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Index
»
Paramedic chapter 11
»
Chapter 1
»
Level 1
level: Level 1
Questions and Answers List
level questions: Level 1
Question
Answer
Abnormal breath sounds, such as wheezing, Rhonchi, crackles, strider, and pleural friction rubs
Adventitious breath sounds
A determination made when assessing mental status by looking at whether the patient is oriented in four areas: person, place, time, and the event itself. Each element provides information about different aspects of the patient’s memory
Alert and oriented (AxO)
Unequal pupils with a greater than 1-mm difference
Anisocoria
The language impairment that affects the production or understanding of speech and the ability to read or write
Aphasia
An episode characterized by some combination of apnea (central or obstructive), color change (cyanosis, pallid, Erythematosus, or plethoras) change in muscle tone (usually diminished), and choking or gagging
Apparent life- threatening event (ALTE)
Abnormal accumulation of fluid in the peritoneal cavity; typically signals liver failure
Ascites
The entry of fluids or solids into th trachea, bronchi, and lungs; the act of drawing material in or out by suction
Aspiration
The act of using a stethoscope to listen to sounds within the body
Auscultation
A method of assessing mental status by determining whether a patient is awake and alert, responsive to verbal stimuli or pain, or unresponsive; used principally in the primary survey
AVPU
Bruising over the mastoid process, which may indicate a basilar skull fracture; also known as retroauricular ecchymosis or raccoon eyes
battle sign
The combination of a narrowed pulse pressure, muffled heart tones, and jugular venous distinction associated with cardiac tamponade; usually caused by penetrating chest trauma
Beck triad
The measurement of the force exerted against the walls of teh blood vessels as the heart contracts and relaxes; it is calculated as the product of cardiac output and peripheral vascular resistance
Blood pressure (BP)
Hollow, tubular, lower-pitched sounds heard over the trachea
Bronchial sounds
A test of decreased breath sounds performed by placing the diaphragm of the stethoscope over the area in question while the patient says “ninety nine;” a loud, clear sound indicates lung consolidation
Bronchophony
A combination of the tracheal and vesicular breath sounds; heard where airways and alveoli are found, in the upper part of the sternum and between the scapulae
Bronchovesicular sounds
An abnormal whooshing sound of turbulent blood flow moving through a narrowed artery; usually heard in the carotid arteries
Bruit
The use of a noninvasive diagnostic tool that can quickly and efficiently provide information on a patient’s ventilator and circulatory status with a graphic and digital depiction similar to an electrocardiogram
Capnography
The use of a capnometer, which is a monitoring device used to measure the amount of expired carbon dioxide. The reading is usually given as a digital reading
Capnometry
Ear wax
Cerumen
The reason the patient is seeking help
Chief complaint
Wet rattling, bubbling, or crackling lung sounds indicative of fluid in the small airways; aka rales
Crackles
A crackling, grating, or grinding sound often heard when fragments of broken bones rub together
Crepitus
A composite picture of a number of factors in a patient’s life, such as dietary habits, current medications, allergies, exercise, alcohol or tobacco use, recreational drug use, sleep patterns and disorders, and immunizations
Current health status
The combination of a slowing pulse, rising blood pressure, and an erratic respiratory pattern; a grave sign for patients with head trauma or cerebrovascular accident
Cushing reflex
A blue-gray skin color that is caused by inadequate levels of oxygen in the blood
Cyanosis
An acute confusional state characterized by global impairment of thinking, perception, judgement, and memory
Delirium
The gradual and pervasive deterioration or loss of cognitive cortical functions
Dementia
Excessive sweating; it is often associated with shock
Diaphoresis
The result of residual pressure in the circulatory system while the left ventricle is relaxing (is, in diastole)
Diastolic pressure
The process of weighing the probability of one disease versus other diseases by comparing clinical findings that could account for a patient’s illness; also refers to teh list of possible conditions considered based on the patient’s signs and symptoms
Differential diagnosis
Double vision
Diplopia
Localized bruising or collection of blood within or under the skin
Ecchymosis
A test of decreased breath sounds performed by placing the diaphragm of the stethoscope over the area in question while the patient saying a drawn-out “eee;” and “A” sound indicates lung consolidation
Egophony
A field conclusion of the patient’s problem based on the clinical presentation and the exclusion of other possible causes through considering the differential diagnoses
Field impression
A type of physical exam that is typically performed on responsive patient who have sustained an isolated injury. This type of exam is based on the chief complaint and focuses on one body system or part
Focused exam
A systematic head to toe exam performed during the secondary assessment of a patient who has sustained a significant mechanism of injury, is unresponsive, or is in critical condition
Full body exam
The overal initial impression that determines the priority of patient care; based on the patient’s surroundings, the mechanism of injury, signs and symptoms, and the chief complaint
General impression
An evaluation tool used to determine level of consciousness by evaluating and assigning point values (scores) for eye opening, verbal response, and motor response, which are then totaled; effective in helping predict patient outcoes
GCS
Contraction of teh abdominal muscles indicating peritoneal irritation
Guarding
The perception that the heart is beating very strongly; felt upon palpating of the chest wall, this finding suggests hypertrophy; aka lift
Heave
A narrative detail of the symptoms that a patient is experiencing, usually obtained using the OPQRST mnemonic
History of teh present illness
Related to a side effect or complication of medications or other medical treatment
Iatrogenic
Looking at the patient, either in general or at a specific area (ie a patients overall appearance from the door was, versus looking specifically at the chest wall for abnormalities/deformities)
Inspection
The visible bulging of teh jugular veins when a patient is in semi-Fowler or full Fowler position; indicates inadequate blood movement through the heart and or lungs
JVD
Sounds related to blood pressure measurement that are heard by stethoscope
Korotkoff sounds
Outward curve of the thoracic spine
Kyphosis
Localized areas of the skin that do not resemble the area surrounding it
Lesions
A sensation felt upon palpating of teh chest wall, in which the heart beats extremely strongly; suggests hypertrophy; aka heave
Lift
Inward curve of the lumbar spine just above the buttocks. An exaggerated form results in the condition known as swayback
Lordosis
The series of events that result in traumatic injuries; teh forces that act on the body to cause injury
MOI
A blotchy pattern on the skin; a typical finding in states of severe protracted hypoperfuion and shock
Mottling
An abnormal whooshing sound heard over teh heart that indicates turbulent blood flow around a cardiac valve
Murmur
The general type of illness a patient is apparently experiencing
NOI
An instrument used to examine. Patient’s eyes and view the retina and aqueous fluid; consists of a concave mirror and a artery-powered light that is usually contained in the handle
Ophthalmoscope
Multiple sets of vital signs taken from he patient in different positions. (For example, in the supine and sitting or standing positions) to determine the degree of hypovolemic; aka tilt test
Orthostatic vital signs
An instrument used to examine the ears of a patient; consists of a head and a handle. The head contains and electric light source and a low-power magnifying lensS
Otoscope
Paleness
Pallor
Physical touching for the purpose of obtaining information (for example, to detect tenderness)
Palpation
Tingling feeling or sensory change
Paresthesias
Information obtained during the history-taking process, such as the patient’s general state of health, childhood and adult diseases, surgeries and hospitalizations, psychiatric and mental illnesses, or traumatic injuries, which may relate to the patient’s current codnition
Past medical history
A fracture that occurs when normal forces are applied to abnormal bone structures
Pathological fracture
Information about the patient’s chief complaint, present symptoms, and previous illnesses
Patient history
Gently striking the surface of the body, typically overlying various body cavities, to detect changes in teh densities of the underlying structures
Percussion
The circulation of oxygenated blood through the body tissues and vessels
Perfusion
The absence of certain signs and symptoms normally expected fo specific illnesses or conditions; these findings warrant no medical ca or intervention, but demonstrate the thoroughness of the patient exam and history
Pertinent negatives
Squeaking or grating sounds that occur when the pleural linings rub together, which may be heard oninspiration, expiration, or both; commonly caused by inflammation of the pleura
Pleural friction rubs
The part of the assessment process that focuses on identifying immediate or potential life- threatening conditions so you can initiate lifesaving care
Primary survey
Reflex reactions such as babinski, grasping, and sucking signs normally found in infants
Primitive reflexes
The drifting of one arm downward toward a patient’s feet while he or she holds out his or her arms, plan side up, with his or her eyes shut; can be a sign of a stroke
Pronator drift
The perception of the position and movement of the body or limbs
Prprioception
The wave of pressure created as the heart contracts and forces blood out the left ventricle and into the major arteries; palpated at a point where an artery passes close to a bone
Pulse
An assessment tool used to measure oxygen saturation of hemoglobin in the capillary beds
Pulse oximetry
A 60-90 second non systematic review and palpation of the patient’s body to identify injuries that must be managed or protected immediately; aka the rapid full body sweep
Rapid full body scan
The portion of the assessment process in which a patient’s condition is reevaluated and responses to treatment is assessed
Reassessment
Involuntary motor responses to a specific sensory stimuli, such as a tap on the knee or stroking the eyelash
Reflexes
Coarse, low pitched breath sounds heard in patients with chronic mucus in the upper airways
Rhonchi
A clinically important sign characterized by marked peritoneal irritation and guarding, indicating an injury or illness for which urgent surgical intervention may be required
Rigidity
Redness; one of the classic signs of inflammation
Rubor
A step in the patient assessment process involving a quick assessment of the scene and its surroundings to gather information about the overall safety and stability of the scene and the MOI or NOI. This process is carried out before you enter and begin patient care
Scene size up
Sideways curvature of the spine
Scoliosis
The process by which more detailed, quantifiable, objective information is obtained from the patient about his or her overall state of health
Secondary assessment
Objective observations that can be seen, heard, felt, smelled, or measured
Signs
A subsection of teh patient history that provides valuable information regarding the patient’s overall health status and helps to identify risk factors for various disease processes; includes items such as tobacco use, alcohol and drug use, sexual behavior, diet, travel history, living environment and occupation
Social history
A blood pressure cuff
Sphygmomanometer
In the context of heart sounds, a situation in which events on the right side of heart occur slightly later than those on the left side, and create two discernible sounds rather than one heart sound
Splitting
A harsh, high pitched respiratory sound produced as air moves past an obstruction within or immediately above the glottis opening; associated with severe upper airway obstruction
Stridor
Subjective infomation the patient feels, such as pain, discomfort or other abnormality
Symptoms
BP created by the left ventricle as it contracts (that is, In systole)
Systolic pressure
A condition in which the skin slowly retracts after being pinched and pulled away slightly from the body; a sign of dehydration
Tenting
A humming vibration that an be palpated through the chest wall, suggesting n underlying bruit or murmur
Thrill
A fracture that occurs when abnormal forces are applied to normal bone structures
Traumatic fracture
Loss of skin elasticity
Turgor
Narrowing of teh diameter of blood vessel
Vasoconstriction
Widening of teh diameter of blood vessel
Vasodilation
Normal breath sounds made by air moving in and out of the alveoli
Vesicular sounds
Determined by the ability or inability to see, and by how far
Visual acuity
A high pitched whistling sound that may be heard on inspiration, expiration, or both, indicating air movement through a constricted lower air way, as in asthma
Wheezing
A test of decreased breath sounds performed by placing the diaphragm of the stethoscope over the area in question as the patient whispers “ninety nine;” a loud, clear sound indicates lungconsolidation
Whispered pectoriloquy
The one diagnosis from a differential list used to base the patient’s treatment plan
Working diagnosis