Exam 7- Ch. 20-24 Flashcards
A 28-year-old female patient is found to be responsive to verbal stimuli only. Her roommate states that she was recently diagnosed with type 1 diabetes and has had difficulty controlling her blood sugar level. She further tells you that the patient has been urinating excessively and has progressively worsened over the last 24 to 36 hours. On the basis of this patients clinical presentation, you should suspect that she:
A. is significantly hyperglycemic.
B. has a urinary tract infection.
C. has overdosed on her insulin.
D. has a low BG level.
A. is significantly hyperglycemic.
A 31-year-old male with a history of diabetes had a seizure that stopped prior to EMS arrival. He is unresponsive and has rapid shallow breathing. His pulse is rapid weak, and his skin is cyanotic. The EMT should:
A. administer oxygen by nasal cannula and assess his BG level.
B. place a thin layer of oral glucose between his cheek and gums.
C. position the PT on his side and give oxygen via nonrebreathing mask.
D. assist the PTs ventilations with a bag-valve mask.
D. assist the PTs ventilations with a bag-valve mask.
You respond to a residence for a PT who is “not acting right.” As you approach the door, the patient, a 35-year-old male, begins shouting profanities at you and your partner while holding a baseball bat. The man is confused and diaphoretic, and is wearing a medical identification bracelet. You should:
A. contact medical control for instructions.
B. calm him down so you can assess him.
C. be assertive and talk the PT down.
D. retreat at once and call law enforcement.
D. retreat at once and call law enforcement.
A 19-year-old male complains of “not feeling right” His insulin and syringe are on a nearby table. The PT says he thinks he took his insulin and cannot remember whether he ate. He is also unable to tell you the time or what day it is. The glucometer reads “error” after several attempts to assess his BG level. You should:
A. transport only with close, continuous monitoring en route.
B. contact medical control and administer oral glucose.
C. request a paramedic ambulance to administer IV glucose.
D. assist him with his insulin injection and reassess him.
B. contact medical control and administer oral glucose.
A 42-year-old male is found unresponsive on his couch by a neighbor. During your assessment, you find no signs of trauma, and the patients BG level is 75 mg/dL. His BP is 168/98 mm Hg, his HR is 45 beats/min and bounding, and his respirations are 8 breaths/min and irregular. The patient is wearing a medical alert bracelet that states he has hemophilia. You should:
A. administer high-flow oxygen, perform a detailed secondary assessment at the scene, and transport promptly.
B. suspect that he has intracranial bleeding, assist his ventilations, and transport rapidly to an appropriate hospital.
C. administer oxygen via a NRBM, apply oral glucose in between his cheek and gum, and transport.
D. suspect that he has internal bleeding and is in shock, administer high-flow oxygen, and transport at once.
B. suspect that he has intracranial bleeding, assist his ventilations, and transport rapidly to an appropriate hospital.
A 75-year-old male with type 1 diabetes presents with chest pain and a general feeling of weakness. He tells you that he took his insulin today and ate a regular meal approximately 2 hours ago. You should treat this PT as though he is experiencing:
A. an acute stroke.
B. hypoglycemia.
C. hyperglycemia.
D. a heart attack.
D. a heart attack.
A 50-year-old male with diabetes has an altered mental status and is unable to tell you when he last ate or took his insulin. Your glucometer keeps malfunctioning and you are unable to determine his BG level. Which of the following clinical signs would MOST likely lead you to the correct diagnosis?
A. Restlessness and irritability.
B. Hypotension and tachycardia.
C. Rapid and weak pulse.
D. Deep and rapid breathing.
D. Deep and rapid breathing.
A 29-year-old female presents with confusion and disorientation. Her respirations are rapid and shallow, and her pulse is 120 beats/min and thready. She is markedly diaphoretic and has an oxygen saturation of 89%. You should:
A. transport immediately.
B. provide ventilatory support.
C. administer oral glucose.
D. treat her for hyperglycemia.
B. provide ventilatory support.
Classic signs and symptoms of hypoglycemia include:
A. cold, clammy skin; bradycardia; hunger; and deep, rapid respirations.
B. warm, dry skin; irritability; bradycardia; and rapid respirations.
C. warm, dry skin; hunger; abdominal pain; and deep, slow respirations.
D. cool, clammy skin; weakness; tachycardia; and rapid respirations.
D. cool, clammy skin; weakness; tachycardia; and rapid respirations.
Diabetes is MOST accurately defined as a(n):
A. disorder of glucose metabolism.
B. abnormally high blood glucose level.
C. mass excretion of glucose by the kidneys.
D. lack of insulin production in the pancreas.
A. disorder of glucose metabolism.
Diabetic ketoacidosis occurs when:
A. insulin is not available in the body.
B. the cells rapidly metabolize glucose.
C. the pancreas produces excess insulin.
D. blood glucose levels rapidly fall.
A. insulin is not available in the body.
What is excessive eating caused by cellular “hunger” called?
polyphagia
Hemoglobin is:
A. a key component of the blood and is produced in response to an infection.
B. found within the red blood cells and is responsible for carrying oxygen.
C. essential for the formation of clots, such as when vessel damage occurs.
D. the fluid portion of the blood that transport cells throughout the body.
B. found within the red blood cells and is responsible for carrying oxygen.
Patients with thrombophilia are at an increased risk for:
A. hemorrhagic stroke
B. various cancers
C. acute arterial rupture
D. pulmonary embolism
D. pulmonary embolism
Patients with type 2 diabetes usually control their disease with all of the following, EXCEPT:
A. tolbutamide (Orinase)
B. diet and exercise
C. glyburide (Micronase)
D. supplemental insulin
D. supplemental insulin
Patients with uncontrolled diabetes experience polyuria because:
A. low BG levels result in cellular dehydration.
B. excess glucose in the blood is excreted by the kidneys.
C. they drink excess amounts of water due to dehydration.
D. high blood sugar levels cause permanent kidney damage.
B. excess glucose in the blood is excreted by the kidneys.
Proper procedure for administering oral glucose to a patient includes all of the following, EXCEPT:
A. checking the medications expiration date
B. requesting permission from medical control
C. ensuring the absence of a gag reflex
D. assessing the patients mental status
C. ensuring the absence of a gag reflex
Symptomatic hypoglycemia will MOST likely develop if a patient:
A. eats a regular meal followed by mild exertion
B. takes too much of his or her prescribed insulin
C. markedly overeats and misses an insulin dose
D. misses one or two prescribed insulin injections
B. takes too much of his or her prescribed insulin
What is the text book normal blood glucose level?
Between 80 and 120 mg/dL
To which of the following diabetic patients should you administer oral glucose?
A. a semiconscious 40-year-old female without a gag reflex
B. a confused 55-year-old male with tachycardia and pallor
C. a conscious 37-year-old female with nausea and vomiting
D. An unconscious 33-year-old male with cool, clammy skin
B. a confused 55-year-old male with tachycardia and pallor
Type 1 diabetes:
A. typically occurs in PTs between 50 nd 70 years of age
B. is defined as a BG level that is less than 120 mg/dL
C. is a condition in which no insulin is produced by the body
D. is typically treated with medications such as metformin
C. is a condition in which no insulin is produced by the body
When assessing an unresponsive diabetic patient, the primary visible difference between hyperglycemia and hypoglycemia is the:
A. rate of the patients pulse.
B. presence of a medical identification tag.
C. rate and depth of breathing.
D. patients mental status
C. rate and depth of breathing.
Which of the following conditions is the diabetic PT at an increased risk of developing?
A. Blindness
B. Alcoholism
C. Hepatitis B
D. Depression
A. Blindness
Which of the following signs or symptoms would the EMT MOST likely encounter in a PT with new-onset type 1 diabetes?
A. total lack of appetite
B. low BG level
C. weight gain and edema
D. weight loss and polyuria
D. weight loss and polyuria