Chapter 25

Question 1

cardiovascular system:
circulate blood to cells and tissues
deliver … and …
carry away … products

Answer 1

oxygen; nutrients; metabolic waste

Question 2

three parts for cardio system:

• … (heart)
• … (blood vessels)
• .. (blood and body fluids)

Answer 2

pump; container; fluid

Question 3

the heart needs a rich and well-distributed blood supply
works as two paired pumps: 
... chamber (...)
... chamber (...) 
blood leaves each chamber through a ...

Answer 3

upper; atrium
lower; ventricle
one-way valve

Question 4

types of blood vessels:
…: carry blood away from the heart
…: connect the arteries and capillaries
…: link arterioles and venules
…: empty into the veins
….: carry blood from the tissues to the heart

Answer 4

arteries;
arterioles
capillaries
venules
veins

Question 5

oxygen and nutrients pass from the … into the …, and waste and carbon dioxide diffuse into the …

Answer 5

capillaries; cells; capillaries

Question 6

blood contains: 
... blood cells 
... blood cells
...: form blood clots
...: fluid portion of the blood

Answer 6

red blood cells
white blood cells
platelets
plasma

Question 7

blood clot formation depends on several factors:
blood …
changes in the …
blood’s ability to …

Answer 7

stasis; blood vessel walls; clot

Question 8

autonomic nervous system:
monitors the body’s … and adjusts … by constricting/dilating blood vessels
automatically redirects blood to the …, …, …, and … in an emergency
adapts to maintain homeostasis and perfusion
if the system fails to provide sufficient circulation for every body part to perform its function, … results

Answer 8

needs; blood flow; heart; brain; lungs; kidneys; shock

Question 9

.. is the circulation of blood within an organ or tissue to meet the cells’ needs for oxygen, nutrients, and waste removal–> blood flow must be … enough to maintain adequate circulation and … enough to allow cells time to exchange ox and nutrients for CO2 and other waste products

Answer 9

perfusion; fast; slow

Question 10

some tissues need a constant supply of blood, while others can survive with very little. all organs and organ systems are dependent on … to function properly. death of an organ system can quickly lead to death of the patient

Answer 10

adequate perfusion

Question 11

… means bleeding
with serious external bleeding, it may be difficult to estimate the amount of blood loss:
blood will look different on …
it is important to estimate the amount of external blood loss

Answer 11

hemorrhage;

different surfaces ;

Question 12

body will not tolerate a blood loss greater than …% of blood volume
changes in vital signs may occur with significant blood loss:
increase in … rate
increase in … rate
decrease in …

Answer 12

20; heart; respiratory; blood pressure

Question 13

how well people compensate for blood loss is related to how ….–> an adult can comfortably donate … unit (… mL) of blood over 15 to 20 minute–> if a similar blood loos occurs in a much shorter time, the person may rapidly develop symptoms of …
consider age and preexisting health

Answer 13

rapidly they bleed; 1; 500; hypovolemic shock

Question 14

arterial bleeding: pressure causes blood to … and makes bleeding difficult to control. typically …red (rich in ox) and spurts in time with the pulse
venous bleeding: …red (low in ox) , does not spurt and is easier to manage, can be profuse and life-threatening

Answer 14

spurt; brighter; dark;

Question 15

capillary bleeding: bleeding from damaged …, dark red, oozes … but …
more likely to clot spontaneously than arterial blood

Answer 15

capillary vessels; steadily; slowly

Question 16

bleeding tends to stop rather quickly, within about … minutes, in response to internal mechanisms and exposure to air
when the skin is broken, blood flows rapidly from the open vessel
the cut ends of the vessel begin to … (…), reducing the amount of bleeding
then a clot forms (…)
bleeding will never stop if a clot does not form, unless the injured vessel is completely cut off from the main blood supply by direct pressure or a tourniquet

Answer 16

10; narrow; vasoconstriction; coagulation

Question 17

hemophilia:
patient lacks …
bleeding may occur …
all injuries, no matter how trivial, are potentially serious
patients should be transported immediately

Answer 17

blood-clotting factors; spontaneously

Question 18

internal bleeding:
bleeding in a … or … inside the body
can be very serious because it is not easy to detect immediately–> injury or damage to internal organs commonly results in …
can cause … shock

Answer 18

cavity; space; extensive internal bleeding; hypovolemic

Question 19

possible conditions causing internal bleeding:
…
lacerated …
ruptured …
broken …, especially the ribs or femur
…
often, the only signs of internal bleeding are … or …

Answer 19

stomach ulcer
liver
spleen
bones
pelvic fracture 
contusion; ecchymosis

Question 20

MOI for internal bleeding:
high-energy MOI should increase your … for serious unseen injuries
internal bleeding is possible whenever the MOI suggests that severe forces affected the body
look for DCAP-BTLS or any other signs of injury

Answer 20

index of suspicion

Question 21

bleeding is not always caused by trauma
nontraumatic causes include: 
.... 
... from ... 
ruptured ... 
... 
it is not as important for you to know the specific organ involved as it is to recognize that the patient is in shock and respond appropriately

Answer 21

bleeding ulcers
bleeding; colon
ectopic pregnancy
aneurysms

Question 22

signs and symptoms of internal bleeding:
… (most common)
… in the area of …
…
bleeding into the chest cavity/lung may cause …, …, …, and …
….: a mass of blood in the soft tissues beneath the skin
…: a contusion, or ecchymosis
bleeding from any …–> bright red bleeding from the mouth/rectum, hematuria, nonmenstrual vaginal bleeding

Answer 22

pain
swelling; bleeding
distension
dyspnea; tachycardia; hypotension; hemoptysis
hematoma
body opening

Question 23

signs and symptoms of internal bleeding:
…: vomited blood, bright red/dark red, coffee-grounds appearance
….: black, foul-smelling, tarry stool with digested blood
pain, tenderness, bruising, guarding, or swelling (possible closed fracture)
…; bruises over the lower part of the chest; or a rigid, distended abdomen (possible lacerated spleen or liver)
… (hypovolemic shock): change in mental status, such as anxiety, restlessness, or combativeness; weakness, faintness, or dizziness on standing, changes in skin color/pallor (pale skin)

Answer 23

hematemesis
melena
broken ribs
hypoperfusion

Question 24

determine transport priority--> signs that imply rapid transport: 
... or ... 
... 
weak ... 
.. skin

Answer 24

tachycardia; tachypnea
low blood pressure
pulse
clammy

Question 25

communication and documentation:
recognize, estimate, and report the amount of … and how … or over what period of time it occurred
communicate all relevant information to the staff at the receiving hospital. document all injuries, the care provided, and the patient’s response

Answer 25

blood loss; rapidly

Question 26

several methods are available to control external bleeding:

• …, … and …
• … and/or …
• …

Answer 26

direct, even pressure; elevation;
pressure dressings; splints
tourniquets

Question 27

direct pressure:
the most effective way to control external bleeding
pressure stops the …. and permits normal … to occur
apply pressure with your gloved fingertip or hand over the top of a sterile dressing
for an object protruding from the wound, apply … to … the object in place, and apply pressure as best you can
hold uninterrupted pressure for at least … mins

Answer 27

flow of blood; coagulation; bulky dressings; stabilize; 5

Question 28

pressure dressing:
firmly wrap a sterile, self-adhering roller bandage around the entire wound
stretch the bandage … enough to control bleeding–> you should still be able to palpate a … on the injured extremity after applying the dressing

Answer 28

right; distal pulse

Question 29

pressure dressing contd:
do not remove a dressing until a … has evaluated the patient: apply … through the dressing
add more dressings over the first

Answer 29

physician; additional pressure

Question 30

hemostatic agents:
any chemical compound that … or … bleeding by assisting with … formation
can be used with direct pressure when direct pressure alone is ineffective
two forms:
…
… impregnated with a … substance

Answer 30

slows; stops; clot; granular powder; gauze; clay substance

Question 31

the tourniquet is useful if a patient has substantial bleeding from an … injury that cannot be controlled with direct pressure
if a commercial tourniquet is unavailable, you can create a tourniquet using a … bandage and a …/…

Answer 31

extremity; triangular bandage; stick; rod

Question 32

tourniquet:
observe the following precautions:
- do not apply a tourniquet directly over any …
- always place the tourniquet … to the injury
- make sure the tourniquet is tightened securely
- never use wire, rope, a belt, or any other narrow material
- place … under the tourniquet to protect the tissues and help with arterial compression
- never cover a tourniquet with a …
- do not loosen the tourniquet after you have applied it
- record the exact … the tourniquet was applied

Answer 32

joint
proximal 
padding
bandage
time

Question 33

… can control internal/external bleeding associated with severe injuries; act as a pressure dressing applied to an extremity; immobilize fractures and act like a pressure dressing applied to an entire extremity rather than to a small, local area
…: will help immobilize fractures, reduce pain, prevent further damage to soft-tissue injuries

Answer 33

air splints; rigid splints

Question 34

once the splint is applied, monitor … and … and … function in the distal extremity

Answer 34

pulse; motor; sensory

Question 35

bleeding from the nose, ears, and mouth caused by several conditions: 
... 
... injuries 
..., ..., ... or ... 
.... 
... 
...

Answer 35

skull fracture
facial 
sinusitis; infections; dried or cracked nasal mucosa
high blood pressure
coagulation disorders
digital trauma

Question 36

… (nosebleed) is a common emergency–> occasionally can cause enough blood loss to send a patient into shock, can usually be controlled by .. together

Answer 36

epistaxis; pinching the nostrils

Question 37

epistaxis contd:
the blood you see may only be a small part of the total blood loss–> much of the blood may pass … into the stomach as the patient swallows
a person who swallows a large amount of blood may become … and start … (may be confused with internal bleeding)
most nontraumatic nosebleeds occur from sites in the …, the tissue dividing the nostrils

Answer 37

down the throat
nauseated; vomiting;
septum

Question 38

bleeding from the nose or ears following a head injury:
may indicate a …
may be difficult to control
do not attempt to …. –> applying excessive pressure to the injury may force the blood leaking through the ear or nose to collect within the head. loosely cover the bleeding site with a sterile gauze pad to collect the blood and help keep contaminants away from the site.
apply light compression by wrapping the dressing loosely around the head
a target or halo-shaped stain may occur on the dressing if blood or drainage contains …

Answer 38

skull fracture
stop blood flow
cerebrospinal fluid

Question 39

Internal bleeding:
usually requires surgery or other hospital interventions
keep the patient calm, reassured, and as still and quiet as possible
provide .
maintain …
… the injured extremity (usually with an air splint)
never use a … to control the bleeding from closed, internal, soft-tissue injuries

Answer 39

body temperature
splint
tourniquet