The physiological function of insulin is to promote utilization of glucose by the cells. What would happen to a patient with a low level of insulin?
Answer(s): D
Insulin is a hormone that is responsible for transporting glucose into the cell where it can be metabolized and made into energy. With a low level of insulin, very little sugar can be metabolized; the result is that the cells’ ability to function is drastically reduced.
You have been called to the top of a mountain resort for a patient that is complaining of a sudden onset of shortness of breath and coughing. Your assessment of the patient reveals an anxious patient with basilar crackles in his lungs. The patient’s vital signs include a heart rate of 136, respirations of 28, and a blood pressure of 176/94 mm Hg. What is your field diagnosis of this patient?
Answer(s): A
High-altitude pulmonary edema (HAPE) usually occurs in an unacclimatized individual who rapidly ascends to an altitude that exceeds 8,000 feet. HAPE develops as a result of increased pulmonary pressure and hypertension caused by changes in blood flow at high altitudes.
Status epilepticus is a seizure that:
Status epilepticus is defined as a seizure that lasts longer than 10 minutes or a seizure that begins again after one seizure stops without that patient regaining consciousness. It is a dire medical emergency, as the patient may sustain bone fractures, airway occlusion, and possible death.
You are transporting a patient that is having night sweats, mild fever, and a productive cough. He states that the health department has been treating him at home for a respiratory condition. How should the patient be transported to the hospital?
Answer(s): B
The patient that has possible TB should wear either a surgical mask or a non-rebreather mask. This is used to prevent the spread of the disease and to protect the safety of the health care provider.
Which of the following vital signs would be most indicative of a patient who has entered the decompensated stage of shock?
Decompensated shock physiologically occurs as the precapillary sphincters that guard the peripheral capillary beds relax secondary to local blood chemistry changes due to shock. The opening of these sphincters allows blood to flow back into the stagnant capillary beds which decreases the available blood volume for core perfusion, and, results in a significant drop in systemic vascular resistance. Thus, the clinical finding consistent with decompensated drop is a sudden decrease in blood pressure, tachypnea, and continued elevation of the heart rate.
Your patient has indicated fear about his illness, stating that he is afraid that he may die. This has made the interview difficult, as you have been unable to get the patient to give you many details regarding his symptoms or the events preceding them. Which of the following techniques is an acceptable method to focus the interview and get the needed information?
Repeating your understanding of the situation back to the patient is useful in helping them realize what relevant information they have not yet revealed. It is typically not advisable to take an authoritarian role with a patient, as this may add to their emotional distress and worsen their communication ability. It is also not a good idea to give patients false assurances, such as telling them that they will be fine. Decreasing the physical distance can be intimidating to the patient, as can tell them that they may worsen if you can’t get the necessary information. Both of these techniques will increase patient apprehension and will likely have a negative impact on communication.
A 65-year-old male with terminal brain cancer calls 911 for shortness of breath. The patient has a d-do-not-resuscitate (DNR) order. What should you do for this patient?
The patient has the right to comfort care even if he is a DNR. This means that the patient has the right to receive oxygen and medications for pain. The patient has the right to make his own medical decisions unless his family has the medical power of attorney to decide if the patent is transported. Patients have the right to die with dignity.
You have a patient that has suffered frostbite to his fingers. How should you prepare the patient’s fingers for transport?
When a patient has suffered frostbite to his fingers, the digits should be wrapped individually to prevent the digits from freezing together and producing more damage. The digits may be submerged in room temperature water if there is no risk of them refreezing. The fingers should never be massaged. This causes the very sharp ice crystals to pierce the cells and cause cellular death.
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