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C-NPT EXAM-STUDY CORE KNOWLEDGE QUESTIONS COMPLETE WITH DETAILED VERIFIED ANSWERS (100% CORRECT ANSWERS) /A+GRADED

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EKG changes with calcium imbalances Hyperkalemia : short QT Hypocalcemia : long QT Hypothermia resuscitation Withhold medications and defibrillation until 30 C (86 F) Rewarming sequence: Passive external, active external then active internal Do not massage to warm body Gravitational forces 1 G represents the force that a person exerts when seated as the result of gravity G forces are applied on descent, ascent, and during changes in speed or direction Positive G forces (ascent): blood pooling in LE, increased intravascular pressures, & stagnant hypoxia Negative G forces (descent): Blood pooling in upper body, HA, stagnant hypoxia Vibration exposure Most common source in aircraft engine and turbulence Exposure to moderate vibration may result in: fatigue SOB motion sickness chest pain abdominal pain Thermal effects Exposure to extremes in temperature may cause increased metabolic rate, oxygen demand, and oxygen consumption S/S: Motion sickness HA disorientation fatigue discomfort irritability impaired performance reduced ability to cope with other stressors such as hypoxia Humidity effects As altitude increases & the air cools, humidity drops Dried secretions may lead to airway obstruction, atelectasis and hypoxemia Needle Cricothyroidotomy ●Hold the trachea in place and provide skin tension with the thumb and middle finger of the non-dominant hand placed on either side of the trachea. Use the index finger to palpate the cricothyroid membrane. In older children, adolescents, and adults: move the finger inferiorly into the depression between the thyroid and cricoid cartilages In infants and young children, palpate the trachea just above the suprasternal notch and move superiorly until the prominence of the cricoid cartilage is felt. ●Hold a 3 to 10 mL syringe half-filled with saline attached to the over-the-needle IV catheter in the dominant hand. ●Place the catheter in the midline of the neck at the inferior margin of the cricothyroid membrane (to avoid the cricothyroid blood vessels located superiorly and laterally). Direct it caudally (toward the feet) at an angle of 30 to 45 degrees. ●Puncture the skin and subcutaneous tissue. Advance the catheter while continuously applying negative pressure on the syringe, until air bubbles are seen, confirming intratracheal placement. ●Advance the catheter forward off the needle until its hub rests at the skin surface. Remove the syringe and the needle. ●Reattach the syringe to the catheter and again aspirate for air to confirm that the catheter remains in the trachea. ●Hold the catheter firmly in place at all times or delegate an assistant to do this to reduce the chance of kinking or dislodgement, even after it has been secured with suture material.

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K
C
C-NPT EXAM-STUDY CORE
LO
KNOWLEDGE QUESTIONS
YC
COMPLETE WITH
DETAILED VERIFIED
D


ANSWERS (100% CORRECT
U



ANSWERS) /A+GRADED
ST

,EKG changes with calcium imbalances
Hyperkalemia : short QT

Hypocalcemia : long QT




K
Hypothermia resuscitation
Withhold medications and defibrillation until 30 C (86 F)
Rewarming sequence: Passive external, active external then active internal




C
Do not massage to warm body




LO
Gravitational forces
1 G represents the force that a person exerts when seated as the result of gravity
G forces are applied on descent, ascent, and during changes in speed or direction
Positive G forces (ascent): blood pooling in LE, increased intravascular pressures, & stagnant
YC
hypoxia
Negative G forces (descent): Blood pooling in upper body, HA, stagnant hypoxia


Vibration exposure
Most common source in aircraft engine and turbulence
D

Exposure to moderate vibration may result in:
fatigue
SOB
U


motion sickness
chest pain
abdominal pain
ST




Thermal effects
Exposure to extremes in temperature may cause increased
metabolic rate, oxygen demand, and oxygen consumption
S/S: Motion sickness
HA
disorientation
fatigue
discomfort
irritability

, impaired performance
reduced ability to cope with other stressors such as hypoxia


Humidity effects
As altitude increases & the air cools, humidity drops
Dried secretions may lead to airway obstruction, atelectasis and hypoxemia


Needle Cricothyroidotomy




K
●Hold the trachea in place and provide skin tension with the thumb and middle finger of the
non-dominant hand placed on either side of the trachea. Use the index finger to palpate the
cricothyroid membrane.




C
In older children, adolescents, and adults: move the finger inferiorly into the depression between
the thyroid and cricoid cartilages
In infants and young children, palpate the trachea just above the suprasternal notch and move




LO
superiorly until the prominence of the cricoid cartilage is felt.

●Hold a 3 to 10 mL syringe half-filled with saline attached to the over-the-needle IV catheter in
the dominant hand.
YC
●Place the catheter in the midline of the neck at the inferior margin of the cricothyroid
membrane (to avoid the cricothyroid blood vessels located superiorly and laterally). Direct it
caudally (toward the feet) at an angle of 30 to 45 degrees.

●Puncture the skin and subcutaneous tissue. Advance the catheter while continuously applying
negative pressure on the syringe, until air bubbles are seen, confirming intratracheal placement.
D

●Advance the catheter forward off the needle until its hub rests at the skin surface. Remove the
syringe and the needle.
U


●Reattach the syringe to the catheter and again aspirate for air to confirm that the catheter
remains in the trachea.
ST




●Hold the catheter firmly in place at all times or delegate an assistant to do this to reduce the
chance of kinking or dislodgement, even after it has been secured with suture material.


Pericardiocentesis, Apical approach
Pt supine with HOB 30-60 degrees
The needle insertion site is 1-2 cm lateral to the apex beat within the fifth, sixth or seventh
intercostal space and advanced over the superior border of the rib to avoid intercostal nerves
and vessels.

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