Ch 22: Diabetic emergencies Flashcards
Your patient is waking up from a seizure; it was the patient’s first seizure ever. When you ask what happened, the patient tells you she had the smell of fresh mown grass just before she seized. This sensation is known as a(n):
aura
Which of the following is the most common cause of seizures in adults?
Failure to take prescribed medication
You respond to a 32-year-old female who is having a seizure. You arrive on the scene to find the patient drowsy, confused, and complaining of a headache. This patient is demonstrating the:
postictal phase
Your patient is a 25-year-old female with a history of diabetes. She is confused, agitated, and verbally abusive to you, and she is very sweaty. Although she refuses to give a history of the present illness, which of the following should you suspect as the likely cause of the patient’s presentation?
Failure to intake sufficient sugar
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Part 1
Your patient is a 59-year-old female with a sudden onset of slurred speech and weakness on her right side. Which of the following measures is appropriate?
Immediately transport the patient to a hospital with specialized treatment for stroke patients.
Which of the following is NOT a sign of a hypoglycemic diabetic emergency?
Slow heart rate
The signs and symptoms of a transient ischemic attack (TIA) may last up to:
24 hours
Treatment of someone with a seizure disorder includes all of the following:
-removing objects that might harm the patient.
-placing the patient on the floor or ground.
-loosening restrictive clothing.
If the blood sugar level is very high, which of the following may result?
Excessive urination, excessive thirst, and excessive hunger
A hormone called insulin is secreted by the:
islets of Langerhans in the pancreas.
The death of brain tissue due to deprivation of oxygen because of a blocked or ruptured artery in the brain is known as which of the following?
Stroke
For the reticular activating system (RAS) to work correctly, what three substances are needed?
Oxygen to perfuse brain tissue, glucose to nourish brain tissue, and water to keep the brain hydrated
Which of the following is a typical cause of seizures in children 6 months to 3 years of age?
Fever
Which of the following is the MOST critical piece of equipment to have immediately available for the seizure patient who has just stopped convulsing?
Suction
What is epilepsy?
A condition in which a person has multiple seizures usually controlled by medication
Your patient is a 19-year-old female who is 7 months pregnant. She just experienced a seizure. Although she has no previous history of seizures or any other medical condition, she was just diagnosed with pregnancy-induced hypertension. Which of the following is the most likely cause of the seizure?
Eclampsia
Many stroke patients are candidates for thrombolytic drugs. One of the most important things that an EMT can do to optimize the care of a stroke patient who is a candidate for the drugs is:
determine the exact time of onset of symptoms.
Which of the following is the role of glucose in the body?
It provides energy for brain cells and other cells in the body.
Which of the following is the cause of most strokes?
Blockage of an artery supplying part of the brain
Which of the following is one of the most common characteristics of a stroke?
Weakness on one side of the body
Which of the following is characteristic of a patient with hyperglycemia?
A “fruity” odor of the breath
With advances in clot-busting (thrombolytic) drugs, the patient has a window of ________ hours to receive treatment.
3-4.5
Your patient is a 70-year-old man whose wife called EMS because her husband began exhibiting unusual behavior. Upon your arrival you introduce yourself to the patient, who responds, “Not until nine o’clock.” This phenomenon is BEST described as:
receptive aphasia.
Compared to hypoglycemia, which of the following is TRUE of hyperglycemia?
Its onset is more gradual.
Which of the following may result in hypoglycemia in the diabetic patient?
Vomiting after eating a meal
Normal consciousness is regulated by a series of neurologic circuits in the brain that compose the reticular activating system (RAS). The RAS has simple requirements to function properly. Which of the following items are requirements?
water
glucose
oxygen
When someone is experiencing hypoglycemia, the body attempts to compensate by using the fight-or-flight mechanism of the autonomic nervous system. Which of the following is NOT one of the fight-or-flight responses?
The skin is hot and dry.
Which of the following is a standardized test to evaluate a conscious patient for possible stroke?
Cincinnati Prehospital Stroke Scale
The most common medical emergency for the diabetic is hypoglycemia, or low blood sugar. Which of the factors below is NOT a cause of hypoglycemia?
Reduces sugar intake by eating too much
Which of the items below is part of the Cincinnati Prehospital Stroke Scale?
Test the patient for arm droop or lack of movement.
Ask the patient to smile.
Have the patient repeat a simple sentence.
The medical term for fainting is:
syncope
During your primary assessment, you find your patient has an altered mental status. This could indicate which of the following?
Failing respiratory system
Which of the following blood glucose levels is considered normal for an adult?
80 mg/dL
Your patient is a 44-year-old male with a history of diabetes. He is lying on the living room floor, unresponsive to all stimuli. He has a respiratory rate of 12 breaths per minute and heart rate of 112 beats per minute, and is pale and sweaty. Which of the following should you do to treat this patient?
Place the patient in the recovery position, administer oxygen, and monitor his airway status.
There are two types of seizures; if your patient is having a seizure that affects only one body part and does not cause her to lose consciousness, it is called a:
partial seizure.
Which of the following is the LEAST important question in obtaining the history of a seizure patient in the prehospital setting?
Does the patient have a family history of seizures?
Which of the following is an action of insulin?
It helps the movement of sugar from the bloodstream to the cell.
Looking at the following list, which of the items does NOT correctly compare the signs and symptoms of hypoglycemia and hyperglycemia?
The hypoglycemic patient usually complains of a headache, whereas the hyperglycemic patient does not.
When assessing a conscious patient for a possible stroke using the Cincinnati Prehospital Stroke Scale, which of the following three functions should be tested by the EMT?
Control of facial muscles, ability to speak, and ability to hold both arms in an extended position for 10 seconds
Your patient is an unresponsive 30-year-old male wearing a Medic-Alert bracelet indicating that he is a diabetic. The patient’s coworkers came by his house to check on him when he did not show up for work and did not call in sick. Your assessment does not clearly indicate to you whether the patient may be hypoglycemic or hyperglycemic. Which of the following should you do next?
Apply oxygen and begin transport without taking further action.
Most of the diabetic emergencies that you will be called to deal with will be related to hypoglycemia. However, occasionally you will experience an instance of hyperglycemia. In the list below, which item is NOT likely to be a sign or symptom of hyperglycemia?
Reduced rate of breathing
For the EMT, which of the following is the most important question to ask of a diabetic patient or his family members?
When was the last time you had something to eat?
A patient who demonstrates any one of the three symptoms from the Cincinnati Prehospital Stroke Scale has a(n) ________% chance of having an acute stroke.
70
Which of the following is within the EMT’s scope of practice for the treatment of the diabetic patient?
Administration of oral glucose
The condition in which there is an insufficient amount of sugar in the blood is called:
hypoglycemia.
Your patient is a 21-year-old female with a history of epilepsy. She is having a convulsion upon your arrival. Which of the following should you do?
Move furniture and other objects away from the patient to prevent injury.
A seizure that occurs spontaneously from an unknown cause is called:
idiopathic.
Which of the following is NOT a sign or symptom of stroke?
Chest pain
Many diabetics today have an insulin pump. Which of the following statements about insulin pumps is NOT true?
They are usually worn around the ankle.
Which of the following refers to difficulty in using words or understanding speech as a result of a stroke?
Aphasia
Which of the following statements about seizures is NOT true?
Many seizures are followed by an aura.
You have arrived on the scene of a call for a possible stroke. On your arrival, the patient denies signs and symptoms, is alert and oriented, and moves all extremities well. Her husband states that before you arrived the patient could not move her right arm and the left side of her face seemed to be “slack.” Which of the following has most likely occurred?
The patient suffered a transient ischemic attack.
Which is NOT one of the steps in managing a patient experiencing dizziness and syncope?
Apply cold packs to the patient’s head.
Which of the following is LEAST important for the patient who has stopped seizing before the EMT’s arrival at the scene?
Requesting advanced life support
Many factors that cause dizziness and syncope are generally related to the:
brain
Which of the following conditions may be mimicked by hypoglycemia?
Intoxication
Which of the following BEST describes status epilepticus?
Two or more seizures with tonic-clonic activity without an intervening period of consciousness