Quiz 12 Review.pdf

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C

HAPTER

38 Q

UIZ

Write the letter of the best answer in the space provided.

1. The leading medical cause of cardiac arrest in infants and children is

A. seizure. C. anaphylactic shock.

B. respiratory failure. D. fever.

2. In caring for a sick child, the EMT should have the parent or caregiver

A. step out of the room.

B. assist in the care of the child when appropriate.

C. follow the ambulance to the hospital.

D. speak only with the doctor about the child.

3. What would be an appropriate rate for performingartificial ventilations on an infant or a child who is apneic but still has a pulse?

A. 10 breaths per minute C. 20 breaths per minute

B. 15 breaths per minute D. 30 breaths per minute

4. Aa normal developmental characteristic of toddlers is that they

A. do not like to be touched.

B. are very accepting of an oxygen mask.

C. are eager to show independence from caregivers.

D. need detailed explanations.

5. The first step in emergency care for a pediatric patient in shock is

A. providing oxygen. C. keeping the patient warm.

B. managing bleeding. D. ensuring an open airway.

6. Children develop hypothermia more easily than adults because of their

A. lower metabolic rate.

B. slower heart rates and lower blood pressure.

C. smaller lung capacity.

D. proportionally larger skin surface area.

7. In assessing a toddler, the EMT knows that the rib cage is

A. more susceptible to fracture than the rib cage in adults.

B. much more pliable than the rib cage in adults.

C. a likely spot for fractures.

D. composed of incomplete skeletal plates.

8. Signs of early respiratory distress in an infant include all the following except

A. intercostal retractions. C. fontanelle retractions.

B. “seesaw” respirations. D. nostril flaring.

9. Approximately 3 to 5 percent of children will experience a seizure due to

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10. After a pediatric submersion patient has been removed from the water, the EMT should provide

A. suctioning while establishing an airway.

B. chest thrusts while establishing an airway.

C. back blows while establishing an airway.

D. spine motion restriction while establishing an airway.

11. The leading cause of death in children age 1–14 years is

A. fever. C. trauma.

B. drowning. D. respiratory arrest.

12. The injuries most commonly sustained by children who, while riding a bike, are struck by a car, involve the

A. leg, hand, and back.

B. head, spine, and abdomen.

C. head, spine, and lower extremity.

D. upper extremity, lower extremity, and abdomen.

13. The most common cause of hypoxia in the unconscious pediatric patient with a head injury is

A. the tongue. C. increased blood pressure.

B. intracranial pressure. D. Kussmaul respirations.

14. One complication to which pediatric burn patients are especially susceptible is

A. hyperthermia. C. hypothermia.

B. febrile seizure. D. hypoxia.

15. The only major cause of infant and child death to have increased in the past 30 years is

A. vehicular trauma. C. child abuse.

B. poisoning. D. burns.

16. When a child for whom an EMT has provided care dies and it results in a stress response in the EMT, it can be a good idea for the EMT to turn for assistance to

A. the ALS crew. C. the QI manual.

B. a trusted friend. D. the ICS plan.

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I

N THE

F

IELD

Review the following real-life situations. Then answer the questions that follow.

You are dispatched to a home where you find an 8-month-old child in her mother’s arms. The mother says the child is lethargic. She is breathing at a rate of 46 times per minute, and her pulse rate is 190. The patient’s skin is cool to the touch, and she is pale. The mother states that the child has been sick for 2 days. This afternoon she became worse. The mother adds that the child has been vomiting and has had diarrhea.

1. What is likely to be the cause of the problem?

2. Which emergency care would you provide while on scene prior to departing for the hospital?

You are called to the home of a frantic mother of a 4-year-old girl. Her daughter is normally active, and this morning was no exception. After putting her daughter to bed for a morning nap, the mother went downstairs and returned a little later to find the child in the bathroom, lethargic and unresponsive, with several empty prescription pill bottles nearby. The mother immediately called for the ambulance.

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You are at the home of a family with a 10-month-old child. The father explains that he called because his daughter had a seizure that lasted about a minute. The child appears flushed. You touch her skin, which is extremely hot to the touch. The father says his daughter has been running a fever all day. He put her to bed about an hour ago. About 10 or 15 minutes ago he heard a crash in the infant’s room and went to investigate. When he entered, the child was convulsing in the crib. That’s when he called 911.

6. Which emergency care would you provide?

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C

HAPTER

38 R

EVIEW

Write the word or words that best complete each sentence in the space provided.

1. During the assessment and treatment of a young child, you will, if possible, want the child to sit in the

.

2. When opening a child’s airway, it is important not to the child’s neck.

3. Use alternating with

to clear a complete airway obstruction in an infant age 1 year or

younger.

4. In infants and children, a disturbance in the ___________________ system typically occurs first, even if the

infant has other medical problems.

5. For infants and young children who are frightened by the oxygen mask, the EMT could provide oxygen

using the ____________________________________ technique.

6. For infants and children in respiratory distress or respiratory failure, the EMT should provide artificial

ventilations at a minimum rate of breaths per minute.

7. Diarrhea and/or vomiting, dehydration, infection, abdominal injuries, and blood loss are common causes of

in infants and children.

8. Because children have a large surface area in proportion to their body mass, they are especially prone

to .

9. Fever, epilepsy, meningitis, drug overdose, hypoglycemia, head trauma, and decreased levels of oxygen can

bring on in children.

10. If a pediatric patient has a seizure and there is no possible spinal injury, the EMT should position the patient

.

11. In the case of a submersion, the EMT should assume that

may have occurred and provide spine motion restriction precautions.

12. The diagnosis of SIDS is made .

13. The simplest method for determining the level of consciousness in a pediatric patient is the

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14. Cases of trauma exceed cases of

trauma in infants and children.

15. With suspected foreign body airway obstruction in an infant or a child, the EMT should never perform

______________________ _____________________________ __________________________.

16. If you suspect abuse as the cause of injury with a child trauma patient, you should not

the caregivers about abuse or them.

17. If bleeding occurs in a pediatric patient with a central intravenous line, emergency care will consist of

to the device and

the patient.

18. Pediatric calls are among the most for EMTs.

19. For children with special airway needs, the most common problems that EMS will encounter are with

tubes,

ventilators, ________________ lines, and feeding tubes.

20. tubes are placed into the stomach to assist with feeding.

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P

EDIATRICS

: T

RUE OR

F

ALSE

Indicate if the following statements are true or false by writing T or F in the space provided.

1. The term “toddler” refers to a child between 3 and 5 years of age.

2. Modesty and body image are very important issues for school-age children.

3. With children, padding under the shoulders is often necessary to maintain an open airway during immobilization to a spine board.

4. Because children have a smaller blood volume than adults, issues of blood loss are less serious in those patients.

5. Determining the cause of respiratory distress in a pediatric patient is an important part of an EMT’s assessment.

6. For any infant or child patient suffering a partial airway obstruction, the EMT should provide an initial series of six blows to the back.

7. Capillary refill can be a useful tool in assessing circulation in pediatric patients.

8. Infants and children need a respiratory tidal volume of approximately 10 mL/kg.

9. In a pediatric patient with a foreign body airway obstruction, the EMT should perform a “blind” finger sweep of the oral cavity if back blows do not dislodge the obstruction.

10. Prolonged seizures—those that last longer than five minutes or recur without a return to consciousness—represent a true medical emergency.

11. To assess an unresponsive child, the EMT should give the child a gentle shake.

12. With any infant or child poisoning patient, you should administer activated charcoal once you determine that the airway is open.

13. A sunken fontanelle is a sign of dehydration in an infant.

14. A drop in blood pressure is a late sign of shock in children.

15. With submersion patients in whom normal breathing is restored, deterioration can still take place from minutes to hours after the event.

16. Explaining to parents that SIDS is a relatively common occurrence is one way the EMT can help them cope with the loss of a child.

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18. The Pediatric Advanced Life Support (PALS) assessment format can be used to establish a general impression of the patient from the “doorway” when presented with a pediatric emergency.

19. The EMT should never ask a suspected victim of child abuse to explain the circumstances of an incident while the possible abuser is present.

20. Talking to a trusted friend is one way EMTs can initially defuse the stress created by dealing with pediatric emergencies.

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P

EDIATRICS

: L

ISTING

1. List at least five signs of respiratory distress in pediatric patients.

2. List the emergency care steps for a child with seizures caused by a high fever.

3. List the basic emergency care steps for the pediatric multisystem trauma patient.

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CHAPTER 38 ANSWER KEY

HANDOUT 38-1: Chapter 38 Quiz

1. B 5. D 9. A 13. A

2. B 6. D 10. D 14. C

3. C 7. B 11. C 15. C

4. A 8. C 12. B 16. B

HANDOUT 38-2: In the Field

1. The child is likely in the early stages of shock (hypoperfusion) from infection and/or hypovolemia. 2. Ensure an open airway. Provide oxygen as appropriate

and be prepared to provide positive pressure

ventilations. Keep the child warm. Expedite transport. 3. The child may be suffering from poisoning.

4. Establish and maintain an airway. Be prepared to suction. Provide oxygen as appropriate and be prepared to provide positive pressure ventilation as needed. Collect any information about the possible overdose medications available. Expedite transport. 5. The child may have suffered a febrile seizure. 6. Maintain the airway and ensure adequate

oxygenation. (Provide positive pressure ventilation, if necessary.) Lower the infant’s body temperature if indicated and allowed by standing orders. Be alert for possible vomiting and the need to suction. Transport.

HANDOUT 38-3: Chapter 38 Review

1. parent’s (caregiver’s) lap 2. hyperextend

3. back blows, chest thrusts 4. respiratory

5. “blow-by” 6. 20

7. shock (hypoperfusion) 8. hypothermia

9. seizures 10. on his side 11. spinal injury 12. postmortem 13. AVPU scale 14. blunt, penetrating 15. blind finger sweeps 16. question, accuse

17. applying pressure, transporting 18. stressful

19. tracheostomy, mechanical, central 20. Gastrostomy

HANDOUT 38-4: Pediatrics: True or False

1. F 6. F 11. F 16. F

2. T 7. T 12. F 17. T

3. T 8. T 13. T 18. T

4. F 9. F 14. T 19. T

5. F 10. T 15. T 20. T

HANDOUT 38-5: Pediatrics: Listing

1. Any five: Nasal flaring, retractions; neck muscle use; “seesaw” respirations; breathing noises such as stridor, wheezing, or grunting; breathing rate above normal for child’s age. Additional: Cyanosis, decreased muscle tone, poor peripheral perfusion, altered mental status, head bobbing.

2. Establish and maintain an airway. Protect the patient from injury. Suction secretions for no longer than 5–10 seconds at a time. Provide positive pressure ventilations with supplemental oxygen at 20 breaths/min if breathing is inadequate; administer oxygen as appropriate if breathing is adequate (consider blow-by oxygen in very young children). Remove clothing and cool by fanning or sponging with tepid water as protocol permits. Consider advanced life support transport. Perform ongoing assessment every 5 minutes.

3. Establish and maintain spine motion restriction and open the airway using the jaw-thrust maneuver. Suction as necessary, no more than 5–10 seconds at a time. Provide oxygen by nonrebreather mask at 15 liters per minute or provide positive pressure ventilation with supplemental oxygen for inadequate breathing. Provide occlusive dressings for any open wound to the chest. Cover any eviscerations with moist, sterile gauze dressing and secure. Consider request for ALS support. Transport. Splint fractures and dress open wounds. Perform ongoing assessment every 5 minutes. 4. Any four of the following: Multiple abrasions,

lacerations, incisions, bruises, broken bones; multiple injuries or bruises in various stages of healing; injuries on both sides or both front and back of the child’s body; unusual wounds; a fearful child; injuries to the genitalia; injuries to the spinal cord and brain when the child is violently shaken; situations in which the injuries are not consistent with the story; lack of adult supervision; untreated chronic illness; malnourishment; delay in reporting injuries.

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C

HAPTER

40 Q

UIZ

Write the letter of the best answer in the space provided.

1. Glaucoma increases intraocular pressure, which damages the

A. orbit. C. lens.

B. optic nerve. D. sclera.

2. All of the following can be causes of language disorders except

A. stroke. C. brain tumor.

B. head trauma. D. renal disease.

3. Cerebral palsy

A. is a specific disease involving the nervous system.

B. is an umbrella term for diseases involving the central nervous system.

C. is a specific disease involving the peripheral muscular system.

D. is a nonspecific term referring to a sensory disorder.

4. Paraplegia refers to paralysis

A. of the entire body. C. from the waist down.

B. from the arms down. D. of just the arms.

5. According to the Centers for Disease Control and Prevention, percent of adults are either overweight or obese.

A. 50 C. 70

B. 60 D. 80

6. Massage parlors, ranches, bars, and hotels are among the many locations where the EMT may find patients trapped by coercion and fraud in a modern-day form of slavery called

A. immigration. C. prostitution.

B. day labor. D. human trafficking.

7. Violence that occurs between two people in an intimate relationship is called

A. elder abuse.

B. infighting.

C. domestic violence.

D. emotional abuse.

8. If a tracheostomy opening is to be permanent, it is referred to as a

A. stoma. C. PTO (permanent tracheal opening).

B. trachea. D. colostomy.

9. A type of machine that delivers a high pressure on inhalation and a lower pressure on exhalation is called

A. CPAP. C. BiPAP.

B. PiPAP. D. a pressure delivery device.

10. Patients with hydrocephalus have an excess accumulation of ________ in the cranial vault.

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11. Which implanted medical device can be found in patients with a seizure disorder?

A. Vagus nerve stimulator C. SpO2 monitor

B. Auroral response sensor D. Implanted defibrillator device

12. Which process introduces fluid into the peritoneal cavity via a port?

A. Spinal tap C. Intraventricular shunt

B. Hydrocephalus shunt D. Peritoneal dialysis

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C

HAPTER

40 R

EVIEW

Write the word or words that best complete each sentence in the space provided.

1. Hospice is a(n) of care that is aimed at providing palliation of symptoms for

patients and support for their families.

2. Nasogastric tubes are used by advanced life support units in the prehospital setting to

the .

3. is a medical procedure designed to support the lost function of the

kidneys.

4. Vascular access devices are typically embedded in the right side of the

.

5. Most home ventilators used today employ ________________________ pressure ventilation..

6. A pulse oximeter is used to monitor the patient’s _____________________ _____________________.

7. An apnea monitor is designed to constantly monitor the patient’s .

8. The U.S. Department of Housing and Urban Development defines a person who, on a given night, is in a

shelter or without a shelter as a person who is experiencing _______________________________.

9. A person is considered to be obese if he weighs _______ percent or more than his ideal body weight.

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P

ATIENTS WITH

S

PECIAL

C

HALLENGES

: M

ATCHING

Write the letter of the term in the space provided next to the appropriate description.

1. A condition in which the lens of the eye becomes cloudy

2. A condition that occurs early in life and interferes with how a body part or system operates

3. A patient who is paralyzed in all four extremities

4. The branch of medicine that deals with the management of obese patients

5. Any action or failure to act that results in unreasonable suffering, harm, or misery to a person, whether physical or mental

6. Excess cerebrospinal fluid in the cranial vault

7. Progressive deterioration causing death

8. Medical interventions centered on reducing the severity of disease symptoms

9. The least invasive device used to divert urine out of the bladder

10. A tube inserted through the mouth that ends up in the stomach

A. abuse

B. palliative care

C. developmental

disability

D. hydrocephalus

E. quadriplegic

F. terminal illness

G. Texas catheter

H. bariatrics

I. OG tube

J. cataracts

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HANDOUT 40-1: Chapter 40 Quiz

1. B 4. C 7. C 10. A

2. D 5. C 8. A 11. A

3. B 6. D 9. C 12. D

HANDOUT 40-2: Chapter 40 Review

HANDOUT 40-3: Patients with Special Challenges: Matching

1. J 4. H 7. F 9. G

2. C 5. A 8. B 10. I

3. E 6. D

1. philosophy

2. decompress, stomach 3. Dialysis

4. upper, chest 5. positive

6. oxygen saturation 7. breathing 8. homelessness 9. 20