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CEN > CEN Psych and Medical Emergencies > Flashcards

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

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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

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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.

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4
Q

All types of Hemophillia are equally

A

severe

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5
Q

What happens in hemophilia? there is ______ of factor _____ and _______

A

ABSENCE not a lack; VIII and IX

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6
Q

Hemophillia is inherited and most often occurs in

A

Male

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7
Q

Hemophillia prevent the formation of a firm _______ _______ and results in ______ _______

A

fibrin clots:; continuous bleeding.

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8
Q

Severity of hemophilia depends on

A

extent of fibrin function.

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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.

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10
Q

If the patients platelet count are greater than 50,000, they patient can tolerate surgery, T or F

A

True

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11
Q

A patient with low platelet between ______ and _________ may experience spontaneous intracranial bleeding

A

20, 000 and 30000

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12
Q

A patient with platelet less than 10,000 then the patient may experience

A

Spontaneous intracranial hemorrhage.

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13
Q

Which clotting profiles assesses the COMMON PATHWAY and the INTRISIC COAGULATION PATHWAY

A

activated Partial Thromboplastin Time (aPTT)

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14
Q

Which clotting profiles assesses the COMMON PATHWA and the EXTRINSIC COAGULATION PATHWAY

A

Prothrombin Time

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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

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16
Q

What does the bleeding time assesses?

A

Platelet function.

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17
Q

Cushing syndromes the result of

A

Excessive STEROIDS

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18
Q

Excessive systemic Corticosteroids can lead to

A

Cushing syndrome

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19
Q

Cushing syndrome is associated with 4 symptoms

A

hypernatremia, hyperglycemia, hypokalemia, hypocalcemia

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20
Q

In cushing syndrome if steroids aren’t weaned what happens__________

A

Addisonian crisis.

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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.

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22
Q

Normal ionized calcium level is _____to ______.

A

4-5

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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

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24
Q

Sudden onset of anxiety that is caused by fear and panic

A

A panic disorder

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25
Q

Behavior that are repetitive and driven by persistent thoughts and feelings

A

Obsessive-compulsive disorder.

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26
Q

Results of one having persistent thoughts and memories after a traumatic events

A

PTSD

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27
Q

Feelings of anxiety that occur within a month after the cessation of substances

A

Substance-induced anxiety disorder.

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28
Q

Persistent eating disorder of non-nutritive susbtances.

A

PICA

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29
Q

Eating disorder related to repeatedly overeating and induced vomiting or laxative consumption

A

BULIMIA NERVOSA

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30
Q

Disorder of INFANCY related to repeatedly regurgitating food or rechewing food is known as

A

RUMINATION

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31
Q

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 _________

A

Anemia; hypertension; osteodystrophy

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32
Q

Aggressive correction of hyponatremia with fluid can cause what?

A

Pituitary damage

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33
Q

Hyponatremia is either to ______extracellular sodium or _____Extracellular volume

A

low; high;

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34
Q

For severe hyponatremia, ________Saline solution is administered followed by _________

A

hypertonic; Diuretics

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35
Q

What is the most common cause of hyperthyroidism

A

Grave’s disease

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36
Q

Precipitating factors of hyperthyroidism:

A

Thyroiditis, nodular goiter, iodine excess, thyroid CA, pituitary tumors

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37
Q

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.

A

every 15-30 mns until stable

Hypochondriasis

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38
Q

What kind of hallucination in which the patient feels things occurring in her own body?

A

Somatic

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39
Q

Hallucinations involve the perception of bodily movements?

A

Kinethics

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40
Q

Hallucinations involving odors

A

Olfactory

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41
Q

Hallucinations involving tastes

A

Gustatory

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42
Q

What are examples of MATURATIONAL crisis

A

Pregnancy Death Marriage

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43
Q

A crisis that occurs over time and IS part of the life cycle’s normal development

A

MATURATIONAL

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44
Q

A crisis that occurs over time and is NOT part of the life cycle’s normal development

A

Situational( unemployment, vehicle accidents, sexual assault, divorce, diagnosis of terminal illness)

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45
Q

Abrupt discontinuation of steroid may result in _________

A

Acute Adrenal Crisis

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46
Q

Acute adrenal crisis is treated with __________ administered IV along with _____ and electrolytes

A

Hydrocortisone Fluids

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47
Q

Which is more common primary or secondary adrenal insufficiency? an example of secondary is______

A

Secondary: steroids induced adrenal crisis.

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48
Q

Symptoms of adrenal crisis

A

hypotension, hyperpigmentation, weakness, fatigue

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49
Q

Patient’s thoughts have some connectivity but little association between the, what though process is that

A

TANGENTIAL

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50
Q

When patient loses the ability to have a normal thought process?

A

Looseness of association

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51
Q

When to patient is distracted by his/her environment and leaps from one thought to another unrelated thought

A

Flight of ideas.-

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52
Q

Thought process that occurs when a patient uses a roundabout way to connect his/her thoughts to the original topic

A

Circumstantial

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53
Q

The initial vasopressors of choice for HYPOTENSION in SEPTIC SHOCK are

A

Norepinephrine (levophed) and DOPAMINE

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54
Q

What should be done prior to initiation of any vasoactive medications?

A

Fluid resuscitation.

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55
Q

Indications that a patient is having a febrile reaction to a blood transfusion are:

A

fever, muscle pain, vomiting, chills, flushing, increased HR.

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56
Q

When does febrile transfusion reaction occurs?

A

Immediately or up to 6 hours after the transfusion

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57
Q

Mild allergic transfusion reaction occurs during or up to _____hour and the symptoms are_____ ___ ____ _____

A

one; flushing, hives; urticaria, itching

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58
Q

occurs days to weeks after the transfusion and have the following symptoms____ ___ ___ ____

A

Delayed Hemolytic transfusion reactions; fever, anemia, mild jaundice, purpura

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59
Q

Noncardiac pulmonary edema transfusion reactions occur _____ or shortly after transfusion and includes

A

fever, chills, shock, dyspnea, hypoxemia, cough and crackles.

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60
Q

In a patient with mania, which type of medication would be prescribed to regulate the patient’s mood?

A

Anticonvulsants

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61
Q

A patient with mania would be prescribed ____ for psychosis

A

Antipsychotics

62
Q

A psych patient may be prescribed ______to block the effects of catecholamines

A

Beta Blockers

63
Q

A patient with depression needs _______to rule out hypothyroidism

A

Thyroid function tests

64
Q

How many types of hypersensitivity reactions are there?

A

4

65
Q

Immediate hypersensitivity reactions occurs within minutes of exposure is type ______and include reactions to ______,PCN, pollen and _______

A

Type I, food products; insect venom

66
Q

Cytotoxic hypersensitivity reactions is type _____ generally occur within minutes to days and include a reaction to ______ ______ ______

A

Type II; Transfusion of mismatched blood

67
Q

Immune complex mediated reaction is type _____ generally occurs within _____ and include reactions to ________ ______

A

III; hours: environmental antigens.

68
Q

Delayed or cell-mediated hypersensitivity reactions generally within one or ____ days and include ________ ____ ____ ____

A

type IV; more; Tuberculosis skin testing reactions.

69
Q

What is normal PT time

A

11.9-18.5 seconds

70
Q

What is normal aPTT

A

24-36 seconds

71
Q

the normal thrombin time

A

10-15 seconds

72
Q

What is the normal bleeding time_________

A

less than 8 minutes.

73
Q

Why is benzodiazepines administered to patient who are suffering from substance abuse?

A

To prevent seizures

74
Q

Patient who are suffering from substance abuse should be monitored for _______ and _____

A

DT and Death

75
Q

The thought process that occurs when patients suspects or doubts something?

A

Suspicious

76
Q

When the patient believing somthing even though there is evidence to the contrary?

A

Delusion

77
Q

The correct dosage for IM epinephrine administration in anaphylactic Shock is: ______ administration may be repeated after _____ to ___minutes

A

1:1000; 15-20

78
Q

What is the purpose of epinephrine during anaphylactic reaction?

A

Promote vasoconstriction, dilate the bronchioles, inhibits further release of mediators.

79
Q

What is the correct dosage concentration for IV epinephrine

A

1:10,000

80
Q

The use of the blood product CRYOPRECIPITATE is for replacement of

A

Clotting factors.

81
Q

The most common replacement for fibrinogen is _____ and is indicated for patients who are _______bleeding or at risk

A

CRYO; acutely

82
Q

What blood products are used to restore oxygen-carrying capacity?

A

PRBCs and Whole blood

83
Q

Which blood products are used to expand blood volume?

A

FFP, albumin and plasma protein fraction.

84
Q

What act ensures that all patients receive the same level of care regardles sof their race, religion, origin, age, gender or disability?

A

Civil Rights Act

85
Q

It is the responsibility of the _______ _____ _____ to ensure that all practitioners are qualified to perform thier duties

A

state’s governing board.

86
Q

HIPAA stands for ______ ____ _____ _____ ____ and date year

A

Health Insurance Portability and Accountability Act; 1996

87
Q

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 ______

A

Glucose; ketoacidosis ; Type II; Type I; HHS ; DKA

88
Q

Diagnosis of Dehydration: Hematocrit is ______ , serum OSMOLALITY is _______ and serum sodium is _______

A

Elevated, elevated, elevated

89
Q

The diagnosis of SIADH : Hematocrit is _____; serum osmolality is _____ and BUN is ______ along with urine specific gravity greater than _______

A

low; low; low; 1.005

90
Q

The diagnosis of water excess syndrome: serum osmolality less than ______ and a decreased _____ and ________

A

280; sodium; hematocrit

91
Q

The diagnosis of HYPERVOLEMIA : Decreased __________; ________; and ________along with urine specific gravity of less than _____

A

hematocrit; serum osmolality and BUN; 1.010

92
Q

When a patient shows signs of sepsis transfusion reaction you should ______

A

stop the tranfusion and obtain culture of the patient’s blood with the remaining tranfusion blood.

93
Q

When a patient shows symtpoms of a noncardiac pumonary edema transfusion reaction, you should stop the transfusion and :

A

Administer oxygen

94
Q

When a patient shows symptoms of a delayed hemolytic transfusion reaction, you should monitor the ______ and ______

A

urine output; hemoglobin

95
Q

Signs of hypermagnesemia include:____ _____ ________

A

Muscular weakness, Loss of Deep tendon reflexes and even RESPIRATORY Muscle paralysis

96
Q

What is given IV to reverse the neuromuscular effects of Hypermagnesemia

A

CALCIUM GLUCONATE

97
Q

All patients in the ER who reports IV drug use should be tested for

A

HIV

98
Q

In DKA, glucose is greater than _____ and his blood serum ketone will be greater than ____

A

250; 5

99
Q

In hyperosolar nonketoci hyperglycemic crisis, blood glucose is greater than _____ and ketone is _______

A

600; normal

100
Q

The psychiatric disorder that causes an individual’s intellectual functioning to deteriorate is

A

DEMENTIA

101
Q

The psychiatric disorder that causes an individual’s moood to be disturbed due to sadness, negativity or loss of interest

Agoraphobia is

A

DEPRESSION

Agoraphobia is anxiety about or avoidance of situations or places from where escape might be difficult.

102
Q

The psychiatric disorder that causes an individual to have an _______mood; _______ mood and _______ mood is _____

A

elevated; irritated; expansive; MANIA

103
Q

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.

A

Psychosis;

Neuroleptic Malignant Syndrome

Dantrolene

104
Q

Malignant proliferation of BLAST CELLS or IMMATURE WBCs is

A

LEUKEMIA

105
Q

Symptoms of Leukemia include :

A

fever, nightsweats, lymphadenopathy, spenomegaly, pallor, bone or joint pain

106
Q

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 _____

A

Hemophillia; VIII; IX

107
Q

Hematologic emergency involving decrease in clotting factors and platelets?

A

DIC

108
Q

2 types of psychosis:

A

functional or organic

109
Q

Predisposing factors of functional psychosis include

A

schizophrenic disorder, severe depression and a brief psychotic episode or mania

110
Q

Predisposing factors of organic psychosis include

Bipolar disorder can be treated primarily with mood stabilizing medications such as _______,_______,_______

A

dementia, delirium, shock, and ingestion of a toxic susbtance.

valproic acid, lithium, or carbamazepine.

111
Q

The co-administration of ______ and _____can result in serious complications and death

A

alcohol and benzodiazepines

112
Q

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), sustained upward deviation of the eyes (oculogyric crisis), extreme arching of the back (opisthotonos), or rarely laryngospasm. Treat with _______

A

alcohol; synergistic; alcohol

Acute distonia

Cogentin

113
Q

Normal mag for adult____ ; for a child ______ for an infant

A

1.3-2.1; 1.4-1.7; 1.4-2.0

114
Q

Kubler Ross stages of grief in ________ include ____ ____ ____ ____ ___ DABDA

A

1969; Denial, anger, bargaining, depression; acceptance

115
Q

Protease inhibitors for HIV are a specific class of drug within ____

A

HAART therapy

116
Q

Side effects of Protease inhibitors are :

A

Hepatotoxicity, HLD, hyperglycemia. LACTIC ACIDOSIS,

117
Q

To make a diagnosis of depression, depressive symptoms must be present for all or ____ of the day for at least _______

A

most; 2 weeks

118
Q

Thought process that occurs when patient stops the flow of his thoughts or speech

A

Blocking

119
Q

Refractory septick shock include

A

tachycardia, hypotension, cool skin, anuria and hypothermia

120
Q

Compensated septic shock include

A

Tachycardia, NORMAL TO LOW BP, Bounding pulses; Warm skin Wide pulse pressure, hyperthermia and OLIGURIA

121
Q

There are several factors that predispose one to sickle cell crisis

A

cold temperature, high altitudes, recent infection, metabolic or respiratory acidosis and STRESS.

122
Q

For patients with hematologic emergencies undergoing high dose chemo, ________ is a serious complication

A

Neutropenic fever

123
Q

For hypotension that is refractory to both fluid resuscitation and vasopressors what should be administered?

A

Hydrocortisone

124
Q

Secretion of ADH leads to an increase in _______ _______. And ________ stimulated the antidiuretic hormone _ADH_

A

Water resorption; HYPERTHERMIA, pain, decreaed blood volume , hypotension and stress

125
Q

What stimulated the RAAS?

A

Hyponatremia

126
Q

_________Stimulates the atrial natriuretic peptide

A

Volume expansion

127
Q

Mechanisms that regulate body fluid:

A

ADH, thirst, RAAS, atrial natriuretic peptide

128
Q

what is given to a patient in anaphylactic shock to block histamine receptors?

A

antihistamine.

129
Q

Steroids is given to anaphylactic shock patients to

A

prevent delayed reaction, decreased capillary permeability, stabilize mast cells.

130
Q

Frequent episodes of binge eating due to emotional distress is a common factor for individuals with

A

BULIMIA NERVOSA

131
Q

Which type of blood is considered universal donor

A

Type O

132
Q

A blood type is compatible with

A

A and O

133
Q

B blood type is compatible with

A

B and O

134
Q

What is the goal of crisis intervention?

A

return individual back to his normal level of functioning.

135
Q

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 _______

A

pituitary; water; Fluid restriction; 500-1000ml; hypertonic; diuretics

136
Q

Which type of of anemia bone marrow fail to produce blood cells?

A

Aplastic

137
Q

Type of anemia that has a deficiency in absorbing Vitamin B12

A

PERNICIOUS

138
Q

What is the role of the electrolytes PHOSPHORUS?

A

Regulating oxygen delivery to the tissues.

139
Q

_______ facilitates muscle contraction

A

Sodium

140
Q

______Maintain intracellular osmolality

A

Potassium

141
Q

What is the BEST recommendation for the prevention of SEPTIC SHOCk

A

Avoid invasive procedures

142
Q

Best recommendation to prevent NEUROGENIC SHOCK

A

IMMOBILIZE THE SPINE

143
Q

Best recommendation to prevent anaphylactic shock

__________is a state of motor restlessness characterized by a physical need to move constantly.

A

remove the offending agent.

Akathisia

144
Q

To prevent cardiogenic shock best to perform

A

Emergency decompression

145
Q

In early septic shock, oxygen delivery to the tissues is ______. But _____ and ______are impaired.

A

increased; extraction ; utilization

146
Q

Patient who are undiagnosed or undertreated from hypothyroidism _________; occurs in ____ older than ___ in ____Months

A

Myxedema coma; women; 60; winter

147
Q

DTs associated with _______ and _______which can lead to ________and ______

A

AMS; sympathetic overdrive; cardiovascular collapse; death.

148
Q

The MAJORITY of anaphylaxis cases involves symptoms related to the

A

SKIN

149
Q

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 _______

A

unconscious

Interest, Sleep, Appetite, Depressed, Concentration, Activity, Guilt, Energy, Suicide

150
Q

Blood product that contains platelets, WBC and plasma is ________. Plasma protein fraction contains _____ and _______ is a saline solution.

A

PLATELETS; albumin and globulin.

CEN (9 decks)

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