Ch. 20 Flashcards
A 28-year-old female patient is found to be responsive to verbal stimuli only. Her roommate states that she was recently diagnosed with type 1 diabetes and has had difficulty controlling her blood sugar level. She further tells you that the patient has been urinating excessively and has progressively worsened over the last 24 to 36 hours. On the basis of this patient’s clinical presentation, you should suspect that she:
-Has overdose on her insulin
-Has a urinary tract infection
-Is significantly hyperglycemic
-Has a low blood glucose level
Is significantly hyperglycemic
Classic signs and symptoms of hypoglycemia include:
-Cool, clammy skin; weakness; tachycardia; and rapid respirations
-Warm, dry skin; hunger; abdominal pain; and deep, slow respirations
-Warm, dry skin; irritability; bradycardia; and rapid respirations
-Cold, clammy skin; bradycardia; hunger; and deep, rapid respirations
Cool, clammy skin; weakness; tachycardia; and rapid respirations
Diabetic ketoacidosis occurs when:
-Insulin is not available in the body
-The pancreas produces excess insulin
-Blood glucose levels rapidly fall
-The cells rapidly metabolize glucose
Insulin is not available in the body
In general, oral glucose should be given to any patient who:
-Has an altered mental status and a history of diabetes
-Is unresponsive, even in the absence of a history of diabetes
-Has documented hypoglycemia and an absent gag reflex
Has an altered mental status and a history of diabetes
Proper procedure for administering oral glucose to a patient includes all of the following except:
-Checking the medication’s expiration date
-Assessing the patient’s mental status
-Requesting permission from medical control
-Ensuring the absence of a gag reflex
Ensuring the absence of a gag reflex
Symptomatic hypoglycemia will most likely develop if a patient:
-Takes too much of his or her prescribed insulin
-Eats a regular meal followed by mild exertion
-Markedly overeats and misses an insulin does
-Misses on or two prescribed insulin injections
Takes too much of his or her prescribed insulin
The normal blood glucose level is between:
-80 and 120 mg/dL
-60 and 80 mg/dL
-160 and 200 mg/dL
-130 and 150 mg/dL
80 and 120 mg/dL
To which of the following diabetic patients should you administer oral glucose?
-A semiconscious 40-year-old female without a gag reflex
-An unconscious 33-year-old male with cool, clammy skin
-A confused 55-year-old male with tachycardia and pallor
-A conscious 37-year-old female with nausea and vomiting
A confused 55-year-old male with tachycardia and pallor
When assessing an unresponsive diabetic patient, the primary visible difference between hyperglycemia and hypoglycemia is the:
-Patients mental status
-Rate and depth of breathing
-Presence of a medical identification tag
-Rate of the patient’s pulse
Rate and depth of breathing
Which of the following statements regarding sickle cell disease is correct?
-The red blood cells of patients with sickle cell disease are round and contain hemoglobin
-Sickle cell disease is an inherited blood disorder that causes the blood to clot to quickly
-Because of their abnormal shape, red blood cells in patients with sickle cell disease are less apt to lodge in a blood vessel
-In sickle cell disease, the red blood cells are abnormally shaped and are less able to carry oxygen
In sickle cell disease, the red blood cells are abnormally shaped and are less able to carry oxygen
Type 1 diabetes is a condition in which:
-Too much insulin is produced
-Glucose utilization is impaired
-Too much glucose enters the cell
-The body does not produce glucose
Glucose utilization is impaired
a 45-year-old man with type 1 diabetes is found unresponsive. Which of the following questions is most important to ask his wife?
-“Did he take is insulin today?”
-“How long has he been a diabetic?”
-“Has he seen his physician recently?”
-“what kind of insulin does he take?”
Did he take is insulin today?
A diabetic patient presents with a blood glucose level of 310 mg/dL and severe dehydration. The patient’s dehydration is the result of:
-Excretion of glucose and water from the kidneys
-A deficiency of insulin that causes internal fluid loss
-An infection that often accompanies hyperglycemia
-An inability to produce energy because of insulin depletion
Excretion of glucose and water from the kidneys
Which combination of factors would most likely cause a hypoglycemic crisis in a diabetic patient?
-Eating a meal and taking insulin
-Skipping a mean and taking insulin
-Eating a meal and not taking insulin
-Skipping a meal and not taking insulin
Skipping a mean and taking insulin
A 19-year-old diabetic male was found unresponsive on the couch by his roommate. After confirming that the patient is unresponsive, you should:
-Suction his oropharynx
-Manually open his airway
-Administer high-flow oxygen
-Begin assisting his ventilations
Manually open his airway
What breathing pattern would you most likely encounter in a patient with diabetic ketoacidosis (DKA)?
-Slow and shallow
-Shallow and irregular
-Rapid and deep
-Slow and irregular
Rapid and deep
A woman called EMS because her 12-year-old son, who had been experiencing excessive urination, thirst, and hunger for the past 36 hours, has an altered mental status and is breathing fast. You should be most suspicious for:
-Low blood sugar
-Hypoglycemia
-Hypoglycemic crisis
-Hyperglycemic crisis
Hyperglycemic crisis
If the cells do not receive glucose, they will begin to metabolize:
-Fat
-Acid
-Sugar
-Ketones
Fat
In contrast to a hyperglycemic crisis a hypoglycemic crisis:
-Rarely presents with seizures
-Presents over a period of hours to days
-Should not routinely be treated with glucose
-Usually responds immediately after treatment
Usually responds immediately after treatment
Patients with diabetic ketoacidosis experience polydipsia because:
-They are dehydrated secondary to excessive urination
-The cells of the body are starved due to a lack of glucose
-Fatty acids are being metabolized at the cellular level
-Hyperglycemia usually causes severe internal water loss
They are dehydrated secondary to excessive urination
When dealing with hematologic disorders, the EMT must be familiar with the composition of blood. Which of the following is considered a hematologic disease?
-Sickle cell disease
-Hemophilia
-Lou Gehrig’s disease
-Both A and B
Both A and B
What are the two main components of blood?
-Erythrocytes and hemoglobin
-Cells and plasma
-Leukocytes and white blood cells
-Platelets and neutrophils
Cells and plasma
The assessment of a patient with a hematologic disorder is the same as it is with all other patients an EMT will encounter. In addition to obtaining a SAMPLE history, EMT’s should ask which of the following questions?
-Have you had a crisis before?
-When was the last time you has a crisis?
-How did your crisis resolve?
-All of the above
All of the above
Which one of the following is not an appropriate treatment for EMT’s to provide to a patient who has hematologic disorder?
-Analgesics for pain
-Support of symptoms
-High-flow oxygen therapy at 12 to 15 L/min
-Rapid transport
Analgesics for pain
