Lecture #15

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Author:
jessjohnson0617
ID:
218312
Filename:
Lecture #15
Updated:
2013-05-08 16:48:40
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Thurston County EMT
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Description:
Multicultural Awareness, Geriatrics, Patients with Special Challenges
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  1. What is culture?
    • our way of life
    • the way we do things
    • the way we hear what others are saying
    • the way we see what is around us
  2. African Americans report higher rates of these two diseases.
    • diabetes
    • obesity
  3. Death from diabetes occurs at ___ times the average rate in African Americans
    3 times
  4. Infant mortality is 2 times the average rate in these two ethnic groups
    • African American
    • American Indian/Alaskan Natives
  5. These 3 ethnic groups report an increased risk of cervical cancer at 2 times the average rate.
    • African Americans
    • Pacific Islanders
    • American Indians
  6. The risk of tuberculosis is ____ times the average rate in Asians
    15 times
  7. The risk of tuberculosis is 7 times the average rate in this ethnic group
    American Indians
  8. African Americans and Hispanics have an increased risk of tuberculosis at ___ times the average rate
    6 times
  9. What is the definition of cultural competence?
    The ability to be effecting in providing care in diverse settings and to diverse populations
  10. What are the possible negative things that could happen in the cardiovascular system of geriatric patients?
    • stenosis (hardening)
    • cardiac hypertrophy (larger heart)
    • dysrhythmias
    • arteriosclerosis
    • orthostatic hypotension (postural hypotension)
  11. What are the possible negative things that could happen in the respiratory system of geriatric patients?
    • decrease in size and strength of muscle tissue used for respiration and smooth muscle fibers
    • diminished resistance to infection
  12. What are the possible negative things that could happen in the nervous system of geriatric patients?
    • decrease in brain mass/weight
    • altered ability to perceive hunger and thirst
    • diminished sensory perception
    • diminished vision - cataracts, glaucoma, macular degeneration, retinal detachment
    • neuropathy (loss of sensation in nerves)
  13. What are the possible negative things that could happen in the gastrointestinal system of geriatric patients?
    • malnutrition due to reduction in taste/smell, deterioration in structures of mouth, drop in salivary flow, decrease in smooth muscle contraction
    • liver decreases in size, weight and funtion
    • peristalsis (digestion) is slowed
    • constipation is common
  14. What are the possible negative things that could happen in the endocrine system of geriatric patients?
    • increase in hormones contributing to fluid imbalance and hypertension
    • drop in responsiveness to insulin
    • elevation in blood sugar lvls
  15. What are the possible negative things that could happen in the musculoskeletal system of geriatric patients?
    • osteoporosis (brittle bones)
    • kyphosis (roundback)
    • decreased joint flexibility and ROM
    • pain with movement
  16. What are the possible negative things that could happen in the renal system of geriatric patients?
    • kidneys become smaller = less filtration
    • electrolyte distribution disrupted
  17. What are the possible negative things that could happen in the integumentary (skin) system of geriatric patients?
    • skin becomes thinner
    • tendency for sores and tearing injuries
    • less perspiration
    • dulled sense of touch
    • diminished protective barrier
  18. What are beta blockers
    reduce how hard and how fast the heart pumps
  19. What are blood thinnners?
    they reduce the body's ability to form clots
  20. What are diuretics?
    reduce the amount of fluid in the body (mainly for ppl with CHF)
  21. What are the changes in vitals in elderly patients?
    • hypertension
    • increased chance of postural hypotension
    • decreased skin temp
    • increased chance of irregular pulse
    • pulse rate may not increase with shock
  22. What are all the possible causes for dyspnea in elderly patients?
    • CHF
    • chronic bronchitits
    • pulmonary embolism
    • pulmonary edema
    • pnuemonia
    • MI
    • asthma
    • emphysema
  23. What does FAST stand for?
    • Facial droop
    • Arm drift
    • Slurred speech
    • Time
  24. What is TIA?
    • transient ischemic attack
    • temporary stroke (symptoms do not stay)
  25. What is the most common fracture in the elderly?
    hip fractures
  26. What is the difference between a hip and a pelvic fracture?
    • hip: most commonly occur in the femoral neck
    • pelvic: fracture of the pelvic bone
  27. What is the pain management protocol?
    • attempt all non pharmacological measures first
    • reassess vitals and physical signs of pain
    • if pt fits the criteria and rates the pain at least 7/10 and states that they would like and IV injection
  28. List the symptoms and location for an upper GI bleed
    • vomiting bright red blood or "coffee grounds"
    • could be in the esophagus, stomach, or duedenim
  29. List the symptoms for a lower GI bleed
    melana = dark tarry stools
  30. Describe a vulnerable adult
    • greater than 60 y/o and unable to care for themselves
    • an adult living in a nursing home, boarding home or adult family home
    • adult with developmental disability
    • adult with legal guardian
    • adult receiving personal care services in own or family's home
  31. List the the 8 ways make a home safer for the elderly
    • eliminate throw rugs
    • install arm rests on chairs
    • replace low back chairs with high back chairs
    • eliminate rolling chairs
    • maintain temp of 72 degrees in winter
    • install slip resistant mats in bathrooms
    • install handrails on stairways
  32. What are the possible vision impairments?
    • glaucoma
    • cataracts
    • diabetic retinopathy
  33. What are the possible speech imparments
    • dysarthria (slurred speech)
    • voice production disorders
    • language disorders
  34. What is dysphagia?
    difficulty swallowing
  35. What is dysphasia
    impaired speech (word salad)
  36. What is aphagia
    unable to swallow
  37. what is aphasia
    unable to speak
  38. What is BiPAP and CPAP
    • assists with every ventilation with uninterrupted pressure
    • keeps bronchioles open during exhalation to improve oxygenation
    • pt who have COPD and sleep apnea use these
  39. What are possible problems with dialysis?
    syncope because too much fluid loss causing hypotension
  40. What are the obvious signs of death?
    • body positioning incompatible with life
    • rigor mortis
    • incineration
    • decapitation
    • decomposition
    • livor mortis
    • evisceration
  41. What does POLST stand for?
    physicians orders on life saving treatment
  42. What are the three situation in which documentation allows the EMT to withhold treatment?
    • POLST form with part A checked (DNAR)
    • patient is in licensed nursing home with a DNR order signed by a physician
    • documentation that the patient is enrolled in hospice
  43. In an MCI, what the qualifications for a black tag?
    apneic pts who do not start breathing with airway positioning
  44. Unless a supervising physician orders otherwise, these patients should have resuscitative efforts begun and transported to nearest hospital
    • hypothermic
    • possible drug OD
    • electricution
    • lightening strikes
    • drowning

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