Chapter 20 Workbook Flashcards by Tom Bowl

A chemical produced by a gland that regulates body organs

Hormone

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Inherited disease that affects red blood cells

Sickle cell disease

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Diabetes caused by autoimmune destruction of pancreatic beta cells

Type 1 diabetes

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A pathologic condition resulting from the accumulation of acids in the body

Acidosis

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A hormone that enables glucose to enter the cells

Insulin

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A state of unconsciousness resulting from several problems, including ketoacidosis, dehydration, and hyperglycemia

Symptomatic hyperglycemia

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Frequent urination

Polyuria

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A tendency to develop blood clots

Thrombophilia

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Excessive eating

Polyphagia

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The study of blood-related diseases

Hematology

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Primary fuel, along with oxygen, for cellular metabolism

Glucose

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Deep, rapid breathing

Kussmaul respirations

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An extremely high blood glucose level

Hyperglycemia

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A disorder affecting the metabolism of glucose

Diabetes mellitus

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Excessive thirst persisting for a long period of time

Polydipsia

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A disorder that causes an inability to develop blood clots

Hemophilia

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Diabetes caused by resistance to insulin

Type 2 diabetes

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When the body’s cells do not receive the glucose they require, the body resorts to burning ___ for energy.
A. fats
B. proteins
C. blood cells
D. ketones

A. fats

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Normal blood glucose levels range from ___ mg/dL.
A. 80 to 120
B. 90 to 140
C. 70 to 110
D. 60 to 100

A. 80 to 120

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A sickle cell–related issue that results in unintentional clot formation is known as a(n):
A. hemolytic crisis
B. aplastic crisis
C. splenic sequestration crisis
D. vasoocclusive crisis

D. vasoocclusive crisis

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Diabetes mellitus is a metabolic disorder in which the hormone ___ is missing or the body has become resistant to it.
A. estrogen
B. adrenaline
C. insulin
D. epinephrine

C. insulin

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Emergency care of a patient with hematologic disorder includes all of the following EXCEPT:
A. rapid transport for patients with an altered mental status
B. providing supportive and symptomatic care
C. oxygen at 4 L/min for patients with inadequate breathing
D. placing patients in a position of comfort

C. oxygen at 4 L/min for patients with inadequate breathing

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The accumulation of ketones and fatty acids in blood tissue can lead to a dangerous condition in diabetic patients known as:
A. diabetic ketoacidosis
B. insulin shock
C. hyperosmolar hyperglycemic nonketotic coma (HHNC)
D. hypoglycemia

A. diabetic ketoacidosis

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The term for excessive eating as a result of cellular “hunger” is:
A. polyuria
B. polydipsia
C. polyphagia
D. polyphony

C. polyphagia

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Insulin is produced by the: A. adrenal glands B. hypothalamus C. spleen D. pancreas

D. pancreas

The patient with diabetic ketoacidosis (DKA) will generally have a fingerstick glucose level higher than: A. 100 mg/dL B. 200 mg/dL C. 300 mg/dL D. 400 mg/dL

D. 400 mg/dL

Where is glycogen stored in the body? A. Liver B. Brain C. Pancreas D. Heart

A. Liver

A sweet or fruity odor on the breath of a patient is commonly found in what condition? A. Hypoglycemia B. Hyperglycemia C. Hemophilia D. Thrombophilia

B. Hyperglycemia

What condition increases a patient's risk for developing thrombophilia? A. Diabetes B. Sickle cell disease C. Cirrhosis of the liver D. Cancer

D. Cancer

Oral diabetic medications do NOT include: A. Micronase B. Glucotrol C. Januvia D. Insulin

D. Insulin

Which of the following is a contraindication to the administration of oral glucose? A. Inability to swallow B. History of diabetic ketoacidosis C. Active infection D. Recent abdominal surgery

A. Inability to swallow

______ is the hormone that is normally produced by the pancreas that enables glucose to enter the cells. A. Insulin B. Adrenaline C. Estrogen D. Epinephrine

A. Insulin

The term for excessive urination is: A. Polyuria B. Polydipsia C. Polyphagia D. Polyphony

A. Polyuria

When fat is used as an immediate energy source, ______ and fatty acids are formed as waste products. A. Dextrose B. Sucrose C. Ketones D. Bicarbonate

C. Ketones

An African American patient complaining of severe, generalized pain may have undiagnosed: A. Sickle cell disease B. Type 1 diabetes C. Thrombopenia D. Hemophilia

A. Sickle cell disease

The onset of hypoglycemia can occur within: A. Seconds B. Minutes C. Hours D. Days

B. Minutes

Without ______, or with very low levels, brain cells rapidly suffer permanent damage. A. Epinephrine B. Ketones C. Bicarbonate D. Glucose

D. Glucose

______ is/are a potentially life-threatening complication of hypoglycemia. A. Kussmaul respirations B. Hypotension C. Seizures D. Polydipsia

C. Seizures

Diabetic ketoacidosis may develop as a result of: A. too little insulin B. too much insulin C. overhydration D. metabolic alkalosis

A. too little insulin

Always suspect hypoglycemia in any patient with: A. Kussmaul respirations B. an altered mental status C. nausea and vomiting D. stridor

B. an altered mental status

The most important step in caring for the unresponsive diabetic patient is to: A. give oral glucose immediately B. perform a focused assessment C. open the airway D. obtain a SAMPLE history

C. open the airway

Determination of hyperglycemia or hypoglycemia should be: A. made before transport of the patient B. made before administration of oral glucose C. determined by a urine glucose test D. based on your knowledge of the signs and symptoms of each condition

D. based on your knowledge of the signs and symptoms of each condition

When obtaining the medical history of a patient experiencing a sickle cell crisis, you should: A. determine the patient’s level of consciousness B. ask the patient about recent illnesses or stress C. take the patient’s vital signs D. avoid asking about previous sickle cell crises

B. ask the patient about recent illnesses or stress

A deep vein thrombosis (DVT) is a worrisome risk for patients who have had: A. gallbladder surgery B. alcoholism C. pneumonia D. joint replacement surgery

D. joint replacement surgery

When reassessing the diabetic patient after administration of oral glucose, watch for all of the following EXCEPT: A. airway problems B. seizures C. sudden loss of consciousness D. joint pain

D. joint pain

Signs and symptoms associated with hypoglycemia include: A. warm, dry skin B. slow pulse C. Kussmaul respirations D. anxious or combative behavior

D. anxious or combative behavior

Hospital interventions for hemophilia may include all of the following EXCEPT: A. blood transfusions B. analgesics for pain C. intravenous (IV) therapy D. decontamination

D. decontamination

Because hyperglycemia is a complex metabolic condition that usually develops over time and involves all of the tissues of the body, correcting this condition may: A. be accomplished quickly through the use of oral glucose B. require rapid infusion of IV fluid to prevent permanent brain damage C. take many hours in a hospital setting D. include a reduction in the amount of insulin normally taken by the patient

C. take many hours in a hospital setting

A patient with hypoglycemia or hyperglycemia may appear to be: A. having a heart attack B. perfectly normal C. intoxicated D. having a stroke

C. intoxicated

True/False When patients use fat for energy, the fat waste products increase the amount of acid in the blood and tissue.

True

True/False The life span of a normal red blood cell is approximately 50 to 75 days.

False

True/False If blood glucose levels remain low, a patient may lose consciousness or have permanent brain damage.

True

True/False Higher glucose levels in the blood cause the excretion of glucose in urine.

True

True/False People with hemophilia A have an increased ability to create a clot after an injury.

False

True/False Diabetic emergencies can occur when a patient’s blood glucose level gets too high or drops too low.

True

True/False Diabetic patients may require insulin to control their blood glucose.

True

True/False Insulin is one of the basic sugars essential for cell metabolism in humans.

False

True/False A clot that forms deep in a vein is called an aplastic crisis.

False

True/False Diabetes can cause kidney failure, blindness, and damage to blood vessels.

True

True/False Most children with diabetes are insulin dependent.

True

True/False Within the red blood cells, leukocytes are responsible for carrying oxygen.

False

True/False Many adults with diabetes can control their blood glucose levels with diet alone.

True

The full name of diabetes is __________________________.

diabetes mellitus

__________ is a general term for many different conditions that result in the blood clotting more easily than normal.

Thrombophilia

Type 1 diabetes is considered to be a(n) __________ problem, in which the body becomes allergic to its own tissues and literally destroys them.

autoimmune

An African American patient or any patient of __________ descent who complains of severe pain may have undiagnosed __________ disease.

Mediterranean, sickle cell

Diabetes is defined as a lack of or __________ action of insulin.

impaired

In __________, the patient cannot drink enough fluid to keep up with the exceedingly high glucose levels in the blood.

HHNS

__________ is the study and prevention of blood-__________ diseases.

Hematology, related

A patient with hypoglycemia needs __________ immediately, and a patient with hyperglycemia needs __________ and IV fluid therapy.

sugar, insulin

A 54‑year‑old golfer collapsed on the 17th green at the golf course. His friend said he wasn’t feeling well after the eighth hole but insisted on walking and finishing out the game. His skin is pale, cool, and diaphoretic, and he provides incoherent answers to your questions. During your rapid full-body scan, you discover a medical alert necklace around his neck that reads “Type 1 Diabetic.” This tells you that he most likely: A. developed diabetes later in life B. produces inadequate amounts of insulin C. takes noninsulin-type oral medications D. will develop HHNS

B. produces inadequate amounts of insulin

A 54‑year‑old golfer collapsed on the 17th green at the golf course. His friend said he wasn’t feeling well after the eighth hole but insisted on walking and finishing out the game. His skin is pale, cool, and diaphoretic, and he provides incoherent answers to your questions. His blood glucose level is 65 mg/dL. You: A. do not suspect hypoglycemia and begin to think that his condition is cardiac in nature B. suspect hyperglycemia and proceed to give oral glucose C. suspect hypoglycemia and proceed to give oral glucose D. suspect hypoglycemia, but oral glucose is contraindicated for him

C. suspect hypoglycemia and proceed to give oral glucose

A 54‑year‑old golfer collapsed on the 17th green at the golf course. His friend said he wasn’t feeling well after the eighth hole but insisted on walking and finishing out the game. His skin is pale, cool, and diaphoretic, and he provides incoherent answers to your questions. The patient loses consciousness, and a second blood glucose level reads 48 mg/dL. You should do all of the following EXCEPT: A. call for, or rendezvous with, an ALS unit B. ensure a patent airway C. provide high-flow oxygen D. give oral glucose

D. give oral glucose

A 54‑year‑old golfer collapsed on the 17th green at the golf course. His friend said he wasn’t feeling well after the eighth hole but insisted on walking and finishing out the game. His skin is pale, cool, and diaphoretic, and he provides incoherent answers to your questions. Because the patient is unconscious and his blood glucose level is 48 mg/dL, how should the glucose be delivered? A. Between the cheek and gum B. Placed on the back of the tongue C. Placed on the tip of the tongue D. You should not deliver oral glucose.

D. You should not deliver oral glucose.

Short Answer What is insulin, and what is its role in metabolism?

Insulin is a hormone that enables glucose to enter the cells, which is essential for cellular metabolism.

Short Answer What are the preparations of commercially available oral glucose?

1. Dissolving gel 2. Chewable tablet 3. Liquid

Short Answer What two basic complications are caused by the shape of the red blood cells in people with sickle cell disease?

Due to the oblong shape of the red blood cells, they are poor oxygen carriers and can become lodged in blood vessels and organs.

Short Answer When should you not give oral glucose to a patient experiencing a suspected diabetic emergency?

A patient who is unconscious or unable to swallow should not be given oral glucose.

Short Answer How can thrombophilia lead to a pulmonary embolism?

A patient with thrombophilia has a tendency to develop clots in the blood vessels. These clots can travel through the circulatory system and become lodged in the lungs, obstructing blood flow and oxygen exchange.

Short Answer List at least four key signs and symptoms of HHNS.

1. Hyperglycemia 2. Altered mental status, drowsiness, lethargy 3. Severe dehydration, thirst, dark urine 4. Visual or sensory deficits 5. Partial paralysis or muscle weakness 6. Seizures

Short Answer When taking a history on a patient with known diabetes, what questions should be asked?

1. Do you take insulin or any pills that lower your blood sugar? 2. Do you wear an insulin pump? Is it working properly? 3. Have you taken your usual dose of insulin (or pills) today? 4. Have you eaten normally today? 5. Have you had any illness, unusual amount of activity, or stress?

Short Answer If a diabetic patient was “fine” 2 hours ago and now is unconscious and unresponsive, which diabetes-related condition would you suspect and why?

Hypoglycemia; it develops rapidly as opposed to hyperglycemia, which takes longer to develop.

Ambulance Calls You are called to a local residence where you find a 22-year-old woman supine in bed, unresponsive to your attempts to rouse her. She is cold and clammy, with gurgling respirations. Her mother tells you that her only history is diabetes, which she has had since she was a small child. How would you best manage this patient?

1. Turn the patient on her side immediately or use suction to clear the airway. 2. Insert an oral or nasal airway and support ventilations with a bag-mask device attached to oxygen. 3. Attempt to obtain a blood glucose level.

Ambulance Calls You are requested to respond to a local convenience store for an unknown medical problem. On arrival, you find a young African American man sitting on the curb, clutching his torso, and crying. He tells you that he is in severe pain and has a history of sickle cell disease. How would you best manage this patient?

The prehospital management of patients suffering from sickle cell crises will commonly include only comfort care and rapid transportation. You may also treat individual symptoms as they arise as per standard protocol. For example, a sickle cell patient presenting with difficulty breathing should receive oxygen therapy or ventilatory assistance if required.

Ambulance Calls You are dispatched to assist with a diabetic patient well known in your department for being noncompliant with his medications and diet. You have responded numerous times to his residence, all for instances of low blood sugar. Family members greet you at the door and say, “It’s Jon again. Just give him some sugar like you usually do.” You walk into the patient’s bedroom to discover him unconscious, with snoring respirations. How would you best manage this patient?

You cannot give this patient anything by mouth because he is unconscious and therefore unable to protect his own airway. If available, you should request ALS providers because they can administer intravenous dextrose (glucose). If you have no emergency providers available with this scope of practice within your system, you must transport this patient immediately. You may encounter family members who do not understand why you cannot “just give him some sugar.” Hopefully, there will be no delays in explaining his need for transport or the seriousness of his condition. Perform a thorough assessment (including blood glucose testing, if permitted), provide oxygen, monitor his ABCs (using airway adjuncts, positive pressure ventilations, and suctioning, as needed), and provide prompt transport.

Chapter 20 Workbook Flashcards

(85 cards)