Exam 3 Study Guide Ch 10-13 Flashcards
What happens during Ventilation/Perfusion mismatch?
Lungs receive Oxygen without blood flow or you have blood flow without it receiving oxygen.
What are indications and contradictions for OPA?
Indications.
Unresponsive patient without a gag reflex.
Any apneic patient being ventilated with a BVM.
Contraindications.
Conscious patients.
Any patient who has a gag reflex.
What are the indications and contradictions for a NPA?
Indications.
Semiconscious or unconscious patient with a intact gag reflex.
Patients who otherwise will not tolerate an oropharyngeal airway.
Contraindications.
Severe head injury with blood draining from nose.
History of fractured nasal bone.
What is insertion procedure for NPA and OPA?
NPA. measure from nose to earlobe. Place in larger nostril. If useing right nare, bevel to septum. If useing left nare, tip of airway pointing up. Insert until you feel resistance, then rotate 180⁰ Rotation not required for right nostril. Flange should rest against nostril.
OPA Measure from earlobe to corner of mouth. Open mouth with ceoss finger technique. Insert with tip facing roof of mouth. Rotate 180⁰ Flange rest on lips and teeth.
What is a Surfactant?
Reduces surface tension within the alveoli and keeps them expanded, thus making it easier for gas exchange to take place.
A liquid protein substance that coats the alveoli in the lungs, decreases alveolar surface tension, and keeps the alveoli expanded, a low level in a premature infant contributes to respiratory distress syndrome.
What is hypoxic drive?
A condition in which chronically low levels of oxygen in the blood stimulate the respiratory drive, see in patients with chronic lung disease.
What is the Phrenic Nerve?
Nerve that innervates the diaphragm muscle allowing it to contract, necessary for adequate breathing to occure.
Define Intrapulmonary Shunting?
The Bypassing of oxygenpoor blood past the nonfunctional alveoli to the left side of the heart.
Basically blood doesn’t get oxygenated and still gets circulated to the left side of the heart, to be circulated.
Define process of inhalation and exhalation and what the diaphragm and intercostal muscles are doing during each phase?
When a person in inhales, the diaphragm and intercostal muscles contract, allowing air to enter body and travel to the lungs. When it contracts, the diaphragm moves down slightly, enlarging the thoracic cage from top to bottom. When the intercoastal muscles contract, they lift the ribs up and out. The combined actions of these structures enlarge the thorax in all directions.
During exhalation, the diaphragm and the intercostal muscles relax. In response, the thorax decreases in size, and the ribs and muscles assume a normal resting position.
What happens during aerobic and anaerobic metabolism?
During aerobic metabolism, with oxygen, cells convert glucose into energy.
Anaerobic metabolism is without adequate oxygen the cells cant completely convert glucose into energy, Lactic acid and other toxins accumulate in the cell.
What is the Partial Pressure of O2 in Alveoli?
104 mm of Hg
What is the Partial Pressure of CO2 in Alveoli?
40 mm of Hg
What is the process of breathing fresh air into the respiratory system and exchanging oxygen and carbon dioxide Alveoli in the blood in the pulmonary capillaries?
External Respiration
What is this exchange of oxygen and carbon dioxide between the systemic circulatory system and the cells of the body
Internal Respiration
How much inspired Oxygen will a Non Rebreather mask provide?
90%
How much Inspired Oxygen can a Nasal Cannula provide?
24-44% 1-6L/min
Indications and Contradictions for CPAP
Indications
Patients experiencing respiratory distress in which there own compensatory mechanisms are not enough to keep up with there oxygen demand.
Contraindications
Patient in respiratory arrest
Signs or symptoms of pneumothorax or chest trama
Patient with a tracheotomy
Active GI bleed or vomiting
Patient unable to follow verbal commands1
What is Ventilation?
The physical act of moving air into and out of the lungs.
What are the Ventilation Rates for Adult, child, and infant?
5 to 6 seconds
3 to 5
3 to 5
What is the respiratory rate for Adults, children, and infants?
12-20
15-30
25-50
What is the Volume Capabilities of BVM for Adult, Pediatric, and infant?
1200-1600
500-700
150-240
When does Gastric Distention occur?
Most likely to occur when you ventilate too forcefully or too rapidly with a BVM or Pocket mask.
May also occur when airway is obstructed by foreign body or improper head position.
What is the only flow meter not affected by gravity?
Bordon Flow Meter
What is Absorption?
Process in which medications travel through the body tissues until they reach the bloodstream.
What is Adsorption?
To bind or stick to a surface
What is a oral medication that binds and adsorbs ingested toxins in the Gastrointestinal tract for treatment of some poisonings and medical overdoses.
Activated Charcoal
What is the dosage of Activated Charcoal?
1-2 g/ kg of body weight
How do you convert kilos to pounds?
Pounds divided by 2.2
1kg=2.2lbs
Or divide by 2 then subtract 10% of that
Whats the difference between Intraosseous and Intravenous?
Intraosseous is into the bone
Intravenous is into the vein
What does a Pulse Oximetry do and explain falso positives?
A assessment tool that measures oxygen saturation of hemoglobin in the capillary beds.
Hypovolemia
Severe peripheral vasoconstriction (chronic hypoxia, smoking, hypothermia)
Time delay in detecting respiratory insufficiency
Dark or metallic polish
Dirty fingers
Carbon monoxide poisoning
What is a fast acting MDI for acute attack of shortness of breath?
albuterol (Proventil, Ventolin)
Alupent is also?
Metaproterenol and Metaprel
What are the Vital Sign changes when a patient changes from compensated shock to decompensated shock?
Falling blood Pressure 90mm Hg or lower in a adult
What is Nerogenic Shock, what does it affect and what vital signs changes will you see with it?
Damage to the cervical spine, causing widespread blood vessel dilation.
Bradycardia (slow pulse)
Low blood pressure
Signs of neck injury
What is shock due to spinal cord damage?
Neurogenic
Define Septic Shock?
Severe bacteria infection
Toxins damage the vessel walls, causing increased cellular permeability. The vessel walls leak and are unable to contract well.
What is the O2 percentage of the Nasal Cannula and NRB?
24-44% 1-6L/min
90-100% 10-15L/min
Whats the difference between Trade name and Generic name?
Trade name is brand name a manufacturer gives a medication and will be Capitalized.
Generic name is the original chemical name of a medication and wont be capitalized
What are the 6 Rights of medications?
Right Patient Right Medication Right Dose Right Route Right Time Right Documentation
What are capsules?
A gelatin shells filled with powder or liquid medication
What are tablets?
Medications are compressed under high pressure.
Tablets often contain other materials that are mixed with the medication.
What is a Solution?
A liquid mixture of one or more substances that cannot be separated by filtering or allowing the mixture to stand.
Can be given in almost any route.
What is a suspension?
Medications ground into fine particles and evenly distributed throughout a liquid by shaking or stirring.
Suspensions will separate if they stand or filtered.
Difference between lotions and ointments?
Lotions are absorbed rapidly and contain mostly water. Topical medications.
Ointments are absorbed most slowly.
Neosporin, triple antibiotic
What is the dosage of Epi pen for anaphylaxis? And where do you apply it?
.3mg IM
Anterior lateral thigh
Where do you give Oral Glucose?
Between cheek and gum on conscious patient only
What is transdermal?
Transcutaneous or route of meditation over the skin
What are causes of shock?
Pump failure (heart) Container, poor vessel function Fluid problem (content low blood volume)
What is cardiac output?
Amount of blood ejected in 1 min
What is Preload?
The precontraction pressure in the heart as the volume of blood builds up
What is Afterload?
The force or resistance against which the heart pumps
What is Pulmonary Embolism?
A blood clot that breaks off from a large vein and travels to the blood vessels of the long, causing an obstruction of blood flow
Obstructive shock
What is Cardiac Tamponade?
Compression of the heart as the result of buildup of blood or other fluid and the precardial sack, leading to decreased cardiac output
Obstructive shock
What is Tension Pneumothorax?
A life threatening collection of air within the pleura space, the volume and pressure have both collapsed the involved lung and caused a shift of the mediastinal structures to the opposite side
Obstructive shock
What is High Flow O2?
NRB 15 L/min
Whats the difference between Obstructive Shock and Distributed Shock?
Obstructive shock is something that occurs when there is a block to blood flow in the heart and great vessels, causing an insufficient blood supply to the body’s tissues
Distributive shock is a condition that occurs when there is widespread dilation of the small he atrioles, small venules, or both.
What does Aspirin do?
Prevents platelet aggregation and can help prevent
Myocardial infarction
Systolic needs to be over____ for you to give Nitroglycerin.
100
Nitroglycerin can not be given if _____ was taken within 24 hrs.
Viagra
When can a EMT administer medication?
Peer-assisted medication
Patient-assisted medication
EMT-Administered medication
What is the lowest portion of the Pharynx?
Laryngopharynx
What warms and humidifiers air as it enters the body?
Mucus Membrane
What folds over to prevent aspiration of contents into the Trachea when swallowing?
Epiglottis
The(______) is a shield-shaped structure formed by two plates that join In a V shape anteriorly to form the (___________) known as the Adam’s Apple.
Thyroid Cartilage
Laryngeal prominence
What level does the Trachea divide at into the two main stem Bronchi?
Carina
What is the thin slippery outer membrane that covers the lung tissue?
Visceral Pleura
What lines the inside of the Thoracic Cavity?
Parietal Pleura
What are the Thin, Hollow tubes made of smooth muscle?
Bronchioles
What is the conduit for air entry into the lungs?
Trachea, or Windpipe
What are the balloon like sacs that serve as the functional site for the exchange of oxygen and carbon dioxide?
Alveoli
What is the space between the lungs called?
Mediastinum
Deoxygenated blood enter the heart through the?
Right Atrium
What pumps Oxygenated blood to the rest of the body?
Left Ventricle
What pumps the blood from the heart to the lungs for Oxygenation and removal of carbon dioxide?
Right ventricle
Where does Oxygenated blood enter the Heart?
Left Atrium
What is the muscular part of breathing called?
Inhilation
What is the process of moving air into and out of the lungs?
Pulmonary Ventilation
What is Partial Pressure measured in?
mm Hg
What is Albuteral, when, how?
If the have Asthma or difficulty breathing
It stimulates nervous system causing bronchodilation
1-2 inhilations and wait 5 min before repeating dose
What is cardiac output?
Amount of blood ejected by the left ventrical in 1 min
What is a device that is used to change a liquid medication into a spray and push it into a nostril?
Mucosa Atomizer Device MAD
How is Nitro administered and how does it affect the body?
SL tablet or Spray
Dilates blood vessels
Why would you use Naloxone(Narcan) and how do you use it?
Reverses respiratory depression secondary to opioid overdose
IM and IN
What are the side effects and Contraindications For Naloxone(Narcan)?
Nausea, Vomiting
Contraindication is Hypersensitivity
How much Naloxone(Narcan) is in each Dose?
0.4 mg autoinjector or
2 mg IN
