26. Which symptоms wоuld the nurse expect tо аssess in а client experiencing decreаsed levels of thyroid hormone? Select all that apply.
Enrоute Phаse Scenаriо: The AEMT is dispаtched tо a 72-year-old male patient at a nursing home who is in respiratory failure. The patient has a history of chronic obstructive pulmonary disease (COPD) and is dependent on a mechanical ventilator for respiratory support. The nursing staff reports that the patient’s ventilator has malfunctioned and is not providing adequate ventilation. The patient is struggling to breathe and is showing signs of respiratory distress. The time of the call is 1400. The response time will be 9 minutes. The AEMT is partnered with an EMT, and a BLS fire department engine crew is dispatched with the ambulance. The nearest hospital is 15 minutes away. On Scene Phase Scenario: Upon arrival at the nursing home, the patient is found in bed, visibly struggling to breathe. The patient is connected to a malfunctioning ventilator, and the nursing staff reports that the patient’s oxygen saturation has been steadily dropping. The patient is unresponsive to verbal stimuli, with labored breathing and a respiratory rate of 30 breaths per minute. The skin is cyanotic, and the patient’s pulse is rapid at 120 beats per minute. Vital signs are BP 100/60, P 120, R 30, SpO2 75% on the ventilator, and T 98.4°F (37°C). The ventilator settings appear to be incorrect, and the patient is not receiving adequate ventilation. Post Scene Phase Scenario: The AEMT successfully provides manual ventilation to the patient and is now preparing for transport. The patient’s oxygen saturation has improved to 90%, and the patient’s skin color is less cyanotic. However, the patient is still unresponsive, and the ventilator malfunction has not been resolved. Vital signs are BP 110/70, P 120, R 18 (with assistance), SpO2 90% on room air, and T 98.6°F (37°C). The patient remains intubated and manually ventilated. The patient’s vital signs remain unstable despite continued manual ventilation, and the AEMT is concerned about potential deterioration. What should the AEMT focus on to ensure continued care during transport?
Enrоute Phаse Scenаriо: The AEMT is dispаtched tо a private residence for a 78-year-old female patient who has fallen in the bathroom. The patient’s daughter reports that the patient was attempting to get up from the toilet and slipped, hitting her head on the edge of the sink. The patient is complaining of neck and back pain and has some visible bruising on her left side. The time of the call is 1030. The response time will be 6 minutes. The AEMT is partnered with an EMT, and a BLS fire department engine crew is dispatched with the ambulance. It is a cool autumn morning with temperatures at 55°F (13°C). The nearest hospital is 10 minutes away. On Scene Phase Scenario: Upon arrival at the residence, the patient is found sitting on the bathroom floor, visibly in pain. She is alert and able to speak but complains of pain in her neck and lower back. There is visible bruising on her left hip and arm. The patient is unable to remember if she lost consciousness after the fall. The patient’s daughter reports that the patient has a history of hypertension, diabetes, osteoporosis and she takes several medications, including a blood pressure medication and insulin. The vital signs are BP 140/85, P 88, R 16, SpO2 95% on room air, and T 98.6°F (37°C). Post Scene Phase Scenario: The patient has been stabilized and is in the ambulance for transport. She is now complaining of increasing pain in her back, especially when she tries to move. The AEMT has maintained spinal immobilization and initiated intravenous therapy. The vital signs are now BP 135/80, P 96, R 18, SpO2 95% on room air, and T 98.7°F (37.1°C). The patient is still alert and oriented, but she appears anxious. The patient’s pain level is increasing during transport, and the AEMT is concerned that the patient may be at risk for developing a pressure ulcer or complications from immobility. What intervention should the AEMT prioritize to prevent further complications during transport?