NREMT xtra p3 Flashcards
You are caring for a 2 year old female patient with a recent history of bronchitis. The patient is being held by her mother, but you notice that the child seems very limp. The airway is patent, breathing is spontaneous but rapid and shallow. The pulse is rapid and the skin is ashen in color. Breath sounds are markedly diminished with both inspiratory and expiratory wheezing bilaterally. Given this situation, you should perform what intervention first?
Initiate PPV with oxygen supplementation
APGAR SCORE
The APGAR score is a numeric representation of the neonates physiological status, and can serve as an indication of the baby’s overall condition. For this infant, the crying = 2 points, the acrocyanosis = 1 point, the active motion = 2 points, the heart rate = 2 points, and the grimacing = 2 points. This totals 9 points (out of a possible 10 points) which means the baby is vigorous and needs only routine care.
A 45 year old female is complaining of trouble breathing. The patient is sitting in a tripod position, has nasal flaring, rapid breathing, accessory muscle use, and diminished alveolar breath sounds. Of these findings, which one is indicative more so of difficult breathing rather than heightened respiratory efforts due to the pulmonary problem?
Diminished alveolar sounds
A 55-year-old female complains of acute onset palpitations and chest pain. She is alert, but pale and diaphoretic. Her vitals are pulse 220, respiration 28, blood pressure 88/60. Those findings most likely indicate:
cardiogenic shock secondary to a cardiac dysrhythmia.
A heart rate of 220 most likely indicates a tachycardic dysrhythmia. It is possible for her to have hypovolemia, but the acute onset of symptoms and the lack of a likely cause make it improbable. Septic shock typically has a long, gradual onset. Anaphylaxis occurs suddenly, but usually is related to allergy-like symptoms.
A 22-year-old female is having an asthma attack. She is 31 weeks pregnant. Which one of the following reasons explains why asthma might affect this patient more profoundly than a nonpregnant patient?
Pregnancy increases the consumption of oxygen
A patient has a gastrointestinal bleed that is resulting in a drop in his circulating blood volume. In order for the body to try and compensate for this volume loss while attempting to maintain adequate peripheral perfusion, what might the negative feedback systems of the body employ?
Enhancing vasomotor tone
A 45 year old female is complaining of trouble breathing. The patient is sitting in a tripod position, has nasal flaring, rapid breathing, accessory muscle use, and diminished alveolar breath sounds. Of these findings, which one is indicative more so of difficult breathing rather than heightened respiratory efforts due to the pulmonary problem?
diminished lung sounds
What term is used to describe the exchange of respiratory gases between the alveoli and the pulmonary capillary bed?
External respiration
A 12-year-old male is having an asthma attack. He appears tired and pale. During your primary assessment you note his respiratory rate to be 40. However, you have difficulty hearing his lung sounds. What is the most likely reason for the difficulty hearing lung sounds?
There is little air moving
A 55-year-old female complains of acute onset palpitations and chest pain. She is alert, but pale and diaphoretic. Her vitals are pulse 220, respiration 28, blood pressure 88/60. Those findings most likely indicate:
cardiogenic shock secondary to a cardiac dysrhythmia.
A 22-year-old female is having an asthma attack. She is 31 weeks pregnant. Which one of the following reasons explains why asthma might affect this patient more profoundly than a nonpregnant patient?
Pregnancy increases the consumption of oxygen
A patient has suffered significant blunt trauma to the chest, resulting in multiple rib fractures and a flail segment. Beyond the impaired ventilation due to thoracic instability, what is a common secondary injury seen with blunt thoracic trauma that can severely hamper normal respiratory efficiency?
Pulmonary contusion
With blunt trauma to the chest there may be fractured ribs causing a flail segment. In addition, this mechanism of injury can also cause bruising to the lung tissue (known as a pulmonary contusion), which causes edema within the lung tissue and severely hampers adequate gas transfer. Ventricular rupture is more often from an MI, not as much from blunt trauma. Diaphragmatic hernia occurs with blunt abdominal trauma. The thoracic vertebrae are actually rarely injured due to the stability provided by articulations with the ribs.
Which one of the following best describes the National Incident Management System?
System designed to be used by federal, state, and local governments to prepare for and manage emergencies in the United States
A four-month-old male is in respiratory arrest. Before initiating positive pressure ventilations, you should:
pad behind his shoulders to account for his large occiput.
A patient has a gastrointestinal bleed that is resulting in a drop in his circulating blood volume. In order for the body to try and compensate for this volume loss while attempting to maintain adequate peripheral perfusion, what might the negative feedback systems of the body employ?
Enhancing vasomotor tone
