Chapter 25 Flashcards by Gail I

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

oxygen; nutrients; metabolic waste

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three parts for cardio system:

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

pump; container; fluid

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

upper; atrium
lower; ventricle
one-way valve

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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

arteries;
arterioles
capillaries
venules
veins

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

capillaries; cells; capillaries

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

red blood cells
white blood cells
platelets
plasma

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

stasis; blood vessel walls; clot

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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

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

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.. 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

perfusion; fast; slow

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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

adequate perfusion

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… 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

hemorrhage;

different surfaces ;

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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 …

20; heart; respiratory; blood pressure

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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

rapidly they bleed; 1; 500; hypovolemic shock

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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

spurt; brighter; dark;

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

capillary vessels; steadily; slowly

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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

10; narrow; vasoconstriction; coagulation

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

blood-clotting factors; spontaneously

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

cavity; space; extensive internal bleeding; hypovolemic

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

stomach ulcer
liver
spleen
bones
pelvic fracture 
contusion; ecchymosis

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

index of suspicion

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

bleeding ulcers
bleeding; colon
ectopic pregnancy
aneurysms

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

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

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)

hematemesis
melena
broken ribs
hypoperfusion

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

tachycardia; tachypnea
low blood pressure
pulse
clammy

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

blood loss; rapidly

several methods are available to control external bleeding: - ..., ... and ... - ... and/or ... - ...

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

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

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

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

right; distal pulse

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

physician; additional pressure

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

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

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 .../...

extremity; triangular bandage; stick; rod

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

``` joint proximal padding bandage time ```

... 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

air splints; rigid splints

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

pulse; motor; sensory

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

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

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

epistaxis; pinching the nostrils

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

down the throat nauseated; vomiting; septum

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 ...

skull fracture stop blood flow cerebrospinal fluid

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

body temperature splint tourniquet