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PCP > Final Study Guide > Flashcards

Final Study Guide Flashcards

1
Q

Define integrity

A

the quality of being honest and having strong moral principles; moral uprightness.

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2
Q

Define empathy

A

the ability to understand and share the feelings of another.

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3
Q

Define self motivation

A

the force that keeps pushing us to go on – it’s our internal drive to achieve, produce, develop, and keep moving forward

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4
Q

Define communication

A

the imparting or exchanging of information or news.

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5
Q

Define teamwork

A

the combined action of a group of people, especially when effective and efficient.

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6
Q

Define respect

A

due regard for the feelings, wishes, rights, or traditions of others.

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7
Q

Define patient advocacy

A

offer independent support to those who feel they are not being heard and to ensure they are taken seriously and that their rights are respected.

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8
Q

Define injury prevention

A

an effort to prevent or reduce the severity of bodily injuries caused by external mechanisms, such as accidents, before they occur.

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9
Q

Define careful delivery of service

A

Mastering and refreshing skills; performing complete equipment checks; demonstrating careful and safe ambulance operations; following policies, procedures, and protocols; following orders.

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10
Q

Define professionalism

A

the competence or skill expected of a professional.

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11
Q

How does cortisol affect the body in relation to stress response?

A

It is released during times of stress, increasing heart rate, blood pressure, blood glucose, respiration and muscle tension in response. It also temporarily shuts down the body’s systems that aren’t needed in the face of crisis, such as digestion and reproduction.

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12
Q

Define critical incident stress

A

refers to the range of physical and psychological symptoms that might be experienced by someone as a result of being involved in a traumatic critical incident.

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13
Q

What are the S/S of critical incident stress?

A

poor concentration, nightmares, blaming attitude, anxiety, guilt, anger, depression, emotional outbursts, change in activity level, easily startled, withdrawal, substance use, change in sleep pattern.

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14
Q

Define burnout

A

a state of emotional, physical, and mental exhaustion caused by excessive and prolonged stress.

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15
Q

What are the S/S of burnout?

A

fatigue, insomnia, excessive stress, sadness, irritability, substance misuse, high blood pressure, vulnerability to illnesses

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16
Q

Define PTSD

A

a mental health condition triggered by a terrifying event, causing flashbacks, nightmares and severe anxiety.

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17
Q

What are the S/S of PTSD?

A
  • Re-experiencing the trauma through intrusive distressing recollections of the event, flashbacks, and nightmares.
  • Emotional numbness and avoidance of places, people, and activities that are reminders of the trauma.
  • Increased arousal such as difficulty sleeping and concentrating, feeling jumpy, and being easily irritated and angered.
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18
Q

Define beneficence

A

an act of charity, mercy, and kindness with a strong connotation of doing good to others including moral obligation.

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19
Q

Define non-malfeasance

A

there is an obligation not to inflict harm on others

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20
Q

Define autonomy

A

the right or condition of self-government.

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21
Q

Define justice

A

just behaviour or treatment.

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22
Q

Define emergency moves

A

When you must move a patient before making an assessment or immobilizing the spine due to hazards on the scene, a need to reposition the patient in order to provide life saving care, or in order to reach critical patients.

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23
Q

Define patient positioning

A

properly maintaining a patient’s neutral body alignment by preventing hyperextension and extreme lateral rotation to prevent complications of immobility and injury.

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24
Q

Define nonverbal communication

A

refers to gestures, facial expressions, tone of voice, eye contact (or lack thereof), body language, posture, and other ways people can communicate without using language.

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25
Q

What is the importance of eye contact?

A

a meaningful and important sign of confidence, respect, and social communication.

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26
Q

How do you actively listen?

A 
Pay Attention. Give the speaker your undivided attention, and acknowledge the message
Show that you're listening
Provide feedback
Defer judgment
Respond appropriately
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27
Q

What are pertinent negatives?

A

a sign or symptom that might be expected based on the patient’s chief complaint that the patient denies having

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28
Q

How is AIDS transmitted?

A

through AIDS or HIV infected blood via IV drug use, semen, or vaginal fluids, blood transfusions, or needle sticks.
Also, mothers to their unborn children

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29
Q

How long is the incubation period for AIDS?

A

several months or years

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30
Q

How is hepatitis A transmitted?

A 
fecal-oral route
-unsafe water or food
-inadequate sanitation
-poor personal hygiene
oral-anal sex
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31
Q

How long is the incubation period for hepatitis A?

A

14-28 days

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32
Q

How is hepatitis B transmitted?

A 
mother to child at birth
exposure to infected blood and body fluids:
needlestick
tattooing
piercing
saliva
menstrual, vaginal, and seminal fluids
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33
Q

How long is the incubation period for hepatitis b?

A

1.5-6 months

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34
Q

How is tuberculosis transmitted?

A

respiratory secretions, airborne or on contaminated objects

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35
Q

How long is the incubation period for tuberculosis?

A

2-6 weeks

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36
Q

How is bacterial meningitis transmitted?

A

oral and nasal secretions

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37
Q

How long is the incubation period for bacterial meningitis?

A

2-10 days

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38
Q

How is pneumonia transmitted?

A

oral and nasal droplets or secretions

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39
Q

How long is the incubation period for pneumonia?

A

several days

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40
Q

How is influenza transmitted?

A

airborne droplets, or direct contact with body fluids

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41
Q

How long is the incubation period for influenza?

A

1-3 days

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42
Q

How are staphylococcal skin infections transmitted?

A

contact with open wounds or sores or contaminated objects

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43
Q

How long is the incubation period for staphylococcal skin infections?

A

several days

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44
Q

How is chicken pox transmitted?

A

airborne droplets, or contact with open sores

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45
Q

How long is the incubation period for chicken pox?

A

11-21 days

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46
Q

How is rubella transmitted?

A

airborne droplets

Mothers may pass it to unborn children

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47
Q

How long is the incubation period for rubella?

A

10-12 days

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48
Q

How is whooping cough transmitted?

A

respiratory secretions or airborne droplets

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49
Q

How long is the incubation period for whooping cough?

A

6-20 days

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50
Q

What is an incubation period?

A

the number of days between when you’re infected with something and when you might see symptoms

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51
Q

What are the PPE requirements for Contact Precautions?

A

gloves

gown

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52
Q

What are the PPE requirements for Droplet Precautions?

A

mask on the patient
mask
face shield/ safety glasses

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53
Q

What are the PPE requirements for Airborne Precautions?

A

mask on the patient

N95

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54
Q

Define pharmacology

A

the branch of medicine concerned with the uses, effects, and modes of action of drugs

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55
Q

Define pharmacokinetics

A

the branch of pharmacology concerned with the movement of drugs within the body

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56
Q

Define pharmacodynamics

A

the branch of pharmacology concerned with the effects of drugs and the mechanism of their action

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57
Q

What is the onset of action for IV medication

A

30-60s

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58
Q

What is the onset of action for IO medication?

A

30-60s

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59
Q

What is the onset of action for inhalation medications?

A

2-3 minutes

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60
Q

What is the onset of action for SL medications?

A

3-5 minutes

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61
Q

What is the onset of action for IM medications?

A

10-20 minutes

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62
Q

What is the onset of action for SQ medications?

A

15-30 minutes

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63
Q

What is the onset of action for PO medications?

A

30-90 minutes

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64
Q

How do you calculate IV flow rate?

A

volume to be infused x set rate (gtts)
____________________________
time in minutes

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65
Q

What are the 6 Rights of Drug Administration?

A 
Right person
Right drug
Right route
Right time
Right dose
Right documentation
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66
Q

What is an example of an anti inflammatory drug?

A

NSAIDs

aspirin, ibuprofen, naproxen

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67
Q

What is an anti-infective drug?

A

a general term used to describe any medicine that is capable of inhibiting the spread of an infectious organism or by killing the infectious organism outright.

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68
Q

What is an example of an anti-infective drug?

A

antifungals or antibiotics

amoxicillin

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69
Q

What is an example of a corticosteroid?

A

prednisone, cortisone

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70
Q

What are analgesics?

A

a class of medications designed specifically to relieve pain.

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71
Q

What is an example of an analgesic?

A

acetaminophen, entonox

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72
Q

What are vasodilators?

A

medications that open (dilate) blood vessels.

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73
Q

What is an example of a vasodilator?

A

ramipril, nitro

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74
Q

What is an antiemetic drug?

A

a drug that is effective against vomiting and nausea.

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75
Q

What is an example of an antiemetic?

A

gravol

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76
Q

What is an anticonvulsant drug?

A

a diverse group of pharmacological agents used in the treatment of epileptic seizures.

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77
Q

What is an example of an anticonvulsant drug?

A

clonazepam, diazepam

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78
Q

What are antipsychotic drugs?

A

a class of medication primarily used to manage psychosis, principally in schizophrenia but also in a range of other psychotic disorders.

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79
Q

What is an example of an antipsychotic drug?

A

haldol, risperidone

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80
Q

What are antispasmodic drugs?

A

a pharmaceutical drug or other agent that suppresses muscle spasms.

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81
Q

What is an example of an antispasmodic drug?

A

atropine

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82
Q

What are antiarrhythmic drugs?

A

prevent and treat abnormal heartbeats

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83
Q

What is an example of an antiarrhythmic drug?

A

amiodarone

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84
Q

What are sedative/hypnotic drugs?

A

commonly known as sleeping pills, are a class of psychoactive drugs whose primary function is to induce sleep and for the treatment of insomnia (sleeplessness), or for surgical anesthesia.

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85
Q

What is an example of a hypnotic drug?

A

ambien

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86
Q

Define cumulative effect

A

The state at which repeated administration of a drug may produce effects that are more pronounced than those produced by the first dose.

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87
Q

Define synergistic effect

A

when two or more “unlike” drugs are used together to produce a combined effect.

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88
Q

Define drug tolerance

A

when a regular user of a drug gradually becomes less responsive to the drug.

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89
Q

Define drug incompatibility

A

an undesirable reaction that occurs between the drug and the solution, container or another drug

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90
Q

Define antagonistic effect

A

The effect produced by the contrasting actions of two (or more) chemical groups.

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91
Q

Define adverse reaction

A

any unexpected or dangerous reaction to a drug.

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92
Q

Define drug toxicity

A

the level of damage that a compound can cause to an organism.

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93
Q

Define idiosyncratic reaction

A

adverse effects that cannot be explained by the known mechanisms of action of the offending agent, do not occur at any dose in most patients, and develop mostly unpredictably in susceptible individuals only.

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94
Q

Define drug allergic reaction

A

the abnormal reaction of your immune system to a medication.

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95
Q

Define anaphylaxis reaction

A

a sudden, life-threatening, whole-body reaction to a drug or other allergen.

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96
Q

Define additive effect

A

the effect of two chemicals is equal to the sum of the effect of the two chemicals taken separately.

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97
Q

Define side effect

A

an effect, whether therapeutic or adverse, that is secondary to the one intended

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98
Q

What are the indications for IV initiation?

A

replace fluid and electrolytes due to hypovolemia and burns

administer medications

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99
Q

What equipment is required for starting an IV?

A 
catheter device
IV solution
IV administration set
IV tubing
tape
tegaderm
tourniquet
alcohol swabs
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100
Q

What are the steps to setting up an IV?

A
  1. Gather and prep equipment:
    - select and inspect catheter device
    - select and inspect the IV solution and administration set
    - prime the IV tubing
  2. Choose and prepare an appropriate site
  3. Initiate IV
  4. Connect IV tubing and infuse solution
  5. Calculate and maintain an appropriate flow rate
  6. Secure the IV
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101
Q

What are some aseptic techniques used with IV administration?

A
  • disinfecting a patient’s skin using antiseptic wipes
  • sterilizing equipment and instruments before a procedure
  • keeping sterilized instruments inside plastic wrappers to prevent contamination before use
  • use appropriate PPE
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102
Q

What are the s/s of an air embolism after you start an IV?

A

respiratory distress with unequal breath sounds
cyanosis (even in the presence of high flow o2)
s/s of shock
loss of consciousness
respiratory arrest

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103
Q

What is the treatment of an air embolism after you start an IV?

A

place the patient on their left side with the head down to trap any air inside the right atrium or right ventricle
administer 100% o2
RTC
be prepared to assist in ventilations.

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104
Q

What are the s/s of circulatory overload after you start an IV?

A 
dyspnea
JVD
HTN
crackles (rales)
acute peripheral edema
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105
Q

What is the treatment of circulatory overload after you start an IV?

A

slow the IV rate TKVO
raise the patient’s head
high flow O2

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106
Q

What are the s/s of thrombophlebitis?

A

pain, swelling, tenderness, warmth, and the arm or leg is restless.

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107
Q

What is the treatment for thrombophlebitis?

A

stop the infusion
discontinue the IV at that site
warm compresses

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108
Q

What are the s/s of infiltration after you start an IV?

A

edema at the cannula site
continued IV flow after occlusion of the vein above the IV site
patient reports tightness and pain around the IV site

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109
Q

What is the treatment for infiltration after you start an IV?

A

discontinue IV line
reestablish IV in the opposite extremity or in a more proximal location on the same extremity
apply direct pressure over the swollen area
do not wrap tape around the area

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110
Q

What are the s/s of an allergic reaction after you start an IV?

A 
pruritis
SOB
edema of face and hands
hives
bronchospasms
wheezing
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111
Q

What is the treatment for an allergic reaction after you start an IV?

A 
discontinue IV line
remove the solution
leave the cannula in place as an emergency medication route
attach a saline lock
notify medical control
maintain ABCs
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112
Q

What are the s/s of catheter shear after you start an IV?

A

sudden dyspnea
SOB
diminished breath sounds

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113
Q

What is the treatment for catheter shear after you start an IV?

A

left lateral recumbent position with the legs down and the head up
these patients need continued IV access, you must try to obtain an IV start in the other extremity.

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114
Q

What is the classification of ASA?

A

platelet inhibitor

antiplatelet

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115
Q

What are the indications for ASA?

A

chest pain or atypical symptoms consistent with cardiac ischemia /AMI

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116
Q

What are the contraindications for ASA?

A

known hypersensitivity or allergy to ASA or other NSAIDs
asthma
pediatric patients with viral symptoms

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117
Q

What is the onset of ASA?

A

20 minutes-1 hour if chewed

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118
Q

What is the dose of ASA?

A

160mg PO

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119
Q

What are the cautions of ASA?

A 
recent internal bleeding
known bleeding diseases
patient is currently taking anticoagulants
recent surgery
possibility of pregnancy
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120
Q

What is the classification of D10W?

A

antihypoglycemic agent

carbohydrate substrate

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121
Q

What are the indications for D10W?

A

suspected or known hypoglycemia
altered level of responsiveness
coma or seizure NYD

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122
Q

What are the contraindications for D10W?

A

none

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123
Q

What is the onset of D10W?

A

immediate

124
Q

What is the dose of D10W?

A

10-25g (100-250ml of 10% solution)

125
Q

What are the cautions for D10W?

A

extravasation causes tissue necrosis

126
Q

What is the classification of Nitro?

A

vasodilator, antiaginal

127
Q

What are the indications for Nitro?

A

Chest discomfort that appears cardiac in nature

128
Q

What are the contraindications for Nitro?

A

SBP <90mmHg
Known allergy or sensitivity to nitrates
Patient has used Viagra or Levitra in the past 24 hours
Patient has used Cialis in the past 48 hours.

129
Q

What is the onset and duration of Nitro?

A

60 seconds with a 30 minute duration q3min

130
Q

What is the dose of Nitro?

A

0.4mg in one spray

131
Q

What are the cautions for Nitro?

A

Hypotension is common in older adults, so ensure the patient is not at risk to fall.

132
Q

What can you do if chest pain is completely relieved for more than 5 minutes after giving Nitro, and then comes back?

A

restart the chest pain protocol

133
Q

How many times can you repeat the Nitro dose?

A

Repeat vitals and drug until pain is relieved, to a max dose of 3 in any 30 minute period.

134
Q

What is the classification of dimenhydrinate?

A

Anti-emetic
Anti-histamine
Anti-cholinergic
Anti-vertigo

135
Q

What are the indications for dimenhydrinate?

A

Prevention or control of nausea, vomiting, and vertigo.

136
Q

What are the contraindications for dimenhydrinate?

A

hypersensitivity or allergy to dimenhydrinate

137
Q

What is the onset of dimenhydrinate?

A

IM 20-30 minutes

IV immediate

138
Q

What is the route and dose of dimenhydrinate?

A

IM/IV 1mg/kg to a max dose of 50mg
IM undiluted
IV dilute with NS and inject over 2 inutes. Draw up 50mg of gravol using a 10ml syringe then draw up an additional 9ml NS.
Elderly-12.5mg

139
Q

What are the cautions for dimenhydrinate?

A 
Glaumcoma
Asthma/COPD
CVD
Prostatic hyperplasia and urinary obstruction
Elderly
Pregnancy
140
Q

What is the classification of glucagon?

A

Glucose elevating agent

141
Q

What are the indications for glucagon?

A

Hypoglycaemia

When IV access attempts have been unsuccessful

142
Q

What are the contraindications for glucagon?

A

Allergy or hypersensitivity to glucagon

143
Q

What is the dose for glucagon?

A

IM 0.5mg-1mg

144
Q

What is the onset for glucagon?

A

IM 8-10 minutes

145
Q

What are the cautions for glucagon?

A 
N/V
Hypokalemia
Urticaria
Respiratory distress
Hypotension
146
Q

What is the classification for TXA?

A

Hemostatic agent

Antifibrinolytic agent

147
Q

What are the indications for TXA?

A

Major trauma patients after initiation of the hypovolemia protocol
Signs of shock in association with MOI or physical findings suggestive of occult or ongoing bleeding.

148
Q

What are the contraindications for TXA?

A

Known hypersensitivity or allergy to TXA
If time is greater than 3 hours after injury
Patient is less than 12 years old.

149
Q

What is the dose and route for TXA?

A

IV piggyback 1g in 50ml NS, 60gtts/min

IVP 1g in 10ml NS, deliver over 10 minutes.

150
Q

What is the onset of TXA?

A

immediate

151
Q

What are the cautions for TXA?

A

Further hypotension if administered too quickly.

152
Q

What is the classification of Entonox?

A

Non narcotic analgesic

153
Q

What are the indications for Entonox?

A

Relief of moderate to severe pain
Cardiac related chest pain where nitro will be of no value or is contraindicated
Isolated extremity injuries.

154
Q

What are the contraindications for Entonox?

A 
Decompression illness
Inhalation injuries
Ventilation
Inability to comply
Nitro in the last 5 minutes
Embolism or pneumothorax
155
Q

What is the route and dose of Entonox?

A

Inhalation-self administered

156
Q

What is the onset of Entonox?

A

rapid

157
Q

What are the cautions for Entonox?

A 
COPD
Facial injuries
Abdominal distension
Depressant drugs
Shock
158
Q

What is the classification of diphenhydramine?

A

Anti-histamine

159
Q

What are the indications for diphenhydramine?

A

Adjunct treatment of allergic reactions

Motion sickness

160
Q

What are the contraindications for diphenhydramine?

A

Known hypersensitivity or allergy to antihistamines

Neonates

161
Q

What is the route and dose for diphenhydramine?

A

PO 25-50mg

IV 25-50mg

162
Q

What are the cautions for diphenhydramine?

A

Narrow angle glaucoma

stenosing peptic ulcer

163
Q

What is the classification of Salbutamol?

A

Bronchodilator

Sympathomimetic

164
Q

What are the indications for Sabutamol?

A

Bronchospasm associated with asthma, bronchitis, or emphysema
Bronchospasm and wheezing secondary to other causes, such as anaphylaxis

165
Q

What are the contraindications for Salbutamol?

A

Known hypersensitivity or allergy to Salbutamol.

Hemodynamically significant tachyarrhythmia

166
Q

What are the routes and doses for Salbutamol?

A

5mg in 5ml NS nebulized (with O2 at 6-8lpm)
100mcg/spray MDI

Nebulized:
< 1 year 2.5mg
> 1 year 5.0mg

MDI:
<20kg: 5x100mcg per round, repeat up to 3 rounds.
>20kg: 10x100mcg per round, repeat up to 3 rounds.
<10kg: not indicated.

167
Q

What are the cautions for Salbutamol?

A

Coronary disease
COPD patients with degenerative heart disease
diabetes

168
Q

What is the onset for Salbutamol?

A

5 minutes

169
Q

What is the dose for Naloxone?

A

1st Dose: 0.4 mg
2nd Dose: 0.4 mg (after 3 mins if needed)
3rd Dose: 0.8 mg (after 3 mins if needed)
4th Dose: 2 mg (after 3 mins if needed)

170
Q

What is the classification of Naloxone?

A

Narcotic antagonist

171
Q

What are the indications for Naloxone?

A

To reverse respiratory depression/depressed mental status secondary to actual or suspected narcotic overdose

172
Q

What are the contraindications for Naloxone?

A

Allergy or known hypersensitivity

173
Q

What are the pediatric doses for Naloxone?

A

0.1 mg/kg (max 2 mg/dose)
Maximum total of 2 mg/dose
Repeat q3 mins as needed to reverse respiratory depression
Higher dose prescribed as pediatric patients are unlikely to experience withdrawal

174
Q

What is the onset for Naloxone?

A

IV-1 minute

IM- 3-5 m minutes

175
Q

What are the cautions for Naloxone?

A

Patient combativeness

May precipitate withdrawal symptoms

176
Q

What is respiratory acidosis?

A

an acid-base balance disturbance due to alveolar hypoventilation. Production of carbon dioxide occurs rapidly and failure of ventilation promptly increases the partial pressure of arterial carbon dioxide

177
Q

What are the s/s of respiratory acidosis?

A

headache, confusion, anxiety, drowsiness, and stupor

178
Q

What is respiratory alkalosis?

A

a primary decrease in Pco2 (hypocapnia) due to an increase in respiratory rate and/or volume (hyperventilation). Ventilation increase occurs most often as a physiologic response to hypoxia

179
Q

What are the s/s of respiratory alkalosis?

A

light-headedness, confusion, peripheral and circumoral paresthesias, cramps, and syncope.

180
Q

What is metabolic acidosis?

A

Metabolic acidosis occurs when either an increase in the production of nonvolatile acids or a loss of bicarbonate from the body overwhelms the mechanisms of acid–base homeostasis or when renal acidification mechanisms are compromised.

181
Q

What are the s/s of metabolic acidosis?

A 
Confusion
Fast heartbeat
Feeling sick to your stomach
Headache
Long and deep breaths (hyperpnea)
Not wanting to eat
Vomiting
Feeling tired
Feeling weak
182
Q

What is metabolic alkalosis?

A

a metabolic condition in which the pH of tissue is elevated beyond the normal range
The most common causes of metabolic alkalosis are:
Volume depletion (particularly when involving loss of gastric acid and chloride [Cl] due to recurrent vomiting or nasogastric suction)
Diuretic use

183
Q

What are the s/s of metabolic alkalosis?

A

headache, lethargy, and neuromuscular excitability, sometimes with delirium, tetany, and seizures.

184
Q

What are hypotonic solutions?

A 
Less solutes than ICF
Fluid shifts INTO cells
0.33% NaCl
2.5% Dextrose in water
Hydrates cells causing them to swell
185
Q

What are isotonic solutions?

A 
Same tonicity as ICF
No fluid shifts
Normal Saline 
Lactated Ringer’s
D5W
186
Q

What are hypertonic solutions?

A 
More solutes than ICF
Fluid shifts OUT of cells
5% NaCl
D10W
Dehydrates cells causing them to shrink
187
Q

What are baroreceptors?

A

located primarily in the carotid artery, aorta, and kidneys; sense and regulate changes in blood pressure.

188
Q

What is the renin-angiotensin aldosterone system?

A

complex feedback system responsible for the kidneys’ regulation of sodium in the body

189
Q

What are volume-sensitive receptors?

A

located in the atria; stimulate release of proteins when the IVF volume decreases.

190
Q

What are osmoreceptors?

A

sensors are primarily located in the hypothalamus; stimulate production of anti-diuretic hormone (ADH) when ECF osmolarity is high.

191
Q

What is the acid-base balance?

A

The body’s balance between acidity and alkalinity.

192
Q

What is the acid-base balance controlled by?

A

lungs, kidneys, buffer systems.

193
Q

What is cellular injury?

A

a variety of changes of stress that a cell suffers due to external as well as internal environmental changes.

194
Q

What is cellular adaptation?

A

changes made by a cell in response to adverse or varying environmental changes.

195
Q

What is fluid distribution?

A

Intracellular fluid is approximately 40% of the total body weight
extracellular fluid comprises approximately 20% of total body weight and further subcategorizes as plasma at approximately 5% of body weight
interstitial space is approximately 12% of body weight

196
Q

What are the electrolytes in your body?

A

Sodium, calcium, potassium, chloride, phosphate, and magnesium

197
Q

What is the bicarbonate buffer system?

A

an acid-base homeostatic mechanism involving the balance of carbonic acid (H2CO3), bicarbonate ion (HCO − 3), and carbon dioxide (CO2) in order to maintain pH in the blood and duodenum, among other tissues, to support proper metabolic function.

198
Q

What is a differential diagnosis?

A

the process of differentiating between two or more conditions which share similar symptoms

199
Q

What is a provisional diagnosis?

A

medical diagnosis by a professional based on the information provided at the time

200
Q

What is clinical decision making?

A

a contextual, continuous, and evolving process where data are gathered, interpreted, and evaluated in order to select an evidence-based choice of action

201
Q

What is hypoperfusion?

A

a reduced amount of blood flow

202
Q

What are the vital trends for compensated shock?

A 
normal BP
increased HR
increased RR
Pale, cool, moist skin
altered mental status
Restlessness, anxiety
203
Q

What is the treatment for compensated shock?

A

high flow O2
treat the underlying cause of shock
blankets
RTC

204
Q

What are the vital trends for decompensated shock?

A 
Decreased BP
Increased HR
Increased and irregular RR
Decreased temperature
Decreased mental status
Dilated pupils
Ashy or cyanotic pallor
205
Q

What is the treatment for decompensated shock?

A 
high flow O2
treat the underlying cause of shock
blankets
RTC
lay flat with legs slightly elevated
206
Q

What are the vital trends for irreversible shock?

A 
Confusion, slurred speech, unconscious
Slow, irregular, thready pulse
Falling BP; diastolic goes to zero
Cold, clammy, cyanotic skin
Slow, shallow, irregular respirations
Dilated, sluggish pupils
Severely decreased body temperature
207
Q

What is FBAO?

A

foreign body airway obstruction

208
Q

What is the pathophysiology of an FBAO?

A

choking due to inhalation of a foreign body-asphyxia

209
Q

What are the key features of an FBAO?

A

patient is clutching at throat
sudden onset
patient is unable to speak and has difficulty breathing
attempts at coughing that are quiet or silent

210
Q

What are the principles of management for an FBAO?

A

encourage the patient to cough
5 back blows, 5 abdominal thrusts
help them to the ground if they lose consciousness
initiate CPR if loss of consciousness
after 30 compressions, check the airway
attempt to give two breaths and continue with cycles of chest compressions, checking airway.
finger sweep or suction when FB appears.

211
Q

What is the pathophysiology of croup?

A

Croup causes swelling of the larynx, trachea, and large bronchi due to infiltration of white blood cells. Swelling results in partial airway obstruction which, when significant, results in dramatically increased work of breathing, and the characteristic turbulent, noisy airflow known as stridor.

212
Q

What are the key features of croup?

A 
cold symptoms like sneezing and runny nose.
fever
barking cough
heavy breathing
hoarse voice
213
Q

What are the principles of management for croup?

A

position of comfort
supplemental O2
transport

214
Q

What is aspiration?

A

Breathing in a foreign object

215
Q

What are the key features of aspiration?

A

coughing or wheezing after eating
chest discomfort
pneumonia

216
Q

What are the principles of management for aspiration?

A

often no symptoms immediately

encourage to cough

217
Q

What is the pathophysiology of COPD?

A

poorly reversible airflow obstruction and an abnormal inflammatory response in the lungs.
increased resistance to airflow in the small conducting airways, increased compliance of the lungs, air trapping, and progressive airflow obstruction

218
Q

What are pink puffers?

A

Emphysema (pink puffers): characterized by an abnormal enlargement of the air spaces distal to the terminal bronchioles accompanied by the destruction of their walls.

219
Q

What are pink puffers?

A

Emphysema (pink puffers): characterized by an abnormal enlargement of the air spaces distal to the terminal bronchioles accompanied by the destruction of their walls.

220
Q

What are blue bloaters?

A

Chronic Bronchitis (blue bloaters): characterized by inflamed and edematous airways filled with secretions. Copious respiratory secretions contribute to expiratory obstruction.

221
Q

What are the principles of management for COPD?

A

high flow O2
4 x 100 mcg dose via MDI Salbutamol
CPAP as required (call CliniCall before)

222
Q

What is the pathophysiology of asthma?

A

the linings of the airways become congested with swollen cells and the mucous produced from those cells.

223
Q

What are the key features of asthma?

A

respiratory distress
wheezing
difficulty speaking more than one or two word sentences

224
Q

What are the principles of management for asthma?

A

high flow O2
4 x 100 mcg dose via MDI Salbutamol
CPAP as indicated (call CliniCall first)

225
Q

What are the key features of an upper respiratory infection?

A

runny nose, nasal congestion, sneezing, cough, and mucus production

226
Q

What is the pathophysiology of an upper respiratory infection?

A

direct invasion of the mucosa lining the upper airway. Inoculation of bacteria or viruses occurs when a person’s hand comes in contact with pathogens and the person then touches the nose or mouth or when a person directly inhales respiratory droplets from an infected person who is coughing or sneezing.

227
Q

What are the principles of management for an upper respiratory infection?

A

supplemental O2

transport

228
Q

What is the pathophysiology of pneumonia?

A

a breakdown in your body’s natural defenses allows germs to invade and multiply within your lungs. To destroy the attacking organisms, white blood cells rapidly accumulate. Along with bacteria and fungi, they fill the air sacs within your lungs (alveoli).

229
Q

What are the key features of pneumonia?

A

Chest pain when you breathe or cough.
Confusion or changes in mental awareness (in adults age 65 and older)
Cough, which may produce phlegm.

230
Q

What are the principles of management for pneumonia?

A

supplemental O2

transport

231
Q

What is the pathophysiology of atelectasis?

A

a complete or partial collapse of the entire lung or area (lobe) of the lung. It occurs when the tiny air sacs (alveoli) within the lung become deflated or possibly filled with alveolar fluid.

232
Q

What are the key features of atelectasis?

A 
recent surgery
SOB
Increased heart rate
Coughing
Chest pain
Skin and lips turning blue
233
Q

What are the principles of management for atelectasis?

A

High flow O2
Transport
CPAP if indicated

234
Q

What is the pathophysiology of cancer?

A

dysregulated proliferation of cancer cells that grow and divide in an uncontrolled manner, invading normal tissues and organs and eventually spreading throughout the body.

235
Q

What are some key features of cancer?

A

Unexplained weight loss
Non-healing wounds
Blood tinged mucus
Lumps under skin

236
Q

What are the principles of management for cancer?

A

pain management
supplemental O2
transport

237
Q

What is the pathophysiology of toxic inhalation?

A

Inhaled toxins that affect the conducting airways induce airway edema, inflammation, and airway obstruction, in part because of bronchoconstriction.

238
Q

What are the key features of toxic inhalation?

A

Eye irritation
Coughing
SOB

239
Q

What are the principles of management for toxic inhalation?

A 
decontamination
transport 
PPE
airway management
high flow O2
240
Q

What is the pathophysiology of a pulmonary embolism?

A

occurs when deep venous thrombi detach and embolize to the pulmonary circulation.

241
Q

What are the key features of a pulmonary embolism?

A 
Acute dyspnea
Pleuritic chest pain
Hemoptysis
tachycardia
tachypnea
242
Q

What is the pathophysiology of pulmonary edema?

A

the heart is not able to pump efficiently and blood can back up into the veins that take blood through the lungs. As the pressure in these blood vessels increases, fluid is pushed into the air spaces (alveoli) in the lungs.

243
Q

What are the key features of pulmonary edema?

A

Shortness of breath, especially if it comes on suddenly. Trouble breathing or a feeling of suffocating (dyspnea)
A bubbly, wheezing or gasping sound when you breathe. Pink, frothy sputum when you cough

244
Q

What is the pathophysiology of ARDS?

A

occurs when fluid builds up in the tiny, elastic air sacs (alveoli) in your lungs. The fluid keeps your lungs from filling with enough air, which means less oxygen reaches your bloodstream. This deprives your organs of the oxygen they need to function.

245
Q

What are the key features of ARDS?

A

SOB
Laboured and unusual rapid breathing
Low blood pressure
Confusion and extreme tiredness

246
Q

What are the principles of management for ARDS?

A

supplemental O2

transport

247
Q

What is the pathophysiology of a pneumothorax?

A

occurs when air leaks into the space between your lung and chest wall. This air pushes on the outside of your lung and makes it collapse.

248
Q

What are the key features of a pneumothorax?

A 
sudden chest pain
SOB
reduced unilateral breath sounds
hyper resonance
subcutaneous air
JVD
tracheal deviation
249
Q

What are the principles of management for a pneumothorax?

A

supplemental O2
RTC
IV access

250
Q

What is the pathophysiology of hyperventilation?

A

During hyperventilation the rate of removal of carbon dioxide from the blood is increased. As the partial pressure of carbon dioxide in the blood decreases, respiratory alkalosis, characterized by decreased acidity or increased alkalinity of the blood, ensues.

251
Q

What are the key features of hyperventilation?

A

rapid, deep breathing

252
Q

What are the principles of management for hyperventilation?

A

coach the patients breathing

253
Q

What are the indications for CPAP?

A 
>13 years old in significant respiratory distress
Awake and following commands
Exhibits all of the following:
-RR > 24
-SpO2 < 94%
-Accessory muscle use
254
Q

What are the contraindications for CPAP?

A 
Decrease LOC
Respiratory arrest –hypoventilation
Vomiting –risk of aspiration
Unable to fit mask
Traumatic cause of SOB
Pneumothorax
SBP < 90 mmHg
255
Q

What are the three layers of the heart, and which level are they at?

A

Outer: epicardium
Middle: myocardium
Inner: endocardium

256
Q

What is the route that blood makes through the body?

A 
blood enters Right Atrium
Right ventricle
lungs to be oxygenated
pulmonary veins
left atrium
left ventricle
rest of body
257
Q

What are the four valves of the heart?

A

pulmonic
tricuspid
aortic
mitral

258
Q

What is coronary circulation?

A

the circulation of blood in the blood vessels that supply the heart muscle. Coronary arteries supply oxygenated blood to the heart muscle, and cardiac veins drain away the blood once it has been deoxygenated.

259
Q

What is peripheral circulation?

A

concerned with the transport of blood, blood flow distribution, exchange between blood and tissue, and storage of blood (venous system)

260
Q

What is the primary function of the lymphatic system?

A

to transport lymph, a fluid containing infection-fighting white blood cells, throughout the body.

261
Q

What are the other functions of the lymphatic system?

A

protecting your body from illness-causing invaders, maintaining body fluid levels, absorbing digestive tract fats and removing cellular waste

262
Q

Which body parts are associated with the lymphatic system?

A 
bone marrow
thymus
tonsils
lymph nodes
spleen
appendix
263
Q

What is happening in the heart during systole?

A

the heart is contracting to pump blood out

264
Q

What is happening to the heart during diastole?

A

The heart is relaxing after contraction

265
Q

What is Starling’s Law?

A

the heart will eject a greater SV if it is filled to a greater volume at the end of diastole.

266
Q

What is preload?

A

the initial stretching of the cardiac myocytes prior to contraction.

267
Q

What is afterload?

A

the force or load against which the heart has to contract to eject the blood.

268
Q

What is contractility?

A

innate ability of the heart muscle to contract.

269
Q

What is the pathway of conduction in the heart?

A 
SA node
internodal pathways
AV node
bundle of His
Purkinje fibres
270
Q

What is the pathophysiology of angina?

A

caused by reduced blood flow to your heart muscle. Your blood carries oxygen, which your heart muscle needs to survive. When your heart muscle isn’t getting enough oxygen, it causes a condition called ischemia.

271
Q

What are the key features of angina?

A

radiating chest discomfort
bloating or gas
chest pain that goes away

272
Q

What are the principles of management for angina?

A 
high flow O2
position of comfort
ASA
Nitro 0.4mg
Entonox
RTC
273
Q

What is the pathophysiology of myocardial infarction?

A

irreversible damage of myocardial tissue caused by prolonged ischemia and hypoxia

274
Q

What are the key features of an MI?

A

Chest pain
SOB
nausea

275
Q

What are the POM for an MI?

A 
high flow O2
position of comfort
ASA
Nitro 0.4mg
Entonox
RTC
276
Q

What is the pathophysiology of CHF?

A

the heart may not provide tissues with adequate blood for metabolic needs, and cardiac-related elevation of pulmonary or systemic venous pressures may result in organ congestion.

277
Q

What are the key features of CHF?

A

peripheral edema
SOB
white or pink-tinged frothy phlegm
persistent cough/wheezing

278
Q

What are the POM for CHF?

A

High flow O2
RTC
Prepare to suction

279
Q

What is the pathophysiology of cardiac tamponade?

A

blood or fluids fill the space between the sac that encases the heart and the heart muscle. This places extreme pressure on your heart. The pressure prevents the heart’s ventricles from expanding fully and keeps your heart from functioning properly.

280
Q

What are the key features of cardiac tamponade?

A

SOB
JVD
Beck’s Triad (low BP, muffled heart sounds, jvd)

281
Q

What are the POM for cardiac tamponade?

A

High flow O2
RTC
IV TKVO
monitor for shock

282
Q

What is a hypertensive emergency?

A

diastolic blood pressure greater than or equal to 120 mmHg or systolic blood pressure greater than or equal to 180 mmHg.

283
Q

What are the POM for a hypertensive emergency?

A

supplemental O2
IV TKVO
contact EPOS

284
Q

What is the pathophysiology of cardiogenic shock?

A

decreased blood flow and oxygen delivery to vital organs caused by a sustained reduction in cardiac output.

285
Q

What are the key features of cardiogenic shock?

A 
peripheral edema
increased RR
increased HR
bulging neck veins
severe SOB
286
Q

What are the POM for cardiogenic shock

A

supplemental O2
IV TKVO
ECG
fluids PRN to increase BP

287
Q

What is atherosclerosis?

A

disease of large and medium-sized arteries characterized by endothelial dysfunction, vascular inflammation and accumulation of lipids, cholesterol, calcium and cellular debris within the intima of the vessel wall

288
Q

What is an aneurysm?

A

widening of an artery that develops from a weakness or destruction of the medial layer of the blood vessel.

289
Q

What is an AAA?

A

an enlarged area in the lower part of the major vessel that supplies blood to the body (aorta).

290
Q

What are the key features of an AAA

A

deep, constant pain in abdomen or side of abdomen
back pain
pulse near bellybutton

291
Q

What are the POM for an AAA?

A 
supplemental O2
RTC
maintain ABCs
IV TKVO
monitor for shock
292
Q

What is an acute arterial occlusion?

A

occurs when blood flow in a leg artery stops suddenly. If blood flow to your toe, foot, or leg is completely blocked, the tissue begins to die.

293
Q

What are the POM for an acute arterial occlusion?

A

place leg in a dependent position (dangling)
keep leg warm
supplemental O2
IV TKVO

294
Q

What is DVT?

A

clotting of blood in a deep vein of an extremity (usually calf or thigh) or the pelvis

295
Q

What are the key features of DVT?

A

warmth, redness, and swelling of the affected leg

296
Q

What are the 6 steps for reading an ECG strip?

A 
Rate (tachy/brady/normal)
QRS interval (wide/narrow)
Rhythm (regular/irregular)
P waves (present/not present)
Axis (normal/deviated to the left or right)
ST changes (elevated/depressed)
297
Q

What are the shock-able rhythms?

A

ventricular fibrillation

ventricular tachycardia

298
Q

What is the function of the spleen?

A
  • clearance of microorganisms and particular antigens from the blood stream.
  • creates lymphocytes.
  • removal of abnormal RBCs.
  • stores blood.
299
Q

What is the pathophysiology of an allergic reaction?

A

After allergen exposure, inflammatory mediators, including large quantities of histamine, are released from mast cells on the mucosal surfaces. Histamine causes immediate bronchoconstriction and bronchospasm, resulting in narrowing of the small airways (bronchioles).

300
Q

What is anaphylaxis?

A

an acute, potentially fatal, multiorgan system reaction caused by the release of chemical mediators from mast cells and basophils. The classic form involves prior sensitization to an allergen with later re-exposure, producing symptoms via an immunologic mechanism

301
Q

What is the function of the hypothalamus?

A

maintaining homeostasis

302
Q

What is DKA?

A

occurs when the body starts breaking down fat at a rate that is much too fast. The liver processes the fat into a fuel called ketones, which causes the blood to become acidic.

303
Q

What is Grave’s disease?

A

an immune system disorder that results in the overproduction of thyroid hormones

304
Q

Is DKA from high or low blood sugar?

A

occurs when blood sugar levels are very high and insulin levels are low.

305
Q

What is Cushing’s syndrome?

A

occurs when your body is exposed to high levels of the hormone cortisol for a long time.

PCP (10 decks)

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