Chap 4,6,7,8 Flashcards
The physiology of disordered function is?
Pathophysiology
The study of disease and its causes?
Pathology
Cellular adaptions
Atrophy
Hypertrophy
Hyperplasia
Metaplasia
Dysplasia
A decrease in cell size resulting from a decreased workload is?
Atrophy
An increase in cell size resulting from an increased workload is?
Hypertrophy
Enlargement
Dilation
An increase in the number of cells resulting from cell division caused by an increased workload is?
Hyperplasia
Cell division with division of the nucleus; each daughter cell contains the same number of chromosomes as the mother cell. ________ is the process by which the body grows?
Mitosis
Replacement of one type of cell by another type of cell that is not normal for that tissue is?
Metaplasia
A change in cell size, shape, or appearance caused by an external stressor is?
Dysplasia
Forms of cellular injury are?
Hypoxia
Chemicals
Infectious agents
Inflammatory reactions
Physical agents
Nutritional factors
Genetic factors
Oxygen deficiency is?
Hypoxia
A blockage in the delivery of oxygenated blood to the cells is?
Ischemia
As the cell becomes progressively more ischemic, the intracellular metabolism becomes?
Anaerobic ( without oxygen )
With anaerobic metabolism, there is a marked decrease in cellular ATP production and an increase in the production of harmful acids ( ketoacids ), primarily ?
Lactic acids
If oxygen is supplied to the cell in time, the injury is reversible true or false?
True
The result of cellular and tissue death is called?
Infarction
A microorganism capable of producing infection or disease is?
Pathogen
Constructive or building up phase of metabolism is?
Anabolism
The destructive or breaking down phase of metabolism is?
Catabolism
Response in which an injured cell releases enzymes that engulf and destroy itself; one way the body destroys and rids itself of damaged and dead cells.
Apoptosis
Cell death
Necrosis
Excess fluid in the interstitial space?
Edema
The liquid part of the blood is?
Plasma
Red blood cells which contain hemoglobin which transport oxygen to the cells is?
Erythrocytes
White blood cells which play a key role in the immune system and inflammatory ( infection fighting ) response?
Leukocytes
Platelets which are important in blood clotting?
Thrombocytes
An iron based compound that binds with oxygen and transports it to the cells is?
Hemoglobin
The percentage of the blood occupied by erythrocytes is?
Hematocrit
Intravenous fluids with the ability to transport oxygen is?
Hemoglobin-based oxygen-carrying solutions (HBOCs)
Substances, such as proteins or starches consisting of large molecules or molecule aggregates that disperse evenly within a liquid without forming a true solution is?
Colloids
A protein commonly present in plant and animal tissues?
Albumin
Substances capable of crystallization.
Crystalloids
A patient having a heart attack should be thought of as having_______?
Myocardial ischemia.
• Myocardial infarction is irreversible and we hope to intervene before this occurs.
__________ have electrolyte composition similar to the blood plasma?
Isotonic solutions
________Have a higher concentration than cells?
Hypertonic solutions
________ have a lower solute concentration than the cells.
Hypotonic solutions
_________ is an isotonic solution of sodium chloride, potassium chloride, calcium chloride, and sodium lactate in water.
Lactated Ringer’s
________ is an electrolyte solution of sodium chloride in water?
Normal Saline
_________ is a hypotonic glucose solution used to keep a vein open and to supply calories necessary for cell metabolism?
D5W
What two solutions are used for fluid replacement, because their administration causes an immediate expansion of the circulatory volume?
Lactated Ringer’s and Normal saline
•however as was noted, due to the movement of electrolytes and water, 2/3’s of either of these solutions is lost into the interstitial space within 1 hour.
Acidity caused by abnormal retention of carbon dioxide resulting from impaired ventilation is?
Respiratory acidosis
Alkalinity caused by excessive elimination of carbon dioxide resulting from increased respirations is?
Respiratory alkalosis
Acidity caused by an increase in acid, often because of increased production of acids during metabolism or from causes such as vomiting, diarrhea, diabetes or medication is?
Metabolic acidosis
Alkalinity caused by an increase in plasma bicarbonate resulting from causes including diuresis, vomiting, or ingestion of too much sodium bicarbonate is?
Metabolic alkalosis
An agent that increases urine secretion and elimination of body water is?
Diuretic
Inadequate pump (cardiogenic)
Inadequate fluid (hypovolemic)
Inadequate container (distributive/neurogenic)
Are all signs of ?
Physiological classifications of shock
Two characteristics of impaired cellular metabolism in any type of shock are ?
Impaired oxygen use and impaired glucose use
At the simplest level, shock is inadequate?
Tissue perfusion
The second stage of metabolism requiring the presence of oxygen in which the breakdown of glucose yields a high amount of energy is? ( aerobic means “with oxygen” )
Aerobic metabolism
The first stage of metabolism which does not require oxygen, in which the breakdown of glucose produces pyruvic acid and yields very little energy is ?
( anaerobic means “without oxygen” )
Anaerobic metabolism
Early stage of shock during which the body’s compensatory mechanisms are able to maintain normal perfusion is?
Compensated shock
Advanced stages of shock when the body’s compensatory mechanisms are no longer able to maintain normal perfusion is ? Also called progressive shock
Decompensated shock
Shock that has progressed so far that no medical intervention can reverse the condition and death is inevitable is?
Irreversible shock
Shock caused by insufficient cardiac output is?
Cardiogenic shock
Types of shock
•Cardiogenic •Hypovolemic •Neurogenic •Anaphylactic •Septic ( Alternative classifications of shock: ) • Cardiogenic • Hypovolemic • Obstructive • Distributive
The hallmark of Decompensated shock is ?
Fall in blood pressure
Most patients with Cardiogenic shock have a normal or _____________ blood pressure?
Increased
Shock caused by a loss of intravascular fluid volume is?
Hypovolemic shock
Greatly increased urination and dehydration due to high levels of glucose that cannot be reabsorbed into the blood from the kidney tubules, causing a loss of water into the urine is?
Osmotic diuresis
Shock resulting from brain or spinal cord injury that causes an interruption of nerve impulses to the arteries with loss of arterial tone, dilation, and relative Hypovolemia is?
Neurogenic shock
A life threatening allergic reaction?
Anaphylaxis also called ( Anaphylactic Shock )
Shock that developed as the result of infection carried by the bloodstream eventually causing dysfunction of multiple organ systems is ?
Septic shock
The study of drugs and their actions on the body is?
Pharmacology
what are the 4 different types of drug names?
- Chemical
- Generic
- Official
- Brand
Components of a Drug Profile
- Names
- Classifications
- Mechanism of action
- Indications
- Pharmacokinetics
- Side affects / adverse reactions
- Routes of administration
- Contraindications
- Dosage
- How supplied
- Special consideration
Six Rights of Medication Administration:
- Right person
- Right drug
- Right dose
- Right time
- Right route
- Right documentation
How a drug is absorbed, distributed, metabolized and excreted is ?(how drugs are transported into and out of the body)
Pharmacokinetics
How a drug interacts with the body to cause its effects is?
Pharmacodynamics
Most drugs travel through the body by means of?
Passive transport
Diffusion and osmosis are forms of ?
Passive transport
______ requires the use of energy to move a substance?
Active transport
The body absorbs most drugs faster when they given __________ than when they are given ___________?
- Intramuscularly
2. Subcutaneously
The amount of a drug that is still active after it reaches its target tissue is?
Bioavailability
The body’s breaking down chemicals into different chemicals is?
Metabolism
The liver’s partial or complete inactivation of a drug before it reaches the systemic circulation is?
First- pass effect
Delivery of a medication through the gastrointestinal tract is?
Enteral route
Delivery of a medication outside of the gastrointestinal tract, typically using needles to inject medications into the circulatory system or tissue is?
Parenteral route
Force of attraction between a drug and a receptor is their?
Affinity
A drug’s pharmacodynamics also involve its ability to cause the expected response , or?
Efficacy
A drug that binds to a receptor and causes it to initiate the expected response is?
Agonist
A drug that binds to a receptor but does not cause it to initiate the expected response is?
Antagonist
Unintended response to a drug is?
Side effect
The time from administration until a medication reaches its minimum effective concentration?
Onset of action
Minimum level of drug needed to cause a given effect is?
Minimum effective concentration
Length of time the amount of drug remains above its minimum effective concentration until it is eliminated from the body is?
Termination of action
Drug that best demonstrates the class’s common properties and illustrates its particular characteristics is?
Prototype
Nerve Cell?
Neuron
Medication that relieves the sensation of pain is?
Analgesic
The absence of the sensation of pain is?
Analgesia
The absence of all sensations is?
Anesthesia
Medication that induces a loss of sensation to touch or pain is?
Anesthetic
State of decreased anxiety and inhibitions?
sedation
Instigation of sleep?
Hypnosis
The part of the nervous system that controls involuntary actions?
Autonomic nervous system
Space between the nerves?
Synapse
Chemical messenger that conducts a nervous impulse across a synapse
neurotransmittter
Pertaining to the neurotransmitter acetylcholine?
Cholinergic
Pertaining to the neurotransmitter norepinephrine?
Adrenergic
drug or other substance that causes effects like those of the parasympathetic nervous system ( also called cholinergic )
Parasympathomimetic
drug or other substance that blocks or inhibits the actions of the parasympathetic nervous system ( also called anticholinergic )
Parasympatholytic
drug or other substance that causes effects like those of the sympathetic nervous system ( also called adrenergic )
sympathomimetic
drug or other substance that blocks the actions of the sympathetic nervous system ( also called antiadrenergic )
sympatholytic
drug used to treat and prevent abnormal cardiac rythms
antidysrhythmic
drug used to treat hypertension
antihypertensive
_______ is effective in the management of angina pectoris as it decreases cardiac work
Nitroglycerin
The stoppage of bleeding
hemostasis
drug that decreases the formation of platelet plugs
antiplatelet
drug that interrupts the clotting cascade
anticoagulant
drug that acts directly on thrombi to break them down ; also called thrombolytic
fibrinolytic
drug used to treat high blood cholesterol
antihyperlipidemic
agent that kills or decreases the growth of bacteria
antibiotic
Measures to decrease your risk of exposure to blood and body fluids
Standard precautions
A condition free of pathogens
Asepsis
Limited to one area of the body
Local
Throughout the body
Systemic
Free of all forms of life
Sterile
Cleansing agent that destroys or inhibits pathogenic organisms and is also toxic to living tissue is?
Disinfectant
Cleansing agent that destroys or inhibits pathogenic organisms but is not toxic to living tissue is?
Antiseptic
Needle handling precautions:
- Minimize tasks in a moving ambulance.
- Properly dispose of all sharps
- Recap needles only as a last resort
You must record all information concerning the patient and the medication including:
- indications for drug administration
- dosage and route delivered
- patient response to the medication - both + and -
Percutaneous medications are applied and absorbed through?
The skin and mucous membranes
Absorbed through the skin?
Transdermal
Percutaneous Routes:
- Transdermal
* Mucous membrane
Mucous Membrane Medication Sites:
- Tongue
- Cheek
- Eye
- Nose
- Ear
Beneath the tongue
Sublingual
Between the cheek and gums
Buccal
Sources of drug information:
- United states Pharmacopeia (USP)
- Physicians’ Desk
- Drug information
- Monthly Prescribing Reference
- AMA Drug Evaluation
The way in which a drug causes its effects; its pharmacodynamics
Mechanism of Action
Conditions that make administration of the drug appropriate ( as approved by the Food and Drug Administration).
Indication
Conditions that make it inappropriate to give the drug.
Contraindications
( a contraindication means that a predictable harmful event will occur if the drug is given in this situation )
Drugs given _________ must first survive the digestive process before being absorbed across the mucosa of the gastrointestinal system.
Orally ( enterally )
Once a drug has entered _________, it must be distributed throughout the body?
Bloodstream
Most drugs will pass easily from the bloodstream, through the ________, into target cells.
Interstitial spaces
Some drugs however, will bind to _________ found in the blood, commonly ___________, and remain in the body for a prolonged time.
- protein
2. Albumin
Changing the bloodstream’s _______ can affect the protein-binding action of a drug.
pH
Drugs are metabolized, or broken down into different chemicals
Metabolites
The special name given to the metabolism of drugs is?
biotransformation
This ______________ is why some drugs cannot be given orally but instead must be given intravenously to bypass the GI tract and prevent first-pass hepatic metabolism.
first-pass effect
Most drugs ( toxins and metabolites ) are excreted in the _______. Some are excreted in the feces or in expired air.
Urine
Enteral Routes:
- Oral (PO)
- Orogastric/nasogastric tube (OG/NG)
- Sublingual (SL)
- Buccal
- Rectal (PR)
Parenteral Routes:
- Intravenous (IV)
- Endotracheal (ET)
- Intraosseus (IO)
- Intramuscular (IM)
- Subcutaneous (SC, SQ, SubQ)
- Inhalation/nebulized
Drug forms: Solid form
- pills
- powders
- tablets
- suppositories
- Capsules
Drug Forms: Liquid drugs
- Solutions
- Tinctures
- Suspensions
- Emulsions
- spirits
- Elixirs
- Syrups
A drug’s pharmacodynamics also involve its ability to cause the expected response or ________
efficacy
length of time the amount of drug remains above its minimum effective concentration?
duration of action
controls voluntary, or motor functions?
somatic nervous system
controls involuntary or automatic functions, is further divided into the sympathetic and parasympathetic nervous system?
Autonomic nervous system
The prototype opioid drug is?
Morphine
As a group tend to cause respiratory, central nervous system (CNS) and cardiovascular depression?
Anesthetics
Neuromuscular blocking agents such as _________ are used to induce paralysis.
Succinylcholine
The gaseous anesthetics given by inhalation incude, halothane, enflurane and?
Nitrous oxide
widely used in the treatment of bipolar disorder, has a very low therapeutic index?
Lithium
Medications that stimulate the sympathetic nervous system are?
sympathomimetics
Medications that inhibit the sympathetic nervous system are called?
sympatholytics
The sympathetic nervous system releases ___________ from the postganglionic end terminals and ___________ from the adrenal medulla.
- norepinephrine
2. epinephrine
________ is also called adrenalin because of its release from the adrenal medulla.
Epinephrine
The primary clinical purpose for medications that stimulate alpha 1 receptors is?
vaso-constriction
alpha 1
- constriction - arterioles
- constriction - veins
- Mydriasis - eye
- Ejaculation - penis
Beta 1
- increased heart rate
- increased conductivity
- increased automacity
- increased contractility
- renin release
Beta 2
- bronchodilation - Lungs
- dilation - arterioles
- inhibition of contractions - uterus
- tremors - skeletal muscles
drug administered through the mucous membranes of the eye
Ocular medication
drug administered through the mucous membranes of the nose
nasal medication
drug administered through the mucous membranes of the ear and ear canal
aural medication
special medications can be administered into the pulmonary system via?
Inhalation or injection
drawing of medication into the lungs along with air during breathing
inhalation
placement of medication in or under the skin with a needle and syringe
injection
inhalation aid that disperses liquid into aerosol spray or mist
nebulizer
Pulmonary medication mechanisms
- Nebulizer
- Metered-dose inhaler
- Endotracheal tube
To administer a drug with a nebulizer, follow these steps:
- Puts medication in reservoir, if medication is not diluted combine with 3 to 5 ml sterile saline solution.
- Set oxygen source regulator for 5 to 8 L per minute
handheld device that produces a medicated spray for inhalation
metered-dose inhaler
Endotracheal Medications:
- Lidocaine
- Epinephrine
- Atropine
- Naloxone (Narcan)
When using an ET tube you must increase conventional IV dosage from?
2 to 2 1/2 times
The delivery of any medication that is taken by mouth and swallowed into the lower gastrointestinal tract
oral drug administration
Medications for oral delivery come in a variety of forms, either _______ or _________.
solid or liquid
contain liquid, dry or beaded medication in a soluble casing
Capsules
comprised of medicated powder compressed into small,solid disk
tablets
comprised of medicated powder compressed into small disk, are the same as tablets.
Pills
liquid medications combined with alcohol or placed in a sweetened fluid
Elixirs
a liquid that contains small particles of solid medication
Suspensions
change in a medications chemical composition that occurs in the liver
hepatic alteration
a liquid bolus of medication that is injected into the rectum
enema
concentrated mass of medication
bolus
drug administration outside of the gastrointestinal tract
parenteral
plastic tube with which liquid medications can be drawn up, stored, and injected
syringe
a hollow metal tube used with the syringe to administer medications
hypodermic needle
types of parenteral drug containers include:
- glass ampules
- single and multidose vials
- prefilled syringes
- intravenous medication fluids
Ampules usually range in volume from?
1 to 5 ml
vial with 2 containers, one holding a powdered medication and the other holding a liquid mixing solution
nonconstituted drug vial / Mix-o-Vial
syringe packaged in a tamper-proof container with the medication already in the barrel
prefilled / preloaded syringe
parenteral medication packaged in an IV bag and administered as an IV infusion
medicated solution
within the dermal layer of the skin
intradermal
___________ injections deposit medication into the dermal layer of the skin
intradermal
relating to the layer of loose connective tissue between the skin and muscle
subcutaneous
To administer an intradermal, you will need the following equipment:
- Tuberculin syringe ( 1ml )
* 25 to 27 gauge needle 3/8 to 1 inch
To perform a subcutaneous injection you will need the following equipment:
- syringe ( 1 to 3 mL )
- 24 to 26 gauge hypodermic needle 3/8 to 1 inch long
- gently pinch a 1- inch fold of skin
- insert at 45 degree angle
Injections deposit medication into the muscle how?
intramuscular
surgical puncture of a vein to deliver medication or withdraw blood
intravenous access ( cannulation )
__________ are chemically prepared solutions tailored to the bodys specific needs
intravenous fluids
intravenous solutions that contain electrolytes but lack the larger proteins associated with colloids
crystalloid
intravenous solutions containing large proteins that cannot pass through capillary membrranes
colloids
state in which solutions on opposite sides of a semipermeable membrane are in equal concentration
isotonic
flexible, clear plastic tubing that connects the solution bag to the IV cannula
administration tubing
hollow needle used to puncture a vein
cannula
administration tubing that delivers a relatively small amount of fluid
microdrip tubing
administration tubing that delivers a relatively large amount of fluid
macrodrip tubing
Mechanisms that cause Edema:
- decrease in plasma oncotic force
- increase in plasma oncotic force
- increase in capillary permeability
- lymphatic channel obstruction
Respirations down CO2 up =
Respiratory acidosis
Respirations up CO2 down =
Respiratory alkalosis
When cells don’t get enough oxygen they change from aerobic to?
Anaerobic
Hypoxic cells start producing?
Lactic acids
Mechanism of hypersensitivity reaction
Type 1 - IGE mediated allergen reactions
L E A N ( pediatrics )
- Lidocaine
- Epinephrine
- Atropine
- Naloxone ( Narcan )
N A V E L ( adults )
- Naloxone ( Narcan )
- Atropine
- Vasopressin
- Epinephrine
- Lidocaine
The prototype opioid drug is?
Morphine
Several of ____________ effects make it useful for clinical practice.
Morphine
At therapeutic doses , __________ causes analgesia, euphoria, sedation, and miosis (pupil constriction). It also decreases cardiac preload and afterload, which makes it useful in treating myocardial infarction and pulmonary edema.
Morphine
_______ ________ _______ stimulates specific receptors that decrease the heart rate.
Sympathetic nervous system
The parasympathetic nervous system stimulates specific receptors that ________ the heart rate?
Decrease
__________ is utilized in the preganglionic nerves of the sympathetic nervous system and in both the preganglionic and postganglionic nerves of the parasympathetic nervous system.
Acetylcholine
__________ is the postganglionic neurotransmitter of the sympathetic nervous system.
Norepinephrine
Synapses that use acetylcholine as the neurotransmitter are _______ synapse.
Cholinergic
Synapse that use norepinephrine as the neurotransmitter are ________ synapse
Adrenergic
The parasympathetic system uses ________ as a neurotransmitter
Acetylcholine
Medications that stimulate receptors specialized for acetylcholine are termed ________ _________ aka
____________________.
Cholinergic receptors
Parasympathomimetics
The prototype direct-acting cholinergic is?
Bethanechol ( Urecholine )
Bethanechol pharmacokinetics make it a good clinical substitute for?
Acetylcholine
___________ agents oppose the parasympathetic ( cholinergic ) nervous system.
Anticholinergic
Buccal medications are generally what type?
Tablets
Equipment for oral administration is:
- soufflé cup
- medicine cup
- medicine dropper
- teaspoon
- oral syringe
A paper or plastic cup to place solid medication in to make it easy to see and minimizes contact with providers hands is?
Soufflé cup
A plastic or glass cup with volume measurements on the side is?
Medicine cup
Has markings for measuring liquid volumes, used for special medications and to administer medications to children
Medicine dropper
Accurately sized to administer liquid medications, normally holds 5 ML of fluid
Teaspoon
The most accurate way to administer liquid based medications
Oral syringe
The deltoid muscle is 3 to 4 finger-breadths below the acromial process ( the bony bump on the shoulder) you can deliver up to how much medication into this muscle?
2.0 mL
The dorsal gluteal muscle or buttock is a common site for intramuscular injections. How much medication can be delivered?
5.0 mL or more
The Vastus lateralis muscle of the thigh is another common site for intramuscular injection, especially for pediatric patients. How much medication can be delivered?
5.0 mL or more
The rectus femoris lies over the femur and is closely associated with the Vastus lateralis muscle. How much medication can be delivered?
Up to 5.0 mL
Over-the-needle Catheter often called the?
Angiocatheter
Stylet that does not have a Teflon tube but is itself inserted into the vein and secured there is called?
Hollow-needle catheter
Teflon catheter inserted through a large metal stylet is called?
Catheter inserted through the needle ( intracatheter )
Never constrict arterial blood flow with the constricting band and never leave it in place longer than ?
2 minutes
IV trouble shooting
- constricting band still in place?
- edema at puncture site?
- cannula abutting vein wall or valve?
- administration set control valves closed?
- IV bag to low?
- completely filled drip chamber?
A foreign protein capable of producing fever is?
Pyrogen
A foreign particle in the blood?
Embolus
An excess in intravascular fluid volume?
Circulatory overload
Inflammation of the vein
Thrombophlebitis
A blood clot?
Thrombus
Air in the vein is ?
Air embolism
The sloughing off of dead tissue is?
Necrosis
A drug that inhibits blood clotting is?
Anticoagulant
A surgically implanted port that permits repeated access to central venous circulation is?
Venous access device
A gravity flow device that regulates fluid’s passage through an electromechanical pump is?
Infusion controller
A device that delivers fluids and medications under positive pressure is?
Infusion pump
Do not attempt IO placement in the following situations:
- fracture to the tibia or femur on the side of access
- osteogenesis imperfect a - a congenital disease
- osteoporosis
- establishment of a peripheral IV line
The presence of gas or air in the pleural cavity
Pneumothorax
What is the most common cause of airway obstruction?
Tongue
Removing a tube from a body opening is called what?
Extubation
What is the most commonly aspirated material?
Vomitus
Asymmetrical movement in the chest wall is a sign of paradoxical breathing and could suggest what?
Flail chest
Assymetrical chest wall movement that lessens respiratory efficiency is called what?
Paradoxical breathing
Defect in the chest wall that allows a segment to move freely, causing paradoxical chest wall motion is what?
Flail chest
Bluish discoloration of the skin is called what?
Cyanosis
An abnormality of breathing rate, pattern, or effort is what?
Dyspnea
Oxygen deficiency
Hypoxia
Forceful exhalation of a large volume of air from the Lungs. Performs a protective function in expelling foreign material from the lungs.
Coughing
Sudden forceful exhalation from the nose
Sneezing
Sudden inspiration caused by spasmodic contraction of the diaphragm with spastic closure of the glottis
Hiccoughing ( hiccups )
Slow, deep, involuntary inspiration followed by a prolonged expiration
Sighing
Deep, slow or rapid, gasping breathing, commonly found in ketoacidosis
Kussmaul’s respirations
Progressively deeper, faster breathing alternating gradually with shallow, slower breathing indicating brainstem injury
Cheyne stokes respirations
Results from partial obstruction of the upper airway by the tongue
Snoring
Results from the accumulation of blood, vomitus, or other secretions in the upper airway
Gurgling
A harsh, high pitched sound heard on inhalation associated with laryngeal edema or constriction
Stridor
A musical, squeaking or whistling sound heard in inspiration and / or expiration, associated with bronchiolar constriction
Wheezing
Diminished or absent breath sounds are an ominous finding and indicate a serious problem with the airway, breathing or both
Quiet
A fine, bubbling sound heard on inspiration, associated with fluid in the smaller bronchioles
Crackles ( rales )
A course, rattling noise heard on inspiration, associated with inflammation, mucus or fluid in the bronchioles
Rhonchi
A measurement of hemoglobin oxygen saturation in the peripheral tissue
Pulse oximetry
A recording or display of the measurement of exhaled carbon dioxide concentrations
Capnography
An uncuffed tube that follows the natural curvature of the nasopharynx, passing through the nose and extending from the nostril to the posterior pharynx
Nasopharyngeal airway
Do not use ________ _________ in patients who are predisposed to nose bleeds or who have nasal obstruction. Also, use caution when you suspect a basilar skull fracture, as the tube can inadvertently pass into the cranial vault.
Nasopharyngeal airway
What is an instrument for lifting the tongue and epiglottis out of the way so that you can see the vocal chords?
Laryngoscope
What is a flexible, translucent tube open at both ends and available in lengths ranging from 12 to 32 cm with cm markings along its length?
Endotracheal tube ( ETT )
Scissor style clamps with circular tips
Magill forceps
Advantages of the endotracheal intubation:
- isolates the trachea and permits complete control of airway
- impedes gastric distention by channeling air directly into the trachea
- eliminates the need to maintain a mask seal
- offers a direct route for suctioning of the respiratory passages
- permits admin of medicine ( LEAN ) via the ET tube
Disadvantages of the ET tube:
- technique requires considerable training and experience
- requires special equipment
- requires direct visualization of the vocal chords
- bypasses the upper airway’s function of warming, filtering and humidifying the inhaled air
To blow into
Insufflate
To avoid hypoxia during intubation, limit each intubation attempt to no more than ________ before reoxygenating the patient.
30 sec
Esophageal intubation is ________ if nits not recognized immediately
Lethal
Giving medications to sedate and temporarily paralyze a patient and then performing orotracheal intubation is called what?
Rapid-sequence intubation ( RSI )
The preferred neuromuscular blocking agent for emergency RSI is what?
Succinylcholine
Common paralytic agents are:
- succinylcholine
- Vecuronium
- Atracurium
- Pancuronium
Guidelines for using succinylcholine include:
- dose 1.5 mg/kg, IV bolus in adults ; 2.0 mg/kg IV bolus in children less than 10 yrs old
- onset of action: 60 to 90 sec
- duration: 3 to 5 min
- contraindications: penetrating eye injuries, pt’s with burns greater than 8 hrs duration, massive crush injuries and neurologic injuries greater than 1 wk out
Describes the lengths of onset, duration and termination of action, as well as the drugs minimum effective concentration and toxic levels.
Plasma-level profile
Primary drug for SVT , had a 1/2 life of 5 to 10 sec, pushed very fast.
Adenocard / Adenosine
Calcium channel blocker used for SVT
Cardizem/ Diltiazem
Potassium channel blocker “ indicated “ for SVT & ventricular arrhythmias
Amiodarone/ Cordarone
Sodium channel blocker “the drug of choice” for V-Tach/V-Fib
Lidocaine
Increases HR due to Anticholinergic
Atropine
An inhaled Anticholinergic that relaxes bronchial smooth muscles causing bronchodilaton
Atrovent/Ipratropium
