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131 Cards in this Set
- Front
- Back
acute asthma attack
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anxiety, wheezing (bronchospasm on exhalation) and mucus plugging, tachypnea and tachycardia, dyspnea and possible chest discomfort, accessory muscle use, forcing each breath out, coughing
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COPD- emphysema
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anxiety and tripod position, dyspnea (trouble getting air IN), pursed lip breathing, accessory muscle use, rhonchi or wheezes, prolonged expiratory phase (forcing breath OUT), cyanosis or ruddines, barrel chest
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pulmonary edema
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starts as mild or pronounced agitation, tachycardia, pale/cool/clammy skin, persistent cough - usually non-productive, wheezes or crackles,
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pulmonary embolous
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sudden and dramatic onset of agitation and apprehension, sudden and dramatic hyperventilation, dyspnea with congestion and SOB, pleuritic chest pain- sharp and sudden on inhalation, tachypnea and tachycardia, hemoptysis, cyanosis, crackles, calf or leg pain
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pneumonia
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hx of upper respiratory infection, fever, productive cough (rhonchi) often with greenish or rust colored mucus, possibly wheezes, chest discomfort or pain
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flu (influenza)
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sudden onset of fever and chills (102-104), general malaise, feel to lousy to function (3-4 days of extreme fatigue), severe headache with photophobia and eye ache, severe muscle aches (back and legs), cough (possibly with substernal bleeding), lasts 3-7 days
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hyperventilation syndrome
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severe anxiety/agitation/fright, hyperventilating, progressive S/S of alkosis; light headiness and dizziness, numbness and tingling around the mouth, tightness in the chest, complaint of not being able to get breath, muscle twitching, carpal/pedal spasms, tetany, seizures, LOC
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epiglottitis
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fever, sore throat (dysphagia and drooling), dyspnea, accessory muscle use, coughing
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pleurisy
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pleuritic chest pain (sharp, stabbing, on inhalation), cough, hx of URI
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adult respiratory distress syndrome (ARDS)
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dyspnea and tachycardia, crackles
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angina pectoris
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P- exercise, activity, stress Q- feels like pressure, chest tightness, weight on the chest, burning R- felt substernal or epigastric, may radiate to jaw, neck or left arm S- mild or moderate pain or discomfort T- sudden onset usually lasts 3-5 minutes... dyspnea, diopheresis, N/V, belching
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myocardial infarction
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P- exercise, activity or stress, may be no provoking factor Q- feels like pressure, chest tightness, burning, weight on chest R- felt substernal or epigastric, may radiate to jaw, neck or left shoulder/arm S- moderate or severe pain or discomfort T- sudden onset, usually lasts 30 min or longer... N/V, diopheresis (soaking wet), weakness or light-headiness, irregular pulse, dyspnea, orthopnea, denial
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CHF (left sided)
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slow onset over several days but may not be noticed until acute, dyspnea, SOB, productive cough, orthopnea, usually found propped up, pulmonary edema
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CHF (right sided)
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dependent edema (pedal edema), JVD, liver enlargement (ascites)
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hypertensive crisis
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HTN with angina, pulmonary edema, pregnancy, signs of cerebral edema (severe headache, blurred vision, N/V, altered mental status, focal neurological signs, paresthesias, dizziness, vertigo, tinnitus), epistaxis, chest pain, SOB, abdominal or back pain
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hypertensive emergency
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pulse that is strong and bounding, tinnitus, headache, epistaxis, N/V
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dissecting aortic aneurysm
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P- lifting heavy weights, straining Q- tearing, hot, knife-like R- pain front anterior chest, boring through to the back S- very severe and hits maximum at time of onset (does not build up) T- sudden onset... unequal left and right radial/femoral pulses, unequal blood pressures
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CVA
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ALOC (coma, stupor, confusion, seizures, delirium), intense or unusually severe headache and or neck/facial pain, hemiparesis or hemiplegia, ataxia, asymmetry of face (facial drooping), aniscoria, dysarthria, aphasia, dysphasia, incontinence, photophobia, sudden blurred vision, vertigo, N/V, HTN (>140/90)
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TIA
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ALOC (coma, stupor, confusion, seizures, delirium), intense or unusually severe headache and or neck/facial pain, hemiparesis or hemiplegia, ataxia, asymmetry of face (facial drooping), aniscoria, dysarthria, aphasia, dysphasia, incontinence, photophobia, sudden blurred vision, vertigo, N/V, HTN (>140/90)
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grand mal seizure
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aura before seizure (odd smell, sound or visual disturbance), tonic/clonic phase (muscle stiffening then spasms), LOC or lack of awareness, tismus, bitting cheek or tongue, incontinence, post-ical phase (relaxation)
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gastric ulcer
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persistent pain in the upper abdomen (described as burning), pain is somewhat or completely relieved by eating bland foods, hematemesis or melena
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abdominal aortic aneurysm
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P- lifting heavy weights, straining Q- tearing, hot, knife-like R- pain from anterior abdomen boring through to the back S- very severe and hits maximum at time of onset T- sudden onset... unequal femoral pulses, may have severe signs of shock
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appendicitis
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fever, anorexia, N/V, sharp right lower quadrant pain, guarding, rebound tenderness (increased over several hours)
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esophageal varices
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massive hematemesis, dramatic hemoptysis, hypovolemia
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gallbladder inflammation (cholecystitis)
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hx of recent ingestion of a meal with a lot of fat, gradual onset of sharp pain in RUQ (possibly right shoulder), possible N/V
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kidney stones
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tremendous pain in lower quadrants radiating in pulse-like waves from rear flank downward, anxiety, N/V, hematuria
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bowel obstruction
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crampy pain in abdomen -in spasms, abdominal distention, anorexia, N/V, fever
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chronic liver disease (hepatitis)
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jaundice, ascites, pedal edema, muscle atrophy, decreased clotting, petechai, varicose or spider veins
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pancreatitis
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sudden onset of severe LUQ epigastric pain- steady boring through to the back- may radiate to left shoulder, usually hx of alcohol abuse, abdominal distention or tenderness, N/V, may develop shock
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irritable bowel syndrome
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abdominal pain, cramping, gas, bloating, diarrhea or constipation, described as "worse than child birth", sudden knife-like pain that doubles pt over
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diverticulitis
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LLQ abdominal pain, fever, vomiting, constipation
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hyperglycemic crisis (diabetic coma)
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gradual onset often over several days, flush/dry/warm skin, mild fever, intense thirst and dry mouth, weak tachycardia, hypotension, rapid-deep sighing breathing (kussmal respirations), fruity or sweet smelling breath (acetone- ketoacidosis), decreased LOC- gradual onset of restlessness-stupor-confusion- eventual coma- feels weak and sleepy, N/V, abdominal pain, anorexia, blurred vision
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hypoglycemic crisis (insulin shock)
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sudden onset (often too fast to react), pale/cool/wet skin (often soaking wet), full strong tachycardia, weakness or dizziness, agitated- restless- uncooperative -abnormal behaivor- syncope- ALOC
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anaphylaxis
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tachypnea, tachycardia, hypotension, red or pale itchy raised skin (bull's eye), dyspnea, wheezing or stridor (from bronchospasm or laryngospasm), respiratory distress, signs of hypovolemia
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bee sting (anything from the hymenoptera family)
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pain and localized swelling, redness, "bull's eye" mark, itching, watch for airway swelling
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staph food poisoning
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onset 1-6 hours after ingestion, VIOLENT onset of N/V/D and abdominal pain
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salmonella food poisoning
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onset 12-72 hours after ingestion, VIOLENT onset of N/V/D and abdominal pain, transmission animal to human from fecal matter
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shigella
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onset 1-2 days, duration 4-7 days, acute bloody diarrhea
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e coli
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onset 1-3 days, acute watery diarrhea (usually without fever) lasts 3-7 days
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botulism food poisoning
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onset 12-36 hours, N/V/D, abdominal cramping, pressing to paralysis, respiratory depression, paresthesias, bronchospasm, cranial nerve weakness
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poison oak dermatitis
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delayed onset (some blisters appear after 12 hours then gradually increase), intense itching then leading to scratching or scarring, small fluid filled vesicles appear which break and leak serum
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antidepressants
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decreased LOC, seizures, cardiac dysrhythmias
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beta blockers
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cardiac dysrhythmias (brady usually), hypotension, bradycardia, cardiac arrest
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narcotics/opiates
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decreased LOC, respiratory depression, hypoventilation, hypotension, N/V
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depressants
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decreased LOC, respiratory depression, hypoventilation, loss of muscle coordination, dysarthria, nystagmus, bradycardia, hypotension
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stimulants
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increased LOC (agitation, anxiety, restlessness, paranoia), tachycardia, hypertension, rapid speech, dilated pupils, seizures- muscle twitching, tremors, chest pain
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hallucinogens
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ALOC, blank stare, aggression, anxiety, agitation, paranoia, inappropriate behavior, tachycardia/hypertension, visual hallucinations, seizures, nystagmus, hot flashes
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hydrocarbons/ solvents
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ALOC, blank stare, CNS depression, coughing, choking
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alcohol withdrawal syndrome
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ALOC, hallucinations (ants crawling on skin), insomnia or nightmares, pale/cool/clammy skin (goose bumps), tremors (delirium tremors), tachycardia, seizures
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aspirin
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tinnitus, N/V, pain and cramping in severe overdoses, hyperventilations, LD50 = 95 tablets
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tylenol (acetaminophen)
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onset 3-7 days, malaise, anorexia, cyanosis, acute liver failure, LD50 = 40-75 tablets
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toxic inhalations
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dyspnea, tachypnea, N/V, ALOC, airway irritation, wheezing or crackles, sore throat, cough
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smoke inhalations (toxic gases)
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dyspnea, tachypnea, cough, stridor/wheezes/ crackles, watery irritated eyes, signed facial hairs (eyebrows and nasal hairs)
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carbon monoxide inhalations
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rapid headache seems "out of nowhere", ALOC- confusion - coma, N/V, dyspnea-tachypnea- tachycardia, flushed skin, dizziness
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cyanide gas inhalations
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sudden onset within minutes on inhalation, pt becomes rapidly unconscious (often falling), respirations are rapid and convulsive at first- then slow and gasping, hypotension, seizures, incontinence, cardiovascular collapse
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chlorine gas inhalations
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instant onset of burning in the lungs, dyspnea, tachypnea, severe cough, abnormal breath sounds, watery irritated eyes
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organophosphates
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Constricted pupils, Diarrhea, Urination/incontinence, Muscle weakness/trembling/ataxia, Bradycardia/hypotension, Bronchospasm-possible wheezing, Bronchorrhea-lots of mucus, Emesis/ N/V, Lacrimation- tearing of eyes, Sweating and flushed skin, Salivation/drooling/dysphagia, Seizures, GI cramping (C-DUMB BBELSSS-G)
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pelvic inflammatory disease (PID)
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tremendous pain in lower quadrants, often have fever, anxiety/restlessness, N/V, abnormal vaginal discharge
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ectopic pregnancy
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abrupt onset of severe tabbing pain in the lower quadrants, abdominal distention, guarding, rigidity, may not know she is pregnant, S/S of shock, N/V, vaginal bleeding (spotting)
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contusion
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discoloration (capillary bleeding or bruising), pain or tenderness, some swelling
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hematoma
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usually some swelling- pronounced bump, discoloration, pain/tenderness
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abrasion
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small amounts of blood loss with large amounts of tissue damage
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puncture
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usually very little external blood loss, but may be significant internal bleeding
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avulsion
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torn or ripped off piece of skin, considerable blood loss but vessels pinch off quickly
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incision
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cut will be smooth minimal bleeding
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laceration
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cut will be rough with lots of bleeding
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evisceration
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will notice internal organs located outside of the body
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larynx/ trachea fracture
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obvious signs of injury, edema, hoarseness, stridor, subcutaneous emphysema
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compartment syndrome
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pallor, paralysis, pulseless, paresthesias, pain on having their limb stretched (passive stretch)
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airway burns
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burns around the face/mouth, singed facial hairs- eyebrows- eyelashes- nasal hairs, productive cough (sooty sputum), hoarseness when pt tries to talk, dyspnea, dysphagia, hx of burn inside an enclosed area,
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thermal burns
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IMMEDIATE respirator burns (most frequent cause of death), smoke or toxic gas inhalation, hypothermia LATER hypovolemia, infections, kidney failure, pulmonary edema (non-cariogenic)
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concussion
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usually temporary LOC followed by a prompt recovery, often pt will complain of headache and light headiness, dizziness, grogginess, N, pt recovery is measured in min-to hours
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cerebral contusion
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much like a concussion usually more severe and last longer, S/S of ICP, pt recovery is measure in hours to days, may be permanent disability
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epidural hematoma
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all signs and symptoms of concussion, ALOC with "lucid interval", onset may be delated 1-4 hours, S/S of ICP, usually following linear fx to temporal or parietal bones
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subdural hematoma
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all signs of concussion, S/S may be delayed 2-4 weeks, S/S of ICP
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intra-cerebral hemorrhage
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sudden onset of extremely severe headache "worst headache i have ever had", rapid LOC without regaining it (falling out of chair), S/S of ICP
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coup- countercoup
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S/S of ICP, increased systolic BP, widened pulse pressure, bradycardia (baroreceptor reflex- vagal response), altered/abnormal respiratory patterns, deteriorating LOC, N/V, severe persistent headache, pupillary changes, seizures, brainstem posturing in severe cases
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cervical spine trauma
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pain (especially on palpation), swelling/deformity at injury site, neck muscle spasms and stiffness, neurological deficits (paralysis, paresthesias, anesthesia)- "sitck em up" position (indicates C6 fx), respiratory compromise, diaphragmatic breathing (sign of fx below C4), neurogenic shock (loss of sympathetic NS- pt lacks common shock signs), incontinence, priapism
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rib fracture
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sharp-stabbing- pleuritic chest pain thats made worse by inhalation, may have abrasion or contusion (seatbelt), pt will attempt to splint area with his own arm, may be hypOventilating due to pain
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flail chest
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dyspnea, tachypnea, "floating" chest wall segment (paradoxical chest movement), cyanosis, subcutaneous emphysema,
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pneumothorax
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dyspnea, tachypnea, diminished breath sounds on one side, sharp- stabbing chest pain
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tension pneumothorax
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progressive dyspnea, tachypnea, absent lung sounds on affected side (muffled or distant), JVD, narrowed pulse pressure (hypotension), unequal chest expansion on inhalation, tracheal deviation (left or right)
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pericardial tamponade (cardiac tamponade)
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JVD, dyspnea, narrowed pulse pressure (hypotension), muffled heart sounds (breath sounds would be equal)
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myocardial contusion
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chest pain, bruising over sternum, dyspnea, tachypnea, dysrhythmia, S/S of shock
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commotio cordis
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S/S of trauma over sternum, v-fib
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pulmonary contusion
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chest pain, bruising over the sternum, progressive dyspnea, decreased breath sounds on one side, hemoptysis, dysrhythmia
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tracheobronchial rupture/laceration
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severe respiratory distress, stridor- hoarseness if able to talk, subcutaneous crackling- sensation to touch (crepitus), decreased or unequal breath sounds, hemoptysis, tachycardia, hypotension, cyanosis
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hemothorax
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S/S of severe shock, respiratory distress, decreased or absent breath sounds on one side
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blunt abdominal trauma
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pain and tenderness- often diffuse- sometimes local (point tenderness), abdominal distention, abdominal "guarding"-rigidity, signs of surface wounds (abrasions, discolorations, bruising), N/V, S/S of shock
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sprains
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may have heard a "snap", pain and tenderness (may prevent walking), swelling, discoloration (often delayed)
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strains
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may have heard a "snap", pain and tenderness, severe weakness
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dislocations
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deformity (usually dramatic), pain and tenderness (usually extreme pain), swelling occurs but may take time or be masked by deformity, discoloration (takes time), inability to move joint
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fractures
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deformity (not always present), pain and tenderness (usually significant), swelling/edema (takes time), discoloration (takes times), CAN be moved, crepitus, pt usually heard it break
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hypothermia
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MILD- amnesia, dysarthria, poor judgement, stupid (maladaptive) behavior, tachycardia, hyperventilations, ataxia and apathy, SEVERE- stupor, decrease in oxygen consumption, decreased LOC, bradycardia, pupils dilate, v-fib, paradoxical undressing, loss of reflexes and voluntary movement, BP may be undetectable
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frostbite
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pale, waxy appearing/ cold skin, usually painless (extreme pain if thawing has started), no cap refill, usually also hypothermic
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heat syncope
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body temp and water/salt balances are normal, brief syncope, fatigue, malaise, drowsiness, headache, confusion, weakness, dizziness, thirst, pale/soaked/ cool skin
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heat exhaustion (exercise hypovolemia)
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dehydration, low water/salt balance, usually exercising, fatigue, malaise, drowsiness, headache, confusion, weakness, dizziness, syncope, rapid thready pulse, hypotension, pale/soaked cool skin, muscle/abdominal cramps (60% get them), N/V/D, thirst
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heat cramps (water toxicity)
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usually after exercise, muscle cramps of legs and muscles being used, hx of prolonged heavy exertion in heat, nausea, body temp normal
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heat stroke
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hot/wet/pale skin (usually sweating after collapse), LOC, altered mental function (bizarre behavior), tachycardia, hypotension, seizures, dilated pupils
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near drowning
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hx of underwater episode (immersion event), vomiting, apnea and cyanosis, tachypnea, dyspnea, wheezing/ stridor/ crackles or rhonchi, hypothermia, ALOC
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air embolism
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dizziness, confusion, headache, chest discomfort or pain, dyspnea, neuro deficits (can mimic CVA- ataxia, aniscoria), dysarthria, unconsciousness, seizures or cardiopulmonary arrest
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barotrauma
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tinnitus or ruptured ear drum, small amounts of blood leaking from ear, epistaxis, coughing up small amounts of blood
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decompression sickness
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joint pain (may be bent over), paresthesias (diver's itch), headache, general fatigue, malaise (just feels bad), dyspnea, dysarthria, ataxia, N/V, vertigo
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acute mountain sickness (AMS)
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headache, dyspnea, N/V, anorexia, insomnia
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high altitude pulmonary edema (HAPE)
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delayed onset usually 1-3 days, dyspnea, SOB (even after rest), persistent cough, usually non-productive but some hemoptysis, crackles, fatigue, tachypnea (>30), tachycardia at rest, hypotension (<106.68)
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high altitude cerebral edema (HACE)
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delayed onset usually 1-3 days, ataxia (primary identifier, absent in AMS), severe lack of energy (lassitude), drowsiness, stupor, impaired mental function- confusion- hallucinations, focal neurological deficits- facial droop, hemiparesis
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black widow spider bite
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usually no local reaction, little to no redness or local pain, symptoms usually delayed 30 min to 2 hours, systemic muscle pain and extreme abdominal pain, muscle cramping, chest tightness, dyspnea, abdominal rigidity (board hard), may develop hypertensive crisis
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brown recluse spider bite
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minimal pain initially, symptoms delayed 2-8 hours, fever/chills, N/V, joint pain, local tissue necrosis- ulceration
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scorpion sting
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little or no redness, no discoloration, instant onset of severe pain, muscle cramps, paresthesias, muscle twitching, possible seizures, excessive salivation, N/V, hypertensive crisis is possible
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jellyfish
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instant burning at site, shock is possible but rare
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stingray (sculpin, cone shells)
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instant burning pain at site, muscle spasms and pain, can cause partial paralysis, shock is possible
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rattlesnake bite
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puncture wounds (1-4), progressive and rapid swelling in the area, pain in the area, weakness, diopheresis, paresthesias, discoloration below the surface due to bleeding
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rabies
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incubation 2 weeks to 4 months, hx of animal encounter within that time frame
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pregnancy induced HTN (eclampsia)
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sudden weight gain, limb edema, HTN, severe headaches, visual disturbances, possibly seizures
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supine hypotensive syndrome
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hypotension, supine, tachycardia
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placenta abruptio
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normally implanted placenta (>20 weeks gestation), often associated with PIH, 3rd trimester acute dark vaginal bleeding, uterine tenderness, abdominal pain between contractions, symptoms of shock greater than amount of blood loss, uterus may be too rigid for signs of contraction
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placenta previa
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sudden 3rd trimester bright red vaginal bleeding, painless - usually not uterine tenderness, usually no contractions, bleeding often occurs in repetitive episodes over days/weeks
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delayed delivery
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after signs of imminent delivery continue for 20 min with no progress, no crowning or no increase in crowning
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prolapsed cord
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upon looking for crowning- cord is visible before the baby is born
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limb presentation
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single arm or single leg is the presenting part
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breech presentation
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buttocks or legs are the presenting part during labor
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premature labor/delivery
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onset of labor prior to delivery date, results in delivery of small infant
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child dehydration
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poor muscle tone- limp, red/warm/ dry skin (could be ashen), poor skin tugor with tenting, dry mucus membranes, sunken fontanels, sunken eyes, decreased urine output, polydipsia, poor or no response to mother
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croup (tracheobronchitis)
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common in 6 months to 4 y/o, usually a hx of URI with a low grade fever, inspiratory stridor, hoarseness, possible wheezing, "seal bark' cough, severe respiratory distress with accessory muscle use, nasal flaring, retractions and tachypnea
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epiglottitis
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common in 3-7 y/o, sudden onset of severe respiratory distress, dyspnea, tripod position, stridor, hoarseness (little or no cough), aphagia, high fever, sore throat, tachycardia and tachypnea
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foreign body aspiration
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severe respiratory distress, use of accessory muscles, nasal flaring, retractions (grunting at the end of each breath), cough, drooling, stridor/wheezing, tachycardia and tachypnea, cyanosis
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asthma
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severe respiratory distress, use of accessory muscles, nasal flaring, tripod position, severe dyspnea, tachypnea, cough, expiratory wheezing, tachycardia and anxiety, pallor or cyanosis
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meningitis
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headache, extreme irritability, stiff neck, nuchal rigidity, photophobia, petechial rash (very small flat red marks, looks like measles), ALOC, odd sounding high pitched cry, N/V/D, high fever, tachycardia, tachypnea, febrile seizures
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impending respiratory failure
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increased respiratory rate and effort- often involving accessory muscles with abdominal breathing, poor muscle tone, diminished breath sounds, decreasing LOC, diminished response to stimuli, cyanosis, infants hearts slow down as they approach respiratory failure
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increased intracranial pressure (ICP)
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high pitched cry, irritability or lethargy, bulging fontanels in infants, headache, dizziness, vomiting, seizures or twitching
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sudden infant death syndrome (SIDS)
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appearance of normal nutrition and hydration, skin may be mottled/cyanotic/ashen, often there is frothy-blood tinged fluids, vomitus may be present, pt may be in unusual position due to muscle spasms, no external signs of trauma
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