Study your flashcards anywhere!

Download the official Cram app for free >

  • Shuffle
    Toggle On
    Toggle Off
  • Alphabetize
    Toggle On
    Toggle Off
  • Front First
    Toggle On
    Toggle Off
  • Both Sides
    Toggle On
    Toggle Off
  • Read
    Toggle On
    Toggle Off
Reading...
Front

How to study your flashcards.

Right/Left arrow keys: Navigate between flashcards.right arrow keyleft arrow key

Up/Down arrow keys: Flip the card between the front and back.down keyup key

H key: Show hint (3rd side).h key

A key: Read text to speech.a key

image

Play button

image

Play button

image

Progress

1/129

Click to flip

129 Cards in this Set

  • Front
  • Back
  • 3rd side (hint)

Code blue

Cardiac arrest

Code red

Fire

Code pink

Infant abduction

Code purple

Child abduction

Code orange

Hazardous material spill

Code green

Incoming cardiac arrest

Code triage

Internal/external disaster. Expecting a lot of patients

Code yellow

Bomb threat

Code white

Pediatric medical emergency

Code silver

Person with weapon or hostage situation

Code grey

Security

Purpose of crash cart

To keep circulation moving

Glasgow coma scale

Eyes, verbal, and motor


Total of 15pts. Score of 7 or less is dangerous

Crash cart

To keep circulation going. Located in room where they perform contract procedures (IV, iodine)

LOC

Levels of consciousness (can deteriorate quickly. Do Glasgow coma scale)



Loss of consciousness (put in shock position, keep warm, turn head sideways)

Shock

The body's physiological reaction to illness, trauma ,or stress in which there is disturbance of blood flow to vital organs



Interuption of circulation or blood flow or body inability to perfuse (gas exchange)

Shock stages

Compensatory (can intervene)


Progressive (can intervene)


Irreversible (prognosis is really bad)

Shock


Compensatory stage


(Symptoms may not appear)

Skin cold and clammy


Urine output decreases


Bowel sounds are hypoactive


BP is normal


Anxiety increases


Respiratory increases



If progresses, BP falls, going into renal and liver failure, and fluids leak out of capillaries. Now going into progressive stage

Blood Pressure


(Normal)

120/80 to 140/90



Systolic (heart squeezing) 120


Diastolic (heart relaxing) 80

Heart Rate


(Normal)

60 to 100 bpm

Respiration Rate


(Normal)

14 to 20 per minute

Tachycardia

Fast heart rate. Over 100 bpm

Bradychardia

Slow heart rate. Below 60 bpm

Shock


Progressive stage

-BP falls below 60 mm hg


-Respiration rapid and shallow


-Severe pulmonary edema from leakage from capillaries


-tachycardia, rapid as 150 bpm


-chest pain


-mental status (confusion, lethargy, LOC)


-renal, hepatic,GI, heme problems




If progresses, called irreversible stage.

Characteristics of Shock

* heart rate increases


* respiration increases


* Blood Pressure decreases


* urine output decreases

Shock


Irreversible stage

-Blood pressure remains low


-Renal and liver failure results


-Release of necrotic tissue toxins and an overwhelming of lactic acidosis (muscle pain or cramping, discomfort of abdominal and stomach, unusual sleepiness, weakness)

Causes of shock



(Disruption of blood flow or lack of perfusion)

-Bleeding


-Emotional or under physical stress


-Serious injury or infection


-Vomiting or diarrhea


-Diabetes


-Experiencing severe pain


-Bowel obstruction


-Undergoing procedure that causes rapid fluid loss


-Anesthesia


-young or very old

Types of shock

-Hypovolemic shock


-Cardiogenic shock


-Distributive shock (neurogenic shock and septic shock)


-Anaphylactic shock


-Obstructive shock

Hypovolemic shock

Low volume of blood circulating in the body. Occurs when 15 to 25% of blood loss.



Causes:


-maybe internal or external


-Hemorrhage


-Loss of plasma(water) from burns


-Fluid loss from vomiting


-Diarrhea, medications that dehydrate or heat stroke(prostration)

Dyspnea

Difficulty breathing

Hypotension

Low blood pressure below

Hypertension

High blood pressure

Clinical manifestation of hypovolemic shock



Class I

Blood loss of 15%


BP within normal limits


HR is less than 100 bpm


Patient is slightly anxious


Respiration normal (14-20 per min)


Urine output is in normal range

Clinical manifestation of hypovolemic shock



Class II

Blood loss of 15% to 30%


BP is in normal limits


HR is greater than 100 bpm


Patient is increasingly anxious


Respiration ranges from 20 to 30


Urine output begins to decrease

Clinical manifestation of hypovolemic shock



Class III

Blood loss of 30% to 40%


BP decreases below limits


HR is greater than 120 bpm


Patient is anxious and confused


RR increases to 30 to 40 per min.


Urine output is greatly decreased

Clinical manifestation of hypovolemic shock



Class IV

-Blood loss of more than 40%


-Systolic BP decreases from 90 to 60mm Hg


-HR greater than 140 bpm w/weak and thready pulse.


-patient is confused and lethargic


-RR greater than 40 per min.


Urine output diminishes or ceases

Hypovolemic shock RT actions

Still what you doing, put in supine position w/ legs elevated 30 degrees unless spinal cord injury. Never put in tendelenburg position. Get doctor, make sure their breathing. If bleeding apply pressure. Get crash cart. Vitals every 5 min. Don't give fluids to patient

Cardiogenic shock

Caused by failure of the heart to pump adequate amounts of blood to vital organs.



Causes:


-Patient hospitalized by myocardial infarction.


-cardiac dysrhythmias or other cardiac pathology.



Initial complaints:


-Chest pain that radiates to jaws and arms.


-Dizziness & respiratory distress

Clinical manifestation of cardiogenic shock

-Cyanosis


-Restlessness anxiety


-Rapid change in LOC


-Pulse irregular and slow; may have tachycardia and tachypnea


-corotid pulse hard to evaluate


-low BP


-decrease urine output


-cool clammy skin


Cardiogenic RT actions

Call code and get crash cart


Notify doctor


Prepare to assist w/oxygen, IV, meds.


Don't leave patient alone


Assess vitals every 5 min


Don't offer fluids


Be prepared to do CPR

Distributive shock

Inability for the blood to be distributed evenly and adequately, this occurs when the blood pools in the periphery (upper and lower extremities) this generally refers to the lower extremities because it is much further away from heart which takes longer to travel. AKA vasogenic shock.



Types of distributive shock:


Neurogenic


Septic

Neurogenic shock



(Nerve shock)

Type of distributive shock



Results from loss of sympathetic tone causing vasodilation of peripheral vessels. resulting in low blood pressure, occasionally with a slowed heart rate, that is attributed to the disruption of the autonomic pathways within the spinal cord. It can occur after damage to the central nervous system, such as spinal cord injury.



Causes:


Spinal cord injury


Severe pain


Neurologic damage


Depressant action of medication


Lack of glucose


Adverse effects of anesthesia



Clinical manifestation of neurogenic shock

-Hypotension (worst of because there


-Bradycardia. Is no balance. Only time. there is low BP and low HR )



-Warm dry skin


-Initial alertness if not unconscious (head injury)


-Cool extremities & diminishing peripheral pulses

Neurogenic shock RT actions

If suspected spinal injury do lateral c-spine to make sure cervical spine is aligned.


Call for help


Put in supine position


Crash cart


Monitor vitals


Get ready to assist

Septic shock

Type of distributive shock




Has a 40-50% mortality rate for its victims and fast within 12 hours. Single cause of death in ICUs.



Causes:


Whole body infection by bacteria, endotoxins(bad for body) are released causing capillary permeability and vasodilation so blood cant circulate back to heart causing distributive shock.



Risks:


Old and young age


Recent surgery


PICC lines, catheters


Diabetes, COPD, renal failure


Patients who are immunosuppressed


Malnutrition


Massive burns or traumatic injury


Prosthesis, indwelling catheter


Invasive surgery(open surgery)

Obstructive shock

Results from pathologic conditions that interfere with the normal pumping action of the heart (unrelated to heart pathologies and conditions itself)



Most common is pulmonary embolism (PE)



Causes:


-Pulmonary embolism **usually only one we see. (Chest pain)


-Pulmonary hypertension


-Arterial stenosis


-Constrictive pericarditis


-Tumors that interfere with circulation

Pulmonary embolism



Clinical manifestation

#1 cause of sudden death


Chest pain


Rapid, weak pulse


Hyperventilation


Dyspnea & tachypnea


Tachycardia


Apprehension


Cough & hemoptysis (coughing up blood)


Diaphoresis (excessive sweating)


Syncope (feeling fajnt)


Cyanosis


Hypotension


Rapidly changing LOC


Coma; sudden death may result


Anaphylactic shock

Exaggerated hypersensitivity to an antigen (foreign body) that was previously encountered by body's immune system. Histamine & bradykinin are released from body acting on smooth muscle to contract, causing vasodilation, which results in peripheral blood pooling. Or summarized: vessels are wide open, so it's trying to close to pump blood back to heart.



Causes:


Medications


Iodinated contrast (found in sea food)


Insect venoms

Anaphylactic clinical manifestation

Mild systemic reaction:


-Begin within 2 hours of exposure


-Nasal congestion, sneezing,itching ect


-Peripheral tingling or itching at site of infection


-tightness of chest, mouth or throat



Moderate systemic reaction:


-All symptoms listed above w/rapid onset


-Flusging,feeling warmth,itching, uticaria(hives)


-Anxiety


-Bronchospasm & edema of airway and larynx


-Dyspnea, cough and wheezing



Severe systemic reaction: worst case


-All above symptoms w/abrupt onset


-Decreasing BP, weak, thready pulse either rapid or shallow


-Rapid progression of bronchospasm, laryngeal edema, severe dyspnea & cyanosis


-dysphagia, stomach cramping, vomiting, diarrhea


-seizures, respiratory and cardiac arrest


-any mild reaction can become major within 2-3min.




Rarely at this stage



Benadryl and solu-cortef

Benadryl=anti histamine


Solu-cortef=corticosteroid



They both relax smooth muscles(prevents restriction) and can be given prior to contrast study to minimize risk of anaphylactic reaction.

Isotonic

Have some thickness properties as your blood

Iodine reaction

Iodine Is foreign material



Contrast agents are categorized as drugs because they can be absorbed into the systemic(whole body) circulation and may affect physiologic response. Most drugs injected are isotonic.


Contrast agents are not isotonic, they are very viscous(thick and sticky). When contrast is injected causes sudden shift in body fluids, by diluting contrast to the same consistency of blood by stealing fluids from surrounding tissues and drawing them into the vessels. In doing so can cause dehydration.


This sudden shift of fluids can contribute to shock because of thickness of contrast agents.

Iodine reaction



Transient response



(Temporary)

*Is not a reaction but a response to contrast agent. Its expected to happen!! Normal




-A warm flushed feeling from a rapid bolus injection


-Nausea or vomiting usually passes quickly


-Headache


-Pain or burning at injection site


-Metallic taste




*Normal, it is expected and its temporary.



Do not confuse with an allergic reation.


Mild


Moderate (intermediate)


Severe



Infusion vs bolus injection

Infusion: slowly delivered in long period of time



Bolus: large amount in short period of time

Iodine reaction



Health assessment information

-Age of patient


-History of impaired hepatic function


-History of impaired renal function


-History of hypersensitivity reactions


-History of thyroid disease (wont work with other medications like cancer)


-Pregnant


-Lactation (can go to baby and give allergic reaction)


-Aspirin sensitivity


-Sensitivity to tartrazine( coloring in food & beverages)


-beta blockers (heart medication)


-history of diabetes mellitus( may have impaired renal function)


-history of multiple myeloma (dont give contrast)


-simple cell disease (contrast attaches to RBC and no room for oxygen)


-hypertension (increases chance of reaction)



Basically anything that leads to heart can cause anaphylactic shock with contrast agent.


Iodine



Extravasation vs infiltration

Iodine contrast can leak out.



Extrvasation= causes no damage to tissues if leaks out



Infiltration= causes damage and necrose to tissues if leaks out

Diabetes

A fluctuation of carbs or sugar going to brain, high bp going into vessels and then shuts off Like a switch off and on off and on off and on ect.. by doing this, the vessels keep stretching out eventually losing elasticity thus not being able to pump blood back to heart. So lower extremities for example are far from heart and wont get nutrients and oxygen due to not being able to pump blood and will die.

Diabetes type I

Type I Diabetes mellitus:



(insulin dependent)


Autoimmune



Normal adult blood glucose level should range from 80 to 115 mg/dL



Body stops producing insulin. Abrupt onset, under 30. Genetic condition.


The body's immune system destroys the cells that release insulin, eventually eliminating insulin production from the body. Need insulin to produce energy.



Person must receive insulin 8njections to control blood glucose levels and prevent ketoacidosis

Diabetes type II

Type II Diabetes Mellitus:



Producing insulin but body is not utilizing insulin properly. (Insulin resistant) Gradual onset, over 40 who are obese. Caused by obesity, hereditary factors, or environmental conditions. Diet and exercise can control it. Take hypoglycemic agents to prevent hyperglycemia if diet and exercise dont work. Ketoacidosis does not occur in type II because there is enough of insulin present in body to prevent the breakdown of fat. Stress or infection may result in ketoacidosis.



In type II diabetes, The body isn't able to use insulin the right way. This is called insulin resistance. As type 2 diabetes gets worse the pancreas may make less and less insulin and this is called insulin deficiency.


Normal adult blood glucose level

should range from 80 to 115 mg/dL

Gestational Diabetes

Occurs in later months Of pregnancy. Caused by hormones secreted by the Placenta that prevent the action of Insulin. Usually treated with diet but insulin may be needed to control blood glucose levels.



Hormones from the placenta help the baby develop. But these hormones also block the action of the mothers insulin in her body. This problem is called insulin resistance. The mother is not able to use insulin properly. Do not know the cause of it.

Hyperglycemia

Coma maybe a complication of type 2 diabetes. It may occur in the elderly with no known history of diabetes. Mistakenly perceived as being inebriated Or having had a stroke. There is a loss of effective insulin leading to diuresis (excessive sweating) And loss of fluid and electrolytes. Blood glucose is often greater than 600 mg/dL



Clinical manifestation of hyperglycemia

-Extreme dehydration, dry skin, sunken eyes.


-Hypotension, tachycardia, increased body temp.


-Extreme thirst, muscle twitching, difficult, slurred speech.


-Metal confusion, seizures, half paralyzed, and coma.

Ketoacidosis

Diabetic ketoacidosis is a Serious condition that can lead to diabetic Coma (passing out for a long time) or even death.



When your cells don't get the glucose they need for energy your body begins to burn fat for energy, which produces ketones. Ketones Are chemicals that the body creates when it breaks down fat to use for energy. The body does this when it doesn't have enough insulin to use glucose the body's normal source of energy. When ketones build up in the blood, they make it more acidic.

Orthostatic hypotension

When you lay for a long period of time and get up quickly you will get dizzy and that is because blood is pooled to lower extremities and if you get up too quickly there's no blood going to brain and you get Dizzy. So we need to do is sit up patient to get circulation going to brain.

Ketoacidosis


Clinical manifestation

Weakness, drowsiness, headache, blurred vision, abdominal pain, nausea and vomiting


Sweet odor to the breath, and ortho static hypotension.


Warm, dry skin Parched tongue breed dry mucus Membranes, extreme thirst( polydipsia) and polyuria


Hypoglycemia

Not enough sugar in system

Vasovagal reaction

Its emotional. Anything that makes you faint, like being star struck, scared, pain, sight of blood, emotional distress ect. Occurs when the patient experiences high anxiety about the procedure and its results.

Vasovagal syncope

BP and HR drop suddenly. (One of the rare cases it doesn't balance out, that's why you pass out) temporary not shock.


Try to calm them and explain the procedure so they know what to expect. Tell them that they will feel a contrast It may be warm and may have a metallic taste.

CVA

Cerebrovascular Accident (Stroke)



Disruption of blood flow circulating through the brain, a clot or ruptured vessel or occlusion. Rupture of cerebral artery, resulting in hemorrhage directly into the brain tissue or into space surrounding brain.



They occur with little to no warning aka brain attacks. Need clotting agents to stop or controlling bleeding.

CVA


Clinical Manifestations

-possible severe headache


-numbness


- Muscle weakness or flaccidity of face or extremities, usually one sided.


- eye deviation usually one sided, possible loss of vision


-confusion


-dizziness, or stupor


-ataxia (not able to move)


-may complain of stiff neck


- Nausea and Vomiting and loss of consciousness


Everything spins.

Seizures

A syndrome! Not disease!



A seizure is an unsystematic discharge of neurons of the cerebrum that results in an abrupt alteration in brain function. Lasts for only seconds or several minutes. Accompanied by a change of LOC.



SIEZURES ARE A SYNDROME OR SYMPTOM OF A DISEASE, NOT A DISEASE THEMSELVES. They may be caused by infectious disease, especially those accompanied by a high fever.

Causes of seizures

Are caused by extreme stress, head trauma, brain tumors, structural abnormalities of the cerebral cortex, genetics defects(epilepsy), birth trauma, vascular disease, malformations, postnatal trauma. Odors and flashing lights can cause a seizure in a person who is seizure prone.

Seizure types

Simple partial: affects one side of brain



Simple/complex partial: starts in one place primary & triggers a secondary pathway.



Generalized /complex: the whole brain is misfiring at same time

Generalized seizure

(Grand-mal)- tonic/clinic seizures



Clinical manifestation:


-May utter sharp cry as air is rapidly exhaled


-muscles become rigid & eyes open wide (TONIC PHASE)


-may exhibit jerky body movements & rapid irregular respirations (CLONIC PHASE)


-may vomit


-may froth and have blood streaked saliva by biting lips and tongue.(cant controll it)


-may exhibit urinary & fecal incontinence.


-usually fall into deep sleep after seizure due to being exhausting.


Sims position

For seizure patients. Turn them to side or between with face downward so secretions can drain from mouth.

Simple partial seizure

The seizure activity depends on the area of the brain involved.



Clinical manifestation



Only finger or hand may shake


May speak unintelligible


May be dizzy


May experience strange odors,smells and taste

Simple complex seizure

Clinical manifestation


The patient is not responsive to the environment, although he appears to be awake. A complex partial seizure or last from 1 to 4 minutes. They look stoke



-patting and rubbing oneself


-may remain motionless or experience emotional outburst of fear, crying or anger.


- lip smacking, grimacing,swallowing movements or panting.


-will be confused for several minutes after episode with no memory of incident.

Head injury LOC

1: alert and conscious


2: drowsy but responsive


3: unconscious but reactive to pain


4: comatose

Gait

How you walk

Head injury RT actions

Lateral recumbent

Lying on their side



Like for head injury, seizure ect... patients

Concussion

Temporary lack of blood flow to brain from tear of small vessels that attach to skull and that is due to vigorously shaking of head or getting hit on head.1 or 2 concussions ok, but a lot is bad.

Spinal injury

Should be evaluated by doctors before being moved. Even a slight movement can cause pressure on cord, resulting in paralysis or death. If possible make film exposures without moving patient. If a change of position is required use logrolling method. When doing logrolling method always 2 or more people. Move whole body in one motion avoiding twisting or bending of spine.

Compound fracture

Open. Bone protrudes through skin

Comminuted fracture

Broken into many pieces

Avulsion fracture

Is where tendon pulls bone and detaches it

Incomplete (greenstick) fracture

Where bone doesn't break but bends significantly

Crepitus

Grading sound or feel.



Ex. Fracture

Casting

When there's a newly fresh wet cast, do not squeeze cast because it will cause indication inside cast pressing down on skin and can stop circulation.

1st degree burn

Redness or hyperemia involving superficial layers of skin. Maybe a little blister. Skin tissue

2nd degree burn

Blisters (vessication) involving deeper layers of skin. Skin tissue

3rd degree burn

Destruction involving any tissue below the skin. Skin tissue and bone

Nausea

Nausea and vomiting are frequently encountered. Vomiting can often be prevented by a reassuring touch and presence of a radiographer and by instruction to breathe through your mouth taking short rapid panting breaths support patient in sitting position or lateral recumbent position to avoid aspiration of vomits. If the patient needs to vomit, give basin tray, and tissue and water to rinse mouth. If patient goes unconscious, turn to side and clear airway.

Epistaxis

Nosebleed



Squeeze firmly against nasal septum for 10 min. If bleeding last more than 5 min get doctor. Dont let them swallow blood, spit out. Dont lie down, blow nose, or talk.

Vertigo

Due to a different cause. Will not feel lightheaded but will describe the Room is moving or whirling. Will cling to table and will fall if not assisted. Alcohol or drugs affect people the same way.

Vital signs

Several situations that may alter a person's normal vital sign, such as sleep, exercise, medications and emotions . Aka cardinal signs



Brain cant function for more than 4 or 5 min without an adequate supply of oxygen.

Temperature

A measurement of the state of metabolism of the body. It is a physiologic balance between the heat produced in body tissues and he lost to the environment. Changes in the body's Physiology occur when the body temperature fluctuates even 2 or 3゚ 3 body temperature is controlled by the hypothalamus. If a fever persist over long period of time CNS damage can occur.



Body utilizes a lot of oxygen

Temperature oral

Put under tongue. Do not use if patient has been drinking hot or cold beverages. Wait 15 min When the patient is breathing oxygen with a face mask, patience is unconscious, delirious, unresponsive, infant, in surgery, injury to nose or mouth, history of convulsions, or unable to breathe. Chewing gum and smoking also affect temperature. Leave the mometer in the mouth for 3 to 5 minutes.



Normal temp with discription: 98.6 O

Temperature axillary

Armpit. Place under the arm and cross arm over the chest. Be sure to wipe off sweat and deodorant. Leave under arm for 5 min.



Normal temp with discription: 97.6 A

Temperature rectal

Core temp!



Usually done on infants. Should not be done if patient is restless or has a rectal pathology such as tumors or hemorrhoids. Wear gloves and provide lubricant. Insert 1 to 11/2 inches and hold in place for 2-3 min.



Normal temp with discription: 99.6 R

Temperature tympanic

Ear



It's a small handheld device that measures the temperature of the blood vessels in the tympanic membrane of the ear.



Normal temp with discription: 98.6 T

Pyrexia

Elevated body temperature (frequent complications of fever is convulsions

Underlying or intermittent temp

Alternating between fever and normal temperatures

Remittent

Temperature rises, then drops, but never returns to normal

Crisis

Sudden turning point of a disease- usually with a sudden drop in fever

Lysis

Fever gradually returns to normal

Afebrile

Without a fever

Hypothermia

Lowered body temperature. Can cause death if below 93.2 F (34C) aka hypopyrexia

Hyperpyrexia

Elevated body temperature


105.8 F or 41 C to 111.2 F or 44 C.



High temperatures can affect CNS

Pulse

Tells how often the heart beats grid areas of the body in which arteries are superficial, the pulse can be felt by holding the artery beneath the skin against a solid surface of bone

Normal HR

60 to 90 beats per minute


Where to take pulse

-Apical - heart heard with stethoscope


-Radial


-Carotid


-Femoral


-Popliteal


-Temporal


-Dorsalis pedis



The first seven are most common and Last are:



-Posterial tibial


-Brachial



Usually the pulse is rapid if BP is low and slow when BP is high

Respiration

One respiration = 1 inspiration + 1 expiration.



Normal:


Adult 15 to 20 breaths/minute


Child 25 to 30


Infant 30 to 60

Discriptors for respiration

Rapid


Shallow


Irregular


Labored

Emphysema

COPD



Lungs expand and stay in expanded state, does not retract. Air is trapped in lungs so cant get air out.

Asthma

Lungs are constricted and xant get air inside

Cyonosis

Lack of oxygen- look for cyanosis around lips, ear lobes,gums and nail beds

Tachypnea

Rapid breathing of 40 or more respiration/minute

Orthopnea

Person can only breath in a upright position. If lay down will have difficult breathing

Stertorous breathing

Snoring

Cheyne-stokes

Death rattle (near death or dying)= rapid breathing for 30 seconds slows down then stops for about 10-30 seconds and the sequence starts all over again.

Croup

Obstructive by secretions. Sounds wet and mucousy

Stridor

Abnormal high pitch. Heard in inspiration. Indicates glottic edema or asthma

Blood pressure

Is the force exerted by the blood on the walls of the vessels as it is pumped by the heart.



Shock is the best indicator



Increases after a big meal, stress, emotions, strenuous activities.

Systolic / diastolic

Systolic :Contractions of the ventricles



Diastolic: relaxation of the ventricles

Normal Blood Pressure

Adult: 120-140/80-90 mm Hg


Children: 90-120/50-70 mm Hg

Most important lab data for technicians

BUN and creatinine



BUN= blood urea nitrogen

BUN

High BUN - renal disease or compromised function



Low BUN - severe liver disease or malnutrition