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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
Alpha and beta receptors: Where is alpha?
Arteries (of smooth muscles)
26
Alpha and beta receptors: Where is beta?
Beats (for B1) | Breaths (for B2)
27
Alpha and beta receptors: Draw A B C D model
DRAW IT NOW
28
What is the equation for fluid over time?
Vol x Drip factor over = gtts/min (drops per minute) Time (min) ex: 500mL x 10gtts/mL over = 83.3gtts/min 60 min
29
Triage: What is the order you should go down?
1. Can you walk 2. Breathing? 3. Perfusing? 4. LOC?
30
Triage: What is the 'walk' assessment?
Can you walk? Yes: Green No: Proceed to next question
31
Triage: What is the 'breathing' assessment?
Are you breathing? Yes: Rate between 10-29? -Yes: yellow -No: Red No: Does opening airway fix it? - Yes: Red - No: Black
32
Triage: What is the 'perfusing' assessment?
Radial pulse present? Yes: yellow No: Red
33
Triage: What is the 'LOC' assessment?
Alert and verbal? Yes: Yellow No: Red
34
What is the inverted neonatal resuscitation pyramid?
Top to bottom 1. Drying, warming, positioning, suction, tactile stimulation 2. Oxygen 3. Bag-mask ventilation 4. Chest compression 5. Intubation 6. Meds (EPI)
35
Thyroid Disorders: What is Graves Disease?
Excessive amount of thyroid hormone
36
Thyroid Disorders: What are the signs and symptoms of Graves Disease?
1. Enlarged thyroid (neck) 2. Bulging eyes (Akmund puppet) 3. Agitation 4. Hot skin 5. Weight loss 6. Tachycardia
37
Thyroid Disorders: What is Myxedema?
Too little thyroid (hypothyroidism)
38
Thyroid Disorders: What are the signs and symptoms of myxedema?
1. Unemotional 2. Puffy face 3. Thinned hair 4. Enlarged tongue 5. Pale, cool skin (doughy) 6. cold
39
Thyroid Disorders: What is a myxedema coma?
Hypothermic, can be fatal if respiratory depression occurs
40
Thyroid Disorders: What should you never do with myxedema?
Active rewarming | * May cause a cardiac problem
41
Adrenal Disorders: Where are the adrenal glands located?
On kidneys
42
Adrenal Disorders: What do the adrenal glands secrete?
Corticosteriods: Cortisol and Aldosterone | and also catecholamines: Epinephrine
43
Adrenal Disorders: What is Cushing's?
Excessive adrenocortical activity | *Has a cushion of hormone*
44
Adrenal Disorders: What are the signs and symptoms of Cushing's?
1. Moon face 2. Weight gain 3. HTN 4. Diabetes 5. Thinner skin
45
Adrenal Disorders: What is Addison's?
Deficient adrenocortical activity Low circulating levels of corticosteriod *Need to ADD a steroid
46
Adrenal Disorders: What are the signs and symptoms of Addison's?
1. Hyperpigmentation 2. Weight loss 3. Hyperkalemia 4. Hypotension 5. Fatigue
47
Adrenal Disorders: What is an Addison's Crisis?
Acute stresses such as infection or trauma; potentially life-threatening
48
Adrenal Disorders: What is the treatment for Addison's crisis?
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
OB: What are the first trimester emergencies?
1. Ectopic Pregnancy | 2. Spontaneous abortion
50
OB: What is an ectopic pregnancy?
Fertilized egg lodged in the fallopian tube
51
OB: What are the signs and symptoms for an ectopic pregnancy?
1. Pain in the RLQ or LLQ (Rarely bilateral) | 2. Time period 4-8 weeks after last period
52
OB: What is the treatment for ectopic pregnancy?
1. Control ABCs 2. Monitor 3. Pain management * Sadly, extremely low odds of saving the baby*
53
OB: What are 3rd trimester emergencies?
1. Abruptio placentae 2. Placentae previa 3. Eclampsia
54
OB: What is abruptio placentae?
Partial or full detachment of the placenta from the uterine wall
55
OB: What are the signs and symptoms of abruptio placentae?
1. PAIN 2. Bright red blood 3. Signs of shock
56
OB: What is the key difference between abruptio placentae and placenta previa?
Pain vs No Pain
57
OB: What is placenta previa?
Placenta partially or completely covers the cervix (Bright red bleeding, but no pain)
58
OB: What is pre eclampsia/ eclampsia signs and symptoms?
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
OB: When does pre eclampsia turn into eclampsia?
Seizure
60
Abnormal Deliveries: What is breech presentation?
Butt or both feet present first
61
Abnormal Deliveries: What do you do if head does not deliver during breech delivery?
Place hand in vag forming a "V" with fingers around the mouth to allow it to breath
62
Abnormal Deliveries: What is a prolapsed cord?
Cord comes out before baby
63
Abnormal Deliveries: What should you do with a prolapsed cord?
DO NOT attempt delivery DO NOT push cord back in Insert two fingers in to raise cord off the fetus TRANSPORT
64
Abnormal Deliveries: What is limb presentation?
Arm or leg protruding
65
Abnormal Deliveries: What should you do during limb presentation?
DO NOT attempt delivery | Assist mother in knee-chest position and TRANSPORT
66
What are the layers of a blood vessel (Outer to inner)?
Tunica adventitia Tunica Media Tunica Intima
67
What is the formula for PED ET tube size?
Age + 16 divided by 4
68
What are the King airway sizes?
3: 4'-5' 4: 5'-6' 5: >6'
69
How should you cut the cord after delivery?
1st clamp: 10cm 2nd: 15cm cut between snip SNIP
70
What is the formula for minimum systolic BP in children >1 year?
(AGE x 2) + 80
71
What is the regular cardiac output in one minute?
5-6L/min
72
What should you do for an unstable patient with a second degree type 2 heart block?
Initiate transcutaneous pacing
73
What is the most common indicator for hypoxia related to ETT becoming obstructed?
Bradycardia
74
What is the voltage for PEDS in v-fib?
1st shock: 2j/kg | 2nd shock: 4j/kg
75
What is the cardiovert voltage for PEDS?
.5-1J/kg | after that 2J/kg
76
What is the most common tachycardia in children?
SVT
77
What is an exception for epi in asystole?
If the patient has a failed pacemaker and the collapse is witnessed - CPR while preparing to pace
78
What abdominal condition is linked to right heart failure?
Acites
79
What kind of oxygen therapy should you initiate if the patient is healthy, denying SOB, and SPO2 is at 89%?
4L/min N.C
80
What does the LAD typically perfuse?
LAD typically perfuses the septal wall, HIS bundle, and Bundle branches
81
What does the RCA typically perfuse?
Supplies blood to the right ventricle, the right atrium, and the SA (sinoatrial) and AV (atrioventricular) nodes
82
Per AHA, what direction should you displace the fundus if you had to?
Displace the fundus to the left
83
What problem arises if you over oxygenate a patient?
Over oxygenating can constrict coronary vessels
84
What is the leading cause of heart failure in adults?
MI
85
What is Cheyene-stokes respirations?
Increasing rate and depth followed by a decrease and then a period of apnea
86
What is Beck's triad used to describe?
Cardiac Tamponade
87
What are the signs of Beck's triad?
1. JVD 2. Muffled heart tones 3. Hypotension (Narrowing PP)
88
What does Cushing Tirad describe?
Increasing intracranial pressure
89
What are the signs of Cushing Triad?
1. HTN 2. Bradycardia 3. Irregular respirations (widened Pulse pressure)
90
What is esophageal varices?
Increase pressure in veins lining esophagus and stomach (Increases portal vein pressure and they eventually burst)
91
What are the signs and symptoms of esophageal varices? What is the treatment?
Vomiting bright red blood | Tx: Fluid Resuscitation
92
What is peptic ulcer disease (PUD)?
Erosion of the stomach and duodenum, allowing acids to eat the protective lining
93
What are the signs and symptoms of peptic ulcer disease (PUD)?
-Pain in the stomach after eating (reoccuring at 2-3 hours after)
94
What is Peritonitis?
Inflammation of abdomen with generalized pain and rebound tenderness
95
What is cholecystitis treatment?
- Pain control - Nausea control - Fluid replenishment
96
What is diverticulum? What is diverticulitis?
- Weak area in the colon that outcrops into pouches | - Abdominal pain localized to the LLQ
97
What are the signs and symptoms of pancreatitis?
Pain to RUQ radiating to the back
98
What is Ulcerative colitis?
Inflammation of the colon
99
What are the signs and symptoms of ulcerative colitis?
- abdominal pain - fever - malaise - bloody diarrhea - hematochezia (bloody poop)
100
What causes acute gastroenteritis? What happens with infection?
Caused by fecal matter entering the mouth. | -Infection: Fever, abd. pain, malaise, n/v
101
Describe the two types of diabetes?
Type 1: zero insulin (juvenile onset) | Type 2: Low insulin production

Paramedic (34 decks)

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