Test 3 Flashcards by Amelia Rowniewski

A 60-year-old man complains of severe chest pressure that feels like a vise around his chest. His skin is cool and moist, and he is short of breath and very anxious. The patient tells you that he has taken three nitroglycerin tablets, but the pain has not been relieved. What do you think is wrong with him and what should you do?

Assume that he is having a heart attack, then help the patient take one adult aspirin (ASA) or 2-4 low-dose aspirins. Administer oxygen if it is available and arrange for prompt transportation.

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Which condition is characterized by acute spasm of the smaller air passages in the lungs?

Asthma (bronchospasm).

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When does a pandemic occur?

When an infectious disease spreads to different parts of the world at the same time.

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How is a stroke most accurately defined? (What is a stroke?)

Damage or death of a portion of the brain as a result of a lack of oxygen.

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Acute blockage of a coronary artery most often causes a patient to experience what?

Immediate severe chest pain.

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What is angina pectoris and what does it indicate/when does it occur?

Recurring acute chest pain or discomfort resulting from decreased blood supply to the heart muscle (myocardial ischemia). Usually due to obstruction or spasm of the coronary/heart arteries.

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What is atherosclerosis most accurately defined as?

Narrowing/hardening of the arteries as a result of the buildup of fatty material like cholesterol.

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A fruity odor of the breath occurs with which condition?

Diabetic ketoacidosis - when the body does not have enough insulin to allow blood sugar into cells for use as energy and the blood produces excess blood acids (ketones)

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You respond to the home of a known diabetic patient. The patient’s husband tells you that his wife was fine earlier in the day, but then suddenly began acting strange. He further tells you that she took her insulin but did not eat. The patient is conscious but confused. Her skin is pale, moist, and cool, and her pulse is weak and rapid. After ensuring a patent airway and adequate breathing, what should you do next?

Give her a tube of oral glucose if available.

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What is the most important thing to consider when assessing a patient’s mental status?

The patient’s initial level of consciousness and any changes that may have occurred.

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On which part of the Nervous System do Opioid drugs have a direct negative effect?

Central nervous system (brain & spinal cord).

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What are symptoms of exposure to an organophosphate insecticide or nerve agent?

Slow heart rate, salivation, and excessive tearing (MAIN ONES).

SLUDGEM symptoms:

S - salivation, sweating
L - lacrimation (excessive tearing of the eye)
U - urination
D - defecation, drooling, diarrhea
G - gastrointestinal upset and cramps
E - emesis (vomiting)
M - muscle twitching, miosis (pinpoint pupils)

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When administering Naloxone (Narcan) via the intranasal route, what should the EMR do?

Administer one-half dose (1 mL maximum) into each nostril.

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What are the different routes by which a poison can enter the body?

Ingestion (eating/drinking), inhalation, injection, or absorption.

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When administering a DuoDote nerve agent auto-injector, how should you inject the medication?

Into the lateral thigh of the leg and hold the injector in place for 10 seconds

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What is the most effective way to slow the spread of an injected poison throughout the body?

Keep the patient quiet and still

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Which route occurs when a person is stung by an insect or bitten by a snake? (e.g. ingestion, injection, absorption, etc.)

Injection

Which of the following statements regarding nerve agents is correct?
a.In general, it takes a significant amount of a nerve agent to cause cardiac arrest.
b.Because of their unique chemical structure, nerve agents can only be inhaled.
c.Nerve agents are much stronger organophosphates than those found in pesticides.
d.Anthrax is a nerve agent that can cause death in very small amounts.

d. Anthrax is a nerve agent that can cause death in very small amounts.

T/F: A snake’s venom is dangerous because it can affect the entire body.

True

Which two environmental toxins, when mixed together, can irritate the lungs and upper respiratory tract and result in violent coughing?

Ammonia and chlorine

Which of the following findings is least indicative of a patient who may become violent?
a.A patient who is shouting obscenities
b.A patient with a large body size
c.A patient who has used alcohol or drugs
d.A patient who cannot sit still

A patient with a large body size

Does working in large numbers increase the risk for violence in the workplace?

What is it called when you imagine yourself in another person’s situation, sharing his or her feelings?

Empathy

What should your initial action be when arriving at a scene where a patient is exhibiting abnormal behavior?

Conduct a scene size-up

What should you NOT say to an emotionally disturbed patient if you are trying to reassure him or her?

Should not - make it clear you are in control of the situation not the patient Should - establish eye and verbal contact and avoid arguing

What is a situational crisis and what can cause one?

Caused by a sudden and disruptive event such as physical illness and death of a love one. Most situational crises are sudden and unexpected and cannot be handled by a person's usual coping mechanism.

Which of the following is not an appropriate response when acknowledging a patient’s or family member’s anger? a.“What can I do to help you?” b.“What’s the matter?” c.“Get control of yourself?” d.“Is there anyone I can call for you?”

c.“Get control of yourself?”

Which of the following statements regarding a situational crisis is correct? a.Situational crises are of long duration and usually can be managed by the patient’s coping mechanisms. b.A situational crisis is typically the result of an ongoing situation, such as a loved one with a terminal disease. c.A situational crisis always causes the patient to exhibit socially unacceptable, self-destructive, or dangerous behavior. d.Most situational crises are sudden and unexpected and cannot be handled by a person’s usual coping mechanisms.

d.Most situational crises are sudden and unexpected and cannot be handled by a person’s usual coping mechanisms.

If a patient dies and a family member becomes verbally abusive towards you, what is important to remember?

retreat and notify law enforcement personnel.

You are dispatched to a residence for an injured child. Your unit and a police officer arrive at the scene at the same time. The patient, a 9-year-old boy, has a possible broken arm. The child’s father, who appears very nervous, tells you that his son wrecked his bike and that he will take his son to the hospital. Your assessment of the child reveals a deformed left arm and multiple bruises of various colors. The child is clearly frightened and looks at his father every time you ask the child a question. What should you do?

provide care for the child's injury and ask the police officer to speak with the father in another room as you speak to the child.

A 10-year-old child, who was submerged in cold water for approximately 30 minutes, is removed by rescue personnel. The child is unconscious, not breathing, and without a pulse. What should you do first?

remove his wet clothing and begin CPR

T/F: A patient suffering from heat stroke may be semiconscious or unconscious.

True

What are some factors that can increase a person’s susceptibility to frostbite?

Old age, Hunger, Exhaustion

What are the signs and symptoms of heat exhaustion?

tiredness. dizziness. headache. feeling sick or being sick

During your primary assessment of a 21-year-old man who was rescued from the water, you note that he is unresponsive, is not breathing, and has water draining from the side of his mouth. What should you do?

carefully turn him onto his side

How may the mammalian diving reflex protect a person who was submerged in cold water for an extended period of time?

The reflex slows the heart rate and metabolic rate and decreases oxygen demand.

Which body parts are most susceptible to frostbite?

hands, feet, ears, nose and lips

What are some of the physiological effects of hypothermia?

Decreased body temperature, pulse, and respiration.

While assessing a conscious and alert 28-year-old man who was exposed to the cold for a prolonged period of time, you note that he is shivering and his fingers are numb and pale. Initial care includes: a.submerging his hands in water that is 120°F (49°C). b.asking him to place his hands in his armpits. c.briskly rubbing his fingers with your hands. d.rubbing his hands with a chemical heat pack.

b.asking him to place his hands in his armpits.

With frostnip, the affected part of the body first becomes: a.swollen. b.numb. c.pale white. d.painful.

b.numb