Chapter 30

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What is the approximate total blood volume of a 150-pound male?

4.8 L

A healthy adult can tolerate blood loss of up to ____ mL over a period of 15 to 20 minutes without any negative effects.

500

Which of the following statements regarding blood flow is correct?

Ejection fraction is the percentage of blood that the heart pumps per contraction.

Which of the following organs can sustain the longest period of inadequate perfusion?

Gastrointestinal tract

Confusion, a sustained heart rate greater than 120 beats/min, and a respiratory rate of 32 breaths/min are MOST consistent with class ___ hemorrhage?

III

Which of the following organs or body systems requires a constant blood supply, regardless of external factors?

Kidneys

What aggregates in a clump and forms much of the foundation of a blood clot during the process of coagulation?

Platelets

Which of the following types of shock is caused by poor blood vessel function?

Septic

Which of the following injuries or mechanisms would MOST likely lead to nonhemorrhagic shock?

Severe burns

Which of the following components is LEAST crucial to the continuous circulation of oxygenated blood throughout the body?

Spleen

Which of the following two factors DIRECTLY affect cardiac output?

Stroke volume and pulse rate

What is "warm ischemic time"?

The period of time that organs and tissues can survive without perfusion, assuming a normal body temperature

Decompensated shock in the adult is characterized by:

a falling blood pressure.

If you suspect internal bleeding during the primary assessment, you should:

keep the patient warm and administer oxygen.

When applying a tourniquet to control major external hemorrhage from an extremity injury, you should:

maintain direct pressure to the wound until the tourniquet has been fully applied.

A trauma patient with hypotension secondary to internal hemorrhage should receive IV fluid boluses in order to:

maintain the systolic blood pressure in a low normal range

If you discover minor external bleeding during your primary assessment of a patient, you should:

make note of it and continue your assessment.

In contrast to a patient with compensated shock, a patient with decompensated shock would be expected to present with:

mottled skin and dilated pupils.

Circulation of blood within an organ or tissue in adequate amounts to meet the cells' current needs is called:

perfusion.

The amount of blood returned to the heart is called:

preload

Afterload is defined as the:

pressure in the aorta against which the left ventricle must pump.

Agents such as Celox, HemCon, and QuikClot are used to:

promote hemostasis

Patients with internal hemorrhage will benefit MOST from:

rapid transport.

The paramedic's MAIN goal in treating a patient with shock is to:

recognize the signs and symptoms of shock in its earliest phase and begin immediate treatment before permanent damage occurs

An organ or tissue that is considerably colder than 98.6°F is better able to resist damage from hypoperfusion because:

the body's metabolic rate is slower.

Perfusion is defined as:

the circulation of blood through an organ or tissue in amounts adequate to meet the body's demands

The MOST significant factor that determines how well the body compensates for blood loss is:

the period of time over which the blood is lost.

The physiologic process of hemostasis is achieved through:

vasoconstriction and platelet aggregation.

A trauma patient with suspected internal hemorrhage and inadequate breathing requires

ventilation assistance and rapid transport.

All of the following are common early signs or symptoms of nontraumatic internal hemorrhage in older patients, EXCEPT:

vomiting.

The cardiac cycle begins with the onset of myocardial contraction and ends:

with the beginning of the next contraction.

Which of the following factors would have the MOST negative effect on the body's process of hemostasis?

Anticoagulant use

Which of the following signs would you MOST likely observe in a patient with compensated shock?

Anxiety or agitation

A motorcycle rider struck a parked car and was catapulted over the handlebars of his bike. Your assessment reveals that he is tachypneic, diaphoretic, and tachycardic. There is no gross external bleeding present. What is the MOST likely cause of this patient's clinical presentation?

Bilateral femur fractures

Which of the following types of medication would MOST likely reduce a patient's ability to compensate when in shock?

Calcium channel blockers

You have successfully controlled a large arterial hemorrhage from a 42-year-old man's leg with direct pressure and a pressure dressing. He is conscious, but restless. His blood pressure is 84/58 mm Hg, pulse is 120 beats/min, and respirations are 24 breaths/min. You should:

administer high-flow oxygen, keep him warm, transport, and establish two large-bore IV lines en route.

A fall in blood pressure and the resultant changes in plasma osmolality cause the release of:

aldosterone and antidiuretic hormone.

You are treating a 20-year-old man with a large laceration involving the brachial artery. The patient is confused, is pale, and has weak peripheral pulses. Your initial attempts to control the bleeding have failed. You should

apply a proximal tourniquet, administer high-flow oxygen, transport, and establish vascular access en route.

Hemoglobin functions by:

binding to oxygen that is absorbed in the lungs and transporting it to the tissues.

Much of the bleeding associated with unsplinted fractures continues because:

bone ends will continue to move and destroy partially formed clots.

External bleeding would be the MOST difficult to control in a patient with a large laceration to the _____________ and a blood pressure of ______ mm Hg.

carotid artery, 100/70

Most external hemorrhage can be controlled with a combination of:

direct pressure and pressure dressings

A patient with hemorrhagic shock would be expected to have:

flattened jugular veins.

Venous bleeding

is more likely to clot spontaneously than arterial bleeding.

Hematochezia:

is the passage of stools that contain bright red blood.


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