Chapter 17 Endocrine and Hematologic Emergencies

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Chapter 17 Endocrine and Hematologic Emergencies
2014-03-23 18:49:44
Endocrine Hematologic Emergencies

Chapter 17 Endocrine and Hematologic Emergencies
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  1. The sweet or fruity odor on the breath of a diabetic patient is caused by ____ in the blood.
  2. The onset of hypoglycemia can occur within:
  3. Blood glucose levels are measured in:
  4. Always suspect hypoglycemia in patients with an:
    altered mental status
  5. Signs and symptoms of hypoglycemia include ____ or ____ behavior.
    • anxious
    • combative
  6. The patient in insulin shock is experiencing:
  7. Insulin shock can develop more often and more severely in children than in adults due to their:
    high activity level and failure to maintain a strict schedule of eating.
  8. A person in insulin shock or diabetic coma may appear to be:
  9. Do hemophilia A and B have the same signs and symptoms?
  10. Can many adults control diabetes through diet alone?
  11. Hematologic emergencies are ____ in most EMS systems.
  12. The main function of the endocrine system is to maintain:
  13. Diabetes affects about _% of the population.
  14. Diabetes can have severe complications such as:
    • Blindness
    • Cardiovascular disease
    • Kidney failure
  15. Hyperglycemia can result in ____ or ____.
    • coma
    • death
  16. Another name for glucose:
  17. Diabetes mellitus (diabetes’ full name) means “____ ____,” which refers to the presence of wasted glucose in the urine.
    sweet diabetes
  18. Diabetes ____ is a rare condition involving excessive urination.  The hormone that regulates urinary fluid reabsorption is missing.
  19. List of non–insulin-type oral medications stimulate pancreas to produce more insulin:
    • Chlorpropamide (Diabinese)
    • Tolbutamide (Orinase)
    • Glyburide (Micronase)
    • Glipizide (Glucotrol)
    • Metformin (Glucophage)
    • Rosiglitazone (Avandia)
  20. Normal glucose levels:
    80 to 120 mg/dL
  21. The classic symptoms of uncontrolled diabetes are as follows (the “3 Ps”):
    • Polyuria is frequent, plentiful urination.
    • Polydipsia is frequent drinking to satisfy continuous thirst.
    • Polyphagia is excessive eating as the result of cellular hunger (a rare symptom).
  22. Frequent, plentiful urination.
  23. Frequent drinking to satisfy continuous thirst.
  24. Excessive eating as the result of cellular hunger.
  25. Ketones and fatty acids accumulate in blood and tissue (____) when fat is used for energy.
  26. Diabetic ____ (DKA) is a form of acidosis seen in uncontrolled diabetes.
  27. Six signs and symptoms of diabetic ketoacidosis (DKA) include:
    • Weakness
    • Nausea
    • Weak, rapid pulse
    • Kussmaul respirations, which “blow off” excess acids
    • Sweet-smelling breath, caused by ketones
    • Altered mental status
  28. Without proper fluid and insulin to reverse fat metabolism and restore glucose use for energy, ____ can progress to coma and death.
  29. Type 2 diabetes more often results in:
    hyperosmolar hyperglycemic nonketotic coma (HHNC).
  30. Which onset is slower, more gradual?  HHNC or DKA?
  31. With ____, sweet smell is not present on the breath because the body does not burn fat for energy.
  32. With ____, the body tries to get rid of excess sugar through urine, causing dehydration.
  33. If left untreated, hyperglycemia can result in:
  34. ____ ____ (diabetic coma) is a state of unconsciousness resulting from DKA, hyperglycemia, and/or dehydration due to excessive urination.
    Hyperglycemic crisis
  35. ____ ____ (insulin shock) is the result of insufficient levels of glucose in the blood (hypoglycemia).
    Hypoglycemic crisis
  36. Hyperglycemic crisis is also known as:
    diabetic coma
  37. Hypoglycemic crisis is also known as:
    insulin shock
  38. The condition is quickly reversed by giving the patient glucose.
    insulin shock
  39. Use gloves and eye protection at a minimum for ____ emergencies.
  40. Rapid and deep respirations are ____ respirations.
  41. Dry, warm skin:
  42. Moist, pale skin:
  43. If patient has eaten but not taken insulin, ____ is more likely.
  44. If patient has taken insulin but not eaten, ____ is more likely.
  45. Kussmaul respirations =
  46. Seizures are more likely a sign of ____ crisis.
  47. One tube of oral glucose gel contains one __-g dose.
  48. The only contraindications for glucose gel are the inability to ____ and ____.
    • swallow
    • unconsciousness
  49. Red blood cells make up __% of male and __% of female blood volume.
    • 47
    • 42
  50. People with sickle cell disease have red blood cells that are oblong or sickle shaped, contain hemoglobin S, are poor oxygen carriers, and live for only __ days.
  51. Sickle cell disease can result in:
  52. ____ ____ may lodge in small blood vessels or spleen, causing swelling, rupture, and ultimately death.
    Sickle cells
  53. Normal red blood cells are round, contain hemoglobin _, and live ___ days.
    • A
    • 120
  54. There are four main types of sickle cell crises:
    • Vaso-occlusive crisis
    • Aplastic crisis
    • Hemolytic crisis
    • Splenic sequestration crisis
  55. -Blood flow to organs becomes restricted causing pain, ischemia, and organ damage (lasts 5–7 days).
    -Circulation to spleen is usually obstructed due to narrow vessels and function of removing damaged red blood cells.
    Vaso-occlusive crisis
  56. -____ ____ is a worsening of a patient’s baseline anemia.
    -Lack of circulating red blood cells in the body causes tachycardia, pallor, and fatigue
    -May be caused by the parvovirus B19, which affects the production of new red blood cells, nearly stopping it for 2–3 days.
    Aplastic crisis
  57. ____ ____ is an acute, accelerated drop in hemoglobin level caused by red blood cells breaking down at a faster rate than normal and is common in patients with an enzyme deficiency.
    Hemolytic crisis
  58. ____ ____ crisis is painful, acute enlargement of the spleen.  The abdomen becomes very hard and bloated.
    Splenic sequestration
  59. The development of a blood clot, occurring in arterial or venous blood vessels.
  60. The tendency to develop blood clots.
  61. A congenital abnormality in which the body is unable to produce clots.
  62. Two types of hemophilia:
    A and B
  63. Most common type of hemophilia with low levels of factor VIII:
    Hemophilia A
  64. Type of hemophilia with a deficiency of factor IX.
    Hemophilia B
  65. What level of glucose causes excess glucose to be excreted by the kidney?
    200 mg/dL
  66. Diabetic ketoacidosis occurs when:
    A. the pancreas produces excess insulin.
    B. blood glucose levels rapidly fall.
    C. insulin is not available in the body.
    D. the cells rapidly metabolize glucose.
    C. insulin is not available in the body.
    (this multiple choice question has been scrambled)