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ch. 14

A 2-year-old girl in cardiac arrest requires epinephrine at a dose of 0.01mg/kg. The mother tells you that her daughter weighs about 25lb. How much epinephrine will you administer? 0.1mg
In contrast to an antiseptic, a disinfectant is: toxic to living issues and should never be used on a patient
Which of the following conditions or situations is associated with the HIGHEST risk of vein rupture during IV cannulation? diabetes
While attempting an start an IV on a patient with large protruding veins, you note that the vein rolls from side to side during your cannulation attempt. The BEST way to remedy this situation is to: Apply downward manual traction below the venipuncture site to stabilize the vein in position
“Track marks” along the course of the patient’s vein are usually a sign of: sclerosis caused by frequent cannulation
Administering large amounts of an isotonic crystalloid solution to a patient with internal bleeding would MOST likely: Increase the severity of internal bleeding by interfering with hemostasis
Which of the following statements regarding osteomyelitis is NOT correct? Osteomyelitis occurs in up to 15% of IO insertion
Prior to cannulating an external jugular vein, it is MOST important to: palpate for carotid pulse
A severely burned patient requires 4,500mL of isotonic crystalloid solution over 8 hours, so medical control orders you to begin the infusion in the field. If you administration set allows 10 gtts/mL, at how many gtts/min will you set the IV flow rate in 94
When drawing medication from an ampule, you should: Gentle tap the ampules if medication is stuck in the neck
Approximately 20 minutes after an IV on a 40-year-old man, he begins complaining of a backache and chills. You should be MOST suspicious of: a pyrogenic reaction
When changing an IV bag, it is important to ensure that fluid remains in the drip chamber
You are transporting a 1-year-old child with moderate dehydration. Your estimated time of arrival at the hospital is 45 minutes. When administrating an isotonic crystalloid solution to this child, you should: Use a Volutrol administration set and fill the calibrated drip chamber with a precalculated volume of fluid
You reassess your patient after administering a medication via the IV bolus route and note that his clinical condition is unchanged. What is the LEAST likely cause of the patient’s unchanged condition? the IV tubing was occluded proximal to the injection port
When administering sublingual nitroglycerin to a patient, you should do all of the following, EXCEPT: instruct the patient to chew and swallow the tablet
100 mL is equal to: 0.1 L
Which of the following statements regarding isotonic crystalloid solutions is correct? Approximately two-thirds of infused isotonic crystalloid solution will leave the vascular space within 1 hour
An unconscious 4-year-old child with a blood glucose reading of 30 mg/dL requires 2 mL/kg of D50. The child’s estimated weight is 35lb. You have a prefilled syringe of D50 at a concentration of 25 g/50 mL. How many grams of dextrose will you administer to 16,000
The use of O-negative blood in the prehospital setting is impractical because: it requires refrigeration
Which of the following statements regarding synthetic blood substitutes is correct? They have the ability to carry oxygen to the body’s cells
When selecting a vein for cannulation, you should avoid areas of the vein that: pass over joints
Which of the following inhaled medications is NOT a beta2 agonist bronchodilator? ipratropium
Which of the following questions does the paramedic generally NOT ask himself or herself when determining the most appropriate IV solution to use on a patient? Has the patient had IV therapy before?
An elderly man with congestive heart failure and shortness of breath requires an IV line in case medication administration is necessary. Which of the following IV catheters is MOST appropriate to use when starting the IV? 20 gauge, 1 ¼ inch
A 71-year-old woman presents with tachypnea, flushed skin, and postural hypotension. Which of the following chief complaints is MOST consistent with these clinical findings? diarrhea
If you give a medication via the oral route in the prehospital setting, you should give it early because: absorption via this route is slow
During the attempted resuscitation of a man in V-Fib cardiac arrest, your protocols call for the administration of 1.5 mg/kg of lidocaine. You have prefilled syringes of lidocaine in a concentration of 100 mg/5 mL. The patient weighs 180 lb. How many mill 6.2
Large protruding arm veins in an otherwise healthy adult can be difficult to cannulate because they often: Roll from side to side during the cannulation attempt
Failure to pinch the tubing proximal to the injection port when administering a drug via the IV bolus route will: Cause the medication to flow up the tubing and away from the patient
To avoid inadvertently cannulating an artery, you should: Always check for a pulse in any vessel you intend to cannulate
If the posterior aspect of the leg rapidly becomes edematous during IO infusion, you should: suspect extravasation fluid
Through which of the following over-the-needle catheters can you infuse the greatest amount of the fluid over the shortest period of time? 14 gauge, 1 ¼”
The purpose of a Volutrol (Buretrol) administration set is to: Avoid inadvertent fluid overload
Thrombophlebitis is MOST commonly caused by: Lapses in aseptic technique
Blood tubing is a: Macrodrip administration set that is designed to facilitate rapid fluid replacement by manual infusion of multiple IV bags or a combination of IV fluids and blood
All of the following medications or preparations are commonly given via the transdermal route, EXCEPT: Acetaminophen
An 80-kg patient weighs _____ lb. 176
A 1% lidocaine (Xylocaine) concentration contains: 1,000 mg/100mL
In the prehospital setting, the MOST commonly used IV solutions are: Isotonic crystalloids
You are preparing to administer a dopamine infusion to a severely hypotensive patient. What is the concentration on hand if you add 800 mg of dopamine to a 500-mL bag of normal saline? 1,600 mcg/mL
Drug reconstitution involves: Injecting diluent or sterile water from one vial into the vial that contains the powdered form of the medication
A nonhypovolemic patient is severely hypotensive and requires a dopamine infusion at 5 mcg/kg/min. The patient’s estimated weight is 190 lb. You add 800 mg of dopamine to a 500-mL bag of normal saline and are using a microdrip administration set. At how m 16
In the prehospital setting, saline locks are used primarily for patients who: Do not need additional fluids but may need rapid medication delivery
0.2 mg equals: 200mcg
Neither subcutaneous nor intramuscular injections should be given to patients: With inadequate peripheral perfusion
What medication route is typically used during allergy testing or when performing a skin test for tuberculosis? intradermal
When administering a drug via IV bolus, you are giving the drug: in one mass
Although medications that are used for maintenance infusions are commonly premixed and prepackaged, you must still: Be aware of the concentration of the drug in the premixed solution
If you receive a medication order from online medical control that seems inappropriate to you, you should: Ask the physician to repeat the order
Medication absorption through a nitroglycerin patch would be increased if the patient has: Skin that is thin or nonintact
A hypoglycemic patient requires IV dextrose. Medical control orders you to administer 25 mL. You have a prefilled syringe of 50% dextrose that contains 25 g/mL. How much dextrose will you give? 12.5 g
To convert 2.5 liters to milliliters, you should: Multiply 2.5 by 1,000
When administering a medication via the intramuscular route, you should: Stretch the skin over the injection site and insert the needle at a 90-degree angle
You are treating a 29-year-old man who was struck in the abdomen with a steel pipe. He is confused, has absent radial pulses, and has a blood pressure of 78/50 mm Hg. You should administer: Normal saline fluid boluses until his mental status and radial pulses improve
The MOST common inhaled medication is: oxygen
Electromechanical infusion pumps are MOST beneficial when administering a medication maintenance infusion because: These devices allow for precise medication dosing
A hypertonic solution has an osmolarity higher than that of serum, meaning that the solution: Has more ionic concentration than serum and pulls fluid and electrolytes from the intracellular and interstitial compartments into the intravascular compartment
If a manually inserted IO needle is placed property in an adult, it should: Rest at a 90-degree angle to the bone
The MOST important point to remember about IV therapy is to: Keep the IV equipment sterile
After inserting an 18-gauge-over-the needle catheter into the hand vein of a 30-year-old woman and securing the IV line in place, you note edema at the catheter site despite continued flow of the IV. The woman complains of pain and tightness around the IV Recognize that infiltration has occurred and immediately discontinue the IV
To administer a drug, you must know the weight of the drug that is present in: 1 mL
The __________ route is the MOST commonly used medication route in the prehospital setting. IV
After attaching the prepared IV line to the hub of the IV catheter and removing the constricting band, you should: Open the IV line and observe for swelling or infiltration
Pyrogenic reactions can be largely avoided by: Inspecting the IV solution carefully before use
Lactated Ringer (LR) solution may be beneficial to patients who have lost large amounts of blood because: The lactate contained within LR is converted to bicarbonate in the liver and can help combat intracellular acidosis
When determining whether an occluded IV line should be reestablished, you should: Infuse 10 mL of normal saline through the injection port to attempt to disrupt the occlusion
IO cannulation is contraindicated in all of the following situations, EXCEPT: Penetrating thoracic trauma
It is MOST important to exercise caution when administering isotonic solutions to patients with: Hypertension and congestive heart failure
As you are preparing to start an IV on a young man, he sees the needle, becomes acutely diaphoretic, and passes out. After placing him in the appropriate position, you should: Administration high-flow oxygen
Which of the following medications is appropriate to administer via the rectal route? Diazepam (Valium)
The first step in discounting an IV line is to: Shut off the flow of fluid with the roller clamp
When initiating an IV line in the upper extremity of a stable patient, you should: Start distally and work proximally
When preparing an IV administration set, you should NOT: Cleanse the piercing spike before inserting it into the IV bag
The IO space collectively comprises the _________ bone of the ________and the medullary cavity of the _________. Cancellous, epiphysis, diaphysis
Immediately after administering intramuscular epinephrine to a patient with an allergic reaction, you should: Dispose of the needle and syringe in a sharps container
Which of the following is NOT always considered a mandatory action after administering a medication via the enteral or parenteral route? Contacting online medical control
Your protocols call for you to administer 5 mg of diazepam (Valium) to a patient who is seizing. You have a 10-mL vial of Valium that contains 10 mg. How many milliliters will you give? 5 mL
All of the following are examples of colloid solutions, EXCEPT: Lactated Ringer
The first signs of IV occlusion is/are: A decreasing drip rate or the presence of blood in the IV tubing
A 60-year-old woman with acute chest discomfort requires 0.4 mg of sublingual nitroglycerin. Prior to administering the medication, you should: Ask her if she wears a transdermal nitroglycerin patch
Regardless of the technique you use to start an IV, you should always: Keep the bevel end side of the catheter up during insertion and maintain adequate traction on the vein during cannulation
A patient with a core body temperature of 35-degree on the Celsius scale has a core body temperature of _______ on the Fahrenheit scale. 95-degrees
Colloid solutions: Contain proteins that are too large to pass out of the capillary membranes, so the solutions remain in the vascular compartment
Medical asepsis is MOST accurately defined as: The practice of preventing contamination of the patient
A 130-lb patient weighs ______kg. 59
How many mg/mL are contained in a prefilled syringe of 50% dextrose with a concentration of 25 g/50 mL? 500
The MOST prominent clinical indicator of a pyrogenic reaction is: fever
A prefilled syringe of lidocaine contains 100mg/5 mL of volume. How many milligrams per milliliter (mg/mL) are present in the syringe? 20
Hypotonic solutions: Hydrate the cells while depleting the vascular compartment
Common risks associated with cannulation of the external jugular vein include all of the following, EXCEPT: Cannulation of the subclavian vein
During IV therapy, the presence of shortness of breath, unequal breath sounds, and cyanosis despite administration of high-flow oxygen should make you MOST suspicious for: an air embolism
Which of the following statements regarding subcutaneous medication administration is correct? Volumes of a drug given subcutaneously are typically 1 mL or less
Which of the following IO devices is NOT used in children? FAST1
While establishing IO access in a critically ill patient, you locate the appropriate anatomic landmark, cleanse the site, and insert the IO catheter at a 45-degree angle. After attaching the IV line and turning the flow on, you note edema developing on th Extraversion due to an inappropriate angle of IO catheter insertion
Signs and symptoms of circulatory overload include: hypertension
Typically, intranasal medications require: 2 to 2.5 times the standard IV dose
All of the following are peripheral veins, EXCEPT the: Subclavian vein
You are treating an unconscious 39-year-old man who overdosed on heroin. You are unable to establish an IV line because his veins are severely sclerosed, and your protocols do not allow for IO cannulation. You should: Administer naloxone via the mucosal atomizer devices
If an adult patient requires fluid replacement for hypovolemic shock, the paramedic should use at least a/an ____ gauge over-the-needle catheter. 18
The signs and symptoms that occur when an IV catheter is sheared and becomes a free-floating segment in the circulatory system MOST closely resemble: an air embolism
Following return of spontaneous circulation, you are ordered to begin a lidocaine infusion at 3 mg/min on your 50-year-old patient. You add 2 g of lidocaine to a 500-mL bag of normal saline and are using a microdrip administration set. At how many drops p 45
A vasovagal reaction is the result of: Dilation of the vasculature
If an adult patient is in hypovolemic shock, you should attempt to insert a(n) ______ over-the-needle catheter into the ______. 14-gauge, metacarpal vein
When a patient needs rapid fluid replacement, you should: Select an administration set that contains a large opening between the piercing spike and drip chamber
To make push-dose epinephrine, you should: Inject 1 mL of epinephrine into a 500 mL bag of normal saline
Which of the following steps is usually necessary when administering a drug via the IO route, but not necessary when administering a drug via the IV bolus route? Placing a pressure infuser device around the IV bag 107.
Created by: Alisha M. Bailey
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