Ch. 12 B

For an adult victim, the person giving CPR should perform about ______ compressions per minute.

100

What percentage of the body is burned in an adult victim with burns of both arms?

18%

When CPR is administered, the ratio of compressions to breaths is

30 to 2

Patients with __________ have red, hot, dry skin; an altered level of consciousness; tachycardia; and rapid, shallow breathing.

heatstroke

The condition in which blood is present in the urine is called __________.

hematuria

Signs and symptoms of shock include all of the following except

hypertension

The medical term for low blood sugar is __________.

hypoglycemia

Part of the recommended treatment for mild frostbite of the fingers is

immersing the fingers in warm water

An adult who suffers sudden cardiac arrest has the best chance of survival if CPR

is started immediately and an AED is used within 4 minutes

A patient with a deep, jagged wound that is bleeding profusely is diagnosed with a(n)

laceration

A strain is a(n)

muscle injury

The medical term for a heart attack is

myocardial infarction

Outline the Standard Precautions you should follow if you are assisting with the examination of a patient suspected of having a community-wide infectious disease.

nfection control procedures include the following: Perform routine hand washing. Wear disposable gloves if the potential exists for contamination with blood and body fluids. Use a mask/eye protection or face shield if the potential exists for being splashed by secretions or blood and body fluids. Wear gowns to protect the skin and clothing as needed; remove them promptly and wash the hands to prevent transmission of infectious material. Sanitize, disinfect, and sterilize equipment, supplies, and environmental surfaces. Dispose of contaminated waste in the appropriate biohazardous waste containers.

__________ are tears of the ligaments that support a joint.

Sprains

Which of the following procedures may be used to relieve dyspnea on a patient with suspected cardiac emergency?

Start oxygen

A temporary loss of neurologic function that is caused by a problem with blood flow to the brain tissues is called a

TIA

Symptoms of a transient ischemic attack usually include which of the following?

Temporary paralysis or weakness of one side of the body

Explain the CDC's recommendations for minimizing negative psychological effects that may arise with a natural or community disaster.

The CDC recommends that a facility's safety plan consider the following to minimize the negative psychological effects of an emergency on both healthcare workers and patients: Provide fact sheets for employees and patients to help them understand the dangers of certain emergencies and to encourage employee participation in disaster drills. Plan in advance for effective communication and action in response to an emergency; the plan should include methods for coordinating a response with local and state agencies and media sources. Put into place a method for clearly explaining emergency situations to patients and healthcare workers; offer immediate evaluation and treatment of an infectious outbreak. Treat acute anxiety with reassurance and explanation; administer medication if reassurance does not relieve acute anxiety; provide follow-up counseling as needed for employees.

Describe what should be included in the evacuation plan for a healthcare facility.

A healthcare facility evacuation plan should include the following: An emergency action coordinator should be designated who will be in charge if an emergency occurs, and all employees must know who this individual is. The coordinator is responsible for managing the emergency at the facility and for notifying and working with community emergency services. All combustibles (e.g., oxygen tanks) must be shut down immediately to prevent a fire or an explosion. Evacuation routes with clearly marked exits must be posted in multiple locations throughout the facility; maps of floor diagrams with arrows pointing toward the closest exits are an easy way even for individuals unfamiliar with the facility to find the closest door out. Exit doors must be clearly marked, well lit, and wide enough for everyone to evacuate. A meeting place outside the facility must be designated for all those evacuating to make sure everyone got out of the facility safely. Employees should be trained to assist any co-worker or patient with special needs. A designated individual must check the entire facility, including bathrooms, before exiting, making sure to close all doors when leaving to try to contain a fire or other disaster.

An AED may save the life of a victim in cardiac arrest. Describe how to apply the AED equipment and perform this skill.

AED guidelines include the following: Make sure neither the patient nor the caregiver is in contact with any metal during defibrillation. Use a pediatric-dose AED system for children age 1 to 8 years or weighing less than 55 pounds (an AED should not be used on infants younger than 1 year old). Remove all clothing from the waist up and apply the pad directly to the skin. The machine offers a prompt (i.e., Check Electrode) if the connection is poor. To prevent burns, make sure the patient is lying on a dry surface. Apply the AED pads at least 1 inch away from implants to avoid interference. Attach the electrode pads as pictured on the AED. Place electrodes at the sternum and apex of the heart. Deliver one shock, leaving the AED attached, and immediately resume CPR.

A child who falls while skating, scraping the skin off her knee, may have which type of wound?

Abrasion

Eddie Thompson, age 16, is allergic to penicillin. If he is given an injection of penicillin G, which of the following shock emergencies might occur?

Anaphylactic

The symptoms of myocardial infarction in women may be very different from those traditionally seen in men. Summarize the typical signs and symptoms of an MI in female patients.

Answers may include a combination of the following: Back pain or aching and throbbing in the biceps or forearms Shortness of breath (SOB) Clammy perspiration Dizziness (vertigo)—unexplained lightheadedness or syncopal episodes Edema, especially of the ankles and/or lower legs Fluttering heartbeat or tachycardia Gastric upset A feeling of heaviness or fullness in the mediastinum

Supplies for the management of emergencies should include several different drugs. List and explain the functions of at least four of these.

Answers may include the following: Epinephrine is a vasoconstrictor that controls hemorrhage and relaxes bronchioles to relieve acute asthma attacks; it is administered for an acute anaphylactic reaction. Atropine reduces secretions, increases respirations and the heart rate, and relaxes smooth muscle. Digoxin is a cardiac drug used to treat arrhythmias and CHF. Nitroglycerin is a vasodilator given to relieve angina. Lidocaine is used intravenously to treat a cardiac arrhythmia and locally as an anesthetic. Sodium bicarbonate corrects the metabolic acidosis that typically occurs after cardiac arrest. Syrup of ipecac causes vomiting for the expulsion of some poisons. Activated charcoal is an antidote that is swallowed to absorb some ingested poisons. Narcan is a narcotic antidote administered intravenously for drug overdoses that acts to raise blood pressure and increase the respiratory rate. Antihistamines are used to treat allergic reactions and anaphylaxis; they include Benadryl for minor reactions and Solu-Medrol, a corticosteroid, for a severe anaphylactic response.

A patient calls in to report abdominal pain. List five questions you should ask to determine the seriousness of the problem.

Answers may include the following: The medical assistant should question the patient to determine whether any of the following, which are signs and symptoms of shock, are present: diaphoresis; cold, clammy skin; cyanosis or gray pallor; rapid respirations; or an altered state of consciousness. If the patient is not in shock, the medical assistant then should ask: Is the pain severe and constant or does it come in waves? Have you had any bloody or tarry stools? Is your fever higher than 101° F? For females: Could you be pregnant or have you missed a menstrual period? Have you had continuous vomiting or severe constipation? Do you have any urinary symptoms (these would include frequency, hematuria, or flank pain)?

List at least four questions that should be asked if a patient calls about a possible poisoning.

Answers may include the following: What is the name, weight, and age of the victim? What is the name of the poison taken and what information is given on the label? How much was taken? How long ago was the poison ingested? Has the victim vomited? Has the victim shown any pertinent symptoms, such as difficulty breathing or an altered state of consciousness? Has any first aid been given?

A 26-year-old patient is being seen today for abdominal pain. The medical assistant is trying to make the patient more comfortable until the physician can see her. Which of the following should the medical assistant not do?

Apply a heating pad to the abdomen

The wife of an elderly patient reports that her husband may be suffering from heatstroke. What recommendations should the medical assistant make?

Apply cool, damp cloths to all exposed skin and then fan the moist skin

You receive an urgent call from a parent, who reports that his child cut her arm with a knife and "There is blood all over the place." What is the first step in controlling the hemorrhage?

Apply direct pressure to the wound

Which of the following is not a use of epinephrine in an emergency situation?

As a vasodilator

If you suspect a head or neck injury, what maneuver should you use to open the patient's airway?

Use the jaw thrust

Before CPR is initiated on an infant, the presence of circulation usually is determined by palpating which pulse?

Brachial

Paco Garcia calls in a panic. One of his workers cut his arm on a saw, and the wound is bleeding profusely. Which artery should the medical assistant tell him to squeeze to try to stop the bleeding until EMS arrives?

Brachial

Which acronym is used by the AHA to help people remember the order of performing the steps of CPR?

CAB

Before CPR is initiated on an adult, the presence of circulation usually is determined by palpating which pulse?

Carotid

Debbie discovers a 40-year-old patient collapsed in the office hallway. What is the best location for checking the patient's pulse?

Carotid artery

If a choking victim is in the late stages of pregnancy, which of the following procedures should be performed?

Chest compressions

Which of the following is one of the primary differences between administering CPR to an adult and administering it to a child?

Compress the sternum with the heel of one hand

Which of the following is considered regulated waste as defined by OSHA?

Contaminated sharps Waste products that contain blood PPE: masks and gowns Both A and B All of the above

If an adult patient is not breathing but has a pulse, what should you do?

Deliver rescue breaths every 4 to 5 seconds

The mother of a 10-year-old boy with diabetes type 1 calls, very concerned about her son. He has been sick for 2 days with a fever and loss of appetite, and he now is very lethargic and is vomiting, and his breath smells fruity. What health emergency may be developing?

Diabetic coma

__________ results from severe hyperglycemia, which develops because the body is not producing enough insulin or because the patient ate too much, is very stressed, or has an infection.

Diabetic coma

Which of the following is a role that the medical assistant is not responsible for in an emergency?

Diagnosing emergencies over the phone

What is the medical term for profuse excretion of sweat?

Diaphoresis

To prevent burns when using an AED, which of the following precautions must be followed?

Dry surface and dry chest

Emergency preparedness plans are designed to coordinate care provided by which of the following agencies?

EMS Fire departments Law enforcement agencies National Guard All of the above

____________ is used to control hemorrhage and shock.

Epinephrine

An emergency phone call from a patient that does not result in a visit to the physician's office need not be documented in the patient's medical record

False

If a patient calls the physician's office with a life-threatening emergency, you should place the person on hold while you activate EMS.

False

An AED apex pad is placed next to or underneath the left breast for which of the following patient scenarios?

Female patient

Which of the following should be done immediately when administering first aid to a patient with a partial-thickness chemical burn?

Flood the affected area with water

__________ is the freezing of tissue, which occurs when the skin temperature falls to a range of 14° to 25° F.

Frostbite

What would the physician order if a patient is in insulin shock?

Glucose

A patient tells you she feels dizzy and lightheaded. What is the first thing you should do?

Have the patient sit down and then help her lower her head to her knees.

Which of the following is the most dangerous form of heat- or cold-related injuries, present with red, hot, dry skin and altered levels of consciousness?

Heatstroke

The wife of a patient with diabetes calls to report that her husband exercised strenuously this morning, and he now feels dizzy and is sweating profusely. What might be the problem?

Hypoglycemia

A family that lives near a neighborhood lake calls to report that their child fell into the water and now has a temperature below 95° F. What type of problem is this?

Hypothermia

Under what circumstances should EMS be activated if a father calls to report that his child has suffered a head injury?

If the child is unconscious If the child is vomiting and disoriented If clear fluid is draining from the right ear All of the above

__________ is caused by severe hypoglycemia, which occurs when a patient with diabetes takes too much insulin, does not eat enough, or exercises more strenuously than usual.

Insulin shock

Which of the following conditions will quickly improve in a patient experiencing a diabetic emergency and given glucose?

Insulin shock Hypoglycemia Both A and B

Which of the following is true about sudden cardiac arrest in children and infants?

It typically is caused by airway obstruction

If a head or neck injury is suspected, what is the best way to open the airway?

Jaw thrust

____________ is used for congestive heart failure.

Lanoxin

____________ is used as a topical anesthetic

Lidocaine

A patient is having a grand mal seizure. Which of the following is the most appropriate step for the medical assistant to take to protect the patient?

Loosen clothing around the patient's neck

Explain the steps that should be taken to maintain a safe work environment.

Maintain office security. Make sure smoke detectors and fire extinguishers are up-to-date and work. Post designated fire exit routes. Store certain items (e.g., narcotics and dangerous chemicals) in locked storage areas. Manage biohazardous waste appropriately. Use personal protective equipment when exposure to blood and body fluids is possible. Flush the eyes with an eye wash unit if exposed to potentially infectious material. Use sharps containers. Make the facility as accident proof as possible by keeping cupboard doors and drawers closed, wiping up spills immediately, and picking up dropped objects. Keep all medications out of sight and away from busy patient areas. If children are in the office, make sure all sharp objects and potentially toxic substances are out of reach. Never leave seriously ill, restless, or unconscious patients unattended.

Discuss the role of medical assistants in emergency preparedness. Explain how they can help if a natural disaster or other emergency occurs in their community.

Medical assistants can contribute to rescue and emergency efforts. The services that trained medical assistants might perform include emergency first aid at the site of a disaster; conducting patient interviews in an empathetic manner while using therapeutic communication tools to help calm victims and gather important health-related information; helping with mass vaccination efforts or distribution of antibiotics; documenting in and managing electronic health records; complying with Standard Precautions procedures; assisting with patient education efforts; and performing phlebotomy and laboratory procedures according to one's skill level.

Which of the following is a role of an emergency action coordinator?

Notifying and working with community emergency services

Which of the following emergency situations should be managed first?

Occluded airway

Rescue breaths for a child who has a pulse are delivered at what ratio?

Once every 3 seconds

You are babysitting your neighbor's infant and discover that the baby is not breathing. What should you do?

Perform CPR for about 2 minutes and then call EMS

If a patient shows signs of shock, which of the following is recommended?

Place patient supine with the legs elevated approximately 1 foot

What are some of the signs and symptoms of heatstroke?

Red, hot, dry skin and a rapid pulse

You are responsible for placing and labeling biohazardous waste containers. Explain the methods for proper disposal of hazardous material in the physician's office.

Place signs on or near the biohazardous waste container to identify its purpose and the materials that should be discarded in it. All biohazardous waste containers should display a biohazard label. Make sure all biohazardous waste containers are covered and have a foot peddle for opening and closing; this prevents the spread of infectious material and reduces the likelihood that noninfectious material will be tossed inside. Biohazardous waste containers should be kept only in treatment areas where contaminated materials are likely to be produced. Place a regular garbage container next to a biohazard bag to encourage staff members to use the biohazard bags only as needed. Discard only sharps in sharps containers; gauze, bandages, and similar contaminated items are discarded in a contaminated waste container; noninfectious packaging material and other such items go into the regular trash.

If a patient presents with burns on the hands and mouth and stains on clothing, complaining of severe nausea or stomach cramps, which of the following has most likely occurred?

Poisoning

Summarize the steps that should be taken in a physician's office to prevent and manage fires.

Properly store potentially flammable chemicals and supplies, following the manufacturers' guidelines. 2. Properly maintain electrical equipment, cords, and outlets throughout the facility. 3. If a fire is suspected, immediately disconnect oxygen supplies or turn off oxygen tanks to prevent an explosion. 4. Make sure smoke alarms are located throughout the facility, checked periodically, and replaced as needed. 5. Make sure fire safety equipment is available and current; have fire extinguishers inspected at least annually; immediately replace an extinguisher that has been discharged. 6. Make sure fire extinguishers are located in multiple sites throughout the facility and mounted on the wall for easy access. 7. If you smell smoke or suspect a fire, immediately notify the fire department (or call 911) and evacuate the facility. Do not use elevators if a fire is suspected.

The percentage of the body surface area burned can be estimated using the __________.

Rule of Nines

If a patient calls the office complaining of moderate to severe abdominal pain, which action is necessary?

Same-day appointment

Systemic spread of a bacterial infection may result in which type of shock?

Septic

Which of the following conditions typically develops edema and ecchymosis around the injury, and any movement of the joint, especially a twisting one, produces pain?

Sprain

For patients experiencing seizure, 911 should be called in which of the following situations?

The patient does not regain consciousness within 10 to 15 minutes. The patient begins a second seizure immediately after the first one. The patient is pregnant. The patient is known to have diabetes. All of the above

_____________ is used to control seizures.

Valium

The mother of a 10-year-old patient calls because she has found a tick behind her daughter's knee. What should you tell her to do about removing the tick and follow-up?

Ticks can cause a number of diseases, including Rocky Mountain spotted fever and Lyme disease. The head, which becomes embedded in the skin so that the tick can obtain blood, should be removed intact as follows: 1. Do not handle ticks with uncovered fingers; use tweezers to prevent personal contamination. 2. Place the tips of the tweezers as close as possible to the area where the tick has entered the skin. 3. Slowly and steadily, pull the tick away from the skin, taking care not to squeeze or crush it if possible. If the tick's entire body is not removed, make a physician's appointment for evaluation of the site. 4. After removal, place the tick directly into a sealable container; then disinfect the area around the bite following Standard Procedures. 5. If the tick is removed at home, the physician may suggest that it be brought to the office to be tested for disease.

Symptoms of a heart attack in female patients include dizziness and syncopal episodes.

True

Which of the following suggestions comes from OSHA?

Use proper body mechanics in all situations

Epistaxis is

a nosebleed

The first step in rendering first aid to a patient who appears to have stopped breathing is to

administer 2 rescue breaths

Good Samaritan laws provide medical assistants with legal protection as long as they

administer first aid at the site within their scope of competence.

The best way to treat a suspected diabetic emergency in a conscious patient is to

administer glucose tabs

On discovering an unresponsive person, the medical assistant first should assess the

airway

An AED is used for

an abnormal heart rhythm

A patient faints in the reception room and falls to the floor. The medical assistant should

check for a pulse

A closed wound caused by blunt force trauma that results in swelling, ecchymosis, and pain is called a(n)

contusion

A person suffers from __________ if he or she excretes more water than is taken in.

dehydration

The medical term for nosebleed is __________.

epistaxis

Syncope is the medical term for

fainting

A(n) __________ seizure is transient and occurs with a rapid rise in fever over 101.8° F (38.8° C).

febrile

A very agitated Madeline Tamarelli calls to report that her 18-year-old son and his friends were playing with knives, and a knife was thrown into his leg. The medical assistant should instruct Mrs. Tamarelli to do all of the following except

remove the knife immediately to prevent further damage

A CVA is a

stroke

With the physician's approval, which agent can be used to induce vomiting?

yrup of ipecac