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DAANCE Study guide questions with correct responses
•Acute |coronary |syndrome |- |correct |answer |-✔plaque |begins |to |form, |partially |occlude |arteries, |plaque |begin |to |rupture, |thrombosis |total |occlusion |of |artery |of |infarction •Angina |- |correct |answer |-✔primary |symptom |of |coronary |heart |disease |which |occurs |when |myocardial |oxygen |demand |exceeds |supply. |Crushing |substernal |pain, |radiating |to |jaw |and |lower |back. |Leads |to |ischemia |and |then |to |infarction. |Treatment |includes |O2 |and |nitroglycerin. | 3 |doses |can |be |administered |once |every |five |minutes. |After |the |third |dose | 911 |should |be |called |if |not |better |because |it |might |be |infarction
- |Myocardial |infarction |- |correct |answer |-✔necrosis |or |death |of |heart |muscle |precipitated |by |decreased |oxygenation |from |partial |or |complete |blockage |of |blood |flow |in |coronary |arteries. |Crushing |chest |pain, |pain |in |the |arm |shoulder |and |jaw, |sweating. |In |an |infarction |the |cell |death |is |irreversible. |JAW, |SHOULDER, |CHEST. |Pain |will |not |be |released |with |nitroglycerin. |Weakness, |anxiety, |feeling |of |impending |doom, |hypotension, |dysrhythmia, |nausea, |vomiting, |pallor |and |sweating |are |all |symptoms. - |MONA |- |correct |answer |-✔ • |Treatment |of |myocardial |infarction |is |MONA- |Morphine, |Oxygen, |Nitroglycerin, |Aspirin. |place |pt |in |comfortable |position, |loosen |clothing. |Establish |IV, |treat |pt |for |pain. |100% |oxygen. - |Rheumatic |Heart |disease |- |correct |answer |-✔inflammatory |reaction |after |infection |of |beta=hemolytic |streptococci. |Can |damage |heart |muscle |valves |and |pericardium - |Mitral |valve |prolapse |- |correct |answer |-✔5% |population |is |affected |usually |women, |Retrograde |flow |of |blood. |present |from |birth. | - |antibiotic |prophylaxis: |Amoxicillin |(Adults |2.0g; |child | 50 |mg |one |hour |prior |to |surgery). |If |allergic |to |PCN |give |Clindamycin |(adult |600mg; |child |20mg). |Azithromycin |(Adults |500mg; |child |15mg)
- |Congestive |heart |failure |- |correct |answer |-✔a |clinical |syndrome |in |which |the |heart |fails |to |maintain |an |adequate |output, |resulting |in |diminished |blood |flow |to |the |tissues |and |congestion |in |the |pulmonary |and |systemic |circulation. |Left |sided |is |poorly |function |left |ventrical. |Right |sided |is |poor |functioning |right |side. |Heart |becomes |enlarged |(cardiomegaly) - |Hypertension |- |correct |answer |-✔abnormally |high |arterial |pressure |(140/90). |Concerns |are |hypertensive |crisis, |which |is |a |sudden |increase |of |bp |240/-250-140. |headache, |dizziness |are |symptoms. - |Cerebrovascular |accident |- |correct |answer |-✔brain |damage |from |lack |of |blood |supply |(stroke) |major |neurologic |deficit |lasting |greater |than | 24 |hours - |Transient |ischemic |attack |(TIA) |- |correct |answer |-✔lesser |manifestations |lasting |less |than | 24 |hours. | • |Warning |of |stroke: |F.A.S.T |(Face, |Arm, |speech, |time): |sudden |numbness |of |weakness |of |the |face |arm |of |leg |on |one |side |of |the |body. |Sudden |confusion |or |difficulty |understanding. |Trouble |speaking. |Sudden |trouble |walking |dizziness, |loss |of |balance |or |coordination. |Sudden |severe |headache |and |trouble |seeing |in |one |or |both |eyes. - |Normal |sinus |rhythm |- |correct |answer |-✔electrical |activity |is |generated |by |the |SA |node. |The |contraction |is |the |P |wave, |QRS, |t |wave - |Dysrhythmias |- |correct |answer |-✔abnormal |rhythm. |can |be |focus |and |ectopic. |Focus- |focal |point |of |the |origin |of |an |impulse. |Ectopic- |displaced. |Thus |ectopic |foci |are |displaced |central |points |in |various |parts |of |the |heart |where |impulses |can |start. |(a |displaced |pacemaker) - |Arrhythmia |- |correct |answer |-✔without |rhythm - |Rules |of |EKG |Interpretation |- |correct |answer |-✔Look |for |the | 3 |R's: |Rhythm, |Rate, |Regularity - |The |small, |short |wave |corresponds |to |the |small |chambers |of |the |atria |"p |waves" - |The |larger |tall |wave |corresponds |to |the |larger |chambers, |the |ventricles |which |pump |blood, |so |you |can |look |for |it |first |"QRS" |complex
-Ventricular |fibrillation |and |asystole- |epinephrine -Electrical |intervention |such |as |synchronized |cardioversion |or |defibrillation -Continue |CPR |for |arrest |rhythms -monitor |vitals
- |Treatment |for |Ventricular |fibrillation |or |pulseless |Ventricular |tachycardia: |- |correct |answer |-✔-CPR-> |O2->shock -CPR->IV-> |shock -CPR->Epi |1mg |IV-> |shock -CPR->amiodarone |300mg->shock -CPR-> |hospital - |Treatment |for |Asystole |- |correct |answer |-✔These |pts |have |no |wave |form |of |any |time |and |this |is |a |flatline. |These |patients |cannot |be |defibrillated. |Treatment |is |CPR-> |IV->CPR-> |Epi |1mg EKG |- |correct |answer |-✔ • |Electrocardiogram - |Used |to |monitor |electrical |activity Nervous |system |- |correct |answer |-✔ • |CNS: |brain |has |overall |control |of |consciousness |and |thought - |Spinal |cord: |extends |central |control |to |the |rest |of |the |body - |PNS: |Sends |input |to |the |brain |and |output |to |the |muscles |and |other |tissues CNS |- |correct |answer |-✔ • |The |control |center |for |body |functions - |The |brain |and |spinal |cord - |Pituitary |gland |(endocrine |coordination) - |Emotion |and |memory |centers
- |Cerebrum |(thought) - |Sensory |Relay - |Pons |and |Medulla |(Vital |centers) - |Cerebellum |(coordination) - |OMS |deals |with |which |nerves |- |correct |answer |-✔VII |(facial |nerve), |the |V |nerve |(trigeminal |sensation |to |the |face) |and |the |X |nerve |(vagus |nerve |controls |heart |and |GI |tract) - |Trigeminal |nerve |- |correct |answer |-✔responsible |for |sensation |of |face |and |helps |with |biting |and |chewing. |Its |divided |into |three |parts. |V1- |opthalmic, |V2 |Maxillary, |V |mandibular, |Inferior |alveolar |and |lingual |nerve. facial |nerve |- |correct |answer |-✔controls |facial |expression |from |forehead, |cheeks |eyes |and |mouth. Benzos |and |narcotics |in |CNS |- |correct |answer |-✔affect |the |center |of |emotion Propofol |in |CNS |- |correct |answer |-✔affects |the |wakefulness |center Ketamine |and |narcotics |in |CNS |- |correct |answer |-✔affect |relay |station propofol, |ketamine |and |narcotics |in |CNS |- |correct |answer |-✔all |affect |vital |centers - |Syncope |- |correct |answer |-✔loss |of |consciousness |usually |due |a |drop |in |BP - |Seizure |- |correct |answer |-✔sudden |attack |of |abnormal |and |involuntary |muscle |contractions
- |Dose |1-5mg |IV. |Half |life |1-4 |hours. | Reverse |with |flumazenil. | - |Anticonvulsant. | - |Don't |use |with |acute |narrow |angle |glaucoma. | - |Dose |dependent |respiratory |depression. | - |MIld |decrease |in |BP. |muscle |relaxant Romazicon |(flumazenil) |- |correct |answer |-✔ • |benzodiazepine |reversal |agent. | - |0.2-1.0mg |IV. | - |Reverse |sedation |and |respiratory |depression. | - |Rapid |onset |of |1-2 |minutes. |Observe |pt |for | 2 |hours. Narcotics |- |correct |answer |-✔ • |All |potent |analgesics. | - |All |respiratory |depressants. | - |Minimal |cardiovascular |effects |at |normal |doses. | - |Relieve |pain |without |altering |other |senses. | - |All |reversible |with |Narcan |(Naloxone) | - |two |narcotics |used |in |OMS |are |Demerol |(meperidine) |the |first |synthetic |opioid. | - |Fentanyl |(sublimaze) |the |most |commonly |used. Demerol |(Meperidine) |- |correct |answer |-✔ • |First |synthetic |narcotic. | - |Has |been |replaced |by |fentanyl. | - |falling |from |favor |due |to: |hypotension |and |tachycardia, |histamine |release. |Delerium. |congestive |dysfunction |in |some |older |pts Fentanyl |(sublimaze) |- |correct |answer |-✔ • |About | 100 |times |more |potent |as |morphine. | - |Rapid |onset |(<1min). |
- |Short |duration |(30-60 |min) | - |Cardiovascular |system |remains |stable |but |may |see |bradycardia. | - |Best |narcotic |for |asthmatics |and |pts |with |history |of |n/v. | - |0.05-0.2 |mg |IV. | - |Can |cause |profound |respiratory |depression |and |it |may |cause |chest |wall |rigidity. Narcan |(naloxone) |- |correct |answer |-✔ • |Narcotic |antagonist, | - |Reverses |sedation |and |respiratory |depression. | - |No |agonist |properties. | - |0.4-2.0 |mg |IV. | - |Rapid |onset |1-2 |minutes. | - |Short |duration |of |action |(45 |mins). |observe |pt |for | 2 |hours |after. Anticholinergics |- |correct |answer |-✔Atropine |and |Robinul Atropine- |- |correct |answer |-✔ • |Blocks |the |vagus |nerve |(X). | - |0.4-0.6 |mg |IV. | - |Produces |increased |heart |rate. | - |Dries |oral |and |pharyngeal |secretions. | - |Slow |onset |for |drying. | - |Used |to |treat |bradycardia. Robinul |(glycopyrrolate) |- |correct |answer |-✔ • |Similar |to |atropine |but |more |potent |drying |agent. | - |0.1-0.2mg |IV. | - |minimal |cardiovascular |effects.
Solu-cortef |(hydrocortisone) |- |correct |answer |-✔similar |to |decadron. | 100 |mg |IV Solu-medrol |(methylprednisolone) |- |correct |answer |-✔similar |to |decadron, |25mg |IV. |available |in |dose |packs. Intravenous |Anesthetic |Agents |- |correct |answer |-✔Brevital |(methohexital), |Diprivan |(propofol), |Ketamine |(ketalar) Brevital |(methohexital) |- |correct |answer |-✔ • |Ultra |short |acting |barbiturate. |
- |1% |solution |(10mg/cc) | - |Titrate |slow |so |it |doesn't |cause |a |laryngospasm, |bronchospasm, |shakes |or |hiccups. | - |Response |is |dose |related, |can |range |from |sedation |to |full |general |anesthesia. | - |Decreases |blood |pressure |10-25% |and |increases |heart |rate |10-30% |(compensating |for |decreased |blood |pressure). | - |Respiratory |depression |is |dose |dependent |and |can |predispose |pt |to |develop |a |laryngospasm. Diprivan |(propofol) |- |correct |answer |-✔ • |Ultra |short |acting |anesthetic. | - |Rapid |onset |<1 |min. | - |Short |duration |4-8 |minutes. | - |produces |hypotension |and |bradycardia |which |can |be |largely |overcome |with |stimulation. | - |Pain |on |injection. | - |Considered |very |safe. | - |Need |to |ask |the |pt |if |they |are |allergic |to |sulfites, |soy |products, |eggs, |or |have |a |sever |asthma |or |sulfite |allergy. | - |Highly |lipid |soluble. | - |Produces |anesthesia |as |rapidly |as |IV |barbiturates. |
- |More |rapid |recovery |(distribution |half-life |2-8 |mins). | - |Redistributed |rapidly |to |muscle |fat |and |skin. | - |Usually |there |is |no |tachycardia |but |modest |bradycardia. | - |Can |cause |hypotension, |A |drop |in |arterial |pressure |do |to |vascular |resistance |(inhibition |of |sympathetic |vasoconstriction). | - |Largely |reversed |by |stimulation |like |local |anesthesia. | - |Exacerbating |factors: |increased |dose, |rate |of |admin, |increased |age. | - |Respiratory |depressant. | - |Apnea |after |induction |largely |reversed |by |stimulation. | - |Decreased |airway |reflexes |allows |suctioning |and |fewer |laryngospasms. |Modest |bronchodilation |in |asthma. | - |Decrease |in |intracranial |pressure |and |cerebral |blood |flow. |Antiemetic. |Anticonvulsant. |Feeling |of |well |being |and |euphoria. | •Smooth |emergence. | - |May |burn |on |injection |but |no |phlebitis. | - |Use |caution |with |seizure |disorders |(give |benzo |prior |to |prop) |no |reversal |drug. Ketamine |(ketalar) |- |correct |answer |-✔ • |Puts |the |pt |in |a |state |of |dissociative |anesthesia. |The |pt |is |dissociated |from |the |environment. - |Appears |conscious |with |eyes |open |and |most |reflexes |in |take |but |impaired |ability |to |respond |to |sensory |input |such |as |visual, |auditory, |and |painful |stimuli. | - |Highly |lipid |soluble. | - |Rapid |uptake |in |brain. | - |Redistribution |to |peripheral |compartments |(distribution |half |life, |10-15 |mins). | - |Increases |BP, |HR |and |cardiac |output. | - |Effects |due |to |central |stimulation |of |the |SNS. | - |Peak |effect |in |2-4 |min |with |a |decrease |of |10-20. | - |Minimal |effect |of |ventilatory |drive. |Potent |bronchodilator. | - |Increased |secretions |which |can |be |attenuated |with |robinul |or |atropine. |
Citanest |(prilocaine) |- |correct |answer |-✔ • |ultra |short |duration |without |vasoconstrictor. |
- |Long |acting |with |vasoconstrictor Marcaine |(Bupivacaine) |- |correct |answer |-✔ • |Long |onset |of |action. | - |Long |duration |6-8 |hours. | - |Used |with |epi. | - |Less |profound |anesthesia Septocaine |(articaine) |- |correct |answer |-✔ • |Intermediate |with |4% |solution |with |1:100, |epi. | - |Carpules |are |1.7 |ml. | - |Max |dose | 7 |carpules |in |average |pt. |Incidence |of |nerve |injury Lidocaine |is |known |as |- |correct |answer |-✔Xylocaine Carbocaine |is |known |as |- |correct |answer |-✔Mepivicaine Citanest |is |known |as |- |correct |answer |-✔Prilocaine Marcaine |is |known |as |- |correct |answer |-✔Bupivicaine Diazepam |is |known |as |- |correct |answer |-✔Valium |(benzodiazepine) Midazolam |is |known |as |- |correct |answer |-✔Versed |(benzodiazepine) Flumazenil |is |known |as |- |correct |answer |-✔Romazicon |(Benzodiazepine |reversal |agent)
Meperidine |is |known |as |- |correct |answer |-✔Demerol |(Narcotic) Fentanyl |is |known |as |- |correct |answer |-✔Sublimaze |(Narcotic) Naloxone |is |know |as |- |correct |answer |-✔Naran |(Narcotic |antagonist) Glycopyrrolate |is |known |as |- |correct |answer |-✔Robinul |(Anticholinergic) Diphenhydramine |is |known |as |- |correct |answer |-✔Benadryl |(Antihistamine) Hydroxyzine |is |known |as |- |correct |answer |-✔Vistaril |or |Atarax |(Ataractics) Promethazine |is |known |as |- |correct |answer |-✔Phenergan |(Ataractics) Dexamethasone |is |known |as |- |correct |answer |-✔Decadron |(corticosteroids) Solu-cortef |is |known |as |- |correct |answer |-✔Hydrocortisone Solu-medrol |is |known |as |- |correct |answer |-✔Methylprednisone Methohexital |is |known |as |- |correct |answer |-✔Brevital |(anesthetic) Diprivan |is |known |as |- |correct |answer |-✔Propofol |(Anesthetic) Ketalar |is |known |as |- |correct |answer |-✔Ketamine |(Anesthetic)
