Nremt Study Guide 1 Flashcards
OSHA
Occupation Safety and Health Administration
HIPAA
Health insurance portability and accountability act
OPQRST
Onset
Provocation
Quality
Radiation
Severity
Time
SAMPLE
Symptoms
Allergies
Medication
Past pertinent history
Last oral intake
Events leading to illness
DCAP-BTLS
Deformities
Contusions
Avulsions
Puncture/Penetrations
Burns
Tenderness
Lacerations
Swelling
AVPU
Alert
Verbal
Pain
Unresponsive
What to look for when assessing the skin
Color temperature and condition
What to look for when assessing pulse
Rate
Strength
Regularity
Dysmenorrhea
Painful menstruation
Will patients who have VAD have a pulse
Not always newer device provide circulation but no palpable pulse while older will produce a pulse while functioning
Side effects of inhaled bronchodilator medications
Tremor palpitations nervousness increased pulse
APGAR
Appearance
Pulse
Grimace
Agitation
Respiration
If patient misses a dialysis appointment
Waste products and fluid build up
Develop edema
Develop dangerous levels of potassium and other electrolytes leading to cardiac rhythm problems and death
Contraindications of aspirin
Allergic to aspirin
Unable to swallow
History gi bleeding
History of a blood clotting disorder
Patient is on blood thinners/ anticoagulants
History of asthmatic reaction to aspirin
Para
How many live births a woman has had
Indications for aspirin
Chest pain of cardiac origin
Not allergic
Able to swallow Recent
Medical director approves(off or online)
Doesn’t have a history of gi bleeding Patient
Activated charcoal does what
Absorbs poison
Common symptoms of an allergic reaction
Itching
Hives
Runny nose
Watery itchy eyes
Wheezing
Swelling and edema of the tissues
Severe allergic reaction symptoms
Signs of shock
Tightening of the throat
Hoarsness
Stridor
A series of cardiac conditions, including myocardial infarction and unstable and pectoris in which the heart muscle is deprived of oxygen
Acute coronary syndrome
Flatline on the ECG, no electrical activity from the heart
Asystole
Your patient has had a substance splash into his eyes describe the treatment for this emergency
Irrigate the eye or eyes for 20 minutes with copious amounts of water if only one eye was involved do not allow the unaffected eye to be contaminated
Apply a dressing to protect the eye if necessary and transport
How to treat excessive post delivery bleeding
Place a sanitary napkin over the vaginal opening, but do not pack or insert anything into vagina
Locate the uterus by palpating the mothers abdomen massage the uterus to promote contraction and slow the bleeding
If a medication is chronotropic, how will it affect the heart?
Chrono means time
Chrono topic medication’s will affect heart rate
Several factors that might predict the need for resuscitation of the newborn
No prenatal care
Premature delivery
Drug use during pregnancy
History of problems during the pregnancy
Meconium staining and multiple births
Three components of Cincinnati pre-hospital stroke scale
Slurred speech
Facial symmetry (facial droop)
Pronator drift(arm drift)
The membrane that lines the abdominal cavity
Peritoneum
Where is the epinephrine auto injector placed for injection?
lateral thigh midway between the hip and knee
Stages of labor
Stage 1: from the beginning of contractions to full dilation of the cervix
Stage 2: from full dilation of the cervix until birth of the baby
Stage 3: begins after birth of the baby the expulsion of the placenta
Three considerations for seeing management and caring for multiple births
Multiple births may be premature and require more aggressive care or resuscitation
Multiple births, create a mini MCI
Not all patients are aware they’re carrying multiple babies
Painless swelling under the skin, most commonly the face
Angioedema
Indications for nitroglycerin
A complaint of chest pain
Cardiac history and nitroglycerin tablets or
spray prescribed to the patient
Medical direction approved (standing orders or on line)
Patient’s blood pressure meets protocols (90-100 mmhg systolic)
“False labor” light, irregular contractions that do not lead to delivery and may occur days two weeks before actual labor begins
Braxton Hicks contractions
Signs and symptoms of ectopic pregancy
Missed menstrual cycle
Abdominal pain
Vaginal bleeding
Rapid pulse and blood pressure (signs of-shock/late signs)
Difficulty breathing that is worse when reclining or lying flat it is usually made better by sitting up or being propped up on pillows. It often indicates heart failure, but it’s also seen in asthma and COPD.
Orthopnea
A condition it was chest pain is caused by ischemia of the heart muscle because of a vessel occlusion or spasm
Is often caused by stress or exertion which creates a need for oxygen that the body can’t keep up with as many cases, the pain subsides with rest and nitroglycerin
Angina pectoris commonly called angina
An interruption of blood supply to a part of the brain
Cerebral vascular accident commonly called stroke
Portion of the brain that is responsible for consciousness and arousal. It consists of circuits that connect the brain stem to the cerebral cortex.
Reticular activating system (RAS)
Birth when a baby is born before the 37th week of gestation
Premature birth
Difference between ischemic stroke and hemorrhage stroke
An ischemic stroke is caused by a blood clot that travels to the brain
A hemorrhagic stroke is caused by blood vessel that ruptures and bleeds into the brain tissue
Rate of chest compressions for adult CPR
100-120/min push hard and fast minimize interruptions
How would you determine if delivery of a baby is imminent ?
A severe urge to push crowning, and I feeling like the mother needs to move her bowels
A period of recovery from a seizure it begins when a seizure ends and involves a gradual return to responsiveness
Postictal
Difference between inhaler and nebulizer
The inhaler is an aerosol device that sprays a fine powder which is inhaled into the lungs
A nebulizer is a device in which air or oxygen is run through a medication, the medication becomes vapor which continuously inhale by the patient through a mask or mouthpiece
What is the treatment for a prolapse umbilical cord?
Place the mother in a head down hips elevated position, insert two or three glove fingers into the vagina to gently lift the babies head off the cord
Place the mother on oxygen and keep the protruding umbilical cord warm by covering it with a sterile dressing from the OB kit
Transport promptly while keeping the babies head off the umbilical cord
Chest compression depth for adults
2-2.4 inches (5-6cm)
Respiratory depression or arrest caused a positioning, a patient in a manner that restricts breathing this may be seen when restraining agitated patient’s face down on or in other positions that limit breathing
Positional asphyxia
What should you note about contractions during labor?
Time between contractions and length of contractions
Indications of opiate overdose
Indications of injecting medications
Track marks on the skin
Pinpoint pupils (in many, but not all opiates)
Decreased respirations or respiratory rate
Information or history from family or bystander regarding opiate use
Umbilical cord presents first during labor. This is a serious emergency because the babies head in the birth canal will occlude the cord against the vaginal wall and stop delivery of oxygen to the baby.
Prolapsed umbilical cord
Several risk factors for suicide
Depression
Alcohol or substance abuse
Those who were single widowed or divorced
Family member suicide
Feeling of hopelessness
Prior threats of suicide
Detailed suicide plan
Ages 15 to 24 and older have higher rates
Where on the body are the AED pads placed?
The upper right chest to the right of sternal and below the right clavicle
The other pad is placed on the lower left chest near the anterior axillart line over the lower ribs
Found in patients who chronically abuse alcohol begins about 48 to 72 hours after the patient stopped consuming can be life-threatening and involve visual, tactile and auditory sensations and disturbances
Delirium tremens or DTs
The placenta prematurely separates from the uterine wall- a cause of severe bleeding in the third trimester and a great risk for mother and fetus
Placental abruption (abruptio placentae)
How and when do you cut the umbilical cord after delivery?
It could be cut after the baby is properly assessed and care for
Place one clamp from the OB kid about 6 inches from the newborn place the second 2 to 3 inches past the first clamp away from the newborn
Cut the cord using the scissors from the kid
Be sure the cord is securely clamp to prevent bleeding from the newborn handle the newborn careful and avoid damage or tension to the cord
Fetal bowel movement, this occurs in the uterus as a result of fetal distress and results in a dark color (green, yellow, or brown) in the amniotic fluid
Meconium
Side effects of nitroglycerin
Hypotension (dizziness, rapid postural hypotension, syncope)
Headache
Failure of the kidneys so that they can no longer remove waste and regulate fluid balance in the body
End stage renal disease
Contraindications of nitroglycerin
Blood pressure below level stated in protocols
No approval for medical direction
Patient has already taken the maximum prescribed dose
A patient has taken erectile dysfunction medication in the past 48 to 72 hours (levitra, Viagra Cialis)
If the newborn’s pulse is less than_ you provide ventilations at a rate of
You will provide chest compressions at a rate of _ if the heart rate is less than_
If the newborn pulse is less than 100 provide ventilations at a rate of 40 to 60 per minute
Provide chest compressions at a rate of 120 per minute if the heart rate is less than 60/min
When the ECG shows electrical activity from the heart without a palpable pulse. electric activity without the corresponding mechanical pumping of the heart
Pulseless electrical activity
Indications for administering or assisting with an inhaler
Patient has respiratory distress and a history of a disease or condition that will be helped by inhaler
The patient has inhaler prescribed
Medical directions given authorization standing orders or online
Patient is breathing adequately and is physically able to get the medication deep into the lungs
A break with or loss of contact with reality
Psychosis
Normal blood glucose level
70-120mg/dl
A condition that occurs to a pregnancy involving severe nausea and vomiting. This usually result in weight loss, dehydration, and electrolyte disturbances.
Hyperemesis gravidarum
Atelectasis
Collapse of part or all of lung
What do beta blockers do to the heart?
Slow the heart rate
Illegal stimulant drugs
Cocaine, methamphetamine, ecstasy
Three Copd diseases
Chronic bronchitis, emphysema, black lung
Four ways of toxic can enter the body
Ingestion absorption, inhalation and injection
Thinning of the cervix which occurs in a week before birth
Effacement
Five rights of medication administration
Right patient
Right medication
Right dose
Right route
Right time
If you include the sixth right documentation
Rescue inhaler versus controller inhaler
Rescue inhaler is used in emergencies to to relieve bronchoconstriction
Control inhalers are used for long-term use. It will not provide relief in an emergency.
Abnormal development of hypertension, edema, and subsequent weight gain during pregnancy?
When hypertension and edema from preeclampsia builds and leads to seizures and unresponsiveness
Preeclampsia
Eclampsia
Build up of fluid in the abdominal cavity
Ascites
A substance or drug that binds to a receptor cite and causes the expected response
Agonist
Pregnancy that develops outside the uterus
Ectopic pregnancy
STEMI
A type of heart attack identified in a 12 lead ECG ST Elevation myocardial infarction
Chaotic disorganized, electrical activity of the heart, which is not create a mechanical contraction of the ventricles and does not produce a pulse
Ventricular fibrillation
Which is secured to a long spine board first head or torso
Torso first then head
Your patient does not have radial pulses, but does have a carrot pulse what is the most likely cause of this?
Shock
Five components of a field spinal assessment
Assess mechanism of injury
Assesses for distracting injuries
Assessment status
Assessed for focal neurological deficit
Assess for midline, spinal tenderness along the entire length of the spine
What do you check before and after splinting?
Distal circulation, sensation, and motion
Difference between pneumothorax intention pneumothorax
A pneumothorax is a collapse of part of a lung. a tension pneumothorax begins as a pneumothorax, but increasing pressure in the thorax becomes severe and causes shock
Name two traumatic injuries to the chest wall that will cause jugular vein distention
Tension pneumothorax and cardiac tamponade
Bleeding to death
Exsanguination
What type of injury causes a fern like pattern to appear on the skin?
Lightning strike
How to treat a nosebleed
Pinch nostrils and have patient lean forward
An incomplete or partial fracture, which usually occurs in children
Green stick fracture
Why does skin become cool and clammy in shock?
Blood is shunted from the skin to more vital organs
3 components of GCS
Eye-opening verbal response and best motor response
For long bone fractures, a splint must immobilize?
The bone end and adjacent joints
Different bleeds
Capillary: oozing dark red
Venous: flowing dark red
Arterial: spurting bright red
How can you tell if a splint had been applied to tightly
Patient may lose distal pulses
Skin may become discolored or cool
Patient may feel tingling or numbness
Extremity is swollen or pushing against strap
Why do pulse and respirations increase in shock
Pulse increases to attempt to increase cardiac output
Respiration to maximize oxygenation of tissues
Why does pulse and respirations increase during shock?
Pulse increase cardiac output
Respirations maximize oxygenation to tissues
Pulse pressure
The difference between systolic and diastolic
What part of the spine provides motor control of the diaphragm
C3-C5 vertebrae
What conditions increase the risk of intercranial bleeding
Patients on blood thinners who experience a head injury
Geriatric and alcoholic patients
Respiratory distress signs found in children
Nasal flaring and sea saw breathing
You’re 86-year-old patient has a atrial fibrillation. What should you expect? When checking the pulse?
Since atrial fibrillation is irregular heartbeat, usually would expect to feel it in a irregular pulse
