Exam 4 Flashcards
What is the purpose of the Primary Assessment
NOI, S&S, C/C, identify & begin to treat immediate life threats
What are the steps of the Primary Assessment
General Impression, rapid examination, LOC, ABC, Priority of treatment &Transport
What are the steps of Secondary Assessment
Assess vital signs with appropriate monitoring device
Reassessment consists of
Monitor changes in a patient’s condition, monitor interventions, and detect life-threatening conditions
Assessment of the medical patient is usually focused on the______.
NOI
Which of the bacterium resistant to most antibiotics and causes skin abcesses?
Methicillin-Resistant Staphylococcus Aureus (MRSA)
When forming your general impression of the patient with a medical complaint, it is important to remember that:
The condition of many medical patients may not appear serious at first
It is especially important to assess pulse, sensation, and movement in all extremities as well as pupillary reaction in patients with a suspected_____ problem.
Neurologic
The determination of whether a medical patient is a high-priority or low-priority transport is typically made:
After primary assessment
After sizing up the scene of a patient with a possible infectious disease, your next priority should be to:
Use standard precautions
Which of the following patients is at greatest risk for complication caused by the influenza virus?
Those with chronic medical conditions, umcompromised immune systems, the very young, the very old
Ten days after treating a 34 y/o patient with TB, you are given a TB skin test, which yields a positive result. This MOST likely indicates that:
You were exposed
In 2009, the H1N1 virus accounted for over 200,000 deaths worldwide in the form of the swine flu. In 1919, a similar outbreak of the H1N1 occurred in the form of the Spanish flu. Starting in Kansas City, the virus spread rapidly worldwide, claiming up to 50 million lives. These are both examples of:
Pandemic
What is the difference between endemic vs pandemic:
An epidemic occurs when the communicable disease spreads from person to person and affects a large number of people. A pandemic occurs over a wide geographic area and affects a high proportion of the population
You patient has a chronic respiratory condition. His stimulus to breathe is triggered by low oxygen levels in the blood. This is known as the _____.
Hypoxia
Which of the following must be assessed in every repiratory patient?
Obtaining lung sounds
Crackles (rales) are caused by_____.
Fluid in the alveoli
Bubbly sounds during inhalation, fluid surrounding or filling the bronchioles/alveoli:
Crackles (rales)
In what areas of the lungs does respiration occure?
Alveoli
Which of the following is MOST characteristic of adequate breathing?
24 breaths/min with bilaterally equal breath sounds and pink skin
A 59-year-old male with a history of emphysema complains of an acute worsening of his dyspnea and pleuritic chest pain following a forceful cough. Your assessment reveals that he has a barrel-shaped chest, unilaterally diminished breath sounds, and tachycardia. What is the MOST likely cause of this patient’s condition?
Spontaneous Pneumothorax
Treatment for crackles/rales
CPAP
Treatment with continuous positive airway pressure (CPAP) would most likely be contraindicated in which of the following situation?
Shortness of breath and a blood pressure of 76/56 mm Hg
Asthma is caused by a response of the:
Exaggerated response of the body’s immune system
Indications for Albuterol
Asthma, difficulty breathing with wheezing
Contraindications of Albuterol;
Albuterol is indicated for the treatment of bronchospasms associated with: asthma, COPD, allergic reactions, and toxic inhalation.
Contraindications of Aluterol
Hypersensitivity
A 30-year-old male presents with acute shortness of breath, widespread hives, and facial swelling. He denies any past medical history and takes no medications. During your assessment, you hear wheezing over all the lung fields. His blood pressure is 90/50 mm Hg and his heart rate is 110 beats/min. In addition to giving him high-flow oxygen, the MOST important treatment for this patient is:
Epinephrine
Indications for Epiniphrine
Anaphylactic reaction
Dosage for Epinephrine
Adult: 0.3 to 0.5 milligrams via IM and onset of action is immediate.
Peds: 0.01 mg/kg up to 0.3 mg. route is intramuscular.
when auscultating the lungs of the patient with respiratory distress, you hear adventitious ounds. This means that the patient has:
Normal breath sounds
While auscultating an elderly woman’s breath sounds, you hear low-pitched “rattling” sounds at the bases of both of her lungs. This finding is MOST consistent with which of the following conditions?
Aspiration pneumonia
You are assisting an asthma patient with his prescribed metered-dose inhaler. After the patient takes a deep breath and depresses the inhaler, you should:
instruct the patient to hold his/her breath for as long as its comfortable for them
Dosage of albuterol in neb form:
NEBULIZER: 2.5mg albuterol in 2-3 mL of normal saline or METERED-DOSE INHALER: 2 Inhalations 90 micrograms (mcg)
NEBULIZER W/O₂: 0.15mg/kg in 2-3 mL of normal saline, repeat as needed.
A pleural effusion is MOST accurately defined as:
A collection of fluid outside the lung
You are attending to a 3-year-old male patient who is presenting with severe shortness of breath. His parents report that he has had a cough and cold with a low grade fever for the past two days. They became worried today, as his level of distress has increased dramatically. On assessment, the patient is sitting upright and making high-pitched noises with each breath. Based on this information, the patient is most likely suffering from:
Croup- an acute viral infection of the upper respiratory tract
His parents tell you that their son has had a chest infection for the past two days and when they took him to their family doctor, they were told it was likely due to the respiratory syncytial virus (RSV). They have kept him well hydrated, but the infection seems to have gotten worse. On auscultation, you hear decreased air entry bilaterally with fine expiratory wheezes and the occasional coarse wet crackle. Based on this information, your patient is most likely suffering from:
Bronchiolitis
You are attending to a 54-year-old female patient in a homeless shelter. The patient tells you that she had the flu a couple of weeks ago, and she has not gotten over it. She has been tired and keeps waking up at night, sweating. She has been coughing up green sputum occasionally and has been experiencing episodes of chest pain that get worse when she breathes. Based on this information, your patient is most likely suffering from
TB
Deoxygenated blood form the body returns to the
Right atrium
Angina pectoris occurs when?
myocardial oxygen demand exceeds supply
Another name for a Heart Attack
Acute myocardial infarction (AMI)
The electrical impulse generated by the heart originates in the:
Sinoatrial Node (SA)
Who’s known as the “Gate Keeper” in the heart:
Atrioventricular Nodes (AV)
Name the valves of the heart:
Pulmonary valve, Aortic valve, mitral valve, tricuspid valve
Risk factors for AMI that cannot be controlled include:
Family history
What is myocardia ischemia
Partial obstruction of blood flow in the coronary arteries so decreased blood flow to myocardium
S&S of Acute Coronary Syndromes:
- Squeezing chest pain or pressure
- Jaw pain
- Shortness of breath
- Sweating
- Nausea
- Lightheadedness
- Palpitations
- Pain/Numbness radiating to the left arm/shoulder
S&S of a hypertensive emergency would MOST likely be delayed in patients who;
have chronic hypertension
A 49 y/o M Presents with an acute onset of crushing chest pain and diaphoresis. You should:
Assess the adequacy of his respirations
Which of the following is NOT a common sign or symptom associated with malfunction of an implanted cardia pacemaker?
A rapid heart rate
A patient in cardiac arrest is wearing an external defibrillator vest, which is interfering with effective chest compressions. The EMT shoudl:
Remove the battery from the monitor and then remove the vest
When do you change roles during CPR?
After every 5 cycles
What is the ratio for 2 person CPR on a child?
15:2
A 66-year-old female with a history of hypertension and diabetes presents with substernal chest pressure of 2 hours’ duration. Her blood pressure is 140/90 mm Hg, her pulse is 100 beats/min and irregular, her respirations are 22 breaths/min, and her oxygen saturation is 92%. The patient does not have prescribed nitroglycerin, but her husband does. You should:
administer oxygen, give her 324 mg of aspirin, and assess her further
Nitroglycerin is contraindicated in patients:
Who have experienced a head injury
What are the actions of Nitroglycerin
- Relaxes smooth muscles causing venous dilation.
- Reduces preload and afterload to the heart.
- Dilates the coronary arteries resulting in increased perfusion of the myocardium.
Indications for the use of Aspirin:
Relief of mild pain headache, muscle aches; chest pain of cardiac-origin
Contraindication of Asprin:
Hypersensitivity & Recent Bleeding
What is the dosage for Aspirin:
160-325mg
A patient tells you that he has a left ventricular assist device (LVAD). Which of the following conditions should you suspect that he as experienced:
Heart Failure: Acute myocardial infarction
Where does blood flow after it leaves the left ventricle:
The Aorta
Most AED’s are set up to adjust the voltage based on the impedance which is the:
Resistance of the body to the flow of electricity
After the AED has delivered a shock, the EMT should:
Resume CPR with chest compressions
You and your partner arrive at the scene of the middle-aged man who collapsed about 5 mins ago. He is unresponsive apneic, and pulseless. Bystanders are present, but have not provided any care. You should:
Begin chest compressions/rescue breaths at 30:2 until an AED arrives
Prior to attaching the AED to a cardiac arrest patient, the EMT should:
Dry the chest if it is wet
Which of the following signs is commonly observed in patients with right-sided heart failure?
Dependent edema
The three major parts of the brain are the:
Cerebrum, cerebellum, and brain stem
The MOST significant risk factor for the hemorrhagic stroke is?
hypertension
what is an ischemic stoke
A type of stroke that occurs when blood flow to a particular part of the brain is cut off by a blockage (eg, a blood clot) inside a blood vessel
Which of the following conditions would be the LEAST likely to mimic the signs and symptoms of a stroke?
hypovolemia
Three things to check is suspicious of a stroke:
Face, Arm, Speech
Which of the following MOST accurately describes what the patient will experience during the postictal state that follows a seizure?
Confusion and fatigue
When caring for a patient with documented hypoglycemia, you should be MOST alert for:
Seizure
What hormone is produced by the pancreas?
Insulin
What lowers sugar level?
Glycogen
What is the normal rage of BGL:
80-100
What is your dosage for Glucose:
0.5-1 tube
During the primary assessment of a semiconscious 70 y/o F, you should:
Ensure the patients airway and support ventilation as needed
When assessing for arm drift of a patient with suspected stroke, you should:
Ask the patient to close his/her eyes during the assessment
A patient who is possible experiencing a stroke is NOT eligible for thrombolytic (fibrinolytic) therapy if he/she:
has head bleeding within the brain
Which of the following conditions would MOST likely affect the entire brain?
Respiratory failure & cardiopulmonary arrest
