Chapter 41 Flashcards
(50 cards)
Carbonic acid is formed by the combination of:
- water and carbon dioxide
- lactate and pyruvic acid.
- water and hemoglobin.
- water and bicarbonate.
Water and carbon dioxide
Which of the following is a disadvantage of using a crystalloid solution when treating a patient with hemorrhagic shock?
- They do not have oxygen-carrying capacity.
- They do not expand the circulating volume.
- They increase the viscosity of the blood.
- They cause platelets to clump together
They do not have oxygen-carrying capacity.
The vasodilation that accompanies distributive shock creates:
- increased preload.
- relative hypovolemia.
- decreased cardiac contractility.
- increased afterload.
Relative hypovolemia
Which of the following is an example of a peri-arrest condition?
- Bradycardia in the absence of chest pain or other symptoms
- Ventricular fibrillation that has persisted for 6 minutes
- Ventricular tachycardia and a systolic blood pressure of 60 mm Hg
- Sinus tachycardia secondary to fever and a mild infection
Ventricular tachycardia and a systolic blood pressure of 60 mm Hg
You have given an 800-mL normal saline bolus to a patient in shock. How much of this fluid will remain in the intravascular space after 20 minutes?
- 320 mL
- 380 mL
- 600 mL
- 480 mL
320 ml
Cardiac output is dependent upon:
- peripheral resistance and heart rate.
- blood pressure and heart rate.
- afterload and peripheral resistance.
- stroke volume and heart rate.
Stroke volume and heart rate
Intrinsic causes of cardiogenic shock include:
- pulmonary embolus.
- tension pneumothorax.
- cardiomyopathy.
- pleural effusion.
Cardiomyopathy
Signs and symptoms of multiple-organ dysfunction syndrome may include:
- marked hyperglycemia.
- severe polyuria.
- uncontrollable bleeding.
- warm, flushed skin.
Uncontrollable bleeding
What is formed when carbon monoxide binds to the hemoglobin molecule?
- Myoglobin
- Oxyhemoglobin
- Carboxyhemoglobin
- Methemoglobin
Carboxyhemoglobin
A patient with severe dehydration is found to be hypotensive during your assessment. The most important intervention in this case is:
- applying blankets to keep the patient warm.
- transport with fluid resuscitation en route.
- high-flow oxygen via nonrebreathing mask.
- immediate fluid resuscitation at the scene
Transport with fluid resuscitation en route
Incomplete glucose breakdown leads to an accumulation of:
- lactic acid.
- carbonic acid.
- bicarbonate.
- pyruvic acid.
pyruvic acid
Relative bradycardia during neurogenic shock occurs because:
- systemic venous pooling of the blood overstimulates the vagus nerve.
- the sympathetic nervous system is not stimulated to release catecholamines.
- the brainstem does not receive messages to increase the heart rate.
- the parasympathetic nervous system does not release acetylcholine.
the sympathetic nervous system is not stimulated to release catecholamines.
Adequately perfused kidneys put out at least how many milliliters of urine per hour?
-70 to 100 mL
- 50 to 70 mL
- 100 to 110 mL
- 30 to 50 mL
30 to 50 mL
Shock in the trauma patient should be considered which type until proven otherwise?
- Hemorrhagic
- Distributive
- Obstructive
- Neurogenic
Hemorrhagic
Which of the following is the most accurate definition of multiple-organ dysfunction syndrome?-
- Acute and predictable failure of the kidneys, liver, lungs, and heart that resulted from any disorder or injury that directly affected these organs
- Sequential failure of two or more organs or organ systems caused by an acute injury or illness affecting any part of the patient’s central nervous system
- Progressive failure of two or more organs or organ systems that were directly affected by the acute disorder or injury that caused the patient’s initial illness
- Combined failure of two or more organs or organ systems that were initially unharmed by the acute disorder or injury that caused the patient’s initial illness
Combined failure of two or more organs or organ systems that were initially unharmed by the acute disorder or injury that caused the patient’s initial illness ?
During anaerobic metabolism, the precapillary sphincters relax in response to which of the following?
- Lactic acid buildup
- Capillary engorgement
- Systemic vasoconstriction
- Decreased carbon dioxide
Lactic acid buildup
Which of the following blood pressures is most consistent with a pericardial tamponade?
- 80/50 mm Hg
- 110/80 mm Hg
- 90/70 mm Hg
- 100/60 mm Hg
90/70 mm Hg
Which of the following is the best indicator of tissue perfusion during compensated shock?
- Skin color and condition
- Systolic blood pressure
- Level of responsiveness
- Pulse rate and quality
Level of responsiveness
The capillary “washout” phase occurs when:
- cellular ischemia causes the postcapillary sphincters to remain constricted, causing the capillaries to become engorged with fluid.
- anaerobic metabolism causes the postcapillary sphincters to remain constricted, causing capillary fluid engorgement.
- precapillary sphincters constrict in response to the buildup of lactic acid, vasomotor failure, and increased carbon dioxide.
- postcapillary sphincters relax, releasing accumulated hydrogen, potassium, carbon dioxide, and thrombosed red blood cells.
postcapillary sphincters relax, releasing accumulated hydrogen, potassium, carbon dioxide, and thrombosed red blood cells.
Accumulating acids and other waste products in the blood:
- cause a marked increase in the production of red blood cells.
- inhibit hemoglobin from binding with and carrying oxygen.
- act as potent vasoconstrictors, which worsens ischemia.
- cause a left shift in the oxyhemoglobin dissociation curve.
inhibit hemoglobin from binding with and carrying oxygen.
Baroreceptors function by:
- measuring subtle shifts in arterial oxygen and carbon dioxide levels.
- dilating the blood vessels when systemic vascular resistance is low.
- constricting the blood vessels when systemic vascular resistance is high.
- sensing decreased blood flow and activating the vasomotor center.
sensing decreased blood flow and activating the vasomotor center.
You and your team are treating an unresponsive trauma patient. Which of the following questions would be the most relevant to ask your team when evaluating for the presence of a tension pneumothorax?
- Is the patient becoming difficult to ventilate?
- What is the patient’s systolic blood pressure?
- Are the patient’s heart tones becoming muffled?
- Does the patient’s pulse weaken during inhalation?
Is the patient becoming difficult to ventilate
Clinical indicators of sympathetic nervous system discharge include:
- diffuse wheezing.
- hypoventilation.
- pupillary dilation.
- increased salivation
Pupillary dilation
In medicine, intuition would most likely be used to:
- triage a patient to a higher category.
- justify not transporting a patient.
- rule out a particular diagnosis.
- downgrade a patient’s transport status
Triage a patient to a higher category
