beta exam 3

EXAM 3 STUDY GUIDE (COMBINED)

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CARDIOLOGY

Supine Hypotensive Syndrome
- Occurs in pregnant women when lying flat compresses the inferior vena cava.
- Reduces blood return to the heart → lowers cardiac output → hypotension.
- Symptoms: dizziness, nausea, pallor, hypotension.
- Treatment: position patient on left side to relieve pressure.

Major Cardiac Conditions
- Angina: Chest pain from ischemia; relieved by rest/nitro.
- MI (Heart Attack): Crushing chest pain, nausea, diaphoresis; treat with oxygen, aspirin, transport.
- CHF: Fluid overload, dyspnea, crackles; treat with upright position, oxygen.
- Arrhythmia: Palpitations, syncope; monitor vitals, transport.

Myocardial Infarction (MI)
- S&S: Chest pain (radiating), nausea, SOB, diaphoresis.
- May present atypically in diabetics/women (e.g., fatigue).
- Treatment: oxygen if hypoxic, aspirin, position of comfort, rapid transport.
- Avoid exertion, monitor vitals, prepare for CPR if needed.

AED (Automated External Defibrillator)
- Analyzes heart rhythm and delivers shock for ventricular fibrillation or pulseless V-tach.
- Use ASAP in cardiac arrest.
- Ensure no contact with patient when delivering shock.
- Resume CPR immediately after shock.

Chest Pain
- S&S: Crushing or pressure-like pain, radiating to jaw/arm; nausea, diaphoresis, SOB.
- Often caused by ischemia (angina or MI).
- Treatment: oxygen (if hypoxic), aspirin, calm environment, rapid transport.
- Monitor vitals and prepare for deterioration.

Blood Flow Through the Heart
- RA → RV → lungs (via pulmonary artery) → LA → LV → body (via aorta).
- Valves: tricuspid, pulmonary, mitral, aortic.
- Pulmonary circulation = right side; systemic = left side.
- Oxygenated blood returns from lungs to left atrium.

Cardiology Medications
- Aspirin: For MI; adult dose 324 mg PO; reduces clotting.
- Nitroglycerin: For chest pain; sublingual; lowers BP; contraindicated in hypotension.
- Epinephrine: In cardiac arrest or anaphylaxis; IM or IV; increases HR and BP.
- Oxygen: If SpO₂ < 94% or signs of hypoxia.

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NEUROLOGY

Decreased Responsiveness
- Causes: hypoxia, hypoglycemia, stroke, seizure, trauma, drugs.
- Assess ABCs, check glucose and pupils, AVPU/GCS.
- Manage airway, give oxygen, consider transport to stroke center.

Seizure
- Types: generalized (tonic-clonic), partial, absence.
- S&S: convulsions, incontinence, postictal state.
- Protect patient, clear area, do not restrain; monitor ABCs.

Stroke
- S&S: facial droop, arm drift, slurred speech (FAST exam).
- Ischemic most common; hemorrhagic may involve headache or vomiting.
- Time is critical — identify last known normal and transport FAST.

Headache
- Can be benign (migraine, tension) or serious (stroke, meningitis).
- Red flags: sudden onset, "worst headache," neuro deficits.
- Treatment: supportive care, pain management, rule out stroke.

Transient Ischemic Attack (TIA)
- Stroke-like symptoms that resolve in <24 hours.
- Warning sign of possible future stroke.
- Same assessment as stroke, still needs immediate evaluation.

AVPU Scale
- Stands for Alert, Verbal, Painful, Unresponsive.
- Quick way to assess LOC across all age groups.
- Infants may not verbalize — assess alertness by response to environment.

Positioning of Stroke Patients
- Position semi-Fowler’s (30–45°) unless hypotensive.
- Protect airway, prevent aspiration.
- Do not give anything by mouth.

Changes in LOC
- Causes: hypoxia, hypoglycemia, drugs, brain injury, infection.
- GCS or AVPU helps monitor severity.
- Treat based on cause (oxygen, glucose, etc.).

Glasgow Coma Scale (GCS)
- Eye (4), Verbal (5), Motor (6) = max 15, min 3.
- Example: Eyes open to pain = 2, incomprehensible speech = 2, withdraws to pain = 4 → GCS = 8.
- Use for trauma, stroke, seizure, altered LOC.

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ENDOCRINOLOGY/HEMATOLOGY

Altered Mental Status (AMS)
- Causes: AEIOU TIPS.
- Rule out glucose with glucometer; check vitals and pupils.
- Consider stroke scale, oxygen, naloxone, glucose as needed.

DKA (Diabetic Ketoacidosis)
- Fruity breath, AMS, dehydration.
- Hyperglycemia with acidosis; requires ALS and fluids.

Blood Glucometry
- Used to check blood glucose levels in AMS or diabetic patients.
- Normal range: 80–120 mg/dL.
- <80 = hypoglycemia, >120 = hyperglycemia.

Polyphagia, Polydipsia, Polyuria
- Polyphagia: Excessive hunger.
- Polydipsia: Excessive thirst.
- Polyuria: Excessive urination.
- Classic signs of diabetes.

Kussmaul’s Respirations
- Deep, rapid breathing.
- Seen in DKA.

Hypoglycemia
- Glucose <80.
- S&S: confusion, combativeness, diaphoresis, rapid pulse, seizures.
- Give oral glucose if awake; if unresponsive → ALS.

Hyperglycemia
- Glucose >120.
- Long-term: wounds don’t heal, numbness, blindness.
- Acute: dehydration, lethargy, fruity breath, rapid breathing.
- Treatment: ALS, fluids, airway support.

Components of Blood
- RBCs: Carry oxygen.
- WBCs: Fight infection.
- Platelets: Help with clotting.
- Plasma: Liquid that carries cells/nutrients.

Oral Glucose
- Used for conscious hypoglycemic patients.
- Forms: gel, tablets, or liquid.
- Contraindication: unresponsive or cannot swallow.
- Side effects: nausea, risk of aspiration.