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DAANCE lia study

QuestionAnswer
1% solution equals One gram of medication in 100% mL solution [1g also = 10oomg]
3 characteristics of normal heart rhythms Rate, regularity and rhythm
4 key questions to ask patient in evaluation Are they currently under physicians care, do they take any meds, do they have any allergies and reactions to them, review of systems
Accessory muscles of respiration Sternocleidomastoid, scalenes and abs which are most important
Addison's disease Life threatening, hypo secretions of glucocorticoids
Adenosine would be given in which emergency? SVT
Adrenal gland Secretes epinephrine, norepinephrine and corticosteroids. Controls electrolyte balance and carb metabolism
What is An AED, what does it do? Automatic external defibrillator - device automatically assesses heart rhythm and delivers shock
Amides Metabolized in bloodstream. Chemical structure derived from ammonia
Amiodarone would be given in which emergency? V. Tach.
Amnesia Failure to remember events related to surgery ( versed/ benzodiapines)
Analgesia Patient doesn't feel pain. ( fentanyl/local/ketamine)
Anesthesia machines Provides O2 and NO2 to the patient. The Dow meter determines ratio and rate in which gases are delivered.
Angina pectoris Chest pain. Caused by ischemia. Can be treated with nitroglycerin.
Antecubital space Anterior surface of elbow located between arm and forearm
Antibiotic prophylaxis for total joint replacement patients Previous joint infection, 2 years following joint replacement, malnourishment, hemophilia , diabetes type 1
Immunosuppressed or immunocompromised patients Anticholinergics
Decrease secretion of salivation glands Block Vegus nerve and can cause tachycardia ( robinul, atropine, scopolamine )
Anticholinesteres Reverse effects of depolarizing agents ( muscle relaxers)
Anxiolytics Anxiety reducing. Benzodiazepine family of meds. Cause increase pressure in eye and should be used with caution on patients with glaucoma
Aorta Main trunk from which arterial system proceeds
Arrest rhythms Ventricular dysrhythmias
Asmtha Usually associated with allergies. Increased secretions in the muscles membrane lining bronchioles
Asystole Sensation of all contractions. " flat line" usually followsV. Fib. Or V. Tach. Treated with CPR
Atropine would be given in which emergency? Symptomatic Bradycardia
Automaticity Ability of heart muscle to contract on its own with out nerve stimulation.
Autonomic nervous system Sympathetic and parasympathetic nervous system
AV blocks PR length is prolonged or varies in length do to impulse being partially or completely blocked as it attempts to travel from atria to ventricles via. AV node
AV node Located between atria and ventricles. Bundle of his cause ventricles to contract.
Barbiturates Taken up by body fat and release into system slowly prolonging effects. Depress respiratory and cardiac function. No analgesic effect and detoxified by liver. Amnesia and hypnotic effects
Basic requirements of anesthesia lack of toxicity, non flammable, non addictive, possess minimal allergenic
Basilic veins located on inner ( medial) aspect of forearm.
Benadryl Primary drug used in mild allergic reactions
Best places to check for patients pulse carotid arteries and radial arteries
beta blockers reduce the rate and force of contractions of the heart ( Atenolol)
A beta blocker would be given in which emergency? Hypertension
Black cylinder is Nitrogen
Blue cylinder is Nitrous Oxide
Brachial artery Supplies blood to shoulder, arm, forearm and hand
Brachiocephalic artery Branches into right common carotid in neck and right subclavian artery in arm.
Bradycardia HR of less than 60 BPM
Brain stem Pons, medulla oblongata, midrain
Brevital Ultra short acting Barbiturate. 1% solution night hightly bound to fat.
Side effects to Brevital. Apnea induction, laryngospasm, bronchospasm, hypotension, tachycardia, hiccups, muscle twitching. Use caution with asthma or seizures disorders .
Bronchitis Inflammation of mucous membranes lining the
Brown Cylinder Helium
Cardioacceleratory center ( CAC) Located within medulla. Sympathetic fibers travel down spinal cord to SA node. When stimulated norepinephrine releases with increased HR and strength on contractinos
Capillaries Smallest arteries where the exchange of O2 and CO2 , cell by products and nutrients are exchanged between blood and cells of body.
capnography Monitoring the patients CO2 in expired air
Capnograph/capnometer Monitors ventilation in real time by measuring the level of O2 of the patients exhales
Cardiac cycle One alternate contraction and relaxation of atria and ventricles followed by a short pause.
Cardiac output Total amount of blood pumped from left ventricles in one minute
Causes if seizures Liver failure, renal failure, sickle cell disease, brain tumor, meningitis, previous stroke and hypo-hyperglycemia
Central nervous system (CVS) Consists of brain and spinal column
Central Sites Responsible for euphoric feeling that accompanies opioid administration
Cephalic Vein Located on outer (lateral) aspect of forearm.
cerebellum Main motor coordinating area.
Cerebrovascular accidents ( CVA/Stroke) Neurological impairment caused by disruption of blood supply to area of brain.
Cerebrum Thought area of brain.
Cardioinhibitory center (CIC) Parasympathetic fibers reach vagus nerve and release acetylcholine which decreases HR and force of contractions
Cirrhosis Fibrosis or scar tissue in liver, May have difficulty metabolizing meds and may have prolonged effects of meds.
Class I (ASA) Patient has no organic , Biochemical, psychiatric or physiological disturbances.
Class II (ASA) Patient has mild to no systemic disturbances. Smokers included
Class III (ASA) PT. has severe systemic disturbances or disease.
Class IV (asa) PT. has a severe, life threatening systemic disorder
Class V (ASA) Patient is morbid with little chance of survival. Surgery is done in desperation.
Combitube generally used for specific emergencies. Both cuffs inflated.
Concentration % Mg/cc
Congestive heart failure Condition caused by the heart is unable to handle blood volume coming back to it from either the lungs or the peripheral circulation
Consideration for diabetic patients Pts with diabetes do not heal as quickly and are more prone to infection. Often placed on antibiotics
Considerations for obese patients Use a large blood pressure cuff, difficult venous access, patients should be treated in upright or semi fowler position
Cricothyrotomy/Coniotomy The passage of a large needle through cricothyroid ligament. Used in upper airway obstruction.
Cushings Disease non life threatening. Hyper secretions of glucocorticoids
Dead space No gases are exchanged. 150 cc. extends from pharynx to bronchioles. Allows CPR to take place.
Defibrilator Only practical and definitive treatment for ventricular fibrillation
Demerol Same pharmacological effects as morphine
Depolarization agents Cause depolarization of muscle with contraction and prolonged relaxation (succinylcholine). Used for intubation and treatment of laryngospasm. Can cause dysrhythmias especially in children and can trigger malignant hypothermia
Diabetes mellitus Metabolic impairment where the body is unable to metabolize glucose causing increased blood glucose levels. This prevents the body from metabolizing carbs properly.
Diaphragm Dome shaped muscle that separates the chest cavity from abdominal cavity. Most important muscle of inspiration
Diastolic phase Both atria contracting simultaneously
Diuretics Reduce the volume of fluid in system. Used to treat coronary artery disease (HCTZ, Lasix)
Dorsal venous plexus Back of hand
Drug reversal agents Narcan and Flumazenil
Dyspnea Difficulty breathing or breathlessness.
Ectopic focus Displaced central point of origin for cardiac dysrhythmias
Electrocardiograph Used to monitor electrical activity of heart.
Emphysema Enlargement of alveolar sac in lungs along with destruction and scarring of alveoli which makes less surface area available for exchange of O2 and CO2. Smokers.
Endotracheal intubation End of tube passes through vocal cords and terminates half way between vocal cords and bifurcation of trachea. Important to listen to both lungs after placement. May or May not be cuffed.
Epiglottis Soft tissue valve located at base of tongue covers larynx. Allows air into lungs and keeps foreign material out.
Epi is given in which two emergencies? V. Fib and asystole
Epilepsy Seizures. If an incident occurs during anesthesia Valium IV can be given
Epinephrine Sympatho- mimetic amine (mimics sympathetic nervous system) with pronounced cardiovascular effects.
Erythrocytes Red blood cells
Esters Metabolized in bloodstream. Chemical structure of acid and alcohol. Procaine and cocaine.
External respiration O2 is inspired and enters the body by coming in contact with blood and alveoli
Facial artery Supplies blood to face, tonsil, palate, and submandibular gland
Facial nerve 7th cranial nerve. Supplies motor fibers to muscles of facial expression.
Fasting blood sugar (FBS) 125 mg/dL normal or in control
Fentanyl Rapid onset of action. Profound respiratory depressant. High doses may cause chest wall rigidity
Flow of blood through the heart Inferior/superior vena cava, right atrium, tricuspid valve, right ventricle, pulmonary valve, pulmonary artery, lungs, pulmonary vein, left atria, mitral valve,eft ventricle, aortic valve, aorta, peripheral circulation.
A fluid bolus of NS and ephedrine can be given with what emergency? Hypotension
Flumazenil Like narcan but used to reverse effects of benzodiazepam derivatives
Focus (foci) Site in atria or ventricles which is center for generation of impulse
General anesthesia (GA) The pt is not arousable even with painful stimulation. Airway intervention is required and positive pressure ventilation may be required. CV function may be impaired
Glucocorticoids Allow the body to respond to stress
Gray Cylinder Carbon dioxide
Green Cylinder Oxygen
Halogenated hydrocarbons Inhalation agents that come in liquid form and are poured into vaporizers that allow for controlled evaporation and release for administration of gas. Sevoflurane, desflurane, isoflurane.
Hematocrit % blood volume made up of red blood cells. Men: 42-52% women: 37-48%. Anything below 35% considered anemic.
Hemoglobin Supplies O2 to body's tissues. Composed of one protein (globin) and four non proteins (hemes)
Hemorrhagic stroke 15% caused by ruptured artery (aneurysm)
Homeostasis The body's normal state which there is minimal variation in respiration and circulation
H's of pulseless electrical activity Hydrogen ion, hypoxia, hypovolemia, hypoglycemia, hypo/hyperkalemia, hypothermia
Hypercarbio Increased CO2 levels
Hypertension Blood pressure of 140/90 or greater. (Hx of nosebleeds, headaches, and dizziness)
Hyperventilation When patient is breathing at a rate faster than his or her normal breathing pattern or breathing more deeply than the body requires. Pt exhales too much carbon dioxide. Pt will feel anxious and light headed.
Hypnosis Loss of consciousness. Patients want to lose consciousness and feel that they are asleep. (Propofol, brevital)
Hypnotic Sleep inducing.
Hypoxia Lack of O2
Inferior alveolar artery Supplies blood to teeth, mandible, lower lip, and chin
Inferior vena cava Drains lower extremities and abdominal viscera into right atrium.
INR International normalized ratio. Patients on anticoagulants usually maintain INR 2-3. Patients usually discontinue anticoagulant 3 days prior to surgery. 1.5 or less needed to operate.
Insulin overdose Give patient sugar, candy, or sugar containing beverage. Glucose IV or glucagon IM if patient is sedated.
Internal jugular vein Drains much of blood from head and neck
Internal respiration Takes place at cellular level. O2 in bloodstream enters cells. CO2 leaves cell and returns to blood
Ischemia Reduced blood flow in coronary arteries. Lack of oxygen to heart cells weakens, but does not kill them.
Ischemic stroke 85% caused by occluded blood vessel
Islets of langerhans Located in pancreas. Secrete insulin and glucagon. Insulin helps the body store sugar to keep glucose levels in a steady state
Ketamine Dissociative anesthetic, provides analgesic effects, amnesia, highly lipid soluble. Increases blood pressure, heart rate, cardiac output, increases salivation with can predispose laryngospasm.
Laryngeal mask airway (LMA) Device that sits over top of larynx. Can be placed blindly. Does not protect against aspiration. Inflated with 30cc to create seal.
Laryngopharynx Located behind voice box.
Laryngospasm Protective reflex of vocal cords which attempt to prevent passage or foreign matter to lungs. Crowing sounds or labored breathing from patient.
Left atrium Receives oxygenated blood from lungs via pulmonary vein.
Left sided heart failure Increased pressure of fluid in blood vessels causes fluid to leak into lungs. Patients often present with shortness of breath.
Left ventricle Pumps oxygenated blood to peripheral circulation via aorta
Lingual artery Supplies blood to tongue of floor of mouth.
Liver Protein and lipid synthesis, bio transformation, detoxification and storage of vitamin A, E, D, K, and B12.
Lower airway Trachea, bronchi, lobular bronchi, bronchioles, and alveoli.
Main function of kidneys Maintain volume and composition of body fluids. Body's main source of filtration and excrete metabolic end products and toxins.
Malignant hypothermia symptoms Genetically transmitted myopathy that is triggered by some inhalation agents and succinylcholine. First sign is tachycardia followed by massager muscle rigidity, elevates temperature, carbon dioxide retention, total body rigidity, or lethal arrhythmias
Mallampati class I Visualization of soft palate, fauces, uvula, anterior/posterior pillars
Mallampati class II Visualization of soft palate, fauces, and uvula
Mallampati class III Visualization of soft palate and base of uvula.
Mallampati class IV Soft palate not visible at all.
Max dose of epi for cardiovascular disease pt .04mg
Maxillary artery Supplies blood to maxilla, teeth, sinuses, and portion of nose.
Maximum dose of epi for healthy pt .2mg
Max O2 hemoglobin 1.34 mL
Medazolam Versed. Similar to Valium but faster acting and water soluble. Respiratory depressant.
Median cubital vein Bridge between cephalic and basilic veins.
Medications to treat seizures Tegretol, Klonopin, Neurontin, luminal, Dilantin, depacon
Meds that help with nausea Antienimetics. Antihistamines, antipsychotics, reglan, zofran, corticosteroids, benzodiazepines
Medulla oblongata Coordinating region for impulses. The seat of many autonomic centers.
Mental artery Supplies blood to chin.
MI (myocardial infarction) Heart attack. Sx should be performed on patient until 6 months after.
Minimal sedation (anxiolytics) Normal response to verbal stimulation with airway reflexes, ventilation, and CV function unaffected.
Moderate sedation conscious sedation Purposeful response to verbal or light tactile stimulation with no compromise of the airway and spontaneous ventilation. CV function usually maintained.
Modifiable risk factors of stroke High blood pressure, diabetes, heart disease, smoking, TIA, increased red blood cells, sickle cell disorder.
MONA Morphine, oxygen, nitroglycerin, aspirin
Morphine Major effects on CNS. Major action analgesia, but also causes euphoria, drowsiness, and sedation. Side effects include nausea, respiratory depression and hypotension.
Motor nerves Carry out responses from CNS.
Muscle relaxants Block nerve impulses at neurotransmitter junction where nerve stimulation causes muscle to contract causing paralysis.
MVP (mitral valve prolapse) One or more of valve flaps don't close completely allowing redundancy of valve leaflets into left atrium.
Narcan Used in treating respiratory depressant and sedative effects of narcotics. Most widely used narcotic agonist antagonist
Narcotic agonist antagonists Standard narcan. Narcotics reversible with drugs that antagonize effects. All relieve pain and provide some degree if sedation. (Narcan, talwin, stadol).
Narcotic receptors 3 levels of activity. Opioids affect transmission of painful impulses initially at site of injury, then spinal cord on the way to brain, and finally at receptor sites in brain.
Narcotics Provide systemic pain control. Respiratory depressant and potential for addiction. May produce drowsiness, euphoria and hypotension. (Morphine, Demerol, fentanyl, remifentanil)
Nasopharyngeal airway When tongue is obstructing airway. Tube is lubricated and passed through the nose into nasal cavity. Sits in oropharynx behind tongue. Well tolerated and can be used on awake pts.
Nasopharynx Located above back of soft palate
Neo-cobefrin Vasoconstrictor compounded with marcaine. Less cardiac and CNS stimulation than epinephrine
Neurons Nerve cells
Nitrous oxide Administered with O2 concentration no less than 30%. Following administration necessary to wash out with 100% O2 for 3-4 min to prevent diffusion hypoxia. Pt to remain in office for 15 min after.
Non de polarizing agents Used for long procedures. Their mode of action is to block acetylcholine receptors at neurotransmitter junction causing prolong muscle relaxation. (Rocuronium, curare, pavulon)
Normal HR 60-100 bpm
Normal levels of hemoglobin Males: 13-18 mg/dL Females: 14-16 mg/dL
O2 capacity Blood has a certain amount of O2 it can carry depending on hemoglobin available.
Obesity 20 % above ideal body weight [(wt in lbs/height in inches)2] x 703
Olfactory nerve 1st cranial nerve that controls smell
Opioid receptor sites Respond to natural opioids produced in body ie endorphins. Ketamine exerts some effects through these receptors.
Optic nerve 2nd cranial nerve that controls sight
Oropharyngeal airway Also placed to position tongue in more anterior position. Often interfere with intra oral procedures. Not tolerated well with awake pts.
Oropharynx Located between soft palate and epiglottis
Parasympathetic nervous system. Slows things down. Decreases heart rate and blood pressure. Skull and sacrum.
Patients who need antibiotic prophylaxis Previous infective endocarditis, prosthetic valves, cardiac transplant patients who develop valvulopathy, congenital heart disease
Peripheral nervous system Consists of sensory and motor nerves
Pharmacodynamics Effects drugs have on various body systems.
Pharmacokinetics Effects body has on drugs
Pharynx Located between nose and trachea. 3 parts nasopharynx, oropharynx, laryngopharynx
Phenergan Potentiates narcotic effects
Phlebitis Inflammation of vein
Precordial Designed to listen to breath sounds during anesthesia. Placed on supersternal notch
Propofol Mimics barbiturates. Rapidly redistributed and metabolized due to being highly bound to fat.Does not tend to predispose to laryngospasm and has antiemetic properties. Discard after 12 hrs.
Protease inhibitors Patients with HIV take this medications. It prolongs effects of benzodiapam derivatives.
Prothrombin time Effectiveness of anticoagulant
Pterygoid plexus Network of veins corresponding to 2nd and 3rd parts of maxillary artery
Pts predisposed to bronchospasm Allergies, asthma, copd, bronchitis
Pulmonary artery One of two arteries that carry venous (oxygen poor) blood from heart to lungs
Pulmonary veins Return oxygenated blood to left atrium from lungs. Only veins that carry oxygenated blood.
Pulseless electrical activity (PEA) Normal appearing tracing, but patient has no pulse
Pulse oximeter Device measures and displays the level of oxygenated hemoglobin compared with total hemoglobin at site if probe. Measures pulse rate and ventilation. Normal O2 sat 96-100%
Purkinje fiber system Causes muscles of heart to contract. Spreads impulse rapidly along heart muscle
PVC's are treated with which medicine? Lidocaine
P wave Atrial depolarization
QRS complex Ventricular depolarization
Rapid redistribution Release of drug from it's initial receptor site and it's movement through bloodstream to other body structures.
Rate of atria 60-80
Rate of AV node 40-60
Rate of SA node 60-100
Rate of ventricles 20-40
Receptor sites Specialized sites on ion channels to which natural neurotransmitter substances or drugs attach usually leading to opening of channel for passage of positively and negatively charged ions.
Relaxation and immobility Essential for patient to be relaxed and immobile during procedure. (Versed, Propofol, brevital, ketamine)
Relay center An ovoid structure in central portion of brain that relays sensory input to cerebral cortex.
Respiration rate 12-16 per minute
Review of systems cardiovascular Headaches, dizziness, nosebleeds, shortness of breath, chest or arm pain, edema.
Review of systems gastrointestinal Loss of appetite, swallowing, change in taste, nausea, vomiting, diarrhea, constipation.
Review of systems general Weight loss, loss of appetite, weakness, fatigue.
Review of systems genitourinary Painful urination, blood in urine, frequent urination, incontinence, discharge in urine.
Review of systems musculoskeletal Weakness of extremities, atrophy of muscles, frequent cramping of muscles.
Review of systems neurologic Weakness of extremities, hx of projectile vomiting, headaches, visual disturbances, any unexplained pain or numbness in body.
Review of systems pulmonary Shortness of breath, dizziness, chronic cough, wheezing, productive cough.
Review of systems skin Bruising, bleeding, discoloration
Rheumatic heart diseases Condition caused secondary to rheumatic fever (beta hemolytic streptococci) which damages the heart valves, primarily the mitral valve, and causes heart murmur.
Right atrium Receives blood from inferior and superior vena cava (peripheral circulation).
Right sided heart failure Increased pressure of fluid in blood vessels causes fluid to leak into body's tissues causing peripheral edema and ascites
Right ventricle Sends deoxygenated blood to lungs via pulmonary artery.
Risks of kidney disease Patients with kidney disease may have difficulty eliminating medications from their body. Sx should not be scheduled on same day as dialysis.
Risks of liver cirrhosis Prolonged effects of medications, prolonged mental depression can cause hepatic coma, trouble clotting, peripheral edema, ascites.
Robinul or atropine Inhibits parasympathetic stimulation of increased saliva. Decreases secretions.
Room air 20% oxygen
SA node Located in right atrium. Acts as pacemaker. Produces sinus rhythms
Scavenging system Reduces levels of noxious agents to acceptably low levels by exhausting then outside operating room.
Sensory nerves Receive messages from environment and and conduct messages back to CNS.
Sinuses Frontal, maxillary, sphenoid, ethmoid
Smoking Predisposes patients to laryngospasm and bronchospasm.
Social history review of systems Patients smoking and alcohol history/current use should be noted along with illegal drug use.
Spinal column Cerebrum, cerebellum, medulla oblongata
Steroids Prevent swelling by stabilizing cell membranes and also prevent acute adrenal deficiency and nausea. (Decadron, solu medrol, solu cortel)
Stroke volume Total amount of blood pumped out of left ventricle in one beat. 60 mL
Superior vena cava Drains head, neck, and upper extremities into right atrium.
Supraventricular foci Located above level of ventricles in atria.
Sympathetic nervous system Speeds things up. Innervates arteries and veins causing vasoconstriction and increased heart rate. Thoracic and lumbar spine.
Symptoms of acute adrenal insufficiency Hypotension, pallor, diaphoresis, nausea, tachycardia, headache, extreme fatigue, high fever, shaking, abdominal pain and confusion.
Symptoms of heart attack Chest pain, anxiety, weakness, sweating, cardiac dysrhythmias, drop in blood pressure.
Symptoms of stroke Paralysis, localized weakness, headache, numbness, slurred speech, inability to speak (aphasia), memory loss, dizziness, blindness to one eye, confusion, loss of consciousness, double vision, ataxia.
Symptoms of syncope Syncope is a loss of consciousness due to sudden sharp, transient drop in blood pressure
Synapse A junction between two neurons.
Systolic phase Both ventricles contracting simultaneously
Tachycardia HR above 100 bpm
Thoracic cage Consists of ribs, sternum, intercostal muscles, diaphragm
what does the Thyroid do? Regulates body's basal metabolic rate.
TIA (transient ischemic attack) Mini stoke. Sudden neurological loss of function with full recovery in 24 hrs.
Tidal volume Normal breathing 500 cc of air is inhaled and exhaled.
Topical anesthetics Benzocaine and lidocaine.
Trachea is also known as Wind pipe.
Treatment for airway obstruction. Foreign bodies. 100% O2, tredelenburg position, retraction of tongue with gauze, forceps, or suture, suctioning of oropharynx.
Treatment for anaphylaxis Activate EMS, 100% O2, monitor vitals, epinephrine, Benadryl, decadron, ACLS protocol while waiting for EMS
Treatment for angina attack 100% O2 via mask, nitroglycerin under tongue 3 times every 5 min, if not relieved by third dose pt is having a heart attack, monitor pt, loosen tight clothing, put pt in comfortable position
Treatment for asystole/PEA CPR, epinephrine IV may repeat every 3-5 min, one dose of vasopressin may be given to replace 1st and 2nd dose of epi
Treatment for bronchospasm 100% O2, albuterol, atrovent, epinephrine, intubation/ventilation, steroid injection, Benadryl, activate EMS.
Treatment for emesis with aspiration Activate EMS, keep IV, 100% O2 via bag/mask, turn patient on right side with head down (tredelenburg), tonsil suction, removal of visible foreign bodies, intubation, transport to care facility.
Treatment for heart attack Activate EMS, closely observe vitals, 100% O2 via mask, make pt comfortable/reassure, attach AED/defibrillator, aspirin 325mg, establish IV with normal saline slow drip, morphine 2-4 mg every 5-10 min
Treatment for high blood pressure 200/100 Terminate procedure, check monitor function, attempt to determine cause, record vitals every 5 min, consider EMS, IV access, beta blockers (labetalol, esmolol, atenolol)
Treatment for hyperventilation Terminate treatment and remove foreign bodies from mouth and surgical instruments from sight, maintain airway, verbally calm patient, monitor vitals, NO O2, have pt breathe into bag to recapture CO2.
Treatment for hyperventilation : Advanced Advanced: IV versed, Valium, Propofol, continue to monitor vitals, discontinue breathing bag, activate EMS if condition deteriorates.
Treatment for hypotension Tredelenburg position, support airway, 100% O2, monitor vitals, consider EMS, IV access, fluid bolus normal saline 10-20mL, ephedrine or phenylephrine IV
Treatment for hypovolemia Pressure to area, cauterization, IV fluid replacement
Treatment for laryngospasm 100% O2, establish proper head position, suction with tonsillar, positive pressure O2 via bag/mask, succinylcholine
Treatment for malignant hypothermia Activate EMS, hyperventalite w/ 100% O2, dantrolene sodium, IB cold saline NOT ringers lactate, ice packs to groin, axilla, neck, cold saline lovage to stomach, bladder, rectum, transport to hospital.
Treatment for mild allergic reaction Place patient in upright or reclined position, 100% O2, monitor vitals, Benadryl
Treatment for premature ventricular contractions (PVC) Try to determine cause (ie hypoxia) and correct, lidocaine IV repeat every 5-10 min until 3mg/kg administered
Treatment for seizures IV access, Valium 5mg IV or medazolam 3mg, continue to monitor vitals, activate EMS
Treatment for stroke (CVA) Activate EMS, not time if incident, monitor vitals closely, place in position of comfort, 100% O2, IV access give bolts of NS/lactated ringers solution, do not treat BP unless greater than 220/120, transport to hospital, note time
Treatment for symptomatic bradycardia Terminate procedure, 100% O2, establish IV, atropine, may need ER for transcutaneous pacing.
Treatment of acute adrenal deficiency Terminate procedure, monitor vitals, tredelenburg position if hypotensive, activate EMS,IV access, steroid administration, fluid bolus, transport to hospital
Treatment of hypoglycemia Activate EMS, IV access, measure blood sugar with glucometer, 1 amp of glucose, IV infusion of dextrose or glucogan IM if no IV
Treatment of intra arterial injection Activate EMS, secure catheter DO NOT REMOVE, 10 cc lidocaine w/o epinephrine, ice pack to limb
Treatment of supraventricular tachycardia Place patient in supine position, adenosine 6mg, after 1-2 min adenosine 12mg, 3rd dose given in 1-2 min as needed.
Treatment of syncope (fainting) Tredelenburg position, ABC's, head tilt chin lift, 100% O2, monitor vitals, relax/reassure patient
Treatment of ventricular fibrillation Activate EMS, CPR/AED, cont CPR and establish IV, give epinephrine 1 mg every 3-5 min, CPR/repeat shocks as above, may give single dose vasopressin to replace 1st and 2nd dose epi, amiodarone, lidocaine, and magnesium considered as well.
Treatment of ventricular tachycardia 100% O2, amiodarone 150mg IV over 10 min, prepare for synchronous cardio version
Trigeminal nerve 5th cranial nerve. Supplies sensation to teeth and jaws.
Trimester to best perform surgery ( pregnant ) 2nd trimester. Most risk to fetus in 1st trimester
T's of pulseleas electrical activity Toxins, trauma, thrombosis, tension pneumothorax, tamponade
T wave Ventricular repolarization
Type I Diabetes Insulin dependent diabetes
Type II diabetes Non insulin dependent
Typical GA regimen Consists of anxiolytic, narcotic, and IV anesthetic agent.
Unmodifiable risk factors for stroke Male, age 55 or older, two times African American, previous stroke, heredity.
Upper airway Nasal passages, sinuses, pharynx, and larynx.
Upper respiratory infection (URI) Common cold or cough which produces increased secretions in airway. Best to delay surgery. Involves sinuses, nasal passages, pharynx, and larynx.
Vagus nerve 10th cranial nerve. Supplies fibers to many parts of body. (Ears, tongue, pharynx, larynx, thoracic/abdominal viscera).
Vaporizer Facilitates the conversion of liquid anesthetic agents to gases suitable for delivery.
Vasoconstrictors in local Epinephrine or neo cobefrin added to anesthetics to prolong duration by causing blood vessels to construct.
Vasodilators Reduce the pressure vasculature. (Norvasc, lisinopril, diovan)
what does a Ventilator do? Breathes for patient. Using bellows type apparatus with positive and negative pressures to move gases in and out of lungs.
Ventricular fibrillation v. fib Course v. fib with prominent, erratic baseline or fine v. fib with far less pronounced vacillations. No p, qrs, or t. Often precedes asystole.
Ventricular foci Located in ventricles
Vistaril Potentiates narcotics and barbiturates. Useful in sedation technique.
Vital centers Centers in brainstem that control physiological processes ie blood pressure, pulse, and respiratory rate.
Volume of one carpule of local anesthetic 1.7 mL Mg/cc * 1.7 to get concentration
Wakefulness system System in brain that maintains the state of consciousness or wakefulness.
What emergency would a cricothyrotomy typically be performed? Airway obstruction
What medications are used to treat malignant hypethermia? Dantrolene, IV cold saline (not Ringer's)
What medications can be given for a sever case of hyperventilation? Versed, Valium, or Propofol
What type of intubation is preferred with emesis with aspiration? ETT. LMA or combitube acceptable
Which monitor tracks both ventilation and circulation? Pulse oximeter
Yellow cylinder Compressed air
Presence of heart disease and lung disease would call for re-evaluation of the surgical and anesthetic regimen in terms of the patients ability to to withstand the _____ involved Stress
Diabetes may compromise the patients ability to _____ Heal
_____ disease may cause bleeding complications or an inability to metabolize some prescribed medications Liver
_____ and _____ diseases may affect the patients ability to undergo anesthesia and respond to stress. Thyroid and adrenal disease
_____ disease may prevent medications from being eliminated from the body, resulting in toxic drug effects. Kidney disease
Created by: Oliverhart