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CH 4 ST120
Special Populations
| Question | Answer |
|---|---|
| Which of the following antibiotics may be administered to neonates? | Vancomycin |
| If a child hyperventilates causing gastric distention/dilation, what can be done to relieve it? | nasogastric tube |
| Which type of diabetes would a patient be diagnosed with if the patient's pancreas produced little or no insulin and he or she was required to have daily doses of insulin? | Type 1 IDDM |
| Which of the following injuries can occur due to shoulder dystocia or breech delivery? | Brachial Plexus palsy |
| What is the normal urine output for neonates and infants? | 1-2 ml/kg/hr |
| At what age do the pediatric patient's vital signs reach adult norms? | 6-12 years of age |
| What is the leading cause of death among children age 1-14? | trauma |
| What a common cause of septic shock in children? a. peritonitis b. drug toxicity c. trauma d. dehydration | a. peritonitis |
| Which of the following is the best choice for pediatric intubation? | inflated cuff tracheal tube |
| A patient is considered morbidly obese when the weight exceeds the ideal weight by ___________ pounds. | 100 |
| A baby is considered a neonate for the first 45 days of life outside the uterus. T or F | FALSE |
| Several team members should be on hand to move a patient with AIDS. T or F | True |
| The average heart rate in children ages 1 to 6 years is: | 100 bpm |
| The trauma center that can provide advanced trauma life support to stabilize the patient for transport is the Level _____ trauma center. | IV (four) |
| Patients who are obese are no more prone than any other patient to an increased incidence of postoperative wound infections. T or F | FALSE |
| The heart rate of an infant up to 2 years old is in the range of 10–110 beats per minute. T or F | FALSE |
| Patients who are disabled include people with _____ disabilities. | developmental, mental, and physical |
| Patients with diabetes have an increased risk of ulcers developing on the extremities. T or F | TRUE |
| Infants do not produce tears until they are: | 2-3 months old |
| A common complication among AIDS patients is the presence of multiple lesions caused by: | Kaposi's sarcoma and the herpes virus |
| There are many different factors that can account for a special population patient. T or F | True |
| In the operating room, _____ temperature is the primary means of measuring a patient’s temperature. | skin |
| An important factor in dealing with pediatric patients is the ability to use language to help the patients understand the situation, environment, and: | procedure |
| GSW stands for: | Gun Shot Wound |
| Children are not little adults. T or F | TRUE |
| Kinematics is the study of: | MOI ( mechanism of injury) |
| There are two common types of shock seen in: | All groups ( pediatric age group , middle age groups, geriatric group) |
| Diabetes mellitus is a disorder of the endocrine system. T or F | true |
| Infants and older adults have increased difficulty adjusting to losses in body temperature. T or F | TRUE |
| One of the physiological conditions related to obesity is myocardial hypertrophy. T or F | True |
| The trauma center that can meet all the needs of a trauma patient is the Level _____ trauma center. | I |
| A child is considered a toddler between the ages of 18 and 30 months. T or F | True |
| A pediatric patient may fear abandonment. T or F | TRUE |
| Septic shock in an infant is usually caused by dehydration. T or F | FALSE |
| When working with patients with deafness, you may need to use: | written instructions, nonverbal communication, sign language |
| RTS stands for: | Revised Trauma Score |
| Patients are considered pediatric patients if they are between birth and 18 years old and have not had any children. T or F | False |
| An adequate number of people should be available to move a patient who is obese to and from the operating room table. T or F | True |
| General anesthesia can increase the incidence of low birth weight, preterm labor, and fetal death. T or F | TRUE |
| The normal respiratory rate for a 10-year-old is 16–20 breaths per minute. T or F | TRUE |
| Arterial blood pressure in pregnant women is higher when compared with pre-pregnancy levels. T or F | FALSE |
| Coronary artery disease is a condition that presents normally in _____ patients. | obese |
| Patients are considered pediatric patients if they are from birth to: | 12 yrs (but actually 18 yrs) |
| Infants and older adults have a hard time adjusting to the: | Loss of boy temperature, Loss of intravascular fluid, stresses of trauma |
| The shorter the response time is to a trauma, the greater the chances are for the patient, especially if within 60 minutes; this period of time is called the: | golden hour |
| Geriatric patients may come to the operating room with several impairments, such as: | arthritis, visual impairments, hearing impairments, |
| All of the following are risks for the diabetic patient except? a. peripheral edema b. coronary artery disease c. poor circulation d. good wound healing | d. good wound healing |
| The three most common complications after gastric bypass surgery are? | internal hernia, abdominal catastrophes, and gastric distention |
| Kaposi sarcoma’s are lesions associated with AIDS, when they present in the __________ they pose a challenge to the ___________? | esophagus, anesthesia provider |
| The most common cause of hypovolemic shock in pediatric age groups is? | dehydration |
| The CST knows that sponge, instrument, and sharps count could be waived when? | It is a life threatening situation |
| While preparing the room for an obese patient, the CST realizes that the patient is at risk for a DVT. The piece of equipment that should be in the room and available for the patient is? | venous compression device |
| When positioning the pregnant patient the surgical technologist knows that a wedge under the patients right hip to? | relieve pressure on aorta and vena cava |
| The CST is preparing to help the surgeon on a patient who is diagnosed with Mycobacterium Tuberculosis. The CST knows that he will need to wear a ______ to protect himself from exposure. | N 95 Respirator |
| One of The most common surgical interventions for a pregnant patient would be? a.laparoscopy b. cholecystectomy c. Inguinal hernia d. colon resection | a. cholecystectomy |
| Geriatric patients are pre disposition to all of the following except? a. decreased blood pressure b. loss of skin elasticity c. increased tolerance of pain d. decreased range of motion | a. decreased blood pressure |
| A physical consideration for a child less than 6 months old is the child's inability to ? a. visualize b. digest c. shiver d. hear | c. shiver |
| In dealing with the immunocompromised patient, the CST knows that the patient is at risk for? a. wound infection b. respiratory distress c. poor circulation' d. dehiscence | a. wound infection |
| A method of monitoring blood oxyenation levels - The standard for monitoring oxygenation for all age groups of surgical patients | Arterial Blood Gases (ABGs) |
| Disease that attacks the body's own tissue -Include multiple sclerosis, lupus erythematosus, and rheumatoid arthritis | Autoimmune diseases |
| A disorder of the endocrine system that affects the production of insulin in the pancrease | Diabetes mellitus |
| Inflammation of the small intestine and colon | Enterocolitis |
| The virus that causes acquired immune deficiency syndrome (AIDS) | Human Immunodeficiency virus (HIV) |
| Abnormally low body temperature typically defined as a core body temperature that is below 35C -Intensifies the effects of acidosis | HYPOTHERMIA |
| is the degree of function for an immune system that is designed to keep a patient from infection by pathogens | immunocompetence |
| A method of ECG monitoring in which the intra-arterial catheter is inserted directly into the artery ----recommended for very ill infants and children who require constant electrocardiographic (ECG) monitoring | intra-arterial measurement |
| A cancer that produces painful external and internal lesions, internally, the lesions can cause complications, such as difficulty in swallowing or bowel obstruction -severe psoriasis rash on the body | Kaposi's sarcoma |
| A potentially lethal disease of newborns caused by excessive accumulation of the bile pigment bilirubin -Is an excess of bilirubin in the blood | kernicterus |
| Injury caused by a foreign object, such as a bullet or knife, that passes through tissue | penetrating trauma |
| Abnormal accumulation of air in the pleural cavity | pneumothorax |
| A scoring system used to assess the severity of a traumatic wound and to determine the condition of a patient | Revised Trauma Score (RTS) |
| A state of shock produce by septicemia, when the body is overwhelmed by the pathogenic microorganisms and cannot adequately fight the infection -Most commonly seen | septic shock |
| An abnormal contracted state of the muscle | torticollis |
| Amount collected and measured from a patient over a given amount of time, indicator of kidney function | urine output |
| A device used for patients who are prone to the develepment of thrombophlebitis, a patient is fitted with intermittent venous compression boots and inflate and deflate every few seconds to promote the movement of venous blood in the legs | venous compression device |
| 1-18 months | infant |
| 18-30 months | toddler |
| 30 months to 5 years | preschooler |
| 6-12 years | school age |
| Critical Parameters to monitor for the pediatric patient | temperature, urine output, cardiac function, and oxygenation |
| Do Neonates and infants usually get catheterized? Why ? | No due to high risk of trauma to the small urethra |
| Fluid management is important, how can they measure urine output in neonates and infants | a collection bag |
| In infants and children who are very ill and require constant electrocardiographic monitoring, how do they get the intra-arterial measurement? | a cutdown approach to the radial artery is most commonly used |
| In neonates what artery do they use for intra-arterial measurement? | the umbilical artery is most commonly used due to easy accessibility |
| What is inserted if no cardiac abnormalities are present in older children? Where ? | central venous catheter, sub clavian or internal juglar vein |
| When no abnormalities are present in neonates and infants where do they place the central venous catheter | cutdown approach to the external jugular vein is preferred |
| Why is the saphenous vein least used in Central venous catheter | higher incidences of contamination when procedures are performed in the groin region |
| The standard for monitoring oxygenation for all age group of surgical patients is measuring the | Arterial blood gasses (ABG's) |
| In infants and children what is the most common type of shock seen | septic shock |
| In pediatric patients what is the most common cause of Septic shock gram negative bacteria | gram negative bacteria |
| What is the initial sign of postoperative infection in pediatric patients | fever |
| Treatment for infected surgical wounds in pediatric patients are | incision, debridement, and placement of antibiotic-impregnated packing. |
| Sulfonamides are associated with an increased incidence of ____________ in neonates. | kernicterus |
| Chloramphenicol ( Chloromycetin) is the synthetic form of an antibiotic originally isolated from streptomyces venezuelae and is associated with what cause? | gray-syndrome - infants skins turns gray from drug toxicity. SHOULD NOT BE ADMINISTERD TO NEONATES |
| Why should Tetracycline not be administered to children ? | causes staining and hypoplasia of the enamel of the developing teeth |
| What is the first priority in a trauma patient ? | make sure the patient has an open airway and that it is maintained. |
| ______ is the term used for difficult labor or delivery of a baby. | dystocia |
| Birth trauma can injure the sternocleidomastoid muscle, which leads to the formation of hematoma and _____? | torticollis (a contracted state of the muscle) |
| Why does morbid obesity increase susceptibility to morbidity and mortality? | the physical difficulties of carrying extra weight |
| When the obese patient is placed on the operating bed what should be placed next ? | a pillow under the patients knees and the safety belt 2 inches above the knees. |
| If the peripheral vein is not visible in the obese patient what might be required? | A venous cutdown to insert and intravenous (IV) line. |
| Why is higher concentration of anesthetic agents in obese patients required ? | Due to the large amount of uptake of adipose tissue. |
| Why should areas of concern in obese patients be padded ? | to prevent bruising and pressure injuries. |
| When placing the grounding pad on a obese patient what should be considered? | Avoid skin wrinkles - also helps with preventing tissue burns |
| Why is obese patients high risk for coronary artery disease ? | because of hypertension and diabetes |
| What should the ST make sure they have in the room to help with venous stasis and thrombophlebitiis ? | venous compression device, and the patient is fitted with intermittent boots. |
| Degenerative osteoarthritis of the ________,__________ and __________ is common in individuals who are obese. | back, hips, and knees |
| When performing surgery on patients who are diabetic, the following conditions must be prevented | Ketonuria, hyperglycemia, ketoacidosis, Acetonuria, Hypoglycemia and hypoglycemic shock |
| In pregnant patients emergency surgery is done for | ectopic pregnancy, appendicitis, trauma injury or incompetent cervix. |
| ectopic pregnancy, appendicitis, trauma injury or incompetent cervix. | increased chance of spontaneous abortion |
| What is the MOST important thing to consider in delivery of anesthetic agents? | preventing preterm labor |
| _________ is the term used to describe a condition that limits an individuals ability to learn and to reason. | cognitive im |
| What is something a isolated patient might have ? | mycobacterium tuberculosis |
| Why are Geriatric patients placed at a risk of emboli and thrombus formation? | may have slow circulation and hypotension |
| When did it become aware when treating those injured, that the shorter the response time the greater is the chance for survival of the trauma patient ? | Military physicians became aware when treating those injured during war |
| can treat seriously injured or ill patients, but does not have all of the resources that a Level I facility would have, work in collaboration with Level I centers | TRAUMA CENTER II |
| Most often a community or rural hospital in an area that does not have a Level I or II facility. These centers offer limited care and have resources for immediate care until the trauma patient is stabilized and the transported to a Level I or II hospital | TRAUMA CENTER III |
| Three factors are important when considering the resulting injury the patient will sustain due to these carious forces | Velocity of the injuring force, flexibility of the tissue, shape of the injuring force |
| Injuries are scored using | Revised Trauma Score |
| Often Trauma patients have been exposed to the environment for a prolonged period of and become what ? | hypothermic |
| If the stomach, gallbladder or intestines are perforated in a trauma patient they will spill their contents into the abdominal cavity which would make the patient at high risk for ? | peritonitis |
| An emergency laparotomy would be the indicated treatment for all of the following postoperative bariatric surgery complication except: | thrombophlebitis |
| What is a common potential side effect of all forms of antibiotic therapy for major pediatric infection? | psuedomembranous enterocolitis |
| Overgrowth of which microorganism is most likely responsible for pediatric cases of enterocolitis following antibiotic therapy? | clostridium difficile |
| A patient undergoing bariatic surgery may require extra time for general anesthetic reversal because anesthetic agents may be accumulated in and slowly eliminated from from what type of tissue? | adipose fat |
| What is a coping mechanism often seen in children reacting to trauma? | regression |
| What is a common response of pediatric patients to injury and may result in gastric dilation? | hyperventilation |
| Which organ is responsible for the failure to produce insulin in a patient with type I diabetes? | pancreas |
| What classification of antibiotics is contraindicated for use in neonates due to increased incidence of kernicterus? | sulfonamides |
| Batriatic patients undergoing surgery and in the immediate postoperative period should have sequential compression devices applied to the lower extremities to prevent | deep vein thrombosis |
| What type of physiological measurement method is rarely done in a neonatal patient due to risk of anatomical trauma? | urethral catheterization for urinary output |
| what other condition frequently suffered by obese patients and discovered intraoperatively may be treated surgically in conjunction with a bariatric procedure? | cholelithiasis |
| What is the name of the device used to test the blood of patients with diabetes for metabolic status? | glucometer |
| What is the major cause of serious trauma suffered by pediatric patients? | motor vehicle accidents |
| What is the usual cause of a clavicular fracture of a neonate during a vaginal delivery? | shoulder dystocia |
| Multiple sclerosis, lupus erythematosus, and rheumatoid arthritis are examples of: | autoimmune disease |
| For what type of transmission - based disease would health care workers need to be fitted for an N-95 respiratory mask? | airbone |
| What national agency may not be exposed to infectious diseases in their work environment? | NFPA |
| For what special patient population group would the help of a counselor or social worker who could communicate the current state of mind or mood of the patient to the OR staff be of benefit to all parties involved? | substance abuse |
| What is the term for the mechanism of injury in a trauma patient that takes into account velocity of the injuring force, flexibility of the tissue, and shape of the injuring force? | kinematics |
| What level of trauma center designation can meet all the needs required for treating patients on a 24-hour basis? | level I |
| What activity would present no risk of contracting HIV from an infected individual? | conversation of close proximity |
| Kaposi's sarcoma is sometimes seen in combination with what diseases? | AIDS |
| Because of the types of drugs used to prevent rejection of a transplanted organ, the recipient patient is considered to have what? | immunosuppressed status |
| What is most often injured in motor vehicle accidents? | spleen |
| The term golden hour refers to the reduction of morbidity and morality of what type of patient population? | trauma victims |
| Physical forces of deceleration, acceleration, compression, and shearing are factors in what type of injury? | blunt |
| High-or-low-velocity projectiles are factors in what type of injuries? | penetrating |
| During a surgical procedure on a pregnant patient, the surgical technologist in the scrub role may be asked to palpate what area to detect possible contractions? | gravid uterus |
| A patient with acquired immunodeficiency virus may have complications of multiple infections from diseases considered to be: | opportunistic |
| In what pediatric age group would all of the craniofacial sinuses be fully developed? | adolescent |
| What anesthetic method helps reduce the anxiety and stress experienced by pediatric surgical patients? | rapid induction |
| What body system is highly susceptible to injury during positioning of bariatric and geriatric patients? | integumentary |
| Vomiting from preoperative narcotics can predispose patients with diabetes to fluid and electrolytes imbalances resulting in: | hypoglycemia |
| What is not a potential risk from administration of general anesthesia to a pregnant patient? | placenta previa |
| What diagnosis could create a social stigma and possible overdramatization of exposure risk by health care workers? | human immunodeficiency virus |
| What special patient populations would likely require diagnostic biopsies for verification of cryptosporidiosis, candidiasis, or cytomegalovirus infections? | HIV/AIDS |
| Conditions such as severe arthritis, contractures, and tremors are categorized under what type of challenge? | physical |
| What broad category of routes of transmission of microorganisms includes food, water, and medical devices and equipment? | common vehicle |
| Approximately 80% of what special patient population presents to surgery with one or more co-morbid conditions? | geriatric |
| What special patient populations group has a 30% to 80% statistical likelihood of coexisting psychiatric illness in addition to the diagnosis for which they are coming to surgery? | substance abuse |
| To preserve evidence in a criminal case, what might be done to the patient's hands if the patient does not require surgery? | bags are placed around the hands and taped in place. |
| In a surgical procedure on a severely injured trauma patient, what measures is of utmost importance? | keeping the patient's spine in alignment during changes in position |
| A surgical technologist working in a Veteran's Administration (VA) facility might frequently encounter patients with what conditions? | PTSD |
| Postoperative recovery time for the patient who is obese is increased because ___. | adipose tissue retains anesthetic agents longer |
| All of the following are clinical syndromes that require surgical intervention in the patient with AIDS EXCEPT ___. | pancreatitis |
| Immediate operative intervention is performed on the pregnant patient for the following emergency procedures EXCEPT ___. |
Created by:
bettyxbx