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Pulmonary |artery |- |correct |answer |-One |of |two |arteries |that |carry |venous |(oxygen |poor) |blood |from |heart |to |lungs
What |type |of |intubation |is |preferred |with |emesis |with |aspiration? |- |correct |answer |-ETT. |LMA |or |combitube |acceptable.
What |emergency |would |a |cricothyrotomy |typically |be |performed? |- |correct |answer |-Airway |obstruction
Atropine |would |be |given |in |which |emergency? |- |correct |answer |-Symptomatic |bradycardia
Adenosine |would |be |given |in |which |emergency? |- |correct |answer |-SVT
Amiodarone |would |be |given |in |which |emergency? |- |correct |answer |-V. |Tach
What |medications |can |be |given |for |a |sever |case |of |hyperventilation? |- |correct |answer |-Versed, |Valium, |or |Propofol
PVC's |are |treated |with |which |medicine? |- |correct |answer |-Lidocaine
Epi |is |given |in |which |two |emergencies? |- |correct |answer |-V. |Fib |and |asystole
Max |dose |of |epi |for |cardiovascular |disease |pt |- |correct |answer |-.04mg
A |beta |blocker |would |be |given |in |which |emergency? |- |correct |answer |-Hypertension
A |fluid |bolus |of |NS |and |ephedrine |can |be |given |with |what |emergency? |- |correct |answer |-Hypotension
What |medications |are |used |to |treat |malignant |hypothermia? |- |correct |answer |-Dantrolene, |IV |cold |saline |(not |Ringer's)
Nasopharyngeal |airway |- |correct |answer |-When |tongue |is |obstructing |airway. |Tube |is |lubricated |and |passed |through |the |nose |into |nasal |cavity. |Sits |in |oropharynx |behind |tongue. |Well |tolerated |and |can |be |used |on |awake |pts.
Oropharyngeal |airway |- |correct |answer |-Also |placed |to |position |tongue |in |more |anterior |position. |Often |interfere |with |intra |oral |procedures. |Not |tolerated |well |with |awake |pts.
Laryngeal |mask |airway |(LMA) |- |correct |answer |-Device |that |sits |over |top |of |larynx. |Can |be |placed |blindly. |Does |not |protect |against |aspiration. |Inflated |with |30cc |to |create |seal.
Endotracheal |intubation |- |correct |answer |-End |of |tube |passes |through |vocal |cords |and |terminates |half |way |between |vocal |cords |and |bifurcation |of |trachea. |Important |to |listen |to |both |lungs |after |placement. |May |or |May |not |be |cuffed.
Combitube |- |correct |answer |-Generally |used |for |specific |emergencies. |Both |cuffs |inflated.
Pts |predisposed |to |bronchospasm |- |correct |answer |-Allergies, |asthma, |copd, |bronchitis
Bronchospasm |- |correct |answer |-Generalized |contraction |of |smooth |muscles |of |small |bronchi |and |bronchioles |in |lungs |causing |restriction |of |air |flow |of |air |to |and |from |lungs.
Maximum |dose |of |epi |for |healthy |pt |- |correct |answer |-.2mg
Liver |- |correct |answer |-Protein |and |lipid |synthesis, |bio |transformation, |detoxification |and |storage |of |vitamin |A, |E, |D, |K, |and |B12.
Hematocrit |- |correct |answer |-% |blood |volume |made |up |of |red |blood |cells. |Men: |42-52% |women: |37- 48%. |Anything |below |35% |considered |anemic.
Mental |artery |- |correct |answer |-Supplies |blood |to |chin.
Ischemia |- |correct |answer |-Reduced |blood |flow |in |coronary |arteries. |Lack |of |oxygen |to |heart |cells |weakens, |but |does |not |kill |them.
Maxillary |artery |- |correct |answer |-Supplies |blood |to |maxilla, |teeth, |sinuses, |and |portion |of |nose.
Medulla |oblongata |- |correct |answer |-Coordinating |region |for |impulses. |The |seat |of |many |autonomic |centers.
Normal |levels |of |hemoglobin |- |correct |answer |-Males: |13-18 |mg/dL
Females: |14-16 |mg/dL
Oropharynx |- |correct |answer |-Located |between |soft |palate |and |epiglottis.
Facial |nerve |- |correct |answer |-7th |cranial |nerve. |Supplies |motor |fibers |to |muscles |of |facial |expression.
Trigeminal |nerve |- |correct |answer |-5th |cranial |nerve. |Supplies |sensation |to |teeth |and |jaws.
Vagus |nerve |- |correct |answer |-10th |cranial |nerve. |Supplies |fibers |to |many |parts |of |body. |(Ears, |tongue, |pharynx, |larynx, |thoracic/abdominal |viscera).
Pulmonary |veins |- |correct |answer |-Return |oxygenated |blood |to |left |atrium |from |lungs. |Only |veins |that |carry |oxygenated |blood.
Superior |vena |cava |- |correct |answer |-Drains |head, |neck, |and |upper |extremities |into |right |atrium.
Adrenal |glad |- |correct |answer |-Secretes |epinephrine, |norepinephrine, |and |corticosteroids.
Ectopic |focus |- |correct |answer |-Displaced |central |point |of |origin |for |cardiac |dysrhythmias.
Inferior |alveolar |artery |- |correct |answer |-Supplies |blood |to |teeth, |mandible, |lower |lip, |and |chin.
Inferior |vena |cava |- |correct |answer |-Drains |lower |extremities |and |abdominal |viscera |into |right |atrium.
Brachial |artery |- |correct |answer |-Supplies |blood |to |shoulder, |arm, |forearm, |and |hand.
Facial |artery |- |correct |answer |-Supplies |blood |to |face, |tonsil, |palate, |and |submandibular |gland.
T's |of |pulseleas |electrical |activity |- |correct |answer |-Toxins, |trauma, |thrombosis, |tension |pneumothorax, |tamponade
H's |of |pulseless |electrical |activity |- |correct |answer |-Hydrogen |ion, |hypoxia, |hypovolemia, |hypoglycemia, |hypo/hyperkalemia, |hypothermia.
Pulseless |electrical |activity |(PEA) |- |correct |answer |-Normal |appearing |tracing, |but |patient |has |no |pulse.
Asystole |- |correct |answer |-Cessation |of |all |contractions. |"Flat |line" |usually |follows |v. |fib |or |v. |tach. |Treated |with |CPR.
Ventricular |fibrillation |v. |fib |- |correct |answer |-Course |v. |fib |with |prominent, |erratic |baseline |or |fine |v. |fib |with |far |less |pronounced |vacillations. |No |p, |qrs, |or |t. |Often |precedes |asystole.
Class |III |- |correct |answer |-Pt |has |severe |systemic |disturbance |or |disease.
Class |IV |- |correct |answer |-Patient |has |a |severe, |life |threatening |systemic |disorder.
Ventricular |foci |- |correct |answer |-Located |in |ventricles
Supraventricular |foci |- |correct |answer |-Located |above |level |of |ventricles |in |atria.
Antibiotic |prophylaxis |for |total |joint |replacement |patients |- |correct |answer |-Previous |joint |infection, | 2 |yrs |following |joint |replacement, |malnourishment, |hemophilia, |diabetes |type |I, |immunosuppressed |or |immunocompromised |patients.
AV |blocks |- |correct |answer |-PR |length |is |prolonged |or |varies |in |length |due |to |impulse |being |partially |or |completely |blocked |as |it |attempts |to |travel |from |atria |to |ventricles |via |AV |node.
Patients |who |need |antibiotic |prophylaxis |- |correct |answer |-Previous |infective |endocarditis, |prosthetic |valves, |cardiac |transplant |patients |who |develop |valvulopathy, |congenital |heart |disease.
Congestive |heart |failure |- |correct |answer |-Condition |caused |by |the |heart |is |unable |to |handle |blood |volume |coming |back |to |it |from |either |the |lungs |or |peripheral |circulation.
3 |characteristics |of |normal |heart |rhythms |- |correct |answer |-Rate, |regularity, |and |rhythm.
MVP |(mitral |valve |prolapse) |- |correct |answer |-One |or |more |of |valve |flaps |don't |close |completely |allowing |redundancy |of |valve |leaflets |into |left |atrium.
Rheumatic |heart |diseases |- |correct |answer |-Condition |caused |secondary |to |rheumatic |fever |(beta |hemolytic |streptococci) |which |damages |the |heart |valves, |primarily |the |mitral |valve, |and |causes |heart |murmur.
MI |(myocardial |infarction) |- |correct |answer |-Heart |attack. |Six |should |be |performed |on |patient |until | 6 |months |after.
Right |sided |heart |failure |- |correct |answer |-Increased |pressure |of |fluid |in |blood |vessels |causes |fluid |to |leak |into |body's |tissues |causing |peripheral |edema |and |ascites
Left |sided |heart |failure |- |correct |answer |-Increased |pressure |of |fluid |in |blood |vessels |causes |fluid |to |leak |into |lungs. |Patients |often |present |with |shortness |of |breath.
Review |of |systems |musculoskeletal |- |correct |answer |-Weakness |of |extremities, |atrophy |of |muscles, |frequent |cramping |of |muscles.
Review |of |systems |neurologic |- |correct |answer |-Weakness |of |extremities, |hx |of |projectile |vomiting, |headaches, |visual |disturbances, |any |unexplained |pain |or |numbness |in |body.
Review |of |systems |pulmonary |- |correct |answer |-Shortness |of |breath, |dizziness, |chronic |cough, |wheezing, |productive |cough.
Review |of |systems |genitourinary |- |correct |answer |-Painful |urination, |blood |in |urine, |frequent |urination, |incontinence, |discharge |in |urine.
Review |of |systems |gastrointestinal |- |correct |answer |-Loss |of |appetite, |swallowing, |change |in |taste, |nausea, |vomiting, |diarrhea, |constipation.
Review |of |systems |skin |- |correct |answer |-Bruising, |bleeding, |discoloration.
Review |of |systems |cardiovascular |- |correct |answer |-Headaches, |dizziness, |nosebleeds, |shortness |of |breath, |chest |or |arm |pain, |edema.
Review |of |systems |general |- |correct |answer |-Weight |loss, |loss |of |appetite, |weakness, |fatigue.
4 |key |questions |to |ask |patient |in |evaluation |- |correct |answer |-Are |they |currently |under |physicians |care, |do |they |take |any |meds, |do |they |have |any |allergies |and |reactions |they |have, |review |of |systems.
Asthma |- |correct |answer |-Usually |associated |with |allergies. |Increased |secretions |in |the |muscles |membranes |lining |bronchioles. |Mucus |plugs |block |smaller |bronchi |making |movement |of |air |in |and |out |if |lungs |difficult. |More |difficulty |with |expiration.
Type |II |diabetes |- |correct |answer |-Non |insulin |dependent
Considerations |for |diabetic |patients |- |correct |answer |-Patients |with |diabetes |do |not |heal |as |quickly |and |are |more |prone |to |infection. |Often |placed |on |antibiotics.
Fasting |blood |sugar |(FBS) |- |correct |answer |-125 |mg/dL |normal |or |in |control
Insulin |overdose |- |correct |answer |-Give |patient |sugar, |candy, |or |sugar |containing |beverage. |Glucose |IV |or |glucagon |IM |if |patient |is |sedated.
Emphysema |- |correct |answer |-Enlargement |of |alveolar |sac |in |lungs |along |with |destruction |and |scarring |of |alveoli |which |makes |less |surface |area |available |for |exchange |of |O2 |and |CO2. |Smokers.
Risks |of |kidney |disease |- |correct |answer |-Patients |with |kidney |disease |may |have |difficulty |eliminating |medications |from |their |body. |Sx |should |not |be |scheduled |on |same |day |as |dialysis.
Epilepsy |- |correct |answer |-Seizures. |If |an |incident |occurs |during |anesthesia |Valium |IV |can |be |given.
TIA |(transient |ischemic |attack) |- |correct |answer |-Mini |stoke. |Sudden |neurological |loss |of |function |with |full |recovery |in | 24 |hrs.
Cerebrovascular |accidents |(CVA/stroke) |- |correct |answer |-Neurological |impairment |caused |by |disruption |of |blood |supply |to |area |of |brain.
Ischemic |stroke |- |correct |answer |-85% |caused |by |occluded |blood |vessel.
Hemorrhagic |stroke |- |correct |answer |-15% |caused |by |ruptured |artery |(aneurysm)
Trimester |to |best |perform |surgery |- |correct |answer |-2nd |trimester. |Most |risk |to |fetus |in |1st |trimester.
Obesity |- |correct |answer |-20 |% |above |ideal |body |weight |
[(wt |in |lbs/height |in |inches)2] |x | 703
Modifiable |risk |factors |of |stroke |- |correct |answer |-High |blood |pressure, |diabetes, |heart |disease, |smoking, |TIA, |increased |red |blood |cells, |sickle |cell |disorder.
Unmodifiable |risk |factors |for |stroke |- |correct |answer |-Male, |age | 55 |or |older, |two |times |African |American, |previous |stroke, |heredity.
Considerations |for |obese |patients |- |correct |answer |-Use |of |a |large |blood |pressure |cuff, |difficult |venous |access, |patients |should |be |treated |in |upright |or |semi |fowler |position.
Protease |inhibitors |- |correct |answer |-Patients |with |HIV |take |this |medications. |It |prolongs |effects |of |benzodiapam |derivatives.
INR |- |correct |answer |-International |normalized |ratio. |Patients |on |anticoagulants |usually |maintain |INR |2-3. |Patients |usually |discontinue |anticoagulant | 3 |days |prior |to |surgery. |1.5 |or |less |needed |to |operate.
Prothrombin |time |- |correct |answer |-Effectiveness |of |anticoagulant.
Right |atrium |- |correct |answer |-Receives |blood |from |inferior |and |superior |vena |cava |(peripheral |circulation).
Lower |airway |- |correct |answer |-Trachea, |bronchi, |lobular |bronchi, |bronchioles, |and |alveoli.
Peripheral |nervous |system |- |correct |answer |-Consists |of |sensory |and |motor |nerves.
Laryngopharynx |- |correct |answer |-Located |behind |voice |box.
Internal |respiration |- |correct |answer |-Takes |place |at |cellular |level. |O2 |in |bloodstream |enters |cells. |CO2 |leaves |cell |and |returns |to |blood.
Pharynx |- |correct |answer |-Located |between |nose |and |trachea. | 3 |parts |nasopharynx, |oropharynx, |laryngopharynx
Synapse |- |correct |answer |-A |junction |between |two |neurons.
Hypoxia |- |correct |answer |-Lack |of |O
Automaticity |- |correct |answer |-Ability |of |heart |muscle |to |contract |on |it's |own |without |nerve |stimulation.
Best |places |to |check |for |patients |pulse |- |correct |answer |-Carotid |arteries |and |radial |arteries.
Trachea |- |correct |answer |-Wind |pipe.
Neurons |- |correct |answer |-Nerve |cells
Tachycardia |- |correct |answer |-HR |above | 100 |bpm
Sensory |nerves |- |correct |answer |-Receive |messages |from |environment |and |and |conduct |messages |back |to |CNS.
CAC |(cardioacceleratory |center) |- |correct |answer |-Located |within |medulla. |Sympathetic |fibers |travel |down |spinal |cord |to |SA |node. |When |stimulated |release |norepinephrine |with |increases |HR |and |strength |of |contractions.
Cardiac |output |- |correct |answer |-Total |amount |of |blood |pumped |from |left |ventricle |in |one |minute.
Brain |stem |- |correct |answer |-Pons, |medulla |oblongata, |midrain
Cephalic |vein |- |correct |answer |-Located |on |outer |(lateral) |aspect |of |forearm.
Epiglottis |- |correct |answer |-Soft |tissue |valve |located |at |base |of |tongue |covers |larynx. |Allows |air |into |lungs |and |keeps |foreign |material |out.
AV |node |- |correct |answer |-Located |between |atria |and |ventricles. |Bundle |of |His |cause |ventricles |to |contract.
Thoracic |cage |- |correct |answer |-Consists |of |ribs, |sternum, |intercostal |muscles, |diaphragm.
Accessory |muscles |of |respiration |- |correct |answer |-Sternocleidomastoid, |scalenes, |abs |which |are |most |important.
Central |nervous |system |(CNS) |- |correct |answer |-Consists |of |brain |and |spinal |column
Median |cubital |vein |- |correct |answer |-Bridge |between |cephalic |and |basilic |veins.
Sinuses |- |correct |answer |-Frontal, |maxillary, |sphenoid, |ethmoid
CIC |(cardioinhibitory |center) |- |correct |answer |-Parasympathetic |fibers |reach |vagus |nerve |and |release |acetylcholine |which |decreases |HR |and |force |of |contractions.
Spinal |column |- |correct |answer |-Cerebrum, |cerebellum, |medulla |oblongata
Right |ventricle |- |correct |answer |-Sends |deoxygenated |blood |to |lungs |via |pulmonary |artery.
Respiration |rate |- |correct |answer |-12-16 |per |minute
QRS |complex |- |correct |answer |-Ventricular |depolarization
Systolic |phase |- |correct |answer |-Both |ventricles |contracting |simultaneously.
P |wave |- |correct |answer |-Atrial |depolarization
Phlebitis |- |correct |answer |-Inflammation |of |vein
Capillaries |- |correct |answer |-Smallest |arteries |where |the |exchange |of |O2, |CO2, |cell |by |products, |and |nutrients |are |exchanged |between |blood |and |cells |of |body.
Diastolic |phase |- |correct |answer |-Both |atria |contracting |simultaneously.
Autonomic |nervous |system |- |correct |answer |-Sympathetic |and |parasympathetic |nervous |system
Motor |nerves |- |correct |answer |-Carry |out |responses |from |CNS.
Cardiac |cycle |- |correct |answer |-One |alternate |contraction |and |relaxation |of |atria |and |ventricles |followed |by |a |short |pause.
Cerebrum |- |correct |answer |-Thought |area |of |brain.
Sympathetic |nervous |system |- |correct |answer |-Speeds |things |up. |Innervates |arteries |and |veins |causing |vasoconstriction |and |increased |heart |rate. |Thoracic |and |lumbar |spine.
Parasympathetic |nervous |system. |- |correct |answer |-Slows |things |down. |Decreases |heart |rate |and |blood |pressure. |Skull |and |sacrum.
Aorta |- |correct |answer |-Main |trunk |from |which |arterial |system |proceeds.
Hemoglobin |- |correct |answer |-Supplies |O2 |to |body's |tissues. |Composed |of |one |protein |(globin) |and |four |non |proteins |(hemes)
Lingual |artery |- |correct |answer |-Supplies |blood |to |tongue |of |floor |of |mouth.
Treatment |for |hypovolemia |- |correct |answer |-Pressure |to |area, |cauterization, |IV |fluid |replacement.
Treatment |for |malignant |hypothermia |- |correct |answer |-Activate |EMS, |hyperventalite |w/ |100% |O2, |dantrolene |sodium, |IB |cold |saline |NOT |ringers |lactate, |ice |packs |to |groin, |axilla, |neck, |cold |saline |lovage |to |stomach, |bladder, |rectum, |transport |to |hospital.
Treatment |for |anaphylaxis |- |correct |answer |-Activate |EMS, |100% |O2, |monitor |vitals, |epinephrine, |Benadryl, |decadron, |ACLS |protocol |while |waiting |for |EMS
Treatment |for |stroke |(CVA) |- |correct |answer |-Activate |EMS, |not |time |if |incident, |monitor |vitals |closely, |place |in |position |of |comfort, |100% |O2, |IV |access |give |bolts |of |NS/lactated |ringers |solution, |do |not |treat |BP |unless |greater |than |220/120, |transport |to |hospital, |note |time
Treatment |for |mild |allergic |reaction |- |correct |answer |-Place |patient |in |upright |or |reclined |position, |100% |O2, |monitor |vitals, |Benadryl
Treatment |for |seizures |- |correct |answer |-IV |access, |Valium |5mg |IV |or |medazolam |3mg, |continue |to |monitor |vitals, |activate |EMS
Treatment |of |syncope |(fainting) |- |correct |answer |-Tredelenburg |position, |ABC's, |head |tilt |chin |lift, |100% |O2, |monitor |vitals, |relax/reassure |patient
Treatment |of |acute |adrenal |deficiency |- |correct |answer |-Terminate |procedure, |monitor |vitals, |tredelenburg |position |if |hypotensive, |activate |EMS,IV |access, |steroid |administration, |fluid |bolus, |transport |to |hospital
Treatment |of |hypoglycemia |- |correct |answer |-Activate |EMS, |IV |access, |measure |blood |sugar |with |glucometer, | 1 |amp |of |glucose, |IV |infusion |of |dextrose |or |glucogan |IM |if |no |IV
Treatment |for |heart |attack |- |correct |answer |-Activate |EMS, |closely |observe |vitals, |100% |O2 |via |mask, |make |pt |comfortable/reassure, |attach |AED/defibrillator, |aspirin |325mg, |establish |IV |with |normal |saline |slow |drip, |morphine |2-4 |mg |every |5-10 |min
Symptoms |of |heart |attack |- |correct |answer |-Chest |pain, |anxiety, |weakness, |sweating, |cardiac |dysrhythmias, |drop |in |blood |pressure.
Black |- |correct |answer |-Nitrogen
Yellow |- |correct |answer |-Compressed |air
Topical |anesthetics |- |correct |answer |-Benzocaine |and |lidocaine.
Treatment |for |angina |attack |- |correct |answer |-100% |O2 |via |mask, |nitroglycerin |under |tongue | 3 |times |every | 5 |min, |if |not |relieved |by |third |dose |pt |is |having |a |heart |attack, |monitor |pt, |loosen |tight |clothing, |put |pt |in |comfortable |position.
Hypnosis |- |correct |answer |-Loss |of |consciousness. |Patients |want |to |lose |consciousness |and |feel |that |they |are |asleep. |(Propofol, |brevital)
Relaxation |and |immobility |- |correct |answer |-Essential |for |patient |to |be |relaxed |and |immobile |during |procedure. |(Versed, |Propofol, |brevital, |ketamine)
Treatment |for |hyperventilation |- |correct |answer |-Terminate |treatment |and |remove |foreign |bodies |from |mouth |and |surgical |instruments |from |sight, |maintain |airway, |verbally |calm |patient, |monitor |vitals, |NO |O2, |have |pt |breathe |into |bag |to |recapture |CO2. |
Advanced: |IV |versed, |Valium, |Propofol, |continue |to |monitor |vitals, |discontinue |breathing |bag, |activate |EMS |if |condition |deteriorates.
Gray |- |correct |answer |-Carbon |dioxide
Hypercarbio |- |correct |answer |-Increased |CO2 |levels
Treatment |for |emesis |with |aspiration |- |correct |answer |-Activate |EMS, |keep |IV, |100% |O2 |via |bag/mask, |turn |patient |on |right |side |with |head |down |(tredelenburg), |tonsil |suction, |removal |of |visible |foreign |bodies, |intubation, |transport |to |care |facility.
Scavenging |system |- |correct |answer |-Reduces |levels |of |noxious |agents |to |acceptably |low |levels |by |exhausting |then |outside |operating |room.
Ventilator |- |correct |answer |-Breathes |for |patient. |Using |bellows |type |apparatus |with |positive |and |negative |pressures |to |move |gases |in |and |out |of |lungs.
Vaporizer |- |correct |answer |-Facilitates |the |conversion |of |liquid |anesthetic |agents |to |gases |suitable |for |delivery.
Anesthesia |machines |- |correct |answer |-Provides |O2 |and |NO2 |to |the |patient. |The |flow |meter |determines |ratio |and |rate |at |which |gases |are |delivered.
Typical |GA |regimen |- |correct |answer |-Consists |of |anxiolytic, |narcotic, |and |IV |anesthetic |agent.
Capnography |- |correct |answer |-Monitoring |the |patients |CO2 |in |expired |air
Halogenated |hydrocarbons |- |correct |answer |-Inhalation |agents |that |come |in |liquid |form |and |are |poured |into |vaporizers |that |allow |for |controlled |evaporation |and |release |for |administration |of |gas. |Sevoflurane, |desflurane, |isoflurane.
Non |de |polarizing |agents |- |correct |answer |-Used |for |long |procedures. |Their |mode |of |action |is |to |block |acetylcholine |receptors |at |neurotransmitter |junction |causing |prolong |muscle |relaxation. |(Rocuronium, |curare, |pavulon)
Anticholinesterases |- |correct |answer |-Reverse |effects |of |depolarizing |agents |(muscle |relaxers)
