CH 28: Hematologic and Renal Emergencies Flashcards
You encounter a patient who has been having diffuse abdominal pain for one week. The patient has a pulse rate of 86, a blood pressure of 140/90, and a respiratory rate of 20. However, the patient appears pale and complains of generalized weakness and shortness of breath during everyday activities. You suspect the patient is experiencing:
chronic anemia
The most frequently transplanted organ is the:
kidney
The kidney’s major function(s) include(s):
maintaining blood volume.
B.
excreting urea.
C.
balancing electrolytes.
There are two main types of dialysis, hemodialysis and peritoneal dialysis. The main difference between them is:
hemodialysis is usually done at a special facility and peritoneal dialysis is usually done at home.
You suspect a patient who has been having a difficult time controlling the bleeding following a small laceration to the foot may have a history of:
taking blood thinners
A patient with renal disease who is currently on dialysis and missed an appointment may present with dangerously high levels of the electrolyte:
potassium
One of the more serious diseases of the body is renal failure. Renal failure occurs when the:
kidneys fail to function as required.
What is a cycle of filling and draining of the abdominal cavity during peritoneal dialysis called?
exchange
Which of the following pathologies put patients at high risk for acute renal failure?
shock
The medications that transplant patients need to take for the rest of their lives to prevent organ rejection also often lead to high susceptibility of:
infection
How frequently is peritoneal dialysis treatment required?
Multiple treatments per day
Peritoneal dialysis allows patients to dialyze at home through:
the abdomen
How many times per week do the majority of American hemodialysis patients receive treatment?
three
Which of the following is the most accurate definition of anemia?
A lack of a normal number of red blood cells in the circulation
The correct terminology used for patients whose kidneys are damaged to the point where they require dialysis to survive is:
end-stage renal disease.
Which of the following abbreviations is not correct?
CAPD for continuous acute peripheral disease
Patients with a history of chronic sickle cell anemia (SCA) may present with which of the following signs and symptoms?
Yellowing of the skin and dyspnea on exertion
Two chronic medical conditions that dialysis patients frequently have in addition to kidney failure are ________ and ________.
hypertension; diabetes
Patients who dialyze at home are at high risk for what type of infection?
Peritonitis
Which of the following organs may be seriously damaged in sickle cell anemia, subsequently leading to severe infections?
spleen
Certain drugs are commonly referred as “blood thinners” or drugs that inhibit clotting. Which of the following would not be considered such a drug?
Prilosec
You are dispatched to a private residence for a sick person. When you arrive, you are told by the patient that due to the snow storm yesterday he missed his scheduled appointment at the dialysis center and is not feeling well. Your assessment does not reveal anything remarkable outside of the fact that he has missed his dialysis. Which of the steps below would not be part of your care?
Place the patient in a supine position.
The blood has many functions critical to a patient’s health. Which of the following is not a function of the blood?
Removal of carbon monoxide from the cells
A patient with a medical history of sickle cell anemia is complaining of chest pain and shortness of breath. The patient is breathing 26 times per minute in short, shallow respirations. However, the patient’s oxygen saturation via pulse oximetry is 100% on room air. The best approach regarding supplemental oxygen is to:
place the patient on a nonrebreather mask.
You are dispatched to a private residence for a 52-year-old African American male sitting in his living room complaining of chest pain. During your assessment, he discloses that he has the sickle cell trait. Because of this you should:
treat the patient as any other 52-year-old with chest pain.
You are dispatched to a sick call. The patient was just extricated from a bathtub where he was trapped under the shower door for 2 days. The 72-year-old male had limited access to water from the bathtub faucet. The patient is complaining of disorientation, nausea, and vomiting. What do you think is the underlying cause for the illness?
acute renal failure
________ patients are at high risk for acquiring the inherited disorder called sickle cell anemia.
African American
The sensation felt when palpating an arterial-venous fistula or shunt is known as a:
thrill
Hemodialysis is used to help the kidneys filter ________ and remove excess ________.
toxins; fluids
Approximately how many Americans are currently on some type of dialysis?
450,000
What is the purpose of the red blood cells?
They are responsible for the delivery of oxygen to the cells.
Dialysis patients who have missed an appointment may present with signs of ________, which is a similar presentation to ________.
fluid accumulation; congestive heart failure
How long does a typical hemodialysis treatment last?
3 to 4 hours
What is one of the most common diseases to affect the renal and urinary system?
urinary tract infection
Once you encounter uncontrolled bleeding from an AV fistula, which of the following methods would you consider using to control bleeding in addition to direct pressure and elevation?
Hemostatic dressings
You are attending to an end-stage renal disease (ESRD) patient who has missed dialysis. Which of the following statements is most accurate?
Patients who have missed dialysis and who become unresponsive and pulseless do not respond very well to the use of an AED.
You are dispatched to a private residence for a sick person. You arrive and find a 47-year-old male patient who recently completed his peritoneal dialysis and complains of severe abdominal pain that is worsened by movement. One of the more serious complications of this type of dialysis is a bacterial infection within the peritoneal cavity. What would be the tell-tale sign that this is what is happening in this case?
The patient’s dialysis fluid appears cloudy when it is drained from the peritoneal cavity rather than having its normal clear appearance.
Which of the following medications does not interfere with the blood-clotting process?
Acetaminophen
You are dispatched to an unconscious hemodialysis patient. On arrival to the dialysis clinic, the patient is unresponsive, apneic, and pulseless. You secure the ABCs, begin ventilation, and initiate chest compressions. However, the patient’s cardiac arrest rhythm is continuously unresponsive to defibrillations with your AED. The best approach is to:
begin transporting and contact an ALS intercept. The patient’s dysrhythmia may be related to kidney failure.
Under which of the following circumstances do the kidneys help the body retain fluid?
dehydration
Platelets are actually fragments of larger cells that are crucial to the formation of clots. Clumping (called aggregation) of platelets is the body’s most rapid response to stop bleeding from an injured site. However, in some situations the clumping of platelets is not desirable, such as when a plaque in a coronary artery ruptures. In this situation, the rapid clumping of platelets can cause a clot that then completely blocks the coronary artery and results in a heart attack (myocardial infarction). One of the most effective and widely available drugs to prevent the aggregation of platelets is:
aspirin
What is continuous ambulatory peritoneal dialysis?
A gravity exchange process for peritoneal dialysis in which a bag of dialysis fluid is raised above the level of an abdominal catheter to fill the abdominal cavity and lowered below the level of the abdominal catheter to drain the fluid out
Approximately what percentage of United States dialysis patients treat themselves at home?
8 percent
Because of abnormally shaped hemoglobin, sickle cell anemia (SCA) patients may occasionally experience ________, causing a blockage of small blood vessels.
sludging
