Increased Pulmonary Edema

3.You are called to intercept an incoming intermediate service, which is transporting a burn patient who has received a superficial burn to the anterior chest and a partial thickness burn to the anterior neck and face from a broken steam pipe. The initial responding crew was able to initiate fluid resuscitation but was unable to place a supraglottic airway as the patient still had a gag reflex. They report ventilations have become increasingly difficult to provide. Which of the following is your greatest concern? a) Hypovolemia from the third spacing of plasma. b) Eschar development involving the burned surface area. c) Increased pulmonary edema from the fluid resuscitation. d) The inability to form a good seal with the BVM due to facial trauma. 21.Which of the following pharmacological interventions would MOST likely be prescribed if the cause of a patient’s hypertension is related to excessive arterial constriction? a) Diuretic. b) Beta blocker. c) ACE inhibitor.* d) Calcium channel blocker. 23.ALS responders are transporting a newborn who experienced a lengthy delivery due to a large body size. Which of the following treatments will benefit this neonate the MOST if there is evidence of a preceding hypoxic event and the infant presents as depressed? a) Intubation. b) IV fluid bolus. c) Hyperventilation. d) Monitoring pulse oximetry. 28.You are resuscitating a neonate with cyanosis and grunting respirations. A mid-wife who assisted with the delivery of the baby advises you the child is bradycardic due to respiratory insufficiency. Vitals are pulse 108 and respiration 32, and the newborn is responsive to suctioning only. What is the MOST beneficial treatment for this patient if only basic, entry-level care has been initiated? a) Neonatal chest compression. b) Bag-valve-mask ventilations. c) Tracheal suctioning with meconium aspirator. d) Administration of epinephrine via umbilical vein catheter or 10. 30.Which of the following methods would be the MOST effective to ventilate an unresponsive patient who is suffering from adult respiratory distress syndrome where you were unable to secure the airway with an endotracheal tube? a) Mouth-to-mask ventilation with supplemental oxygen. b) 2-person bag-valve-mask ventilation with adjustable peep setting. c) 1-person BVM ventilation and the administration of a loop diuretic. d) Insertion of supraglottic airway and positive pressure ventilation. 45.You are assessing a patient with no arms. Where would you place the stethoscope to determine an auscultated blood pressure? a) Dorsalis pedis. b) Femoral artery. c) Popliteal artery. d) Posterior tibial. 50.You are attending to a patient suffering from a blunt trauma to the chest, which resulted in respiratory distress, cyanosis, hemoptysis, and massive subcutaneous emphysema. You have intubated this patient and initiated positive pressure ventilations. Compliance is minimal and lung sounds are diminished bilaterally. Which of the following should be your NEXT action? a) Perform bilateral pleural decompressions. b) Extubate and switch to an esophageal airway. c) Extubate and switch to bag-valve-mask ventilations. d) Reposition the endotracheal tube to cause a right mainstem intubation. 59.The pathophysiology that ensues from vomiting and diarrhea secondary to Acute Gastroenteritis (AGE) affects every body system. Respiratory symptoms typically include an increase in tidal volume and respiratory rate. This change in respiratory system mechanics is a result of: a) Respiratory compensation of metabolic acidosis. b) A decrease in tissue perfusion requiring more oxygen. c) Osmotic fluid shifts from the gastrointestinal tract to the pulmonary vasculature. d) The body’s compensatory response to decreased circulating blood volume by increasing intrathoracic pressure in order to shunt blood to vital organs. 72.You arrive at a scene with a patient in respiratory distress. Shortly into your assessment the patient becomes unconscious and stops breathing. You begin to ventilate with a BVM and an OPA in place. Your ventilations do not produce chest rise. Your partner removes the patient’s shirt and you see the patient has a stoma. You begin ventilating through the stoma with the BVM. Because the ventilations are through a stoma, which of the following will most likely occur? a) Forceful ventilations will cause gastric distension. b) Adequate minute ventilation will be difficult to achieve. c) Unless the seal is adequate, air will escape around the stoma. d) Air will likely be forced under the skin with this type of ventilation.

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