Test 2 Flashcards

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1
Q

How do you insert a Nasopharyngeal Airway

A
  1. Size the airway by measuring from the tip of the patients nose to the earlobe. Lube the tip
  2. Insert the lubed airway, curvature following the floor of the nose. Bevel should face the septum.
  3. Advance the airway, if using left Nate rotate the NPA 180 into position. Not needed in right nostril.
  4. Continue until flange rests against the nostril. If obstructed move to other nostril.
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2
Q

How much oxygen concentration can a nasal cannula deliver?

And non rebreather deliver?

A

Nasal cannula = 24% to 44%

Non rebreather = 95%

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3
Q

What facilitates has exchange in The lungs?

A

Alveoli

Gas exchange takes place in the millions of alveoli in the lungs and the capillaries that envelop them. As shown below, inhaled oxygen moves from the alveoli to the blood in the capillaries, and carbon dioxide moves from the blood in the capillaries to the air in the alveoli.

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4
Q

How do you suction the oropharynx?

A
  1. Make sure suction unit is turned on, clamp the tubing, vacuum more than 300mm Hg.
  2. Measure the catheter from corner of the mouth to the earlobe, or angle of the jaw.
  3. Turn Pt. Head to the side(unless spinal injury). Open the mouth using the cross finger technique, insert catheter to the predetermined depth without suctioning.
  4. Apply suction in a circular motion, no more than 15 seconds.
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5
Q

What are the structures of the lower airway?

A
  1. Trachea (wind pipe)
  2. Carina (base of the trachea- fork to lungs)
  3. In the lung -
    A. Alveoli
    B. Main bronchi (from Carina)
    C. Smaller bronchi
    D. Bronchioles
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6
Q

What nerve allows the diaphragm to contract?

A

Phrenic nerve!

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7
Q

What is the medication Alpuent used for?

A

Used to treat wheezing and shortness of breath that commonly occur with lung problems (e.g., asthma, chronic obstructive pulmonary disease).

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8
Q

What is the difference In geriatric pt and regular pt when taking medication?

A

Geriatric pt’s often have slower absorption and elimination times, necessitating modification of the doses administered.

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9
Q

What does Aspirin do and what is it used for?

A

Aspirin is an antipyretic (reduces fever), analgesic (reduces pain), and anti-Inflammatory. Inhibits platelet aggregation (clumping).

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10
Q

How is nitroglycerin used?

A

Nitroglycerin which is prescribed for chest pain, can be given sublingually as a spray or a tablet.

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11
Q

What does nitroglycerin do?

A

Nitro increases blood flow by relieving the spasms or causing the arteries to dilate. It does this by relaxing the muscular walls of the coronary arteries and veins.

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12
Q

When to assist someone with their Epipen?

A

When they are having a life-threatening anaphylactic reaction.

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13
Q

What is neurogenic shock?

A

Neurogenic shock is usually the result of high spinal cord injury. In neurogenic shock the muscles in the walls of the blood vessels are cut off from the sympathetic nervous system and nerve impulses that caused them to contract. Therefore all vessels below the level of the spinal injuries daily widely increasing the size and capacity of the vascular system and causing blood to pool.

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14
Q

What do you do when you get gastric distention?

A

Contact medical control

Check the airway again

Reposition the patient

Watch for rise and fall of the chest

Avoid giving forceful breaths

Have a suction unit nearby just in case pt vomits

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15
Q

What to do with a choking infant?

A

Responsive:

  1. Do not use abdominal thrusts!
  2. Hold infant face down on forearm. Support the jaw and face with your hand. Perform back slaps, 5 between the shoulder blades, using the heel of your hand.
  3. Then turn the infant over and give the infant five quick chest thrusts, using two fingers placed on the lower half of the sternum.

Unresponsive: begin cpr with chest compressions, open the airway and clear any seen obstructions. Resume compressions and look in airway after compressions.

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16
Q

What do do with airway obstructions?

A

Mild obstruction:

  1. If patient has strong effective cough, encourage them to cough.

Responsive patients:

  1. Perform Abdominal Thrust Maneuver or cheat thrusts for pregnant patients.

Responsive to Unresponsive patients:

  1. Help pt to ground.
  2. 30 chest compressions
  3. Open airway look in mouth, if it can be easily removed, remove it.
  4. Repeat step 2-3 until obstruction is removed.
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17
Q

What to do if you witness a cardiac arrest?

A
  1. Activate emergency response system, 911
  2. Immediate high quality CPR
  3. Rapid defibrillation
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18
Q

When to use CO2 end tidal monitoring?

A

Paramedic or other ALS providers use these devices as a secondary means to

  1. determine proper placement of an advanced airway,
  2. asses the pt’s ventilators status, and
  3. avoid inadvertent hyperventilation of pt’s with head injuries.
19
Q

What are other ways to check patient circulation other that the pt pulse?

A

Capillary refill

Temperature

Color

20
Q

Steps of secondary assessment

A

Pulse rate, Rhythm, and quality

Blood pressure

Skin color

Temperature, and condition

Pupil size and reactivity

21
Q

Findings during an assessment with someone who has a cardiovascular problem?

A
  1. Pulseless, not breathing, unresponsive.
  2. Dizziness, fainting
  3. Shortness of breath
  4. Chest pain
  5. Pulse OX 94% or lower
  6. Abnormalities in pulse
  7. Changes in perfusion
  8. Skin color, temperature
  9. Capillary refill time
22
Q

When to apply oxygen?

A
  1. When a pt has an altered mental status.
  2. Poor skin color
  3. Cyanotic
  4. Low oxygen saturation
23
Q

How to treat someone with symptoms of anxiety?

A

Pg. 344

  1. Smiling
  2. Delicate touch
  3. Positive demeanor
  4. Your presence
  5. Remember safety
24
Q

What are the causes of pulmonary edema?

A
  1. Heart muscle is so injured after a heart attack or other illness that it cannot circulate blood properly. High blood pressure , low cardiac output.
  2. In these cases the left side of the heart cannot remove blood from the long as fast as the right side delivers it. As a result fluid builds up within the alveoli and in the long tissue between the alveoli and the pulmonary capillaries.
  3. This accumulation of fluid is referred to as pulmonary edema and it is usually a result of congestive heart failure.
25
Q

What is Alkalosis?

A

The build up of excess base (lack of acids) in the body fluids.

26
Q

What is a cute hyperventilation syndrome?

A

Quick rapid deep breaths.

May present with chest pain, synscope, stiffness in fingers periasthesis

27
Q

What is dyspnea?

A

Shortness of breath

28
Q

When do you insert an NPA ?

A

Usually used with an unresponsive pt.

Or a patient with altered mental status

or who has an intact gag reflex and is not able to maintain his or her airway spontaneously.

Or a pt has just had a seizure.

29
Q

What do you do if someone is in cardiac arrest and has an implant a defibrillator?

A

Should be treated like anyone else and CPR should be initiated.

Pg. 654

30
Q

What is acute coronary syndrome?

A

A group of symptoms caused by myocardial ischemia includes angina and myocardial infarction.

31
Q

Cardiogenic shock followed by acute myocardial infarction (AMI)

A

Cardiogenic shock is often caused by a heart attack.

Cardiogenic shock can occur immediately or as late as 24 hours after the Onset of the AMI.

32
Q

What to do after you assist someone with their own nitroglycerin?

A

Recheck blood pressure within 5 minutes.

33
Q

Common side effects of nitroglycerin?

A

Bradycardia

Hypocardia

Severe headache

34
Q

Signs and Symptoms of an Acute Myocardial Infarction?

A
  1. Sudden onset of weakness, nausea, and sweating without an obvious cause.
  2. Chest pain, discomfort, or pressure that is often crushing and squeezing and that does not change with each breath.
  3. Pain, discomfort, or pressure in the lower jaw, arms, back, abdomen, or neck.
  4. irregular heartbeat and synscope
  5. Shortness of breath, or dyspnea.
  6. Nausea/vomiting
  7. Pink, frothy sputnum (pulmonary edema)
  8. Sudden death
35
Q

What it means when the AED says no shock advised?

What rhythms an AED will shock?

A
  1. Has a pulse, Regained a pulse, or is pulseless but not in a shockable rhythm.
  2. VF or VT (ventricular tachycardia)
36
Q

When and how inhalation occurs?

A

Inhalation occurs when the diaphragm contracts increasing the volume of the lung cavity.

37
Q

Oral glucose

A

Given to patients who have low blood sugar, are diabetic.

Contraindications Are if a pt has altered mental status or is unresponsive.

38
Q

Anaphylactic shock?

A

Occurs due to an acute immunologic reaction to venom or foods.

Treatment: Epinephrine

39
Q

Signs of adequate ventilation?

A

Respiration between 12-20

Equal chest rise and fall

Bilateral clear and equal chest sounds

Reg pattern of inhalation and exhalation

40
Q

How to fix a tension pneumothorax?

A
  1. Needle decompression
41
Q

What do you do if you receive a blood pressure from an automatic machine and does not match patient symptoms?

A

Take the blood pressure manually

42
Q

Assessment priorities

A
  1. Scene Size up
    BSI-Scene safety
    Moi/NOi
  2. primary survey/resuscitation
    ABC’s
  3. History taking OPQRST
  4. Secondary Assessment
  5. Vital Signs
  6. Reassessment
43
Q

When can an adult administer aspirin?

A

?

44
Q

Main cause of prehospital attest?

A

Dysthymia

V- Fib

V- Tachycardia