Chapter 26 Workbook Flashcards by Tom Bowl

A mass of blood in the soft tissues beneath the skin

Hematoma

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The formation of a clot to plug an opening in an injured blood vessel, stopping blood flow

Coagulation

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The upper chamber

Atrium

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A congenital condition in which a patient lacks one or more of the blood’s normal clotting factors

Hemophilia

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Works as two paired pumps

Heart

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The largest artery in the body

Aorta

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A condition in which low blood volume results in inadequate perfusion

Hypovolemic shock

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Returns oxygen-rich blood from the lungs to the left atrium

Pulmonary vein

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Bruising

Ecchymosis

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Blood flow to the left and right lungs

Pulmonary artery

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The lower chamber

Ventricle

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Bleeding

Hemorrhage

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A nosebleed

Epistaxis

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The function of the blood is to _________ all of the body’s cells and tissues.
A. remove oxygen from
B. deliver nutrients to
C. carry waste products to
D. hydrate

B. deliver nutrients to

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The cardiovascular system consists of all of the following EXCEPT:
A. a pump
B. a container
C. fluid
D. a battery

D. a battery

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Blood leaves each chamber of a normal heart through a(n):
A. vein
B. artery
C. one-way valve
D. capillary

C. one-way valve

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Blood enters the right atrium from the:
A. coronary arteries
B. lungs
C. vena cava
D. coronary veins

C. vena cava

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Blood enters the left atrium from the:
A. coronary arteries
B. pulmonary veins
C. vena cava
D. coronary veins

B. pulmonary veins

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Which of the following is NOT a factor in the formation of blood clots?
A. Pumping function of the heart
B. Blood stasis
C. Ability of blood to clot
D. Changes to the walls of blood vessels

A. Pumping function of the heart

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The ________ link(s) the arterioles and the venules.
A. aorta
B. capillaries
C. vena cava
D. valves

B. capillaries

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________ are the key to the formation of blood clots.
A. Capillaries
B. White blood cells
C. Red blood cells
D. Platelets

D. Platelets

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Blood contains all of the following EXCEPT:
A. white blood cells
B. plasma
C. cerebrospinal fluid
D. platelets

C. cerebrospinal fluid

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________ is the circulation of blood within an organ or tissue in adequate amounts to meet the cells’ current needs for oxygen, nutrients, and waste removal.
A. Anatomy
B. Perfusion
C. Physiology
D. Conduction

B. Perfusion

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The ________ only require(s) a minimal blood supply when at rest.
A. brain
B. kidneys
C. skeletal muscles
D. heart

C. skeletal muscles

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What part of the human body helps the cardiovascular system adapt to changes in order to maintain homeostasis? A. Respiratory system B. Central nervous system C. Autonomic nervous system D. Musculoskeletal system

C. Autonomic nervous system

________ is inadequate tissue perfusion. A. Shock B. Hyperperfusion C. Hypertension D. Contraction

A. Shock

The brain and spinal cord usually cannot go for more than ________ minutes without perfusion, or the nerve cells will be permanently damaged. A. 30 to 45 B. 12 to 20 C. 8 to 10 D. 4 to 6

D. 4 to 6

Keeping the patient ________ is an important aspect of bleeding and trauma management. A. warm B. cold C. hypotensive D. hypertensive

A. warm

The body will not tolerate an acute blood loss of greater than ________ of blood volume. A. 10% B. 20% C. 30% D. 40%

B. 20%

If the typical adult loses more than 1 L of blood, significant changes in vital signs, such as ________, will occur. A. decreased heart rate B. increased respiratory rate C. increased blood pressure D. improved capillary refill time

B. increased respiratory rate

________ shock is a condition in which low blood volume results in inadequate perfusion or even death. A. Hypovolemic B. Metabolic C. Septic D. Psychogenic

A. Hypovolemic

Life-threatening external bleeding demands your immediate attention, even before the ________ has been managed. A. fracture B. extrication C. airway D. scene

C. airway

The process of blood clotting and plugging the hole is called: A. conglomeration B. configuration C. coagulation D. coalition

C. coagulation

Which of the following inhibits the body’s ability to control bleeding? A. Medications that interfere with normal clotting B. Wounds that are extremely small in size C. Increased constriction of the blood vessels D. Shifting of blood to protect organs

A. Medications that interfere with normal clotting

A lack of one or more of the blood’s clotting factors is called: A. a deficiency B. hemophilia C. platelet anomaly D. anemia

B. hemophilia

You respond to a 25-year-old man who has cut his arm with a circular saw. The bleeding appears to be bright red and spurting. The patient is alert and oriented and converses with you freely. He appears to be stable at this point. What is your first step in controlling his bleeding? A. Direct pressure B. Maintaining the airway C. Standard precautions D. Elevation

C. Standard precautions

When applying a bandage to hold a dressing in place, stretch the bandage tight enough to control the bleeding. You should still be able to ________ after the bandage is secure. A. palpate a distal pulse B. see bleeding through the dressing C. examine the wound D. remove the dressing

A. palpate a distal pulse

If bleeding continues after applying a pressure dressing, you should do all of the following EXCEPT: A. remove the dressing and apply another sterile dressing B. apply manual pressure through the dressing C. add more gauze pads over the first dressing D. secure both dressings tighter with a roller bandage

A. remove the dressing and apply another sterile dressing

When using an air splint to control bleeding in a fractured extremity, you should reassess the ________ frequently. A. airway B. breathing C. circulation in the injured extremity D. fracture site

C. circulation in the injured extremity

When treating a patient with signs and symptoms of hypovolemic shock and no outward signs of bleeding, always consider the possibility of bleeding into the: A. thoracic cavity B. abdomen C. skull D. chest

B. abdomen

Which of the following is NOT a cause of nontraumatic internal bleeding? A. Ulcer B. Ruptured ectopic pregnancy C. Aneurysm D. Laceration

D. Laceration

The most common symptom of internal abdominal bleeding is: A. bruising around the abdomen B. distention of the abdomen C. rigidity of the abdomen D. acute abdominal pain

D. acute abdominal pain

Signs and symptoms of internal bleeding in both trauma and medical patients include: A. hematemesis B. abrasions C. lacerations D. avulsions

A. hematemesis

The first sign of hypovolemic shock is a change in: A. respirations B. heart rate C. mental status D. blood pressure

C. mental status

True/False Venous blood tends to spurt and is difficult to control.

False

True/False The human body is tolerant of blood losses of greater than 20% of blood volume.

False

True/False The first step in controlling external bleeding is applying pressure to the proximal artery.

False

True/False The first step in preparing to treat a bleeding patient is standard precautions.

True

True/False A properly applied tourniquet should be loosened by the EMT every 10 minutes.

False

True/False You should only loosen a tourniquet if instructed to do so by medical control.

True

True/False If a wound continues to bleed after it is bandaged, you should remove the bandage and start over again.

False

True/False A tourniquet is always required for massive, spurting blood loss.

False

True/False You should provide high-flow oxygen whenever you suspect internal bleeding and signs of shock are present.

True

The ________ side of the heart circulates blood from the body to the lungs.

right

________ is the circulation of blood within an organ or tissue in adequate amounts to meet the cells’ current needs for oxygen, nutrients, and waste removal.

Perfusion

A(n) ________ is also called a contusion.

bruise

________ bleeding is any bleeding in a cavity or space inside the body.

Internal

A systolic blood pressure of less than ________ mm Hg with a weak, rapid pulse suggests the presence of hypoperfusion in a patient who may have significant bleeding.

100

________ is vomited blood.

Hematemesis

________ blood is dark red and oozes from a wound steadily but slowly.

Capillary

The ________ ________ system monitors the body’s needs from moment to moment and adjusts blood flow by changing the vascular tone, as needed.

autonomic nervous

________ are small tubes that are about the same diameter as a single red blood cell.

Capillaries

All organs depend on the ________ to provide a rich blood supply.

heart

The Left and Right Sides of the Heart A. Left pulmonary artery B. Aorta C. Superior vena cava D. Right pulmonary artery E. Right atrium F. Inferior vena cava G. Right ventricle H. Right pulmonary veins I. Oxygen-rich blood to head and upper body J. Aorta K. Left pulmonary veins L. Left atrium M. Left ventricle N. Oxygen-rich blood to lower body

Perfusion A. Artery B. Arterioles C. Capillaries D. Organ or tissue E. Capillaries F. Venules G. Vein

You and your partner respond to a patient who has had his hand nearly severed by a drill press. As you approach, you note that the patient is pale, and there appears to be a lot of blood on the floor. The wound continues to bleed copiously. After applying a tourniquet, you write ________ on a piece of adhesive tape and apply it to the patient’s forehead. 1. the patient’s name 2. your last name 3. the exact time applied 4. estimated amount of blood lossYou and your partner respond to a patient who has had his hand nearly severed by a drill press. As you approach, you note that the patient is pale, and there appears to be a lot of blood on the floor. The wound continues to bleed copiously. After applying a tourniquet, you write ________ on a piece of adhesive tape and apply it to the patient’s forehead. A. the patient’s name B. your last name C. the exact time applied D. estimated amount of blood loss

C. the exact time applied

D. not loosen the tourniquet after you have applied it

You are called to a playground for an 8-year-old girl who has an uncontrolled nosebleed. The child is crying and will not talk to you. The babysitter and other children present did not witness any trauma, but there is a bump on the temporal portion of the girl’s head. The babysitter does state that the girl has had a cold for several days but can give you no further information on her medical history. What could NOT be the possible cause of the bleeding? A. A skull fracture B. Sinusitis C. Coagulation disorder D. A temper tantrum

D. A temper tantrum

You respond to a 33-year-old man who was hit in the ear by a line drive during a softball game. He is complaining of a severe headache, ringing in his ears, and dizziness. He has blood draining from his ear. Why would you NOT apply pressure to control bleeding? A. It should be collected to be reinfused at the hospital. B. It could collect within the head and increase the pressure on the brain. C. It is contaminated. D. You could fracture the skull with the pressure needed to staunch the flow of blood.

B. It could collect within the head and increase the pressure on the brain.

You are dispatched to a store in the downtown mall for an arm injury. When you arrive, you are directed to a small stockroom where you find a teenage girl holding a blood-soaked cloth tightly on her left forearm. You notice blood droplets high up the wall and on the floor several feet from where she is sitting. “I was opening a shipment with a box cutter,” she says, her skin noticeably pale. “And it slipped and cut my arm. The blood spurted everywhere.” What type of bleeding should you anticipate? A. You should suspect heavy venous bleeding. B. She most likely has arterial bleeding. C. Internal bleeding is probably causing her skin to appear pale. D. Very sharp blades usually only cause capillary bleeding.

B. She most likely has arterial bleeding.

Short Answer Describe how the autonomic nervous system responds to severe bleeding.

Arteries; blood away from; veins; blood toward; to the heart; brain, lungs, and kidneys.

Short Answer Describe the characteristics of bleeding from each type of vessel (artery, vein, capillary).

Artery: Bright red, spurting Vein: Dark color with steady flow Capillary: Darker color, oozes

Short Answer List, in the proper sequence, the methods by which an EMT should attempt to control the external bleeding of an extremity.

1. Direct pressure and elevation 2. Pressure dressings 3. Tourniquets 4. Hemostatic agent/splints

Short Answer List at least 10 signs and symptoms of hypovolemic shock.

1. Tachycardia 2. Weakness, fainting, or dizziness on standing or at rest 3. Thirst 4. Nausea and vomiting 5. Cold, moist (clammy) skin 6. Shallow, rapid breathing 7. Dull eyes 8. Slightly dilated pupils, slow to respond to light 9. Capillary refill in infants and children of more than 2 seconds 10. Weak, rapid (thready) pulse 11. Decreasing blood pressure 12. Altered level of consciousness

Short Answer List, in the proper sequence, the general EMT emergency care for patients with internal bleeding.

1. Follow standard precautions. 2. Maintain the airway with cervical spine immobilization (if needed). 3. Administer high-flow oxygen and provide artificial ventilation as necessary. 4. Control all obvious external bleeding. 5. Treat suspected internal bleeding in an extremity by applying a splint. 6. Depending on local protocols, use a pelvic compression device or splint to control suspected internal bleeding from the pelvic area. 7. Monitor and record the patient’s vital signs at least every 5 minutes. 8. Keep the patient warm. 9. Give nothing by mouth, not even small sips of water. 10. Provide prompt transport for all patients with signs and symptoms of hypoperfusion. Report changes in condition to the emergency department.

Ambulance Calls You arrive at a local school playground for a 9-year-old boy with a minor laceration on his left wrist. The teacher, who is holding a blood-soaked dressing on the boy’s wound, tells you that she cannot stop the bleeding and that the boy has a history of hemophilia. The blood is steady, but not spurting, and dark in color. How would you best manage this patient?

Control bleeding with direct pressure, a pressure dressing, and a tourniquet if the previous steps are not effective. Consider applying oxygen (if needed), and place the patient in a position of comfort. Monitor the patient’s vital signs, and provide rapid transport.

Ambulance Calls You are dispatched to a local lumberyard for a machinery accident. When you arrive, you observe a man sitting on the ground, surrounded by coworkers. The very pale foreman runs up to you as you get out of the truck and says, “His shirt got caught in a chop saw. His arm got cut off just below the elbow.” As you approach, you see that the man is holding a blood-soaked towel to the shortened end of his right arm. How would you best manage this patient?

You must control bleeding through direct pressure, pressure dressings, and a tourniquet, as needed. You must also transport the amputated portion of the limb with the patient to the hospital. Quickly attempt to determine how much blood has been lost and assess his skin and vital signs because these will provide accurate indicators of the significance of blood loss. Place the patient in a position of comfort, consider applying oxygen as necessary, and provide prompt transport.

Ambulance Calls Your team is called to the local jail for an inmate who has injured his arm with a ballpoint pen. You find that he is bleeding continuously from a wound that is in the area of the antecubital vein of his left arm. How would you best manage this patient?

This is an isolated injury that, depending on the severity of the injury to the antecubital vein, can result in significant blood loss. Attempt to control the bleeding through direct pressure, pressure dressings, and a tourniquet, as needed. Something as benign as a pen can cause significant damage in the hands of a determined person.

When you are performing a scene size-up on a patient with external bleeding, the minimum standard precautions that should be taken are: A. gloves and gown B. gown and eye protection C. gloves and eye protection D. gown and face mask

C. gloves and eye protection

For a patient with suspected internal bleeding, you should assess circulation by checking the pulse for: A. rate and quality B. rate and rhythm C. quality and rhythm D. presence

A. rate and quality

If you have completed your primary assessment and transport decision on an unresponsive patient with a significant mechanism of injury, what components should be included in the secondary assessment? A. Quick check for life-threatening injuries B. Detailed, comprehensive exam C. Determination of scene safety D. A comprehensive reassessment

B. Detailed, comprehensive exam

Your severe external bleeding patient needs a detailed physical exam. When should it be performed? A. Immediately after the primary assessment B. During the reassessment C. When you arrive at the patient’s side D. En route to the hospital

D. En route to the hospital

Why are proper communications to the hospital needed when dealing with a patient with significant bleeding? A. Prompts the staff when to schedule breaks B. Allows the hospital time to contact the patient’s family C. Allows the hospital to prepare resources D. Encourages good rapport with the staff

C. Allows the hospital to prepare resources

Chapter 26 Workbook Flashcards

(83 cards)