CH 26: Abdominal Emergencies Flashcards
Which of the following questions may help the EMT assess a patient with abdominal pain?
A.
Do you have any medical problems, such as diabetes or heart problems?
B.
Do you have any allergies to foods or medicines?
C.
What medications are you taking?
You are called to a residence for a 48-year-old male patient. He is lying in bed, groaning in pain and curled into a fetal position. His blood pressure is 88/50, pulse 136, and respiratory rate of 32. His wife states that he complained of lower right abdominal pain for several days that got progressively worse, until about an hour ago when it became suddenly unbearable. The wife states the husband had been refusing to see a doctor, but she finally called 911. You suspect appendicitis and are concerned about the subsequent onset of:
peritonitis
You are responding to a 52-year-old male patient complaining of heartburn with epigastric pain. The patient’s vital signs are stable and he does not have any pain upon palpation. He has a history of reflux disease and is on several medications for heartburn and acid reflux. What is your greatest concern with this patient?
He is suffering from a myocardial infarction.
You respond, along with fire department Emergency Medical Responders, to a 48-year-old female having a syncope episode in the bathroom. You find the patient sitting on the commode vomiting into the trash can. The vomitus appears to look like coffee grounds and has a foul smell. The patient is pale and has been weak for the past few days. She has:
GI bleeding.
The patient complaining of parietal abdominal pain who would concern you the most is the one who:
is lying on the floor very still and quiet with his knees drawn up to his chest.
You are called to a nursing home for an 85-year-old patient complaining of abdominal pain. The patient has a history of dementia and cannot describe the pain to you. The nurse states the patient has been vomiting for about an hour, and the vomit looks like dark coffee grounds. His blood pressure is 90/40, pulse 100, and respiratory rate of 24. Aside from the airway, what is your greatest concern?
The patient will go into shock.
You are examining a 24-year-old female patient with lower quadrant abdominal pain. What is the most lethal possibility?
Ectopic pregnancy
Your patient is a 17-year-old female with a history of asthma. She is complaining of pain in her lower abdomen. Assessment reveals that her breath sounds are clear and equal, she has a respiratory rate of 28 breaths per minute, a heart rate of 96 beats per minute, the pulse oximeter displays 92%, the blood pressure of 110/88 mmHg. She tells you that she is 5 weeks late on her period and she started having heavy vaginal bleeding this morning. Which of the following is the most appropriate next step?
Provide high-concentration oxygen.
With the exception of the ________, most abdominal organs are not able to sense tearing sensations.
aorta
You respond to the scene of a 50-year-old male complaining of severe abdominal pain. He has a history of alcohol and drug abuse. His vital signs are stable and he presents with epigastric pain that radiates to the back. He has guarding and point tenderness in the upper quadrants. You suspect:
pancreatitis.
You respond to a 75-year-old female who is complaining of epigastric pain that feels like heartburn and radiates to the right shoulder. Her vital signs are stable and she has a previous history of myocardial infarction. She has prescription nitroglycerine tablets. An ALS unit is en route. After performing a physical examination and applying oxygen by nasal cannula, you should:
contact medical control regarding the administration of the patient’s nitroglycerin.
Pain that originates in an organ, such as the intestines, is called ________ pain.
visceral
When the gallbladder is diseased, the pain is not only felt in the right upper quadrant (RUQ) but also in the right shoulder. This is known as:
referred pain
Most organs of the abdomen are enclosed within the:
peritoneum.
Which of the following structures is (are) not located in the abdominal cavity?
kidneys
Which abdominal quadrant contains the appendix?
Right lower
Pain that the patient feels in a body part or area of the body that has nothing to do with a diseased organ is termed:
referred pain
Pain that the patient feels in a body part or area of the body that has nothing to do with a diseased organ is termed:
referred pain
You respond to a 65-year-old patient complaining of abdominal pain. Your physical exam reveals a nonpulsating mass in the lower left quadrant. You suspect:
hernia
Your patient is a 40-year-old female who has been experiencing abdominal pain and vomiting for 2 days. She is now responsive to verbal stimulus; has cool, dry skin; a heart rate of 116; respirations of 24; and a blood pressure of 100/70. Which of the following is the best position for transporting this patient?
Left lateral recumbent with the legs bent
The detection of a bulging mass through the belly button that is not pulsating should make the EMT suspicious that the patient may be suffering from which of the following?
hernia
You respond to an abdominal pain call. Your partner suspects that the patient is having an abdominal aortic aneurysm (AAA). What type of pain is the patient most likely experiencing?
tearing
You respond to a 75-year-old female who is complaining of epigastric pain that feels like heartburn. The pain radiates to the right shoulder. Her vital signs are stable and she has a previous history of a myocardial infarction. She has prescription nitroglycerin tablets. She is most likely suffering from:
cholecystitis.
Which patient is experiencing visceral pain?
45-year-old female complaining of abdominal pain “all over”
Your patient was diagnosed with cholecystitis (gallbladder inflammation) three days ago. The patient now presents with nausea, vomiting, and pain in the right shoulder. The pain in the shoulder can be classified as:
referred pain
You are called to a nursing home for an 85-year-old patient complaining of abdominal pain. The patient has a history of dementia and cannot describe the pain to you. The nurse states the patient has been vomiting for about an hour, and the vomit looks like dark coffee grounds. His blood pressure is 90/40, pulse 100, and respiratory rate of 24. In what position should you transport the patient?
Left lateral recumbent
You are called to the scene of a patient with abdominal pain. Upon arrival, you find a 38-year-old Asian man on the floor next to his desk writhing in pain. He is complaining of severe right-sided flank pain. His blood pressure is 140/90, pulse 100, and his skin is ashen and diaphoretic. You suspect:
renal colic.
Organs of the right upper quadrant include:
most of the liver, gallbladder, and part of the large intestine.
In what position should the patient complaining of severe abdominal pain be placed if there are no signs or symptoms of shock?
One of comfort
When treating a patient with acute abdominal pain, you should do which of the following?
Have the patient lie still and assume a position of comfort.
Which of the following questions is inappropriate when taking the history of a female patient with abdominal pain?
What is your sexual orientation?
Which of the following is a characteristic of referred pain?
It is felt in a location other than the organ causing it.
Your patient is a 35-year-old female with abdominal pain. Which of the following findings cannot be attributed to the patient experiencing pain?
Decreased level of consciousness
You are called to a residential neighborhood at 12:30 A.M. Your patient has just finished eating a super-sized meal of deep fried fish. He is now complaining of a “crampy” pain in the right upper quadrant and has had two episodes of nausea and vomiting with green vomit. What condition do you suspect that your patient is experiencing?
Cholecystitis
You are called to a nursing home for an 85-year-old patient complaining of abdominal pain. The patient has a history of dementia and cannot describe the pain to you. The nurse states the patient has been vomiting for about an hour, and the vomit looks like dark coffee grounds. His blood pressure is 90/40, pulse 100, and respiratory rate of 24. Why should the EMT use an oxygen mask with caution?
The patient cannot clear any additional vomit.
Your patient is a 34-year-old male complaining of pain “in his right side.” He is pale and diaphoretic with a heart rate of 90 beats per minute, a respiratory rate of 28 breaths per minute, and a blood pressure of 132/80 mmHg. The patient is very agitated and anxious. Which approach is most appropriate?
Reassure him that you will make him as comfortable as possible and get him to the hospital for additional care.
Which of the following is not a cause of abdominal pain?
stroke
You are treating a 38-year-old female patient with abdominal distress. The patient’s vital signs are stable and you are getting ready to transport. What is the best position to transport the patient?
Position of comfort
You are called to a 25-year-old male complaining of right lower quadrant (RLQ) pain. His other symptoms are nausea and vomiting, fever, and decreasing pain in the umbilicus area. As an EMT, you feel this patient might have:
appendicitis.
Pain felt in the epigastric region of the abdomen is of concern because of the possibility of which of the following?
Myocardial infarction
Which of the following is true concerning parietal pain?
It is generally localized to a particular area.
Which of the following organs is located in the retroperitoneal space?
kidneys
Which of the following is a concern when caring for the patient with abdominal pain?
Patient comfort
B.
Airway management
C.
Shock
Which of the following is not a cause of parietal pain?
muscle spasm
Your patient is a 60-year-old male who is complaining of severe epigastric abdominal pain and difficulty breathing. He is pale, sweaty, and pleads with you, “Don’t let me die, I think I’m going to die.” Which of the following measures is not part of your initial treatment of this patient?
Applying the defibrillator pads to his chest
Which of the following is not true concerning abdominal pain in geriatric patients?
The causes of abdominal pain in geriatric patients are rarely serious.
Which of the following is the main focus of the EMT’s assessment and history taking of the patient with abdominal pain?
Determining the presence of shock
You arrive on the scene to find an approximately 60-year-old male patient writhing on the floor. He is complaining of a tearing pain radiating to his lower back. He has absent femoral pulses and has a pulsatile mass just superior to his umbilicus. You suspect which of the following conditions?
Abdominal aortic aneurysm
