NREMT Paramedic Exam(National Registry)Latest 2023

NREMT Paramedic Exam(National Registry)Latest 2023 stridor - Answer Harsh or high-pitched respiratory sound, swelling, fb in upper airway. Croup is an example Snoring - Answer The sound of the soft tissue of the upper airway creating a partial obstruction of air flow. The tongue blocking the airway is an example. gurgling - Answer indicates presence of fluid in the upper airway, need for suctioning Decorticate - Answer elbows and hands flexed, and legs flexed. They are internally rotated (the lets look bowlegged) (make an O with their arms: corticate) Decerebrate (worse) - Answer Stiffened and internally rotated elbows and legs, teeth clenched, legs stiff and feet extended. Babinski's response - Answer dorsiflexion (splaying) of toes -abnormal plantae reflex response if over 18 months mydriasis - Answer dilation of the pupil. Appears in cardiac arrest, shock, cerebral hypoxia, cocaine, epinephrine, and amphetamines. Miosis - Answer Constricted pupils. Narcotics, CNS disorder, glaucoma medication, bright light anisocoria - Answer unequal pupil size that may indicate serious neurologic dysfunction nystagmus - Answer involuntary rapid eye movements - often reported as horizontal, vertical, or rotary subcutaneous emphysema - Answer Air under the skin; crepitus sound rales (crackles) - Answer Fluid in small airways (aveoli). Common in CHF, pulonary edema, drowning, pneumonia, and COPD Rhonchi - Answer Coarse, low-pitched breath sounds heard in patients with chronic mucus in the upper airways. Found in Bronchitus, COPD, and pneumonia. Wheezing - Answer The production of whistling sounds during expiration such as occurs in asthma and bronchiolitis. Bronchial lung sounds - Answer heard over trachea/upper sternum; expiratory sound predominates; is higher pitched and louder; if heard in other locations it indicates consolidation -- a space that usually contains air now has fluid Bronchovesicular - Answer Heard over scapula and 2/3rd intercostal space lateral to sternum. Apneustic breathing - Answer Characterized by prolonged inspirations unrelieved by attempts to exhale, which indicates trauma to the pons. AKA long, deep breaths that are stopped during inspirations then periods of apnea. Biot's (Ataxic) Respirations - Answer Shallow, deep respirations with periods of apnea Irregular pattern Precipitating factors: respiratory depression, brain damage Cheyne-Stokes respiration - Answer pattern of breathing characterized by a gradual increase of depth and sometimes rate to a maximum level, followed by a decrease, resulting in apnea Hyperventilation - Answer rapid, shallow breathing Kussmaul respirations - Answer very deep and rapid respirations. Example: DKA Hyperresonant - Answer tension pneumothorax, emphysema, asthma resonant - Answer echoing normal sound right upper quadrant - Answer Liver, gallbladder, and stomach Right Lower Quadrant - Answer Appendix, right ovary, and tube. Bladder if distended Left Upper Quadrant - Answer Spleen, stomach, liver, and pancreas left lower quadrant - Answer Left ovary and tube. Bladder if distended Visceral Pain - Answer Internal organs damaged or injured. Vague, not well organized, pressure like, or dull aching, can't point to pain with one finger. Hollow organs stretches, ischemia, inflammation. somatic pain - Answer Pain that originates from skeletal muscles, ligaments, or joints. Peritoneal linining sharp, localized, throbbing, deep breath increases pain Cullen's sign - Answer ecchymosis in umbilical area, seen with pancreatitis. aka bleeding in abdominal cavity Grey Turner's Sign (ecchymosis in flank area) - Answer Chronic hemorrhagic from kidneys and pancreatitis Kehr's sign - Answer Referred pain down the left shoulder; indicative of a ruptured spleen. Murphy's sign - Answer Pain with palplation of gall bladder (seen with cholecystitis) Brudzinski's sign - Answer pain with resistance and involuntary flex of hip/knee when neck is flexed to chest when lying supine. Seen in meingitis Hamman's sign - Answer Cruching shound on auscultation Emphysematous mediastinum Seen with Boerhaave's syndrome, pneumomediastinum, etc. Homan's sign - Answer DVT Kernig's sign - Answer Severe stiffness of the hamstrings causes an inability to straighten the leg when the hip is flexed to 90 degrees. Clubbing of fingers - Answer Caused by chronic hypoxia. Presence of this is suggestive of pulmonary disease. Orthostatic tilt test - Answer Supine, Sitting, and standing. BP raising 20 systolic, increase in heart rate by 20, and decrease in diastolic by 10 MAP (mean arterial pressure) - Answer The average pressure for the entire cardiac cycle MAP=Diastolic Pressure + 1/3 of the Pulse Pressure Pediatric Assessment Triangle (PAT) - Answer A structured assessment tool that allows you to rapidly form a general impression of the infant or child without touching him or her; consists of assessing appearance, work of breathing, and circulation to the skin. Drip calculations gtts/min - Answer gtts/min= ml*drip size/time in minutes drip calculation ml/hr - Answer ml/hr= (gtts/min) * time in minutes(/)drip size weight based dosing - Answer Desired Dose*Weight (in KG)*GTT(drop set) (/) concentration*Time Dosage calculation formula - Answer Example:Atropine 0.02mg/kg. (Atropine comes 1mg/5ml)Patient weighs 55lbs(55/2.2) becomes 25kg. 0.02mg*25kg= 0.5 mg. 0.5mg*5ml= 2.5 ml Alkalosis - Answer pH above 7.45 Acidosis - Answer pH below 7.35 pC02 - Answer 35-45 Hypercabia - Answer excessive levels of carbon dioxide in the blood hypocarbia - Answer insufficient carbon dioxide, hyperventilation syndrome. Kussmaul's breathing HC03 (bicarbonate) - Answer 22-26. above 26 (metabolic alkalosis), below 22 (metabolic acidosis) examples include shock, dka, aspirin overdose, cardiac arrest, lactic acid (waste product). hypovolemic shock - Answer shock resulting from blood or fluid loss (burns or dehydration). High heart rate, high respiration, eventually low BP, pale or cyanotic, flat neck veins. Pale skin. Management- Airway, O2, BVM, if needed, control bleeding, position flat, isotonic crystalloid, keep warm cardiogenic shock - Answer Shock caused by inadequate function of the heart, or pump failure. High or low heart rate, may have pulmonary edema, pale, or cyanotic. Management- Airway, O2, BVM, restrict fluids, and dopamine (vasopressor/inotropic agent Adult dose- 5-20 mcg/kg per minute. Pediatric- 5-20 mcg/kg per minute) anaphylactic shock (distributive shock) - Answer A severe reaction that occurs when an allergen is introduced to the bloodstream of an allergic individual. Characterized by bronchoconstriction, labored breathing, widespread vasodilation, circulatory shock, and sometimes sudden death. Angioedema, hives, stridor, wheezing, vasodilation. Management- Airway, O2, BVM, beta 2 agonist, epi (adults 0.3-0.5 mg, peds-0.01mg/kg) or benadryl (adults 25-50 mg, peds-1 to 2mg/kg) neurogenic shock (distributive shock) - Answer a state of shock (hypo-perfusion) caused by nerve paralysis that sometimes develops from spinal cord injuries. Management- Airway, O2, dopamine (vasopressor/intropic 5-20 mcg/kg). Flat position, spinal precautions if needed. septic shock - Answer a serious condition that occurs when an overwhelming bacterial infection affects the body. Low BP, temp may be high, low or normal skin- pale, cyanotic or red, vasodilation. Rhonci obstructive shock - Answer Shock that occurs when there is a block to blood flow in the heart or great vessels, causing an insufficient blood supply to the body's tissues. Causes- Pulmonary embolus, cardiac tamponade, tension pneumothorax. Management- Rapid transport, airway, O2, pleural decompression for tension. antagonist drugs - Answer drugs that block or change the effects of an addictive drug agonist drug - Answer mimics and enhances a neurotransmitter's effect Schedule 1 drugs - Answer Highest potential for abuse, no therapeutic use, (Heroin, marijuana, LSD, crack cocaine) Schedule II drugs - Answer - Drugs have high potential for abuse - Drugs have currently accepted medical uses, although there may be serious restrictions. (Fentanyl, cocaine, morphine, methadone) Pediatric Drugs - Answer Weight based due to being absorbed more cumulative - Answer increasing, building upon itself Therapeutic effect - Answer The desired or intended effect of a particular medication. synergistic effect - Answer interaction of two or more medicines that results in a greater effect than when the medicines are taken alone Tolerance - Answer the diminishing effect with regular use of the same dose of a drug, requiring the user to take larger and larger doses before experiencing the drug's effect Refractory effect - Answer Half-life of a medication - Answer the amount of time it takes for half of the drug to be eliminated. Liver and kidney disease, aging, absence of food, and slowed metabolic rate prolong half-life because of their effects on metabolism and excretion. Pontentiation - Answer Summation of drug effects - Answer SLUDGEM - Answer Salivation, sweating Lacrimation (excessive tearing) Urination Defecation, drooling, diarrhea Gastric upset and cramps Emesis (vomiting) Muscle twitching/miosis (pinpoint pupils) Alpha blockers - Answer Vasodilate by blocking smaller blood vessels cells from receiving vasoconstriction signals. AKA constricts Beta Blockers - Answer decrease heart rate and dilate arteries by blocking beta receptors. Dialates Beta 1 receptors - Answer increase heart rate Beta 2 - Answer Respiratory, Bronchodilation, Vasodilation Inotropic - Answer strength of contraction Catecholamines - Answer dopamine, norepinephrine, epinephrine 5 Rights of patient medication delivery - Answer Right medication Right dose Right patient Right route Right time Right documentation intramuscular injection - Answer an injection into deep muscle tissue, usually of the buttock, thigh, or upper arm Subcutaneous drug administration - Answer under the skin Inhaled drug administration - Answer