EMS1055 FINAL EXAM QUESTIONS AND ANSWERS WITH
COMPLETE SOLUTIONS GRADED A++ LATEST UPDATE
40; 80
to read blood pressure, the cuff should have a width of _____% upper arm
circumference and a length of ______% upper arm circumference
systolic; diastolic
when listening for blood pressure, the first sound we hear is __________ BP and the
last sound is ___________ BP
120/80 mmHg
what is "normal" blood pressure?
carotid (60 mmHg)
radial (80 mmHg)
brachial (70 mmHg)
femoral (70 mmHg)
pedal (90-100 mmHg)
what are the major arteries for taking pulse points and their needed systolic pressure?
early hypovolemic shock
- weakness, pallor, tachycardia, diaphoresis, tachypnea, low urinary output, weak
peripheral pulses, thirst reflex
- for tachycardia, suspect hemorrhage sustained rate >100 and red flag for shock pulse
,rate >120 (tachycardia is greater than 160 in infants, greater than 140 in preschool age
child, greater than 120 in school age child, greater than 100 in adults)
distributive (high space) shock
- problem is with the "pipes" of the heart
- relative hypovolemia ("vasodilatory shock")
- interruption of sympathetic system, loss of normal vasoconstriction, vascular space
becomes "too large"
neurogenic shock
- any factor that stimulates parasympathetic (dilates) activity or inhibits sympathetic
(constricts) activity of smooth vascular muscles can cause this shock, which results in
widespread and massive vasodilation
- causes are spinal cord injury at or above T6, spinal anesthesia, vasomotor center
depression
- may take hours to appear
- signs and symptoms are different than typical shock: skin warm and dry, bradycardia
- pokilothermia (unable to control body temperature, high)
- treat as general shock, protect against further spinal cord damage if applicable
hypovolemic shock
- problem is low volume; major contributor to early mortality from trauma (number one
cause of death in those less than 45 years old)
- has early shock, late shock, and low-volume shock
late hypovolemic shock
,- hypotension
- altered LoC
- cardiac arrest (if in this type of shock and go into cardiac arrest, less than 0.5% get
resuscitated)
low-volume hypovolemic shock
absolute hypovolemia
- loss of volume (catecholamines causes vasoconstriction)- minor blood loss:
vasoconstriction sufficient
- severe blood loss: vasoconstriction insufficient
- clinical presentation is thready pulse, tachycardia, pale and flat neck veins
obstructive (mechanical) shock
heart is healthy but something is interfering with it doing its job
-blood flow obstruction to or through heart
- slow venous return, decreases cardiac output
- clinical signs are distended neck veins, cyanosis, catecholamine effects
- pallor, tachycardia, diaphoresis
cardiogenic shock
- problem with the pump to heart (reduced pumping strength; decreased cardiac output,
decreased blood pressure)
- a major component of the mortality associated with cardiovascular disease (number
one cause of US deaths before covid)
- may be caused by cardiac contusion, myocardial infarction
anaphylactic shock
, - severe allergic reaction, onset is quick
- most cases are caused by bee sting or eating foods known to allergies
- anyone can have this shock to anything at any time
- most deaths from people with NKA (no known allergies) and no epi-pen (epinephrine)
- symptoms are runny nose, wheezes or stridor, abdominal pain, vomiting, hives,
itchiness, swelling of lips tongue and throat
- BIG 3 symptoms are urticaria (hives), wheezes, pruritus (itchiness)
- look at chest and trunk and back first for hives
septic shock
- due to severe infection that becomes systemic
- very common in the ICU setting
- patients often febrile
- antibiotics are needed to treat infection
- more gradual onset, starting with SIRS (systemic inflammatory response system), then
sepsis, then septic shock, then MODS
pseudo shock (insulin)
- not a true shock
- also called hypoglycemia (insulin shot is hypoglycemic)
- issue due to low blood glucose levels, not hypoperfusion
- common cause is when a patient injects insulin, but does not eat in time (can affect
non-diabetics)
- normal BGL 70-110 mg/dL
- can look similar to shock (pale, cool, diaphoretic)
COMPLETE SOLUTIONS GRADED A++ LATEST UPDATE
40; 80
to read blood pressure, the cuff should have a width of _____% upper arm
circumference and a length of ______% upper arm circumference
systolic; diastolic
when listening for blood pressure, the first sound we hear is __________ BP and the
last sound is ___________ BP
120/80 mmHg
what is "normal" blood pressure?
carotid (60 mmHg)
radial (80 mmHg)
brachial (70 mmHg)
femoral (70 mmHg)
pedal (90-100 mmHg)
what are the major arteries for taking pulse points and their needed systolic pressure?
early hypovolemic shock
- weakness, pallor, tachycardia, diaphoresis, tachypnea, low urinary output, weak
peripheral pulses, thirst reflex
- for tachycardia, suspect hemorrhage sustained rate >100 and red flag for shock pulse
,rate >120 (tachycardia is greater than 160 in infants, greater than 140 in preschool age
child, greater than 120 in school age child, greater than 100 in adults)
distributive (high space) shock
- problem is with the "pipes" of the heart
- relative hypovolemia ("vasodilatory shock")
- interruption of sympathetic system, loss of normal vasoconstriction, vascular space
becomes "too large"
neurogenic shock
- any factor that stimulates parasympathetic (dilates) activity or inhibits sympathetic
(constricts) activity of smooth vascular muscles can cause this shock, which results in
widespread and massive vasodilation
- causes are spinal cord injury at or above T6, spinal anesthesia, vasomotor center
depression
- may take hours to appear
- signs and symptoms are different than typical shock: skin warm and dry, bradycardia
- pokilothermia (unable to control body temperature, high)
- treat as general shock, protect against further spinal cord damage if applicable
hypovolemic shock
- problem is low volume; major contributor to early mortality from trauma (number one
cause of death in those less than 45 years old)
- has early shock, late shock, and low-volume shock
late hypovolemic shock
,- hypotension
- altered LoC
- cardiac arrest (if in this type of shock and go into cardiac arrest, less than 0.5% get
resuscitated)
low-volume hypovolemic shock
absolute hypovolemia
- loss of volume (catecholamines causes vasoconstriction)- minor blood loss:
vasoconstriction sufficient
- severe blood loss: vasoconstriction insufficient
- clinical presentation is thready pulse, tachycardia, pale and flat neck veins
obstructive (mechanical) shock
heart is healthy but something is interfering with it doing its job
-blood flow obstruction to or through heart
- slow venous return, decreases cardiac output
- clinical signs are distended neck veins, cyanosis, catecholamine effects
- pallor, tachycardia, diaphoresis
cardiogenic shock
- problem with the pump to heart (reduced pumping strength; decreased cardiac output,
decreased blood pressure)
- a major component of the mortality associated with cardiovascular disease (number
one cause of US deaths before covid)
- may be caused by cardiac contusion, myocardial infarction
anaphylactic shock
, - severe allergic reaction, onset is quick
- most cases are caused by bee sting or eating foods known to allergies
- anyone can have this shock to anything at any time
- most deaths from people with NKA (no known allergies) and no epi-pen (epinephrine)
- symptoms are runny nose, wheezes or stridor, abdominal pain, vomiting, hives,
itchiness, swelling of lips tongue and throat
- BIG 3 symptoms are urticaria (hives), wheezes, pruritus (itchiness)
- look at chest and trunk and back first for hives
septic shock
- due to severe infection that becomes systemic
- very common in the ICU setting
- patients often febrile
- antibiotics are needed to treat infection
- more gradual onset, starting with SIRS (systemic inflammatory response system), then
sepsis, then septic shock, then MODS
pseudo shock (insulin)
- not a true shock
- also called hypoglycemia (insulin shot is hypoglycemic)
- issue due to low blood glucose levels, not hypoperfusion
- common cause is when a patient injects insulin, but does not eat in time (can affect
non-diabetics)
- normal BGL 70-110 mg/dL
- can look similar to shock (pale, cool, diaphoretic)
