Chapter 32 Flashcards
When caring for a patient with an open chest wound, you should:
• frequently assess breath sounds for indications of a pneumothorax.
• secure a dressing in place by circumferentially wrapping the chest.
• routinely transport the patient in a left lateral recumbent position.
• place a porous dressing over the wound and secure it on three sides.
frequently assess breath sounds for indications of a pneumothorax.
Applying direct pressure to a bleeding wound stops the flow of blood because:
• pressure shunts blood away from the injury.
• pressure stimulates the release of fibrin.
• it allows platelets to seal the vascular walls.
• direct pressure facilitates vasoconstriction.
It allows platelets to seal the vascular walls.
When applying a dressing and bandage to a scalp wound, you should:
• carefully assess the skull for an underlying fracture.
• apply a cervical collar in case the c-spine is injured.
• always use a loose dressing to soak up the blood.
• remove any foreign particles from the wound first.
Carefully assess the skull for an underlying fracture
A 41-year-old man was assaulted during a robbery attempt. Your primary assessment reveals that the patient is semiconscious. He has massive soft-tissue trauma to the face, inadequate breathing, and oropharyngeal bleeding. You should:
• apply direct pressure to his facial wounds and promptly intubate him.
• suction his oropharynx for 30 seconds and then perform endotracheal intubation.
• insert a nasal airway, apply oxygen via nonrebreathing mask, and transport.
• suction the blood from his mouth and assist ventilations with a bag-mask device.
suction the blood from his mouth and assist ventilations with a bag-mask device.
The stratum corneum are dead cells that have had their cytoplasm replaced with:
• fibrin.
• keratin.
• collagen.
• melanin.
Keratin.
Which of the following statements regarding crush injury is correct?
• Gangrene often sets in if a body part is entrapped for longer than 30 minutes.
• In a crush injury, the external appearance is a good predictor of internal damage.
• A crush injury can occur if the patient is left in an air splint for greater than 1 hour.
• Crush syndrome can occur if the body part is entrapped for more than 4 hours.
Crush syndrome can occur if the body part is entrapped for more than 4 hours.
During the inflammation phase of the healing process:
• the processes of epithelialization and collagen synthesis are impaired.
• histamine causes vasodilation and increased blood flow to the injury.
• damaged cell parts and microorganisms invade and infect the wound.
• white blood cells are forced away from the injury by vasoconstriction.
histamine causes vasodilation and increased blood flow to the injury.
Which of the following patients is at highest risk for a pressure injury?
• A bedridden patient
• A patient with diabetes
• A hypertensive patient
• An obese patient
A bedridden patient.
A 22-year-old man was struck in the forehead by a softball. He is conscious and alert, but complains of a severe headache. Your assessment reveals a large hematoma to his forehead. His vital signs are stable and his breathing is adequate. You should:
• place him in a sitting position and apply a chemical heat pack to his head.
• apply firm manual pressure to the hematoma to reduce internal bleeding.
• apply an icepack to the hematoma and monitor his level of consciousness.
• start an IV of normal saline and administer 2 mg of morphine for the pain.
apply an icepack to the hematoma and monitor his level of consciousness.
Packing a wound with hemostatic-impregnated gauze is indicated when:
• the wound is below the elbow or knee.
• severe intra-abdominal bleeding is present.
• the patient’s systolic blood pressure is greater than 90 mm Hg.
• tourniquet placement is not possible.
Tourniquet placement is not possible.
The skin helps regulate body temperature through:
• the production of sweat, which is evaporated from the surface of the skin.
• peripheral vasodilation, which shunts cool blood to the core of the body.
• cutaneous vasoconstriction, which brings warm blood to the skin’s surface.
• increased elastin production, which provides insulation to the epidermis.
the production of sweat, which is evaporated from the surface of the skin.
A patient with nerve compromise following an open injury to the hand:
• will likely lose all neurologic function.
• should be given analgesia for the pain.
• requires prompt transport to the hospital.
• will not be able to move their hand.
requires prompt transport to the hospital.
A crushing or tearing amputation:
• is initially treated by applying a proximal tourniquet and retrieving any detached body parts.
• can result in excessive blood loss due to hemorrhage if the paramedic does not intervene rapidly.
• cannot be surgically reattached due to the severe vascular and soft-tissue damage that accompanies it.
• causes less blood loss than expected because the blood vessels retain their ability to constrict.
can result in excessive blood loss due to hemorrhage if the paramedic does not intervene rapidly.
A young woman attempted to commit suicide by cutting her wrist. Bright red blood is spurting from the injury site. Despite direct pressure, the wound continues to bleed heavily. You should:
• locate and apply digital pressure to the brachial artery.
• apply a tourniquet between her elbow and wrist.
• elevate the extremity above the level of her heart.
• apply supplemental oxygen and keep her warm.
apply a tourniquet between her elbow and wrist.
Which of the following conditions or factors would most likely delay or impair healing of a wound?
• Obesity
• Hypertension
• Diabetes
• Alcohol use
Diabetes.
Which of the following is a function of the skin?
• Killing bacteria and infections
• Providing the immune response for the body
• Protecting the underlying tissue from injury
• Sensing changes in the internal environment
Protecting the underlying tissue from injury
The subcutaneous tissue is:
• the layer of tissue above the dermis that mainly produces sweat.
• a thin layer of tissue from which blood vessels exclusively originate.
• also called the superficial fascia and consists mainly of adipose tissue.
• the deep fascial layer that ensheathes muscle and other internal structures.
also called the superficial fascia and consists mainly of adipose tissue.
A laceration that lies perpendicular to the skin’s tension lines:
• results in minimal external bleeding and typically heals spontaneously within 2 to 3 hours.
• generally remains closed and does not require suturing or other methods of wound closure.
• does not disrupt the body’s blood-clotting process and tends to heal without the formation of a scar.
• often remains open, heals more slowly, and is more likely to result in abnormal scar formation.
often remains open, heals more slowly, and is more likely to result in abnormal scar formation.
Which of the following statements regarding lacerations is correct?
• The first priority in treating a laceration is to cover it with a sterile dressing to prevent infection.
• The seriousness of a laceration depends on its depth and the structures that have been damaged.
• A laceration must be sutured or otherwise closed within 8 to 10 hours following the injury.
• Lacerations are linear cuts that tend to heal well due to their relatively even wound margins.
The seriousness of a laceration depends on its depth and the structures that have been damaged.
Necrosis of tissue caused by an anaerobic, toxin-producing bacterium is called:
• tetanus.
• fasciitis.
• lymphedema.
• gangrene.
Gangrene.
Systemic signs of infection secondary to a soft-tissue injury include:
- erythema.
- pus drainage.
- fever and chills.
- lymphangitis.
fever and chills.
A 30-year-old man presents with jaw and neck stiffness and fever. During your assessment, he tells you that he cut his hand on a piece of metal about a week ago. You should suspect:
- tetanus.
- meningitis.
- a staph infection.
- a viral infection.
Tetanus
A patient taking which of the following medications would most likely experience a delay in the healing of a wound?
- Corticosteroids
- Antihypertensives
- Acetaminophen
- Antidepressants
Corticosteroids
In contrast to a contusion, a hematoma is:
- rarely accompanied by a bruise.
- accompanied by ecchymosis.
- a less significant closed injury.
- caused by large vessel damage.
caused by large vessel damage.
