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208 Cards in this Set

  • Front
  • Back

S/S Hyperglycemia/DKA/Diabetic Coma

Gradual onset (hours to days)

Intense thirst


Deep, rapid (Kussmaul) respirations

Sweet, fruity breath

Rapid, weak, and thready pulse

Restlessness, might progress to coma

Abnormal/slurred speech

Unsteady gait

S/S Hypoglycemia/Insulin Shock

Rapid onset (minutes)

Pale, cool, moist skin

Intense hunger

Rapid, shallow breathing





Rapid, weak pulse

GCS Verbal Response

5 - Oriented conversation

4 - Confused conversation

3 - Inappropriate words

2 - Incomprehensible sounds

1 - None

Stages of assessment

1. Scene size-up

2. Primary assessment

3. History taking

4. Secondary assessment

5. Reassessment

S/S Decompensated Shock

-Falling BP (<90 systolic in adults)

-Labored or irregular breathing

-Ashen, mottled, or cyanotic skin

-Thready or absent peripheral pulses

-Dull eyes, dilated pupils

-Poor urinary output

S/S Pulmonary Embolus

-Sharp, pinpoint pain


-Sudden onset

-After childbirth or surgery

-Hemoptysis (coughing up blood)



S/S Cholecystitis (Gallbladder Inflammation)

RU quadrant pain (direct)

R shoulder pain (referred)



GI distress

Protonix/pantoprazole use

Gastric reflux

Child range for respirations

15-30 breaths/minute

Administration concerns for Epinephrine

-Medication will last approximately 5 minutes

-Do not repeat dose

-Ensure ALS in route for continuing treatment

Adult dose of acetaminophen

500 to 1000 mg every 4 hours as needed; dose is weight-based for children

S/S Kidney Stone

R or L flank, radiating to genitalia



Hematuria (bloody urine)

S/S Pancreatitis

Upper abdomen pain

Back pain



Abdominal distention and tenderness

Klor-con/Potassium chloride use

Low potassium levels

Contraindications for Aspirin

Hypersensitivity; recent bleeding

Zetia/ezetimibe use

Lowers cholesterol

Contraindications of Oral Glucose

Decreased LOC



S/S Diverticulitis

LL Quadrant pain







Diovan/Valsartan use

High blood pressure

Actions of Ibuprofen

Non-steroidal anti-inflammatory drug that reduces inflammation and fever.


Pertussis pathophysiology

Airborne bacterial infection




Psychogenic Causes







Los Angeles Stroke Screen

Age > 45 years

No Hx of seizures or epilepsy

Symptoms present < 24 hrs

Baseline not wheelchair-bound or bedridden

Blood glucose between 60 and 400

Asymmetry in any of the following three:

-Facial smile/grimace

-Grip strength

-Arm drift

S/S Appendicitis

RL Quadrant pain (direct)

Rebounding pain

Navel pain (referred)



Lack of appetite



S/S Compensated Shock




-Feeling of impending doom

-Altered mental status

-Weak, rapid or absent pulse

-Clammy skin

-Pallor, with cyanosis around the lips

-Shallow, rapid breathing

-Air hunger, esp. w/ chest injury



-Cap Refill > 2 seconds in infants and children

-Marked thirst

Lexapro/escitalopram action

Fights depression

Sides effects of ibuprofen



Stomach pain


Allergic reactions

Indications for Albuterol

Asthma/difficulty breathing with wheezing

Prevacid/lansoprazole use

Stomach ulcers

GCS Motor Response

6 - Obeys commands

5 - Localizes pain

4 - Withdraws to pain

3 - Abnormal flexion

2 - Abnormal extension

1- None

S/S Ulcer

Upper mid-abdomen

Upper back




S/S Cystitis (bladder inflammation)

Lower mid-abdomen (retropubic) pain

Urinary retention

Increase in urgency and frequency of urination

Nexium/esomeprazole action

Fights gastric reflux

PASTE Assessment of Dyspnea


Associated Chest Pain


Talking Tiredness

Exercise Tolerance

Actions of Diphenhydramine

Antihistamine (blocks histamine)

Adult dose of Ibuprofen

200 to 400 mg every 4 to 6 hours; dose is weight-based in children

Action of aspirin

Anti-inflammatory agent and anti-fever agent; prevents platelets from clumping, thereby decreasing clot formation

Normal pulse rate range for toddlers (1-3 years)

90-150 bpm

Normal pulse rate range for school age children (6-12 years)

70-120 bpm

Plavix/Clopidogrel use

Prevents stroke and heart attack

Side effects of nitroglycerin


Burning under tongue



Contraindications of Diphenhydramine






Contraindications for Albuterol



Myocardial Infarction

Side Effects of Oral Glucose












S/S Spontaneous Pneumothorax

Sudden chest pain with dyspnea

Decreased lung sounds on affected side

Administration concerns for acetaminophen

Weight of child is more important than age

Action of acetaminophen

Analgesic and antifever

Singulair/Montelukast use

Helps prevent asthma attacks

Contraindications of nitroglycerin


Having taking an erectile dysfunction drug in past 24 hours

Head injury

Normal blood pressure range for children (1-8)

80-110 mmHg systolic

Normal blood pressure range for infants (<= 1 yr)

50-95 mmHg systolic

Administration concerns for Diphenhydramine

Can use in severe allergic reaction; however, epinephrine is administered first

Administration concerns for activated charcoal

Stains; protect clothing; do not give with other PO medications

Normal pulse rate range for adults (18+ years)

60-100 bpm

Head-to-Toe Survey -- Eyes

-Ability to open

-Foreign body or prosthesis

-Size of each pupil

-Reaction to light

-Equality of reaction time to light and size

-Lower eye lid color

Head-to-Toe Survey--Neck

-Trachea deviation


-Medic alert

-Accessory muscle usage

-Neck vein distention

-Palpate C-spine for mid-line point tenderness

Interactions of Epinephrine

Increases effects of other nervous system stimulants

Normal pulse rate range for infants (1 mo - 1 yr)

100-160 bpm

Normal pulse rate range for preschool age (3-6 yr)

80-140 bpm

S/S Stroke

-Sudden loss of strength, sensation, or movement

-Facial droop

-Lack of muscle coordination (ataxia)

-Slurred speech

-Sudden, severe headache

-Altered mental status

-Difficulty saying or understanding words

S/S Abdominal Aortic Aneurysm

Lower back pain

LL/RL quadrant pain

Pulsating abdominal mass

Per Rectum (PR) route and rate

By rectum, rapid

S/S Peritonitis

Abdominal pain

Indications of Oxygen

Hypoxia or suspected hypoxia

Route(s) for Oral Glucose


Diovan HCT/valsartan and hydrochlorothiazide use


Contraindications for Oxygen

Very rarely in patients with COPD

Do not use near open flames

Crestor/rosuvastatin use

Lowers cholesterol

Action(s) for Nitroglycerin

Dilates blood vessels

S/S Hernia

Abdominal pain

Route(s) for Albuterol


Route(s) for Epinephrine

IM (auto-injector)

Interactions of Oxygen

Can support combustion

GCS Eye Opening

4 - Spontaneous

3 - In response to speech

2 - In response to pain

1 - None

Indication(s) for Oral Glucose

Low blood glucose (hypoglycemia) (generally <60mmHg)

GCS score of 9-12

May indicate moderate dysfunction

Administering O2 with nasal cannula

1. Attach to flow meter nipple

2. Select 1-6 liters/minute flow rate

3. Place on patient

Administration concerns for albuterol

Patient must inhale all medication in one breath; coach patient to hold breath for 5 seconds after inhalation

Route(s) for activated charcoal


Intraosseous (IO) route and rate

Into the bone; immediate

Side effects of Epinephrine





Administration concerns for aspirin

Do not administer for pain caused by trauma or for fevers in children; chest pain pts must be able to chew tablets

Action of Epinephrine

Stimulates nervous system, causing bronchodilation

Indications for Epinephrine

Severe allergic reaction

Interactions of Activated Charcoal

Bonds with and inactivates most medications/substances in the digestive tract

Side effects of oxygen

Decreased respiratory effort in rare cases in patients with COPD

Adult dose(s) of Oxygen

Use oxygen delivery devices to administer 28% to 100% oxygen

Levaquin/levofloxacin use


Adult dose for Activated Charcoal

1-2 g/kg

Action of Albuterol

Stimulates nervous system, causing bronchodilation

Action(s) of Oxygen

Reverses hypoxia

Provides oxygen to be absorbed by lungs

Per Os (PO) route and rate

By mouth; slow

Indications for Acetaminophen

Relief of mild pain or fever, headache, muscle aches

Toprol/Metoprolol use

Lowers blood pressure

Administration concerns for Nitroglycerin

Ensure ALS is en route

O2 Tank and Regulator Assembly

1. Fit regulator pins into neck of tank, keeping hand on tank

2. Screw regulator on securely (not too tight)

3. Open O2 valve (don't stand in front of gauge)

4. State psi; must be >400

5. Check for leaks

6. Open tank completely, -1/4 turn

Route(s) for Aspirin


Adult dose(s) for Aspirin

160 to 325 mg; 160 to 325 mg chewable tablets for chest pain

Action(s) of Oral Glucose

When absorbed, provides glucose for cell use

Adult dose(s) of Nitroglycerin

0.3 to 0.4 mg SL

0.4 mg spray

Contraindications of Epinephrine

Myocardial Infarction



Zyrtec/Cetirizine use


Adult/Adolescent normal range for respirations

12-20 breaths/minute

Side Effects of Albuterol





Fosamax/Alendronate use


GCS score of 13-15

May indicate mild dysfunction

Croup pathophysiology

Inflammation and swelling of the whole airway

Interactions of Ibuprofen

Do not take with aspirin

S/S Congestive Heart Failure

-Dependent edema


-Paroxysmal nocturnal dyspnea

S/S Emphysema

-Barrel chest

-Pursed lip breathing

-Dyspnea on exertion

Trauma patient-Minor injury-First contact

1. State general impression

2. Place hand on forehead

3. Introduce self & ask permission

4. Instruct patient not to move head or neck

5. Direct other person to hold immobilization

Head-to-Toe Survey--Chest

1. Bilateral equality of movement

2. Paradoxical motion

3. Effort of breathing

4. Scars and bruises

5. Sternal or intercostal retractions

6. Breath sound auscultation

7. Barrel-hoop test

Interactions of Oral Glucose


Adult dose(s) of Oral Glucose

1/2 to 1 tube

Side effects of activated charcoal




Black stools

Indications for Ibuprofen

Mild pain or fever


Muscle ache

Contraindications for Ibuprofen


Indications of Diphenhydramine

Mild allergic reactions

S/S Pertussis

Coughing spells

Whooping cough


Mostly seen in pediatric patients

Route(s) for Ibuprofen


Administration Concerns for Ibuprofen

Do not take for pain caused by trauma

Weight of child is more important than age

Route(s) of Diphenhydramine


Action(s) of Activated Charcoal

Adsorbs toxic substances in the digestive tract

Six rights








S/S Acute Myocardial Infarction

-Sudden onset of weakness, nausea, and sweating

-Chest pain often described as crushing

-Pain, discomfort, or pressure anywhere from lower jaw down to arms and torso

-Irregular heartbeat



-Pink, frothy sputum

Normal pulse rate range for Adolescents (12-18 years)

60-100 bpm

General steps in administering medication

1. Obtain an order from medical control

2. Verify six rights

3. Reassess vital signs, esp. HR and BP, at least every five minutes or as the patient's condition changes.

4. Document

Medical patient--Loose ends

-Make sure pt is on O2

-Continue complete medical assessment, including physical exam

-Vital signs

-Position of comfort


S/S Kidney Infection

Costovertebral angle pain

Advair diskus/Fluticasone and Salmeterol use


Cincinnati Stroke Scale

Facial droop

Arm drift


Side effects of diphenhydramine

Sleepiness (although it can stimulate children)

Dry mouth and throat

Administration concerns for oxygen

No open flames nearby

Do not withhold from patients in respiratory distress

Interactions of Nitroglycerin

Increases effects of blood vessel-dilating medications

Effexor/Venlafaxine use


Indications for Activated Charcoal

Most oral poisonings


S/S Tension Pneumothorax

-Progressive shortness of breath

-Increasing altered level of consciousness

-Neck vein distention

-Tracheal deviation

S/S Bronchitis

-Chronic cough



-Productive cough

Side effects of aspirin



-Stomach pain


-Allergic reaction

Pocket mask usage

-Attach one-way valve to mask

-Hold mask in place with:

--Index finger and thumb over mask

--Remaining fingers under mandible pulling upward and forward

S/S Anaphylaxis

-Flushed skin or hives

-Generalized edema

-Decreased blood pressure

-Laryngeal edema with dyspnea

Route(s) for Acetaminophen


Interactions of Acetaminophen

Overdosing due to presence of acetaminophen in many OTC medications

Childbirth Questions

-Are you under a doctor's care?

-Does your doctor expect any problems with this delivery?

-Is this your first vaginal delivery?

-When did the contractions begin?

-How far apart are contractions?

Interactions of Albuterol

Increases effects of other nervous system stimulants

Contraindications of Activated Charcoal

-Decreased level of consciousness

-Overdose of corrosives, caustics, or petroleum substances

Side effects of Acetaminophen

Allergic reaction

Contraindications for Acetaminophen


Routes for Nitroglycerin


Indications for Nitroglycerin

Chest pain due to MI or Angina

GCS score of 3-8

Indicative of severe dysfunction

Three serious consequences of an AMI

-Sudden death

-Cardiogenic shock

-Congestive heart failure

Congestive Heart Failure (CHF) pathophysiology

-Damaged ventricles

-Attempt by heart to compensate with increased rate

-Backup of fluid into the body

Route(s) for oxygen


Interactions of Diphenhydramine

Do not take with alcohol or MAO inhibitors (depression medication)

Synthroid/levothyroxine use

Decreased thyroid functioning

Lipitor/Atorvastatin use

Lowers cholesterol

Administration concerns of Oral Glucose

Patient must...

-Have control of airway

-Be awake

-Be able to follow commands

Vytorin/ezetimibe and simvastatin use

Lowers cholesterol

Interactions of aspirin

Caution should be used in patients who are taking anticoagulants

Trauma patient--Pre-assessment

1. Apply appropriate PPE

2. Assess scene for:

--Safety: human, biological, and environmental hazards

--Mechanism of injury

--Number of patients

--Need for additional resources

3. Consider C-Spine stabilization

Head-to-Toe Survey--Abdomen

-Penetrating injuries




-Pulsating masses (do not palpate if present)

Medical patient--Pre-Assessment

1. Apply appropriate PPE

2. Assess scene for:

--Safety: human, biological, or environmental hazards

--Nature of illness

--Number of patients

--Need for additional resources

3. Consider C-spine stabilization

Battery-operated suction and rigid catheter [or flexible]

1. Check for opening

2. Turn on suction

3. Crimp tube to test patency

4. Measure insertion depth from earlobe tip to corner of mouth [tip of nose to tip of earlobe]

5. Suction pharynx

--While withdrawing catheter in a circular fashion

--<15 seconds for adults, <10 for children, <5 for infants

6. Consider log roll for vomiting

7. Hyperoxygenate after suctioning

S/S Croup


-Barking cough

-Mostly seen in pediatric patients

S/S Asthma

-Wheezing on inspiration/expiration


Ventilating intubated patients (ET tube)

1. Attach BVM valve to adapter on ET tube

2. Hold tube with fingers and note placement number

3. Ventilate patient

Bronchitis Pathophysiology

An acute or chronic inflammation of the air passage

Class D Cylinder Capacity

350 L

Normal Blood Pressure Range for Adults

90-140 systolic

Intravenous (IV) route and rate

Into the vein; immediate

Adult dose of epinephrine

1 auto-injector

Indications for Aspirin

Mild pain, headache, muscle aches; chest pain when considering AMI

Adult Dose for Albuterol

1 to 2 inhalations, wait 5 minutes before repeating dose

S/S Pneumonia


-Chills, fever


-Dark sputum

Adult dose of Diphenhydramine

25-50 mg

Infant Normal Range of Respirations

25-50 breaths/minute

Pneumonia pathophysiology

-Acute bacterial or viral infection that damages lung tissue.

-Fluid can also accumulate in the surrounding normal lung tissue, separating alveoli from their capillaries.

Questions for Known Diabetics

-Do you take insulin or any pills that lower your blood sugar?

-Have you taken your normal dose today?

-Have you eaten normally today?

-Have you had any illnesses, unusual amount of activity, or stress?

Ch. 17, p 628

Administering Glucose

1. 5 Rights

2. Squeeze OG onto bite stick or tongue depressor

3. Open pt's mouth

4. Place OG between cheek and gum, with OG on cheek side.

5. Remove once OG is dissolved or pt loses consciousness or has a seizure

6. Repeat until entire tube is used.

Ch. 17, p 631-632

5 General Categories of Allergies

-Insect bites and stings





Ch. 18, p 647-648

Using an EpiPen Auto-Injector

1. Remove safety cap and wipe thigh with antiseptic

2. Place tip of auto-injector against lateral part of thigh.

3. Push auto-injector firmly against thigh and hold until all medication is used.

Ch. 18, p 656

Using a Twinject Auto-Injector

1. Remove injector from container

2. Clean injection site

3. Pull of green cap 1, then green cap 2

4. Place round red tip against lateral part of thigh

5. Press hard for 10 seconds, then remove

6. Repeat steps if needle is not visible after removal

7. If symptoms do not improve, remove red tip then remove syringe from barrel

8. Slide yellow collar off plunger, insert needle and push plunger.

Ch. 18, p 658-659

Medical Patient--Initial Assessment (Appears unresponsive and no C-Spine injury)

1. State general impression

2. Establish unresponsiveness--shake and shout

3. Assess upper torso for adequate breathing

4. Feel for carotid pulse, <10 seconds

5. Verbalize pulse absence, call for ALS & defibrillator

6. Compressions (30:2 for adults)

7. Head tilt/chin lift

8. Ventilate 2x, 1 second each, until chest rise

Skill sheet

Administering O2 with Non-Rebreather Mask (NRM)

1. Attach to flow meter nipple

2. Select 10-15 liters/minute flow rate

3. Fill reservoir bag with O2

4. Remove one mask flap

5. Place on patient

6. Observe reservoir bag for deflation/inflation

Skill sheet

Oropharyngeal Airway (OPA)

1. Determine appropriate size airway

2. Head tilt-chin lift

3. Maintain hyperextension of neck

4. Insert OPA, rotate 180 degrees as distal tip touches roof of mouth

5. Look, listen, and feel for breathing for 3-5 sec

Skill sheet

Nasopharyngeal Airway (NPA)

1. Determine appropriate size NPA

2. Lubricate distal 1-2 inches of NPA

3. Maintain hyperextension of neck

4. Place beveled end medially

5. Slide until flange rests against nares

6. Look, listen, and feel for breathing for 3-5 sec

Skill sheet

Bleed and disconnect regulator

1. Close tank

2. Open liter flow valve

3. Close liter flow valve

4. Remove regulator

Administering O2 with Bag-Valve Mask (BVM)

1. Select mask (bridge of nose to midway between lower lip and base of chin)

2. Attach mask to bag, tubing to BVM and nipple

3. Attack reservoir bag to BVM (if available)

4. Select 15 liters/minute flow rate

5. Position self at heat and insert OPA or NPA

7. Hold mask in place with appropriate technique

Skill sheet

Vital Signs

1. Pulse

2. Respirations

3. Palpated Blood Pressure

4. Ausculated Blood Pressure

Skill Sheet

Skin Signs

1. Color

2. Temperature

3. Moisture

Skill Sheet

Head-to-Toe Survey--Extremity Bleeding

1. Dry sterile dressing

2. Direct pressure with palm of hand

3. Elevate extremity above heart (maintain past steps; do not extend arm toward head for C-spine pt)

4. Apply pressure to brachial artery (if arm; maintain past steps)

5. Tourniquet (just above wound; not over joint

Skill Sheet

Head-to-Toe Survey--Arms, Legs, Hands, Feet

1. Needle marks

2. Fistula

3. Bleeding

4. Scars and Bruises

5. Deformities

Skill sheet

DUMBELS mnemonic



-Miosis (pupil constriction)

-Bronchorrhea (mucus discharge from lungs)


-Lacrimation (tearing)


Ch. 19, p 685

S/S Cholinergic Overdose


-Muscle fasciculations (twitching)



Ch. 19, p 670

S/S Opioid Overdose

-Hypoventilation/respiratory arrest

-Pinpoint pupils



S/S Sympathomimetic Overdose



-Dilated Pupils




Ch. 19, 670

S/S Sedative-hypnotic Overdose

-Slurred speech




Ch. 19, p 670

S/S Anticholinergic Overdose




-Dilated pupils

-Dry skin and mucous membranes






-Decreased bowel sounds

Ch. 19, p 670

Four routes for poisoning


-Absorption (surface contact)



Common Opioid Drugs

-Butorphanol (stadol)


-Fentanyl derivatives ("china white")


-Hydrocodone (vicodin)

-Hydromorphone (Dilaudid)

-Meperidine (Demerol)

-Methadone (Dolophine)


-Oxycodone (Percocet)

-Oxycodone hydrochloride (OxyContin)

-Pentazoline (Talwin)

-Propoxyphene (Darvan)

Ch. 19, p 681

S/S Delirium Tremens (DTs)

-Agitation and restlessness




-Confusion and/or disorientation

-Delusions and/or hallucinations


Ch. 19, p 681

Common barbiturates (Sedative-Hypnotic)

-Amobarbital (Amytal)

-Butabarbital (Butisol)

-Pentobarbital (Nembutal)

-Phenobarbital (Luminal)

-Secobarbital (Seconal)

Ch. 19, p 682

Common Benzodiazephenes (sedative-hypnotics)

-Alprazolam (Xanax)

-Chlordiazepoxide (Librium)

-Diazepam (Valium)

-Flunitrazepam (Rohypnol)

-Lorazepam (Ativan)

-Oxazepam (Serax)

-Temazepam (Restoril)

Ch. 19, p 682

Common Non-Barbiturate, Non-Benzodiazepine Sedative-Hypnotics

-Carisoprodol (Soma)

-Chloral hydrate ("Mickey Finn")

-Cyclobenzaprine (Flexeril)

-Ethchlorovynol (Placidyl)

-Ethyl alcohol

-Glutethimide (Doriden)

-Hydrocarbon inhalants

-Isopropyl alcohol (rubbing alcohol)

-Meprobamate (Equagesic)

Ch. 19, p 682

Common Sympathomimetics






Commonly Abused Hallucinogens

-Bufotenine (toad skin)



-Jimson weed




-Morning Glory




-Psilocybin (mushroom)

Ch. 19, p 684