension and trauma

149

S/S of abruptio placenta

Bright red blood, severe abdominal pain, pt may report “cant feel baby,” abdomen will be tender

150

Placenta previa

Placenta forms over the cervical opening obstructing birth canal

151

S/S and treatment for placenta previa

-S/S: bright red blood, fetal movement may be present, uterus will be soft-non-tender
-Tx for both: look for grey turner and Cullen signs, treat for shock, left lateral, fluids, place pads loosely over vaginal opening

152

Stages of development

-Neonate: P: 100-205, BP: 66-84, RR: 55
-Infant: P: 100-190, BP: 72-104, RR: 30-55
-Toddler: P: 98-140, BP: 86-106, RR: 22-37
-Preschool: P: 80-120, BP: 89-112, RR: 20-28
-School aged: P: 75-128, BP: 97-116, RR: 18-25
-Adolescent: P: 60-100, BP: 110-130, RR: 12-20

153

Types of consent

-Informed consent
-Expressed consent
-Implied consent
-Consent to treat a minor
-Involuntary consent

154

Informed consent

Before emergency care is administered, pt must be informed of what is going on

155

Expressed consent

Pt of legal age is informed and either gives verbal or nonverbal consent

156

Implied consent

You assume the pt would give consent if able too

157

Consent to treat a minor

Consent received from parent or guardian, if non around treat as they are non an adult

158

Involuntary consent

Life threat, adult who doesn’t want treatment, forced consent