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60 Cards in this Set

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Describe the pathophysiology fo anaphylactic shock?
An Antigen enters the body, it is attacked by an antibody. In Anaphylaxis, however the Antibody does not destroy the antigen. Instead they react, causing shock. Because a white blood cell called a mast cell releases chemicals, the most important substance is histamine. Histamine cuase Severe Bronchoconstriction/spasm (airway compromise) Intense vasodilation, leaking fluid from vessels due to change in permaebility, and reponses can range from milde to extreme, Death.
Anaphylaxis?
A severe allergic reaction; may cause breathing difficulty, circulatory problems, and ultimately, shock.
Antigen?
A Foreign Substance.
Antibody?
A substance in the body that functions to destroy foreign substances.
Mast Cell?
A specialized white blood cell that releses histamine into the body.
Histamine?
Released into the body during anaphylactic shock; may cause airway comprommise and vasodilation.
List common signs and symptoms of anaphylactic shock?
Sense of Uneasiness or agitation, first noticed by patient.

Swelling of soft tissues (hands, tongue, pharynex

Skin flushing with hives

Coughing sneezing,
Wheezing - upper and lower airway spasms, rales, rhonchi, no breath sounds.

Abdominal Pain

Tachycardia

Weak, thready pulse,
Describe the treatment of anaphylaxis?
Aggressive airway management
Ventilatory support
O2
Circulatory support
IV large-bore
Epi-pen if patient has one
reassureance to the patient
position of comfort
Asthma?
A common respiratory disease that causes sufferers to experience acute airflow obstruction in the lower portion of the airway.
Describe the pathophysiology of asthma.
involves the lowwer airway, beyond the level of the trachea and minstem bronchi. It occurs when the bronchial airways narrow and make breathing difficult.
Describe the signs and symptoms of asthma and list those that indicate a very serious condition.?
Sitting upright, tripod position, using accessory muscles to breathe.

Short of breath
Wheezing abnormal sounds
Hyperinflated chest
Coughing
Tachycardia
Hypertension
Tachypnea
Cyanosis
Decreased O2 sat
Answers short sentences

For Severe -
Altered Mental Status
Silent Chest, no air moving
Marked Diaphoresis
Cyanosis.
Too Tired to breathe anymore
Identify the treatment for a patient experienceing an acute asthma attack.
Combitube them
Reassure patient
Provide O2 if in distress
Position of comfort
Timely transport
IV lifeline
Assist with Medicanes if Medical Direction approves.
Status Asthmaticus?
Is a severe prolonged asthma attack that does not respond to standard medications. Its onset may be sudden or insidious and is frequently precipitated by Viral Resp. infection. Rapid Transport.
Chronic Obstructive Pulmonary Disease
(COPD)
A respiratory disease that causes decreased inspiratory and expiratory function.
List 3 priorities of care for COPD?
Transport in sitting position
Give O2 per protocol
Loosen restrictive clothing
Encourage the patient to cough up secretions.
Start IV at TKO rate
Administer Nebulized bronchodilator as per local protocol.
Hyperventilation
Is a respiratory rate greater than that required for normal body function.
Hyperventilation causes an excessive elimination of carbon dioxide.
Identify 5 conditions that may cause hperventilation?
Asthma Attack
COPD
MI
Pulmonary embolism
Spontaneeous pneumothorax
Congestive heart failure
others.
Describe the care given to patients who hyperventilate?
Assume that there is an underlying medical cause of hyperventilation.
Give O2 -Nasal/Non-rebreather
Control breathing/calm patient.
If Chest Pain, EKG/IV
Transport
Recall three patients who are at risk for pulmanary embolism?
Inactive lifestyle - long hospital stays, long trips (car/airplane)
Obesity
Thrombophlebitis, inflammation of the veins
birth control pills
Long bone fracture
Pregnancy
Surgery
Blood diseases
Identify four signs/symptoms of plumonary embolism?
Massive - Cardiac arrest or syncopal spell
Smaller - Sudden unexplained chest pain, with deep breathing, Respiratory distress - Rate increased, Wheezing, coughing up blood, Anxiety, Tachycardia, shock, hypotension
Spontaneous pneumothorax?
is a sudden accumulation of air in the pleural space. Due to a rupture of a weak area on the lung surface.
Describe the mechanism of spontaneous pneumothorax
Due to a ruptured weak are on the lung surface. Air enters the pleural space, the lung on the involved side collapses. Common cause of shortness of breath and chest pain in young individuals, More men then women.
Cerebrovascular accident (CVA)
A stroke - is a condition that results from a disruption of circulation to the brean, causing ischemia and damage to brain tissue.
List 5 signs and symptoms of stroke?
Gradual or rapid onset.

paralysis, usually one side of body affected. Damage to one side of brain affects opposite side of body.

Face droop, sagging muscles beneath eye and cheek, slurred speech, month not working, decreased sensation. Elevated Blood pressure.
Describe the importance of airway management in the stroke patient.
Airway problems are common in stroke; maintain airway and give high flow O2 by nonrebreather.
Transient ischemic attack (TIA)
sometimes called a mini-stroke, is a stroke like neurologic deficit that completely resolves within minutes to hours.
Coma
is a state of unresponsiveness characterized by the absense of spontaneous eye movements and responses to painful stimuli and vocalization. The comatose person cannot be aroused. Describe patient as unresponsive to pain and verbal stimulus.
Five intracranial causes of coma
Intracranial bleeding
stroke
tumor
infection - meningitis, encephalitis
Seizure
Identify five causes of coma that originate outside the nervous system?
Blood chemistry abnormalities
Hypertensive crisis
kidney or liver failure
abnormalitties of the endocrine gland
Vitamin deficiencese
Drugs
Psychiatric problems

Use the AEIOU-TIPS for causes of coma

A-Acidosis, alcohol
E-Epilepsy
I-Infection
O-Overdose
U-Uremia -(kidney failure
T-Trama
I-Insulin
P-Psychosis
S-Shock, stroke
Describe the patient care priorities for Coma?
Airway
O2
C-spine
VS every 5 minutes
suction/vomit/airway
IV, TKO=
Blood sugar
Call ALS
What is seizure?
A sudden, intense episode of heightened electrical activity in the brain.
List four types of seizures?
Grand mal seizures
Focal Motor Seizure
Behavioral seizure
Status epilepticus
Status Epilepticus
A series of seizures with no responsive intervals. Seizures without an interval of wakefulness between them.
Postictal State
A period following a seizure whereby the sufferer gradually returns to a normal state.
FACTS for seizure patient:
F-Focus - Was there a single initiating movement
A-Activitiy - What movements took place during the event?
C-Color - Did patient become cyanotic? Cocaine
T-Time how long did it last
S-Secondary information - before the seizure what happened, Aura? incontinence occure, bite tongue, history of seizures, antiseizure medicine.
Aura
patients will notice the presence of an aura, is a warning sign that consists of seeing, hearing, or smelling somthing unusual before losing responsiveness.
Describe the patient care priorities for seizure-
Airway
Assist ventilation in postictal state
Suction
High-Flow O2
IV afer seizure
bystanders back
transport
List four causes of headache?
brain tumors
Intracranial bleeding
Hypertensive crisis
Meningitis
Poisoning
Gastrointestinal Bleeding?
refers to hemorrhage anywhere in the GI tract from the moutn to the anus
List four causes of gastrointestinal bleeding?
Upper and lower types

Lower GI bleeding results from bleeding due to a lesion of the GI tract below the level of the duodenum.
Diverticulosis, tumors, hemorrhoids, polyps

Upper GI bleeding - Peptic ulcer disease, Gastritis, Esophagitis
Describe the patient care priorities for gastrointestinal bleeding?
Airway
High O2
Care for Shock
IV 500 to 1000 CC bolus
prepare for vomitting/suction
Nothing by mouth
Life-threating
Diabetes Mellitus
A disease whereby an insufficient amount of insulin is produced to regulate blood sugar levels in the body.
Hypoglycemia?
is an abnormally low blood sugar level. Sometimes called insulin shock.
Describe five signs and symptoms of hypoglycemia.
Rapidly, over a few minutes to few hours.

shakiness, weakness
Diaphoresis
Rapids pulse and RR
Altered mental status
Slurred speech
Neurologic deficit
Seizures- unusual in adults more in kids.
Describe the care given to patients with hpoglycemia
Control Airway and assist breathing
Give O2 by nasal 6L
If responsive oral glucose
IV
Blood sugar check
Hyperglycemia
is an elevation of the blood sugar level above normal. The most common cause of hyperglycemia is diabetes.
Diabetic ketoacidosis
is a metabolic condition consisting of hyperglycemia, dehydration and the accumulation of abnormal compounds called ketones and ketoacides in the body.
List five signs and symptoms of diabetic ketoacidosis
slow onset -
Weakness
Nausea and vomiting
Abdominal pain
Frequent urination
Thirst
Rapids, deep sighning repirations
Alterations in the level of responsiveness
A fruity, acetone-like odor to the breath
Normal to decreaed BP
Rapid, weak pulse
Describe the most common presentation of hyperosmolar hyperglycemic nonketotic coma
Over 60
poor health, Nursing home
Over four or five days of being sick
Infectin, extreme cold, dehydration
Describe the care given to patients with hyperglycemia
Airway, O2, Blood sugar, IV, VS and EKG
Identify four routes of exposure to poison?
Ingestion - Month
Inhalation
Absorption
Injection
List four items of information needed when assessing a patient who ingested a poison?
What was taken?
How much was ingested?
When the poisioning occurred?
What if anything, has been done for the patient?
Identify five areas to assess with a poisoned patient?
Pulse, RR, Tempterature, Blood pressure. and body systems
Heat cramps
are cramps and pains in the muscles, expecially the muscles of the abdomen and lower extremities, which occure in hot enviroment. Most common in heat injury syndromes.
Describe care provided for patients with heat cramps, heat exhaustion, and heat stroke.
Cool environment.
sips of cool water
IV 500 to 1000 CC
O2 - 15 L
Transport
Heat exhaustion -
is more severe los of fluid and salt than occurs in heat cramps, ususally follwoing exertion in a hot, humid environment.
Heat stroke -
or sun stroke, a failure of the body's tempterature regulation mechanisms, is an extreme mediacl emergency. Heat stroke develops when the body is no longer able to get rid of heat.
Frostbite
is the formation of ice crystals within the tissues.
List the care for frostbite.
Rule out total body hypothermia, fractures, bleeding and intoxication.
Transport
Protect
Cover with dry sterile dressings
Describe care for hypothermia
Gently handle patient
CPR as necessary, check pulse a long time.
02 high flow
warm fluids
IV - warmed to 104
Dress and protect Frostbite
Remove wet clothes
warming protocels.