Zach EMT-B Exam 4

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Zach EMT-B Exam 4
2010-04-04 21:19:40
Zach EMT B

Zach EMT-B Exam 4
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  1. Drug Card - Epinephrine
    • Classification: Sympathomimetic; Endogenous Catecholamine
    • Action: Alpha 1: Vasoconstriction Beta 1: Increased rate, conduction, contraction, workload, v-fib threshold, irritability. Beta 2: Stimulate respiration, bronchodilator
    • Indications: Anaphylaxis, asthma
    • Contraindications: None when used in life threatening condition
    • Side effects: Tachycardia, palpitations, head ache, nausea, vomiting, anxiety, tremors
    • Dose: 0.3-0.5 mg adult, 0.15 mg child
    • How supplied: 1 epinephrine pen (adult or child)
    • Route: Intramuscular, intravenously
  2. Drug Card - Nebulized Inhaler
    • Classification - Beta 2 agonist - Synthetic Sympathomimetic
    • Action: Broncodilation, relaxation of bronchiole smooth muscle, reduce airway resistance
    • Indication: Relief of bronchospasm (asthma, anaphylaxis, COPD)
    • Contraindications: Not patient's inhaler, excessive tachycardia, already used maximum amount
    • Side effects: Shakiness, headache, tachycardia, anxiety
    • Dose: 90-100 micrograms
    • How supplied: 1 puff of meter dosed inhaler; number of inhalations based on medical direction
    • Route: Inhalation
  3. Drug Card - Glucose
    • Classification: Carbohydrate
    • Actions: Essential for normal metabolism, increases the amount of sugar available for use in the body.
    • Indications: Hypoglycemia
    • Contraindications: Decreased LOC
    • Side Effects: May be aspirated if no gag reflex
    • Dose: One tube
    • How supplied: 15 - 24 grams / tube
    • Route: Buccal
  4. Define palpitations
    Awareness of one's own heartbeat
  5. What are the three kinds of shock?
    • Compensating
    • Decompensating
    • Irreversible
  6. What happens during compensating shock?
    • Blood returns to the five major organs for survival.
    • -Heart
    • -Brain
    • -Lungs
    • -Liver
    • -Kidneys
    • Tachycardia - 120
    • Increased respirations
    • Pallor
    • Diaphoresis
    • Slow CR
    • Altered LOC
    • General Weakness
    • Poor Peripheral Pulses
    • Cool extremities
    • Dilated Pupils
  7. What happens during decompensating shock?
    • The blood is removed from the kidneys, liver, and brain
    • Mentations decreased
    • Hypotension
    • Tachycardia - 130-140
    • Decreased urine output
  8. What happens during Irreversible shock?
    • Bradycardia
    • Systole under 60
    • Death
  9. Define ergophobia
    The fear of work
  10. Define poison
    Any substance that is taken into the body that interferes with normal body function
  11. Define substance abuse
    The deliberate, persistent, and excessive self-administration of a substance in a way that is socially or medically not approved
  12. Define phobia
    An irrational and constant fear of a specific activity, object, or situation
  13. Define Obsessive Compulsive Disorder (OCD)
    Recurring thoughts, impulses, or images that causes the person anxiety or rituals or behavior
  14. Define sympathomimetic
    A toxidrome that mimics the sympathetic nervous system
  15. What is narcan?
    A narcotic agonist
  16. Define opiate
    A substance derived from the opium plant
  17. Define depression
    A state of mind characterized by feelings of sadness, worthlessness, and discouragement
  18. Define hemaphobia
    The fear of blood
  19. Define behavior
    The way in which a person acts or performs
  20. Define paranoia
    A mental disorder characterized by excessive suspicion or delusions
  21. Define Withdrawl
    The condition produced when an individual stops using or abusing a drug to which she is physically or psychologically addicted
  22. Define bipolar
    A condition characterized by extreme changes in mood, energy, thinking and behavior. Patients cycle through periods of high energy (manic) and major lows (depression)
  23. Define hallucations
    Patient sees, hears, or feels things others cannot; can be disproved
  24. Define enetophobia
    The fear of needles
  25. Define tolerance
    When an individual requires progressively larger doses of a drug to achieve the desired effect
  26. Define iatrophobia
    The fear of doctors
  27. Define toxidrome
    Signs, symptoms, and characteristics that often occur together in toxic exposures
  28. Define panic attack
    An intense fear that occurs for no apparent reason
  29. Define delusions
    False beliefs in spite of evidence to the contraty noited in schizophrenia
  30. Define schizophrenia
    Schizophrenia is a mental disorder that makes it difficult to tell the difference between real and unreal experiences, to think logically, to have normal emotional responses, and to behave normally in social situations.
  31. Define claustrophobia
    The fear of enclosed spaces
  32. Define socialphobia
    The fear of people
  33. Define anxiety
    State of worry or agitation
  34. Define agoraphobia
    The fear of open spaces
  35. Define overdose
    An intentional or unintentional overmedication or ingestion of a toxic substance
  36. Define hallucinogen
    A group of agents that alter a person's perception of reality
  37. Define addiction
    A psychological and physical dependence on a substance that has gone beyond voluntary control
  38. Define antidote
    A substance that is given to a patient that has to ability to counter the effects of a toxin
  39. Define prolapsed cord
    A presentation of the umbilical cord prior to delivery
  40. Define APGAR
    A scale to determine the wellness of a newborn instant at 1 and 5 minutes
  41. Define perineum
    The area between the vagina and anus
  42. Define crowning
    Bulging or the baby's head beginning to emerge from the birth canal
  43. Define breeched birth
    When the baby's butt or feet come out of the uterus first
  44. Define gravida
    The number of pregnancies a woman has gone through
  45. Define para
    The number of successful pregnancies (live births) a woman has gone through (20+ weeks)
  46. Define abruptio placenta
    Occurs when a normally implanted placenta separates prematurely from the wall of the uterus prior to delivery
  47. Define menstruation
    The periodic discharge of blood and tissue from the uterus
  48. Define meconium
    The baby's first stool while in utero
  49. Define placenta previa
    The partial or complete covering of the cervix by the placenta
  50. Define ectopic pregnancy
    Pregnancy occurring when a fertilized egg implants outside the uterus
  51. Define eclampsia
    Seizure phase of preeclampsia
  52. Define acrocyanosis
    Cyanosis noted on the extremities of a newborn
  53. Define fallopian tubes
    Either a pair of tubes that receives and transports the egg from the ovary to the uteus, where an ectopic pregnancy may occur
  54. Define delivery
    Birth of the baby at the end of the second stage of labor
  55. Define preeclampsia
    Condition of high blood pressure and swelling during pregnancy
  56. Define abortion
    Termination of pregnancy before the fetus is able to live on its own outside the uterus
  57. Define vagina
    The birth canal
  58. List 4 routes of exposure for a poison.
    • Ingestion
    • Inhalation
    • Absorption
    • Injection
  59. List 5 sources of common poisonings.
    • Ethanol
    • Acetaminophen
    • Carbon monoxide
    • Acetylsalicylic acid
    • Household products;
    • Drugs of abuse
    • Bites
    • Stings
  60. List six signs and symptoms of a patient experiencing an exposure to carbon monoxide.
    • Headache
    • Confusion
    • Nausea
    • Vomiting
    • Irritability
    • Loss of coordination
    • Cardiac disturbances
    • Seizures
    • Coma
    • Death
  61. List 5 signs and symptoms of a patient who has taken an overdose of aspirin
    • Abdominal pain
    • Nausea
    • Tinnitus
    • Hyperventilation
    • Hyperpnea
    • Altered mental status
    • Pulmonary edema
  62. List two types of stimulants a person would take
    • Cocaine
    • Amphetamine
    • Methamphetamines
  63. List eight signs and symptoms of a patient with a stimulant toxicity
    • Hypertension
    • Diaphoresis
    • Restlessness
    • Dilated pupils
    • Seizures
    • Arrhythmias
    • Hyperthermia
    • Euphoria
    • Anxiety
    • Paranoia
    • Agitation
    • Delirium
    • Tachycardia
  64. List 4 types of opiates a patient may take
    • Heroin
    • Morphine
    • Codeine
    • Hydrocodone
    • Oxycodone
    • Fentanyl
    • Meperidine
  65. List six signs and symptoms of a patient who has an opiate toxicity
    • Sleepiness
    • Respiratory depression
    • Constricted pupils
    • Vomiting
    • Coma
    • Respiratory arrest
  66. List six common clinical effects of poisons
    • Coma
    • Seizure
    • Agitation
    • Hypoglycemia
    • Hypotension
    • Hypertension
    • Bradycardia
    • Tachycardia
  67. List five questions to ask for a suspected overdose or poisoning
    • Chief complaint?
    • Substance?
    • How long ago was the exposure?
    • How much did you ingest?
    • How long were you in environment?
    • How long was contact with skin?
    • What have you done so far to treat poisoning?
    • Have you called poison control center?
  68. List 3 physiologic changes that occur in a pregnant patient
    • Increased HR
    • Increased RR
    • Increased blood volume
    • Decreased BP (2nd trimester)
  69. List 3 signs and symptoms of a patient having a miscarriage
    • Cramping
    • Vaginal bleeding
    • Passage of tissue
  70. List 3 interventions for a patient who has had a miscarriage
    • Oxygen
    • Trendelenburg position
    • Keep warm
    • Transport tissue
    • Consider ALS
    • Rapid transport
  71. List 4 signs and symptoms of a patient with pregnancy induced hypertension
    • HA
    • Peripheral edema
    • Abdominal pain
    • Nausea
    • Vomiting
    • Visual changes
    • Hypertension
  72. Briefly describe the three stages of labor
    • Stage 1 – from contractions to full dilation
    • Stage 2 – from full dilation to delivery of fetus
    • Stage 3 – from delivery of fetus to delivery of placenta
  73. List 5 questions to ask a pregnant patient who is in labor
    • Have your waters broken
    • Is this your first pregnancy
    • How frequent are your contractions
    • How long are your contractions lasting
    • Have you had prenatal care
    • Do you feel the need to push
    • What is your due date
    • Could you be having multiple births
    • Are you bleeding or do you have discharge
  74. List 5 items you need in an OB kit.
    • Towels
    • Blankets
    • Bulb syringe
    • Cord clamps
    • Gauze sponges
    • Scissors
    • Container for placenta
  75. List the first six steps of care you would provide for a newborn
    • Dry
    • Warm
    • Position
    • Suction
    • Stimulate
    • Oxygen
  76. List what is noted in the APGAR score, when it is taken and what the scoring system is.
    • Check at 1 and 5 minutes
    • Appearance – 2 all pink, 1 pink core blue extremities, 0 all blue
    • Pulse - 2 > 100, 1 < 100, 0 absent
    • Grimace - 2 strong cry and cough, 1 weak cry and cough, 0 no response
    • Activity - 2 Active, 1 some flexion, 0 limp
    • Respirations - 2 good no effort, 1 slow increased effort, 0 absent
  77. List 4 ways heat is lost.
    • Convection
    • Conduction
    • Radiation
    • Evaporation
    • Respiration
  78. List 4 signs and symptoms of a patient exhibiting hypothermia
    • Core temperature: 89.6° to 95°F, Shivering, cold skin, poor judgment, difficulty speaking, difficulty walking, apathy
    • Core temperature: 78.8° to 89.6°F, Shivering stops, ↓ LOC, ↓ HR, irregular rhythm (A fib), ↓ respirations, ↓ pupillary response, rough handling, including bumping & jarring can lead to V fib
    • Core temperature: <78.8°F, Reflexes absent, no response to pain, nonreactive pupils, bradycardia progresses to asystole, tissues stiff & cold, pulse & respirations may be undetectable
  79. List 5 treatments for a patient with hypothermia
    • Airway
    • Breathing
    • Circulation
    • Remove from environment
    • Prevent further heat loss
    • Warmed, humidified oxygen
    • Warm packs
    • Verify pulselessness for 1 minute
    • Limit defibrillation
    • Hypothermic patients are not dead until they are warm & dead!
    • Handle very gently to avoid V fib
    • Warm packs can be applied to the armpits and groin
  80. List 6 signs and symptoms of a patient with heat exhaustion
    • Skin pale
    • Cool
    • Clammy
    • Goose bumps
    • Dizziness
    • Headache
    • Syncope
    • Nausea
    • Fatigue
  81. List four signs and symptoms of a patient with heat stroke
    • Disorientation
    • Incoherence
    • Confusion
    • Red, hot, dry skin
    • ↑ Respirations
    • ↑ HR
  82. List 5 treatment s for a patient with a heat emergency
    • Remove from source
    • Remove clothes
    • Cover with cool moist sheet
    • Oxygen
    • Small sips of water
    • ALS rendezvous
  83. List 4 problems that may be included in mental illness.
    • Changes in sensory perception
    • Thought disturbances
    • Paranoia
    • Depression
    • Psychosis
  84. List 4 causes that may lead to behavioral emergencies
    • Psychological
    • Medical
    • Intracranial
    • Infectious
    • Metabolic
    • Psychosocial
    • Situational
    • Alcohol & drug abuse
  85. List 6 points to consider when assessing a patient with a behavioral problem
    • Observe patient from door
    • Note – Posture – Speech -Possession or access to weapons
    • Any object can become a weapon if patient feels threatened
    • Watch patient for changes as you approach
    • Some patients want and will accept help; others may feel threatened by your approach
    • Use a slow, calculated approach
    • Always have path to exit
    • Introduce yourself and other responders
    • Establish rapport
    • Treat any medical condition
  86. List 4 calming or crisis management techniques to use with a patient having an emergency
    • Anticipate changes in scene safety
    • Enlist law enforcement as needed
    • Designate 1 person to have patient contact
    • Speak in slow, relaxed tone
    • Do not insult or antagonize
    • Do not go along with hallucinations or delusions
    • Use restraints only as last resort
  87. List 6 signs and symptoms of a patient experiencing severe depression
    • Depressed mood
    • Loss of interest in activities
    • Weight loss/gain
    • Sleep disturbances
    • Agitation
    • Fatigue
    • Feelings of worthlessness
    • Inability to concentrate
    • Recurrent thoughts of death
  88. List 6 general treatments for a patient with a behavioral emergency
    • Scene safety
    • Be calm and reassuring
    • No sudden movements
    • Communicate clearly
    • Introduce yourself
    • Talk to the patient not family members or bystanders
    • Don’t play into delusions or hallucinations
    • Assess VS
    • O2 as needed
    • Transport
    • Restrain as needed
  89. List ten causes of AMS
    • Cerebrovascular accident (CVA)
    • Hypoglycemia
    • Hyperglycemia
    • Transient ischemic attack (TIA)
    • Seizure
    • Hypoxia
    • Drugs
    • ETOH
    • Environment
    • Uremia
    • Trauma
    • Tension pneumothorax
    • Tumor
    • Infection
  90. List five actions that should be done all patients with AMS
    • Position
    • Airway
    • Oxygen
    • Keep warm
    • Rapid transport
    • Consider ALS
    • Blood glucose
  91. Differentiate between altered and Decreased LOC
    • Altered is a pt is conscious, however disoriented
    • Decreased patient drops to the AVPU scale
  92. List the three components of the GCS and break down the score for each part
    • Eyes : A-4 V-3 P-2 U-1
    • Verbal: oriented – 5 disoriented – 4 inappropriate – 3 incomprehensible – 2 none - 1
    • Motor: obey – 6 localizes pain – 5 withdraw – 4 decorticate – 3 decerebrate – 2 none - 1
  93. List the three types of diabetic emergencies you may see and a brief description of each
    • Hypoglycemia – Low blood sugar, need glucose
    • Diabetic Keto Acidosis (DKA) – Excessive sugar in the blood, inability to move into cells due to lack of insulin, ketones
    • Hyperglycemic hyperosmolar nonketotic coma (HHNC) – Excessive sugar in blood with minimal movement of sugar in cells, no ketones
  94. List five signs and symptoms for a pt with hypoglycemia and DKA.
    • Hypoglycemia – Pale; diaphoretic; low glucose; altered LOC; seizures; incontinence; normal pulse; normotensive; sudden onset; may be confused with
    • DKA – poyuria; polyphagia; polydipsia; kussmauls; acetone breath; altered or decreased LOC; hypotension; abd pain; nausea; vomiting; tachycardia
  95. List three types of seizure a pt may develop and a brief description of each.
    • Absence – A loss of awareness, may not lose consciousness
    • Focal – One part of the body is seizing IE- arm-leg-eye
    • Generalized – Full clonic tonic activity, total body activity
  96. Differentiate between the two types of CVA
    • Ischemic – Blockage of artery from a blood clot or clot other than blood
    • Hemorrhagic – A blood vessel in the brain ruptures
  97. List ten signs and symptoms noted in a pt experiencing a CVA
    • Hemiparesis
    • Hemiplegia
    • Hypertension
    • Headache
    • Weakness
    • Dizziness
    • Pupil changes
    • Incontinence
    • Seizures
    • Parasthesia
    • Facial droop
    • Dysphasia
    • Aphasia
    • Positive stroke scale
  98. List 5 specific interventions for a pt exhibiting signs and symptoms of a critical hemorrhagic CVA
    • High fowlers position
    • Maintain airway
    • High flow oxygen
    • Rapid transport
    • ALS rendezvous;
    • Assessment and reassessment
  99. Briefly describe the difference between resistance and compliance issues.
    • Resistance is a situation that inhibits airflow : IE – obstruction; anaphylaxis; croup
    • Compliance is a situation that inhibits exchange of gases at the alveoli: IE: asthma; pulmonary edema; pneumonia
  100. List ten signs and symptoms of a patient in respiratory distress or failure.
    • Restlesness
    • Anxiety
    • Altered or decreased LOC
    • Tachycardia
    • Bradycardia(late sign)
    • Tachypnea
    • Bradypnea
    • Skin color changes
    • Abnormal BS
    • Poor phonation
    • Accessory muscle use
    • Position
    • Pursed lips
    • The “O” sign
  101. List five respiratory problems a patient may present with.
    Obstruction; asthma; emphysema; chronic bronchitis; pulmonary edema; pulmonary embolism; pneumonia; hyperventilation; anaphylaxis; spontaneous pneumothorax
  102. Briefly describe asthma and five specific triggers.
    • Hyper-reactive airway disease that leads to bronchoconstriction
    • Increased edema
    • Excessive mucous plugging
    • Anxiety
    • Stress
    • Exercise
    • Aerosols
    • Smoke
    • Temperature
    • Dander
    • Dust
    • Pollen
    • Medications
  103. Briefly describe emphysema and four signs and symptoms noted with a patient.
    • Damage to the alveoli causing a loss of elasticity(atelectasis) leading to decrease in gas exchange
    • Pursed lip breathing (building PEEP)
    • Barrel chest
    • Thin
    • Shallow rapid resp
    • Poor color
    • Low oxygen saturation
  104. Briefly describe chronic bronchitis and four signs and symptoms noted with a patient.
    • An excessive secretion of mucous that leads to poor exchange and a chronic cough;
    • Cyanotic
    • Right heart failure
    • Chronic cough
    • Low oxygen saturation
    • Dyspnea
    • Tachypnea
    • Hypopnea
  105. Briefly describe pulmonary edema and four specific signs and symptoms to pulmonary edema
    • A build up of fluid in the alveoli due to left heart failure causing a decrease in exchange of gases
    • Frothy sputum(hemoptysis)
    • Pallor
    • Cyanosis
    • Tachypnea
    • Wet lung sounds
    • Orthopnea
    • Paroxsysmal nocturnal dyspnea
  106. Briefly describe anaphylaxis and four specific treatments for the patient.
    • A situation where an antigen (invader in the body) leads to a build up of antibodies to identify it. If and when it happens again it triggers a response that causes increased edema and bronchoconstriction in the airway. Leads to circulatory collapse and death if not relieved
    • BVM
    • Assist with an epi-pen
    • Call for ALS transport
    • Rapid transport
    • High flow oxygen
  107. Define antigen.
    Substance that immune system recognizes as foreign and induces sensitivity and the immune response system
  108. Define antibody
    A substance that initiates sensitization and then detects, locates and destroys antigens with chemical mediators
  109. Define allergic reaction
    • An initiation of the immune system that leads to specific signs and symptoms due to chemical mediator release
    • List 4 differences between allergic reaction and anaphylaxis
    • Allergic reaction - hives; itching; edema; redness; lacrimation; S.O.B.
    • Anaphylaxis - altered or decreased L.O.C.; hypotension; angioedema; stridor; wheezes; tachycardia; respiratory distress or failure
  110. List four specific treatments for a patient experiencing an asthma event.
    • High flow oxygen
    • Vital signs
    • Rapid transport
    • Assist with inhaler
    • Assessment
  111. Define poyuria
    The excessive passage of urine
  112. Define polyphagia
    Excessive eating or desire for food
  113. Define polydipsia
    Excessive thirst
  114. Define kussmauls respirations
    Deep and labored breathing pattern often associated with severe metabolic acidosis, particularly diabetic ketoacidosis (DKA) but also renal failure. It is a form of hyperventilation, breathing which is increased above the normal rate.