Chapter 19

Question 1

reticular activating system (RAS)

Answer 1

series of neurologic circuits in the brain that control the functions of staying awake, paying attention, and sleeping

Question 2

oxygen is needed to ______ brain tissue?

Answer 2

perfuse

oxygen is needed to perfuse brain tissue (oxygenate)

Question 3

glucose is needed to _______ brain tissue?

Answer 3

nourish

glucose is needed to nourish brain tissue

Question 4

water is needed to _____ brain tissue

Answer 4

hydrate

water is needed to hydrate brain tissue

Question 5

lack of water, O2, glucose leads to_____?

Answer 5

altered mental status

Question 6

substance abuse can also harm _____?

Answer 6

brain tissue

Question 7

safety when treating a patient under an altered mental status

Answer 7

keeping your self, and team safe prior to approaching.

use law enforcement if necessary

Question 8

one of the most common causes of altered mental status

Answer 8

hypoxia

Question 9

Signs of hypo perfusion

Answer 9

tachycardia
pulsless
pale diaphoretic skin
delayed capillary refill time

Question 10

glucose and insulin

Answer 10

glucose by itself is too large to pass on to a cell, it requires insulin to do so.

insulin binds to receptors and allows the large glucose molecule to pass into the cells

Question 11

pancreas

Answer 11

secretes insulin when the blood sugar levels rise above 90 mg/dl

Question 12

islets of Langerhans

Answer 12

specialized clusters of cells secrete insulin

• brain cells do not need insulin to move glucose from the bloodstream
• most other body cells need insulin to process the glucose

glucose/insulin described as (lock and key)

Question 13

diabetes mellitus

Answer 13

also known as diabetes

Question 14

type 1 diabetes

Answer 14

occurs when the pancreatic cell fails to function properly and insulin is not secreted normally
(generally prescribed synthetic insulin)

(formerly known as insulin dependent diabetes)

Question 15

type 2 diabetes

Answer 15

(formerly known as non insulin dependent diabetes)

occurs when the body fails to use insulin properly.
-pancreas creates insulin but the body can not transfer glucose through the insulin produced

-can be controlled by diet and oral antidiabetic medications

Question 16

hypoglycemia

Answer 16

low blood sugar
this is the most common emergency for diabetes

caused by the following

• too much insulin
• reduced sugar intake by not eating
• uses glucose too quickly (over exertion)
• vomits a meal
• increase of metabolic rate

Question 17

hyperglycemia

Answer 17

high blood sugar

normally caused by a decrease in insulin, which leaves sugar in the bloodstream rather than helping it into the cells

• signs
• patient might complain of chronic thirst or hunger
• increased urine (body trying to get rid of the excess sugar)
• dry mouth
• intense thirst
• abdominal pain
• vomiting

Question 18

side effects of hyperglycemia

blood sugar in high 100’s

Answer 18

-high blood sugar causes water to be drawn from the bodies cells, potentially resulting in profound dehydration

Question 19

diabetic ketoacidosis

Answer 19

condition caused by high blood sugar

effects of high blood sugar

• dehydration
• altered mental status
• shock

Question 20

diabetic children

Answer 20

• more at risk than diabetic adults.
• exhaust blood sugar levels quicker than adults, especially if their insulin was taken.
• less disciplined to eat proper, and on time.

(more risk of hypoglycemia)

Question 21

blood glucose meter

Answer 21

portable blood glucose meters

used up to 6 times a day

Question 22

blood sugar of less than 60 mg/dl

Answer 22

typical of hypoglycemia and should be quickly administered glucose

Question 23

blood sugar of less than 50 mg/dl

Answer 23

patients with this low of blood sugar can cause unresponsive and altered mental status

Question 24

potentials of wrong blood sugar reading

Answer 24

if a reading comes in at 25mg/dl and the patient is alert and aware, there would be cause for concern to believe that the reading is wrong.

• glucose meter needs calibration
• not enough blood on the test strip
• expired test strips

Question 25

meter reading "High"

Answer 25

if the meter reads high, and doesn't give a numeric result the patient is in excess of roughly 500 mg/dl (extreme)

Question 26

meter reading "low"

Answer 26

if reading low, patient is roughly less than 15mg/dl (extreme)

Question 27

intranasal glucagon

Answer 27

when patients are unable to safely swallow oral glucose, when EMS systems allow intranasal glucose can be administered. -glucose is put into an atomizer device and administered into nostril

Question 28

sepsis

Answer 28

infection, a severe system wide infection

Question 29

3 types of infections

Answer 29

- respiratory infection (pneumonia) - urinary tract infections (UTI) - skin/wound infections

Question 30

evidence of severe sepsis

Answer 30

- altered mental status - increased heart rate - increased respiratory rate - low blood pressure - high blood glucose level - decreased capillary refill time

Question 31

patients unaltered mental status with history of an infection

Answer 31

always consider severe sepsis

Question 32

hyperglycemic patients frequently breath______?

Answer 32

-very deeply and rapidly, as though they have just run a race

Question 33

common symptoms of hyperglycemia

Answer 33

- dry mouth - intense thirst - abdominal pain - vomiting