Chapter 11



Handout 21-1 Student’s Name ________________________Chapter 21: Caring for Chest and Abdominal Emergencies--QuizCircle the letter of the best answer to each multiple-choice question. 1.In the condition known as a ________, air works its way in between the chest wall and the lung, causing the lung to collapse.a.flail chest b.thoracic decompression c.pneumothorax d.negative pressure syndrome 2.Which type of dressing should be applied to an open chest wound?a.Porous b.Occlusive c.Absorbent d.Form-fitting3.In a life-threatening condition known as a ________, a pneumothorax puts pressure on the heart and great vessels of the chest, causing profound shock.a.hemothorax b.tension pneumothorax c.spontaneous pneumothorax d.paradoxical pneumothorax 4.The grating sound of bone ends rubbing together is called:a.rubbing.b.stridulous.c.scour. d.crepitus. 5.A person has ________ sets of ribs that give structure and form to the chest wall. a.12 b.16 c.20d.24 6.Which position is favored for a patient who is suspected of having fractured ribs?a.Lying flat with arms above headb.Sitting forward with arms by sidec.Fetal position with arms against ribsd.Sitting upright and arms against ribs7.The type of breathing that may be observed with a patient who has a flail chest, with one side of the chest rising while the other fails, is called: a.tension breathing.b.retrograde breathing.c.paradoxical breathing.d.agonal breathing.8.You are assessing a patient who has suffered blunt trauma to the chest and has distended neck veins, blue skin, and bulging eyes. Which of the following should you most likely suspect?a.Tamponade of the lungsb.Retrograde circulationc. Traumatic asphyxiad.Vascular collapse 9.What is the general recommendation for a patient who has suffered an evisceration to the abdomen?a.Cover the organs with a moist sterile dressing and then an occlusive dressingb.Cover the organs with a dry sterile dressing and then an occlusive dressingc.Cover the organs with a dry sterile dressing and then a dressing that air can passd.Do not cover the protruding organs10.When the abdominal cavity fills up with blood, such as seen with a puncture wound, the belly will bulge—a condition known as: a.peritoneal protrusion. b.abdominal distention. c.colon catastrophe. d.cavity extension. ?2012 by Pearson Education, Inc.EMR 9Handout 21-2 Student’s Name ________________________The Call: An Eviscerated AbdomenRead the scenario. Then, in the space provided, answer the questions that follow.Dispatch has advised you that your patient is a butcher’s assistant at McGuire’s Meats. You are on scene in less than five minutes. When you arrive, you find the police, who tell you that the young man tripped while handling a just-sharpened butcher knife. “When he fell,” the police officer tells you, “he sliced open his abdomen.” The police assure you that the scene is safe.1.After taking standard precautions, what should you, as an Emergency Medical Responder, set as your priorities in providing care for this patient?2. When you expose the injury site, you find that some of the patient’s internal organs are protruding. How should you dress the patient’s open wound??2012 by Pearson Education, Inc.EMR 9Handout 21-3 Student’s Name ________________________Chapter 21 ReviewIn the space provided, write the word or words that best complete each sentence. Both the muscles of the chest wall and the muscle called the ____________ work to draw air into and push air out of the lungs. 2.An open chest wound in which air is pulled in and pushed out as the patient breathes is called a(n) ____________ ____________ ____________. 3.A(n) ____________ occurs when leaking blood builds up and collapses the lung in the same manner as a pneumothorax. 4.You should apply an occlusive dressing over an open chest wound and tape it on ____________ sides. 5.____________ ____________ is the result of accumulated air in the plural space; it collapses the lung and puts pressure on the heart and great vessels, causing profound shock.6.A massive blunt trauma that is applied over a large portion of the chest, forcing blood out of the heart and in an opposite direction, is called ____________ ____________. 7.____________ may be the most significant problem with rib fractures.8.In general, an Emergency Medical Responder should never remove an ____________ ____________ from the chest or abdomen.9.A(n) ____________ occurs when abdominal organs, such as intestines, protrude from an open wound.10.When inspecting and palpating all four quadrants of the abdomen, the Emergency Medical Responder is looking for ____________, ____________, and ____________. ?2012 by Pearson Education, Inc.EMR 9Handout 21-4 Student’s Name ________________________ListingComplete each listing activity on the lines provided.1.List four signs or symptoms that indicate that the breathing of a patient with a chest injury has been affected.2.List five signs and symptoms that may be identified when palpating the chest of a patient with a chest injury. 3.List seven signs and symptoms that may indicate internal abdominal injury.?2012 by Pearson Education, Inc.EMR 9 Answer Key Handout 21-1: Chapter 21 Quiz1.c2.b3.b4.d5.a6.d7.c8.c9.a10.bHandout 21-2: The Call: An Eviscerated Abdomen1. The priorities are the patient’s ABCs. Maintain an open airway, administer oxygen, assist respirations if necessary, control external bleeding as needed, and treat for shock. 2.General treatment guidelines usually include the following:Clean away any large debris.Cover organs with a moist sterile dressing and then an occlusive dressing.Prevent heat loss. Never allow the exposed organs to dry out; it may be necessary to reapply sterile saline to keep the exposed abdominal contents moist.Never push organs back into the cavity.Handout 21-3: Chapter 21 Reviewdiaphragmsucking chest woundhemothorax three (3)Tension pneumothorax traumatic asphyxia Painimpaled object evisceration tenderness, rigidity, guarding Handout 21-4: Listing1.Any four of the following: Shortness of breathPainful breathingCyanosis and other signs of hypoxia Coughing up bloodSigns and symptoms of shock 2.Any five of the following:Pain and tendernessPoor chest expansion or decreased ability to move airPenetrating traumaReduced or absent lung soundsDistended neck veins Chest wall deformity 3.Any seven of the following:PainTenderness (pain on palpation)Distended abdomenRigid or guarded abdomen Bruising to the abdomen, back, or flanksPain radiating to shouldersNausea and vomitingBlood in vomit, urine, or stoolSigns and symptoms of shock ?2012 by Pearson Education, Inc.EMR 9 ................
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