Chapter 22 Workbook Flashcards by Tom Bowl

A substance whose chemical action can damage body structures or impair body functions

Poison

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Misuse of any substance to produce a desired effect

Substance abuse

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A substance that will counteract the effects of a particular poison

Antidote

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A need for increasing amounts of a drug to obtain the same effect

Tolerance

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Overstimulates body functions controlled by parasympathetic nerves

Cholinergic

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Taking a substance by mouth

Ingestion

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Vomiting blood

Hematemesis

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An agent that produces an excited state

Stimulant

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A type of narcotic medication used to relieve pain

Opioid

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A substance that decreases activity and excitement

Sedative

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Atropine, Benadryl, some cyclic antidepressants

Anticholinergic

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Activated charcoal is in the form of a(n):
A. elixir
B. suspension
C. syrup
D. emulsion

B. suspension

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The presence of burning of the mucous membranes around the mouth suggests:
A. ingestion of depressants
B. ingestion of poison
C. overdose of heroin
D. that the patient may be a heavy smoker

B. ingestion of poison

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Treatment for ingestion of poisonous plants includes all of the following EXCEPT:
A. assessing the patient’s airway and vital signs
B. taking the plant to the emergency department
C. administering activated charcoal
D. prompt transport

C. administering activated charcoal

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The most important consideration in caring for a patient who has been exposed to an organophosphate insecticide or some other cholinergic agent is to:
A. maintain the airway
B. apply high-flow oxygen
C. avoid exposure yourself
D. initiate CPR

C. avoid exposure yourself

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Which of the following would NOT provide clues to the nature of the poison?
A. Patient age
B. Scattered pills
C. Chemicals
D. A needle or syringe

A. Patient age

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Which of the following is TRUE regarding injected poisons?
A. Injected poisons cannot be diluted after injection.
B. Injected poisons can be easily removed from the body.
C. Injected poisons are absorbed over time.
D. Injected poisons only include intravenous drugs.

A. Injected poisons cannot be diluted after injection.

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The major side effect of ingesting activated charcoal is:
A. depressed respirations
B. overproduction of stomach acid
C. constipation
D. increased blood pressure

C. constipation

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Alcohol is a powerful central nervous system depressant. It:
A. sharpens the sense of awareness
B. slows reflexes
C. increases reaction time
D. increases reflexes

B. slows reflexes

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Which of the following is NOT a narcotic?
A. Heroin
B. Morphine
C. Ativan
D. Codeine

C. Ativan

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Which of the following is NOT part of the treatment of patients who have overdosed with sedative-hypnotics and have respiratory depression?
A. Provide airway clearance.
B. Provide ventilatory assistance.
C. Provide prompt transport.
D. Induce vomiting.

D. Induce vomiting.

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Anticholinergic medications have properties that block the ______ nerves.
A. parasympathetic
B. sympathetic
C. adrenergic
D. parasympatholytic

A. parasympathetic

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______ crack produces the most rapid means of absorption and therefore the most potent effect.
A. Injected
B. Absorbed
C. Smoked
D. Ingested

C. Smoked

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Cholinergic agents overstimulate normal body functions that are controlled by parasympathetic nerves, causing:
A. increased salivation
B. pupil dilation
C. decreased urination
D. decreased lacrimation

A. increased salivation

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Signs and symptoms of staphylococcal food poisoning include: A. difficulty speaking B. nausea, vomiting, and diarrhea C. skin boils or abscesses D. respiratory distress

B. nausea, vomiting, and diarrhea

Inhalant effects range from mild drowsiness to coma, but unlike most other sedative-hypnotics, these agents may often cause: A. seizures B. vomiting C. swelling of the tongue D. rashes

A. seizures

Cocaine is called all of the following EXCEPT: A. lady B. snow C. blow D. weed

D. weed

The effects of bath salts can last as long as: A. 12 hours B. 24 hours C. 48 hours D. 72 hours

C. 48 hours

The ingestion of marijuana can lead to cannabinoid hyperemesis syndrome, resulting in extreme nausea and vomiting. How are these symptoms typically relieved? A. Hot showers B. Oxygen therapy C. Activated charcoal D. Massaging the feet

A. Hot showers

Sympathomimetics are central nervous system stimulants that frequently cause: A. hypotension B. tachycardia C. pinpoint pupils D. muscle weakness

B. tachycardia

Characteristics of carbon monoxide include all of the following EXCEPT: A. is odorless B. produces severe hypoxia C. does not damage or irritate the lungs D. smells like rotten eggs

D. smells like rotten eggs

Chlorine: A. is odorless B. does not damage or irritate the lungs C. causes pulmonary edema D. does not cause sore throat or hoarseness

C. causes pulmonary edema

Localized signs and symptoms of absorbed poisoning include: A. a history of exposure B. burns and irritation of the skin C. dyspnea D. muscle weakness

B. burns and irritation of the skin

Which of the following statements regarding injected poisons is FALSE? A. They may result in dizziness, fever, and chills. B. They are frequently the cause of drug overdoses. C. They are easily diluted once in the bloodstream. D. You should remove rings, watches, and bracelets in areas of swelling.

C. They are easily diluted once in the bloodstream.

________ is a highly toxic, colorless, and flammable gas with a distinctive rotten-egg odor. A. Carbon monoxide B. Hexane C. Chlorine D. Hydrogen sulfide

D. Hydrogen sulfide

Injected poisons are impossible to dilute or remove because they are usually ________ or cause intense local tissue destruction. A. absorbed quickly into the body B. bound to hemoglobin C. large compounds D. combined with the cerebrospinal fluid

A. absorbed quickly into the body

Medical problems that may cause the patient to present as intoxicated include all of the following EXCEPT: A. head trauma B. diarrhea C. uncontrolled diabetes D. toxic reactions

B. diarrhea

Which of the following is NOT considered a sign or symptom of alcohol withdrawal? A. Agitation and restlessness B. Fever and sweating C. Seizures D. Chest pain

D. Chest pain

Treatments for inhaled poisons include: A. removing the patient from the exposure B. applying a self-contained (SCBA) to the patient C. covering the patient to prevent spread of the poison D. considering continuous positive airway pressure (CPAP) application

A. removing the patient from the exposure

Signs and symptoms of chlorine exposure include all of the following EXCEPT: A. cough B. chest pain C. rales D. wheezing

C. rales

Which of the following is NOT a typically ingested poison? A. Aerosol propellants B. Household cleaners C. Plants D. Contaminated food

A. Aerosol propellants

Naloxone (Narcan) should only be used in a patient with a suspected opiate or opioid overdose who has: A. an altered mental status B. constriction of the pupils C. depressed mental status D. depressed respirations or apnea

D. depressed respirations or apnea

Inhaled poison include: A. chlorine B. venom C. Dieffenbachia D. Salmonella

A. chlorine

Which of the following is NOT considered a typical route of administration for naloxone? A. Intravenous B. Intranasal C. Intramuscular D. Intradermal

D. Intradermal

You have responded to the home of a 26-year-old woman who has reportedly taken a large number of pills in an attempt to commit suicide. As you enter the living room, you see her unresponsive in a chair, with several empty alcohol bottles. She is breathing heavily. You are able to arouse her consciousness for a short period of time. Which course of action takes priority? A. Administer syrup of ipecac. B. Cover her with a blanket to maintain body temperature. C. Ensure scene safety. D. Attempt to administer naloxone.

C. Ensure scene safety.

You have responded to the home of a 26-year-old woman who has reportedly taken a large number of pills in an attempt to commit suicide. As you enter the living room, you see her unresponsive in a chair, with several empty alcohol bottles. She is breathing heavily. You have decided to give her activated charcoal. How much should you give her? A. Half a glass B. 12.5 to 25 g C. 30 to 100 g D. 30 to 100 mL

C. 30 to 100 g

You have responded to the home of a 26-year-old woman who has reportedly taken a large number of pills in an attempt to commit suicide. As you enter the living room, you see her unresponsive in a chair, with several empty alcohol bottles. She is breathing heavily. What would be the desired goal of giving her activated charcoal? A. To vomit the drugs and alcohol B. To bind the toxin and prevent absorption C. To teach her a lesson D. To prevent excretion

B. To bind the toxin and prevent absorption

You have responded to the home of a 26-year-old woman who has reportedly taken a large number of pills in an attempt to commit suicide. As you enter the living room, you see her unresponsive in a chair, with several empty alcohol bottles. She is breathing heavily. If she does not want to take the activated charcoal, you should: A. restrain her, pinch her nose, and make her drink it B. have her sign a patient refusal form C. attempt to persuade her D. leave the scene

C. attempt to persuade her

You have responded to the home of a 26-year-old woman who has reportedly taken a large number of pills in an attempt to commit suicide. As you enter the living room, you see her unresponsive in a chair, with several empty alcohol bottles. She is breathing heavily. Side effects of ingesting activated charcoal include all of the following EXCEPT: A. constipation B. hematemesis C. vomiting D. black stools

B. hematemesis

Which of the following is NOT commonly associated with an overdose from a cardiac medication? A. Cardiac arrhythmia B. Bleeding C. Unconsciousness D. Urinary incontinence

D. Urinary incontinence

Ringing in the ears is associated with an overdose of: A. acetaminophen B. aspirin C. ethylene alcohol D. methyl alcohol

B. aspirin

True/False The usual adult dose of activated charcoal is 30 to 100 g.

True

True/False The general treatment of a poisoned patient is to induce vomiting.

False

True/False Activated charcoal is a standard of care in all ingestions.

False

True/False Inhaled chlorine may produce pulmonary edema and lung irritation.

True

True/False Shaking activated charcoal decreases its effectiveness.

False

True/False Opioid overdose typically presents with pinpoint pupils.

True

True/False Cholinergics include nerve gases used in chemical warfare and organophosphate insecticides.

True

True/False Alcohol is a stimulant.

False

True/False Dilaudid and Vicodin are examples of opioids.

True

True/False Cocaine is classically inhaled through the nose and absorbed in the nasal mucosa.

True

True/False Alcohol can result in significant respiratory depression.

True

True/False Ingestion of the plant Dieffenbachia can cause irritation of the upper airway.

True

The most severe form of toxin ingestion from food poisoning is __________.

botulism

__________ __________ produce euphoria, increased mental clarity, and sexual arousal.

Bath salts

__________ __________ is the misuse of any substance to produce a desired effect.

Substance abuse

If the patient has a liquid chemical agent on the skin, you should flood the affected part for __________ to __________ minutes.

15 to 20

Opioid analgesics are central nervous system depressants and can cause severe __________ __________.

respiratory depression

Severe acute alcohol ingestion may cause __________.

hypoglycemia

Your primary responsibility to the patient who has been poisoned is to __________ that a poisoning occurred.

recognize

The usual dosage for activated charcoal for an adult or child is __________ of activated charcoal per __________ of body weight.

1 gram, kilogram

As you irrigate the eyes, make sure that the fluid runs from the bridge of the nose __________.

outward

Approximately 80% of all poisoning is by __________, including plants, contaminated food, and most drugs.

ingestion

Patients experiencing alcohol withdrawal may develop __________ __________ if they no longer have their daily source of alcohol.

delirium tremens

The __________ _____-________ is a single auto injector containing 2 mg of atropine and 600 mg of pralidoxime.

DuoDote auto-injector

A person with a(n) __________ has an overwhelming desire or need to continue using the substance, at whatever cost, with a tendency to increase the dose.

addiction

__________ may develop from sweating, fluid loss, insufficient fluid intake, or vomiting associated with delirium tremens.

Hypovolemia

Short Answer How does activated charcoal work to counteract ingested poison?

Activated charcoal adsorbs (binds to) the toxin and keeps it from being absorbed in the gastrointestinal tract.

Short Answer What are four routes of contact for poisoning?

1. Ingestion 2. Inhalation 3. Injection 4. Absorption (surface contact)

Short Answer List the typical signs and symptoms of an overdose of sympathomimetics.

Hypertension, tachycardia, paranoia, and dilated pupils, along with irritability, agitation, anxiety, restlessness, or seizures

Short Answer What are the two main types of food poisoning?

1. The organism itself causes the disease. 2. The organism produces toxins that cause disease.

Short Answer Why is it that accidental acetaminophen overdose may in some ways be worse than intentional overdose? What does this mean to the prehospital caregiver?

Symptoms of acetaminophen overdose do not appear until the damage is irreversible, up to a week later. Finding evidence at the scene can save a patient’s life.

Short Answer What condition do the mnemonics DUMBELS and SLUDGEM pertain to, and what do they mean?

They describe patient presentation in cholinergic poisoning (organophosphate insecticides, wild mushrooms). DUMBELS: Diarrhea, urination, miosis/muscle weakness, bradycardia/bronchospasm/bronchorrhea, emesis, lacrimation, salivation/seizures/sweating SLUDGE: Salivation/sweating, lacrimation, urination, defecation/drooling/diarrhea, gastric upset/cramps, emesis, muscle twitching/miosis

Short Answer List at least five questions you should ask a possible poisoning victim.

1. What substance did you take? 2. When did you take it or become exposed to it? 3. How much did you ingest or were exposed to? 4. How long ago did you take it or were exposed? 5. What actions have been taken? Did it help? 6. How much do you weigh?

Ambulance Calls You are dispatched to a private residence for “accidental ingestion.” You arrive to find a 3 year old whose parents tell you he “got into some rat poison.” The child is alert, crying, and responding appropriately to his parents and environmental stimuli. How would you best manage this patient?

You should attempt to identify the substance. Some rat poisons are actually blood thinning agents or anticoagulants, such as warfarin. You should collect the substance and call the poison control center and/or the hospital emergency department for patient care instructions. Some substances require the administration of activated charcoal, whereas others do not. Perform your initial assessment, start oxygen (if appropriate), and provide prompt transport. Know your local protocols.

Ambulance Calls You are dispatched to the sidewalk in front of a small business for “an intoxicated man.” You arrive to find a 60 year old man sitting on the curb, holding a bottle inside a paper bag. He is not fully alert and can only tell you that his name is Andy. He allows you to take his blood pressure, and as you roll up his sleeve, you notice needle marks along his veins. How would you best manage this patient?

This patient potentially abuses alcohol and illegal substances. However, you cannot automatically assume that his decrease in mentation is directly related to alcohol intoxication or the influence of other substances. He may have other medical conditions, which may mimic intoxication or even be obscured by it. You should perform a thorough assessment, take his vital signs, monitor his ABCs (because these could change at any time), and transport him to the nearest appropriate medical facility for evaluation. It is also important to be aware of the possibility of used needles when performing assessments and/or removing clothing when visualizing any potential injuries. Protect yourself.

Ambulance Calls You are called to a possible suicide attempt. You arrive on the scene to find police and a neighbor in the home of a 25 year old woman who is unresponsive, supine on her bed. The neighbor tells you that the patient recently broke up with her boyfriend and has been very distraught. There is an empty pill bottle on the nightstand. When you look at the label, you see that the prescription was filled yesterday and that 30 tablets were dispensed. An empty liquor bottle is on the floor. How would you best manage this patient?

Maintain the airway with an adjunct and high flow oxygen via a bag mask device or a nonrebreathing mask with 100% oxygen. Monitor vital signs and provide supportive measures and rapid transport. Take the pill bottle along to the emergency department. Be alert for possible vomiting, monitor the patient closely, and be prepared for the possible need for CPR.

Which of the following would NOT be an appropriate question to ask regarding an ingested poison? A. What is the substance? B. How much did the patient ingest? C. Why have you not gotten help for your addiction? D. Have any interventions been performed?

C. Why have you not gotten help for your addiction?

“Hot as a hare, blind as a bat, dry as a bone, red as a beet, and mad as a hatter” describes which of the following conditions? A. Cholinergic poisoning B. Anticholinergic poisoning C. Delirium tremens D. Sympathomimetic poisoning

B. Anticholinergic poisoning

Shigella, Campylobacter, and Enterococcus are associated with what type of poisoning? A. Plant B. Food C. Hallucinogen D. Sympathomimetic

B. Food

Ice, crank, speed, uppers, and meth are all street names for which type of drug? A. Hallucinogens B. Sympathomimetics C. Sedative hypnotics D. Anticholinergics

B. Sympathomimetics

When would you NOT give activated charcoal? A. If the patient drank methanol B. If the patient overdosed on aspirin C. If the patient overdosed on antidepressants D. If the patient overdosed on opiates

A. If the patient drank methanol

Chapter 22 Workbook Flashcards

(92 cards)