Week 3 Flashcards

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1
Q

PERRLA

A

Pupils
Equal
Round
Reactive
Light
Accommodating

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2
Q

Baseline Vital Signs

A

Pupils
Heart Rate
Respiratory Rate
Blood Pressure
Skin

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3
Q

Cyanosis

A

Bluish skin
Moderate Sign of Hypoxia
(Starts at fingers and works up as it gets worse)

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4
Q

Mottled

A

Red splotchy skin
Possible sign of shock

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5
Q

Jaundice

A

Yellowing of skin / mucus membranes

Sign of liver failure

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6
Q

Pallor

A

Paleness

vasoconstriction
bloodloss
shock
heart attack
anemia

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7
Q

Flushed

A

Red Skin

Heat exposure
Carbon Monoxide Poisoning

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8
Q

Fontenelle

A

Soft spots on infants head where the skull has not fused yet

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9
Q

Hypotension

A

Lower than normal BP

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10
Q

Hypoxia

A

Low oxygen

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11
Q

Hypoxemia

A

low oxygen in the blood

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12
Q

Hypertension

A

Higher than normal BP

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13
Q

Breath Sounds

A

wheezing
Rhonchi
Rales
crowing/ stridor
Gurgling
snoring

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14
Q

Wheezing

A

swelling constriction of lower airways

High pitched exhalation but can also be heard during inhalation

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15
Q

Rhonchi

A

obstruction of the larger conducting airways of the respiratory tract by thick secretions of mucus
chronic bronchitis, emphysema, aspiration, and pneumonia

coarse crackles, are snoring or rattling noises heard on auscultation

sound changes if person coughs/changes position

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16
Q

Rales

A

fluid that has surrounded or filled the alveoli or small bronchioles
pulmonary edema or pneumonia

bubbly or crackling sounds heard during inhalation

posterior base of lungs

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17
Q

Crowing/stridor

A

swelling or muscle spasms that result from conditions
airway infections, allergic reactions, or burns to the upper airway

high-pitched sounds produced on inspiration

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18
Q

Gurgling

A

liquid substance in airway

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19
Q

Snoring

A

Tongue or Epiglottis bloacking airway

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20
Q

Apnea

A

Not breathing

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21
Q

Consensual reflex

A

Both pupils reacting equally

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22
Q

Hypoxia

mild-moderate

A

Tachypnea
Dyspnea
Pale, cool, clammy skin (early)
Tachycardia
Elevation in blood pressure
Restlessness and agitation
Disorientation and confusion
Headache

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23
Q

Tachypnea

A

increased respiratory rate

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24
Q

Dyspnea

A

shortnes of breath

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25
Q

Hypoxia

Severe

A

Tachypnea
Dyspnea
Cyanosis
Tachycardia dysrhythmias
bradycardia
Severe confusion
Loss of coordination
Sleepy appearance
Head bobbing with droopy eyelids
Slow reaction time
Altered mental status
Seizure

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26
Q

dysrhythmias

A

Irregular heart rythmes

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27
Q

Diaphoretic

A

excessive sweating and clamminess

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28
Q

hypercarbia

A

buildup of carbon dioxide in the blood

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29
Q

cricoid pressure

A

backward pressure to displace the larynx posteriorly

BURP, ELM

can impede airflow
used to facilitate endotracheal tube

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30
Q

Respiratory distress

A

Compensatory (Adequate Tidal volume and Respiratory rate)
SOB
Resltessness/anxiety
Retractions
Abdominal breathing
coughing
tripod position

94% or greater.

Provide supplemental oxygen to maintain SPO2

31
Q

Respiratory Failure

A

Compensatory Mech. not working. insufficient rate/ tidal volume

bag-valve-mask device with supplemental oxygen connected to the device.

32
Q

Respiratory Failure

A

stopped breathing
(Agonal possible)

BVM with supplemental oxygen

33
Q

orthostatic vital signs

A
  1. BP + HR in supine
    2.stand pt up and after 2 mins BP + HR
    3.while standing.
  2. HR increases by greater than 10–20 bpm
    systolic blood pressure decreases by 10–20 mmHg as compared to the readings taken while the patient was supine
    = positive orthostatic test, which typically indicates a significant loss of blood or fluid
34
Q

Alveolar ventilation

A

amount of air moved in and out of the alveoli in one minute.

35
Q

Lordosis

A

stomach is too anterior and the buttocks are too posterior, causing excessive stress on the lumbar region of the back

36
Q

kyphosis

A

shoulders are rolled forward, which results in fatigue of the lower back and increases pressure on every region of the spine

37
Q

Emergency move

A

AMS
Inadequate respiratory rate
Indications of shock
Injuries to head, neck, chest, abdomen, pelvis Fracture of both femurs
Major bleeding

immediate threat to life and the patient must be moved quickly

38
Q

Cap refill

A

2 seconds for infants, children, and male adults;
3 seconds for females;
4 seconds in the elderly.

compressed capillaries to fill up again with blood

39
Q

Adjectives to describe pulse

A

1.Rapid, regular full
Exertion, fright, fever, high blood pressure, or very early stage of blood loss
2.Rapid, regular, and thready
Reliable sign of shock = early stage of blood loss
3.slow
Head injury, barbiturate or narcotic use, some poisons, possible cardiac problem or other medical conditions such as hypothyroidism
4.No pulse
Cardiac arrest, profound hypotension
5. Thready
Irregular

40
Q

7 places to palpate pulses

A

Carotid
femorial
radial
brachial
popliteal (behind knee)
Posterior tibial
dorsalis pedis

41
Q

Life span ages

A

Neonate - birth to one month
Infant - one month - 1 year
toddler - 1-2 years
Preschooler - 3-5 years
child - 6-11
adolescent - 12- 15/18
adult - 20-40
middle age - 41-60
late adult - 61 and up

42
Q

Infant reflexes

A

blinking, startling, rooting, sucking, swallowing, stepping, gagging, and grasping reflexes.

43
Q

OPA

A

Dis. cannot be used on pt with gag reflex
too long can push tongue or epiglottis and obstruct. does not protect from aspiration
Adv. keeps tongue from falling back

44
Q

NPA

A

Adv. Used when pt has gag reflex/can’t take OPA
Dis. does not protect for aspiration, can damage nose and cause bleeding, not used when there is facial trauma or skull fracture

45
Q

O2 sat %, and meaning

A

person breathing room air is in the high 90s, typically 97–100% SpO2
Less than 94% - indicate hypoxia, needs to be investigated - Apply 02
90% or less is a definite indication of hypoxia.

Low BP
Hypothermia
Excessive movement
nail polish
Anemia
Co2

46
Q

When to take vitals stable/nonstable

A

Stable - every 15 mins
Unstable - every 5 mins

47
Q

Assessing skin color

A

Look - Mottled, Cyanosis, red, pallor, Edema, bruising
Feel - Back of hand for temp, Clamminess
Cap refill (Perfusion)

48
Q

correct BP cuff placement

A

Adult or Ped cuff
Pt sitting, palm up, legs not crossed, one inch above crease of elbow. Arrow pointing to brachial artery
level with the heart

49
Q

CPAP indications

A

Awake, alert, and oriented enough to obey commands
Able to maintain own airway
Able to breathe on his own
respiratory rate >25 breaths/minute
moderate to severe respiratory distress or early respiratory failure (use of accessory muscles or SpO2 <94%)
Presenting with increased end tidal CO2 (ETCO2) values
Able to wear the face mask or interface chosen

50
Q

CPAP contraindications

A

Apnea
respiratory arrest
agonal respirations
Inability to understand or obey commands (GCS <11)
Inability to maintain his own airway
Unresponsiveness
Shock associated with cardiac insufficiency (signs of poor perfusion and a SBP <90 mmHg)
Cardiac arrestActive vomiting
Upper gastrointestinal bleeding or history of recent gastric surgery
Pneumothorax or trauma to the chest
Tracheotomy
Facial trauma
Increased intrathoracic pressure causing hypotension

51
Q

Types of respiratory drives

A

Hypercarbic - when the carbon dioxide level decreases in the blood, the chemoreceptors sense this and send signals
hypoxic drive - chemoreceptors relying on O2 levels

52
Q

Supplies needed to start an IV

A

IV Catheter
Tubing
Bag of fluid
tape
Tegaderm
Alcohol prep
4x4
tourniquet
flush

53
Q

NRB

A

Nonrebreather mask
15 LPM
90% O2
still able to breath on own
ppv

54
Q

FROPVD

A

Flow-Restricted, Oxygen-Powered Ventilation Device
PPV
100%
adult pt only
breathing on own

dis. emt not aware of lung compliance

55
Q

BVM

A

Bag valve mask
deliver 600ml of O2
15 lpm
21% O2
Add O2 = 100% O2
PPV

56
Q

Humidified O2

A

recommended for asthma pt
for long transport
makes dryness more comfy

57
Q

nasal canula

A

24 – 44% oxygen 1-6 lpm

58
Q

upper airway structures

A

nasalpharynx
oropharynx
vellecula
eppiglottis
larynx
(trachea, esophagus - lower)

59
Q

Indications of giving adequate ventilation

A

Rate
chest rise and fall
heart rate returns to normal
color improves

60
Q

what decreases minute volume

A

Tidal volumexfrequency (MV)
decreases: tidal volume

61
Q

Hazards of O2 therapy

A

increase coronary artery in pt with cardiac disease
tissue damage in stroke and acute coronary syndrome
O2 toxicity
damage to retina through scare tissue
Respiratory depression or respiratory arrest in patients with COPD

62
Q

When to suction

A

Always before ventilation

63
Q

Types of suctioning

A

rigid/hard/yankaur
soft/French

64
Q

Causes of hypoxia

A

occluded airway
inadequate breathing,
hypoperfusion or shock
toxic gases
lung and airway diseases (e.g., asthma and emphysema),
drug overdose that suppresses the respiratory center in the brain
stroke,
injury to the chest or respiratory structures
head injury.

65
Q

signs of inadequate airway

A

Abnormal upper airway sound
An awake patient who is unable to speak
foreign body airway obstruction
Swelling to the mouth, tongue, or oropharynx

66
Q

drug effect on pupils

A

Amphetamines - constricts
Opioids - Dilates

67
Q

O2 tank pressure

A

2,000 PSI

68
Q

4 lead placement

A

The arm leads should be placed on the right and left arm right above the wrist.The leg leads should be placed on the right and left leg above the ankles

69
Q

12 lead placement

A

V1 lead immediately right of the sternum at the fourth intercostal space V2 immediate left of the sternum at the fourth intercostal space V4 to the left midclavicular line at the fifth intercostal space V3 place midway between V2 and V4 leads on the left anterior chest V5 to the left anterior axillary line at the same level as V4 V6 to the left midaxillary line at the same level as V4 and V5

70
Q

Steps for Kingtube and combitube placement

A

Check for obstructions
Correct sizing
Lubricate device
Insert until blocked
Inflate

71
Q

Factors to consider before moving patient

A

PT Spinal injuries
Body mechanics
Planning a move (gear and people needed)
Packing a patient

72
Q

Adult

A

Rr : 12-20
Hr: 60-100
Bp: 120/80

73
Q

Adolecent

A

12-18
Rr: 12-20
Hr: 60-100
Bp: 110/65 - 130/80

74
Q

Child

A

6-11
Rr: 18-25
Hr: 75-118
Bp: 90/45 - 112/72