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118 Final Review Flashcards

1
Q

Atropine is what type of drug?

and what is it for?

A

Anticholinergic

Bradycardia

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2
Q

Midazolam (lam) is what type of drug?

and what is it for?

A

Benzodiazepine (Benzo)

Seizure/Sedation

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3
Q

Lidocaine is what type of drug?

and what is it for?

A

Na Channel Blocker (sodium)

and Class 1 Anti dysrhythmic

VTACH

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4
Q

Epinephrine is what type of drug?

and what is it for?

A

Alpha & Beta Agonist

1000 = Allergic Rx

10,000 = Cardiac Arrest

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5
Q

Dextrose is what type of drug?

and what is it for?

A

Carbohydrate

Hypoglycemia

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6
Q

Adenosine is what type of drug?

and what is it for?

A

Class 5 antidysrhythmic

SVT

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7
Q

Diltiazem is what type of drug?

and what is it for?

A

Ca Channel blocker (class 4 antidysrhythmic)

AFIB

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8
Q

Ondansetron is what type of drug?

and what is it for?

A

(zofran) Anti-emetic

nausea/vomitting

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9
Q

What degree angle is a
subcutaneous IV

what is the max

A

45 degrees

3mL max

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10
Q

What degree angle is a
Intramuscular IV

what is the max

A

90 degrees

5mL max

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11
Q

What are 3 Enteral (GI)
routes

A

G-tube

Oral

NG Tube

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12
Q

What are 5 Parenteral routes

A

SQ

IV

IM

Transdermal

IO

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13
Q

What is the right locations to do an I/O

A

Proximal humural head

Distal tibia

Proximal tibia

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14
Q

What FDA drug category should you not give to a pregnant woman

A

Category X

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15
Q

What is the dividing line between upper and lower airway

A

Glottis/glottic opening

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16
Q
A

a. vallecula
b. epiglottis
c. vocal cords
d. piriform fossae
e. arytenoid

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17
Q

Define
External Respirations

also known as

A

oxygen and carbon dioxide exchanging in the alveoli and the blood in the pulmonary capillaries

aka
pulmonary respiration

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18
Q

Define
Internal Respiration

also known as

A

exchange in the systemic circulation and the cells of the body

aka
cellular respiration

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19
Q

Define Biots

caused by?

aka?

A

Irregular breathing with periods of apnea

caused by ICP

aka Ataxic

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20
Q

Define Cheyne-Stokes

A

Gradual increase in resp rate (more rapid than biots) and depth followed by decrease with periods of apnea

caused by Brainstem injury

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21
Q

What is a normal ETCO2

A

35-45

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22
Q

How should you breath for someone with HIGH
ETCO2

A

Increase respirations

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23
Q

How should you breath for someone with LOW
ETCO2

A

Decrease respirations

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24
Q

How do you find

Minute Volume

A

TIDAL VOLUME

X

RESP RATE

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25
What is normal resp rate for adult
12-20 RR
26
What is a Mallampati Score What is the worst
Grades opening of airway on scale 1-4 4 is the worst
27
What is the 3-3-2 rule what indicates difficulty
Using fingers assess hyoid bone to the chin 3 thyroid cart to chin 2 Any measurement less than 332 indicates potential difficulty with airway managment
28
Define Hypoxic drive
The body's backup for resp control based on if the amount of OXYGEN in the blood instead of NORMALLY C02 in the blood.
29
Define PEEP
the amount of pressure the patient EXHALES against positive end expiratory pressure
30
Hyper/hypo capnia
Hyper/excess hypo/low CO2 levels in the blood
31
How can you tell if you have poor lung compliance
you will have increased resistance during vent attempts
32
What is DOPE
A mnemonic for intubated patients Displacement Obstruction Pneumothorax Equipment fail
33
Max suction time without oxygenating
10 seconds
34
What are 2 non invasive mechanical vents
CPAP and BiPAP
35
What is the normal range of PH - define PaCO2 - define HCO2 - define What amount is acid/alk
ph - potential hydrogen acid - alk 7.35 - 7.45 paco2 - respiratory ALK - ACID 35 - 45 hco3 - metabolic acid - alk 22 - 26
36
ph is a measurement of
equilibrium
37
How does acidosis and alkalosis effect the CNS
acidosis SUPPRESSES CNS alkalosis IRRITATES CNS
38
What are the 3 main regulators of the system (fast to slow)
1. chemical buffers (fast) 2. respiratory system 3. renal system (slowest)
39
What are the 4 main buffer systems
1. bicarb 2. phosphate 3. hemoglobin 4. protein
40
What are the two parts of the Peripheral nervous system
Somatic and Autonomic
41
What are the two parts of the Autonomic system
Sympathetic and Parasympathetic
42
What are the two parts of the CNS
Brain and Spinal cord
43
Midrysis vs Miosis
Midrysis - Dilated Miosis - Constricted
44
What are the NTM Receptors Sub-receptors of the SYMPATHETIC sys
Sympathetic NTM - Norepi, Epi Receptors - Adrenergic Sub-recp - A1, A2, B1, B2
45
What are the NTM Receptors Sub-receptors of the PARASYMPATHETIC sys
Parasympathetic NTM - Acetylcholine Receptors - Cholinergic Sub-Recp- Nicotinic, Muscarinic
46
PharmacoKINETICS vs PharmacoDYNAMICS
Kinetics - what the body does to the drug Dynamics - what the drug does to the body
47
Dysphagia vs Dysphasia
gia - (Gulp) swallowing Sia - Speech
48
Define Efficacy and Affinity
Efficacy - Initiating cell activity Affinity - How much the drug LIKES receptor
49
Define Agonist vs Antagonist
Antagonist - PREVENTS from receptor Agonist - INITIATES cell activity
50
What is brand name for Diltiazem and what does it do
Cardizem Ca Ch Blocker Antihypertensive
51
What is brand name for Captopril and what does it do
Capoten Ace Inhibitor Antihypertensive
52
Epi 1,000 vs 10,000 how much fluid and what is it for
1,000 - 1mg/1mL alergic 10,000 1mg/10mL cardiac
53
What does Morphine do
It is an Opioid Agonist
54
What route is Bucal/Sublingual and Rectal considered
Parenteral - subL / Bucal Enteral - Rectal
55
What are signs/symptoms of Opioid and causes
s/s - Miosis, low RR, low cns, Nodding out causes - Fentanyl, Oxy, Heroin, etc.
56
What are signs/symptoms of Sedative and causes
s/s - lethargy, ataxia, low cns, dysarthria causes - (lams/pams) Midazolam, Diazepam, sleep aids
57
What are signs/symptoms of Anticholinergic and causes
s/s - mad, blind, dry, red, hot causes - atropine, antihistamines
58
What are signs/symptoms of Cholinergic and causes
s/s - SLUDGE/DUMBELLS causes - Sarin, Insecticides, Organophosphates
59
What are signs/symptoms of Sympathomimetics/Stimulants and causes
s/s restlessness, agitation, high rr, mydriasis causes - cocaine, diet pills, amphetamines, decongestants, bath salts
60
Ataxia and Dysarthria
Ataxia - difficulty walking dysarthria - difficult mouth movement
61
Hepatitis inflammation affects what part of the body first
RUQ pain (liver)
62
Define Ascites
Fluid collects in spaces within your abdomen can affect your breathing sign of heart failure if in lungs
63
Which part of the heart do pulses come from
The LEFT ventricle
64
What is a Cholecystectomy
Removal of the GALL Bladder
65
Define Bruits and Thrill
Bruit - turbulent blood flow Thrill - palpated sensation
66
Which Cranial Nerves effect the eyes
3/4/6 make eyes do tricks 3 - oculomotor 4 - trochlear 6 - Abucens
67
What is the mnemonic for remembering all the Cranial Nerves and Sensory or Motor
oh oh oh to touch and feel a green vegetable a heaven Oh - olfactory Oh - Optic Oh - oculomotor To - Trochlear Touch - Trigeminal And - Abducens Feel - Facial A - Acoustic Green - Glossopharygeal Vegetable - Vagus A - accessory Heaven - hypoglossal Some Say Money Matters But My Brother Says Big Brains Matter More
68
Define the words Encephalo Cephalo Oto Chole Hepato
Encephalo - brain Cephalo - head Oto - ear Chole - bile/gall bladder Hepato - liver
69
Where is the Spleen located
LUQ
70
Define Erythema
Redness
71
Name 3 hollow organs in the stomach
Small intestine Large intestine and Pancreas
72
What does AVPU stand for
Alert and Oriented Verbal Pain Unresponsive
73
TB infection vs disease
infection - bacteria lies dormant disease - at least 1 symptom, can transmit
74
Where does the patient Hx and Rx (and what patient says) go in SOAPE
Subjective
75
Where does the patient V1 (and what you see) go
Objective
76
Where does the what you think is wrong and rule outs go
Asessment
77
Where does what was done for the patient (along with patient belongings) go
Plan
78
Where does effects of your treatment (2nd/3rd set of vitals) go
Evaluation
79
Define Tort
Wrongful act giving rise to a civil lawsuit
80
Define Libel vs Slander
Libel - WRITTEN false Slander - ORAL false
81
Define NPO PO CABG qd PRN
Npo - nothing by mouth po - by mouth CABG - coronary artery bypass graft qd - every day PRN - as needed
82
What drip set do you use if there is none in math
60 gtts
83
What is the formula for drug calc
Have Time divided by Desired Weight kg Fluid Drip
84
What are the intrinsic rates of the heart
SA 60 -100 AV 40 - 60 Ventricles 20 - 40
85
What does PRI represent and QRS T and first half of T and back half of T
pri - Atrial Depolarization qrs - vent depolarization T - vent repolarization q- t - absolute refractory back half of t - relative
86
During Polarization Depolarization Repolarization where is sodium and potassium
Polarization - ready state na outside / k inside DEpolarization (QRS) - discharge they SWITCH k outside / na inside REpolarization (T) - recovery switch back to na outside / k inside
87
What are the 4 E's
Economic Engineering Enforcement Education
88
What makes a good goal
It can be measured
89
An airbag is considered what type of prevention
Primary / passive
90
Define the 4 types of consent
informed - expressed - implied - involuntary -
91
Define the 4 types of Negligence
Duty to Act Breach of Duty Proximate Cause Harm
92
Base and Apex of Lungs vs Heart
Base (top)/Apex (bottom) - heart Apex (top)/ Base(bottom) - lungs
93
When do you get a set of vitals
during the secondary assessment you get hx/sample/opqrst
94
Name the 3 lower airway sounds
Wheezing (whistling) Crackles Rales
95
Name the 3 lower airway sounds
Wheezing (whistling) Crackles Rales
96
Name 2 upper airway sounds
Stridor Plura Friction Rub
97
Define Becks Triad
Beck's triad - excess fluid or air around the heart. 1 low blood pressure, 2 bulging neck veins, 3 muffled heartbeats.
98
What does the S2 sound indicate
the semi-lunar valve closing
99
Define (tropys) Chrono - Ino - Drono -
Chrono - HR (SA) INO - Contractility (Vent) Drono - Conductivity (A/V)
100
What does OLD BEN stand for with GCS
Obeys - 6 Localizes - 5 Draws from pain - 4 Bends - 3 Extends - 2 None - 1
101
What does VOICE stand for with GCS
Eloquent - 5 Confused - 4 Incomprehensible - 3 Oohh - 2 Voiceless - 1
102
What does Amiodarone do
K+ channel blocker
103
Which organ elementate and which biotransfers
Kidneys eliminate Liver bio transfer
104
Transport Decision is part of what assessment
primary
105
Define Reflexes Moro Palmar Rooting Sucking
Moro - startled Palmar - object in palm Rooting - cheek sucking - sucking, lips
106
Breathing what is active what is passive
active - inhalation passive - exhalation
107
what does fio2 measure
fraction of inspired oxygen % of oxy inhaled during ventilation
108
Define V/Q mismatch
Vent and Perfusion must match
109
bpm for Junctional escape Accelerated junctional junctional tachycardia
junctional escape 40-60 accelerated junc 60-100 junc tachy 100-180
110
What size needle do you use for I/O
o 15mm 3-39kg patients o 25mm over 40kg patients o 45mm Excessive subcutaneous tissue & Humeral IO insertion
111
What are IV site reactions and complications
- Infiltration - Occlusion - Vein Irritation - Thrombophlebitis - Hematoma - Nerve, tendon, or ligament damage - Arterial puncture
112
Define Isotonic, Hypertonic, and Hypotonic
- Isotonic 0.9% sodium chloride (normal saline), Lactated Ringers - Hypertonic Greater concentration of sodium, water drawn out of cells, and cell may collapse - Hypotonic Lower concentration of sodium, water drawn into cells, cells may swell & possibly burst
113
What are the needle sizes for Intradermal, SQ, and IM
Intradermal - 25-27 gauge - 3/8” to 1” long - 10–15-degree angle w/ bevel up Subcutaneous - 24-26 gauge - ½” to 1” long - 45-degree angle w/ bevel up o Up to 3mL Intramuscular - 21 gauge - 1-2’ long - 90-degree angle o Up to 5mL
114
What are the 10 rights
- Right Patient - Right Medication - Right Dose - Right Route - Right Time - Right Education - Right to Refuse - Right Evaluation - Right Assessment - Right Documentation & Reporting
115
Define A1,A2,B1,B2
* A1 – Vasoconstriction * A2 – Gatekeeper for endogenous stuff * B1 – Heart rate, contract, conduct all increase * B2 – Broncho smooth muscle dilation
116
Define the sub-receptors of the Parasympathetic sys
 Sub Receptors: Nicotinic & Muscarinic * Nicotinic – Skeletal muscle contraction * Muscarinic – SLUDGEM/DUMBBELLS
117
What are the classes of Antidysrhythmic Meds
Class 1: Sodium Lidocaine Class 2: Beta Blockers Beta Blockers Class 3: Potassium Channel Blockers Amiodarone Class 4: Calcium Channel Blockers Diltiazem
118
Define Dose Response, Threshold, and Potency
Dose-Response Curve: Relationship with does and efficacy Threshold level: dose at which cellular activity begins Potency: The relationship of concentration and the cellular response
119
What are the processes when a med enters the body
- Absorption - Distribution - Biotransformation - Elimination
120
Where do meds come from (sources) (and what are they also categorized as i.e. natural...)
- Sources of medications o Plant o Animal o Microorganism o Mineral - Medications are either o Natural o Semisynthetic o Synthetic
121
Which side of the heart is the mitral valve and the tricuspid valve
mitral - left side tricuspid - right side
122
Define Babinski sign
toes move up (positive) or down (negative) In pediatrics under 2 years old the positive sign is normal, but in adults the positive sign suggests central nervous system disorder or injury.
123
Define Orthostatic Hypotension
o Systolic down 20, diastolic up 10, pulse up 20 = positive finding for Orthostatic Hypotension
124
Cullens Sign vs Grey Turners
- Cullen sign – blue discoloration periumbilical area - Grey Turners sign – blue discoloration along flanks
125
Define Korotkoff Sounds
o Sounds related to a patient’s blood pressure  5 phases, but only 1 & 5 are clinically significant * 1st Phase: Faint tapping that increases in intensity, correlates to systolic contractions * 5th Phase: all sounds disappearing, correlates to diastolic pressure
126
Define the heart sounds S1, S2, S3, S4
o S1  Represents: Aortic Region, closure of AV valves  Where heard: 2nd-3rd intercostal space at right sternal boarder o S2  Represents: Pulmonic Region, closure of Semilunar valves  Where heard: 2nd-3rd intercostal space at left sternal boarder o S3  Represents: Tricuspid Region  Where heard: 4th, 5th & 6th intercostal space at left sternal boarder o S4  Represents: Mitral Region, closure of Mitral valve  Where heard: Apex of the heart, 5th&6th intercostal space at midclavicular line
127
Define Egophony vs Pectoriloquy
o Whispered Pectoriloquy  Preformed in the same manor but ask the patient to whisper “ninety-nine”. Should be muffled and indistinct, if loud and clear, positive sign. o Egophony  Place stethoscope over suspected area of consolidation and ask the patient to say a drawn out “eeeeeeee”. A normal response will be a muffled long vowel sound. However if there is any consolidation, the sound will sound like an “A”.
128
Brassy crowing sound
o Stridor – brassy crowing sound often heard without stethoscope, upper airway, obstruction
129
Define Differential Diagnosis
is the list of possible diagnoses based on patient assessment findings, and the working diagnosis is the one diagnosis from the differential list which you are basing your treatment plan
130
What are the ages of Infants, Toddlers, Preschoolers, School Age, Adolescents, Early Adults, Middle Adults, Late Adults
- Infants: 1 month – 1 year - Toddlers: 1-2 years old - Preschoolers: 3-5 years old - School Age: 6-12 years old - Adolescents: 13-19 years old - Early Adults: 19-40 years old - Middle Adults: 41-60 years old - Late Adults: 61+ years old
131
Define Bioavailability
the percentage of unchanged substance that is present in the systemic circulation.
132
Define Half-Life
the amount of time needed for the average person to metabolize or eliminate 50% of a substance in the plasma. The half-life of a drug is commonly expressed in minutes, but it is possible for the half-life to last for hours or even days.
133
Where does most absorption take place?
the small intestine (little absorption occurs in the stomach)
134
What are the 5 major toxidromes
narcotic, sympathomimetic, sedative-hypnotic, cholinergic, anticholinergic
135
Give examples and signs of Cholinergic Toxidrome
Ex. Organophosphates Signs: DUMBELS: diarrhea, Urination, Miosis (constrict), Muscle weak, Brady, Emesis, Lacrimation (tearing of eyes) Seizures, respiratory depression, apnea (not breathing)
136
Define Wernicke Korsakoff Syndrome
is a memory disorder that results from vitamin B1 deficiency and is associated with alcoholism. Damages nerve cells, part of the brain involved with memory.
137
Define Nystagmus
Double vision, eyelid drooping
138
Define DT's
Delirium Tremens, withdrawal from alcoholism, fever sweating, agitation, seizures, can be fatal. tremors, diaphoresis, confusion, fever, reslessness, and tachy
139
Define SSRI
Selective Serotonin Reuptake Inhibitors A class of anti-depressants that inhibit the reuptake of serotonin
140
Acid vs Alkalis with water
Acid is more water soluble (diluted quick) Alkalis needs water continually flowing (takes longer)
141
Signs- cold dry skin could be...
sedative overdose or alchol
142
signs - resp slower 12 shallow could be...
Sedative overdose
143
signs - Pupils dilated and not reactive to light, shallow breathing, sluggishness, drowsy, lack of consciousness could be...
Barbituate overdose
144
Define Obtunded
Dulled or reduced level or alertness
145
Define Labile
Rapidly shifting among different emotional states
146
Metformin
class - anti-diabetic for - type 2 diabetes trade name - glucophage
147
Atorvastatin
class - statin for - high cholesterol trade name - lipitor
148
Omeprazole
class - proton-pump inhibitor for - gerd, ulcers, heartburn trade name - prilosec
149
Define Agnosia
Failure to recognize objects
150
Define Cataonia
Immobility and stupor
151
What Does Sharkfin Wave form Indicate
Bronchospasm/Bronchoconstriction Difficulty during the exhalation phase with incomplete alveolar emptying COPD, asthma
152
What are the Phases of the waveform?
Phase 1 (AB) Respiratory Baseline - initial exhalation Phase 2 (BC) EXPIRATORY Upslope Phase 3 (CD) Alveolar Plateau Phase 4 (DE) INSPIRATORY Downstroke
153
What are the 3 primary buffer systems in order of speed
1 Bicarbonate (Chemical) Buffer 2. Respiratory 3. Renal (kidneys)
154
Name the parts
A. Vallecula B. Epiglottis C. Vocal Cords D. PIRIFORM Fossae E. Arytenoid/Corniculate
155
Name the parts
A. Hard Palate B. Oral Cavity C. Tongue D. Larynx E. Thyroid Cartilage F. Cricoid Cartilage G. Nasopharynx H. Soft Palate I. Oropharynx J. Epiglottis K. Esophagus L. Trachea
156
Define Hypoxic Drive
Brain (CSF) starts using oxygen chemoreceptors to control breathing instead of normally CO2 receptors usually end-stage COPD
157
What is the normal total lung capacity of an adult man? what is it broken into (4) ?
6,000mL total 1. Inspiratory - 3,000 mL 2. Expiratory - 1,200 mL 3. Residual - 1,200 mL 4. Tidal Volume - 500mL
158
What is Tidal volume?
The amount of air that is moved into or out of the lungs during a single breath.
159
What is Dead Space?
The area of the lung that has little or no gas exchange usually 150mL
160
Define Oxygenation
loading oxygen ONTO HEMOGLOBIN in the blood stream
161
Define Respiration
Actual GAS EXCHANGE of oxygen and CO2 in the alveoli
162
Define Ventilation
PHYSICAL act of MOVING air in/out of lungs
163
Which cervical nerves control the diaphragm
C3 thru C5 keep the diaphragm alive
164
The diaphragm is both a ________ and _________ muscle
voluntary (skeletal) and involuntary (smooth)
165
Oxygenation _____________ occur without ventilation. Ventilation is possible _________ Oxygenation.
Oxygenation __cannot__ occur without ventilation. Ventilation IS possible _without_ Oxygenation.
166
Sedative drug and Dose (used for RSI)
Ketamine IV/IO 2mg/kg over 1 min
167
Paralytic and Dose (Dep and Non-Dep)
Dep- SUCCS 1.5mg/kg IV/IO (rapid) Non-Dep - VECURONIUM 0.1mg/kg IV/IO
168
Dose for Midazolam as a sedative (RSI)
18-68 y/o - 5mg IV/IM 69 (or over) - 2.5mg IV/IM consult for repeat dose
169
CPAP vs BiPAP Differences
CPAP: Increases PRESSURE IN lungs, opens collapsed alveoli PUSHES O2 across alveolar membrane, and forces interstitial fluid back into the pulmonary circulation BiPAP: Two Pressures (Ins iPAP/ Exp ePAP) iPAP higher pressure for bases ePAP lower pressure to keep bases open
170
Define RHINORRHEA What conditions may be associated
Thin, clear nasal discharge Asthma, Pneumonia, Chronic BRONCHITIS, COVID, RSV (wet respiratory conditions)
171
What are the 2 types of Respirations (which EXTERNAL or INTERNAL) ?
1. PULMONARY Resp is EXTERNAL (alveoli) 2. CELLULAR Resp is INTERNAL (in cells)
172
Define Intrinsic and Extrinsic
Intrinsic (internal) extrinsic (external) pertaining to airway obstructions
173
Anoxia
Absence of oxygen
174
Define Peak Expiratory Flow
Estimate of the extent of bronchoconstriction, to determine if therapy is working
175
Decrease the number of H+ (hydrogen) ions the more __________
Alkaline Raises the PH
176
Removal of Acids is performed by
Lungs and Kidneys
177
What regulates the bicarbonate buffer
the kidneys
178
What is the ratio of buffers to acids (bicarb to carbonic)
1:20
179
What cells line the airways and produce mucous
Goblet Cells
180
Alveoli function best when they are
partially inflated
181
What causes a person to cough if too deep a breath is taken (prevents lungs from over inflating)
Hering-Breuer Reflex
182
How can you assess gag reflex
Use eyelash reflex
183
Name 4 uses of CAPNO
detection of ROSC Effective CPR Correct Airway placement Detect hypo/hyper vent
184
Term for positional dyspnea
Orthopnea difficulty breathing while laying down sign of heart failure or lung disease
185
Define PACO2
its the partial pressure of co2 in ARTERIAL blood
186
What is the Adult/ped dead space Infant/neonate dead space
Adult/ped - 6.6mL (et tube greater than 4.5mm) Infant/Neo - 0.5mL
187
What is the dip at the top of the wave form called (during exhalation)
Curare Cleft during phase 3 C-D plateu can be sign of bucking the tube, spontaneous resp effort (movement of the diaphragm) recovering from paralytics (needs more sedation)
188
ph 7.6 co2 28 HCO2 29
Mixed Alkalosis ph over 7.45 alk co2 under 35 alk hco2 over 26 alk
189
ph 7.44 co2 37 hco3 25
normal no acid/base disturbance
190
Ph 7.2 CO2 37 HCO3 21
Metabolic Acidosis uncompensated (no change in co2, resp) 7.2 - ph under 7.35 acid co2 normal 21 - hco3 under 22 acid (metabolic)
191
ph 7.6 co2 42 hco3 30
Metabolic Alkalosis uncompensated (no change in co2, resp) 7.6 - ph over 7.45 alk co2 normal 30 - hco3 over 26 (metabolic)
192
The Renal system is also known as the
Metabolic System (HCO3 measures it)
193
pH 7.1 co2 26 hco3 19
7.1 acid 27 low alk (system thats compensating) 19 acid META Partially Compensated Metabolic Acidosis
194
pH 7.6 co2 25 hco3 20
7.6 alk co2 25 low alk RESP hco3 20 acid (system that's compensating) Partially Compensated Respiratory Alkalosis
195
What defines a COMPENSATED
the co2 and the hco3 are opposite but the pH level is normal but FAVORING one side so because its still normal is not partially.
196
pH 7.42 Co2 24 hco3 19
Compensated Respiratory Alkalosis
197
Increase of H+ makes it more Decrease of H+ makes it more
increase - acidic decrease - alk
198
What vol-control mode of vent kicks on when a patient takes a spontaneous breath with full tidal volume
assist control
199
What are two volume control modes of vent
Assist control AC CMV SIMV Pressure support
200
How does the blood move from heart to the lungs
The Pulmonary Artery
201
What is Polycythemia
Excessive red blood cell production
202
How many lobes are in the L and R lungs
L - 2 R - 3
203
The Diaphragm _________ during inhalation
flattens
204
What is Atelectasis
Colapse of the aveoli
205
How does an Emphysema patient present
Pink Puffer Barrel chest, pursed-lips, tachypnea
206
How does a Chronic Bronchitis patient present
Sleeps upright Productive cough - waste basket full of used tissues, secretions
207
Grunting is a _______ airway obstruction
lower
208
Pink frothy sputum is an indication of
Heart failure
209
Two most common UPPER ped airway emergencies
Croup and Pneumonia
210
Which cranial nerve is major for the parasympathetic nervous system
X the vagus nerve
211
Treatment for Epiglotitis
BVM,and poss ET tube (1-2 sizes smaller) Limit agitation
212
Treatment for Croup
IM Epi Dex - corticosteroids Neb Epi IF ET needed use 0.5-1mm smaller
213
What are the 3 Inherent rates of the conduction system
SA Node 60-100 bpm AV Junction 40-60 bpm Ventricles 20-40 bpm
214
Parasympathetic Stimulation causes
Decreased: Slows DOWN HR AV conduction Decreased Irritability only affects the atria
215
List the (6) areas of the conduction system in order which the impulse travel through the heart
1. SA Node 2. Intratrial and Intrernodal Pathways 3. AV Node 4. Bundle of His 5. Bundle Branches 6. Purkinje Fibers
216
What are the 6 H's also known as
Hypovolemia Hypoxia Hydrogen Ions (Acidosis) Hypo and Hyper Kalemia Hypothermia probable causes
217
What are the 5 T's also known as
Tension Pneumo Tamponade Cardiac Toxins Thrombosis Coronary Thrombosis Pulmonary probable causes
218
Treatment for Hydrogen Ion (Acidosis)
Sodium BiCarb airway management CPR
219
Treatment for Hypo-HyperKalemia
Hypo - not much (needs potasium) Hyper - CA- SIGH - K 1 Calcium Chloride 2 Albuterol Hco3 - sodium bicarb I insulin G glucose (dextrose) 3 Hemodialysis Kayexelate 1 Stablize/ 2shift /3excrete
220
Treatment for Toxins 1 organophosphate 2 beta blocker OD 3 TCA OD 4 opioid OD
1 Atropine for organophosphate poisoning 2 beta blocker OD = glucagon 3 TCA OD = sodium bicarb 4 opioid OD = naloxone
221
H and T are most important with
PEA Cardiac Arrest
222
What is the hr of brady
less than 50 (for treatment)
223
When should you avoid Atropine
When there is a high degree block (2nd type II, 3rd Degree) go right to pacing
224
What class intervention is Dopamine and Epinephrine Infusions
Class IIb
225
For Brady what is the quick treatment atde
All Trained Dogs Eat Atropine TCP Dopamine Epinephrine
226
with ROSC wide QRS (H's and T's) narrow QRS (H's and T's)
wide - toxins, metabolic narrow - obstructive, tamponade, tension pneumothorax
227
What are the 2 shockable rhythms to DEFRIBRILLATE
V- Fib (squiggly worms) Pulseless V-Tach (no pulse) (tombstones)
228
Accelerated Junctional with unifocal PVC's PVC - early ventricular, unifocal because they look the same junctional originates from av junction, Junctional and hr is 60-100 so it’s accelerated junctional!
229
-
Ventricular Tachycardia 100-250 bpm wide tall bizarre QRS
230
3rd Degree AV Block Complete heart block no relationship between P and QRS QRS can be both narrow or wide P-R interval varries
231
-
A Fib fast atrial activity, lots of f waves R_R irregular,
232
Sinus with PAC early atrial activity early p wave looks different
233
SVT hr 160-250 cant see P waves so fast vagal then cardiovert
234
Sinus with Atrial Pacing
235
Accelerated Junctional Can’t see the p waves so it’s junctional and the hr is 80 60-100 accelerated 40-60 junctional escape 100-180 junctional tachy
236
Idioventricular Rhythm Here are the rules for Idioventricular Rhythm (Figure 78): Regularity: usually regular Rate: 20–40 bpm; can drop below 20 bpm P Waves: none PRI: none QRS: wide and bizarre; 0.12 second or more
237
What lead are we looking at when placing PADs
Lead 2
238
how many small boxes is a 6 second strip
150
239
What are the 3 types of pacemakers & how do we know the difference when viewing these EKG’s?
a. Atrial- Pacer spike followed by p wave & normal QRS b. Ventricular-Pacer spike followed by wide QRS c. AV Sequential/ Dual-Pacer spike followed by p wave AND pacer spike followed by wide QRS
240
My rate is 30bpm. My complexes are regular (they all march out). I have NO P waves and my QRS is >.18s
idioventricular
241
My rate is 30bpm. My complexes have a ‘normal’ morphology of P, QRS & T waves that all look the same. I am a regular rhythm.
Sinus Brady
242
The AV node is my gate keeper. I am throwing a lot of signals at it from all different foci in both atria. The AV node will let 152 signals through in one minute.
Uncontrolled a-fib (A-fib with RVR (rapid ventricular response))
243
My rate is 80. I have a complex with ‘normal’ morphology (P, QRS & T waves) followed by a complex with a QRS of .14s and no p wave! This pattern continues.
Ventricular Bigeminy
244
SVT with a wide QRS
245
Atrial Fibrillation (controlled) with 2 unifocal PVC's
246
Sinus Brady with 1 PVC
247
how much time is between the two heavy lines on a graph
0.20 seconds
248
What must occur for the heart to contract
muscle cells must receive electrical stimulus
249
What is the atrial rate in a-flutter
250-350 bpm
250
To get the accurate rate you would count small squares between R-R and divide by
1500
251
What is the drug dose of Lidocaine and when do you give?
0.5-0.75mg/kg Tachy
252
what is the drug dose of cardizem when do you give
.35mg/kg IV tachy
253
Junctional Tachycardia inverted P wave rate 101-180
254
Accelerated Junctional inverted P wave rate 61-100
255
Junctional with P waves after QRS rate 40-60 bpm
256
Atrial Flutter F waves, saws, QRS narrow atrial rate 250-350
257
Where is sodium and potassium during ready state
Sodium is outside and potassium is on the inside
258
Define R on T
situation where stimulation could put heart into v-tach - PVC hits on relative refractory - Vulnerable to sending into v-tach
259
What is 1 beat of the heart called
stroke volume (ejection fraction)
260
How do you find cardiac output
Stroke volume x HR
261
Define Excitability Automaticity Contractility Extensibility Conductivity
Excite = response to electric Contractility = squeeze Auto = create impulse extense = stretch,expand conduct = pass electric
262
What are the ECG rules
- Are there p-waves o Are they present? o Are they 1:1 QRS? o Are they upright? o Do they look the same/ alike? - Regular or irregular o R-R the same? o Extra beats? Are they early or late? o Are PRIs the same? - Rate o R-R interval, count the boxes / 1500 o Count complete cycles x 10 (if 6 sec strip) o Triplicate method (least accurate) o Are the p-waves the same rate as R waves? (3rd deg.) - QRS o Wide or narrow? o What do they look like? Do they look alike? o Equal duration? - PRI o 0.12 – 0.20
263
Define PVC
- Premature ventricular complex - Has compensatory pause - If all match = unifocal; if they don’t match = multifocal
264
Define PJC
- p wave inverted - or p-wave missing - underlying rhythm needs to be mentioned
265
Sinus Tachycardia Hr 100
266
SVT (no P waves seen)
267
A-Fib f waves, irregular R-R 350-600 bpm Atrial rate multiple sources trying to fire in the atrium other than SA Node lots of squiggles
268
A flutter instead of P waves there are F waves, sawtooth or sharkfin f waves
269
A fib, with bigeminy of PVC's afib - f waves, irregular R-R 350-600 bpm Atrial rate multiple sources trying to fire in the atrium other than SA Node lots of squiggles PVC - premature ventricular contractions, wide bizarre, early
270
A-fib with 2 unifocal PVCs
271
V-Tach wide, bizarre QRS
272
Define Coast Map
C - consciousness O - orientation A - activity S - speech T - thought M - memory A - affect P - perception
273
Sinus with Trigeminy of PVCs
274
Sinus with a PJC
275
You can't see my P-wave, nor can you determine my PRI. My QRS-duration is 0.10 seconds. My R-R intervals are regular, and my rate is 146.
Junctional tachy
276
P-waves than QRS-complexes. My PRI gets progressively longer until one of my PRIs doesn't want to show up to the party. My QRS-duration is 0.11 seconds. My R-R intervals are irregular.
2nd Degree Type 1

Paramedic (24 decks)

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