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Fund - Medical Emerg
Lecture 5
| Question | Answer |
|---|---|
| the bodies pathological reaction to illness, trauma, or severe physiological or emotional stress | shock |
| first stage shock symptoms | -cold clammy skin -decreased urine output -increase in respirations -change in blood pressure -anxiety level increases |
| second stage shock symptoms | -decreased blood pressure -rapid respirations -pulmonary edema -rapid heart rate -chest pain -loss of consciousness |
| abnormally low volume of circulating blood in the body caused by either hemorrhage (internal or external), loss of fluids, burns, vomiting, diarrhea, or medications | hypovolemic shock |
| hypovolemic shock symptoms | -cold extremities -restlessness and anxiety (early) -loss of consciousness (later) -thirst -cold, clammy skin -decreased blood pressure -weakness |
| response to shock | -stop procedure -elevate legs -call for help -apply pressure to wound if bleeding -crash cart -vital signs |
| loss of sympathetic tone resulting in vasodilatation of peripheral vessels caused by spinal cord injuries, severe pain, neurological damage, psychological stress, adverse affects of spinal anesthesia | neurogenic shock |
| symptoms of neurogenic shock | -decreased blood pressure -decreased heart rate -warm, dry skin -initial alertness -diminished peripheral pulses |
| response to neurogenic shock | -call for help -keep patient supine -vital signs -if spinal cord injury do not move patient do not leave patient unattended |
| failure of the heart to pump an adequate amount of blood to the vital organs due to MI (myocardial infarction) | cardiogenic shock |
| symptoms of cardiogenic shock | -chest pain, may radiate to arms and jaw -dizziness and/or respiratory distress -cyanosis -irregular pulse -hypotension -cool, clammy skin |
| response to cardiogenic shock | -call for help -place patient in semi-fowlers position -prepare and assist with O2 -crash cart -NPO (nothing by mouth) -CPR |
| shock least likely to see in department, gram negative bacteria are most frequent cause, toxins in body | septic (vasogenic) shock |
| first stage symptoms of septic shock | -skin is hot, dry, flushed -heart rate increase -respirations increase -fever -nausea -diarrhea |
| second stage symptoms of septic shock | -cool, pale skin -normal or low BP -rapid heart rate -rapid respirations -seizures and organ failure |
| response to septic (vasogenic) shock | -stop procedure -call emergency team -keep patient supine -vital signs -cover patient with blanket, warmth -CPR |
| a chronic disease involving a disorder of carbohydrate, protein and fat metabolism, which affects the structure and function of blood vessels and other organs | diabetes |
| insulin is produced by | the islets of langerhans in the pancreas |
| type I diabetes, young people under 30 usually, little or no insulin production in the body, may be inherited | insulin dependent |
| Type II diabetes, combination of many diseases that cause hyperglycemia, may be impaired tissue sensitivity to insulin or a reduced extracellular response to insulin - initially more is produced to compensate for the deficiency | non-insulin dependent |
| what results when the pancreas cannot produce enough insulin to account for the excessive secretions in type II non-insulin dependent diabetes | hyperglycemia |
| diabetes associated with or produced by medical conditions or syndromes, pancreatic diseases, hormonal abnormalities may produce diabetic symptoms and may require treatment with insulin or other drugs | diabetes mellitus |
| diabetes in later months of pregnancy, caused by hormones secreted by the placenta that prevent the action of insulin | gestational diabetes |
| a complication of mild type 2 diabetes or may occur in an elderly person with no known history of diabetes - factors are acute illness, therapeutic procedures such as dialysis, and diagnostic procedures that require a change in diet | hyperglycemia - hyperosmolar nonketotic coma |
| hyperglycemia - hyperosmolar nonketotic coma | -results in a loss of insulin leading to diuresis and loss of electrolytes -blood glucose greater than 600mg/dl -patient acts like he is drunk or has had a stroke -serious life-threatening condition |
| symptoms of hyperglycemia | -extreme dehydration -hypotension, tachycardia, increased body temp -extreme thirst, muscle twitching -mental confusion, seizures, hemiparesis, coma |
| response to hyperglcycemia hyperosmolar nonketotic coma | -call for help -vital signs |
| when patients with diabetes have an excessive amount of insulin or oral hypoglycemic drug in bloodstream an increased metabolism of glucose, or inadequate food intake with which to utilize the insulin - blood glucose falls below 50-60 mg/dl | hypoglycemia |
| mild reaction signs to hyperglycemia | -mild tremor -sweating -complaint of hunger -tachycardia -nervousness, irritability |
| moderate reaction signs to hyperglycemia | -dizziness -headache -numbness of lips, and tongue -confusion |
| severe reaction signs to hyperglycemia | -disorientation -difficulty arousing from sleep -impaired motor function -diminished level of consciousness -seizures and coma |
| insufficient supply of insulin, the amount of glucose entering body cells is decreased and the liver begins to produce more glucose, which results in hyperglycemia - excessive urination - dehydration - electrolyte imbalance in the body | ketoacidosis |
| true or false ketoacidosis occurs more slowly than hypoglycemia | true - can result from patient being detained in radiology department for a long time, missing insulin dose |
| symptoms of ketoacidosis | -weakness, drowsiness, headache, blurred vision -sweet odor to breath -warm, dry skin -extreme thirst |
| response to ketoacidosis | -call for help -stop treatment -monitor vital signs |
| most common shock in X-ray | anaphylactic shock |
| exaggerated hypersensitivity to an antigen, iodinated contrast materials | anaphylactic shock |
| symptoms of anaphylactic shock | -itching at site of injection -itching around eyes and nose -nasal congestion, sneezing -tightness in chest -nausea, vomiting, diarrhea -edema of hands, face -uticaria -choking, wheezing, dyspnea, cyanosis -increased bp -dilated pupils -coma |
| response to anaphylactic shock | -drug cart -interview prior to injection -do not leave patient alone -place in semi-fowlers position -vital signs -epinephrine (adrenalin) -diphenhydramine (benadryl) -hydrocortisone and aminophylline |
| mild TIA (trans-ischemic attack) caused by occlusion or rupture of cerebral arteries directly into brain tissue or subarachnoid space, small clots, may occur during stressful situations (high blood pressure) | cerebral vascular accident |
| signs and symptoms of a cerebral vascular accident | -possible severe headache -ataxia, muscle weakness or flaccidity or one sided facial weakness -eye deviation (one sided, possible vision loss) -dizziness, dysphasia, or aphasia (speaking) -nausea or vomiting -loss of consciousness |
| caused by insufficiency in blood supply to brain as well as heart disease, hunger, poor ventilation, fatigue, emotional stress | fainting (syncope) |
| syncope | fainting |
| signs and symptoms of fainting (syncope) | -pallor, dizziness, possible nausea, decreased blood pressure -cold clammy skin -transient postural hypotension |
| when a patient sits up to fast and feels lightheaded | transient postural hypotension |
| RT actions for fainting (syncope) | -assist patient to lie down if possible, head lower than body, legs elevated -summon help, smelling salts, spirits of ammonia -never leave patient alone, be prepared to take vital signs |
| convulsive seizures are caused by | -epilepsy is the most common cause, children more susceptible -eclampsia -tetanus -high temp -brain tumor |
| total body convulsions, loss of consciousness | grand mal seizure |
| signs and symptoms of grand mal seizure | -sharp cry as air is suddenly exhaled, rigid muscles, eyes wide open -jerky body movements, rapid irregular respirations -may vomit -incontinence -followed by deep sleep |
| RT actions for a grand mal seizure | -prevent patient from injuring self -do not insert hand objects or finger in patient mouth -retrain gently -call for help -after seizure position patient in recovery position to prevent choking or aspiration -remove dentures if possible -report |
| may not be easily observed (rare in adults), more difficult to control | petit mal (absent seizure) |
| signs and symptoms of petit mal seizure | -brief loss of awareness (blank stare) return to consciousness -may be blinking, mild body movements -patient may stop speaking, lower his head momentarily, then resume speaking |
Created by:
teresachristensen
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