Week 6 Flashcards
(59 cards)
1
Q
Type 1 Diabetes
A
- IDDM (Insulin Dependent Diabetes Mellitus)
- Lack of insulin production due to an autoimmune disorder targeting β cells in the pancreas.
- Commonly diagnosed in children (early onset)
- Medications: Humalog, Novalog, Novalin, Lantis
2
Q
Type 2 Diabetes
A
- NIDDM (Non-Insulin Dependent Diabetes Mellitus)
- Body isn’t sensitive to insulin (“wack” regulation or built up tolerance)
- Commonly found later in life due to poor lifestyle choices
- Medications: Metformin/Glucophage
3
Q
Gestational Diabetes
A
Occurs during pregnancy (changes in how cells use glucose)
• Tends to lead to hyperglycemia
• Risk factor: Developing type 2 after childbirth.
• Treatment: Birth
4
Q
Role of Insulin/What produces it?
A
- insulin is the key that allows for the uptake of glucose by cells
- decreases BGL
- increases glucose within cells
- produced by pancreas, specifically beta cells ( a type of islet cell)
5
Q
Role of Glucagon/What produces it?
A
- Breaks down glycogen stores
(sugar stores) in the liver into the blood - Increases BGL when glucose within cells are low
- produced by the alpha cells, found in the islets of Langerhans, in the pancreas
6
Q
Definition: DKA
A
- diabetic ketoacidosis
- Body starts breaking down ketones (a type of sugar), which increases blood acidity because increased
generation of CO2 - usually associated with hyperglycemia
7
Q
Definition: Insulin Shock
A
- the body shutting down because low BGL
- associated with hypoglycemia; taking too much insulin
8
Q
Defintion: Diabetic Coma
A
- occurs when BGL of patient is so low or so high, they can no longer function normally, and become AMS
9
Q
Definition: Diabetic Neuropathy
A
- a type of nerve damage that can occur if you have diabetes
- High blood sugar (glucose) can injure nerves throughout your body.
10
Q
3 P’s of diabetes
A
- Polyphagia: Excessive hunger
• Polydipsia: Excessive thirst
• Polyuria: Excessive/frequent urination - associated with hyperglycemia
11
Q
Oral Glucose
A
Indications: BGL < 60 mg/dL, AMS, history of diabetes
Contraindications: head/facial trauma, unable to swallow, unable to follow directions
Route: buccal
Mechanism: increases BGL
Dose: 1 tube oral glucose; max three tubes
Consider: sugary drinks
12
Q
4 components of blood
A
- plasma and proteins
- erythrocytes
- leukocytes
- megakaryocytes
13
Q
What is sickle cell anemia? Why is it a concern to us? How does the patient present? What are our treatments?
A
- genetic condition that causes the hemoglobin to form globular S-Hemoglobin that affects the shape of the
hemoglobin protein and the RBC - this is a concern for us because it means patient is not able to move oxygen adequately throughout the body
- S/Sx: swelling, LOC, fatigue, headache/dizziness, jaundice, intense pain in areas with fine capillaries
- Our treatments: High flow O2, rapid transport
14
Q
Hemophilia
A
- reduced ability for blood to clot
15
Q
Thrombophilia
A
- increased tendency to clot
16
Q
What is a behavioral emergency?
A
- when someone behaves in a way
that is not within the social norm or in a way that is
not acceptable to friends and family - Can pose a risk to themselves or others
17
Q
6 causes of AMS
A
- hypoxia
- drugs/alcohol
- post-seizure
- head injury
- exacerbated mental illness/disorder
- infection
18
Q
When should you restrain? How? How many people should you have?
A
- restrain when pt is a danger to themselves, you, your crew, bystanders, other providers, etc
- use only force necessary, tie to stretcher (not the moveable parts), tie one arm up, one arm down, feet apart, check CMS every five minutes, take not of mileage
- should have atleats 3 people
19
Q
Major Depressive Disorder
A
- episodes of decreased mood, willingness to do things
- comes in episodes that vary in length and severity
20
Q
Bipolar Disorder
A
- episodes of elevated mood and irritability
- could lead to someone being rash, displaying psychotic features
- an episode could last for days
- 2 types: 1 = manic ep; 2 = only hypomanic ep
21
Q
Generalized Anxiety Disorder
A
- anxiety that comes with intense worry, discomfort with uncertainty
- comorbid with depression; has many similar symptoms
22
Q
Schizophrenia
A
- disorder linked to positive (hallucinations, delusions) and negative effects (empathy) and disorganized speech and mood
- pt. can have auditory, visual, or even olfactory delusions
23
Q
Phobias
A
- intense fear of specific object or experience that is not explainable/ordinary/justifiable
24
Q
Obsessive Compulsive Disorder
A
- pt. has obsessions, compulsions, or both
- need to satisfy compulsions and obsessions
25
Ensuring crew's safety
- approach patients slowly
- ensure patient has no type of weapon in their hand
- call PD as a precaution if patient seems to be violent
26
Concerns for patient/Consent
- concerned about possible suicide attempt
| - she cant refuse treatment as she is a threat to herself (involuntary consent)
27
3 questions to ask suicidal patient?
- Is there anyone you can talk to about personal issues?
- Have you though about hurting yourself before?
- Do you find yourself lacking the will to do things on a daily basis?
- How would you describe your mood most days?
28
2 organs that are part of lymphatic system
- spleen
| - liver
29
Histamine's Role
- Histamine is the main compound involved in an anaphylactic reaction
- Effects: vasodilations, wheezing/stridor lung sounds, angoredema/edema, urticaria
30
Nosocomial Infection
- infections picked up in hospital environment
| - population at risk: providers, immunocompromised patients, and patients who are in such an environment frequently
31
What should you do when you see localized welling?
1. take off jewelry the could impose on the swelling
| 2. remove allergen by swiping it off
32
Definition: urticaria
- hives that form on the body
33
Definition: Angioedema
- swelling of the tongue
34
Definition: allergic reaction
- Exaggerated immune response to something that usually is nonpathogenic.
35
Epinephrine Protocol
indications: obvious signs of anaphylaxis, hypotension or severe respiratory distress, prescribed an epi-pen
contraindications: none in emergent situations
mechanism: sympathomimetic
route: intramuscular
dose: .3 mg for adults; .15 mg for peds; max dose = 1
Side Effects: reflect sympathetic nervous system
36
What is anaphylaxis
- Serious life-threatening hypersensitive
systemic allergic reaction that compromises
two or more body systems.
37
Symptoms of both Allergic reaction and anaphylaxis
```
- Swelling
• Nausea/Vomitting
• Abdominal pain
• Dizziness
- wheezing
```
38
Symptoms unique to anaphylaxis
- Hypotension***
• Tachycardia
• Urticaria (hives)
• Angioedema (swelling of the tongue)
39
Define: Addiction
- the psychological desire to take drugs despite recognizing negative
consequences
40
Define: Tolerance
- Need for more after long-term use to achieve an effect
41
Define: Agonist
- something that INCREASES function at postsynaptic cell
42
Define: Physical Dependence
- The physical need for a drug to function normally
43
Define: Idiosyncrasy
- Basically an uncommon side effect or reaction
44
Define: Potentiation
- Achieving a greater effect than the sum of the drugs
45
Define: Antagonist
- something that DECREASES or BLOCKS function
46
Define: Enteral
- Passing through the epithelium of the GI tract
47
4 routes of medication administration
- enteral - oral, buccal
- parenteral - IV, IM, I0, Subcutaneous
- absorbed - buccal, nasal, inhalation, transdermal
48
Severe Alcohol Withdrawal
- leads to delirium tremens
- characterized by Nausea/Vomiting, Tremors, Disorientation, Hallucinations, Seizure Activity, and Tachycardia/Hypertension
- Our concerns: seizure activity; electrolyte imbalance can lead to cardiovascular collapse
49
6 rights of medication administration
- Dose
- Drug
- Documentation
- Time
- Patient
- Route
50
Depressant
- Decrease CNS Activity
| - alcohol
51
Stimulant
- Increase CNS Activity, Stimulate Sympathetic Nervous
System
- cocaine
52
Narcan Protocol
Indications: suspected opioid overdose, AMS, RR<10
Contraindications: none
Route: Intranasal via atomizer
Mechanism: opiate receptor antagonists
Dose: 2 mg in adults, 1 mg in peds; half dose in each nostril; max dose of 2
Side Effects: vomiting, withdrawal symptoms, aggression, delirium
53
Name 2 opiates
- fentanyl
| - heroin
54
4 signs of opiate overdose
- low respirations, AMS, hallucinations, tremors,
55
What is an opioid? Why is it a concern?
- opium derived drugs that numb pain and sensation
| - very easy to overdose on it; mixed with other drugs so people will consume without knowing as well
56
What drug class does Tylenol belong to? Risk of overdose?
- acetaminophen
| - liver toxicity, jaundice, confusion, bleeding
57
Name an anticoagulant. What do they do and why are they prescribed?
- Heparin, Warfarin, Xarelto
- Target soluble blood proteins like Thrombin and Fibrin
- prescribed to prevent blood clots (DVT, PE)
58
Situation
- cholinergic agents
- affected by an organophosphates
- symptoms:
- - Salivation
- - Lacrimation
- - Urination
- - Defecation
- - GI Discomfort
- - Emesis
- - Miosis
- remove patient from scene ASAP
59
CPEP
- Comprehensive Psychiatric Emergency Program
