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Critical Care 2 > Exam 1, Deck 2 > Flashcards

Exam 1, Deck 2 Flashcards

1
Q

What burn zone?

cells in this area receive maximum contact with heat source, necrosis occurs

A

zone of coagulation (site of injury)

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2
Q

what burn zone?

decreased blood supply, high risk of burn wound progression without adequate fluid resus

A

Zone of stasis (area extending peripherally from site of injury):

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3
Q

what burn zone?

cells sustain minimal injury, mild inflammation, spontaneous heals in 7-10 day

A

Zone of hyperemia (located furthest away from injury):

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4
Q

Burns > __% TBSA have a larger systemic response

A

15%

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5
Q

what happens in large TBSA burns that places the pt at risk for compartment syndrome

A

Fluid shifts

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6
Q

Complications in Burns

A

Infection

Fluid shifts -risk for compartment syndrome

Rhabdomyolysis

Hypermetabolic response - 24-72 hours ->Gluconeogenesis, weight loss, negative nitrogen balance, decr in E stores, incr risk of infection

Body temp -> risk for heat loss (increased cortisol, glucagon and catecholamine secretion)

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7
Q

most common cause burns in pediatric

A

Scalds
child maltreatment

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8
Q

What degree burn

restricted to the epidermal layer
Sunburn
Erythematous, painful, absent of bullae
Heals 2-5 days without scarring

A

Superficial 1st degree

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9
Q

what degree burn

extends into dermal layer – have bullae (fluid containing blisters) and very painful due to nerve ending exposure, assess cap refill

A

Partial Thickness (2nd degree)

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10
Q

most frequent burn for which treatment is sought out

A

Partial Thickness (2nd degree)

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11
Q

what degree burn

Entire epidermis and deeper dermis

Blistering

Dermal base is less
blanching, mottled pink or white, less painful than superficial partial thickness
Require excision and grafting

A

Deep partial-thickness (2nd degree):

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12
Q

what degree burn

all layers of the skin — epidermis and dermis — are destroyed, and the damage may even penetrate the layer of fat beneath the skin.

A

full thickness
3rd degree

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13
Q

what type of burn

Involved underlying fascia, muscle, or bone
May need reconstruction and grafting

A

4th degree burn

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14
Q

Non-blanching wound is a ________ _____ wound

A

full thickness

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15
Q

when should you suspect inhalation injury

A

facial burn
singed nose hairs
Carbonaceous sputum
Hoarseness

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16
Q

Labs and imaging in burn

A

CBC, type/screen, coags, chem10, ABG, chest xray
Carboxyhemoglobin if inhalation exposure
Cyanide level: smoke inhalation with AMS

Burn >15% TBSA: BMP, BUN, Cr, prealbumin

Electrical: get UA (goal urine pH >6), myoglobin, ECG to eval for ST changes

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17
Q

Care of wound pt

A

Nutrition must be assessed within first 24hr – needed to manage the hypermetabolic state
-High protein, high calorie
- Steroid-Oxandrolone (incr protein synthesis),
–propranolol (helps blunt hypermetabolic state), growth hormones (aid in wound healing)
Pain control, blood glucose control
Wound care
Topical antimicrobials: silver sulfadiazine (can cause kernicterus in peds, pancytopenia), bacitracin, mafenide cream (metabolic acidosis)

100% humidified O2 if hypoxia or inhalation suspected

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18
Q

Silver sulfadiazine used as topical antimicrobial in burns can cause

A

Kernicterus in peds
Pancytopenia

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19
Q

Mafenide cream used in burns can cause

A

metabolic acidosis

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20
Q

Urine output goal in burn

A

<30kg: 0.5-1ml/kg/hr
>30kg: 1-2 ml/kg/hr

If UO too high, titrate LR infusion down by ⅓
If UO too low, titrate LR infusion up by ⅓
Reassess UO in 2hr and adjust as needed

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21
Q

Parkland formula for TBSA >

A

15%

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22
Q

Parkland formula

A

4ml x weight in kg x %TBSA burned = volume of LR to deliver in 24 hrs.

deliver first half of fluid in 1st 8 hrs
second half over the next 16 hrs

For pt <30kg: deliver MIVF (4-2-1 rule) with dextrose in addition to parkland fluid

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23
Q

special considerations
chemical burns

A

cleanse immediately, do not alkalize, call poison control

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24
Q

special considerations
eye burns

A

ophtho consult, erythromycin ointment

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25
Q

special considerations
Perineum burns

A

urinary drainage catheter, bacitracin

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26
Q

Bleed
injury to the middle meningeal artery or vein

A

Epidural

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27
Q

Bleed?
Bridging vein rupture

A

Subdural

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28
Q

Bleed?
Tearing of small vessels in the pia matter

A

Subarachnoid

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29
Q

Which bleed has a lucid interval

A

Epidural

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30
Q

which bleed is from shaken baby

A

Subdural

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31
Q

Bleed?
result from direct trauma or rotational forces from vigorous shaking

A

Subdural

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32
Q

Bleed?
Sudden, severe HA due to rupture of intracranial aneurysm

A

Subarachnoid

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33
Q

acceleration/deceleration forces that result in shear trauma at the interface of grey and white matter

A

diffuse axonal injury

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34
Q

Secondary Brain injury is

A

local and systemic events triggered by primary injury
-Posttraumatic energy failure and excitotoxicity
-Axonal injury
-Cerebral edema with increased ICP

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35
Q

Mild TBI has GCS of

A

13-15

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36
Q

Moderate TBI has GCS of

A

9-12

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37
Q

Severe TBI has GCS of

A

<8

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38
Q

Cushing Triad

A

Bradycardia
Hypertension
Irregular resp

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39
Q

Secondary impact syndromes

A

repeated concussions carry r/o permanent brain injury

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40
Q

ICP > ____= poor outcome

A

> 20

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41
Q

CPP =

A

MAP-ICP

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42
Q

CPP Infant
children
adolescent

A

Infant >40-50
Children >50-60
Adolescent >60

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43
Q

Physical abuse fractures

A

-Long bone fracture in non-ambulatory child

-Rib fracture (needs a lot of force to fracture)

-Grabbing baby and squeezing chest

-Fractures of sternum, scapula or spinous process (needs a lot of force to fracture)

-Multiple fractures in various stages of healing

-Digital fracture in child < 3 years old

-Complex skull fracture

-Metaphyseal corner and bucket fractures
- Bone shaved off

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44
Q

Baby GCS

A

Eye opening
spontaneous - 4
speech - 3
pain- 2
none - 1

Verbal
coos, babbles - 5
irritable cries - 4
Cries to pain - 3
moans to pain-2
none- 1

Motor
Normal - 6
withdraw touch-5
withdraws pain 4
abnormal flexion -3
abnormal extension 2
none 1

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45
Q

GCS

A

eyes
spontaneous 4
to command 3
to pain 2
none 1

verbal
oriented -5
confused-4
inappropriate words-3
incomprehensible sounds - 2
None-1

Motor response
obeys commands -6
localizes pain-5
withdraws-4
abnormal flexion-3
abnormal extension-2
none-1

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46
Q

maintenance fluid for SJS

A

2ml/kg x TBSA
for 24 hours

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47
Q

maintenance rhabdo

A

2xs maintenance

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48
Q

Hypotension formula

A

70 + 2(age)
systolic
if systolic is this number. Lower limit for hypotension

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49
Q

for children 1-4 yrs old what is the leading cause of death?

A

drowning

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50
Q

for children less than 1 yr what is the leading cause of death

A

suffocation

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51
Q

Highest death rate across all age groups cause of death is

A

MVC

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52
Q

leading cause of nonfatal injuries

A

falls

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53
Q

pediatric anatomy differences

A

Larger head with shorter neck

Occiput causes neck to flex while laying flat

Posterior pharynx can buckle anteriorly without proper shoulder support

Large floppy tongue and tonsils can obscure view

Funnel shaped larynx allows secretions to accumulate

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54
Q

Gather medical history, allergies, medications, last food/fluids and events surrounding incident

Primary or secondary survey?

A

secondary

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55
Q

Trauma
hemoptysis
subcutaneous emphysema
Tension pneumothorax with mediastinal shift

What type of injury should you be thinking about

A

Tracheobronchial tree injury

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56
Q

Trauma with the following symptoms
> 2 ribs fractured in 2 or more places
Abnormal chest wall movement
Crepitus of ribs
Pulmonary contusion.
Ventilation/Oxygenation

what are you thinking?

A

Flail chest

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57
Q

what type of pneumothorax has neck vein distention and tracheal deviation

A

Tension pneumothorax

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58
Q

What type of pneumothorax requires needle decompression and chest tube

A

Tension pneumothorax

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59
Q

Symptoms of cardiac tamponade

A

Becks Triad:
1)Hypotension is the first sign, but it is not related to hypovolemia
2)Jugular venous distention is often noted as the veins begin to back up
3) Lastly muffled heart sounds are heard

Other signs include Pulsus Paradoxus:
A decrease of at least 10 mm Hg in arterial blood pressure when the patient inhales

Electrical Alternans

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60
Q

signs of Tension pneumo

A

Hypotension
JVD
Absent breath sounds

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61
Q

what type of bleed?
Caused by tears in bridging veins that rupture across the subdural space
Blood gathers between the dura mater and the brain

A

Subdural bleed

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62
Q

When does a subdural bleed need surgical decompression

A

if 5mm midline shift or greater

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63
Q

What type of bleed?
Often located in temporal or parietal region
Results from tear in Middle Meningeal Artery
Usually causes midline shift of brain matter
Common for patient to have “lucid event” from time of injury to deterioration

A

Epidural bleed
(requires immediate surgical decompression)

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64
Q

leading cause of TBI and mortality in children

A

Skull fractures

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65
Q

what skull bone is most frequently involved in skull fx

A

Parietal bone

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66
Q

Type of skull fracture most common

A

Linear fx

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67
Q

skull fx signs

A

Bogginess to palpation of scalp
Skull bone depression or “Step-Off”
Periorbital bruising (raccoon eyes)
Bruising behind ears (battle’s sign)
CSF leakage from the nose or ears
Paralysis of the face
Hearing loss

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68
Q

symptoms of TBI with Herniation

A

Altered MS
Hypotension with tachycardia
Retinal hemorrhage
Unequal pupils
Seizures
Altered respiratory rate

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69
Q

Treatment for TBI with herniation

A

Prevent hypotension and hypoxia
Intubation with mechanical ventilation
Maintain SBP 90mmHg or >
Hyperventilation PaCO2 35+/-3
Sedation
Avoid fluid overload

70
Q

SCTWORA

A

traumatic myelopathy will have spinal cord injury without any radiographic abnormality

71
Q

what does a cervical spine assessment include

A

No midline cervical tenderness

No focal neurological deficits

Normal mental status/alert

No intoxication

No painful, distracting injury

72
Q

Cervical x rays

A

Cross table lateral
AP of lower cervical column
Atlanto-axial AP (Open mouth)
BL supine oblique views

73
Q

40% of children under 7 yrs of age show anterior displacement of C2 on C3 which is called a

A

Pseuosubluxation

74
Q

what kind of burn?
with hot fluid such as coffee, tea or soup

A

scald burn

75
Q

what kind of burn?
when touch hot object such as stove, iron, grill or muffler

A

contact burn

76
Q

what kind of burn
friction with treadmill, rope, or pavement

A

mechanical burn

77
Q

what kind of burn?

contact with fire

A

flame burn

78
Q

what kind of burn?

when electrical current travels from the contact site into body

A

electrical burn

79
Q

what kind of burn

contact with strong acids (drain and toilet cleaners) or strong alkalis (fertilizers, detergents, oven cleaners)

A

chemical burn

80
Q

what kind of burn?

from hot gases or smoke

A

inhalation burn

81
Q

Burns increase risk of

A

infection
hypothermia
metabolic acidosis

82
Q

how long does it take for a 2nd degree burn to heal

A

7-10 days

83
Q

how long does it take for a deep partial thickness burn to heal

A

2-3 weeks

84
Q

how long does it take for a full thickness burn to heal?

A

> 1 month

85
Q

what chart to determine TBSA

A

Lund and Browder chart or palmar surface

86
Q

management of superficial partial thickness burns

A

Xeroform (petroleum gauze infused with 3% bismuth tribromophenate)

Mepilex AG: (silver impregnated antimicrobial dressing that lasts 5-7 days)

87
Q

Management of deep partial thickness burns:

A

Mepitel
and
Acticoat: silver impregnated rayon/polyester/polyethylene mesh. Active release of antimicrobial silver ions into burn wound when moistened. Lasts 3-7 days but antimicrobial activity lasts up to 96 hours

88
Q

Management of full thickness burns

A

Silver sulfadiazine 1% cream - absorbs into epidermis and dermis. Bactericidal against gram positive and gram neg organisms, fungi and some viruses

skin grafting

89
Q

Burns need what immunizations

A

Tetanus
Booster if >5 yrs since last

<7 years for DTaP
>7 years: Tdap or Td if child has already received one Tdap.

90
Q

what burns need hospital admission

A

Partial thickness burns 10-20% and full thickness burns >5%

91
Q

Burns > ___% require IV fluids, Burs greater than ___% should be resuscitated using parkland formula

A

10%
15%

92
Q

greatest risk for submersion injuries are < __ yrs

A

5
another peak at 16-24 yrs

93
Q

pH imbalance in submersion

A

metabolic acidosis

94
Q

submersion injury
indications for intubation

A

unconscious child, peripheral arterial carbon dioxide (PaCO2) levels >50 mmHg, inability to maintain peripheral arterial oxygen (PaO2) >90% with supplemental oxygen. Positive end-expiratory pressure should be used to prevent atelectasis and overcome intrapulmonary shunting.

Kline, Andrea M.; Haut, Catherine. Lippincott Certification Review: Pediatric Acute Care Nurse Practitioner (p. 1032). Wolters Kluwer Health. Kindle Edition.

95
Q

needle aspiration for tension pneumo location

A

Second intercostal space mid-clavicular line

96
Q

Thoracostomy tube is placed

A

4th, 5th or 6th intercostal space midaxillary line and connected to water seal or suction

97
Q

Injury to lung parenchyma with edema and hemorrhage without associated pulmonary laceration.

Kline, Andrea M.; Haut, Catherine. Lippincott Certification Review: Pediatric Acute Care Nurse Practitioner (p. 1037). Wolters Kluwer Health. Kindle Edition.

A

PUlmonary contusion

98
Q

what injuries in children are almost always associated with a pulmonary contusion

A

flail chest
scapular fractures

99
Q

when does symptoms peak in pulmonary contusion. when do they resolve?

A

peaks 24-48 hours after injury and resolves within 7 days

100
Q

chest x ray may not show changes in pulmonary contusion until how long after injury

A

4-6 hours and may not reflect extent of injury

101
Q

imaging for pulmonary contusion

A

CT

102
Q

management of pulmonary contusion

A

supportive

Close monitoring for >24-48 hrs after injury

oxygen for hypoxia

pulmonary toilet
fluid mgmt
pain control

Fluids -judicious
-too little -> hypovolemia and hypoxemia

too much -> pul edema

No benefit for abx or corticosteroids

prone positioning may help with perfusion

103
Q

complications of pulmonary contusion

A

pneumonia
ARDS

104
Q

a bending of the bone which causes a small fracture that does not cross the bone. Most common in the ulna.

Kline, Andrea M.; Haut, Catherine. Lippincott Certification Review: Pediatric Acute Care Nurse Practitioner (p. 1044). Wolters Kluwer Health. Kindle Edition.

A

plastic deformation

105
Q

fracture on the tension side of the bone near the softer metaphyseal bone; crosses the bone and buckles the harder bone on the opposite side, causing a bulge.

Kline, Andrea M.; Haut, Catherine. Lippincott Certification Review: Pediatric Acute Care Nurse Practitioner (p. 1044). Wolters Kluwer Health. Kindle Edition.

A

buckle (torus) fx

106
Q

Bone is bent with an initial fracture which does not go through bone.

Kline, Andrea M.; Haut, Catherine. Lippincott Certification Review: Pediatric Acute Care Nurse Practitioner (p. 1044). Wolters Kluwer Health. Kindle Edition.

A

greenstick fx

107
Q

fracture that involves total width of bone

A

complete fx

108
Q

fx that occurs from a rotational or twisting force

A

spiral fx

109
Q

fx that viewed diagonally across the diaphysis

A

Oblique

110
Q

fx that is usually diaphyseal

A

transverse fx

111
Q

fx that is through the physis or growth plate

A

Epiphyseal fx

112
Q

immobilization for most fractures is < __ weeks

A

12

113
Q

simple fractures that are closed and nondisplaced can heal enough to be free from immobilization within __ weeks

A

3

114
Q

injury to a ligament resulting from excessive stretching force

A

sprain

115
Q

grade that sprain
minimal discomfort, minimal or no loss of function

A

grade I

116
Q

grade the sprain
ligaments are partially torn with tenderness, swelling, and ecchymosis with mild-to-moderate loss of function.

Kline, Andrea M.; Haut, Catherine. Lippincott Certification Review: Pediatric Acute Care Nurse Practitioner (p. 1046). Wolters Kluwer Health. Kindle Edition.

A

grade II

117
Q

grade that sprain
completely torn ligament with unstable joint, significant tenderness, swelling, and ecchymosis with loss of function.

Kline, Andrea M.; Haut, Catherine. Lippincott Certification Review: Pediatric Acute Care Nurse Practitioner (p. 1046). Wolters Kluwer Health. Kindle Edition.

A

grade III

118
Q

Ottawa ankle rules

A

rules for when to x ray sprain

-point tenderness on lateral or medial malleolus and the distal 6cm of posterior edge of tibia or fibula

or inability to bear weight
or
take 4 unassisted steps in exam room

119
Q

how long does Sprain take to heal

A

4-6 weeks

120
Q

foreign body in eye
what abx should be given

A

4th gen fluoroquinolone or ciprofloxacin drops 4 times a day until healed

no steroids

121
Q

Quadriplegia is now known as

A

Tetraplegia

122
Q

spinal cord injury at what level increases risk for neurogenic shock

A

T6

123
Q

In neurogenic shock
How do you treat the bradycardia and hypotension

A

Bradycardia - Atropine
Hypotension- fluids

keep MAP 80-85

124
Q

Temp loss of sensory, motor, autonomic and reflex function below level of injury. Flaccid paralysis -> venous pooling -> hypovolemia

A

spinal shock

125
Q

inappropriately strong sympathetic response to triggers that occur below the level of injury. Patients develop vasoconstriction, hypertension, and reflexive bradycardia. flushing to face, headache Triggers may include bladder and bowel distention.

Kline, Andrea M.; Haut, Catherine. Lippincott Certification Review: Pediatric Acute Care Nurse Practitioner (p. 1051). Wolters Kluwer Health. Kindle Edition.

A

Autonomic dysreflexia

use urinary catheter and bowel regimen to prevent

126
Q

Autonomic dysreflexia usually happens if injury is ___ or above

A

T6

127
Q

most sensitive imaging to evaluate spinal cord, surrounding ligaments and soft tissues

A

MRI

128
Q

GI complication in spinal cord injury

A

ileus
gastric decompression is recommended to prevent emesis and aspiration

129
Q

____ and ____ perpetuate secondary spinal cord injury

A

hypotension
hypoxia

130
Q

the first ___ after spinal cord injury are crucial for therapeutic interventions

A

24 hours

131
Q

pneumonic for risk of person at risk for suicide

A

IS PATH WARM

Ideation
substance abuse
purposelessness
anxiety
trapped
hopelessness
withdrawal
anger
recklessness
mood changes

132
Q

what risk category for suicide

  • History of serious or nearly lethal attempts or planning.
  • Recently institutionalized for a psychiatric disorder or recent psychiatric disorder.
  • Persistent suicidal ideation, psychosis, or history of aggression and impulsive acts.

Kline, Andrea M.; Haut, Catherine. Lippincott Certification Review: Pediatric Acute Care Nurse Practitioner (p. 1055). Wolters Kluwer Health. Kindle Edition.

A

High

133
Q

what suicide risk category
* Under medical care of a psychiatric specialist. * Suicidal ideation without plans or attempts. * No other identified signs.

Kline, Andrea M.; Haut, Catherine. Lippincott Certification Review: Pediatric Acute Care Nurse Practitioner (pp. 1055-1056). Wolters Kluwer Health. Kindle Edition.

A

Moderate

134
Q

What suicide risk category
* Mild suicidal ideation, but without attempt. * Social support. * No previous attempts.

Kline, Andrea M.; Haut, Catherine. Lippincott Certification Review: Pediatric Acute Care Nurse Practitioner (p. 1056). Wolters Kluwer Health. Kindle Edition.

A

low

135
Q

After a TBI, keep ICP <___mmHG with optimal CPP for age

A

<20mm Hg

136
Q

behavior/response scale used to evaluate the state of consciousness through interaction of the pt with the environment or response to stimuli

A

Rancho Los Amigos Scale

137
Q

Acute presentation of sexual abuse is within ____ hours

A

72

138
Q

fractures concerning for child abuse

A

posterior rib fx
fx in a child <1 yr
classic metaphyseal lesions

139
Q

eye finding in abuse

A

retinal hemorrhages found in 65-80% of pt with abusive head trauma

140
Q

what rancho los amigos level?
a generalized response with inconsistent and nonpurposeful reaction to stimuli in a nonspecific manner. Responses may be delayed and include physiologic changes, gross body movements, and/or vocalizations.

Kline, Andrea M.; Haut, Catherine. Lippincott Certification Review: Pediatric Acute Care Nurse Practitioner (p. 1078). Wolters Kluwer Health. Kindle Edition.

A

level II

141
Q

Rancho los amigos level?
no response to stimuli

A

Level I

142
Q

Rancho los Amigos level?
when the response to stimuli is more localized, such as withdrawal from painful stimuli or inconsistent following of simple, one-step commands.

Kline, Andrea M.; Haut, Catherine. Lippincott Certification Review: Pediatric Acute Care Nurse Practitioner (p. 1078). Wolters Kluwer Health. Kindle Edition.

A

Level III

143
Q

rancho los amigos level?
exhibits automatic but appropriate responses although “robotic-like” and demonstrates decreased safety awareness and impaired judgment.

Kline, Andrea M.; Haut, Catherine. Lippincott Certification Review: Pediatric Acute Care Nurse Practitioner (p. 1078). Wolters Kluwer Health. Kindle Edition.

A

Level VII

144
Q

rancho los amigos
Purposeful and modified independent

A

Level X

145
Q

injury to L frontotemporal where Broca is located may result in

A

motor aphasia or dysarthria

may understand but have difficulty expressing thoughts

146
Q

The wernicke area is located in the parietal temporal area and is responsible for

A

language comprehension and receptive speech

may have fluent aphasia where they can express their thoughts fluently in nonsensical speech pattern

147
Q

primary catalyst for secondary injury in drowning victim

A

Hypoxemia

148
Q

incomplete Spinal cord injury in which some degree of sensory and/or motor fx is preserved up to 3 vertebrae below the level of injury

A

sacral sparing

149
Q

Silver dressings should not be applied where?

A

face, so moisturizers without alcohol are sufficient

150
Q

following grade III liver lac, how long does he need to maintain strict bed rest

A

2 nights

1 day for grades I and II, 2 days for grades III and IV

151
Q

Salter Harris III fx is considered a fracture involving what area of the bone?

A

Epiphyseal

152
Q

fracture through growth plate
Salter Harris?

A

Type I

153
Q

Fracture through growth plate and metaphysis
salter harris?

A

Type II

154
Q

Fracture through growth plate and epiphysis
salter harris?

A

type III

155
Q

Fracture through growth plate, metaphysis and epiphysis
salter harris?

A

type IV

156
Q

crushing of growth plate
salter harris?

A

Type V

157
Q

most common symptom in a fabricated illness

A

apnea

158
Q

which venomous spider triggers inflammatory cascade…can develop into tissue necrosis

A

Brown recluse (Loxosceles reclusa)

159
Q

which venomous spider triggers intense pain via catecholamine release affecting neurotransmitters

A

Black widow (Latrodectus mactans)

160
Q

which venomous spider may present with fang marks or target sign

A

Black widow

161
Q

a ring of white tissue ischemia may develop, followed by a blister or pustule and then a bulls eye appearance

A

brown recluse

162
Q

Local symptoms after a brown recluse bites begins how long

A

3-4 hours

163
Q

Severe envenomation of brown recluse occurs ___ - ___ hours after bite and presents with what symptoms

A

24-72 hours
fever
chills
nausea
vomiting
signs of kidney injury
can lead to thrombocytopenia
hemolysis
shock
kidney failure
bleeding
pulmonary edema

164
Q

what venomous spider
sudden onset of acute pain, swelling, muscle spasms, tachycardia, htn, pain, agitation

increased ICP, HTN, resp failure

positive tap test

A

Black widow

165
Q

black widow antivenom derived from ___ serum

A

horse

166
Q

___ __ spider bite presentation can be similar to an early community acquired staph aureus infection

A

Brown recluse

167
Q

Black widow mild cases…how long do you monitor for

A

6 hours

168
Q

Black widow muscle cramps can be treated with

A

Benzodiazepines
opioids
dantrolene

169
Q

Wasps vs Bees after they sting

A

wasps can sting multiple times
Bee dies after stinging

170
Q

Bee and wasp stings - systemic reactions occur as a result of massive ___ - mediated hypersensitivtity reaction to envenomation

A

IgE-mediated hypersensitivity

171
Q

wound eval
maroon color intact skin close to sacrum
what best describes this skin ulcer

A

deep tissue injury

Critical Care 2 (14 decks)

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