EMS Ch. 16-17

Stridor

Harsh or high-pitched respiratory sound or characteristic

stridor

Harsh or high-pitched respiratory sound, caused by an obstruction of the air passages

chronic bronchitis

Irritation of the major lung passageways from long-term exposure to infectious disease or irritants such as smoke.

who have experienced a head injury.

Nitroglycerin is contraindicated in patients:

vesicular breath sounds

Normal breath sounds made by air moving in and out of the alveoli.

it delivers prompt defibrillation to patients with ventricular fibrillation.

The AED is MOST advantageous to the EMT because:

Pumps blood into the aorta and systemic circulation

The left ventricle has the thickest walls because:

Occlusion

closure of a blood vessel due to blockage

atelectasis

collapse of alveoli

Atrium

upper chamber of the heart

Ischemia

An lack of oxygen that deprives tissues of necessary nutrients

Pandemic

An outbreak that occurs on a global scale.

Myocardial oxygen demand exceeds supply

Angina pectoris occurs when:

Lumen

The inside diameter of an artery or other hollow structure.

Epinephrine

A 30-year-old male presents with acute shortness of breath, widespread hives, and facial swelling. He denies and past medical history and takes no medications. During your assessment, you hear wheezing over all lung fields. His blood pressure is 90/50 mm Hg, and his heart rate is 110 beats/min. In addition to giving him high flow oxygen, the most important treatment for this patient is:

Deliver the shock followed by immediate resumption of CPR.

A 40-year-old man is in cardiac arrest. Your partner is performing CPR. You are attaching the AED when the patient's wife tells you that he has an automatic implantable cardiac defibrillator (AICD). The AED advises that a shock is indicated. What should you do?

Oxygen via nonrebreathing mask and a focused secondary assessment

A 60-year-old male presents with acute respiratory distress. He is conscious and alert, has pink and dry skin, and has respirations of 22 breaths/min with adequate depth. Which of the following treatments is MOST appropriate for this patient?

A. administer oxygen, give her 324 mg of aspirin, and assess her further.

A 66-year-old female with a history of hypertension and diabetes presents with substernal chest pressure of 2 hours duration. Her blood pressure is 140/90 mm Hg, her pulse is 100 beats/min and irregular, her respirations are 22 breaths/min, and her oxygen saturation is 92%. The patient does not have prescribed nitroglycerin, but her husband does. You should:

Dissecting Aortic Aneurysm

A 66-year-old woman presents with a stabbing pain in the middle of her chest that radiates to her back. She tells you that the pain suddenly began about 30 minutes ago and has been severe since the onset. She has a history of hypertension, but admits to being noncompliant with her antihypertensive medications. When you assess her, you find that her blood pressure is significantly higher in her left arm than it is in her right arm. What do these signs and symptoms MOST likely indicate?

embolus

A blood clot or other substance in the circulatory system that travels to a blood vessel where it causes a blockage.

pulmonary embolism

A blood clot that breaks off from a large vein and travels to the blood vessels of the lung, causing obstruction of blood flow.

thromboembolism

A blood clot that has formed within a blood vessel and is floating within the bloodstream.

Pleural effusion

A collection of fluid between the lung and chest wall that may compress the lung.

carbon dioxide retention

A condition characterized by a chronically high blood level of carbon dioxide in which the respiratory center no longer responds to high blood levels of carbon dioxide.

hypoxic drive

A condition in which chronically low levels of oxygen in the blood stimulate the respiratory drive; seen in patients with chronic lung diseases.

dissecting aneurysm

A condition in which the inner layers of an artery, such as the aorta, become separated, allowing blood (at high pressures) to flow between the layers.

Emphysema

A disease of the lungs in which there is extreme dilation and eventual destruction of the pulmonary alveoli with poor exchange of oxygen and carbon dioxide; it is one form of chronic obstructive pulmonary disease.

congestive heart failure (CHF)

A disorder in which the heart loses part of its ability to effectively pump blood, usually as a result of damage to the heart muscle and usually resulting in a backup of fluid into the lungs.

The inner layers of the aorta suddenly contract

A dissecting aortic aneurysm occurs when

Epiglottis

A flap of tissue that seals off the windpipe and prevents food from entering.

Wheezing

A high-pitched, whistling breath sound that is most prominent on expiration, and which suggests an obstruction or narrowing of the lower airways; occurs in asthma and bronchiolitis.

continuous positive airway pressure (CPAP)

A method of ventilation used primarily in the treatment of critically ill patients with respiratory distress; can prevent the need for endotracheal intubation.

metered-dose inhaler (MDI)

A miniature spray canister used to direct medications through the mouth and into the lungs.

acute myocardial infarction

A patient tells you that he has a left ventricular assist device (LVAD). Which of the following conditions should you suspect that he has experienced? Select one: A. Acute myocardial infarction B. Thoracic aortic aneurysm C. Uncontrolled hypertension D. Obstructive lung disease

Absence of palpable pulse

A patient with a left ventricular assist device (LVAD) tells you that the device's pump flow is continuous. Which of the following should you expect to encounter during your assessment?

the lumen of the coronary artery is narrowed and cannot accommodate increased blood flow.

A patient with atherosclerotic heart disease experiences chest pain during exertion because:

Tachycardia

A rapid heart rate, more than 100 beats/min.

small-volume nebulizer

A respiratory device that holds liquid medicine that is turned into a fine mist. The patient inhales the medication into the airways and lungs as a treatment for conditions such as asthma.

COVID-19

A respiratory disease caused by the virus SARS-CoV-2. The virus is a coronavirus, similar to the one that causes the common cold.

cardiogenic shock

A state in which not enough oxygen is delivered to the tissues of the body, caused by low output of blood from the heart. It can be a severe complication of a large acute myocardial infarction, as well as other conditions.

croup

A viral inflammatory disease of the upper respiratory system that may cause a partial airway obstruction and is characterized by a barking cough; usually seen in children.

Immediately resume CPR

After the AED has delivered a shock, the EMT should:

adventitious breath sounds

Abnormal breath sounds such as wheezing, stridor, rhonchi, and crackles.

A group of symptoms that are caused by myocardial ischemia

Acute coronary syndrome (ACS) is a term used to describe

Toxic chemical inhalation

Acute pulmonary edema would MOST likely develop as the result of:

Reassess his or her blood pressure within 5 minutes to detect hypotension

After assisting your patient with prescribed nitroglycerin, you should:

Three

Amount of nitroglycerin doses patients are instructed to take before calling EMS

pneumothorax

An accumulation of air or gas in the pleural cavity.

Myocardial tissues dies secondary to the absence of oxygen

An acute myocardial infarction (AMI) occurs when

bronchitis

An acute or chronic inflammation of the lung that may damage lung tissue; usually associated with cough and production of sputum and, depending on its cause, sometimes fever.

Asthma

An acute spasm of the smaller air passages, called bronchioles, associated with excessive mucus production and with swelling of the mucous lining of the respiratory passages.

Pertussis(whooping cough)

An airborne bacterial infection that affects mostly children younger than 6 years, in which the patient is feverish and exhibits a "whoop" sound on inspiration after a coughing attack; highly contagious through droplet infection. Also called whooping cough.

hay fever

An allergic response usually to outdoor airborne allergens such as pollen or sometimes indoor allergens such as dust mites or pet dander; also called allergic rhinitis.

hypertensive emergency

An emergency situation created by excessively high blood pressure, which can lead to serious complications such as stroke or aneurysm.

Diptheria

An infectious disease in which a membrane forms, lining the pharynx; this lining can severely obstruct the passage of air into the larynx.

pneumonia

An infectious disease of the lung that damages lung tissue.

A bounding pulse, a severe headache, and dizziness

Common signs and symptoms of hypertensive emergency include:

flows into the pulmonary arteries

Blood that is ejected from the right ventricle:

There is not enough time in between contractions for the heart to refill completely

Cardiac output may decrease if the heart beats too rapidly because:

decreased pumping force of the heart muscle

Cardiogenic shock following AMI is caused by:

Perfusion

Circulation of blood within an organ or tissue in adequate amounts to meet current needs of the cells.

Rhonchi

Coarse, low-pitched breath sounds heard in patients with chronic mucus in the upper airways.

Hypertension

Common side effects of nitroglycerin include all of the following, EXCEPT:

Pain exacerbated by breathing

Common signs and symptoms of AMI include all of the following, EXCEPT:

Right atrium

Deoxygenated blood from body returns to the:

slows the heart and respiratory rates

In contrast to the sympathetic nervous system, the parasympathetic nervous system:

Alveoli

In what area of the lungs does respiration occur?

Bronchiolitis

Inflammation of the bronchioles that usually occurs in children younger than 2 years and is often caused by the respiratory syncytial virus.

Anaphylaxis

Life threatening allergic reaction

Hypoxia

Low oxygen saturation of the body, not enough oxygen in the blood

Hypoglycemia

Major risk factors for AMI include all of the following, EXCEPT

Hyperventilation could be associated with all of the following, EXCEPT:

Narcotic overdose

ventricular fibrillation

Sudden death following AMI is MOST often cause by:

dry the chest if it is wet

Prior to attaching the AED to a cardiac arrest patient, the EMT should:

ensure that no one is touching the patient

Prior to defibrillating a patient with an AED, it is MOST important that you:

The patient may be eligible to receive thrombylotic therapy

Prompt transport of a patient with a suspected AMI is important because:

family history

Risk factors for AMI that cannot be controlled include:

paroxysmal nocturnal dyspnea

Severe shortness of breath, especially at night after several hours of reclining; the person is forced to sit up to breathe.

pleuritic chest pain

Sharp, stabbing pain in the chest that is worsened by a deep breath or other chest wall movement; often caused by inflammation or irritation of the pleura.

failure of the EMT to ensure the battery is charged.

The MOST common error associated with the use of AED is:

Are in denial

The MOST common reason that many people experiencing AMI do not seek immediate medical attention is because they:

Automaticity

The ability of the heart to generate and conduct electrical impulses on its own.

umbilicus

The descending aorta divides into the two iliac arteries at the level of:

sinoatrial node

The electrical impulse generated by the heart originates in the:

autonimic nervous system

The electrical stimulus that originates in the heart's primary pacemaker is controlled by impulses from the brain that arrive by way of

Respiration

The exchange of gas

Anterior

The front facing of the body

carotid arteries

The head and brain receive their supply of oxygenated blood from the:

femoral arteries

The iliac arteries immediately subdivide into the:

Brain

The inferior vena cava returns deoxygenated blood to the right side of the heart from all of the following EXCEPT

coronary arteries, aorta

The myocardium receives oxygenated blood from the __________, which originate(s) from the __________.

Oxygenation

The process of delivering oxygen to the blood by diffusion from the alveoli following inhalation into the lungs.

chronic stretching of the alveolar walls.

The respiratory distress that accompanies emphysema is caused by:

return of spontaneous circulation (ROSC)

The return of a pulse and effective blood flow to the body in a patient who previously was in cardiac arrest.

Right ventricle and inferior wall of the left ventricle

The right coronary artery supplies blood to the

inspiration and expiration

The two processes that occur during respiration are:

Hyperventilation syndrome

This syndrome occurs in the absence of other physical problems. The respirations of a person who is experiencing hyperventilation syndrome may be as high as 40 shallow breaths/min or as low as only 20 very deep breaths/min. Also known as a panic attack.

assess the scene for potential hazards.

Upon arriving at the residence of a patient with a possible cardiac problem, it is MOST important to:

Influenza type A

Virus that has crossed the animal/human barrier and has infected humans, recently reaching a pandemic level with the H1N1 strain.

It receives oxygenated blood from the lungs.

What is the function of the left atrium?

blood can pass from the atria to the ventricles.

When an electrical impulse reaches the AV node, it is slowed for a brief period of time so that:

abnormal breath sounds

When auscultating the lungs of a patient with respiratory distress, you hear adventitious sounds. This means that the patient has:

Cardiac Output (CO)

When the heart fails to generate effective and detectable blood flow, pulses are not palpable in cardiac arrest. Calculated by the stroke volume times the heart rate

Cardiac arrest

When the heart fails to generate effective and detectable blood flow; pulses are not palpable in cardiac arrest, even if muscular and electrical activity continues in the heart.

respirations increase in rate and depth

When the level of arterial carbon dioxide rises above normal:

The cause of pain cannot be diagnosed in the field

When treating a patient with chest pain, you should assume that he or she is having an AMI because:

pulmonary veins

Which of the following blood vessels transports oxygenated blood

ventricular tachycardia

Which of the following cardiac dysrhythmias has the greatest chance of deteriorating into a pulseless rhythm

Severe anxiety

Which of the following conditions would be LEAST likely to result in hypoxia?

Family history of hypertension

Which of the following is LEAST important when obtaining a medical history from a patient complaining of chest discomfort?

24 breaths/min with bilaterally equal breath sounds and pink skin

Which of the following is MOST characteristic of adequate breathing?

Constriction of blood vessels in the muscles

Which of the following is NOT a function of the sympathetic nervous system?

Anginal pain typically subsides with rest.

Which of the following is a major difference between angina pectoris and AMI?

Pulse oximetry measures the percentage of hemoglobin that is saturated with oxygen but does not measure the actual hemoglobin content of the blood

Which of the following statements regarding pulse oximetry is correct

The hypoxic drive stimulates a person to breathe on the basis of low oxygen levels

Which of the following statements regarding the hypoxic drive is correct?

Increased heart rate and increased stroke volume

Which of the following would cause the greatest increase in cardiac output?

aspiration pneumonia

While auscultating an elderly woman's breath sounds, you hear low-pitched "rattling" sounds at the bases of both of her lungs. This finding is MOST consistent with which of the following conditions?

begin CPR, apply the AED, and deliver a shock if it is indicated

You and your EMT partner are the first to arrive at the scene of an unresponsive 70-year-old man. Your assessment reveals that he is apneic and pulseless. A paramedic unit is en route to the scene and will arrive in approximately 5 minutes. You should:

A. begin high-quality CPR and apply the AED as soon as possible.

You and your partner arrived at the scene of a middle-aged man who collapsed about 5 minutes ago. He is unresponsive, apneic, and pulseless. Bystanders, are present, but have not provided any care. You should:

bag mask ventilation at 10 breaths/min and assessment of oxygen saturation

You and your partner have achieved return of spontaneous circulation (ROSC) in a patient who was in cardiac arrest. An ALS unit will arrive in less than two minutes. The patient remains unresponsive and has slow, irregular breathing. Further treatment of the patient should include

Acute pulmonary embolism

You are dispatched to a residence for a 67-year-old female who was awakened by shortness of breath and sharp chest pain. Her husband tells you that she was recently discharged from the hospital after having hip surgery. Your assessment reveals dried blood around her mouth, facial cyanosis, and an oxygen saturation of 88%. This patient's presentation is MOST consistent with

insert a nasopharyngeal airway and begin assisted ventilation.

You are dispatched to an apartment complex where a 21-year-old female has apparently overdosed on several narcotic medications. She is semiconscious and has slow, shallow respirations. You should:

assist her ventilations with a bag-mask device.

You receive a call for a 70-year-old female with respiratory distress. Her husband tells you that she has congestive heart failure; however, he does not think that she has been taking her medications as prescribed. The patient is laboring to breathe, appears tired, and has cyanosis around her lips. You should:

carbon monoxide

a colorless, odorless, and poisonous gas

chronic obstructive pulmonary disease (COPD)

a lung disease characterized by chronic obstruction of lung airflow that interferes with normal breathing and is not fully reversible

allergen

a substance that causes an allergic reaction

Respitory Syncytial Virus (RSV)

a virus that causes and infection of the lungs and breathing passages; can lead to other serious illnesses that affect the or heart, such as bronchiolitis and pneumonia. RSV is highly contagious and spreads through droplets.

pulmonary edema

accumulation of fluid in the lungs

Alkalosis is a condition that occurs when:

blood acidity is reduced by excessive breathing.

Infarction

death of tissue

Acidosis

excessive acidity of body fluids

crackles

fine, crackling sounds made as air moves through wet secretions in the lungs

Myocardium

heart muscle

dilating the coronary arteries and improving cardiac blood flow.

nitroglycerin relieves cardiac-related chest pain by:

Ventilation

movement of air in and out of the lungs

Atherosclerosis

narrowing of the coronary arteries due to buildup of debris along the artery walls

bronchial breath sounds

normal breath sounds made by air moving through the bronchi

Ventricle

one of two lower chambers of the heart

Orthopnea

severe dyspnea experienced when lying down and relieved by sitting up

Dyspnea

shortness of breath

Bradycardia

slow heart rate (less than 60 bpm)

Common signs and symptoms of acute hyperventilation syndrome include:

tachypnea and tingling in the extremities

Asystole

the complete absence of all heart electrical activity

Hyperventilation

the condition of taking abnormally fast, deep breaths

parasympathetic nervous system

the part of the autonomic nervous system that controls vegetative functions such as digestion of food and relaxation

Dilation

widening, stretching, expanding

Assess the heart rate and strength of the pulse.

Which of the following is the MOST reliable method of estimating a patient's cardiac output?

Aspirin

Which of the following medications is commonly given to patients with chest pain to prevent blood clots from forming or getting bigger?

dependent edema

Which of the following signs is commonly observed in patients with right-sided heart failure?

Nitroglycerin usually relieves anginal chest pain within 5 minutes

Which of the following statements regarding nitroglycerin is correct?

perform CPR for 2 minutes and reassess.

Your EMS team is performing CPR on a 60-year-old male in cardiac arrest. You connect the AED, push the analyze button, and receive a "no shock advised" message. You should:

Tuberculosis

a contagious disease that mostly attacks the lungs and can remain dormant in a person's lungs for decades