Emergency Care - Chapter 18

You are treating a 59-year-old male patient whose wife called EMS because he had difficulty breathing and was acting anxious and confused. He is diaphoretic and cyanotic, and his vitals are rapid respirations, tachycardia, and hypertension. He has swollen ankles and is coughing up pink sputum. What do you suspect is wrong with this patient?

He has CHF as well as right heart failure.

Why is nitroglycerin administered to the patient with chest pain?

It dilates the blood vessels and decreases the work of the heart.

acute coronary syndrome (ACS)

a blanket term used to represent any symptoms related to lack of oxygen (ischemia) in the heart muscle. Also called cardiac compromise.

sudden death

a cardiac arrest that occurs within 2 hours of the onset of symptoms. The patient may have no prior symptoms of coronary artery disease.

thrombus

a clot formed of blood and plaque attached to the inner wall of an artery or vein.

asystole

a condition in which the heart has ceased generating electrical impulses. Commonly called flat line.

ventricular fibrillation (VFib or VF)

a condition in which the heart's electrical impulses are disorganized, preventing the heart muscle from contracting normally.

pulseless electrical activity (PEA)

a condition in which the heart's electrical rhythm remains relatively normal, yet the mechanical pumping activity fails to follow the electrical activity, causing cardiac arrest.

ventricular tachycardia (VTach)

a condition in which the heartbeat is quite rapid; if rapid enough, ventricular tachycardia will not allow the heart's chambers to fill with enough blood between beats to produce blood flow sufficient to meat the body's needs.

dysrhythmia

a disturbance in heart rate and rhythm.

nitroglycerin

a medication that dilates the blood vessels.

pedal edema

accumulation of fluid in the feet or ankles.

pulmonary edema

accumulation of fluid in the lungs.

cardiopulmonary resuscitation (CPR)

actions taken to revive a person by keeping the person's heart and lungs working.

A condition in which a portion of the myocardium dies as a result of oxygen starvation is known as:

acute myocardial infarction.

You are treating a 62-year-old male patient who is complaining of crushing substernal chest pain and shortness of breath. His pulse is fast, BP is high, and pulse oximetry in the low 90s. The management of this patient should include all the following EXCEPT: administering oxygen by nasal cannula at 10 lpm. - placing the patient in the position of comfort. - administering oxygen by nonrebreather mask at 15 lpm. - administering oxygen by nasal cannula at 10 lpm. - assisting the patient with nitroglycerin administration if medical direction authorizes.

administering oxygen by nasal cannula at 10 lpm.

Factors that put a person at risk for developing acute coronary syndromes include: - age. - cigarette smoking. - obesity. - all of these.

all of these.

Your 70-year-old female patient has a cardiovascular disorder that stems from weakened sections in the arterial walls. These weak spots began to dilate to form a condition that is known as a(n):

aneurysm.

Acute coronary syndrome(ACS) is a blanket term that refers to:

any time the heart may not be getting enough oxygen.

When the AED is analyzing the patient's heart rhythm, the EMT must

avoid touching the patient.

embolism

blockage of a vessel by a clot or foreign material brought to the site by the blood current.

occlusion

blockage, as of an artery, by fatty deposits.

Most cardiovascular emergencies are caused directly or indirectly, by all of the following EXCEPT: - changes in the inner walls of arteries. - problems with the heart's electrical function. - problems with the heart's mechanical function. - complications resulting from cardiovascular surgery.

complications resulting from cardiovascular surgery.

You are treating a 55-year-old male patient who has a history of three past MIs and angina. Due to his difficulty breathing and normally sedentary lifestyle, you suspect he may be experiencing congestive heart failure (CHF). CHF is a(n):

condition in which excessive fluids build up in the lungs and/or other organs.

defibrillation

delivery of an electrical shock to stop the fibrillation of heart muscles and restore a normal heart rhythm.

coronary artery disease (CAD)

diseases that affect the arteries of the heart.

The single most important factor in determining survival from cardiac arrest is:

early defibrillation.

You should consider using nitroglycerin when the 65-year-old female patient:

has her own nitroglycerin and has crushing chest pain.

agonal breathing

irregular, gasping breaths that precede apnea and death.

apnea

no breathing.

angina pectoris

pain in the chest occurring when blood supply to the heart is reduced and a portion of the heart muscle is not receiving enough oxygen.

Of the cardiac arrest patients listed below, which one can be defibrillated immediately?

patient with an implanted defibrillator.

A nonshockable rhythm that can be the result of a terminally sick heart or severe blood loss is called:

pulseless electrical activity.

The reason an emergency occurs in most cardiac-related medical emergencies is due to:

reduced blood flow to the myocardium.

cardiac compromise

see acute coronary syndrome.

dyspnea

shortness of breath; labored or difficult breathing.

Patients with heart problems may complain of any of the following EXCEPT: - pain in the center of the chest. - mild chest discomfort. - sudden onset of sharp abdominal pain. - difficulty breathing.

sudden onset of sharp abdominal pain.

edema

swelling resulting from a buildup of fluid in the tissues.

Chest pain from the heart is typically described by the patient as a "crushing pain." It is also often describes as any of the following except: - dull - squeezing - tearing - heavy

tearing.

acute myocardial infarction (AMI)

the condition in which a portion of the myocardium dies as a result of oxygen starvation; often called a heart attack by laypersons.

aneurysm

the dilation, or ballooning, of a weakened section of the wall of an artery.

congestive heart failure (CHF)

the failure of the heart to pump efficiently leading to excessive blood or fluids in the lungs, the body, or both.

cardiovascular system

the heart and the blood vessels.

A patient is complaining of chest pain. In order for the EMT to administer nitroglycerin, all the following conditions must be met EXCEPT: - medical direction should authorize its administration. - the patient's physician should have prescribed the medication. - the patient's blood pressure is lower than 100 systolic. - the patient's blood pressure is greater than 100 systolic.

the patient's blood pressure is lower than 100 systolic.

The primary electrical disturbance resulting in cardiac arrest is:

ventricular fibrillation.

If it is necessary to remove a nitroglycerin patch to defibrillate a patient, you should:

wear gloves.

tachycardia

when the heart rate is fast, more than 100 beats per minute.

bradycardia

when the heart rate is slow, usually less than 60 beats per minute.