Component 9: Care for Special Patient Populations

Question 1

Differentiate:

Kyphosis from Lordosis

Answer 1

Kyphosis: Extensive outward curvature of the upper spine.

Lordosis: Extensive curvature of the lower spine, swayback.

Question 2

What is the medical term for bedsores?

Answer 2

Decubitus Ulcers

Question 3

Differentiate:

Dementia from Alzheimer’s

Answer 3

Dementia: is a slow decline in normal brain functions. Loss of memory and reasoning skills.

Alzheimer’s: is an actual disease process.

Question 4

Differentiate:

Mechanical Fall(s) and Physiologic Fall(s)

Answer 4

Mechanical Fall(s): include external forces, for instance tripping or being knocked down.

Physiologic Fall(s): result from an internal malfunction, for example, syncope, stroke, and/or vision disturbances.

Question 5

Why is polypharmacology an additional concern with geriatric patients?

Answer 5

Because of the normal aging process and deterioration of normal bodily functions, and the likelihood that a geriatric patient is prescribed multiple medications.

Question 6

What does the acronym APGAR stand for and when should the assessment be performed?

Answer 6

APGAR scoring should be completed at one minute and 5 minutes after the child has been delivered.

A - Appearance
P - Pulse
G - Grimace
A - Activity
R - Respiratory

Question 7

During childbirth, what is the term when the baby’s buttocks presents first in the vagina?

Answer 7

Breech Presentation

Question 8

Why is a prolapsed cord lethal to the fetus?

Answer 8

During delivery, the fetus’s head will put pressure on the cord, cutting off its own circulation of oxygenated blood.

Question 9

Differentiate:

Primigravida and Multigravida

Answer 9

Primigravida: A woman’s first pregnancy
Multigravida: A woman’s second and future pregnancies

Question 10

What is an imminent sign of delivery?

Answer 10

Crowning - the presence of the fetus’s head at the vaginal opening.

Question 11

Define:

Eclampsia

Answer 11

Eclampsia is hypertension during a pregnancy that progresses to seizures.

Question 12

What is the medical term for when the placenta separates from the wall of the uterus before childbirth?

Answer 12

Abruptio placenta

Question 13

How should a nuchal cord be assessed?

Answer 13

Once the infant’s head has presented, visualize and feel for the presence of the cord around the infant’s neck. If present, slip the cord over the baby’s head.

Question 14

List:

Tools in an Obstetrical (OB) kit

Answer 14

OB Kit Tools:

• Umbilical clamps
• Scalpel or scissors
• Blanket
• Infant cap
• Bulb suction
• Sterile gloves
• Plastic bag
• Towels, drape and/or sheets

Question 15

How far from the newborn should the first umbilical clamp be placed?

Answer 15

The first umbilical clamp should be placed six inches (15 cm) from the newborn.

The second clamp should be placed two to four inches from the first.

Question 16

True or False

It is important to ask if the pregnant mother has had prenatal care during their current pregnancy.

Answer 16

True

Question 17

What stage of labor is the delivery of the baby?

Answer 17

Second stage of labor

1. Cervical dilatation
2. Expulsion or delivery
3. Placental delivery

Question 18

The mother says that her bag of waters has broken. The fluid is a green/brown color with a foul odor. What is the concern with this information?

Answer 18

The fetus has had their first bowel movement in utero. Be prepared for meconium to be present during the delivery of the baby and provide aggressive airway suction and management.

Question 19

Describe:

During pregnancy, what is lightning?

Answer 19

Lightning is when the fetus drops into the mother’s pelvic region, positioning itself for birth usually 2 to 4 weeks prior to childbirth.

Question 20

True or False

When stimulating a newborn after delivery, it is best done by spanking the neonate’s butt.

Answer 20

False

The best practice is to rub the baby’s back while drying and/or flick the baby’s feet.

Question 21

True or False

Pregnant women have an increased possibility of physical abuse.

Answer 21

True

Question 22

Describe:

Ectopic pregnancy

Answer 22

Ectopic pregnancy is when an embryo develops outside the uterus, most often in the uterine (fallopian) tubes.

Question 23

What position should a pregnant patient be placed in to avoid supine hypotensive syndrome?

Answer 23

Place the patient in the left lateral recumbent (LLR) or recovery position on the left.

Question 24

Define:

Term gestation

Answer 24

Term gestation is when the pregnancy has reached 39 weeks but not exceeded 40 weeks and 6 days.

Question 25

Fill in the blank(s)

If the newborn’s pulse is below 60 beats per minute, we should __________ __________.

Answer 25

Start CPR

Question 26

List:

Anatomical differences between adults and children

Answer 26

Anatomical differences:

• Children’s occipital regions are larger
• Infants and young children’s tongues are larger
• Children’s abdominal muscles are less developed
• The cartilaginous rings of the trachea are less developed than adults
• A child’s bones are softer, more pliable

Question 27

List

The components of the Pediatric Assessment Triangle (PAT)

Answer 27

PAT:

• Appearance (generally muscle tone, movement)
• Work/effort of breathing
• Circulation (skin color)

Question 28

True or False

Suspected abuse or neglect of any age group is required to be reported to the proper authorities.

Answer 28

True

Question 29

What is the disease called that is caused by swelling and enlargement of the epiglottis?

Answer 29

Epiglottitis

Question 30

Approximately at what age does the fontanelle become fused or closed?

Answer 30

Around 18 months of age

Question 31

What is another term for pertussis?

Answer 31

Whooping Cough

Question 32

What upper airway disorder/disease in children presents with a seal-like barking cough?

Answer 32

Croup

Question 33

What syndrome does the picture represent?

Answer 33

Shaking/Shaken Baby Syndrome

Question 34

True or False

The definitive diagnosis of Sudden Infant Death Syndrome (SIDS) can only be done from a thorough autopsy.

Answer 34

True

Question 35

List:

A 16 month old’s mother states that the child has had a recent respiratory infection and today has developed a very rapid onset of a high temperature. What are some critical concerns for this child?

Answer 35

Critical concerns for a 16 month old:

• Febrile Seizure
• Respiratory Compromise
• Dehydration
• Sepsis

Question 36

What age group commonly experiences their world by putting things in their mouths?

Answer 36

Toddlers (1 to 3 years old)

Question 37

What is the leading medical cause of death in small children?

Answer 37

Respiratory Emergencies/Compromise

Question 38

Describe:

Why would we consider padding under the infants’ shoulders and body to provide airway management?

Answer 38

An infant’s head (occipital region) is larger disproportionately to their body. If we don’t pad under the infant’s body, their heads will hyperflex causing kinking or obstruction of their airway.

Question 39

You want to provide high flow oxygen (O₂) for a patient with a stoma. Where should the non-rebreather mask be placed?

Answer 39

The mask should be placed over the patient’s stoma.

Question 40

When lifting/moving and packaging patients with disorders such as cerebral palsy, spina bifida, or paralysis, what additional concerns might you have?

Answer 40

• Communications may be challenging
• Due to changes in their body’s sensations, or inability to feel, they will not be able to report painful movement or pinching

Question 41

True or False

Poverty and/or homelessness are NOT included in our awareness of special populations.

Answer 41

False

Question 42

Define:

Obesity

Answer 42

Obesity is defined as an excessive or abnormal amount of body fat that causes additional health concerns.