Term
| (218) What additional risk factors contribute to diabetic neuropathy? |
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Definition
| High blood pressure, over weight, and over the age of 40 |
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Term
| (218) explain the four main types of neuropathies. |
|
Definition
Peripheral can cause either pain or loss of feeling in the toes, feet, legs, hands, and arms.
Autonomic causes changes to the organ systems like the digestive, sexual responses, and perspiration as well as the nerves that serve the heart.
Proximal neuropathy can cause pain the the thighs, hips or buttock that may lead to weakness in the legs.
Focal neuropathy results in the sudden weakness of one nerve or a group of nerves causing weakness or pain at the nerve site. |
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Term
| (218) Why is it important for all diabetic patients to perform daily foot care? |
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Definition
| Peripheral neuropathy can lead to changes in the patient's gait causing foor deformities such as hammertoes and the collapse of the midfoot (flattened arches) may occur. Blisters and sores appear on the numb areas of the foot because the pressure or injury goes unnoticed. |
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Term
| (218) With autonomic neuropathy, how are the heart and circulatory systems affected? |
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Definition
| the nerves interfere with the body's ability to adjust blood pressure and heart rate. The result is a sharp drop in blood pressure with position changes, or the heart rate remaining high instead of rising and falling in response to normal function or exercise. |
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Term
| (218) Which type of neuropathy is most often seen in older patients? |
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Definition
|
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Term
| (218) What is the primary treatment used to prevent or delay diabetic neuropathy? |
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Definition
| To bring the blood glucose levels within normal range. |
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Term
| (219) Explain the two main categories of seizures? |
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Definition
| Partial seizures occur in just one part of the brain. Generalized involves abnormal activity in may parts of the brain. |
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Term
|
Definition
| Epilepsy is a brain disorder in which clusters of nerve cells, or neurons in the brain sometimes signal abnormally. |
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Term
| (219) Give a brief explanation of the six subcategories of generalized seizures. |
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Definition
1.Absence seizure seem to be staring into space and or have twitching or jerking muscles. the individual is conscious, but unaware of their surroundings.
2.Tonic seizures cause stiffening of the large muscle groups of the body, generally those muscles in the legs, back and arms.
3.Clonic seizures cause repeated jerking movements of muscles on both sides of the body.
4.Myoclonic seizures cause jerks or twitches of the upper body, arms or legs.
5.Atonic seizures cause a loss in the normal muscle tone. A-meaning without, tonic-meaning tone or contraction.
6.Tonic-clonic seizures are a mixture of both the tonic and clonic seizure activities. |
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Term
| (219) What is one of the best ways to determine the type of seizure? |
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Definition
| Taking a detailed medical history, including symptoms and the duration of the seizures, is still one of the best methods to determine the type of seizure. |
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Term
| (219) When is a seizure considered life threatening, and what actions should the AMSC take. |
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Definition
| If an individual has a prolonged seizure more than 5 minutes, this is considered to be a life-threatening event possible needing life-saving measures to include oxygen, IV therapy, and possibly CPR and intubation. |
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Term
| (220) With a comatose patient, what aspects of patient care does the health care team concentrate on? |
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Definition
| Preventing infections and maintaining the patient's physical state. |
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Term
| (220) Who else is able to provide essential care for the unconscious or immobile patient an dhow is this care provided? |
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Definition
| Family members and friends. Some skills are easy to learn, such as changing a bed and providing skin care. Helping with personal care like bathing and using the toilet can also be learned. Some of the equipment that may be used is a portable commode, bedpan, or urinal. |
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Term
(220) Match the conditions listed below to either (A)tracheosomy or (B) Endotracheal tube type of artificial airway.
1) most common for long-term pediatric and neonatal patients.
2) cuffed tube used in conjunction with positive pressure ventilation.
3) cuff may cause mucosal ulceration in 5-7 days.
4) soft balloon cuff pressure is checked every 8hrs.
5) primarily used for long-term ventilatory support.
6) usually removed after 48-72 hrs.
7) Long-term complication of tracheal stenosis |
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Definition
1-B
2-A
3-B
4-A
5-A
6-B
7-B |
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Term
| (221) What are the two categories of patient assessment? |
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Definition
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Term
| (221) What are the main components of a trauma assessment? |
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Definition
| scene size-up, initial assessment, rapid trauma assessment, detailed physical exam. |
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Term
| (221) explain the three velocity categories. |
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Definition
1. Low velocity: the force of a hand usually makes these injuries, such as a stab wound with a knife. Injuries are limited to the area that was penetrated. Low velocity does not mean minimal injury. There may be multiple wounds, or the knife blade may have been moved inside the patient causing damage to multiple vital organs.
2. Medium velocity: handguns and shotguns usually cause these wounds. Some forcefully propelled item launched by an external force to produce more energy.
3. High velocity: Bullets propelled by a high-powered or assault rifle are of high velocity. |
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Term
| (221) What is the purpose of the initial assessment? |
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Definition
| To discover and deal with any life threatening problems. |
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Term
| (221) What are considered high priority patient conditions? |
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Definition
| Poor general impression, unresponsive, responsive but not following commands, difficulty breathing, shock, complicated childbirth, chest pain with systolic blood pressure less than 100, uncontrolled bleeding, severe pain anywhere. |
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Term
| (221) Explain the acronym DCAP-BTLS |
|
Definition
Deformities- altered appearance
Contusions- bruises
Abrasions- most common
Punctures/Penetrations- holes
Burns- ouch
Tenderness- pain upon palpation
Lacerations- cut/open wound may have significant bleeding under the skin
Swelling- very common with injured capillary bleeding under the skin |
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Term
| (221) When assessing a patient's neck during an RTA, what will you be evaluating? |
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Definition
| Jugular vein distension(JVD), Tracheal deviate(trachea shifts to one side, sign of a severe chest injury), stomas, medical alert tags, measure and apply cervical collar. |
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Term
| (221) At what point of the trauma assessment will you treat non-life threatening injuries? |
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Definition
| During the detailed physical exam. |
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Term
| (221) Explain the five categories of triage. |
|
Definition
1:minimal, color code green. Minor treatment required to minimize pain and suffering. This category also encompasses vitims and medical personnel either emotionally overwhelmed or physically overtaxed by the situation. Minimal patients are commonly called the "walking wounded"
2:Delayed, color code yellow. injury is serious, but a delay in treatment will not jeopordize life or limb to an unreasonable extent.
3. immediate, color code red. patients who require immediate treatment in order to save life or limb.
5. deceased, color code black. mortuary affairs notification is required for transport and disposition. When communicating over the radio, these casualties are referred to as "DELTAs" |
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Term
| (221) What are the marking you would use if triage tags were not available? |
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Definition
| "Dead" for dead, "I" for severely injured, or "D" for moderately injured. unmarked or untagged persons should be considered unevaluated. |
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Term
| (221) What are the six steps used in rapid extrication for the seated patient? |
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Definition
1. takes multiple persons to extricate.
2. manually stabilize and apply rigid collar.
3. at the direction of the individual holding stabilization, two additional persons will lift the patient and slide long spine board between the patient and the seat.
4. the two additional persons will reposition their hands ond holding the upper chest and arms, the other stabilizing the pelvis and legs.
5. then quickly secure patient to board and remove from vehicle.
6. assess distal PMS and transport. |
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Term
| (222) explain the normal flow of electrical conduction through the heart. |
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Definition
| the sinoatrial(SA) node generates an electrical impulse that travels through the right and left atrial muscles: the P wave represents atrial depolarization. The electrical impulse then continues to travel through specialized tissue (internal nodal pathways) leading the electricity to the atrioventricular (AV) node: the ventricular contraction is represented electrically on the ECG by the QRS complex. The T-wave represents the electrical changes in the ventricles as re-polarizing. |
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Term
| (222) why is the re-polarization of the atria's not seen on an ECG? |
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Definition
| The re-polarization of the atria is not seen on the ECG because the electrical activity of the ventricle is more powerful and is seen as the electrical activity in the QRS complex. |
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Term
| (222)What are likely causes of extrinsic mechanisms or arrhythmias? |
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Definition
| Cardiac drugs such as digoxin, lidocain, epinephrine, and isoproterenol, trauma, or heat exhaustion can stress the heart are extrinsic causes of arrhythmias. |
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Term
(222) Cardiac conditions and heart rhythms. may be more than one answer.
Lower chambers quiver
a. Pulseless v-tach
b. V-fib
c. PEA
d. Asystole |
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Definition
|
|
Term
(222) Cardiac conditions and heart rhythms. may be more than one answer.
Needs advanced life support and medication.
a. Pulseless v-tach
b. V-fib
c. PEA
d. Asystole |
|
Definition
|
|
Term
(222) Cardiac conditions and heart rhythms. may be more than one answer.
Caused by hypoxia
a. Pulseless v-tach
b. V-fib
c. PEA
d. Asystole |
|
Definition
|
|
Term
(222) Cardiac conditions and heart rhythms. may be more than one answer.
Ectopic pacemaker in ventricles
a. Pulseless v-tach
b. V-fib
c. PEA
d. Asystole |
|
Definition
|
|
Term
(222) Cardiac conditions and heart rhythms. may be more than one answer.
Caused by cardiac tamponade
a. Pulseless v-tach
b. V-fib
c. PEA
d. Asystole |
|
Definition
|
|
Term
| (222) Why is it important for early defibrillation when treating V-fib or Pulseless V-tach? |
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Definition
| When defibrillation is done withing the first minute, the survival rate is close to 90%. survival then decreases by 2-10% per minute. By 10minutes, chances of survival are almost none. This rapid decrease is primarily due to the depletion of the heart's energy stores by the fibrillating heart. |
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Term
| (223) A soldier's ability to cope with stress will increase when he or she gains confidence in what three elements? |
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Definition
| Self-confidence, the confidence in the equipment, and his or her fellow soldiers. |
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Term
| (223) Explain the fight or flight response a soldier may experience on the battlefield. |
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Definition
| the soldier is torn between the will to survive, the need to escape or run. |
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Term
| (223) why is it important that the combat stress patient does not identify himself or herself as a sick patient? |
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Definition
| they increase the likelihood of returning to duty. |
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Term
| (223) What are the six individual principles of BICEPS? |
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Definition
| Brevity, Immediacy, Centrality, Expectancy, Proximity, and Simplicity. |
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Term
| (223) When using BICEPS principles, combat stress patients should be treated no longer than how many hours? |
|
Definition
|
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Term
| (223) Explain the proximity principle of BICEPS |
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Definition
| Care is provided in an area as close as possible to the individual's unit of assignment. This again enforces the idea that the individual will be returning to the unit; it also allows the opportunity to maintain unit bonding. |
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Term
| (223) Battle fatigue causalities should be allowed to rest for a minimum of how many hours? |
|
Definition
|
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Term
| (223) What kind of support can the AMSC provide for the combat stress patient? |
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Definition
| Helping individuals gain an understanding of the symptoms they're having. help to provide a way for the individuals to express their feelings, and never respond with criticism, but acceptance. Bolster the individual's coping mechanism. |
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Term
| (224) Heat casualties are the result of the interaction of what three factors? |
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Definition
| The soldier, The external heat stress from the environment and the internal heat stress required by the mission. |
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Term
| (224) In hot environments, how much water can a soldier lose and what is the maxiumum fluid intake? |
|
Definition
15liters per day loss
do not exceed 12quarts per day intake. |
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Term
| (224) Explain hyponatremia: the cause and the side effects. |
|
Definition
| Low blood sodium generally happens after drinking too much plain water, over several hours, hyponatremia can lead to damage of certain kinds of tissues in the body. Changes are most noticeable in the nervous system, where seizures, coma, and even death can result. |
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Term
| (224) During a continuous easy work schedule, what is the fluid replacement guidelin for the heat category red? |
|
Definition
|
|
Term
| (224) What is the WBGT index? |
|
Definition
| The standard metric for environmental stress. |
|
|
Term
| (224) The rate at which sweat can evaporate is also known as what? |
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Definition
|
|
Term
| (224) What three elements are taken into consideration for work intensity? |
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Definition
| Work intensity in MOPP 0-1, Work intensity in MOPP 2-4, activity. |
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Term
| (224) What is the average caloric intake of a typical adult and the caloric intake needed by a member of the special forces? |
|
Definition
Typical adult requires 1500-2000
special forces 6000-8000 calories a day |
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Term
| (224) Performance eating nutrition should include what percentage of carbohydrates, protein, and fat of the total caloric intake? |
|
Definition
Carbohydrates 55-70%
Protein 12-15%
Fat 30-35% |
|
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Term
| (224) Explain sustained and continuous operations. |
|
Definition
| During sustained operations, warfighters get less than four hours sleep each night, which is considered severe sleep restriction or deprivation. Sustained operations can go on for days. Continuous operations, warfighters get four or more but less than seven hours sleep each night, which is considered mild to moderate sleep restriction. Continuous operations can go on for weeks or months. |
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|
Term
(218) What are the four types of diabetic neuropathy?
a. autonomic, peripheral, focal, proximal.
b. generalized, partial, proximal, autonomic
c. partial, focal, generalized, peripheral
d. focal, progressive, autonomic, generalized |
|
Definition
| a. autonomic, peripheral, focal, proximal. |
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Term
(218) Autonomic neuropathy affects the body system that
a. restores blood glucose levels to normal after a hypoglycemic episode
b. provides the chemical trigger to rest the body after a hyperglycemic event
c. increases urination to excrete blood glucose faster after a hyperglycemic event
d. decreases the respiraions, and increases the heart rate after a hypoglycemic event. |
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Definition
| a. restores blood glucose levels to normal after a hypoglycemic episode |
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Term
(219) When is a seizure considered a life-threatening emergency?
a. as soon as it begins.
b. if the individual has not taken any medication
c. when the seizure occurs in a public place
d. after five minutes of seizure activity. |
|
Definition
| d. after five minutes of seizure activity. |
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Term
(220) Individuals in a persistent vegitative state retain
a. all normal body functions
b. responsiveness to the environment
c. communication through blinking
d. noncognitive function and normal sleep patterns |
|
Definition
|
|
Term
(220) For patients who are immobile, a primary nursing care is to
a. assist the patient in the abscence of the family
b. schedule physical therapy appointments
c. prevention of pneumonia and bed sores
d. teach the family how to care for the patient |
|
Definition
| c. prevention of pneumonia and bed sores |
|
|
Term
(220) An endotracheal tube is used
a. for short term treatment
b. on adults only
c. for long term treatment
d. for children only |
|
Definition
| a. for short term treatment |
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Term
(220) Ensuring the proper placement of an endotracheal tube is accomplished by what means?
a. aspirating fluid from the lungs
b. auscultation or chest x-ray
c. by irrigating the tube to check for bubbling
d. to mark the tube where the patients lips rest |
|
Definition
| b. auscultation or chest x-ray |
|
|
Term
(221) High priority patient conditions include all of the following except
a. shock
b. responsive but not able to follow commands
c. chest pain with systolic blood pressure less than 150
d. difficulty breathing with respirations of 30 per minute |
|
Definition
| c. chest pain with systolic blood pressure less than 150 |
|
|
Term
(221) all of the following are recognized civilian triage colors except
a. red
b. green
c. yellow
d. blue |
|
Definition
|
|
Term
(222) what arrhythmia is represented by no electrical activity in the heart?
a. asystole
b. ventricular fibrillation
c. pulseless electrical activity (PEA)
d. pulseless ventricular tachycardia |
|
Definition
|
|
Term
(223) During combat situations military fighting forces are expected to be affected by combat stress when
a. they have killed the enemy
b. fighting on the front lines
c. they witness death of another soldier
d. exposed to continuous combat for more than 100 days |
|
Definition
| d. exposed to continuous combat for more than 100 days |
|
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Term
(223) Individual suffering from combat stress should be
a. considered ill
b. isolated from all others
c. allowed to carry out normal activities
d. allowed to provide simple care for other patients |
|
Definition
| c. allowed to carry out normal activities |
|
|
Term
(223) When using the principles of BICEPS, what is the "E"?
a. evacuation
b. expectancy
c. evaluation
d. extreme |
|
Definition
|
|
Term
(223) Most combat stress patients are returned to their unit
a. between 24-48hrs
b. after 72hrs
c. before they become combative
d. after receiving 12hrs of sleep |
|
Definition
|
|
Term
(224) the need for water intake is
a. necessary when soldiers are thirsty
b. the medical officers responsibility
c. the security sergeants responsibility
d. necessary even when soldiers are not thirsty |
|
Definition
| d. necessary even when soldiers are not thirsty |
|
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Term
(224) Fluid intake should not exceed
a. 5 quarts per day
b. 1/2 quart per hour
c. 20 quarts per day
d. 1 1/2 quarts per hour |
|
Definition
|
|
Term
(224) What is the principle component of the wet globe temperature?
a. humidity
b. wind
c. cloud cover
d. time of day |
|
Definition
|
|
Term
(224) The activity level of cleaning a rifle is considered
a. light
b. heavy
c. very light
d. moderate |
|
Definition
|
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