CH. 21 Flashcards
Answers to Assessment in Action Questions
Answers to Assessment in Action Questions
1. Answer: D. Take vital signs.
2. Answer: C. Heroin
3. Answer: C. Venous scarring (track marks)
4. Answer: D. 30 minutes to 1 hour
5. Answer: C. Stage around the corner and wait for police to declare the scene safe.
6. Answer: B. No
7. Answer: A patient in alcohol withdrawal may experience delirium tremens. The condition is characterized by delusions, hallucinations, agitation or restlessness, fever, sweating, tremors, confusion, and seizures. Hallucinations come and go, can be auditory or visual, and can be frightening. Delirium tremens can develop about 1 to 7 days after a person stops drinking or when alcohol consumption levels are decreased suddenly.
Assess the patient and provide prompt transport. Manage seizures as you would any other seizure. Protect the patient from self-injury. Provide oxygen as needed. Watch carefully for vomiting; have suction ready. Watch for signs of hypovolemic shock. Use a calm, relaxed approach, reassure the patient, and provide emotional support.
8. Answer: The four routes by which toxins enter the body are inhalation, absorption (surface contact), ingestion, and injection. Examples of inhaled toxins include natural gas, sewer gas, certain pesticides, carbon monoxide, chlorine, or other gases. Examples of absorbed toxins include acids, alkalis, and some petroleum (hydrocarbon) products, poison ivy, and poison oak.
Examples of ingested toxins include liquids, household cleaners, contaminated food, plants, alcohol, and drugs. Examples of injected toxins include medications or illicit drugs, and envenomation by insects, arachnids, and reptiles.
9. Answer: One example is lysergic acid diethylamide (LSD). Like other hallucinogens, LSD causes visual hallucinations, intensifies vision and hearing, and generally separates the user from reality. This can be terrifying. The experience is sometimes referred to as a “bad trip.” Patients will usually have hypertension, tachycardia, anxiety, and paranoia.
Another example is phencyclidine (PCP, or angel dust). PCP is a dissociative anesthetic that is easily synthesized and highly potent. Its effectiveness by oral, nasal, pulmonary, and intravenous routes makes it easy to add to other street drugs. It is dangerous because it causes severe behavioral changes in which people often inflict injury on themselves.
Care for a patient who is having a bad reaction to a hallucinogenic agent is the same as that for a patient who has taken a sympathomimetic.
10. Answer: Ideally, naloxone is administered via the IV route. However, IV access can be difficult to obtain in chronic users of illicit intravenous drugs such as heroin. These patients have venous scarring (track marks) from repeated use of needles. Some EMS systems allow EMTs to administer naloxone via the intranasal route. Prior to administering intranasal naloxone, place an oropharyngeal airway and ventilate the patient using a BVM to decrease the risk of permanent brain damage, and a violent emergence from the apneic state related to hypoxia. Watch the patient closely; as the level of consciousness rises, the patient will no longer tolerate the oropharyngeal airway and you will have to remove it to prevent aspiration.
