Component 7: Care for the Medical Patient Flashcards
A review of common illnesses, treatments, and the NREMT Management of the Medical Patient skill sheet.
Describe:
Medical Emergencies
These are caused by illness or disease processes (Nature of Illness).
NOI
What are the six major processes in order of assessment?
- Scene Size-up
- Primary Survey/Resuscitation
- History Taking
- Secondary Assessment
- Vital Signs
- Reassessment
List the causes/types of infectious diseases.
- bacteria
- viruses
- fungi
- parasites
List a minimum of five common communicable diseases.
- Covid
- Influenza
- Herpes Simplex
- HIV
- Hepatitis
- Meningitis
- Tuberculosis
- Methicillin-resistant Staphylococcus Aureus (MRSA)
True or false.
A mask should be placed on the patient with tuberculosis.
TB
True
As of 2020, a minimum for mask, gloves, and eye protection (PPE) should be worn.
If blood enters the heart from the superior vena cava, what is the order the blood will go through the chambers and ventricles?
Drop of blood path from the superior vena cava
- Right atria
- Right ventricle
- (Out the pulmonary vein, unoxygenated)
- (Returning through the vein, oxygenated)
- Left atria
- Left ventricle
What do we call a group of symptoms caused by cardiac ischemia including myocardial infarctions and angina?
Acute Coronary Syndrome
(ACS)
Define:
Referring to medical terminology, define the term acute.
It is the experience of sudden and most likely severe complaints of onset of symptoms.
Describe:
Pathophysiology of acute myocardial infarction.
(AMI)
This happens when there is an occlusion of a coronary artery causing ischemia progressing to injury of the cardiac tissue and then to infarction.
Define:
infarction
Death of a localized tissue.
Fill in the blank.
A temporary and transient blockage to the cardiac blood flow resulting in chest discomfort or pain is called ________ ________.
Angina Pectoris
What is the cardiac muscle’s ability to have its own electrical system not dependant on the nervous system called?
automaticity
What is the stroke volume multiplied by the heart rate called?
cardiac output
Differentiate:
The onset of pain and quality of pain of:
- Acute Myocardial Infarction (AMI)
- Dissecting Aneurysm
AMI:
- Onset of pain- will be acute with additional signs/symptoms.
- Quality of pain - will most likely be described as tight or pressure, increasing over time.
Dissecting Aneurysm:
- Onset of pain- will be acute without additional signs/symptoms.
- Quality of pain- will most commonly be described as tearing or burning from the onset.
What is a late vital sign finding of cardiogenic shock?
Hypotension, the drop in blood pressure below 90 mm Hg.
Define:
Orthopnea, and what disorder does it present with most commonly?
It is an increase or inability to breathe when lying flat, most commonly associated with patients suffering congestive heart failure (CHF).
What cardiac disorder frequently presents with jugular venous distension (JVD) and pedal edema?
Congestive Heart Failure
(CHF)
List:
Signs/symptoms of acute myocardial infarction
- Acute onset of chest pain or discomfort
- Diaphoresis
- Dyspnea
- Nausea/vomiting
- Syncope
- Additional pain in the jaw, arms, neck, and/or back
- Death
True or false.
Best practices suggest we give high flow oxygen via a non-rebreather mask (15 Lpm) for a patient who has no difficulty breathing, pulse oximetry of 97%, complaining of severe and acute chest pain radiating to their jaw that woke them from their sleep.
False
Too much oxygen in this situation may cause additional harm.
List:
Dysrhythmias that may present during a cardiac event
- Tachycardia
- Bradycardia
- Ventricular Tachycardia (V-Tac)
- Ventricular Fibrillation (V-Fib)
- Asystole
Or the EKG could be normal, but normal is not a dysrhythmia.
List:
Components of high-quality CPR
- Correct ventilation/compression ratio
- Appropriate depth
- Full recoil
- Adequate breaths or ventilations
- Minimizing interruptions
True or false.
CPR must be immediately initiated as soon as the patient is determined as pulseless.
True
What cardiac dysrhythmia(s) is the Automatic External Defibrillator (AED) designed to shock?
Ventricular Fibrillation (V-Fib) and Ventricular Tachycardia (V-Tach)
True or false.
The automatic external defibrillator (AED) will shock asystole.
False
The AED is designed to sense electrical activity in the cardiac muscle. Asystole is the absence of any electrical activity.
True or false.
Even though angina most often occurs during exertion, we as EMTs should not differentiate angina from an acute myocardial infarction (AMI) in the field.
True
Diagnosis of an AMI or angina should be done by a physician.
List:
Lobes of the cerebrum
- Frontal
- Parietal
- Temporal
- Occipital
List:
Common types of headaches
- Tension
- Migraines
- Sinus
Differentiate:
Ischemic stroke and a hemorrhagic stroke
- Ischemic Stroke: is a blood vessel in the brain that is blocked either by thrombosis or an embolism.
- Hemorrhagic Stroke: is the result of a ruptured aneurysm in a vessel of the brain.
List:
Signs/symptoms of a cerebral vascular accident (CVA)
- Facial drooping
- Speech disturbances
- Acute onset of a headache
- Hemiparesis
- Confusion
- Loss of balance
- Combativeness
- Vision disturbances
True or false.
Just like differentiating between angina and an acute myocardial infarction, EMTs should differentiate an ischemic stroke from a hemorrhagic stroke.
False
Diagnoses and differentiating require a physician’s evaluation and tests.
Fill in the blank.
Transient Ischemic Attacks (TIA) are considered as a _____________ to having a stroke.
precursor
True or false.
The treatment for a patient presenting with stroke signs/symptoms should be given high flow oxygen (O2) and oral glucose.
False
Because we do not differentiate types of strokes, glucose should not be given (only in hypoglycemic emergencies). Also, like myocardial infarctions, too much oxygen (O2) can cause additional damage to the tissues.
What are two common types of seizures?
Generalized (tonic/clonic) and partial (focal) siezures.
Which phase of a seizure does an aura present?
before
Not all seizures present with auras, and some auras may present as a partial seizure and progress to a generalized seizure.
True or false.
All patients suffering first-time seizure activity should be evaluated by a doctor.
True
What is the medical term for fainting?
syncope
Define:
Altered Mental Status (AMS)
It is defined as any changes to a person’s awareness of person, place, time, and event that are not considered normal for the patient.
Explain the mnemonic utilized when attempting to discover the cause of a patient suffering from altered mental status (AMS) from an unknown cause.
Alcohol/acidosis
Epilepsy, endocrine, electrolytes
Insuline
Opiates and/or other drugs
Uremia (kidney failure)
Trauma, temperature
Infection
Poisoning or psychogenic
Shock, stroke, seizure, syncope
What does the mnemonic BE FAST represent?
Balance
Eyes (pupil response)
Facial drooping
A drift
Speech
Time frame from last seen normal
Why would a patient be incontinent after a generalized seizure?
The spasmatic electrical activity in the brain causes all muscles to erratically contract. This would lead to the urinary sphincters to spasm and leak urine.
True or false.
Providing oxygen (O2) for a patient in a postictal state may shorten the postictal time frame.
True
List:
Potential causes of an acute abdomen.
- Cholecystitis and/or cholelithiasis
- Ulcers
- Pancreatitis
- Appendicitis
- GI bleed(s)
- GERD (gastroesophageal reflux disorder/disease
- Esophageal Varices
What is the medical term for a patient vomiting blood?
hematemesis
A patient complaining of having abdominal pain and coffee-groud emesis is most likely suffering from what disorder?
Gastrointestinal Bleed (GI Bleed)
What is the most common pertinent history of a patient presenting with esophageal varices?
alcoholism
What are kidney stones (nephrolithiasis) caused by?
Uric acid that is crystalizing urine.
Fill in the blank.
While palpating a patient’s abdomen, they complain of shoulder pain. This is commonly called ________ _____.
referred pain
What are two things the brain needs to survive?
- Oxygen (O2)
- glucose
What is the endocrine system responsible for?
Production, secretion, and communication of hormones.
List:
Types of diabetes
- Diabetes mellitus type 1
- Diabetes mellitus type 2
- Gestational
What is the most common first presentation of a diabetic emergency: a hypoglycemic patient or a hyperglycemic patient?
hyperglycemic patient
List:
The “Polys” of diabetes
- Polyuria
- Polyphagia
- Polydipsia
What is the function of insulin?
It is a hormone that enables glucose to move into cells.
What hyperglycemic syndrome causes profound dehydration?
Hyperosmolar hyperglycemic nonketotic syndrome
(HHNS)
True or false.
It is an acceptable treatment to provide oral glucose buccally for the unresponsive diabetic emergency.
False
Oral glucose in an unresponsive patient will cause airway obstruction and possible aspiration.
What is the name of the disease of a patient that is born with a decreased ability to clot blood?
hemophilia
Fill in the blank.
The study of the recognition, treatment, and management of blood related disorders is called ____________.
Hematology
What should we do with the epi-pen after administration?
Dispose of it properly in a Sharps container.
What must happen before the body can identify an allergen?
The body must be exposed to the allergen at least once for the sensitization process.
List:
common allergens
- food
- medication(s)
- chemicals
- plants
- insect/animal bites or stings
Why is angioedema including the lips, tongue, and larynx considered critical/lethal?
It is considered critial/lethal due to airway obstruction, narrowing, or occlusion. Early recognition/suspicion and airway management are crucial.
True or false.
A patient can be hypersensitive to an allergen and still not progress to anaphylaxis.
True
What does the presence of stridor indicate?
Swelling of the upper airways.
What is the contraindication for the administration of the epi-pen?
There are no contraindications if the patient is in true anaphylaxis. Anaphylaxis is an emergent life threat.
How often should a patient with a severe allergic reaction be reassessed?
Every 5 minutes, staying alert for any signs of progression to anaphylaxis.
List:
Routes that toxin(s)/poison(s) enter the body
- Injection
- Ingestion
- Inhalation
- Absorption
Is alcohol a central nervous system (CNS) stimulant or depressant?
Alcohol is a CNS depressant.
Differentiate:
Addiction and tolerance
- Addiction: is a physical and psychological need/desire to consume a particular substance (alcohol, stimulants, hallucinogens, etc…)
- Tolerance: results when the abuse/addiction of a substance will no longer have the same effect and will require more of the substance to reach the individual goal/high.
Define:
dependence
It develops when a substance is misused so frequently that a psychological and physical need emerges.
What is it called when a person’s reactions or behaviors are extreme and outside of societal norms?
behavioral crisis
True or false.
A patient’s history of depression is a critical insight as to the risk of suicide.
True
What is the disorder called that results from spasming and swelling of the smaller airways (bronchioles)?
asthma
The acronym COPD stands for what respiratory disorder?
Chronic Obstructive Pulmonary Disease/Disorder
List:
Signs/symptoms of emphysema
- Chronic exertional dyspnea
- Pursed lip breathing
- Barrel chest
- Decreased lung sounds
- Chronic or worsened cyanosis
List:
Potential treatments for patients with an exacerbated chronic respiratory complaint (respiratory crisis treatment)
- High flow oxygen (O2)
- Assistance with medication (metered dose inhalers MDI)
- Position of comfort (POC), typically Semi-Fowler’s
- Assisted positive pressure ventilation (PPV)
- Transport
Fill in the blank.
Hyperventilation syndrome is commonly associated with an _______ _______.
anxiety attack
What will the lung sound be when assessing the lung sounds on the affected side of a patient with a suspected pulmonary embolism?
Initially, the lung sounds will be clear in the affected area and possibly progress to diminished and/or absent.
What is an indication for the administration of a metered-dose inhaler (MDI) or a small-volume nebulizer (SVN)?
The patient is presenting with dyspnea, most likely with a history of chronic respiratory illness. Suspected bronchial spasms are commonly associated with wheezing.
