Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

Exam 9 > Hemorrhage And Shock > Flashcards

Hemorrhage And Shock Flashcards

1
Q

The transition between normal function and death is called ____.

A

Shock

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

How does a capillary hemorrhage present?

A

Generally oozes from the wound, normally an abrasion, and clots quickly on its own.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

What color is blood in a capillary hemorrhage?

A

Bright red

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

The loss of the body’s most important and dynamic medium, blood, is called ____.

A

Hemorrhage

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

How does venous hemorrhage present?

A

Flows quickly but generally stops in a few minutes

Dark in color

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

Bleeding associated with arterial hemorrhage flows _____ and ____ from the wound.

A

Rapidly

Spurts

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

Blood from arterial blood is what color?

A

Bright red

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

What occurs when a blood vessel is torn and begins to lose blood, it’s ______ muscle contracts.

A

Smooth

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

The _____ phases the clotting process is the step in which smooth blood vessel muscle contracts, reducing the vessel lumen and the flow of blood through it.

A

Vascular

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

When a blood vessels smooth interior lining is disrupted, it causes?

A

Turbulent blood flow

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

The turbulent blood flow within the blood vessel attracts ______.

A

Platelets

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

What occurs in the platelet phase of the clotting process?

A

Platelets stick to collagen on the vessels injured inner surface and to other tissue in the area. They aggregate other platelets

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

To _____ is to cluster or come together.

A

Aggregate

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

What is the third and final step of the clotting process?

A

Coagulation

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

_____ are fibers which entrap red blood cells and form a stronger, more durable clot.

A

Fibrin

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

Coagulation normally takes _____ to _____ minutes.

A

7-10

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

If a blood vessel is cut transversely, the muscles of the vessel wall ____.

A

Contract

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

If a blood vessel is lacerated longitudinally, the smooth muscle contraction _______.

A

Pulls the vessel open

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

In a longitudinal laceration, bleeding is?

A

Heavy and continued

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

What kind of injury produces heavy continued bleeding?

A

Crushing trauma

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

If severe hemorrhage continues post laceration, _____ reduces the blood pressure at the hemorrhage site.

A

Hypotension

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

Systemic hypotension may be beneficial in controlling?

A

Serious internal hemorrhage

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

What are the factors which hinder the clotting process?

A
  • Movement of the wound site
  • Aggressive fluid therapy
  • Low body temperature
  • Medications such as aspirin, heparin, Coumadin
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

____ modifies the enzymes on the surface of platelets that cause them to aggregate the injury.

A

Aspirin

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
Q

_____ hemorrhage presents with blood oozing, flowing, or spurting from the wound.

A

External

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
26
Q

Bleeding from capillary and venous wounds is easy to halt because the _____ is limited.

A

Pressure

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
27
Q

Bleeding from an arterial wound is _____.

A

Forceful

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
28
Q

To stop bleeding from an arterial wound, pressure must?

A

Exceed the arterial pressure

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
29
Q

When a tourniquet is placed, the limbs arterial and venous pressures _____ as well as the rate of hemorrhage.

A

Rise

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
30
Q

Employ a tourniquet only to?

A

Half persistent hemorrhage

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
31
Q

What metabolites accumulate in the stagnant blood during the absence of perfusion present when using a tourniquet?

A

Lactic acid
Potassium
Other anaerobic metabolisms

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
32
Q

The hemorrhages which occur within the tissue or fascia are?

A

Self-limiting because the pressure within the tissue or fascia controls blood loss

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
33
Q

What are the best indicators of significant internal hemorrhage?

A

Mechanisms of injury
Local signs and symptoms of injury
Early signs and symptoms of blood loss and shock

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
34
Q

____ is bleeding from the nose resulting from injury, disease, or environmental factors; a nosebleed.

A

Epistaxis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
35
Q

Esophageal varies are?

A

Enlarged and tortuous esophageal veins

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
36
Q

What are the common outward signs that indicate hemorrhage in lungs and respiratory?

A

Hemoptysis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
37
Q

If blood is evacuated early in esophageal varces the blood is ____ in color.

A

Bright red

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
38
Q

Bowel hemorrhage may present as?

A

Bleeding from the rectum

Black and tarry stool(Melena)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
39
Q

What are the characteristics of acute hemorrhage?

A

Rapid shock

Quickly recognizable

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
40
Q

Chronic hemorrhage is ____ volume, _______, and leads to?

A

Limited in
Continues over time
Anemia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
41
Q

In anemia, the patient experiences _______ and ____.

A

Fatigue

Lethargy

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
42
Q

Cells contain about ____ percent of total fluid volume.

A

62

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
43
Q

Interstitial space holds ______ percent blood volume.

A

26

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
44
Q

_____ precent of fluid resides in the vascular space.

A

7

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
45
Q

Stage 1 hemorrhage is a blood loss of up to ____ percent of circulating blood.

A

15

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
46
Q

In stage 1 hemorrhage, what do vitals do?

A

Blood pressure, pulse, respiratory rate, urine output remain constant

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
47
Q

A patient experiencing stage 1 hemorrhage may present with?

A

Nervousness
Marginally cool skin
Slight pallor

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
48
Q

Stage 2 hemorrhage occurs as ____ to _____ precent of blood volume is lost.

A

15-25

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
49
Q

What occurs to the vitals in a patient experiencing stage 2 hemorrhage?

A

Tachycardia

Pulse strength diminishes

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
50
Q

In stage _____ hemorrhage, peripheral resistance is ______.

A

2

Increased

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
51
Q

In stage 2 hemorrhage, systolic blood pressure ______.

A

Stays the same

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
52
Q

Patients with stage 2 hemorrhage present with?

A

Cool, clammy skin, restlessness, and thirst

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
53
Q

Thirst presents with stage 2 hemorrhage due to?

A

Fluid leaving the intracellular and interstitial spaces and the osmotic pressure of blood changes

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
54
Q

Respiratory rate in stage 2 hemorrhage _____.

A

Increases

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
55
Q

Stage 3 hemorrhage occurs when blood loss reaches ____ to ______ percent of blood volume.

A

25-35

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
56
Q

In which stage of hemorrhage do signs of shock appear?

A

3

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
57
Q

What are vitals doing in stage 3 hemorrhage?

A

Rapid tachycardia
Blood pressure begins to fall
Pulse is barely palpable

58
Q

A patient experiencing stage 3 hemorrhage presents with?

A

Anxiety, restlessness, thirst, decreased level of responsiveness, pale, cool, diaphoretic

59
Q

Stage 4 hemorrhage occurs with a blood loss greater than ____ precent of body’s total blood supply.

A

35

60
Q

In stage 4 hemorrhage, the patients vital signs are?

A

Pulse is barely palpable in central arteries

Respirations are very rapid, shallow, and ineffective

61
Q

How do patients experiencing stage 4 hemorrhage present?

A

Patient is lethargic, confused
Skin is cool, clammy, pale
Urinary output decreases

62
Q

What patient may lose rather large volumes of blood before progressing through the various stages of hemorrhage?

A

Pregnant patients

63
Q

The _____ patient has a blood volume close to ____ precent of ideal body weight, but not actual body weight.

A

Obese

7

64
Q

Blood volumes in infants and children approximate ____ to _____ percent of body weight.

A

8-9

65
Q

Compensatory mechanisms in infants and children are?

A

Neither well developed nor effective

66
Q

Signs of blood loss and shock in elderly patients may be masked by?

A

Reduced perceptions of pain and by lowered levels of mental acuity due to disease

67
Q

Which injury results in the most severe amount of blood loss?

A

Fractured pelvis

68
Q

What are the early signs and symptoms of internal hemorrhage?

A
  • pain, tenderness, swelling
  • bleeding from mouth, rectum, vagina
  • vomiting of bright red blood
  • tender, rigid, distended abdomen
69
Q

What are the signs and symptoms of late internal hemorrhage?

A
  • Anxiety
  • weakness
  • thirst
  • Melena
  • rapid, weak, pulse
70
Q

_____ is the passage of stools containing red blood.

A

Hematochezia

71
Q

What indicates a positive tilt test?

A

Drop in systolic BP of 20
Increase of pulse 20
When the patient is moved from a supine to sitting position

72
Q

A tilt test is suggestive of?

A

Hypovolemia

73
Q

During the primary assessment, when should you care for serious hemorrhage?

A

Only after any airway and breathing problems are corrected

74
Q

Cover any open neck wound with what type of dressing?

A

Occlusive

75
Q

____ is the transitional stage between normal life and death.

A

Shock

76
Q

What occurs in the heart which blood loss?

A

Stroke volume drops

Immediate drop in systolic blood pressure

77
Q

What does the medulla oblongata do during blood loss?

A

Increases peripheral vascular resistance and heart rate

78
Q

_____ pressure is the pressure of liquids in equilibrium; the pressure exerted by or within liquids.

A

Hydrostatic

79
Q

____ is the group of red blood cells that are stuck together.

A

Rouleaux

80
Q

A ____ is the release of accumulated lactic acid, carbon dioxide, potassium, and Rouleaux into venous circulation.

A

Washout

81
Q

_____ shock is a hemodynamic shock insult to the body in which the body responds effectively.

A

Compensated

82
Q

In compensated shock, symptoms are ________.

A

Limited. Systems function normally

83
Q

In ____ shock, signs and symptoms are pronounced.

A

De compensated

84
Q

Entry into decompensated shock is indicated by?

A

Drop in systolic blood pressure

85
Q

____ is the final stage of shock in which organs and cells are so damaged that recover us impossible.

A

Irreversible

86
Q

A rapid secondary assessment is performed on a patient with?

A

a significant MOI or signs of shock or serious injury

87
Q

The primary principal of shock care is to?

A

Ensure the best possible chance for tissue oxygenation and carbon-dioxide off load

88
Q

_________ is positive pressure ventilation supplied to a breathing patient.

A

Overdrive respiration

89
Q

The most practical choice for prehospital fluid resuscitation is _______ solution.

A

Lactated ringers

90
Q

When blood is lost, angiotension II increases __________ and reduces _____.

A

Peripheral vascular resistance

Blood flow

91
Q

During blood loss, _______ reduces the ability of the capillaries to provide oxygen and nutrients to, and remove carbon-dioxide and other waste products from, the cells.

A

Interstitial edema

92
Q

During blood loss, he building acidosis from the accumulating lactic acid and carbon dioxide causes?

A

Relaxation of the post capillary sphincters

93
Q

The body’s first recognizable response to serious blood loss is probably an increase in?

A

Pulse rate

94
Q

The first sign of shock is?

A

A narrowing pulse pressure and weakening pulse strength

95
Q

What are the late signs of shock?

A

Tachypnea

Air hunger

96
Q

Tachycardia suggests?

A

Hypovolemia

97
Q

What type of CO2 levels reflect cardiac arrest, shock, pulmonary embolism, or incomplete airway obstruction?

A

Decreased

98
Q

_____ ETCO2 levels reflect hypoventilation, respiratory depression, or hyperthermia.

A

Increased

99
Q

ETCO2 readings above 40mmHg suggest the need for?

A

Increased ventilatory support

100
Q

ETCO2 readings below 30 mmHg suggest the need for

A

hyperventilation, respiratory depression, or hyperthermia

101
Q

An abnormally low alveolar CO2 level may produce _______.

A

Severe Cerebral Vasoconstriction

102
Q

Two techniques to improve ventilatory efficiency are?

A

End-expiratory pressure

Continuous positive airway pressure

103
Q

_____ uses special ventilation equipment that increases pressure during both inspiration and expiration.

A

Cpap

104
Q

If there is any sign of tension pneumothorax, provide pleural decompression where?

A

Second intercostal space, Midclavicular line or at the fifth intercostal space

Or midaxillary line

105
Q

The field treatment of choice for significant blood loss in trauma cases is ________.

A

Blood transfusion

106
Q

Why should a patient with tension pneumothorax be monitored after decompression?

A

It is common for the catheter to clog and the tension pneumothorax to reappear

107
Q

What should be done for a pneumothorax with a clogged decompression?

A

Insert another needle close to the first to relive any subsequent buildup of pressure

108
Q

What is the most practical fluid for prehospital administration?

A

Isotonic crystalloid aka Lactated ringers solution or normal saline

109
Q

Hypertonic crystalloid solutions can mobilize ______ and _____ fluid volumes to replace lost blood volume.

A

Interstitial

Cellular

110
Q

Hypertonic crystalloid solutions are not able to carry?

A

Either the oxygen or the clotting factors essential for hemorrhage control

111
Q

What is the biggest advantage of hypertonic solutions?

A

Low volume and weight

112
Q

What are polyhemoglobins?

A

These solutions are either animal or human hemoglobin that has been processed to exclude antigens and microorganisms that would cause disease or adverse reaction in the recipient.

113
Q

What are the positive attributes of polyhemoglobins?

A

Prolonged shelf life
Inexpensive
Can effectively carry oxygen from the lungs to the tissues

114
Q

Fluid flow is proportional to the _____ power of the internal diameter.

A

4th

115
Q

The longer the catheter, the ______ the resistance to flow.

A

Greater

116
Q

The ideal catheter for the shock patient is?

A

1.5 inch or shorter

117
Q

If you are unable to elevate the fluid bag, position it _________, in a ____ or in a ________ inflated to _____ or ______ mmHg.

A

Under the patient
Pressure infused
Blood pressure cuff
100 or 200

118
Q

That is the goal systolic for a head injury patient with a GCS of 8 or less?

A

At or above 90mmHg

119
Q

_____ decreases the skins ability to act as part of the body’s temperature control.

A

Cutaneous vasoconstriction

120
Q

The _____ nervous system efficiently compensates for low volume.

A

Sympathetic

121
Q

________ is not included in the initial signs of compensated shock accompanying external hemorrhage.

A

Unconsciousness

122
Q

In a patient with no suspected trauma, and signs and symptoms of shock, you can perform the tilt test. The test is performed to determine:

A

Orthostatic hypotension

123
Q

The arterial blood pressure is monitored by receptors in the aortic arch and carotid sinuses. These receptors are the?

A

Baroreceptors

124
Q

Baroreceptors send signals to the ____ to help maintain blood pressure that assures adequate perfusion.

A

Medulla oblongata

125
Q

When the body is working to counteract the effects of hemorrhage and cardiovascular insufficiency, it constricts arterioles and increases the heart rate and contractility. The most rapid hormonal response occurs with the release of:

A

Catecholamines

126
Q

A patient with vital signs indicating a falling blood pressure and bradycardia as well as cool, clammy skin is most likely in:

A

Decompensated shock

127
Q

A patient with suspected serious internal hemorrhage should be transported to?

A

Trauma facility

128
Q

Your patient is determined to be in Decompensated shock. Fluid therapy is indicated. The most practical fluid for prehospital administration is:

A

Lactated ringers

129
Q

A patient develops shock secondary to Hypovolemia. You understand that the reduced flow of oxygen to the cells leads to a buildup of lactic acid and other by-products. You further understand that ______ metabolism causes this process to work.

A

Anaerobic

130
Q

What is Ficks Principle?

A

Getting oxygen into lungs, into body, into cells, and back out

131
Q

Stroke volume is?

A

Amount ejected in one contraction of heart

132
Q

Cardiac output is?

A

Amount of output per minute

133
Q

How is cardiac output found?

A

Heart rate times stroke volume

134
Q

Peripheral vascular resistance is ____.

A

After load

135
Q

After load is?

A

A measure of friction between the vessel walls and fluid

136
Q

What is the main factor affecting the resistance of blood flow?

A

Vessel diameter

137
Q

Under normal conditions, over _____ of blood volume is in the venous system

A

60%

138
Q

Oxygen exchange takes place in the ____.

A

Capillary

139
Q

Radial pulse is at least _____ systolic.

A

80

140
Q

Femoral pulse is at least _____ systolic.

A

70

141
Q

Carotid pulse is at least _____ systolic.

A

60

Exam 9 (11 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions