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Paramedic > Paramedic Final Notes > Flashcards

Paramedic Final Notes Flashcards

1
Q

What is different with the Mag Sulfate dose with Eclampsia? What is it for?

A

The dosage is 4g diluted in 20ml over 20 minutes.

  • Think of twice the usual dose of 2g, because there is two times the patients (with baby)
  • It is used to manage the high blood pressure
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2
Q

What are the three components to consider when dealing with respiratory and metabolic acidosis/alkalosis?

A
  1. pH
  2. Co2
  3. HCO3
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3
Q

What affects does respiratory acidosis have on the three components?

A

Respiratory acidosis:
pH: Decreases
Co2: Increases
HCO3: Normal

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4
Q

What affects does respiratory alkalosis have on the three components?

A

Respiratory alkalosis:
pH: Increases
Co2: Decreases
HCO3: Normal

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5
Q

What affects does metabolic acidosis have on the three components?

A

Metabolic acidosis:
pH: Decreases
Co2: Normal
HCO3: Decreases

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6
Q

What affects does metabolic alkalosis have on the three components?

A

Metabolic Alkalosis:
pH: Increases
Co2: Normal
HCO3: Increases

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7
Q

Dealing with an acidotic state, what happens to the pH?

A

pH decreases

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8
Q

Dealing with an alkalotic state, what happens to the pH?

A

pH Increases

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9
Q

What does respiratory levels change?

A

Changes CO2

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10
Q

What does metabolic levels change?

A

Changes HCO3

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11
Q

ETCO2 of hypoventilations?

A

Acidic
>45
-retaining more CO2

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12
Q

ETCO2 of hyperventilations?

A

Alkalotic
<35
-Releasing more C02

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13
Q

What do you give and in what order for cyanide poisoning?

A
  1. Amyl nitrate
  2. Sodium nitrate
  3. Sodium thiosulfate
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14
Q

What is the trend with compensated shock?

A

BP: Increases
HR: Increases
RR: Increases

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15
Q

What is the trend with decompensated shock?

A

BP: Decreases
HR: Increases
RR: Increases

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16
Q

What is the trend with irreversible shock?

A

BP: Decreases
HR: Decreases
RR: Decreases or Increases

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17
Q

Cardio: What leads are Inferior?

A

2, 3, AVf

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18
Q

Cardio: What leads are Lateral?

A

1 and AVL

V5 and V6

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19
Q

Cardio: What leads are septal?

A

V1 and V2

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20
Q

Cardio: What leads are anterior?

A

V3 and V4

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21
Q

Cardio: What leads include the left circumflex?

A

1 and AVL

V5 and V6

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22
Q

Cardio: What leads include the RCA?

A

2, 3, and AVF

*May also be posterior, do a 15 lead

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23
Q

Cardio: What leads include the LAD?

A

V1-V4

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24
Q

Alpha and beta receptors: What is affected with “1” and “2”? Location and Actions

A 
Location
1: Heart
2: Lungs
Action
1: Constrict
2. Dilate
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25
Q

Alpha and beta receptors: Where is alpha?

A

Arteries (of smooth muscles)

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26
Q

Alpha and beta receptors: Where is beta?

A

Beats (for B1)

Breaths (for B2)

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27
Q

Alpha and beta receptors: Draw A B C D model

A

DRAW IT NOW

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28
Q

What is the equation for fluid over time?

A

Vol x Drip factor
over = gtts/min (drops per minute)
Time (min)

ex: 500mL x 10gtts/mL
over = 83.3gtts/min
60 min

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29
Q

Triage: What is the order you should go down?

A
  1. Can you walk
  2. Breathing?
  3. Perfusing?
  4. LOC?
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30
Q

Triage: What is the ‘walk’ assessment?

A

Can you walk?
Yes: Green
No: Proceed to next question

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31
Q

Triage: What is the ‘breathing’ assessment?

A

Are you breathing?
Yes: Rate between 10-29?
-Yes: yellow
-No: Red

No: Does opening airway fix it?

  • Yes: Red
  • No: Black
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32
Q

Triage: What is the ‘perfusing’ assessment?

A

Radial pulse present?
Yes: yellow
No: Red

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33
Q

Triage: What is the ‘LOC’ assessment?

A

Alert and verbal?
Yes: Yellow
No: Red

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34
Q

What is the inverted neonatal resuscitation pyramid?

A

Top to bottom

  1. Drying, warming, positioning, suction, tactile stimulation
  2. Oxygen
  3. Bag-mask ventilation
  4. Chest compression
  5. Intubation
  6. Meds (EPI)
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35
Q

Thyroid Disorders: What is Graves Disease?

A

Excessive amount of thyroid hormone

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36
Q

Thyroid Disorders: What are the signs and symptoms of Graves Disease?

A
  1. Enlarged thyroid (neck)
  2. Bulging eyes (Akmund puppet)
  3. Agitation
  4. Hot skin
  5. Weight loss
  6. Tachycardia
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37
Q

Thyroid Disorders: What is Myxedema?

A

Too little thyroid (hypothyroidism)

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38
Q

Thyroid Disorders: What are the signs and symptoms of myxedema?

A
  1. Unemotional
  2. Puffy face
  3. Thinned hair
  4. Enlarged tongue
  5. Pale, cool skin (doughy)
  6. cold
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39
Q

Thyroid Disorders: What is a myxedema coma?

A

Hypothermic, can be fatal if respiratory depression occurs

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40
Q

Thyroid Disorders: What should you never do with myxedema?

A

Active rewarming

* May cause a cardiac problem

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41
Q

Adrenal Disorders: Where are the adrenal glands located?

A

On kidneys

42
Q

Adrenal Disorders: What do the adrenal glands secrete?

A

Corticosteriods: Cortisol and Aldosterone

and also catecholamines: Epinephrine

43
Q

Adrenal Disorders: What is Cushing’s?

A

Excessive adrenocortical activity

Has a cushion of hormone

44
Q

Adrenal Disorders: What are the signs and symptoms of Cushing’s?

A
  1. Moon face
  2. Weight gain
  3. HTN
  4. Diabetes
  5. Thinner skin
45
Q

Adrenal Disorders: What is Addison’s?

A

Deficient adrenocortical activity
Low circulating levels of corticosteriod
*Need to ADD a steroid

46
Q

Adrenal Disorders: What are the signs and symptoms of Addison’s?

A
  1. Hyperpigmentation
  2. Weight loss
  3. Hyperkalemia
  4. Hypotension
  5. Fatigue
47
Q

Adrenal Disorders: What is an Addison’s Crisis?

A

Acute stresses such as infection or trauma; potentially life-threatening

48
Q

Adrenal Disorders: What is the treatment for Addison’s crisis?

A

Tx:

  1. Maintain ABCs
  2. Close monitoring of cardiac and oxygen stats
  3. Monitor BGL
  4. Be aggressive with fluid resuscitation
  5. Administer prednisone or methylprednisolone
49
Q

OB: What are the first trimester emergencies?

A
  1. Ectopic Pregnancy

2. Spontaneous abortion

50
Q

OB: What is an ectopic pregnancy?

A

Fertilized egg lodged in the fallopian tube

51
Q

OB: What are the signs and symptoms for an ectopic pregnancy?

A
  1. Pain in the RLQ or LLQ (Rarely bilateral)

2. Time period 4-8 weeks after last period

52
Q

OB: What is the treatment for ectopic pregnancy?

A
  1. Control ABCs
  2. Monitor
  3. Pain management
    * Sadly, extremely low odds of saving the baby*
53
Q

OB: What are 3rd trimester emergencies?

A
  1. Abruptio placentae
  2. Placentae previa
  3. Eclampsia
54
Q

OB: What is abruptio placentae?

A

Partial or full detachment of the placenta from the uterine wall

55
Q

OB: What are the signs and symptoms of abruptio placentae?

A
  1. PAIN
  2. Bright red blood
  3. Signs of shock
56
Q

OB: What is the key difference between abruptio placentae and placenta previa?

A

Pain vs No Pain

57
Q

OB: What is placenta previa?

A

Placenta partially or completely covers the cervix (Bright red bleeding, but no pain)

58
Q

OB: What is pre eclampsia/ eclampsia signs and symptoms?

A
  1. BP at or over 140-90
  2. Severe headache
  3. Changes in vision
  4. N/V
  5. Swelling in extremities (edema)
  6. Possible RUQ pain
59
Q

OB: When does pre eclampsia turn into eclampsia?

60
Q

Abnormal Deliveries: What is breech presentation?

A

Butt or both feet present first

61
Q

Abnormal Deliveries: What do you do if head does not deliver during breech delivery?

A

Place hand in vag forming a “V” with fingers around the mouth to allow it to breath

62
Q

Abnormal Deliveries: What is a prolapsed cord?

A

Cord comes out before baby

63
Q

Abnormal Deliveries: What should you do with a prolapsed cord?

A

DO NOT attempt delivery
DO NOT push cord back in
Insert two fingers in to raise cord off the fetus
TRANSPORT

64
Q

Abnormal Deliveries: What is limb presentation?

A

Arm or leg protruding

65
Q

Abnormal Deliveries: What should you do during limb presentation?

A

DO NOT attempt delivery

Assist mother in knee-chest position and TRANSPORT

66
Q

What are the layers of a blood vessel (Outer to inner)?

A

Tunica adventitia
Tunica Media
Tunica Intima

67
Q

What is the formula for PED ET tube size?

A

Age + 16 divided by 4

68
Q

What are the King airway sizes?

A

3: 4’-5’
4: 5’-6’
5: >6’

69
Q

How should you cut the cord after delivery?

A

1st clamp: 10cm
2nd: 15cm
cut between
snip SNIP

70
Q

What is the formula for minimum systolic BP in children >1 year?

A

(AGE x 2) + 80

71
Q

What is the regular cardiac output in one minute?

72
Q

What should you do for an unstable patient with a second degree type 2 heart block?

A

Initiate transcutaneous pacing

73
Q

What is the most common indicator for hypoxia related to ETT becoming obstructed?

A

Bradycardia

74
Q

What is the voltage for PEDS in v-fib?

A

1st shock: 2j/kg

2nd shock: 4j/kg

75
Q

What is the cardiovert voltage for PEDS?

A

.5-1J/kg

after that 2J/kg

76
Q

What is the most common tachycardia in children?

77
Q

What is an exception for epi in asystole?

A

If the patient has a failed pacemaker and the collapse is witnessed
- CPR while preparing to pace

78
Q

What abdominal condition is linked to right heart failure?

79
Q

What kind of oxygen therapy should you initiate if the patient is healthy, denying SOB, and SPO2 is at 89%?

A

4L/min N.C

80
Q

What does the LAD typically perfuse?

A

LAD typically perfuses the septal wall, HIS bundle, and Bundle branches

81
Q

What does the RCA typically perfuse?

A

Supplies blood to the right ventricle, the right atrium, and the SA (sinoatrial) and AV (atrioventricular) nodes

82
Q

Per AHA, what direction should you displace the fundus if you had to?

A

Displace the fundus to the left

83
Q

What problem arises if you over oxygenate a patient?

A

Over oxygenating can constrict coronary vessels

84
Q

What is the leading cause of heart failure in adults?

85
Q

What is Cheyene-stokes respirations?

A

Increasing rate and depth followed by a decrease and then a period of apnea

86
Q

What is Beck’s triad used to describe?

A

Cardiac Tamponade

87
Q

What are the signs of Beck’s triad?

A
  1. JVD
  2. Muffled heart tones
  3. Hypotension (Narrowing PP)
88
Q

What does Cushing Tirad describe?

A

Increasing intracranial pressure

89
Q

What are the signs of Cushing Triad?

A
  1. HTN
  2. Bradycardia
  3. Irregular respirations
    (widened Pulse pressure)
90
Q

What is esophageal varices?

A

Increase pressure in veins lining esophagus and stomach (Increases portal vein pressure and they eventually burst)

91
Q

What are the signs and symptoms of esophageal varices? What is the treatment?

A

Vomiting bright red blood

Tx: Fluid Resuscitation

92
Q

What is peptic ulcer disease (PUD)?

A

Erosion of the stomach and duodenum, allowing acids to eat the protective lining

93
Q

What are the signs and symptoms of peptic ulcer disease (PUD)?

A

-Pain in the stomach after eating (reoccuring at 2-3 hours after)

94
Q

What is Peritonitis?

A

Inflammation of abdomen with generalized pain and rebound tenderness

95
Q

What is cholecystitis treatment?

A
  • Pain control
  • Nausea control
  • Fluid replenishment
96
Q

What is diverticulum? What is diverticulitis?

A
  • Weak area in the colon that outcrops into pouches

- Abdominal pain localized to the LLQ

97
Q

What are the signs and symptoms of pancreatitis?

A

Pain to RUQ radiating to the back

98
Q

What is Ulcerative colitis?

A

Inflammation of the colon

99
Q

What are the signs and symptoms of ulcerative colitis?

A
  • abdominal pain
  • fever
  • malaise
  • bloody diarrhea
  • hematochezia (bloody poop)
100
Q

What causes acute gastroenteritis? What happens with infection?

A

Caused by fecal matter entering the mouth.

-Infection: Fever, abd. pain, malaise, n/v

101
Q

Describe the two types of diabetes?

A

Type 1: zero insulin (juvenile onset)

Type 2: Low insulin production

Paramedic (34 decks)

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