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58 Cards in this Set
- Front
- Back
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After emergency team is notified what do you do?
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ASSESSMENT
* Assess vitals * ACB (used to be called ABC) * Neuro assessment -Eye opening - Motor response (can you move your hand..) - Verbal response (get as much medical info as possible, as they may be going downhill fast) * Can they follow directions * Pain assessment |
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What is shock?
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The bodies pathological reaction to illness, trauma or emotional stress. Shock can be life threatening.
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What does shock look like? What are the progression of signs?
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Skin - cold & clammy
Urine Output - decreased Respirations - increased Bowel Sounds - hypoactive BP - normal Anxiety levels increase complain of chest pain BP falls as Shock progresses Respirations - rapid and shallow Pulmonary edema results Tachycardia Death |
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What are signs of hypovolemic shock?
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Abnormally low blood volume, possibly due to internal injuries or external hemorrhage, vomiting, diarrhea or medications
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What do you do in hypovolemic shock?
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Call 911 & monitor
CPR if necessary Rescue breathing if necessary |
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What is a pulmonary embolus?
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An occlusion of one or more pulmonary arteries by a thrombus or thrombi
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What is a thrombus?
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A clot in the cardiovascular system that is attached to the blood vessel or heart wall.
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What is an embolus?
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A detached thrombus that may occlude a vessel
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What are the signs of an embolus?
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* Chest pain
* Rapid weak pulse * Hyperventilation * Dyspnea or tachypnea * apprehension * Cough or hemoptysis (blood tinged spit) * Diaphoreses (profuse sweating) * Syncope * Hypotension * Cyanosis * Rapid change in level of consciousness * Coma - sudden death |
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What do we do if we see signs of an embolus?
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This is a medical emergency. Call 911.. Monitor and respond
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What is diabetes?
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A chronic disorder characterized by high blood glucose (hyperglycemia) and the disruption of the metabolism of fats, proteins and carbohydrates
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What is insulin?
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A hormone that helps the body use energy from sugar and starch
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What is glucose?
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A form of sugar produced when the body digests sugars and starches
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Where does insulin come from?
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The pancreas
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Describe Type I diabetes
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* They are insulin dependent
* Childhood diabetes, genetic predisposition. * Viral infection of ilset cells. * Autoimmunity |
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Describe Type II diabetes
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Non-insulin dependent
* Genetics * Diet * Obesity * Lack of exercise |
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Hypoglycemia may lead to insulin shock. What are the signs & symptoms of hypoglycemia?
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* Shakiness
* Increased HR * Cold sweat * Light headed * dizzy * hunger * impaired vision * weakness * Fatigue * Headache * Mood swings * Pallor * Tingle in the mouth * Clumsy or jerky |
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How do we treat if we see signs of hypoglycemia?
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Give Candy, OJ, Glucose tabs, milk. After recovery - snack
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Why is it fairly common for us to see hypoglycemia in the clinics?
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Because when we are exercising a patient, the muscles are calling for more glucose. If you see the signs or symptoms of hypoglycemia, stop exercising them.
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What are the signs and symptoms of hyperglycemia?
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* Extreme thirst
* Frequent urination * Dry skin * Blurred vision * Fatigue * Nausea * Dizzy * Increased appetite * Ketones in urine * weight loss * difficulty breathing * Fruity odor to breath * |
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What is diabetic ketoacidosis?
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It is a complication of diabetes that occurs when the body cannot use sugar (glucose) as a fuel source because the body has no insulin or not enough insulin, and fat is used instead. Byproducts of fat breakdown, called ketones, build up in the body.
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Insulin dependent diabetics get injections to get their insulin. What happens when injection shot is the area we are exercising?
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We might tell them to pick a different spot because the blood will flow in the area as we exercise it.
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What are the signs and symptoms of diabetic ketoacidosis?
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* Deep, rapid breathing
* Dry skin and mouth * Flushed face * Fruity breath * Nausea & vomiting * Stomach pain * High blood glucose * Ketones in urine * Fatigue * Frequent urination or thirst for a day or more * mental stupor that may progress to coma * Muscle stiffness or aching * Shorness of breath * Abdominal pain * Breathing difficulty while lying down * Decreased appetite * Decreased consciousness * Headache |
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If you are not sure whether a pt is hypo or hyperglycemic, should you give them sugar?
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Yes. It won't hurt them if they are hyper, but it will help if hypo. Still call 911
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What happens if ketoacidosis is left untreated?
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Can lead to:
* Vision changes * CP complications * Kidney problems * Neuropathy * Hypertension |
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If blood glucose is above ____ we should not exercise the pt.
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250 mm/dl
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What is a normal blood glucose range?
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low to mid 100 mg/dl. A normal fasting blood glucose level is less than 110 mg/dl
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If we know a pt is diabetic, what can we instruct the patient to do before their visit?
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Ask the pt to eat 2 hours before
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What is a CVA?
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Cerebrovascular accident or a stroke
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What are the signs and symptoms of a CVA?
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* One sided weakness or paralysis
* Slurred speech * Sweating * Maybe headache * BP changes * Call 911, they are having a stroke |
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What is hypotension?
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This is a sudden drop in BP of at least 20 mm/Hg from normal
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There are three types of hypotension, what are they?
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* Orthostatic
* Neurally mediated hypotension * Severe hypotension brought on by a sudden loss of blood (shock) |
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What type of hypotension do we normally see?
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Orhostatic, because pt have been in bed for along period of time. When they get up, they get a sudden drop in BP. We see this often, because we are usually the first people to get them out of bed
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What are the signs & symptoms of orthostatic hypotension?
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* Palor (turn white)
* Dizziness & nausea * Hyperpnea & tachycardia * cold & clammy skin * Blurry vision * Confusion * Fainting (syncope) * Light-headedness * Sleepiness * Weakness |
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What do we do when we observe the signs of orthostatic hypotension?
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* Lie pt down
* Legs elevated * Anti-embolic exercises: ankle pumps, ankle circles, gluteal contractions * Medical assistance if they do pass out * Monitor vitals |
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What are the Signs of a Seizure?
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* May utter sharp cry
* Rigid muscles * Eyes wide open * Jerky movements * Irregular rapid respirations * May vomit * Froth * Incontinence |
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What do you do if someone is having a siezure?
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Clear the area to prevent injury
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What is Autonomic Dysreflexia?
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Potential life threatening, medical emergency common in spinal cord injuries of T6 or higher. It is the reaction of the autonomic nervous system to overstimulate
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What are the signs & symptoms of Autonomic Dysreflexia?
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* Hypertension
* Bradycardia * Vasodilation * Headache * Increased spasticity * Profuse Sweating * Constricted pupils * Nasal congestion * Pilo erection * Burred vision Problem is their BP is spiking so high, they are going to stroke out. |
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What time frame of a spinal cord injury do you normal see Autonomic dysreflexia occur?
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Initially after the spinal cord injury up to 6 months to a year & then the body starts to stabilize.
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What are the triggers for autonomic dysreflexia?
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Loss of bowel or bladder function (is catheter kinked?)
Temperature changes Emotions Spasms Pain |
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What do you do if you recognize autonomic dysreflexia?
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* Medical emergency, activate emergency response
* Look for triggers, Catheter? * Sit them up to lower BP * Keep looking for triggers |
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The AGS guidelines recommend assessing an older person using the "Get Up and Go Test" if the person A.) seeks medical attention after a fall B) Reports more than one fall in a year C) Reports a single fall incident D) Has a gait or balance problem
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B) Reports more than one fall in a year
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Falls in the elderly most commonly occur during activities that are A) Risky, such as standing on a chair B) Routine activities of daily living C) Related to outdoor sports D) Strenuous
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B) Routine activities of daily living
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Falls in the home most commonly occur in A) areas that are most frequently used such as the bathroom & bedroom B) Storage areas such as the garage or tool shed C) Confined spaces such as closets and pantries D) Poorly ventilated rooms such as attics and basements
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A) Areas that are most frequently used such as the bathroom and bedroom
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The most common cardiovascular risk factor associated with falls is A) Orthostatic hypotension B) Myocardial infarction C) Heart failure D) Peripheral vascular disease
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A) Orthostatic hypotension
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Intrinsic factors that contribute to falls include A) Ill fitted assistive devices B) The use of restraints C) Cognitive changes D) Low socioeconomic status
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C) Cognitive changes
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A common consequence of falls in the elderly is A) Soft tissue injuries B) Migraines C) Cervical fracture D) Death
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A: Soft tissue injuries
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the relationship of medication use to falls in the elderly is: A) Restricted to class -IV narcotics B) the strongest when prescribed drug doses are in a toxic range C) Usually related to antibiotics D) Directly related to the use of four or more medications
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D) Directly related to the use of 4 or more medications
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Self-efficacy is: A) A motivation to learn in a social setting B) An individual's confidence in the ability to perform activities of daily living C) The effectiveness of psychotropic medications D) The ability to express one's self through independent living
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B) An individual's confidence in the ability to perform activites of daily living
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LTC institutions assess functional status with: A) intelligence quotient B) A complete minimum data set C) An orthostatic blood pressure reading D) an MRI
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B) A complete minimum data set
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Fall prevention strategies include all of the following EXCEPT: A) Patient education of fall risk B) Monitoring for changes in vital signs. C) Safety checks for environmental hazards D) Restraining the patient
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D) Restraining the patient
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Identification of persons at risk for falls is the responsibility of the A.) Physician B) Multidisciplinary team C) Risk manager D) PT
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B) Multidisciplinary Team
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Most elderly patients who fall will: A) fall again B) have dementia C) Require sutures D) Need psychotropic medications
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A) Fall again
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What percentage of older people that sustain a serious injury from a fall lose independence for life.
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50%
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What percentage of of all LTC admittances are due to falls?
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40%
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What are intrinsic factors that contribute to falls?
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Neurological diseases, Parkinsons, dementia, seizures, peripheral neuropathy (changes in sensation in extremities), vestibular dysfunction, arthritis, diabetes, orthostatic hypertension, post micteration syncope (get dizzy after you pee), decrease vision
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What are some extrinsic factors that contribute to falls?
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Poor lighting, slippery surfaces, uneven surfaces, kids, clutter in walk way, pets, etc
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