CCP SG2 Flashcards by Bradley Lumley

Scenario: Moving patient over to ICU bed and receives another emergency call, nurse is unable to take report so CCP gives report to nurse aide. Who could be held liable and for what if the patient falls out of the bed and breaks a hip?

Abandonment

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Instructions given by competent individuals specifying what actions should be taken for their health in the event that they are no longer able to make decisions due to illness or incapacity best describes what?

Living Will

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What requires doctor to doctor contact and is considered the “Anti-Dumping Act.”

EMTALA

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Designed to prevent financially motivated transfers of patients in unstable condition describes what?

COBRA

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Keeps patients’ health information private. Scenario: CCP worked a call with multiple DOA’s and informed the media of the patient’s name details of the call.

HIPAA

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The ultimate responsibility for the action or inaction of a CCP rests with the medical director. Scenario: Transferring a cardiac patient from an outlying facility back to your facility for possible PTCA. Patient needs a medication and who do you contact. Choices consisted of the sending facility, the receiving facility ER charge nurse, the receiving facility medical director, and another choice.

Online Medical Direction

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Cormack-Lehane Grading System, which choice was a grade 2?

A) The entire glottis opening is visible.
B) The arytenoid cartilages or the posterior portion of the glottis opening is visible.
C) Epiglottis only is visible.
D) Tongue and/or soft palate only is visible.

B) The arytenoid cartilages or the posterior portion of the glottis opening is visible.

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Which choice was the correct location for ET tube placement?

A) 3-7 cm above the carina
B) 4-8 cm above the carina
C) 5-8 cm above the carina
D) 1-4 cm above the carina

A) 3-7 cm above the carina

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What is the best way to confirm ET tube placement?

Best way to confirm ET tube placement is capnography

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You have an xray that presents with a white out appearance, would suspect the patient would have?

A) Pneumonia
B) ARDS
C) COPD
D) Bronchitis

B) ARDS

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What you would expect with a LEFTWARD Shift on the Oxyhemoglobin Dissociation Curve?

A) Hypothermia
B) Fever
C) Acidosis
D) Increased CO2.

A) Hypothermia

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You have a patient with the following symptoms: fever, SOB, and yellow odorish sputum. What you suspected was wrong with the patient?

Pneumonia

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What is the purpose of giving corticosteroids in an asthma patient?

A) bronchodilator
B) dry up secretions
C) reduce inflammation

C) reduce inflammation

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You have a patient with a chest tube that has excessive continual bubbles in the water seal chamber, what would that indicate?

pleural or system leak

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You have a patient with a confirmed case of ARDS being mechanically ventilated. What is the purpose of not increasing the FiO2 above 50%?

V/Q Mismatch – can be due to inadequate ventilation, perfusion, or both.

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What ventilator mode best describes a patient can breathe over set limits but each breath is at preset Tidal Volume?

Assist/Control

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What would a high BNP indicate?

CHF

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Which drug prolongs the QT interval?

A) Albuterol
B) Cardizem
C) Dopamine
D) Procainamide

D) Procainamide

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You have a patient with decreased cardiac output and heart failure. Which drug would be the best choice to give this patient to improve cardiac output?

A) Dobutamine
B) Dopamine
C) Levophed
D) Epinephrine

A) Dobutamine

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What is Aggrastat?

A) glyocpotien lla/lllb
B) glycoprotein IIb/IIIa
C) glycoprotein IlIb/IIIa
D) glycoprotein IIb/IIa

B) glycoprotein IIb/IIIa

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Which is the best choice describing the goal of therapy for IABP?

A) increase oxygen demand
B) decrease cardiac output
C) increase blood flow to the coronary arteries

C) increase blood flow to the coronary arteries

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What syndrome presents with a Delta Wave?

Wolfe-Parkinson White (WPW)

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What drug you would give a patient in WPW?

Procainamide

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What drug was contraindicated
in a patient with Stokes Adam?

Lidocaine

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what is goal of malignant hypertension?

Goal is to lower no more than 20-25%, or to maintain diastolic pressure between 100-110 mmHg.

What best describes afterload?

resistance against which the ventricles must pump against. Afterload = Pressure.

At what location the phlebostatic axis is?

Phlebostatic Axis – located at the 4 th intercostal space, midaxillary line.

What is the formula of MAP?

DBP + 1/3 (SBP-DBP) 2(DBP) + SBP/3

You have a patient with a subclavian central line that is complaining of SOB. Upon assessment you notice absent breath sounds to the right side. What do you suspect is wrong with this patient?

Tension pneumothorax

what does an elevated troponin indicate?

myocardial necrosis

Normal range for troponin

0 – 0.04.

what drug you would give if you had a patient with high potassium?

Sodium Bicarbonate.

how would hypokalemia would appear on the monitor?

Hypokalemia = Flat T waves and/or U waves.

A patient presenting with potassium of 7.2, cardiac instability and the EKG showed tall peak T waves, what would be the drug of choice? A) Insulin/D50W B) Calcium Chloride C) Calcium Gluconate D) Kayexalate

D) Kayexalate

Damage to what area caused expressive aphasia?

Broca’s Area

Trauma to what area in the brain would cause loss of the ability to coordinate fine movements?

Cerebellum

You have a patient that is on a ventilator, had no gag reflex, and fixed pupils. What area of the brain is damaged?

Medulla – Deals with autonomic functions such as breathing, heart rate, and blood pressure. A patient with an injury to the medulla may be apneic with no gag reflex and nonreactive pupils.

You have a patient with a spinal cord injury that had a foley catheter and presented with goosebumps, fever, and diaphoresis. What would we considered the problem to be?

Autonomic Dysreflexia

If a patient was having a subclinical seizure, what we would expect the patient to have?

Smacking lips/repetitive eye movement

What kind of hemorrhage best describes a patient with the worst headache of their life?

Subarachnoid Hemorrhage

You are presented with a patient that fell and had greater loss of function in the upper extremities than in the lower. What was wrong with the patient?

Central Cord Syndrome – Hyperextension injuries to the cervical area present with hemorrhage or edema to the central cervical segments. Patients present with a greater loss of function in the upper extremities than in the lower extremities, with a variable loss of sensation to pain and temperature.

What signs and symptoms were associated with Cushing’s Phenomenon (Cushing's Triad)?

increase ICP. S/S = Hypertension, Bradycardia, and Irregular Respirations.

You have a patient with a brain injury that had eyes open but not aware of surrounding. What is wrong with this patient? A) clinically brain dead B) persistent vegetative state C) lock-in syndrome

B) Persistent Vegetative State

You have a patient with motor loss on the same side of damage, but below the injury. What kind of injury/syndrome does this patient have? A) Central Cord Syndrome B) Anterior Cord Syndrome C) Brown-Sequard Syndrome

C) Brown-Sequard Syndrome

What is the proper level for an EVD transducer?

The proper level for the transducer is at the foramen of Monro measured at the outer canthus of the eye, tragus of the ear, or alternatively, at the spine for lumbar drainage

What is the proper procedure when moving a patient with an EVD?

When moving a patient with an EVD, keep below the level of the heart, keep open, close clamps and flush clots. Keep in LOCKED position during movement.

What indicates proper placement of the Bolt?

Proper placement = good waveform.

What complication would be expected if a patient with a VP shunt started having a seizure?

A blockage or obstruction of the shunt is the most common complication of the system.

At what level should you maintain the ETCO2 of a patient with increased ICP? A) 25-30 mmHg B) 35-45 mmHg C) 45-50 mmHg D) 30-35 mmHg

A) 25-30 mmHg

What drug you would use to blunt increased ICP in RSI?

Lidocaine Use Lidocaine to blunt increased ICP in RSI

Where should Mannitol be administered?

Mannitol – Must be administered with a filter line.

How much Solu-Medrol you would give in a patient with a spinal cord injury?

Bolus – 30 mg/kg; Infusion – 5.4 mg/kg/hr.

You have a patient that was struck by lightening. What should you be concerned about happening to this patient?

Rhabdomyolsis

Why would your burn patient have an increased HCT?

Due to plasma. Patients with burns will have increased HCT secondary to plasma loss

What would be the 1st sign of shock as the first compensatory mechanism of the body? A) anxiety, B) tachycardia, C) low B/P

Either A or B Study guide was marked as A with the following reasoning: the earliest sign of shock is a low pH. The first indicator or compensatory mechanism of shock is anxiety and tachycardia.

What is Obstructive Shock?

A form of shock associated with the physical obstruction of the great vessels of the heart itself.

What are two forms of Obstructive Shock?

Pulmonary Embolism and Cardiac Tamponade

What is Cardiogenic Shock?

Based upon the inadequate circulation of blood due to the primary failure of the ventricles of the heart to function effectively.

What is Distributive Shock?

Characterized by a relative hypovolemia, can be further broken down into the chemical and neural causes.

What is Hypovelmic Shock?

It is a condition that occurs when the circulating blood volume is inadequate for delivering adequate oxygen and nutrients to the body.

What is Septic Shock

A form of shock that occurs in septicemia when endotoxins or exotoxins are released from certain bacteria in the bloodstream, resulting in a persistently low mean arterial blood pressure despite adequate fluid resuscitation.

What is Anaphylactic Shock?

Anaphylactic Shock – A severe hypersensitivity reaction that involves bronchoconstriction and cardiovascular collapse.

What do Chemoreceptors do during shock?

During shock they stimulate to increase RR and depth.

Where are Chemoreceptors located?

located in the aortic arch and carotid arteries.

When does Lactic Acid build up and was is a byproduct of Lactic Acid?

Shock and Pyruvic Acid Patients in shock build up lactic acid. Lactic acid is a byproduct of pyruvic acid.

A patient had had shoulder surgery and now has petichie, what would we expect she has developed?

Fat Embolism

What labs are related to pancreatitis?

Patients will have an elevated amylase and lipase with pancreatitis

What does Cullen sign and grey-turner’s sign indicated?

Pancreatitis

What is the most common cause of lower GI bleeds?

Diverticulosis

What the most common cause of upper GI bleeds?

Ulcers

You have a patient who is an alcoholic recently taking NSAIDS. What could be wrong with the patient?

Mallory Weiss Syndrome

You have a patient with a Sengstaken-Blakemore Tube needing intubated. What do you needed to do prior to intubation? A) deflate both tubes B) inflate both tubes C) Intubate around the tube

A) deflate both tubes

What drug would be given to someone with a peptic ulcer?

Treatment is proton pump inhibitor.

You have a patient c/o severe sharp abdominal pain radiating to his back. What we would expect is wrong with the patient?

AAA Rupture

What test is the best indicator of renal function?

Creatinine

You have a pregnant patient with the following symptoms: edema, hypertension, proteinuria, headache, visual disturbances. What would you expected is wrong with this patient?

Preeclampsia

>>>What signs would indicate child abuse? A)infant with full fontenelles, N/V, and no fever B) asymmetrical burns to chest C) multi-staged bruises to the knees and elbows of a toddler

Child Abuse – Symmetrical burns on the body, bruises on the arms and legs, infant with N/V, swollen fontenelles and no fever.

What are the s/s of a Pediatric in Respiratory Failure?

Increased work of breathing and tachypnea are indicators of respiratory failure in children.

How much Atropine you would give to a 5kg patient?

0.1 mg Atropine – 0.02 mg/kg/dose

What is the dose of epinephrine in a pediatric patient?

Epinephrine – 0.01 mg/kg (1:10,000)

What level glucose shows up in the urine?

has to be at a level of 300+ to show up in urine. The question asked at what level glucose shows up in the urine. I think there was not a 300 option, but there was a 400. Every other option was below 300.

What is the preferred IV site for neonates?

umbilicus

You have a patient that takes antidepressants and has the following symptoms: Dry, increased heart rate, agitation, delirium, mydriasis, hot. What do you suspect is wrong with this patient?

Anticholinergic Overdose

What can someone get from food poisoning by eating spoiled fish?

Scombroid

What is the antidote for Cyanide poisoning?

Amyl Nitrate

What is Ethylene Glycol Poisoning?

poisoning with antifreeze

What that could happen with a patient that had prolonged exposure to cortisol?

Cushing’s Syndrome

What is a mode of flight used when the weather conditions are good, meaning there is generally very good visibility and minimal cloud cover; the pilot is responsible for maintaining separation from other aircraft called?

Visual Flight Rules (VFR)

What is a condition in which a person has an incorrect understanding of the body’s position with respect to the earth called?

Spatial Disorientation

What is spatial disorientation, fatigue, noise, flicker vertigo, 3rd spacing, and vibration called?

Flight Stressors

You are flying a patient with a pneumothorax, what law would affect this patient?

Boyle’s Law – as altitude increases, the atmospheric pressure decreases.

What law applied to the following definition: the total pressure of a gas mixture is the sum of the individual pressures. Or, all of the parts equal the whole?

Dalton’s Law

What is the most common Crew Configuration on a helicopter?

RN/Medic