Medical And obstetrics Gynecology Flashcards
1
Q
What is the pulse rate and respiratory rate of a neonate ?
A
100 to 160 BPM
25 to 50 breathes per minute
2
Q
What is the pulse rate, respiratory rate and blood pressure for toddlers ?
A
Pulse: 90 to 150 BPM
Respiratory: 20 to 30 breathes/min
Blood pressure: 80 to 100 systolic
3
Q
What is the pulse rate, respiration, and blood pressure for preschoolers ?
A
Pulse: 80 to 140 BPM
Respiration’s: 20 to 25 Breaths
Blood pressure: 80 to 100 systolic
4
Q
What is the pulse rate, respiration rate and blood pressure if school age children?
A
Pulse - 70 to 120
Respiration: 15 to 20
Blood pressure 80 to 110 systolic
5
Q
What is the pulse rate, respiration rate, and blood pressure for teenagers ?
A
Pulse 60 to 100 BPM
Respiration 12 to 20 breaths
Systolic blood: 90 to 100
6
Q
What is the pulse rate, respiration and blood pressure for Adults ?
A
Pulse 60 to 100
Respiration 12 to 20
Blood pressure 90 to 140 systolic
7
Q
What happens in the cardiovascular system for older adults ?
A
- declines largely due to atherosclerosis
- heart rate and cardiac output decreases
- vascular system becomes stiff
- ability to produce replacement blood cells declines as does blood volume
8
Q
What happens in the respiratory system for older adults ?
A
- size of airway increases
- surface area of alveoli decreases
- natural elasticity of lungs decrease
9
Q
Seizures may occur as a result of:
A
- Recent or prior head injury
- Brain tumor
- Metabolic problem
- Fever
- Generic disposition
10
Q
What are the 3 major parts of the brain ?
A
Brainstem, cerebellum and cerebrum; cerebrum is the largest part
11
Q
What does the brain stem control ?
A
- breathing
- blood pressure
- swallowing
- pupil construction
12
Q
What are signs of left sided and right sided strokes ?
A
Left side affects speech, could cause asphasia
Right side affects body movement, could cause paralysis
13
Q
Simple partial seizure
A
No change in the patients level of consciousness
14
Q
Complex partial seizure
A
- Altered mental state resulting from abnormal discharges from the temporal lobe of the brain
- lip smacking, eye blinking, isolated jerking
15
Q
How long do most seizures last ?
A
3 to 5 minutes
16
Q
How long does the postictal state last ?
A
5 to 20 minutes
17
Q
What is status epilepticus ?
A
Seizures lasting more than 5 minutes can lead to this. Seizures continue every few minutes without the person regaining consciousness or last longer than 30 minutes
18
Q
What are some structural causes for seizures ?
A
Brain tumors
Infection (brain abscess, meningitis)
Scar tissue from some type of injury
19
Q
What are the causes of altered mental states?
A
Hypoglycemia,delirium
20
Q
What is chloecytitis?
A
Inflammation of the gall bladder
21
Q
What is diverticulitis ?
A
Inflammation of small pockets at weak areas in the muscle walls
22
Q
Parietal peritoneum
A
Supplied by the same nerves that supply the skin of the abdomen
Perceives •pain •touch •pressure •heat •cold
23
Q
Visceral peritoneum
A
Supplied by the autonomic nervous system
•produces referred pain
24
Q
What is a peptic ulcer ?
A
Caused by
•helicobacter pylori infection
•chronic use of nonsteroidal anti inflammatory drugs
•alcohol and smoking
Type of pain
•burning
•gnawing pain in the stomach that subsided or diminished immediately after eating
25
Gallstones
Condition in which the gall bladder is inflamed . Pain in the upper right or midabdominal region and may refer to the right upper back, flank, or shoulder area
26
Pancreatitis
* inflammation of the pancreas
* caused by instructing gallstones, alcohol abuse and other disease as
* pain in the upper left and right quadrants
* sepsis it hemorrhage can occur (look for fever or tachycardia)
27
Gastrointestinal hemorrhage
Blessing in upper GI tract occurs from the esophagus to the upper small intestines causing hematemesis
Bleeding in the lower GI tract occurs in the upper part of the small intestines and Amy’s causing Melena
28
Esophagitis (GERD)
A condition in which the sphincter between the stomach opens allowing stomach acid to move up in the esophagus. Can cause heart burn
29
Esophageal varices
When blood flow is blocked in the portal vessels. Vessels dilate, cause the capillaries of the esophagus to bring bleeding. If pressure continues patient will have massive upper GI bleeding and hematemesis. Could take years to develop
30
Mallory Weiss Syndrome
Junction between esophagus and stomach tears causing vomiting due to alcoholism and eating disorders
31
Diverticulitis
Decal matter that gets caught in the colon walls causing inflammation and infection
32
Hemorrhoids
Caused by swelling and inflammation of blood vessels surrounding rectum, producing great bright red bloody stool
33
What is cystitis ?
A bladder infection commonly known as a UTI.May report urge to constantly urinate
34
What is the only definitive treatment for chronic kidney failure ?
Dialysis
35
What are the 3 common signs of anaphylaxis?
1. Urticaria
2. Angioedema (areas of localized swelling)
3. Wheezing
36
What percentage of poisoning is by mouth ?
80%
37
Alcohol
* CNS depressant
* induces sleep
* sedative
38
What is delirium tremens?
Frightening hallucinations from alcohol withdrawal
39
Opioids
* narcotic
* CNS depressant
* tolerance develops quickly
* sedative
* pin point pupils
40
Sedative hypnotic drugs
* CNS depressant
* can ALOC
* patient appears drowsy, peaceful, intoxicated
* often used as knock out drink
41
Inhalants
* Halogenated hydrocarbon solvents can make the heart hypersensitive to the patients own adrenaline
* use stretcher to move patient
42
Hydrogen sulfide
* highly toxic flammable gas
* rotten egg smell
* affects all organs , esp lungs and CNS
* used to commit suicide
43
Sympathomimetics
* CNS stimulant
* angel dust
* coke
* ecstasy
* meth
* speed
* uppers
44
What is sympathomimetics
Produces excited state.
Frequently causes hypertension, tachycardia, dilated pupils
45
Bath salts
```
Produce
•euphoria
•increased mental clarity
•sexual overdose
.•last long as 48 hours
```
46
What are anticholinergic agents?
* block parasympathetic nerves
* hot as a hare, blind as a bat, dry as a bone, red as a beet, mad as a hatter
* dilated pupils
* agitated
* tachycardia
47
Cholinergic agents signs and symptoms
```
Diarrhea
Urination
Miosis
Bradycardia
Bronchospasm
Bronchihorrhea
Emesis
Lacrimation
Seizures, salivation, sweating
```
48
What do EMTs have to use if they are exposed to anticholinergic agents ?
DuoDote Auto injector that consists of atropine and pralidoxime
49
What is psychosis ?
A state of delusion in which a person is out of touch with reality
50
Excited delirium
Condition of impairment in cognitive function that can present with disorientation, hallucinations, or delusions
•patient may strike out irrationally
51
How’s does a pediatrics airway differs from adults ?
* smaller in diameter
* shorter in length
* smaller lungs
* heart is higher in child’s chest
* larger tongue
* narrowing funnel shaped upper airway
* trachea size of a drinking straw
* nose breathers
* respiratory 20 to 60
* oxygen demand twice that of an adult (increases risk for hypoxia)
* muscles of diaphragm dictate the amount of oxygen a child inspires
52
How does a child’s circulatory system differ from adults ?
Children fast heart beat is the primary method used to compensate for decreased perfusion
53
what sound will a Chid make with a complete airway obstruction ?
No sound or have no breath sounds and become rapidly cyanotic
54
What is the best way to auscultate breath sounds in pediatrics?
Listen to both sides of the chest at armpit level
55
What is the leading cause of death in infants ?
Pneumonia
56
What is croup ?
An infection of the airway below the level of vocal cords, usually caused by a virus. Starts with a cold, cough, and low grade fever that develops over 2 days
Stridor and seal bark cough
57
What is epiglottis?
Infection to the soft tissue above vocal cords. Very sore throat and high fever. Will often be found in the tripod position and drooling
58
What is bronchiolitis ?
Viral infection of newborns and toddlers, caused by RSV.
* inflammation of the bronchioles
* RSV is highly contagious and spread thru coughing or sneezing
* can survive on surfaces
* dehydration
* SOB
* fever
59
What is pertussis ?
Whooping cough caused by a bacterium Via respiratory droplets
* coughing
* sneezing
* runny nose
Coughing becomes more severe with distinctive whoop sound during inspiration
60
NPA potential problems
* May become obstructed by mucus, blood, vomitus, or the soft tissues of the pharynx
* May stimulate Vagus nerve
* May enter esophagus and cause gastric distention
* May cause spasm of the larynx and result in vomiting if inserted in responsive patient
* should not be used on pediatrics with facial trauma
61
How do pediatrics respond to fluid loss ?
May respond by increasing heart rate, respiration’s, showing signs of pale or blue skin
62
What is meningitis ?
Inflammation of tissue that covers the spinal cord and brain
Signs are fever and altered level of consciousness
Signs in children are stiff neck, photophobia and building on the fontanels
63
Febrile seizures
* common between 6 months and 6 years
| * caused by fever alone
64
What is the JUMPSTART triage ?
Intended for patients younger than age 8 and weighing less than 100 pounds
Categories
•Green - able to walk
•yellow - spontaneous breathing, peripheral pulse, responsive to painful stimuli
•red - apnea responsive to positioning or rescue breathing; respiratory failure; breathing without pulse;
•black - apneic without pulse or apneic and unresponsive to rescue breathing
65
Why is it important to assess and support body temperatures for newborns ?
Newborns become hypothermic very easily which can cause hypoglycemia, respiratory problems, increased oxygen demand, and bradycardia
66
Why is wrapping a newborns head & body so important ?
To maintain their temperature. Newborns lose most of their heat from their head
67
When are the normal respiratory and cardiovascular physiologic responses expected in a new born after delivery ?
15-30 seconds after birth
68
What can hyperextension or flexion if the neck do to a new born when assessing the airway ?
Can cause an airway obstruction.
69
How should you properly assess the airway of a newborn ?
1. Position on back or side with neck in neutral position
2. Place a rolled blanket or towel under the neck and shoulders to maintain in sniffing position
(Place on side with neck flighty extended allow secretions to collect in the mouth and not in the posterior or pharynx)
70
What problems can the aspiration of meconium cause ?
Pneumonia or other breathing problems.
71
What is the AHA’s guideline when meconium is noted during delivery ?
AHA no longer recommends routine suctioning if meconium is noted unless an airway obstruction is present.
72
How far do you place the bulb syringe when suctioning new burns ?
1 to 1 1/2 inches into the mouth and no more than 1/2 inch into the nostrils
73
What is the most reliable indicator of a newborns distress level ?
The heart rate
74
What is the normal heart rate of a newborn ?
120-160 BPM
75
What do you do if a neonate isn’t responding to treatment for distress ?
Ventilate, no longer than 90 seconds with room air before switching to ventilation with O2 at 15L/min
76
After birth continue drying, warming, and stimulating the infant if …
If breathing is adequate, shallow, or slow and the heart rate is 100-120
77
What do you do if a newborns HR Is lower or equal to 100-120 BPM and there are signs of central cyanosis ?
Administer blow by oxygen at 10-15L/min
78
What do you do if a newborns is gasping, or has inadequate respiration’s ?
Provide positive pressure ventilation with room air at 40-60 breaths/min for 30 seconds
79
What do you do if a newborn HR remains more than 60 and less than 100 or signs of central cyanosis?
Provide positive pressure ventilation with room air for 60-90 seconds. if no increase after 90 seconds ventilate with oxygen for 30 seconds . If the heart rate remains under 60 BPM after 30 seconds of ventilation with oxygen start CPR at 3:1 (120 compressions per minute)
80
How do you give a neonate O2? Why this method ?
Blow by method which consists of holding the tubing or mask 1/2 inch from the nose and mouth but keep the flow of oxygen away from their eyes. Set flow rate to 10-15L/min.
The reason for this is because all newborns are vulnerable to injuries to their eyes from high concentrations of oxygen
81
What is the least important indicator of adequate circulation in new borns ?
Color
82
What do you do if a newborn scores less than 7 on apgar score card ?
Repeat every 5 minutes for 20 minutes
83
When should an APGAR score not be attempted ?
If the newborn requires resuscitation measures
84
How many minutes do you need to reassess a newborn that shows signs or poor perfusion ?
Every 2 minutes
85
What is Asprin used for in the prehospital setting ?
It is only used for its Antithrombotic properties
86
How is aspirin administered to a patient and how much ?
To chew the aspirin. AHA recommends 162-325 mg
87
What are the indications and contraindications for Aspirin?
Indications
•patient must be alert
•nontraumatic chest discomfort of suspected myocardial origin
•over 30 years old
Contraindications
•does not meet the indications
•patient has a history of GI bleeds or peptic ulcer disease
•allergic to Non steroidal anti-inflammatory drugs
88
What is the only thing an AED will shock ?
Ventricular fibrillation & ventricular tachycardia
89
What is the correct age for pediatric AED pads ?
On an infant or child up to 8 years old. Over 8 , treat as an adult
90
When should you turn off the AED ?
When the patient has been transferred to a higher medical care provider
91
What shouldn’t you do after the AED delivers a shock ?
Check the pulse because it delays CPR
92
Child CPR is indicated for children ….
1 year of age to puberty
93
What is the neutral position ?
Sniffing position
94
Depending on the size of the child what is an alternative to palpating the Cartoid pulse in an unresponsive child ?
Palpating the femoral pulse
95
What pulse do you check for infants ?
Brachial pulse
96
What are the indications for CPR on newborns ?
* Infants who are unresponsive, apneic, pulse less
| * heart rate is less than 60 BPM
97
Active cooling or passive cooling for pediatrics ?
Passive cooling
