Altered Mental Status

Question 1

What does AVPU stand for

Answer 1

A - Alert, patient responds with appropriate words

V- Verbal, patient responds to verbal stimulation

P- Pain, patient opens eyes to pain

U- Patient is unresponsive

Question 2

What is the proper care for an attempted suicide?

Answer 2

1. Standby and scene size up
2. search for life threatening injuries
3. secondary assessment care and vitals
4. detailed exam if patient allows
5. reassess and monitor mood
6. contact hospital and report to police

Question 3

What is important to note in your assessment for a possible/attempted suicide?

Answer 3

•depression - take your patient seriously
•high current/recent stress levels
•recent emotional trauma
•age
•alcohol/drug abuse
•threats of suicide
•suicide plan
•previous attempts
•sudden improvement of depression

Question 4

What are the common causes of seizures in neonates?

Answer 4

•perinatal hypoxia and ischemia
•inter-cranial hemorrhage and trauma
•acute CNS infection
•Metabolic disturbances (hypo/hyperglycaemia)
•drug withdrawal
•development disorders
•genetic disorders

Question 5

What are the causes of seizures in infants and children (1month -12years)?

Answer 5

-febrile seizures
-genetic disorder
-CNS infection
-developmental disorders
-trauma induced
-idiopathic

Question 6

What are the causes of seizures for adolescents? 12-18

Answer 6

-trauma
-genetic disorders
-infection
-brain tumour
-illicit drug use
-idiopathic

Question 7

What is a behavioural emergency?

Answer 7

When behaviour is not typical for the situation or in unacceptable or intolerable. Patient may harm self or others.

Question 8

What are neurotransmitters?

Answer 8

chemicals within the body that transmits messages in the brain from distal end of one neuron to the proximal end of next neuron.

Question 9

What symptom will the body show when body temp is between 37-35°

Answer 9

shivering

Question 10

What symptoms will the body show when internal temp is between 35.5-32.7?

Answer 10

shivering, difficulty speaking

Question 11

What symptoms will the body show when internal temp is between 32-30?

Answer 11

shivering decreases, muscle rigidity, poor coordination, less alert, and out of touch

Question 12

What symptoms will the body show when internal temp is between 29-27?

Answer 12

irrational, out of touch, pulse and respirations slow

Question 13

What symptoms will the body show when internal temp is between 26-20

Answer 13

loss of consciousness, unresponsive, loss reflex, cardiac arrest

Question 14

What is conduction?

Answer 14

transfer of heat from one material to another- direct contact

Question 15

What is convection?

Answer 15

carrying away of heat by current air, water, other gases or liquids

Question 16

What is radiation?

Answer 16

sending out energy, heat in waves into space

Question 17

What are the 5 mechanisms of heat loss?

Answer 17

-convection
-radiation
-respiration
-evaporation
-conduction

Question 18

What is the proper care for hypothermia?

Answer 18

1. remove any wet clothes
2. actively rewarm patient
3. warm liquids at a slow rate
4. transport

Active rewarming - slow
central rewarm
keep patient at rest
be gentle

Question 19

What are the signs and symptoms of early cold injury?

Answer 19

-light skin reddened
-dark skin lightened
-area feels numb

Question 20

What is the care for an early cold injury?

Answer 20

-get into warm area
-warm affected area
-splint and cover extremity

do mot massage or re expose to cold

Question 21

What is the care for an Unresponsive Hypothermic patient?

Answer 21

-ensure open airway
-high concentration o2, warm water, humidifier
-wrap in blankets
-transport immediately

Question 22

Where do you check pulse in hypothermic patient

Answer 22

carotid pulse

Question 23

What are the signs and symptoms of a late or deep cold injury?

Answer 23

-skin is white and waxy
-mottled and blotchy skin
-white skin to grey
-yellow skin to blue
-swelling and blistering
-soft tissue death
-dark black skin

Question 24

What are the proper steps of care in a late or deep cold injury?

Answer 24

1.oxygen
2.transport
3.warm
4.active rewarming
-warm water submerge
-als

Question 25

What are the two types of rewarming, describe them?

Answer 25

central rewarming - application of heat onto chest, neck, armpits and groin

Active rewarming - external heat sources to body

Question 26

What are the signs and symptoms of Hypothermia?

Answer 26

-shivering
-numbness
-stiff/rigid posture
-drowsiness
-rapid breathing
-loss of motor functions
-joint or muscle stiffness
-decreased Loc
-cool and red skin

Question 27

What are the signs and symptoms of a heat emergency?

Answer 27

•Muscle Cramps - legs/abdomen
•Weakness/Exhaustion
•Rapid, Shallow breathing
•Weak Pulse
•Heavy Perspiration
•Loss of Consciousness
•Pale, moist, cool skin

Question 28

What is the care for a heat related emergency?

Answer 28

1.Remove Patient from heat
2. O2 if shocky
3. Loosen clothing, watch for shivering
4. supine position, keep resting
5. Small Sips of water
6. Lay on left side
7. Moist towels for muscle cramps
8. Transport

Question 29

What is the proper care for an animal/insect bite or sting?

Answer 29

1. Treat for shock (O2, warm, supine)
2. Call medical direction if animal is unknown or super venomous
3. remove stinger or sac
4. remove jewelry
5. place hands/ tourniquet to prevent venom spread
6. immobilize limb that was affected

Question 30

What are the signs and symptoms for a bug bite or sting?

Answer 30

-altered LOC
-bites/stings
-puncture marks
-blotchy skin
-pain/itching
-numbness
-burning
-redness
-swell/blisters
-weakness
-headache
-chills
-fever
-nausea/vomiting
-muscle cramps, chest, tightness,
joint pain
-saliva/drooling
-sweating

Question 31

What are the physical causes of Altered Mental Status?

Answer 31

-low blood sugar
-lack of oxygen
-stroke/inaccurate blood flow to brain
-head trauma
-seizures
-mind altering substances
-environmental temperature changes

Question 32

What is the proper treatment for hypoglycaemia?

Answer 32

1.Maintain Airway
2.Vitals and Blood glucose
3. Oxygen
4. Glucose paste
5. Suction
6. Glucagon
7. Retake Blood glucose
8. Consider ALS
9. Reassess

Question 33

What is the care for hyperglycaemia?

Answer 33

1. Maintain Airway
2. Vitals and glucose
3. 02 if needed
4. ALS
5. Position of comfort
6. monitor vitals

Question 34

What are the signs and symptoms of hyperglycaemia?

Answer 34

-thirst
-headaches
-tired
-weak
-cramps
-dizzy
-eyesight blurred
-nauseous
-constantly peeing
-ketones on breath

Question 35

what are the causes of seizure for adults 18-35?

Answer 35

-trauma induced
-alcohol withdrawal
-illicit drug use
-brain tumour
-idiopathic (unknown)

Question 36

what are the causes of seizures in adults 35+

Answer 36

-cerebrovascular disease
-brain tumour
-alcohol withdrawal
-metabolic disorders
-alzheimer’s disease
-degenerative CNS disease
-idiopathic

Question 37

Explain the generalized tonic/clonic seizure…

Answer 37

Tonic - 1/2 mins
1.loss of consciousness
2.fall ~ tonic stiffening
3.cry ~ bladder control altered

Clonic - 1/2 mins
1. jerking of limbs
2. salivary frothing

Postictal- hours
1. patient is lethargic and confused

Question 38

What is status epilepticus?

Answer 38

a seizure that lasts more that 5 minutes OR a more than 1 seizure in 5 minutes

Question 39

What are the signs and symptoms of heat stroke?

Answer 39

-loss of consciousness
-rapid, shallow, breathing
-full rapid pulse
-weakness
-little to no perspiration
-dilated pupils
-seizures

Question 40

What is the proper care for heat stroke?

Answer 40

1. remove from hot environment
2. remove clothes and apply cool packs, keep skin wet
3. high 02
4. transport immediately

Question 41

what kind of breathing will diabetic attacks present to breathe off ketones?

Answer 41

kussmal breathing

Question 42

What will cause a diabetic to go into a low blood sugar dip?

Answer 42

-take too much insulin
-reduces sugar intake
-over exercises
-vomits
-fever/shivering

Question 43

what are the signs and symptoms of hypoglycaemia?

Answer 43

-hungry
-confused
-dizzy
-grumpy
-shakey
-sweaty
-headache

Question 44

what is type one diabetes?

Answer 44

-immune cells destroy beta cells in the pancreas
-pancreas cannot produce insulin
-more glucose in blood

Question 45

what is type two diabetes?

Answer 45

-pancreas produces less insulin
-less glucose in cell, more in blood