pronikání molekul rozpouštědla z méně koncentrovaného roztoku do roztoku koncentrovanějšího outcome /'aut.kAtn/ výsledek, výsledek čeho, jak věc dopadne, závěr palliative /lpael.i.3.tiv/ paliativní, utišující, bolest zmírňující peers /piarz/ vrstevníci permissible /pa'mis.s.bl/ přípustný, dovolený permit /pe'mit/ povolit, dovolit pooling /puil.irj/ nahromadění krve nebo jiné tekutiny, nahromadění krve je následkem dilatace a zastavení oběhu v kapilárách a žilách v oblasti possession /ps'zej.an/ majetek, vlastnictví posttraumatic /.paust.tn^rnaet.ik/ posttraumatický, poú rázový precede /pn'siid/ předcházet časově preserve /pn'z3iv/ zachovat, uchovat rape /reip/ znásilnit, znásilnění reasonable /'rii.zan.s.bj / přijatelný, rozumný refusal /rťfjuizal/ odmítnutí regional /'rii.djan.al/ regionální, týkající se dané oblasti right / rait/ právo scope /sloup/ rozsah solvent /'soi.vsnt/ ředidlo, rozpouštědlo spouse /spaus/ choť, manžel/ka standing /stEend.irj/ order /'aida/ trvalý příkaz statute /'stastjuit/ zákon, předpis steady /'sted.l/ stálý survivor /sa'vai.vsr/ přeživší, pozůstalý take /teik/ time /taim/ trvat, věnovat čas turn out /'t3in,aut/ zahnout ven, naruby, projevit se upgrade /Ap'greid/ zlepšit, stoupnout, zvýšení valid /'vaelid/ platný, oprávněný vent /vent/ ventilovat, otvor, průduch Volume 2 Unit 1 1 You are called for a 55-year-old man who "suddenly collapsed." He is__________ Initial management of this patient's airway should include. - Insertion of an oropharyngeal airway and ventilation with bag-valve mask. * An apnoeic and pulse less patient is unlikely to have an intact gag reflex, _____________an OPA to help control the ____________. A BVM will need at least 10 Lpm of oxygen flow in order to adequately _________the patient during ventilations. ti_ oxygenate, apnoeic and pulse less, upper airway, necessitating 2 You respond to a college fraternity where you encounter a 19-year-old male with a partially obstructed airway. According to witnesses, he was eating pizza and drinking beer when he began to________ ____his throat. The patient is able to speak in a_____________only, and he has been coughing repeatedly for about 20 minutes. What is the best treatment for this patient? - Remove the___________with forceps.* A conscious patient with a partial obstructed airway should be dealt with by _________________and continuous monitoring of patient status. Interventions like Heimlich manoeuvre are considered counterproductive, as they may actually ______the obstruction. To perform a needle cricothyrotomy, you should place the patient: supine with head and neck hyperextended.* - 152 - A_____________________will place the anatomical structure. headache complaints, this is most likely hoarse whisper, hyperextended position, worsen, identified, obstruction, cough and grab, encouraging coughing 3 Your patient is a 26-year-old male with a midshaft_____________and no other apparent injuries. The patient is_____and oriented, and all vital signs are normal. The best way to__________this fracture is to use: the PASC/MAST a long spine board a traction splint. * a softly padded board In a stable patient, the PASC is unnecessary. The long board will not adequately immobilize this injury because the muscles of the leg will_____and _______the leg. A padded board may not provide adequate traction to prevent muscle spasms either, so the______._ ______is the best choice. shorten, immobilize, femur fracture, spasm, alert 4 A 16-year-old male complains of a fever, sore neck, nausea, vomiting, and headache. During transport, he begins to have a ________Which of the following would be your most likely field impression? _____abscess cerebral________ meningitis * sepsis While the other answers are possible, based upon the fever, vomiting, and seizure, neoplasm, meningitis, Brain S Your patient is a 24-year-old female who shows signs and symptoms of pelvic What is the goal of_______________ for this patient? - Make the patient as comfortable as possible and transport to the hospital. * The goal of prehospital care for patients with PID is to______________. There is no need to perform a___________or ask any questions regarding sexual contacts. provide comfort, inflammatory disease, vaginalexam, prehospital care 6 You respond to a 22-year-old male who is complaining of__________of chest pain. The patient states that the pain________ and sharp and that it started when he surfaced from a_________from 60 feet (18.2 metres) down. The patient's diving partner states that the patient________too rapidly. What is this patient most likely suffering from? - Pulmonary embolism. * A too rapid ascent from a scuba dive may result in a pulmonary embolism due to lung______________ What does treatment for this patient consist of? - IV, high-flow oxygen, and rapid transport to a recompression chamber. * An IV, 100% oxygen via a nonrebreather mask, and transport to a_____________ _______are essential for this patient. - 153 - Due to his rapid ascent, this patient may also be suffering from another diving related emergency: decompression sickness.* Due to the_____of the dive and the rapid ascent, this patient may also be suffering from_____________________. What is an additional possible problem associated with this injury? -Nitrogen bubbles entering tissue spaces and smaller blood vessels. * scuba dive, rapid onset, is tearing, decompression sickness, cyanotic, depth, surfaced, overinflation, recompression chamber 7 Your patient is a 28-year-old diver who has been using scuba equipment. His diving partner states that he was unconscious when he surfaced after_____. You should suspect: air embolism. * ___________presents as____________ _______(including unconsciousness) during or after______from a dive, or as a sharp pain in the chest. Due to his rapid ascent, this patient may also be_____________another diving related emergency: decompression sickness. * Due to the depth of the dive and the rapid ascent, this patient may also be suffering from decompression sickness. What is an additional possible problem associated with this injury? - Nitrogen bubbles entering____________ and smaller blood vessels.* In this patient, nitrogen__________may have entered tissue spaces and blood vessels. a dive, tissue spaces, Air embolism, ascent, suffering from, gas bubbles, neurological deficit 8 This statement about care of a near-drowning ______is correct: The patient should be admitted to the hospital for observation.* Due to the chance of post event pulmonary oedema, all___-________ victims should be admitted to the hospital for___________. victim, near-drowning, observation 9 Your patient is a 23-year-old man who complains of abdominal pain. The patient states that the pain began________and was originally located only in the area around the_________. Now, however, it has moved to the__________quadrant. The patient also complains of nausea and vomiting, and he has a fever of 102 °F (38.8 °C). Examination displays rebound What would you suspect? -Apendicitis. * tenderness, right lower, suddenly, umbilicus 10 A patient suspected of having an_________ aortic aneurysm will receive oxygen, an IV, ECG monitoring, and rapid transport as part of his or her treatment. What else should you do when treating such a patient?_____the PASG/MAST garment. * Treat the patient for shock and transport rapidly. Do not_______the abdomen. This is one of the few medical conditions that may still benefit from the use of PASG/MAST as the garment may tamponade any________that may be occuring,___________which stimulate the cardiovascular system should be avoided. Medications, bleeding, palpate, Apply, abdominal 11 A 42-year-old male complains of sudden, intense pain that is centered in his._____ ____. He is____,____, and diaphoretic, especially_____the level of his umbilicus. He is tachycardic and hypotensive. What condition best describes the patient presentation? - Abdominal aortic aneurysm. * The abdominal aorta is located in the _____-__________space. A sudden____of pressure due to an aortic aneurysm will result in loss of perfusion below the site of injury. lower back, below, pale, cooi, retroperitoneal, loss 12 You are called to the home of a 36-year-old man who is having a seizure. His wife reports that he has not taken his "_______ ___" lately and that he has now had three seizures in a row without_________ -------------. You have______„ the airway and are now ventilating with the_________ What should you do next? - Begin an IV, monitor cardiac rhythm, and administer diazepam. * For a patient in_________________, treatment consists of establishing an IV, monitoring cardiac rhythm, and administering diazepam to stop the seizures. Status epilepticus, seizure pills, regaining consciousness, bag valve mask, secured 13 What is the primary reason that diazepam is given to a seizure patient? to suppress the spread of electrical activity in the brain and relax muscles. * Although diazepam (Valium) does reduce _______, it is given to seizure patients to suppress the spread of__________._______ through the brain as well as to_____ anxiety, relax muscles, electrica! activity 14 A 52-year-old male has been ejected from a car. He is apnoeic, with a slow pulse palpated at the__________ What procedure would best manage this patient's airway? - Ventilate with the bag-valve mask and attach to high-flow oxygen. * This patient needs immediate___________ _._____________. Using a bag-valve mask will__________this task most effectively. accomplish, oxygenation and ventilation, femoral artery 15 Your patient is a 27-year-old male who is found unconscious on a bathroom floor. He is not breathing, has______________, and has a fresh________wound to his right forearm. He has_____________that form a bluish streak over the veins on the backs on both hands. This patient is most likely suffering from which of the following? a seizure disorder multiple spider bites a narcotic overdose * anaphylactic shock Common signs of a_____________.___are described: Pinpoint pupils are characteristic of heroin and narcotic use, a fresh puncture wound over a vein indicates a recent _:____________, and____________._ over the veins is consistent with the presence of track marks. bluish scarring, multiple scars, puncture, narcotic overdose, injection site, pinpoint pupils 16 A 24-year-old female is complaining of chest pain and difficulty breathing. She has been up for three days studying for finals and has been taking ephedrine supplements to help her__________and alert. She also admits to drinking 12 ___________soft drinks in the past day-Vitals are BP 80/40, P 1 80 carotid, and R 42. She is_________and lethargic. The best treatment for this patient would include: cardioversion at 100 joules This patient presents in unstable supraventricular_____________Her condition may___________quickly; therefore, immediate synchronized _____________is indicated. cardioversion, caffeinated, stay awake, tachycardia, very pale, deteriorate 17 Your patient is a 19-year-old female who has been stung by a stingray while swimming. What should you do after________ airway breathing and circulation are intact? - Apply heat or warm water to reduce pain and________the poison. * Heat will cause the______to break down and______the harm to the patient. detoxify, poison, ensuring, lessen 18 Your patient is a comatose 56-year-old male. His breath smells fruity and sweet aYid his respirations are very deep and rapid. After the initial assessment, you should provide the following treatments: Draw blood, start an IV of 0.9% NaCI, and give a 500 ml fluid bolus.* This patient is showing signs and symptoms of diabetic___________. Avoid the use of______________________if at all possible. At the minimum, you should obtain a ________________before administering any glucose containing solutions. The fluid bolus will help_______the glucose contained within his blood. glucose administration, glucometer reading, ketoacidosis, dilute 19 Your patient is a 30-year-old female who is complaining of a generalized rash and a dyspnoea after eating shellfish. The patient has small itchy, red welts all over her body and says her tongue feels like it is swollen. She complains of difficulty moving air in - 156 - and difficulty___________________. This patient's vital signs show a blood pressure of 11 0/60; a pulse of 100, strong and regular; and a respiratory rate of 36. Her breathing is somewhat shallow and This patient is exhibiting the signs and symptoms of: an allergic reaction. * This patient's blood pressure is still _______________the allergic reaction; therefore, the patient is not in anaphylactic shock. This patient needs close monitoring because she could____________: anaphylactic shock * Compensating for, catching a full breath, progress into, laboured 20 You respond to a 1 7-year-old female found unconscious in her backyard by her parents. She has a newly developing skin rash on her right arm and is having difficulty breathing. You note that she is wheezing. Her parents state that she has no history of respiratory problems or other medical disorders. Which of the following is a possible cause of her condition? Anaphylaxis * febrile seizures status asthmaticus epiglottitis The environment she is in and previously unseen____,________, difficulty breathing and negative past history are keys to this being a case of possible anaphylactic shock. What is the first step in managing this patient? - Aggressively manage the airway. * You should aggressively manage the airway. It may be necessary to_________ ________this patient, and you may get only one attempt. Once the tube contacts the larynx, the__________can spasm and completely shut off the airway. The next step in treating this patient is to start a normal saline or Ringer's lactate IV and to give: epinephrine * Epinephrine is a potent_____________and can reverse many of the effects of histamine________. This patient is __ ________and should first be treated with epinephrine. If respiratory________ continues once the epinephrine has entered the patient's system, you may try using diphenhydramine (another antihistamine) or albuterol to bring about Antihistamine, distress, bronchodilation, carefully intubate, rash, vocal cords, in extremis, overload, wheezing Vocabulary 1 abdominal /aeb'dDm.r.rol/ thrust /OrAst/ břišní úder, první pomoc při dušení abscess /'aeb.ses/ absces accomplish /a'kAm.pliJ/ dosáhnout, provést, uskutečnit admit /aďmit/ připustit, uznat, hospitalizovat aggressively /a'gres.iv.li/ agresivně, útočně air /'ear/ embolism /'em.ba.li.zsm/ vzduchová embólie anaphylaxis /.aen.a.fťlsek.sis/ anafylaxe, druh alergie, přecitlivělosti na cizorodou bílkovinu ascent /a'sent/ stoupání, výstup bag /baeg/ mask /maisk/ dýchací maska, ambuvak, resuscitační vak, samorozpínatelný vak s maskou bolus /bsu.las/ jednorázově podaná dávka léku break /breik/ down /daun/ porucha, porušení, havárie, defekt, zhroutit se, nevydržet bring /brirj/ about /a'baut/ způsobit, vyvolat bronchodilation ^brDrj.kau.'dileifsn/ dilatace, rozšíření průdušek caffeinated /'kaaf.i.nei.tid/ s kofeinem (nápoj) cardioversion /.kai.di.a'vsi.Jsn/ kardioverze, elektrický výboj použitý při léčbě srdečních arytmií catching /'kaetf.irj/ nakažlivý, přenosný center /'sen.tsr/ střed, centrum, středisko comfortable /'kAmf.tar.bal/ pohodlný, příjemný consciousness /'kon.Jas.nas/ vědomí, povědomí counterproductive /.kaun.ta.pra'dAk.tiv/ kontraproduktivní, mající opačný účinek cricothyreotomy /"krai.ks.Gaia'rD.ta.mi/ krikotyreotomie, chirurg, rozdělení chrupavky prstencové a štítné decompression /^ii.lom'prej.an/ sickness /'sik.nas/ dekompresní nemoc deficit /'def.i.sit/ deficit, nedostatek detoxify /dii'tok.si.fai/ detoxikovat dilute /daťluit/ zředit, oslabit diphenhydramine /di.fen'hi.drs.miin/ difenylhydramin, antihistaminikum, užívané v léčbě alergických poruch diving /'dai.vin/ reflex /'rii.fleks/ reflex zahrnující kardiovaskulární a metabolické adaptace pro uchování kyslíku vyskytující se u živočichů během potápění do vody drowning /'draun.irj/ tonutí, utopení encourage /in'kAr.ids/ povzbudit, vést femoral /'femarsl/ femorální, stehenní final /'fai.nal/ závěrečná zkouška forceps /'bi.seps/ chirurgické, lékařské kleště fraternity /fra't3i.n9.ti/ bratrstvo, jednota fruity7'frui.ti/ ovocný gag /gaeg/ reflex /'riifleks/ reflex zvracení garment /'gaimsnt/ oděv, oblek glucose /'glui.kaus/ glukóza, hroznový cukr goal /gaul/ cíl grab /graeb/ snažit se popadnout haemostasis /.hii.ms'stei.sis/ hemostáza, zástava krvácení, zástava krevní cirkulace Heimlich maneuver /'hciim.iik.ms.nu.vsr/ Heimlichův manévr je určený k vypuzení předmětu, který ucpal dýchací cesty in extremis /.in.ik'strii.mis/ krajní, v krajním případě itchy /'itf.l/ svědivý MAST, Military Anti-Shock Trousers vojenské protišokové pneumatické kalhoty viz také PASG mid /mid/ střední NaCI, sodium /"sau.di.am/ chloride /'kbiraid/ chlorid sodný, kuchyňská sůl near /mar/ téměř, blízko necessitate /na'ses.i.teit/ vyžadovat, vynutit si neoplasm /.nii.au'plaez.am/ zhoubný nádor neurological /.njua.ra'lods.i.kal/ neurologický nitrogen /'nai.tra.d3an/ dusík, dusíkatý nonrebreather /.non.rabra.óar/ mask / maisk/ dýchací maska jednocestnou klapkou, vydechnutý oxid uhličitý je vyloučen a není znovu vdechován oropharyngeal /'Di.ra .fa'rm.dsi.al/ orofaryngeální, týkající se úst a hltanu overinflation /.auva.in'fleiľ.an/ nadměrné naplnění vzduchem, nahuštění overload /.au.va'laud/ přetížit, přetížení oxygenate /'ok.si.dsa.neit/ okysličovat padded /'peed.id/ vycpaný, s vycpávkou PASG, Pneumatic /nju'maetik/ Antishock /'aen.ti.Jok / Garment /'gaimant/ nafukovací obiek, používaný k potlačení šoku, stabilizaci zlomenin, podporování hemostázy a zvýšení periferní cévní rezistence, viz také MAST pneumatic /nju'maetik/ vzduchový, na stlačený vzduch poison /'pDi.zan/jed, otrávit pulseless /pAls.las/ bez pulzu recompression /.rii.kam'pref.an/ chamber /'tfeim.bar/ rekompresní komora regain /n'gein/ znovu získat, vrátit retroperitoneal /.ret.rau.per.i.tau.'nii.al/ ležící za pobříšnicí reverse /n'v3is/ zvrátit, změnit, otočit, opačně, pozpátku Ringer's lactate /laek'teit/ Ringerův roztok, infuzní roztok, podobně jako fyziologický roztok je izotonický a obsahuje ionty sodíku a chloru, navíc pak obsahuje ionty draslíku a vápníku, čímž je bližší složení krevní plasmy scar /skair/ jizva, zjizvit scuba diving /'skui.ba.dai.virj/ potápění s dýchacím přístrojem, sportovní potápění shaft /Jaift/ diafýza, střední část dlouhé kosti shellfish /'Jel.fif/ měkkýši, korýši shut //At/ off /of/ vypnout, zastavit, odtáhnout softly /'soft.li/ jemně, tlumeně scire /sDír/ bolavý, bolestivý spasm /'spaez.am/ křeč, záchvat spider /'spai.dar/ pavouk spine /spam/ board /baid/ páteřní deska splint /splint/ dlaha, zpevnit dlahou status /"stei.tas/ status, stav stingray /'stirj.rei/ trnucha, rejnok s jedovým bodcem na ocase streak /striik/ stopa, proužek suddenly /'sAd.an.li/ náhle, najednou suffering /'sAf.ar.irj/ from trpící Čím suit /sjuit/ oblek supplement /'sAp.li.mant/ doplnit, dodatek suppress /sa'pres/ potlačit, zastavit track /trsek/ dráha, cesta, sledovat traction /'traek.Jan/ trakce, tah tube /1juib/ trubice, trubička umbilicus /Am'bil.i.kas/ pupek unconsciousness /An'kDn.Jas.nas/ bezvědomí unlikely /An'lai.kli/ nepravděpodobný unseen /An'siin/ neviditelný, nevídaný valve /vselv/ klapka, ventil welt /welt/ šrám, podlitina whisper /'wis.par/ šeptat, šepot worsen /'w3i.san/ zhoršit (se) Unit 2 1 What is the reason for giving______ beta agonists to patients with severe allergic reactions? - To reverse bronchospasm and relax airways * ____________such as albuterol help In the treatment of severe allergic reactions by relaxing the______and thus relieving Beta agonists, airway, bronchospasm, inhaled 2 Your patient is a 27-year-old male who has fallen from a 24-foot (7.3 m) ladder. As you are approaching and forming your general impression, you note that he is conscious and talking. What should you do first? - _________stabilize his neck in a neutral position." The______is always given first priority, but in this case, since the patient__________, the first step in his assessment and care would be to stabilize the______________as you begin your_________________ ABC assessment, is talking, cervical spine, Manually, airway 3 When using the OPQRST________to assess a patient's pain, you would assess the R portion of the mnemonic by asking: "Does the pain move anywhere?" * R stands_________. You should determine if the pain is radiating,________, or causing any_________________. for radiation, referred, associated problem, mnemonic 4 The focused history and physical examination of a patient begins after you have: controlled immediate threats to the patient's life. * The purpose of the focused history and physical examination is to detect additional problems after you have controlled________________to the patient's life. The_______________is typically performed during transport. ______________may be consulted anytime during the call when you feel it is ___________or whenever your protocols and standing orders require it. Appropriate, Medical control, ongoing assessment, immediate threats 5 Using your sense of touch during a physical examination is called: palpation. * The technique of_________is using touch during a____________________to gather information. ____________is listening with a stethoscope; __________is using gentle tapping in order to identify the presence of air or fluid in body tissues. Percussion, Auscultation, physical examination, palpation 6 What are the components of the focused history and physical exam? -SAMPLE history and focused examination. * The______________and physical exam, undertaken only after_______________to 1 "life have been corrected, consists of ascertaining the nature of____________.___ previous history (via SAMPLE), _._________, and focused exam. focused history, illness or injury, immediate threats, vital signs 7 What is the purpose of the OPQRST mnemonic? - To define the major complaint. * The OPQRST mnemonic is used to define the___________,__ associated with_______ __________such as pain, dyspnoea, dizziness, and vague sensations. It is not usually used in trauma or______ medical conditions, actual unconsciousness, chief complaint 8 What is a major concern when dealing with a patient with - 160 — organophosphate poisoning? - Exposure of rescuers to the poison.* _________to organophosphate is a major concern. Proper______________________are ________to rescuer safety.__________all patient clothing according to Environmental Protection Agency guidelines. Dispose of, Exposure, paramount, isolation procedures 9 Your patient is a farmer who has employed a crop cluster to spray his fields. The fields were sprayed earlier today and now the farmer has teary eyes, nausea and vomiting, diarrhoea, and excessive salivation. What was he most likely poisoned with? - Organophosphates. * The symptoms of organophosphate __________are described by the acronym SLUDGE (excessive__________,___________, __,_______, diarrhoea, gastrointestinal distress,______). salivation, absorption, emesis, lacrimation, urination 10 What__________is commonly used to treat patients who are the victims of organophosphate poisoning? - Atropine sulfate * A large dose of atropine sulfate is used to __________cholinergic poisoning from ________________and carbamates. Counteract, organophosphates, medication 11 A victim is unresponsive after possible exposure to______________in a closed garage. Which of the following procedures should you do first? - Wait for properly trained personnel to enter and evacuate the garage.* ____the windows of the garage to ventilate the environment. _______high-flow oxygen to the patient via positive pressure ventilations. ______the patient from the environment. Safety first! Of the three__________options, _______________and protected rescuers can remove the patient safely. Extrication, Provide, carbon monoxide, properly trained, Open, Remove 12 Which finding is helpful________________ poisoning by spider venom from an acute abdominal condition? abdominal rigidity with no palpable tenderness * right-lower-quadrant pain in the absence of fever diaphoresis accompanied by______ the presence of multiple_________ on the stomach This finding is helpful in ruling out acute abdomen as the cause.____________ generally always has pain associated with rigidity, whereas a__________may be painless initially due to the neurotoxicity of the_____. Spiders______bite more than once, ruling out the last choice as a realistic clue. — 161 - rarely, in distinguishing, spider bite, bite marks, chills and fever, Acute abdomen, venom 13 These are characteristic of a mild or moderate pit viper envenomation: __.______located around the wound site * _____.__________like nausea or vomiting * Localised______at the wound site * Pit viper____________is generally very painful. Little or no pain is characteristic of coral snake (__________) envenomation. neurotoxic, Systemic effects, envenomation, Bruising, oedema 14 * The physiological cause of the anxiety and restlessness that make up the classic______._____of shock are a______ _______ of what phenomena? - The release of catecholamines. * The release of catecholamines that results from the initial drop in blood pressure causes the feelings of__________ early signs, anxiety and restlessness, direct result 15 A patient who experienced a seizure, rather than a period of syncope, usually reports that the episode: happened without any warning. * ________unlike syncope, do not usually have_____________such as a period of lightheadedness. Some seizures are ___________a feeling or sensation of impending seizure called an aura. preceded by, Seizures, warning signs 16 * During the initial phase of an acute stress reaction, what physiological response will occur? - Increased pulse rate and papillary dilatation. * Both good stress (________) and bad stress (________) will initially cause symphatetic stimulation such as_________heart and respiratory rate, bronchodilation,_______ ______, and increased blood flow to the V. skeletal muscles, distress, Increased, dilated pupils, eustress 17 Continual reexperiencing of atraumatic event is a characteristic of which of the following? an_______disorder stress and_______ cumulative stress reaction delayed stress reaction * _____________________, or post-traumatic stress disorder, is characterized by reexperiencing of the traumatic event and diminished responsiveness to___________, as well as physical and cognitive symptoms. burnout, anxiety, Delayed stress reaction, everyday life 18 What signs and symptoms are characteristic of a patient in compensated shock? - Lethargy; confusion; pulse and — 162 — blood pressure normal to slightly elevated; skin cool; and capillary refill delayed.* The signs and symptoms given________, _________, pulse and blood pressure normal to slightly elevated; skin cool; and _______________delayed are characteristic of early, or compensated, shock. The single characteristic signalling the change from compensated to uncompensated shock is a drop in blood pressure that remains below normal despite____________ ,_____________You___________wait to see a decrease in BP to decide if shock is present or not, since early______._____ _____._______, sympathetic stimulation during compensation may result in a slight elevation of the diastolic blood pressure- intervention and treatment, lethargy, capillary refill, in the shock process, confusion, should never 19 * What is the purpose of the body's _____________________ to a stressor? - To prepare for the most efficient reaction. ^ All the components of the stress reaction - _________ACTH, relaxation of the young healthy adult,_____________, slowdown of _________, release of adrenaline - prepare the body to react to the________as efficiently as possible. stressor, bronchial tree, physiological response, release of, digestion 20 Why are vital signs changes not a good early indicator of shock in a young healthy adult? ~ The body attempts to compensate______________normal vital signs. * The body's physiological mechanism _____________the insult that causes shock. Therefore, although changes in_____.„____ are ominous late signs in patients with poor tissue perfusion, they are unlikely to occur in a_________________who has just entered a state of shock. young healthy adult, by maintaining, compensate for, vital signs Vocabulary 2 ACTH, Adrenocorticotropic /g.drii.nau.kDi.ti.kau'trof.ik/ Hormone /'ho:.maun/ adrenokortikotropní hormon actual /'aak.tju.sl/ skutečný, opravdový, současný aldosterone /'nil.das.tar.aun/ aldosteron, mineralokortikoidní hormon vylučovaný nadledvinami ataxia /a'taek.si.s/ ataxie, ztráta kontroly volních pohybů atropine /'astra.pin/ sulfate /'sAl.feit/' atropin-sulfát, lék aura /'Di.ra/ aura, předzvěst, bezprostřední známky blížícího se záchvatu beta-2 /'biita.tui/ agonists /'aeg.a.nists/ beta-2 agonisté, uvolňují a otevírají dýchací cesty, které se během astmatického záchvatu zužují, astma „uvolňovače" nebo bronchodilatátory burnout /[b3inaut/ vyhoření, naprosté vyčerpání carbamate /'kaiba.meit/ sůl nebo ester kyseliny karbamové (karbamová kyselina -H2N-COOH, kyselina, která se okamžitě rozpadá na oxid uhličitý a amoniak; její soli jsou karbamáty, otrava, stažení zorniček, svalový třes, salivace, ataxie, dyspnoe cervical /'S3ivik3l/ spine /spam/ krční — 163 — páteř cholinergic /l2: airway obstruction, hypoventilation, physical exertion.* PaCh measures_____________levels in the blood, which are influenced by___________ in CO2 production or____________Such levels would be increased by________ ________of muscles, by_______________, or by an airway obstruction. carbon dioxide, hypoventilation, elimination, physical exertion, alterations 17 Which of the following factors would normally cause a________in a patient's respiratory rate? anxiety sleep* fever « hypoxia A patient will breathe more slowly when ______than when_____; all the other factors listed increase_______________. awake, decrease, respiratory rate, asleep 18 The volume of air normally inhaled and exhaled during each respiration is called the: tidal volume.* Tidal volume is the amount of air that moves into and out of the lungs during the ________________; minute volume is the total amount of air exchanged in the lungs in one______; inspiratory_______is the extra air that could be inspired in addition to the tidal volume; total____________is the sum of the inspiratory reserve, tidal volume, expiratory reserve, and residual volume. lung capacity, respiratory cycle, reserve, minute 19 Which is the recommended method when measuring respiratory rate? - Count respirations while pretending to take a radial pulse.'' Place your hand on the patient's wrist as if you were measuring his or her pulse and ______.------------This will prevent the patient from consciously________the respiratory rate. Placing the wrist and hand over the patient's _________is called the pledge of allegiance method. chest wall, changing, count for 30 seconds 20 When using a peak flow meter to measure peak expiratory flow, the correct procedure is to: ask the patient to inhale ^ deeply, then exhale once as quickly as possible, taking one reading. * The correct procedure is to have the patient____________and____________. Some meters ask you to repeat the procedure and_______your findings, but you would still have the patient inhale deeply and quickly exhale with each______. average, inhale deeply, exhale quickly, reading Vocabulary 4 allegiance /9'li:.d_ans/ věrnost, loajalita alternating /'ol.ts.nei.tirj/ střídavý, střídající se asleep /a'sliip/ spící, usnout average yaev.9r.1d3/ průměr, činit v průměru balloon /ba'lum/ balónek bleb /bleb/ puchýřek confirmed /k9n'f3imd/ potvrzený consciously /'kDnJas.li/ vědomě, úmyslně count /kaunt/ počítat cycle /'sai.kj / cyklus deflation /dťfleijan/ vyfouknutí exertion /ig'z3i.Jan/ úsilí, námaha frequency /'frii.kwBn.si/ frekvence, četnost výskytu garment /'gen,ment/ oděv, šaty, svršky haemothorax /'hii.ma'Ooi.rseks/ hemotorax, nahromadění krve v dutině hrudní hole /houl/ díra, otvor, mezera hypoventilation /.haipau.ven.tťlei.Jan/ hypoventilace, omezené dýchání increase /m'kriis/ zvýšit, zvýšení inflation /in'flei.fsn/ naplnění, nafouknutí interference /.in.ts'fis.rsns/ interference, zasahování, rušení JVD, Jugular /'dsAg.js.lar/ Venous /'vii.nss/ Distension /dťsten.t/an/ roztažení krční tepny lasting /"laistirj/ trvalý, stálý method /'meB.sd/ metoda, způsob otherwise /Vvd.a.waiz/ jinak, v jiném případě peak /piik/ flow /fteu/ vrcholový výdechový průtok place /pleis/ místo, umístit, položit pledge /pledg/ závazek, slib pleural /'plus.ral/ pleurální, pohrudniční pool cue /kju:/ tágo pressurized /'pre/.9r.aizd/ přetlakový, s regulovaným tlakem pretend /prťtend/ předstírat, tvrdit progressively /pra'gres.iv.li/ progresivně, postupně rate /reit/ frekvence regular /'reg.ju.lsr/ pravidelný, častý, obvyklý relieve /ri'Jiiv/ utišit, zmírnit, pomoci reserve /n'z3iv/ rezerva, vyhradit si, zamluvit setting /'set.irj/ prostředí shear /'JiB.r/ nůžky, stříhat, utrhnout se sweep /sw'np/ (swept, swept) shrnout, stáhnout, smést — 174 —