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pt. with special challenges EMT

Vagal nerve stimulators may be an alternative treatment to medication for patients with:
chronic seizure disorders.
Spina bifida is MOST accurately defined as:
a birth defect caused by incomplete closure of the spinal column.
Airway management can be challenging in patients with Down syndrome because their:
teeth are misaligned and they have a large tongue
In contrast to an automated implanted cardioverter/defibrillator, an internal cardiac pacemaker:
regulates the patient’s heart rate if it falls below a preset value.
You are assessing a 440-lb man who complains of shortness of breath and lower back pain. The patient is conscious and alert, his blood pressure is 148/98 mm Hg, and his heart rate is 120 beats/min. Your MOST immediate action should be to:
avoid placing him in a supine position if possible and administer oxygen.
When assessing or providing care to a patient with a developmental disability, you should:
be observant for signs of fear or reluctance from the patient.
Which of the following statements regarding patients with developmental disabilities is correct?
Patients with developmental disabilities are susceptible to the same disease processes as other patients.
The tip of a central venous catheter rests in the:
vena cava.
A significant number of patients with cerebral palsy also have:
a seizure disorder.
An important aspect in the assessment of a patient who experienced a previous brain injury involves:
speaking with the patient and family to establish what is considered normal for the patient
Autism is MOST accurately defined as a:
pervasive developmental disorder characterized by impairment of social interaction.
A service dog is easily identified by its:
harness
The purpose of a ventricular peritoneum shunt is to:
Prevent excess cerebrospinal fluid from accumulating in the brain.
Common complications associated with central venous catheters include all of the following, EXCEPT:
rupture of a central vein
Patients with autism:
have extreme difficulty with complex tasks that require many steps.
When interacting with a developmentally disabled patient, the best approach is to:
ask your team members to wait until you can establish a rapport with the patient.
You receive a call to a residence for an apneic 2-month-old male. When you arrive at the scene, the infant’s mother tells you that her son was born prematurely and that his apnea monitor has alarmed 4 times in the past 30 minutes. Your assessment of the infant reveals that he is conscious and active. His skin is pink and dry, and he is breathing at an adequate rate and with adequate tidal depth. His oxygen saturation reads 98% on room air. You should:
transport the infant to the hospital and bring the apnea monitor with you.
Which of the following statements regarding gastrostomy (gastric) tubes is correct?
Patients with a gastrostomy tube may still be at risk for aspiration.
When caring for a morbidly obese patient, you should:
establish his or her chief complaint and then communicate your plan to help
In contrast to conductive hearing loss, sensorineural hearing loss is caused by:
nerve damage
Conductive hearing loss
is the result of sounds not being able to pass freely to the inner ear. This usually results from a blockage in the outer or middle ear, such as a build-up of excess ear wax or fluid from an ear infection (especially common in children). It can also happen as a result of some abnormality in the structure of the outer ear, ear canal or middle ear – or be due to a ruptured eardrum.
sensorineural hearing loss
This type of hearing loss is sometimes referred to as sensory, cochlear, neural or inner ear hearing loss.
A permanent sensorineural hearing loss is the result of damage to the hair cells within the cochlea or the hearing nerve (or both). Damage to the cochlea occurs naturally as part of the ageing process (age-related hearing loss is known as presbycusis) – but there are many things that cause sensorineural hearing loss, or add to it, such as:
When caring for a patient who is visually impaired, it is important to:
tell him or her what is happening, identify noises, and describe the situation and surroundings.
Which of the following does NOT usually contribute to or cause obesity?
rapid metabolism
Because a tracheostomy tube bypasses the nose and mouth:
secretions can build up in and around the tube.
Which of the following would be the MOST practical method of communicating with a hearing-impaired patient until his or her hearing aids can be located?
using a piece of paper and writing utensil to ask questions
Which of the following statements regarding interaction with the caregiver of a child or adult with special health care needs is correct?
Communication with the patient’s caregiver or family members is important because they are the most familiar with the patient’s condition.
By placing one hand on top of your head and the other hand over your abdomen, you are asking a hearing-impaired patient if he or she:
is sick.
General care for a patient with a tracheostomy tube includes all of the following, EXCEPT:
removing the tube if the area around it appears to be infected.
Disentanglement involves:
.removing a patient from a dangerous position.
A tube from the brain to the abdomen that drains excessive cerebrospinal fluid is called a:
shunt.
Two thirds of children born with Down syndrome have:
congenital heart disease.
According to the “E” in the DOPE mnemonic, which of the following actions should you perform to troubleshoot inadequate ventilation in a patient with a tracheostomy tube?
Check the mechanical ventilator for malfunction.
Common associated conditions in patients with spina bifida include all of the following, EXCEPT:
spastic limb movement.
Brain injury
Patients with brain injuries may be difficult to treat.
• Talk with patient and family.
– Get medical history.
– Establish what is considered normal for the patient.
• Explain procedures and reassure patient.
• Types – Ventricular peritoneum shunt – Ventricular atrium shunt
• Keep pressure in the skull from building up • Fluid reservoir
• – A device beneath skin on side of head, behind the ear
• – Its presence will alert you to the presence of a shunt.
• Blocked/infected shunt may cause changes
• in mental status and respiratory arrest
• • Infection may occur within 2 months of insertion
• Signs of distress – Bulging fontanelles (in infants) – Headache – Projectile vomiting – Altered mental status – Irritability – High-pitched cry
• Signs of distress (cont’d) – Fever
• – Nausea – Difficulty with coordination (walking) – Blurred vision
• Signs of distress (cont’d) – Seizures
• – Redness along the shunt track – Bradycardia – Heart arrhythmias
Visual impaired
Possible causes
• – Congenital defect
• – Disease
• – Injury
• – Degeneration of the eyeball optic nerve, or nerve pathway (eg, with aging)
• Range in degree of blindness – Peripheral or central vision – Light from dark or shapes
• • Visual impairments may be difficult to recognize.
Patientinteraction
• – Make yourself known when you enter.
• – Introduce yourself and others.
• – Retrieve any visual aids.
• – Patient may feel vulnerable and disoriented.
• – Describe the situation and surroundings to the patient.
• Patient ambulation
• – Take cane or walker, if used.
• – May make arrangements for care or accompaniment of service dog.
• – Patients should be gently guided, never pulled or pushed.
• – Communicate obstacles in advance.

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