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131 Cards in this Set

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acute asthma attack
anxiety, wheezing (bronchospasm on exhalation) and mucus plugging, tachypnea and tachycardia, dyspnea and possible chest discomfort, accessory muscle use, forcing each breath out, coughing
COPD- emphysema
anxiety and tripod position, dyspnea (trouble getting air IN), pursed lip breathing, accessory muscle use, rhonchi or wheezes, prolonged expiratory phase (forcing breath OUT), cyanosis or ruddines, barrel chest
pulmonary edema
starts as mild or pronounced agitation, tachycardia, pale/cool/clammy skin, persistent cough - usually non-productive, wheezes or crackles,
pulmonary embolous
sudden and dramatic onset of agitation and apprehension, sudden and dramatic hyperventilation, dyspnea with congestion and SOB, pleuritic chest pain- sharp and sudden on inhalation, tachypnea and tachycardia, hemoptysis, cyanosis, crackles, calf or leg pain
pneumonia
hx of upper respiratory infection, fever, productive cough (rhonchi) often with greenish or rust colored mucus, possibly wheezes, chest discomfort or pain
flu (influenza)
sudden onset of fever and chills (102-104), general malaise, feel to lousy to function (3-4 days of extreme fatigue), severe headache with photophobia and eye ache, severe muscle aches (back and legs), cough (possibly with substernal bleeding), lasts 3-7 days
hyperventilation syndrome
severe anxiety/agitation/fright, hyperventilating, progressive S/S of alkosis; light headiness and dizziness, numbness and tingling around the mouth, tightness in the chest, complaint of not being able to get breath, muscle twitching, carpal/pedal spasms, tetany, seizures, LOC
epiglottitis
fever, sore throat (dysphagia and drooling), dyspnea, accessory muscle use, coughing
pleurisy
pleuritic chest pain (sharp, stabbing, on inhalation), cough, hx of URI
adult respiratory distress syndrome (ARDS)
dyspnea and tachycardia, crackles
angina pectoris
P- exercise, activity, stress Q- feels like pressure, chest tightness, weight on the chest, burning R- felt substernal or epigastric, may radiate to jaw, neck or left arm S- mild or moderate pain or discomfort T- sudden onset usually lasts 3-5 minutes... dyspnea, diopheresis, N/V, belching
myocardial infarction
P- exercise, activity or stress, may be no provoking factor Q- feels like pressure, chest tightness, burning, weight on chest R- felt substernal or epigastric, may radiate to jaw, neck or left shoulder/arm S- moderate or severe pain or discomfort T- sudden onset, usually lasts 30 min or longer... N/V, diopheresis (soaking wet), weakness or light-headiness, irregular pulse, dyspnea, orthopnea, denial
CHF (left sided)
slow onset over several days but may not be noticed until acute, dyspnea, SOB, productive cough, orthopnea, usually found propped up, pulmonary edema
CHF (right sided)
dependent edema (pedal edema), JVD, liver enlargement (ascites)
hypertensive crisis
HTN with angina, pulmonary edema, pregnancy, signs of cerebral edema (severe headache, blurred vision, N/V, altered mental status, focal neurological signs, paresthesias, dizziness, vertigo, tinnitus), epistaxis, chest pain, SOB, abdominal or back pain
hypertensive emergency
pulse that is strong and bounding, tinnitus, headache, epistaxis, N/V
dissecting aortic aneurysm
P- lifting heavy weights, straining Q- tearing, hot, knife-like R- pain front anterior chest, boring through to the back S- very severe and hits maximum at time of onset (does not build up) T- sudden onset... unequal left and right radial/femoral pulses, unequal blood pressures
CVA
ALOC (coma, stupor, confusion, seizures, delirium), intense or unusually severe headache and or neck/facial pain, hemiparesis or hemiplegia, ataxia, asymmetry of face (facial drooping), aniscoria, dysarthria, aphasia, dysphasia, incontinence, photophobia, sudden blurred vision, vertigo, N/V, HTN (>140/90)
TIA
ALOC (coma, stupor, confusion, seizures, delirium), intense or unusually severe headache and or neck/facial pain, hemiparesis or hemiplegia, ataxia, asymmetry of face (facial drooping), aniscoria, dysarthria, aphasia, dysphasia, incontinence, photophobia, sudden blurred vision, vertigo, N/V, HTN (>140/90)
grand mal seizure
aura before seizure (odd smell, sound or visual disturbance), tonic/clonic phase (muscle stiffening then spasms), LOC or lack of awareness, tismus, bitting cheek or tongue, incontinence, post-ical phase (relaxation)
gastric ulcer
persistent pain in the upper abdomen (described as burning), pain is somewhat or completely relieved by eating bland foods, hematemesis or melena
abdominal aortic aneurysm
P- lifting heavy weights, straining Q- tearing, hot, knife-like R- pain from anterior abdomen boring through to the back S- very severe and hits maximum at time of onset T- sudden onset... unequal femoral pulses, may have severe signs of shock
appendicitis
fever, anorexia, N/V, sharp right lower quadrant pain, guarding, rebound tenderness (increased over several hours)
esophageal varices
massive hematemesis, dramatic hemoptysis, hypovolemia
gallbladder inflammation (cholecystitis)
hx of recent ingestion of a meal with a lot of fat, gradual onset of sharp pain in RUQ (possibly right shoulder), possible N/V
kidney stones
tremendous pain in lower quadrants radiating in pulse-like waves from rear flank downward, anxiety, N/V, hematuria
bowel obstruction
crampy pain in abdomen -in spasms, abdominal distention, anorexia, N/V, fever
chronic liver disease (hepatitis)
jaundice, ascites, pedal edema, muscle atrophy, decreased clotting, petechai, varicose or spider veins
pancreatitis
sudden onset of severe LUQ epigastric pain- steady boring through to the back- may radiate to left shoulder, usually hx of alcohol abuse, abdominal distention or tenderness, N/V, may develop shock
irritable bowel syndrome
abdominal pain, cramping, gas, bloating, diarrhea or constipation, described as "worse than child birth", sudden knife-like pain that doubles pt over
diverticulitis
LLQ abdominal pain, fever, vomiting, constipation
hyperglycemic crisis (diabetic coma)
gradual onset often over several days, flush/dry/warm skin, mild fever, intense thirst and dry mouth, weak tachycardia, hypotension, rapid-deep sighing breathing (kussmal respirations), fruity or sweet smelling breath (acetone- ketoacidosis), decreased LOC- gradual onset of restlessness-stupor-confusion- eventual coma- feels weak and sleepy, N/V, abdominal pain, anorexia, blurred vision
hypoglycemic crisis (insulin shock)
sudden onset (often too fast to react), pale/cool/wet skin (often soaking wet), full strong tachycardia, weakness or dizziness, agitated- restless- uncooperative -abnormal behaivor- syncope- ALOC
anaphylaxis
tachypnea, tachycardia, hypotension, red or pale itchy raised skin (bull's eye), dyspnea, wheezing or stridor (from bronchospasm or laryngospasm), respiratory distress, signs of hypovolemia
bee sting (anything from the hymenoptera family)
pain and localized swelling, redness, "bull's eye" mark, itching, watch for airway swelling
staph food poisoning
onset 1-6 hours after ingestion, VIOLENT onset of N/V/D and abdominal pain
salmonella food poisoning
onset 12-72 hours after ingestion, VIOLENT onset of N/V/D and abdominal pain, transmission animal to human from fecal matter
shigella
onset 1-2 days, duration 4-7 days, acute bloody diarrhea
e coli
onset 1-3 days, acute watery diarrhea (usually without fever) lasts 3-7 days
botulism food poisoning
onset 12-36 hours, N/V/D, abdominal cramping, pressing to paralysis, respiratory depression, paresthesias, bronchospasm, cranial nerve weakness
poison oak dermatitis
delayed onset (some blisters appear after 12 hours then gradually increase), intense itching then leading to scratching or scarring, small fluid filled vesicles appear which break and leak serum
antidepressants
decreased LOC, seizures, cardiac dysrhythmias
beta blockers
cardiac dysrhythmias (brady usually), hypotension, bradycardia, cardiac arrest
narcotics/opiates
decreased LOC, respiratory depression, hypoventilation, hypotension, N/V
depressants
decreased LOC, respiratory depression, hypoventilation, loss of muscle coordination, dysarthria, nystagmus, bradycardia, hypotension
stimulants
increased LOC (agitation, anxiety, restlessness, paranoia), tachycardia, hypertension, rapid speech, dilated pupils, seizures- muscle twitching, tremors, chest pain
hallucinogens
ALOC, blank stare, aggression, anxiety, agitation, paranoia, inappropriate behavior, tachycardia/hypertension, visual hallucinations, seizures, nystagmus, hot flashes
hydrocarbons/ solvents
ALOC, blank stare, CNS depression, coughing, choking
alcohol withdrawal syndrome
ALOC, hallucinations (ants crawling on skin), insomnia or nightmares, pale/cool/clammy skin (goose bumps), tremors (delirium tremors), tachycardia, seizures
aspirin
tinnitus, N/V, pain and cramping in severe overdoses, hyperventilations, LD50 = 95 tablets
tylenol (acetaminophen)
onset 3-7 days, malaise, anorexia, cyanosis, acute liver failure, LD50 = 40-75 tablets
toxic inhalations
dyspnea, tachypnea, N/V, ALOC, airway irritation, wheezing or crackles, sore throat, cough
smoke inhalations (toxic gases)
dyspnea, tachypnea, cough, stridor/wheezes/ crackles, watery irritated eyes, signed facial hairs (eyebrows and nasal hairs)
carbon monoxide inhalations
rapid headache seems "out of nowhere", ALOC- confusion - coma, N/V, dyspnea-tachypnea- tachycardia, flushed skin, dizziness
cyanide gas inhalations
sudden onset within minutes on inhalation, pt becomes rapidly unconscious (often falling), respirations are rapid and convulsive at first- then slow and gasping, hypotension, seizures, incontinence, cardiovascular collapse
chlorine gas inhalations
instant onset of burning in the lungs, dyspnea, tachypnea, severe cough, abnormal breath sounds, watery irritated eyes
organophosphates
Constricted pupils, Diarrhea, Urination/incontinence, Muscle weakness/trembling/ataxia, Bradycardia/hypotension, Bronchospasm-possible wheezing, Bronchorrhea-lots of mucus, Emesis/ N/V, Lacrimation- tearing of eyes, Sweating and flushed skin, Salivation/drooling/dysphagia, Seizures, GI cramping (C-DUMB BBELSSS-G)
pelvic inflammatory disease (PID)
tremendous pain in lower quadrants, often have fever, anxiety/restlessness, N/V, abnormal vaginal discharge
ectopic pregnancy
abrupt onset of severe tabbing pain in the lower quadrants, abdominal distention, guarding, rigidity, may not know she is pregnant, S/S of shock, N/V, vaginal bleeding (spotting)
contusion
discoloration (capillary bleeding or bruising), pain or tenderness, some swelling
hematoma
usually some swelling- pronounced bump, discoloration, pain/tenderness
abrasion
small amounts of blood loss with large amounts of tissue damage
puncture
usually very little external blood loss, but may be significant internal bleeding
avulsion
torn or ripped off piece of skin, considerable blood loss but vessels pinch off quickly
incision
cut will be smooth minimal bleeding
laceration
cut will be rough with lots of bleeding
evisceration
will notice internal organs located outside of the body
larynx/ trachea fracture
obvious signs of injury, edema, hoarseness, stridor, subcutaneous emphysema
compartment syndrome
pallor, paralysis, pulseless, paresthesias, pain on having their limb stretched (passive stretch)
airway burns
burns around the face/mouth, singed facial hairs- eyebrows- eyelashes- nasal hairs, productive cough (sooty sputum), hoarseness when pt tries to talk, dyspnea, dysphagia, hx of burn inside an enclosed area,
thermal burns
IMMEDIATE respirator burns (most frequent cause of death), smoke or toxic gas inhalation, hypothermia LATER hypovolemia, infections, kidney failure, pulmonary edema (non-cariogenic)
concussion
usually temporary LOC followed by a prompt recovery, often pt will complain of headache and light headiness, dizziness, grogginess, N, pt recovery is measured in min-to hours
cerebral contusion
much like a concussion usually more severe and last longer, S/S of ICP, pt recovery is measure in hours to days, may be permanent disability
epidural hematoma
all signs and symptoms of concussion, ALOC with "lucid interval", onset may be delated 1-4 hours, S/S of ICP, usually following linear fx to temporal or parietal bones
subdural hematoma
all signs of concussion, S/S may be delayed 2-4 weeks, S/S of ICP
intra-cerebral hemorrhage
sudden onset of extremely severe headache "worst headache i have ever had", rapid LOC without regaining it (falling out of chair), S/S of ICP
coup- countercoup
S/S of ICP, increased systolic BP, widened pulse pressure, bradycardia (baroreceptor reflex- vagal response), altered/abnormal respiratory patterns, deteriorating LOC, N/V, severe persistent headache, pupillary changes, seizures, brainstem posturing in severe cases
cervical spine trauma
pain (especially on palpation), swelling/deformity at injury site, neck muscle spasms and stiffness, neurological deficits (paralysis, paresthesias, anesthesia)- "sitck em up" position (indicates C6 fx), respiratory compromise, diaphragmatic breathing (sign of fx below C4), neurogenic shock (loss of sympathetic NS- pt lacks common shock signs), incontinence, priapism
rib fracture
sharp-stabbing- pleuritic chest pain thats made worse by inhalation, may have abrasion or contusion (seatbelt), pt will attempt to splint area with his own arm, may be hypOventilating due to pain
flail chest
dyspnea, tachypnea, "floating" chest wall segment (paradoxical chest movement), cyanosis, subcutaneous emphysema,
pneumothorax
dyspnea, tachypnea, diminished breath sounds on one side, sharp- stabbing chest pain
tension pneumothorax
progressive dyspnea, tachypnea, absent lung sounds on affected side (muffled or distant), JVD, narrowed pulse pressure (hypotension), unequal chest expansion on inhalation, tracheal deviation (left or right)
pericardial tamponade (cardiac tamponade)
JVD, dyspnea, narrowed pulse pressure (hypotension), muffled heart sounds (breath sounds would be equal)
myocardial contusion
chest pain, bruising over sternum, dyspnea, tachypnea, dysrhythmia, S/S of shock
commotio cordis
S/S of trauma over sternum, v-fib
pulmonary contusion
chest pain, bruising over the sternum, progressive dyspnea, decreased breath sounds on one side, hemoptysis, dysrhythmia
tracheobronchial rupture/laceration
severe respiratory distress, stridor- hoarseness if able to talk, subcutaneous crackling- sensation to touch (crepitus), decreased or unequal breath sounds, hemoptysis, tachycardia, hypotension, cyanosis
hemothorax
S/S of severe shock, respiratory distress, decreased or absent breath sounds on one side
blunt abdominal trauma
pain and tenderness- often diffuse- sometimes local (point tenderness), abdominal distention, abdominal "guarding"-rigidity, signs of surface wounds (abrasions, discolorations, bruising), N/V, S/S of shock
sprains
may have heard a "snap", pain and tenderness (may prevent walking), swelling, discoloration (often delayed)
strains
may have heard a "snap", pain and tenderness, severe weakness
dislocations
deformity (usually dramatic), pain and tenderness (usually extreme pain), swelling occurs but may take time or be masked by deformity, discoloration (takes time), inability to move joint
fractures
deformity (not always present), pain and tenderness (usually significant), swelling/edema (takes time), discoloration (takes times), CAN be moved, crepitus, pt usually heard it break
hypothermia
MILD- amnesia, dysarthria, poor judgement, stupid (maladaptive) behavior, tachycardia, hyperventilations, ataxia and apathy, SEVERE- stupor, decrease in oxygen consumption, decreased LOC, bradycardia, pupils dilate, v-fib, paradoxical undressing, loss of reflexes and voluntary movement, BP may be undetectable
frostbite
pale, waxy appearing/ cold skin, usually painless (extreme pain if thawing has started), no cap refill, usually also hypothermic
heat syncope
body temp and water/salt balances are normal, brief syncope, fatigue, malaise, drowsiness, headache, confusion, weakness, dizziness, thirst, pale/soaked/ cool skin
heat exhaustion (exercise hypovolemia)
dehydration, low water/salt balance, usually exercising, fatigue, malaise, drowsiness, headache, confusion, weakness, dizziness, syncope, rapid thready pulse, hypotension, pale/soaked cool skin, muscle/abdominal cramps (60% get them), N/V/D, thirst
heat cramps (water toxicity)
usually after exercise, muscle cramps of legs and muscles being used, hx of prolonged heavy exertion in heat, nausea, body temp normal
heat stroke
hot/wet/pale skin (usually sweating after collapse), LOC, altered mental function (bizarre behavior), tachycardia, hypotension, seizures, dilated pupils
near drowning
hx of underwater episode (immersion event), vomiting, apnea and cyanosis, tachypnea, dyspnea, wheezing/ stridor/ crackles or rhonchi, hypothermia, ALOC
air embolism
dizziness, confusion, headache, chest discomfort or pain, dyspnea, neuro deficits (can mimic CVA- ataxia, aniscoria), dysarthria, unconsciousness, seizures or cardiopulmonary arrest
barotrauma
tinnitus or ruptured ear drum, small amounts of blood leaking from ear, epistaxis, coughing up small amounts of blood
decompression sickness
joint pain (may be bent over), paresthesias (diver's itch), headache, general fatigue, malaise (just feels bad), dyspnea, dysarthria, ataxia, N/V, vertigo
acute mountain sickness (AMS)
headache, dyspnea, N/V, anorexia, insomnia
high altitude pulmonary edema (HAPE)
delayed onset usually 1-3 days, dyspnea, SOB (even after rest), persistent cough, usually non-productive but some hemoptysis, crackles, fatigue, tachypnea (>30), tachycardia at rest, hypotension (<106.68)
high altitude cerebral edema (HACE)
delayed onset usually 1-3 days, ataxia (primary identifier, absent in AMS), severe lack of energy (lassitude), drowsiness, stupor, impaired mental function- confusion- hallucinations, focal neurological deficits- facial droop, hemiparesis
black widow spider bite
usually no local reaction, little to no redness or local pain, symptoms usually delayed 30 min to 2 hours, systemic muscle pain and extreme abdominal pain, muscle cramping, chest tightness, dyspnea, abdominal rigidity (board hard), may develop hypertensive crisis
brown recluse spider bite
minimal pain initially, symptoms delayed 2-8 hours, fever/chills, N/V, joint pain, local tissue necrosis- ulceration
scorpion sting
little or no redness, no discoloration, instant onset of severe pain, muscle cramps, paresthesias, muscle twitching, possible seizures, excessive salivation, N/V, hypertensive crisis is possible
jellyfish
instant burning at site, shock is possible but rare
stingray (sculpin, cone shells)
instant burning pain at site, muscle spasms and pain, can cause partial paralysis, shock is possible
rattlesnake bite
puncture wounds (1-4), progressive and rapid swelling in the area, pain in the area, weakness, diopheresis, paresthesias, discoloration below the surface due to bleeding
rabies
incubation 2 weeks to 4 months, hx of animal encounter within that time frame
pregnancy induced HTN (eclampsia)
sudden weight gain, limb edema, HTN, severe headaches, visual disturbances, possibly seizures
supine hypotensive syndrome
hypotension, supine, tachycardia
placenta abruptio
normally implanted placenta (>20 weeks gestation), often associated with PIH, 3rd trimester acute dark vaginal bleeding, uterine tenderness, abdominal pain between contractions, symptoms of shock greater than amount of blood loss, uterus may be too rigid for signs of contraction
placenta previa
sudden 3rd trimester bright red vaginal bleeding, painless - usually not uterine tenderness, usually no contractions, bleeding often occurs in repetitive episodes over days/weeks
delayed delivery
after signs of imminent delivery continue for 20 min with no progress, no crowning or no increase in crowning
prolapsed cord
upon looking for crowning- cord is visible before the baby is born
limb presentation
single arm or single leg is the presenting part
breech presentation
buttocks or legs are the presenting part during labor
premature labor/delivery
onset of labor prior to delivery date, results in delivery of small infant
child dehydration
poor muscle tone- limp, red/warm/ dry skin (could be ashen), poor skin tugor with tenting, dry mucus membranes, sunken fontanels, sunken eyes, decreased urine output, polydipsia, poor or no response to mother
croup (tracheobronchitis)
common in 6 months to 4 y/o, usually a hx of URI with a low grade fever, inspiratory stridor, hoarseness, possible wheezing, "seal bark' cough, severe respiratory distress with accessory muscle use, nasal flaring, retractions and tachypnea
epiglottitis
common in 3-7 y/o, sudden onset of severe respiratory distress, dyspnea, tripod position, stridor, hoarseness (little or no cough), aphagia, high fever, sore throat, tachycardia and tachypnea
foreign body aspiration
severe respiratory distress, use of accessory muscles, nasal flaring, retractions (grunting at the end of each breath), cough, drooling, stridor/wheezing, tachycardia and tachypnea, cyanosis
asthma
severe respiratory distress, use of accessory muscles, nasal flaring, tripod position, severe dyspnea, tachypnea, cough, expiratory wheezing, tachycardia and anxiety, pallor or cyanosis
meningitis
headache, extreme irritability, stiff neck, nuchal rigidity, photophobia, petechial rash (very small flat red marks, looks like measles), ALOC, odd sounding high pitched cry, N/V/D, high fever, tachycardia, tachypnea, febrile seizures
impending respiratory failure
increased respiratory rate and effort- often involving accessory muscles with abdominal breathing, poor muscle tone, diminished breath sounds, decreasing LOC, diminished response to stimuli, cyanosis, infants hearts slow down as they approach respiratory failure
increased intracranial pressure (ICP)
high pitched cry, irritability or lethargy, bulging fontanels in infants, headache, dizziness, vomiting, seizures or twitching
sudden infant death syndrome (SIDS)
appearance of normal nutrition and hydration, skin may be mottled/cyanotic/ashen, often there is frothy-blood tinged fluids, vomitus may be present, pt may be in unusual position due to muscle spasms, no external signs of trauma