CEN Psych and Medical Emergencies Flashcards
1
Q
Patient going through withdrawal should be approached in a
A
non-judgmental manner Keep sentences short and simple Room quiet with little stimulation
2
Q
A patient who is hypoglycemic and conscious should be given________ and if the patient is unconscious give _____________
A
10 to 15g of carbohydrates IV glucose
3
Q
Examples of 15 g of carb food: MOCHS
A
1 cup of milk 8 small sugar cubes 3 tsp of honey 1/2 cup of orange 8 hard candies.
4
Q
All types of Hemophillia are equally
A
severe
5
Q
What happens in hemophilia? there is ______ of factor _____ and _______
A
ABSENCE not a lack; VIII and IX
6
Q
Hemophillia is inherited and most often occurs in
A
Male
7
Q
Hemophillia prevent the formation of a firm _______ _______ and results in ______ _______
A
fibrin clots:; continuous bleeding.
8
Q
Severity of hemophilia depends on
A
extent of fibrin function.
9
Q
Children develop anxiety when they are _________ from parents. Adolescents often develop anxiety disorders when they feel pressure to ________ and Adults often develop anxiety disorders when they experience ____pressures. Older adults often develop when their _______is taken away
A
separated; achieve; career; independence.
10
Q
If the patients platelet count are greater than 50,000, they patient can tolerate surgery, T or F
A
True
11
Q
A patient with low platelet between ______ and _________ may experience spontaneous intracranial bleeding
A
20, 000 and 30000
12
Q
A patient with platelet less than 10,000 then the patient may experience
A
Spontaneous intracranial hemorrhage.
13
Q
Which clotting profiles assesses the COMMON PATHWAY and the INTRISIC COAGULATION PATHWAY
A
activated Partial Thromboplastin Time (aPTT)
14
Q
Which clotting profiles assesses the COMMON PATHWA and the EXTRINSIC COAGULATION PATHWAY
A
Prothrombin Time
15
Q
What does the thrombin time assess? The amount of time it takes for _______to converts to ______into a _____
A
the amount of time it take for thrombin to convert to fibrinogen into a clot
16
Q
What does the bleeding time assesses?
A
Platelet function.
17
Q
Cushing syndromes the result of
A
Excessive STEROIDS
18
Q
Excessive systemic Corticosteroids can lead to
A
Cushing syndrome
19
Q
Cushing syndrome is associated with 4 symptoms
A
hypernatremia, hyperglycemia, hypokalemia, hypocalcemia
20
Q
In cushing syndrome if steroids aren’t weaned what happens__________
A
Addisonian crisis.
21
Q
If the patient had an infection is at risk for ______shock, if they had external blood loss they are at risk for ______Shock; if they had an allergic reaction they are at risk for ________ shock and if they had a head injury they are at risk for ______shock
A
Septic; hypovolemic; anaphylactic; neurologic.
22
Q
Normal ionized calcium level is _____to ______.
A
4-5
23
Q
Symptoms of hypocalcemia
A
Numbness and tingling N/V muscle tremor Twitching Chvostek’s sign Trousseau’s sign hyperactive reflexes seizures Prolonged QT interval and ST segment
24
Q
Sudden onset of anxiety that is caused by fear and panic
A
A panic disorder
25
Behavior that are repetitive and driven by persistent thoughts and feelings
Obsessive-compulsive disorder.
26
Results of one having persistent thoughts and memories after a traumatic events
PTSD
27
Feelings of anxiety that occur within a month after the cessation of substances
Substance-induced anxiety disorder.
28
Persistent eating disorder of non-nutritive susbtances.
PICA
29
Eating disorder related to repeatedly overeating and induced vomiting or laxative consumption
BULIMIA NERVOSA
30
Disorder of INFANCY related to repeatedly regurgitating food or rechewing food is known as
RUMINATION
31
In a patient with CRF, an interference with RBC synthesis and maturation process could cause \_\_\_\_\_\_; an interference with prostaglandin synthesis could cause \_\_\_\_\_\_\_; An interference with renal bone mineralization could cause \_\_\_\_\_\_\_\_\_
Anemia; hypertension; osteodystrophy
32
Aggressive correction of hyponatremia with fluid can cause what?
Pituitary damage
33
Hyponatremia is either to \_\_\_\_\_\_extracellular sodium or \_\_\_\_\_Extracellular volume
low; high;
34
For severe hyponatremia, \_\_\_\_\_\_\_\_Saline solution is administered followed by \_\_\_\_\_\_\_\_\_
hypertonic; Diuretics
35
What is the most common cause of hyperthyroidism
Grave's disease
36
Precipitating factors of hyperthyroidism:
Thyroiditis, nodular goiter, iodine excess, thyroid CA, pituitary tumors
37
A patient going through withdrawal, how often should the vital signs be taken?
\_\_\_\_\_\_\_\_\_\_\_has four features: (1) The patient's symptoms are typically disproportionate to physical examination findings of organic disease. (2) A preoccupation with one's own body. (3) A compulsive insistence on being labeled as “sick” and subsequently crippled. (4) Continuous and unsatisfactory pursuit of medical care and opinion with a history of intervention yet eventual return of symptoms.
every 15-30 mns until stable
## Footnote
**Hypochondriasis**
38
What kind of hallucination in which the patient feels things occurring in her own body?
Somatic
39
Hallucinations involve the perception of bodily movements?
Kinethics
40
Hallucinations involving odors
Olfactory
41
Hallucinations involving tastes
Gustatory
42
What are examples of MATURATIONAL crisis
Pregnancy Death Marriage
43
A crisis that occurs over time and IS part of the life cycle's normal development
MATURATIONAL
44
A crisis that occurs over time and is NOT part of the life cycle's normal development
Situational( unemployment, vehicle accidents, sexual assault, divorce, diagnosis of terminal illness)
45
Abrupt discontinuation of steroid may result in \_\_\_\_\_\_\_\_\_
Acute Adrenal Crisis
46
Acute adrenal crisis is treated with __________ administered IV along with _____ and electrolytes
Hydrocortisone Fluids
47
Which is more common primary or secondary adrenal insufficiency? an example of secondary is\_\_\_\_\_\_
Secondary: steroids induced adrenal crisis.
48
Symptoms of adrenal crisis
hypotension, hyperpigmentation, weakness, fatigue
49
Patient's thoughts have some connectivity but little association between the, what though process is that
TANGENTIAL
50
When patient loses the ability to have a normal thought process?
Looseness of association
51
When to patient is distracted by his/her environment and leaps from one thought to another unrelated thought
Flight of ideas.-
52
Thought process that occurs when a patient uses a roundabout way to connect his/her thoughts to the original topic
Circumstantial
53
The initial vasopressors of choice for HYPOTENSION in SEPTIC SHOCK are
Norepinephrine (levophed) and DOPAMINE
54
What should be done prior to initiation of any vasoactive medications?
Fluid resuscitation.
55
Indications that a patient is having a febrile reaction to a blood transfusion are:
fever, muscle pain, vomiting, chills, flushing, increased HR.
56
When does febrile transfusion reaction occurs?
Immediately or up to 6 hours after the transfusion
57
Mild allergic transfusion reaction occurs during or up to \_\_\_\_\_hour and the symptoms are\_\_\_\_\_ ___ \_\_\_\_ \_\_\_\_\_
one; flushing, hives; urticaria, itching
58
occurs days to weeks after the transfusion and have the following symptoms\_\_\_\_ ___ \_\_\_ \_\_\_\_
Delayed Hemolytic transfusion reactions; fever, anemia, mild jaundice, purpura
59
Noncardiac pulmonary edema transfusion reactions occur _____ or shortly after transfusion and includes
fever, chills, shock, dyspnea, hypoxemia, cough and crackles.
60
In a patient with mania, which type of medication would be prescribed to regulate the patient's mood?
Anticonvulsants
61
A patient with mania would be prescribed ____ for psychosis
Antipsychotics
62
A psych patient may be prescribed \_\_\_\_\_\_to block the effects of catecholamines
Beta Blockers
63
A patient with depression needs \_\_\_\_\_\_\_to rule out hypothyroidism
Thyroid function tests
64
How many types of hypersensitivity reactions are there?
4
65
Immediate hypersensitivity reactions occurs within minutes of exposure is type \_\_\_\_\_\_and include reactions to \_\_\_\_\_\_,PCN, pollen and \_\_\_\_\_\_\_
Type I, food products; insect venom
66
Cytotoxic hypersensitivity reactions is type _____ generally occur within minutes to days and include a reaction to ______ \_\_\_\_\_\_ \_\_\_\_\_\_
Type II; Transfusion of mismatched blood
67
**Immune complex mediated** reaction is type _____ generally occurs within _____ and include reactions to ________ \_\_\_\_\_\_
III; hours: environmental antigens.
68
**Delayed or cell-mediated hypersensitivity** reactions generally within one or ____ days and include ________ \_\_\_\_ ____ \_\_\_\_
type IV; more; Tuberculosis skin testing reactions.
69
What is normal PT time
11.9-18.5 seconds
70
What is normal aPTT
24-36 seconds
71
the normal thrombin time
10-15 seconds
72
What is the normal bleeding time\_\_\_\_\_\_\_\_\_
less than 8 minutes.
73
Why is benzodiazepines administered to patient who are suffering from substance abuse?
To prevent seizures
74
Patient who are suffering from substance abuse should be monitored for _______ and \_\_\_\_\_
DT and Death
75
The thought process that occurs when patients **suspects or doubts** something?
Suspicious
76
When the patient believing somthing even though there is evidence to the contrary?
Delusion
77
The correct dosage for **_IM_ epinephrine** administration in anaphylactic Shock is: ______ administration may be repeated after _____ to \_\_\_minutes
1:1000; 15-20
78
What is the purpose of **epinephrine** during anaphylactic reaction?
Promote vasoconstriction, dilate the bronchioles, inhibits further release of mediators.
79
What is the correct dosage concentration for **_IV_** epinephrine
1:10,000
80
The use of the blood product **CRYOPRECIPITATE** is for replacement of
Clotting factors.
81
The most common replacement for fibrinogen is _____ and is indicated for patients who are \_\_\_\_\_\_\_bleeding or at risk
CRYO; acutely
82
What blood products are used to restore oxygen-carrying capacity?
PRBCs and Whole blood
83
Which blood products are used to expand blood volume?
FFP, albumin and plasma protein fraction.
84
What act ensures that all patients receive the same level of care regardles sof their race, religion, origin, age, gender or disability?
Civil Rights Act
85
It is the responsibility of the _______ \_\_\_\_\_ _____ to ensure that all practitioners are qualified to perform thier duties
state's governing board.
86
**HIPAA** stands for ______ \_\_\_\_ _____ \_\_\_\_\_ ____ and date year
Health Insurance Portability and Accountability Act; 1996
87
The main difference among **HHS and DKA** is that **_HHS_** consists of more severely elevated _______ and the lack of \_\_\_\_\_\_\_\_\_; HHS occurs most commonly in Type \_\_\_\_DM while DKA occurs most often in type _____ DM. And \_\_\_\_\_carry a higher mortality rate than \_\_\_\_\_\_
Glucose; ketoacidosis ; Type II; Type I; HHS ; DKA
88
Diagnosis of **Dehydration:** Hematocrit is ______ , serum **OSMOLALITY** is _______ and serum sodium is \_\_\_\_\_\_\_
Elevated, elevated, elevated
89
The diagnosis of **SIADH** : Hematocrit is \_\_\_\_\_; serum osmolality is _____ and BUN is ______ along with urine specific gravity greater than \_\_\_\_\_\_\_
low; low; low; 1.005
90
The diagnosis of **water excess syndrome**: serum osmolality less than ______ and a decreased _____ and \_\_\_\_\_\_\_\_
280; sodium; hematocrit
91
The diagnosis of **HYPERVOLEMIA :** Decreased \_\_\_\_\_\_\_\_\_\_; \_\_\_\_\_\_\_\_; and \_\_\_\_\_\_\_\_along with urine specific gravity of less than \_\_\_\_\_
hematocrit; serum osmolality and BUN; 1.010
92
When a patient shows signs of **sepsis transfusion** reaction you should \_\_\_\_\_\_
stop the tranfusion and obtain culture of the patient's blood with the remaining tranfusion blood.
93
When a patient shows symtpoms of a **noncardiac pumonary edema transfusion** reaction, you should stop the transfusion and :
Administer oxygen
94
When a patient shows symptoms of a **delayed hemolytic transfusion** reaction, you should monitor the ______ and \_\_\_\_\_\_
urine output; hemoglobin
95
Signs of hypermagnesemia include:\_\_\_\_ _____ \_\_\_\_\_\_\_\_
Muscular weakness, **Loss of Deep tendon reflexes** and even **RESPIRATORY Muscle paralysis**
96
What is given IV to reverse the neuromuscular effects of **Hypermagnesemia**
**CALCIUM GLUCONATE**
97
All patients in the ER who reports IV drug use should be tested for
HIV
98
In DKA, glucose is greater than _____ and his blood serum ketone will be greater than \_\_\_\_
250; 5
99
In hyperosolar nonketoci hyperglycemic crisis, blood glucose is greater than _____ and ketone is \_\_\_\_\_\_\_
600; normal
100
The psychiatric disorder that causes an **individual's intellectual functioning** to _deteriorate is_
**DEMENTIA**
101
The psychiatric disorder that causes an individual's moood to be disturbed due to **sadness, negativity or loss of interest**
**Agoraphobia is**
DEPRESSION
## Footnote
**Agoraphobia** is anxiety about or avoidance of situations or places from where escape might be difficult.
102
The psychiatric disorder that causes an individual to have an \_\_\_\_\_\_\_mood; _______ mood and _______ mood is \_\_\_\_\_
elevated; irritated; expansive; MANIA
103
Psychiatric disorder that is associated with the **loss of contact with reality**; a decrease in the **ability to function socially** and a **deranged personality** is
\_\_\_\_\_\_\_\_
Pt with persistent fever, diaphoretic, on haldol, tachy cardic, suspect which condition\_\_\_\_\_\_\_\_\_\_\_\_\_
Treatment of _____________ consists of fever reduction, intravenous rehydration, and supportive measures. ___________ a direct-acting muscle relaxant, should be used in severe cases.
**Psychosis;**
**Neuroleptic Malignant Syndrome**
Dantrolene
104
Malignant proliferation of **BLAST CELLS or IMMATURE WBCs** is
LEUKEMIA
105
Symptoms of Leukemia include :
fever, nightsweats, lymphadenopathy, spenomegaly, pallor, bone or joint pain
106
Genetic disorder that causes **blood not to clot** normally is\_\_\_\_\_\_ and there is ***_LACK_*** of one of the two essential ciruclating plasma proteins either factor ____ or \_\_\_\_\_
Hemophillia; VIII; IX
107
Hematologic emergency involving **decrease in clotting factors and platelets**?
**DIC**
108
**2** types of **psychosis**:
functional or organic
109
Predisposing factors of **functional psychosis** include
schizophrenic disorder, severe depression and a brief psychotic episode or mania
110
Predisposing factors of **organic psychosis** include
## Footnote
Bipolar disorder can be treated primarily with **mood stabilizing** medications such as \_\_\_\_\_\_\_,\_\_\_\_\_\_\_,\_\_\_\_\_\_\_
dementia, delirium, shock, and ingestion of a toxic susbtance.
valproic acid, lithium, or carbamazepine.
111
The co-administration of ______ and \_\_\_\_\_can result in serious complications and death
alcohol and benzodiazepines
112
Before prescribing benzodiazepines, you should assess the patient for recent \_\_\_\_use because benzodiazepines are \_\_\_\_\_\_\_with \_\_\_\_\_\_\_\_
\_\_\_\_\_\_\_\_\_\_ the most common adverse effect seen Haldol.
It involves the sudden onset of involuntary contraction of the muscles of the face, neck, or back. The patient may have protrusion of the tongue (buccolingual crisis), deviation of the head to one side **(acute torticollis), s**ustained upward deviation of the eyes (oculogyric crisis), extreme arching of the back (opisthotonos), or rarely laryngospasm. Treat with \_\_\_\_\_\_\_
alcohol; synergistic; alcohol
## Footnote
**Acute distonia**
**Cogentin**
113
Normal mag for adult\_\_\_\_ ; for a child ______ for an infant
1.3-2.1; 1.4-1.7; 1.4-2.0
114
Kubler Ross **stages of grief** in ________ include ____ \_\_\_\_ ____ \_\_\_\_ ___ DABDA
1969; Denial, anger, bargaining, depression; acceptance
115
Protease inhibitors for HIV are a specific class of drug within \_\_\_\_
**HAART therapy**
116
Side effects of Protease inhibitors are :
**Hepatotoxicity**, HLD, **hyperglycemia.** **LACTIC ACIDOSIS,**
117
To make **a diagnosis of depression**, depressive symptoms must be present for all or ____ of the day for at least \_\_\_\_\_\_\_
most; 2 weeks
118
Thought process that occurs when **patient stops the flow** of his thoughts or speech
Blocking
119
**Refractory septick** shock include
tachycardia, hypotension, **cool skin**, anuria and **hypothermia**
120
**Compensated** septic shock include
Tachycardia, **NORMAL TO LOW BP,** **Bounding pulses**; **Warm skin _*Wide pulse pressure*,_** hyperthermia and **OLIGURIA**
121
There are several factors that predispose one to **sickle cell crisis**
**cold temperature, high altitudes**, **recent infection,** metabolic or respiratory acidosis and STRESS.
122
For patients with hematologic emergencies undergoing high dose chemo, ________ is a serious complication
Neutropenic fever
123
For _hypotension_ that is **refractory to both fluid resuscitation and vasopressors** what should be administered?
**Hydrocortisone**
124
Secretion of ADH leads to an increase in _______ \_\_\_\_\_\_\_. And ________ stimulated the antidiuretic hormone \_**ADH\_**
Water resorption; **HYPERTHERMIA,** pain, **_decreaed blood volume , hypotension_** and stress
125
What stimulated the **RAAS?**
Hyponatremia
126
\_\_\_\_\_\_\_\_\_Stimulates the atrial natriuretic peptide
**Volume expansion**
127
Mechanisms that regulate body fluid:
ADH, thirst, RAAS, atrial natriuretic peptide
128
what is given to a patient in anaphylactic shock to block histamine receptors?
antihistamine.
129
**Steroids** is given to _anaphylactic shock_ patients to
prevent delayed reaction, **decreased capillary permeability**, **stabilize mast cells.**
130
Frequent episodes of binge eating due to emotional distress is a common factor for individuals with
**BULIMIA NERVOSA**
131
Which type of blood is considered universal donor
Type O
132
A blood type is compatible with
A and O
133
B blood type is compatible with
B and O
134
What is the **goal of crisis** intervention?
return individual **back to his normal level of functioning.**
135
**SIADH** results from abnormal amounts of **ADH** from the ______ results in _______ intoxication. Asymptomatic patients can be treated with ______ \_\_\_\_\_\_ from ___ to ____ ml but symptomatic patients can be treated with ______ and \_\_\_\_\_\_\_
pituitary; water; Fluid restriction; 500-1000ml; hypertonic; diuretics
136
Which type of of anemia ***_bone marrow fail to produce blood cells_***?
**Aplastic**
137
Type of _anemia_ that has a deficiency in absorbing **Vitamin B12**
**PERNICIOUS**
138
What is the role of the electrolytes **PHOSPHORUS?**
Regulating oxygen delivery to the tissues.
139
\_\_\_\_\_\_\_ facilitates muscle contraction
Sodium
140
\_\_\_\_\_\_Maintain intracellular osmolality
Potassium
141
What is the **BEST recommendation** for the **prevention** of _SEPTIC SHOCk_
**Avoid invasive procedures**
142
**Best recommendation** to _prevent NEUROGENIC SHOCK_
**IMMOBILIZE THE SPINE**
143
**Best recommendation** to prevent _anaphylactic shock_
## Footnote
\_\_\_\_\_\_\_\_\_\_is a state of motor restlessness characterized by a physical need to move constantly.
**remove the offending agent.**
**Akathisia**
144
To prevent **cardiogenic shock best to perform**
**Emergency decompression**
145
In **_early_ septic shock**, oxygen delivery to the tissues is \_\_\_\_\_\_. But _____ and \_\_\_\_\_\_are impaired.
increased; extraction ; utilization
146
Patient who are undiagnosed or undertreated from hypothyroidism \_\_\_\_\_\_\_\_\_; occurs in ____ older than ___ in \_\_\_\_Months
Myxedema coma; women; 60; winter
147
DTs associated with _______ and \_\_\_\_\_\_\_which can lead to \_\_\_\_\_\_\_\_and \_\_\_\_\_\_
AMS; sympathetic overdrive; cardiovascular collapse; death.
148
The **MAJORITY** of **anaphylaxis cases** involves symptoms related to the
SKIN
149
Suicidal thoughts are not always conscious thoughts they can be\_\_\_\_\_\_thoughts as well.
A useful mnemonic for eliciting **_signs of depression_** is IN **SAD CAGES \_\_\_\_\_\_\_**
unconscious
Interest, Sleep, Appetite, Depressed, Concentration, Activity, Guilt, Energy, Suicide
150
Blood product that contains platelets, WBC and plasma is \_\_\_\_\_\_\_\_. Plasma protein fraction contains _____ and _______ is a saline solution.
PLATELETS; albumin and globulin.
