EMT Chapter 15 – Flashcards

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aneurysm
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swelling or enlargement of part of a blood vessel, resulting from the weakening of the vessel wall
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aphasia
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the inability to understand and/or produce speech
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aura
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a sensation experienced prior to a seizure; serves as a warning sign that a seizure is about to occur
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cerebrovascular accident
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(CVA/stroke) an interruption of blood flow to the brain that results in the loss of brain function
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coma
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a state of profound unconsciousness from which one cannot be roused
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dysarthria
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slurred speech
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embolus
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a blood clot or other substance in the circulatory system that travels to a blood vessel where it causes a blockage
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febrile seizures
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seizures that result from sudden high fevers, particularly in children
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generalized seizure
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a seizure characterized by twitching of all of the body's muscles that may last several minutes or more; formerly known as a grand mal seizure
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hemiparesis
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weakness on one side of the body
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hemorrhagic stroke
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when a blood vessel ruptures, causing increased pressure in the brain and subsequent brain damage
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hypoglycemia
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a condition characterized by a low blood glucose level
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ischemia
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a lack of oxygen that deprives tissues of necessary nutrients, resulting from partial or complete blockage of blood flow; potentially reversible because permanent injury has not yet occurred
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ischemic stroke
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occurs when blood flow to part of the brain is cut off by blockage inside a blood vessel
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partial seizure
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a seizure affecting a limited portion of the brain
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postictal state
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a period following a seizure lasting between 5 and 30 minutes; characterized by labored respirations and some degree of altered mental status
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seizure
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generalized, uncoordinated muscular activity associated with loss of consciousness; a convulsion
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status epilepticus
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a condition in which seizures recur every few minutes or last more than 30 minutes
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stroke
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an interruption of blood flow to the brain that results in the loss of brain function; also called cerebrovascular accident (CVA)
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thrombosis
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a blood clot that forms at the site of blockage
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tonic-clonic seizure
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a type of seizure that features rhythmic back-and-forth motion of an extremity and body stiffness
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transient ischemic attack
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(TIA) a disorder of the brain in which cells temporarily stop working because of insufficient oxygen, causing stroke like symptoms that resolve completely within 24 hours of onset
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muscle control and body coordination are controlled by the
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cerebellum
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a 58-year-old male presents with confusion, right-sided weakness, and slurred speech. as your partner is applying oxygen, it is most important for you to
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ask his wife when she noticed symptoms
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the most basic functions of the body, such as breathing, blood pressure, and swallowing, are controlled by the
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brain stem
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what glascow coma scale would you assign to a patient who responds to painful stimuli, uses inappropriate words, and flexes his or her arms in response to pain?
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8
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a patient without a history of seizures experiences a sudden convulsion. the least likely cause of this seizure is
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epilepsy
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you are caring for a 70-year-old female with signs and symptoms of an acute stroke. she is conscious, has secretions in her mouth, and is breathing as a normal rate with adequate depth. you should
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suction her oropharynx and apply 100% oxygen
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the mental status of a patient who has experienced a typical seizure
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is likely to improve over a period of 5 to 30 minutes
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a transient ischemic attack occurs when
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the normal body processes destroy a clot in a cerebral artery
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you are transporting a semiconscious patient to the hospital. en route, you note that the patient's mental status is not improving, despite 100% supplemental oxygen. you should suspect that this patient
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is hypoglycemic
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which of the following most accurately describes the cause of an ischemic stoke? A) acute atherosclerotic disease B) narrowing of a carotid artery C) rupture of a cerebral artery D) blockage of a cerebral artery
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blockage of a cerebral artery
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when transporting a stable stroke patient with unilateral hemiparalysis, it is best to place the patient in a
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recumbent position with the paralyzed side down
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which of the following is not an assessment parameter included in the Cincinnati Stoke Scale? A) memory B) arm drift C) facial droop D) speech
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memory
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a patient with an altered mental status is
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not thinking clearly or is incapable of being aroused
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the principle clinical difference between a stroke and hypoglycemia is that patients with hypoglycemia
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usually have an altered mental status or decreased level or consciousness
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during the initial assessment of a semiconscious 70-year-old female, you should
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ensure a patent airway and support ventilation as needed
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when caring for a child with documented hypoglycemia, you should be most alert for
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a seizure
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a patient whose speech is slurred and difficult to understand is experiencing
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dysarthria
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successful treatment of a stroke depends on whether or not
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clot-buster therapy is given within 2-3 hours of symptom onset
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which of the following conditions is not a common cause of seizures? A) acute alcohol withdrawal B) severe hypovolemia C) acute hypoglycemia D) poisoning or overdose
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severe hypovolemia
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you are dispatched to a residence for a 66-year-old male who, according to family members, has suffered a massive stroke. your initial assessment reveals that the patient is pulseless and apneic. you should
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initiate CPR and attach an AED as soon as possible
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you arrive at a grocery store shortly after a 35-year-old male stopped seizing. your assessment reveals that he is confused and incontinent of urine. the patient's girlfriend tells you that he had a history of seizures and takes Tegretol. when obtaining further medical history from the girlfriend, it is most important to
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obtain a description of how the seizure developed
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which of the following conditions would most likely affect the entire brain? A) blocked cerebral artery in the frontal lobe B) respiratory failure or cardiopulmonary arrest C) reduced blood supply to the left hemisphere D) ruptured cerebral artery in the occipital lobe
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respiratory failure or cardiopulmonary arrest
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you respond to a residence for a child who is having a seizure. upon arrival at the scene, you enter the residence and find the mother holding her child, a male 2-year-old. the child is conscious and crying. according to the mother, the child had been running a high fever and then experienced a seizure that lasted approximately 3 minutes. you should
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transport the child to the hospital and reassure the mother en route
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which of the following most accurately describes the postictal state that follows a seizure? A) rapidly improving level of consciousness B) dazed, confused, or combative appearance C) hyperventilation and hypersalivation D) gradually decreasing level of consciousness
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dazed, confused, or combative appearance
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an absence seizure is also referred to as a
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petite mal seizure
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you are caring for a conscious, confused patient with left-sided hemiparalysis. his airway is patent and his respirations are 22 breaths/min with adequate tidal volume. treatment for this patient should include
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oxygen via nonrebreathing mask, left lateral recumbent position, and transport
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a patient who is possibly experiencing a stroke is not eligible for thrombolytic (fibrinolytic) therapy if he or she
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has bleeding within the brain
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which of the following conditions would most likely mimic the signs and symptoms of a stroke? A) alcohol intoxication B) acute poisoning C) hypoglycemia D) high fever
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hypoglycemia
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you receive a call to a residence, where a neighbor has found the resident, a 40-year-old female, semiconscious on her living room floor. during your assessment you discover a bottle of Dilantin on a nearby table. you should be most suspicious that this patient
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is postictal following a seizure
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which of the following medications is not used to treat patients with a history of seizures? A) Tegretol B) Dilantin C) Dilaudid D) Phenobarbital
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Dilaudid
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interruption of cerebral blood flow may result from all of the following, except: A) a thrombus B) cerebral vasodilation C) an acute arterial rupture D) an embolism
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cerebral vasodilation
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which of the following most accurately describes a focal seizure? A) a seizure that begins in one extremity B) generalized seizures without incontinence C) a seizure that is not preceded by an aura D) a blank stare without muscle contractions
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a seizure that begins in one extremity
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individuals with chronic alcoholism are predisposed to intracranial bleeding and hypoglycemia secondary to abnormalities in the
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liver
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the spinal cord exits the cranium through the
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foramen magnum
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a patient who is experiencing receptive aphasia is
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able to speak clearly but has difficulty understanding
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the three major parts of the brain are the
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cerebrum, cerebellum, and brain stem
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status epilepticus is characterized by
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prolonged seizures without a return on consciousness
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the most significant risk factor for a hemorrhagic stroke is
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hypertension
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which of the following clinical signs would be most suggestive of a ruptured cerebral artery? A) unilateral hemiparesis B) nasal discharge of blood C) confusion and weakness D) sudden, severe headache
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sudden, severe headache
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which of the following conditions would be least likely to mimic the signs and symptoms of a stroke? A) postictal state B) hypoglycemia C) intracranial bleeding D) hypovolemia
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hypovolemia
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when assessing arm movement of a patient with a suspected stroke, you should
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ask the patient to close his or her eyes during the assessment
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a 35-year-old mildly obese woman is complaining of localized pain in the upper right quadrant with referred pain to the right shoulder. the most likely cause of her pain is
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cholecystitis
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the most appropriate treatment for a patient with severe abdominal pain and signs of shock includes
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transporting the patient without delay
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febrile seizures are
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usually benign but should be evaluated
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a generalized seizure is characterized by
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severe twitching of all the body's muscles
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when obtaining medical history information from the family of a suspected stroke patient, it is most important to determine
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when the patient last appeared normal
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which of the following is a metabolic cause of a seizure? A) brain tumor B) massive stroke C) poisoning D) head trauma
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poisoning
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which of the following patients would most likely demonstrate typical signs of infection or fever? A) an 88-year-old male with chronic renal problems B) a 17-year-old male with depression and anxiety C) a 3-month-old female who was born prematurely D) a 35-year-old female in the later stages of AIDS
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a 17-year-old male with depression and anxiety
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the anterior aspect of the cerebrum controls
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emotion
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a patient experiencing a tonic-clonic seizure exhibits
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tachycardia, hyperventilation, sweating, and intense salivation
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"tips on vowels"
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T-trauma I-infection P-psychogenic causes S-seizure/syncope A-alcohol E-electrolytes I-insulin O-opiates U-uremia
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in the immediate postictal state you should anticipate
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rapid, deep respirations and fast heart rate
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You arrive at a local grocery store approximately 5 minutes after a 21-year-old female stopped seizing. She is confused and disoriented; she keeps asking you what happened and tells you that she is thirsty. Her brother, who witnessed the seizure, tells you that she takes phenytoin (Dilantin) for her seizures, but has not taken it in a few days. He also tells you that she has diabetes. In addition to applying high-flow oxygen, you should: A) administer one tube of oral glucose and prepare for immediate transport. B) place her in the recovery position and transport her with lights and siren. C) monitor her airway and breathing status and assess her blood glucose level. D) give her small cups of water to drink and observe for further seizure activity.
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monitor her airway and breathing status and assess her blood glucose level
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when obtaining medical history information from the family of a suspected stroke patient, it is MOST important to determine: A) when the patient last appeared normal. B) if there is a family history of a stroke. C) if the patient has been hospitalized before. D) the patient's overall medication compliance
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when the patient last appeared normal
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you arrive at the residence of a 33-year-old woman who is experiencing a generalized seizure. she has a small amount of vomitus draining from the side of her mouth. after protecting her from further injury, you should:
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maintain her airway with manual head positioning, suction her airway to remove the vomitus, insert a nasopharyngeal airway, and administer high-flow oxygen
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law enforcement has summoned you to a nightclub, where a 22-year-old female was found unconscious in an adjacent alley. your primary assessment reveals that her respirations are rapid and shallow and her pulse is rapid and weak. she is wearing a medical alert bracelet that identifies her as an epileptic. there is an empty bottle of vodka next to the patient. you should: A) place a bite block in her mouth in case she has a seizure and transport at once. B) apply oxygen via a nonrebreathing mask, place her on her left side, and transport. C) assist ventilations, perform a rapid exam, and prepare for immediate transport. D) apply oxygen via nonrebreathing mask and transport her for a blood-alcohol test.
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assist ventilations, perform a rapid exam, and prepare for immediate transport.
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you are assessing a 49-year-old man who, according to his wife, experienced a sudden, severe headache and then passed out. He is unresponsive and has slow, irregular breathing. his blood pressure is 190/94 mm Hg and his pulse rate is 50 beats/min. his wife tells you that he has hypertension and diabetes. he has MOST likely experienced: A) acute hypoglycemia. B) a ruptured cerebral artery. C) a complex partial seizure. D) an occluded cerebral artery.
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a ruptured cerebral artery
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