exam 4 buttaro

exam 4 buttaro A patient brought to an emergency department after a diving accident is receiving inhaled 100% oxygen. What is the goal of this intervention? a. Enhancing oxygen delivery to ischemic tissues b. Improving oxygen saturations c. Preventing the need for recompression therapy d. Reducing the risk of neurological symptoms - ANS A -Breathing 100% oxygen increases the extraction of nitrogen from tissues and can enhance oxygen delivery to ischemic tissues. It is not given to improve oxygen saturations, because the oxygen level is not of concern. Patients will still need recompression therapy. Oxygen is not given to minimize neurological symptoms A scuba diver reports persistent nosebleeds after a diving trip. What is the treatment for this condition based on this history? a. A period of bedrest b. Decongestant medications c. Recompression therapy d. Referral to an otolaryngologist - ANS B -Topical and systemic nasal decongestants may provide both relief and prophylaxis for divers predisposed to epistaxis. Bedrest is not indicated. Recompression therapy is not used for sinus barotrauma. Referral to an otolaryngologist is necessary when conservative treatments are not effective When evaluating a person who is interested in taking a scuba diving class, the practitioner will screen for which conditions? (Select all that apply.) a. Chronic sinusitis b. Diabetes mellitus c. Peptic ulcer disease d. Pressure equalizing ear tubes e. Recurrent urinary tract infection - ANS A, B, D- Diving is relatively contraindicated in any patient with a history of frequent ear infections or chronic sinus infections. Diabetes, if unstable, is a contraindication. Pressure equalizing tubes are absolute contraindications. Peptic ulcer disease and recurrent UTI are not contraindications. A patient with poorly controlled diabetes mellitus (DM) has chronic fatigue symptoms. Which of the following is the most likely underlying cause of this patient's fatigue? a. Calorie depletion b. Decreased metabolism c. Psychological distress d. Sleep apnea - ANS A-Patients with poorly controlled DM can have significant fluid and calorie depletion causing fatigue. Diabetes Fatigue Syndrome requires glycemic control, a healthy diet, regular exercise and sleep, plus careful monitoring. Patients with hypothyroidism have decreased metabolism leading to fatigue. Psychological distress causing fatigue is associated with malignant neoplasms of the blood. Sleep apnea causing fatigue is associated with morbid obesity A patient is seen in the clinic with reports of constant fatigue. The patient's spouse reports that the patient moves and kicks the legs frequently during sleep. What treatment will the provider anticipate once a diagnosis of the underlying cause is confirmed? a. An anti-oxidant diet b. Cognitive behavioral therapy c. Iron supplements d. Melatonin daily at bedtime - ANS C-This patient most likely has restless leg syndrome which may result from low ferritin levels and which is treated with iron supplements. Anti-oxidant diets and cognitive behavioral therapy are sometimes used to treat non-specific CFS. Melatonin has not been shown to be effective Which are causes of physiologic fatigue? (Select all that apply.) a. Acute and chronic illness b. Excessive alcohol use c. Irregular sleep habits d. Medication side effects e. Morbid obesity - ANS B, C, D -Physiologic causes are those resulting from external influences and include poor sleep hygiene, substance abuse, and medication effects. Physical causes are those where fatigue is secondary to diseases or conditions. A patient reports daily, recurrent fever associated with sweating, chills, and recent weight loss. What may this type of fever indicate? a. An underlying disease caused by animal bites b. Fever related to an immunocompromised state c. Possible exposure to tropical diseases d. Tuberculosis (TB) or lymphoma - ANS D -Hectic fever, or recurring fever associated with weight loss, sweating, and chills is concerning for tuberculosis or lymphoma. Fever from animal bites or travel to tropical areas is diagnosed after a history of exposure. A patient has a fever of unknown etiology and blood tests reveal elevated eosinophils. The patient has no history of asthma or allergies. What may be the cause of this fever? a. Animal bite b. Endocarditis c. Lymphoma d. Parasites - ANS D-Eosinophils classically suggest a parasitic infection, asthma, or allergy. They are not present with other conditions unless there is concurrent parasitic infection or underlying asthma or allergies.