TEST REVIEW CH 42-46 Flashcards
Reflex that makes baby turn towards nipple
Rooting Reflex
What is the Moro Reflex?
Startle Reflex
Nipple in Mouth, Baby Sucks….
Sucking Reflex
Neurological test that involves stimulating the sole of the foot to assess the CNS.
Babinski Sign (Plantar Reflex)
An involuntary reflex in babies that causes them to close their fingers around the object that touches their palm.
Palm Grasp Reflex
When the placenta implants low in the uterus, and covers the cervix as the baby grows, cannot be caused by trauma…
Placenta Previa
What’s the average blood loss during birth?
150ml
How much blood loss is considered postpartum hemorrhage?
Over 500ml
Non-functioning Alveoli
Atelctasis
What causes Down Syndrome?
Mutation of the 21st chromosome
In this maneuver, mother pulls knees to chest, in order to…
McRoberts Maneuver, used to displace the baby’s shoulders for delivery
Birth - 24hrs
Newborn
Normal Apgar Score and what are you assessing?
10
2 - Appearance (pink)
2 - Pulse (over 100HR)
2 - Grimace/Irritability (cries, withdraws from stimulation)
2 - Activity (resists attempts to straighten hips/knees)
2 - Respiration (Rapid)
What would indicate a low Apgar Score? And what would the score be for the following findings?
Hands/Feet remain blue
HR less than 100
Weak cry in response to stimuli
Weak attempts to resist straightening
Slow Respirations
What year was the APGAR scoring created?
1952
An infant within the 1st month of birth….
Neonate
1 month to 1year of age…
Infant
What EKG changes will you see for a PE?
S1 - Slurred S in Lead 1
Q3 - Slurred Q wave in Lead 3
T3 - Inverted T wave in Lead 3
What sign is when pt is laid supine, and you raise the head…..
What happens if it is positive?
And what does it indicate?
Brudzinski Sign
Flexion of hips/knees
Meningitis
What sign is when the pt is lying supine, a you raise the knee?
What indicates a positive sign?
What does the positive sign indicate?
Kernig’s Sign
Resistance, pain, or inability to extend knee
Meningitis
What sign is when the pt is laid supine and the legs are elevated, causing referred pain in the L shoulder?
What does this test for?
Kehr’s Sign
Splenic Rupture
What is a positive Merkel Sign?
And what does it indicate?
Pain in RLQ that is illicited following sudden jarring after standing on their toes and suddenly dropping to their heels.
Indicates Appendicitis.
What sign illicits pain when RUQ is palpated and the pt takes a deep breath?
What does a positive sign indicate?
Murphy’s Sign
Cholecystitis
Periumbilical bruising….
Cullen’s Sign
Bruising to flank….
Grey Turner Sign
Rare autoimmune disorder affects neuromuscular transmission. Muscles weaken and tire easily. May localize to eyelids or become generalized, affecting respiratory muscles & skeletal muscles; face, jaw, neck & upper extremities are most commonly affected.
Myasthenia Gravis
Causative agent of shingles
Herpes Zoster Virus
Which of the following major changes from middle age to elders, most significant;y affects EMS?
Changes in Pharmacokinetics
Ax of a 12yo w/wide complex Tachycardiac on EKG, which of the following S/S would reveal to EMS that the pt is clearly unstable & requires immediate Cardioversion.
Impaired LOC
Which S/S severely indicates hypoxia in peds?
Bradycardia
How many attempts, & how long should you spend obtaining IV access on a critical pt?
No more than 90 seconds.
2 attempts on stable pt, 1 attempt on peds.
Increased work of breathing.
Respiratory Distress
Pt can no longer compensate (retains CO2)
Respiratory Failure
Pt is no longer spontaneously breathing on their own
Respiratory Arrest
Not breathing
Apnea
Difficulty breathing
Dyspnea
Which has the greatest risk for carrying HBV or HIV?
Blood
72yo M OD on beta blockers to commit suicide. Which drug is contraindicated for this pt?
Propranolol
These S/S indicate what disorder? & how do you treat it?
Seal-like, barking cough
Croup:
Comfort, possible steroids & nebulized Epi
These S/S indicate what disorder? & how do you treat it?
Anxious, sniffing position, stridor, drooling, increased work of breathing.
Epiglottittis:
Try not to manipulate the airway. O2. Rapid Transport. Only intubate when respiratory failure has occurred.
Typical finding in SIDS pts.
The presence of frothy or blood-tinged fluid in the mouth or nose, or on the bedding.
Be mindful & respectful of cultural diversity. Such as, some cultures may not….
All male healthcare workers to examine a pregnant pt.
12 steps to a call.
Scene safe
moi/noi
bsi
# of pts
additional resources
C-spine
general impression
Loc
airway
breathing
Circulation
transport
High Pitched Inspiratory sound that indicates upper airway obstruction
Stridor
High pitched expiratory sounds, indicates closing airway
Wheezes
Sounds wet, typically in base of the lungs, indicates fluid in the lungs.
Rales/Crackles
Continuous low pitched sound, indicates fluid in the large airways.
Ronchi
A rare, life threatening condition found in pts with thyrotoxicosis, usually triggered by a stressful event or increased volume of thyroid hormones. Can present with fever, tachycardia, N/V, AMS, & possibly heart failure.
Thyroid Storm
The most common cause of hyperthyroidism. An autoimmune disorder in which the thyroid hypertrophied, or enlarges, as its activity increases. S/S can include goiter, weight loss, muscle wasting.
Graves Disease
Decreased thyroid hormones, which presents with decrease in metabolism, and possibly decreased respiratory effort, may require O2 or PPV.
Hypothyroidism
An increase in thyroid hormones, increases metabolism, which increases O2 demand, may require supplemental O2.
Hyperthyroidism
Adrenal insufficiency, leads to atrophy of adrenal gland, leading to deficiencies of all steroid hormones produced by these glands.
Addison’s Disease
Overproduction of cortisol by the adrenal glands.
Cushing Syndrome
Similar to diabetes mellitus in S/S, but not related to the pancreas. It is due to the body being unable to regulate fluid d/t lack of ADH or the kidney’s being unable to respond appropriately.
Diabetes Insipidus
Ped w/ 103 degree fever, clear lung sounds, ℅ sore throat prior to going to bed. What condition do you suspect.
Viral infections (RSV, flu, etc)
Chegg says Epiglottisis
Weakened area in the colon that begin to have outcroppings that turn into pouches, that can become inflamed when food or fecal matter gets trapped? Most commonly presents with pain Where?
Diverticulitis
LLQ
S/S of bowel obstructions
Stool changes
Hematochezia
Melena
Pain
Melena is what…..
Dark blood, that indicates bleeding from a high area of GI system
Heamtochezia is bright red blood that indicates…..
Bleeding close to orifice to outside of body, whether from esophagus, stomach, or lower colon.
What are common causes of bowel obstructions?
Small Intestines: postoperative adhesions, scarring
Large Intestines: Cancer, Diverticulitis, stricture of colon, or Volvulus (twisting of colon)
PPV being performed, partners on scene advised that the ventilations should be stopped. What do you think they witnessed to advises to discontinue ventilations.
Improvement to baby’s condition
Newborn Resuscitation algorithm
Warm, dry, and stimulate
ppv if hr below 100
intuubate.
Hr below 60, cpr & ppv
Neonate CPR on new born, done all the things. They are ventilating and performing cpr. First step of the als crew.
Intubate
Partner ventilations non intubated 1 year old w/ a BVM @ 60/bpm
Gastric Distention
What would be the most common cause of decreased loc for pediatric trauma pt?
Head Injury
What is an important consideration when conducting a hx on a obese pt
Past medical hx. Any underlying medical conditions heart disease, stroke, dm, HTn etc.
Difference between Ped ACLS CPR and Adult ACLS CPR
Jules setting (defib start @ 2j/kg, and increase by 2j/kg each time, max of 10j/kg or adult Jules setting), and 2 rescuer CPR/Ventilation ration, and drug doses
Which statement is true about alcohol use in the geriatric population
More common in elders
Higher concentration of BAC d/t lack of body fluids in elders
Typically slower elimination
Blood thinner
decreased LOC
S/S of hypovolemia in newborn. The last present symptom. (When do certain symptoms appear)
Dry mucous membranes, tachycardia, sunken fontanelle(late)
focal or generalized. Posturing of one limb, the neck or truck with horizontal eye deviation
Tonic Seizure
horizontal eye deviation, eye blinking or fluttering, chewing, lip smacking, drooling.
Subtle Seizure
focal or multifocal sz, jerking of limbs
Clonic Seizure
sz caused by sudden spike or decrease in temperature in kids
Febrile Seizure
Elderly pt’s spouse secretly reports alcoholism, suspects the alcohol is the source of chest pain. Pt denies alcohol use that day. What is the most important reason for clarifying the alcohol useage.
Substance misuse can complicate treatments
Know about questions to ask when obtaining HX on OB pt.
Grávida
para
Complications with previous pregnancies and births
c-section
prenatal care
otc, recreational, herbal drug use
how many fetus’s
Experiencing chest pain with ST elevation, who statistically has the least likelihood of survival?
Family hx
genetics
long term alcohol use
smoking
multiple medical conditions
ALS personnel assisting in delivery of an EXTREMELY large baby. What injuries are the most preventable during the birth.
Clavicle fracture
Medical terminology related to how many living children the pt has.
Para
Medical terminology related to how many pregnancy’s the pt has had.
Gravida
Meaning 2 or more pregnancies
Multigravida
A woman that has had 2 or more deliveries.
Multipara
First pregnancy
Primigravida
The mechanism by which the products of conception are expelled from the uterus.
Labor
Time period when the pts body is preparing for delivery, effacement of the cervix, contractions, amniotic sac ruptures.
First stage of labor
This stage of labor begins when the cervix is fully dilated. The end of this stage is when the baby is delivered.
Stage 2
After the baby has been delivered, when the placenta is expelled from the body.
Stage 3 of labor begins
Normal progression of aging w/ geriatrics/ changes to body
Linear Aging
