Chapter 36 Flashcards
… disability:
Insufficient development of the brain resulting in some level of dysfunction or impairment
Includes intellectual, hearing, or vision impairments
…disability:
Results in the inability to learn and socially adapt at a normal developmental rate
Developmental; Intellectual
intellectual disability–…:
Slow to understand or limited vocabulary
Behave immaturely compared to peers
If severe, may have inability to care for themselves, communicate, understand, or respond
Rely on patients and family members for information.
Patient may have difficulty adjusting to … or a ….
Patients with intellectual disabilities are susceptible to the same diseases as other patients.
Slight impairment; change; break in routine
autism spectrum disorder: Developmental disorder characterized by impairment of s…
Severe behavioral problems
… motor activities
Impairment in verbal and nonverbal skills
May be hyper- or hyposensitive to … stimuli
social interaction; Repetitive; sensory
autism spectrum disorder:
Wide spectrum of disability
Patients have difficulty using or understanding ….
Do best with simple, one-step directions
Affects males .. times more than females
Rely on parents/caregivers for information
nonverbal communication; five
down syndrome:
Genetic chromosomal defect during fetal development
Causes mild to severe intellectual impairment
Physical abnormalities:
Round head with flat …
…, … tongue
Slanted, wide-set eyes
occiput; enlarged, protruding;
down syndrome contd:
Increased risk for medical complications
40% may have … conditions and … and … problems
Intubation may be difficult due to large tongues and small … and … cavities.
Mask ventilation can be challenging
Jaw-thrust or nasopharyngeal airway may be necessary.
heart; hearing; vision; oral; nasal
down syndrome contd:
Management of seizures is the same as for any other patent
The … joint is unstable in approximately 15% of patients:
Increased risk of complications when they experience trauma
atlantoaxial
visual impairment: Possible causes Range in degree of visual impairment Some patients lose … or … vision Some can distinguish … from … or ... May be difficult to recognize
peripheral; central; light; dark; shapes
for the visually impaired:
Transport considerations
Take … or …, if used.
Make arrangements for care or accompaniment of …
Patients should be gently guided, never pulled or pushed.
Communicate obstacles in advance.
cane; walker; service animal;
hearing impaired patients:
Assist the patient with finding and inserting any …
Face the patient while you communicate.
Do not … your lip movements or look away.
Position yourself approximately … directly in front of the patient.
Do not speak louder; try … of your voice.
hearing aids; exaggerate; 18”; lowering the pitch
Hearing aids make sound louder.
Several types are available.
Behind-the-ear, conventional body, in-the-canal, in-the-ear
Device should fit snugly.
If …occurs, it may not be in far enough.
whistling
…: Group of disorders characterized by poorly controlled body movement
Symptoms
Considerations
Observe airway closely and suction as needed.
Do not assume intellectual disability.
cerebral palsy
cerebral palsy contd:
Considerations (con’t)
…are prone to injury.
Unsteady gait makes patients prone to …
… the patient to ensure comfort.
Never force extremities into position.
Take walker or wheelchair with the patient.
underdeveloped limbs
falls
pad
spina bifida: Associated conditions … Partial or full … of the lower extremities Loss of … and … control Extreme … allergy
hydrocephalus
paralysis
bowel; bladder
latex
paralysis:
Inability to voluntarily move body parts
Possible causes
May have normal sensation or …
… may not function correctly (requires ventilator).
Difficulty swallowing may require suctioning.
hyperesthesia; diaphragm
paralysis contd: Specialized equipment Urinary ... … tubes … tube ... tubes Ask patients how it is best to move them before you transport them.
catheters
tracheotomy
colostomy
feeding
Obesity: person has excessive body fat
Obese: …% over ideal body weight
Severe obesity: … times over ideal weight
Imbalance between calories consumed and calories used
May be attributed to low … or … predisposition
Associated health problems
30; 2-3 times; metabolic rate; genetic
obesity contd:
Look for … or … points from equipment (deep venous thrombosis).
Large patients may have difficulty breathing if you lay the patient in a … position.
Plan egress routes.
Notify the receiving facility early.
pinch; pressure points; supine;
Tracheal stoma provides a path between the … and the …
Kept open by plastic tracheostomy tube
Tubes bypass .. and …
Tubes are prone to obstruction by mucus or foreign bodies
DOPE mnemonic (causes of obstruction)
Common problems
Management
neck; trachea; nose; mouth
mechanical ventilators:
Used when patients cannot breathe without assistance
If ventilator malfunctions:
Remove patient from ventilator.
Apply a …
Patients require assisted ventilation throughout transport.
tracheostomy collar.
apnea monitors: Used for infants who: Are … Have severe … Have family history of … Experienced a life-threatening event Used 2 weeks to 2 months after birth Sounds alarm if the infant experiences bradycardia or apnea Bring the apnea monitor to the hospital with the patient.
premature
gastroesophageal reflux
SIDS
internal cardiac pacemakers:
Implanted under skin to regulate …
May include automated implanted defibrillator
Never place defibrillator paddles or pacing patches directly over the implanted device.
Gather information about the type of cardiac pacemaker during history taking.
heart rate;
left ventricular assist devices:
Takes over the function of either one or both …
Typically used as a bridge to heart …
May be difficult to palpate a …
Provide support measures and basic care.
Use the caregiver or medical control as a resource.
heart ventricles; transplantation;
pulse
external defibrillator vest:
Vest with built-in monitoring … and …
Worn by the patient under his or her clothing
Attached to a monitor that provides alerts and delivers a shock
If patient is in cardiac arrest, vest should remain in place while you perform CPR.
electrodes; defib pads;
central venous catheter:
Catheter with its tip placed in the vena cava to provide …
Used for many types of home care patients
venous access;
gastrostomy tubes:
Placed into the stomach for patients who cannot ingest fluids, food, or medication by …
May become dislodged
Immediately stop the … .
Assess for signs or symptoms of …into the stomach.
Increased risk of …–>Always have suction available. Transport patients with dyspnea on their right side with the head elevated… .
mouth; flow of any fluids bleeding aspiration 30°
shunts:
For patients with chronic neurologic conditions
Tubes that drain excess …
Types:
Ventricular … shunt
Ventricular … shunt
Palpation of a fluid reservoir… will alert you to the presence of a shunt.
Blocked/infected shunt may cause changes in mental status and respiratory arrest.
Infection may occur within 2 months of insertion.
Signs of distress
cerebrospinal fluid; peritoneum; atrium; behind the ear
vagus nerve stimulators:
Treatment for seizures not controlled with medication
Stimulate the … to prevent seizure activity
Alternative treatment for seizures
Located under the patient’s skin
About the size of a silver dollar
vagus nerve
colostomies, ileostomies, and urostomies:
Colostomy or ileostomy–>
Surgical procedure creates an opening between the small or large intestine and the body’s …
Allows for elimination of waste products into external bag or pouch
Consider … if patients complains of diarrhea or vomiting.
surface; dehydration
colostomies, ileostomies, and urostomies contd:
Stoma site is prone to infection
Signs of infection
Urostomy:
A surgical opening connecting the … to the surface of the skin
Urine drains through a stoma in the …
urinary system; abdominal wall
