PATIENT ASSESSMENT
Findings such as inadequate breathing or an altered level of consciousness should be identified in the:
primary assessment
Breathing is controlled by an area in the
Brainstem(pons and medulla)
When a small child falls from a significant height, the ______ MOST often strikes the ground first.
Compared to adults, pediatric patients have proportionately larger heads. When they fall from a significant height, gravity usually takes them headfirst. This is why head trauma is the most common cause of traumatic death in the pediatric patient.
According to the GEMS diamond, a person’s activities of daily living are evaluated during the:
The GEMS diamond was created to help you remember what is unique to older people. During the social assessment (the “S” in the GEMS diamond), the patient’s activities of daily living (eg, eating, dressing, bathing, toileting) are evaluated. Are these activities being provided? If so, by whom? Are there delays in obtaining food, medication, or other necessary items?
You are transporting a woman who is 8 months’ pregnant. To prevent supine hypotensive syndrome, how should you position this patient?
To prevent supine hypotensive syndrome, the patient must be positioned on her left side. This stops the weight of the fetus from compressing the inferior vena cava, which can cause low blood pressure
Your 12-year-old patient can speak only two or three words without pausing to take a breath. He has a serious breathing problem known as:
Two- to three-word dyspnea is a severe breathing problem in which a patient can speak only two to three words at a time without pausing to take a breath.(Talking Tiredness)
During insertion of an oropharyngeal airway into an unconscious patient, she begins to vomit. The first thing you should do is:
Whenever an unconscious patient begins to vomit—whether you are inserting an oropharyngeal airway or not—you should immediately turn the patient onto his or her side; this will allow drainage of vomit from the mouth and prevent aspiration. After the patient is on his or her side, remove the oral airway and suction the mouth.
The purpose of a shunt is to:
A ventriculoperitoneal (VP) shunt—simply called a “shunt”—is a tube that extends from the ventricles (cavities) of the brain to the peritoneal cavity. VP shunts are used to drain excess fluid from the brain, thus preventing increased pressure within the skull.
A condition that clouds the lens of the eye is called:
Cataract
When a person is exposed to cold temperatures and strong winds for an extended period of time, he or she will lose heat mostly by
Convection occurs when heat is transferred to circulating air, as when cool air moves across the body surface. A person wearing lightweight clothing and standing outside in cold, windy weather is losing heat to the environment mostly by convection.
How should you determine the pulse in an unresponsive 8-year-old patient?
A.Palpate the carotid pulse in the neck.
A patient is found unconscious after falling from a third-floor window. His respirations are slow and irregular. You should:
The patient is not breathing adequately. Slow, irregular respirations will not result in adequate oxygenation. You should assist the patient’s breathing with a bag-mask device attached to 100% oxygen. Suctioning is indicated if the patient has blood or other liquids in the airway; there is no evidence of this in the scenario.
You respond to a sick child late at night. The child appears very ill, has a high fever, and is drooling. He is sitting in a tripod position, struggling to breathe. You should suspect:
This child has all the classic signs of epiglottitis: high fever, drooling, and severe respiratory distress. Epiglottitis is a potentially life-threatening bacterial infection that causes the epiglottis to swell rapidly and potentially obstruct the airway.
The slow onset of progressive disorientation, shortened attention span, and loss of cognitive function is called:
Dementia is defined as the slow onset of progressive disorientation, shortened attention span, and loss of cognitive function. Alzheimer disease is an example of dementia. In contrast to dementia, delirium is an acutely altered mental status, such as that caused by hypoglycemia.
The term “shock” is MOST accurately defined as:
Shock, or hypoperfusion, refers to a state of collapse and failure of the cardiovascular system, or any one of its components (eg, heart, vasculature, blood volume), which leads to inadequate perfusion of the body’s cells and tissues.
When assessing your patient’s pain, he says it started in his chest but has spread to his legs. This is an example of what part of the OPQRST mnemonic?
Region/radiation
You and your partner are ventilating an apneic adult when you notice that his stomach is becoming distended. You should:
Gastric distention occurs when air enters the stomach. Severe gastric distention can result in vomiting and aspiration if not recognized and treated. To minimize the amount of air that enters the stomach during ventilations, you should reposition the patient’s head.
When using the mnemonic CHILD ABUSE to assess a child for signs of abuse, you should recall that the “D” stands for:
The mnemonic CHILD ABUSE stands for Consistency of the injury with the child’s developmental age, History inconsistent with the injury, Inappropriate parental concerns, Lack of supervision, Delay in seeking care, Affect, Bruises of varying stages, Unusual injury patterns, Suspicious circumstances, and Environmental clues. A delay in care may happen when the parent or caregiver does not want the abuse noted by other people.
A 71-year-old man with a history of hypertension and vascular disease presents with tearing abdominal pain. His blood pressure is 80/60 mm Hg, his heart rate is 120 beats/min, and his respirations are 28 breaths/min. Your assessment reveals that his abdomen is rigid and distended. Considering his medical history and vital signs, you should be MOST suspicious for a(n):
Arteriosclerosis is a vascular disease in which the arteries thicken, harden, and calcify. This places the patient at risk for stroke, heart disease, bowel infarction, and hypertension, among other conditions. Hypertension and vascular disease are significant risk factors for an aneurysm—a weakening in the wall of an artery. The patient’s vital signs; abdominal pain; and rigid, distended abdomen should make you highly suspicious for a leaking abdominal aortic aneurysm.
The MOST reliable indicator of upper airway swelling during a severe allergic reaction is:
Stridor is a high-pitched sound that is most often heard during inhalation. It indicates swelling of the upper airway. Wheezing, a whistling sound, is caused by narrowed bronchioles; it indicates narrowing or swelling of the lower airway. Anxiety and cyanosis can occur from a variety of causes; they are not exclusive to airway swelling.
You arrive at the scene of an “injured person.” As you exit the ambulance, you see a man lying on the front porch of his house. He appears to have been shot in the head and is lying in a pool of blood. You should:
A.retreat to a safe place and wait for law enforcement to arrive.
In an otherwise healthy individual, the primary stimulus to breathe is a(n):
Under control of the brainstem, rising levels of carbon dioxide in arterial blood normally stimulate breathing in an otherwise healthy patient.
What is the normal pulse rate for newborn to 3 months?
85-205
The LEAST common cause of death in patients over 65 years of age is:
The leading causes of death in patients over 65 years of age are heart disease, diabetes, stroke, cancer, pulmonary diseases, and trauma. Drug overdose—intentional or unintentional—is not a leading cause of death in this age group.