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PNC 102 lecture > Chapter 13: nursing care of patients w/ emergent conditions and disaster/bioterrorism response > Flashcards

Chapter 13: nursing care of patients w/ emergent conditions and disaster/bioterrorism response Flashcards

1
Q

Primary survey: abcde

A

a = airway
b = breathing
c = circulation
d = disability
e = exposure: remove clothing, look for injuries and medical alert jewelry

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2
Q

secondary survey

A
  • for patient w/ severe trauma
  • identifies non life threatening injuries
  • rapid head to toe assessment
  • keep covered and warm
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3
Q

shock

A
  • circulatory failure
  • decreased cellular perfusion
  • treatment: control bleeding, vital signs, keep warm, IV fluids
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4
Q

types of shock

A

hypovolemic
cardiogenic
obstructive
distributive

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5
Q

shock nursing care

A
  • control bleeding
  • monitor vital signs
  • give oxygen as ordered
  • give iv fluids as ordered
  • keep warm
  • give medications as ordered
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6
Q

anaphylaxis

A
  • severe allergies reaction to protein/drug
  • sudden
  • distributive shock
  • signs and symptoms: respiratory distress (wheezing), hypotension, decreased consciousness
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7
Q

anaphylaxis treatment

A
  • airway
  • oxygen
  • epinephrine
  • antihistamines
  • steroids
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8
Q

shock nursing diagnoses

A
  • risk for shock
  • risk for ineffective peripheral tissue perfusion
  • risk for allergic reaction
  • ineffective airway clearance
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9
Q

major trauma

A
  • mechanism of injury
  • penetrating (open) injuries
  • blunt (closed) injuries
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10
Q

mechanism of injury

A

transfers environmental energy to person

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11
Q

penetrating (open) injuries

A

sharp object, projectiles

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12
Q

blunt (closed) injuries

A

trauma extends to surrounding structures

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13
Q

surface trauma

A

closed wound
open wound

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14
Q

closed wound

A

contusion, hematoma

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15
Q

open wound

A
  • abrasion, puncture, laceration
  • avulsion, amputation
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16
Q

tetanus

A
  • cause: bacillus clostridium tetani
  • spores enter open wound and active
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17
Q

signs and symptoms of tetanus

A
  • jaw spasm (lockjaw)
  • abdominal rigidity
  • dysphagia, dyspnea
  • muscle stiffness
  • seizures
  • death
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18
Q

tetanus vaccinations

A

boosters every 10 years

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19
Q

treatment for tetanus

A
  • hospitalization
  • airway maintenance
  • human tetanus immune globulin (intramuscular)
  • muscle spasm control
  • wound care
  • tetanus toxoid booster
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20
Q

head trauma

A

first phase
second phase

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21
Q

first phase of head trauma

A

initial injury

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22
Q

second phase of head trauma

A
  • involve intracerebral bleeding and edema
  • increased intracranial pressure (ICP)
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23
Q

signs and symptoms of ICP

A
  • headache
  • nausea/vomiting
  • change in LOC
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24
Q

late signs and symptoms of ICP

A
  • dilated, nonreactive pupils
  • unresponsive
  • abnormal posturing
  • decreased pulse rate, widening pulse pressure
  • changes in respiratory pattern
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25
Q

head trauma treatment: decrease ICP

A
  • oxygen
  • head elevated 30-45 degrees
  • head midline
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26
Q

spine trauma

A
  • suspect w/ all trauma pts
  • stabilize spine (neck/back) until injury ruled out
  • maintain airway
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27
Q

chest trauma: heart and lung damage

A
  • pericardial tamponade
  • hemothorax
  • tension pneumothorax
  • flail chest
28
Q

treatment for chest trauma

A
  • oxygen
  • chest tube as needed (PRN)
  • surgery
29
Q

abdominal trauma

A
  • spleen, liver, bladder, intestinal damage
  • monitor for shock
  • abdominal distention
  • IV fluids
  • surgery
30
Q

orthopedic trauma

A
  • emergency care: “splint it as it lies”
  • fractures
  • joint dislocations
  • treatment
31
Q

treatment for orthopedic trauma

A
  • immobilize
  • elevate
  • ice
  • open/closed reduction
  • pain control
32
Q

majo trauma assessment

A
  • identify mechanism of injury
  • vital signs
  • pain level
  • glascow coma scale
33
Q

major trauma nursing diagnoses

A
  • acute pain
  • risk for ineffective cerebral tissue perfusion
  • ineffective breathing pattern
  • ineffective airway clearance
  • impaired physical mobility
  • decreased cardiac output
  • deficient fluid volume
  • risk for infection -
34
Q

major trauma nursing care

A

closed wound
open wound
monitor vital signs

35
Q

closed wound

A

elevation, ice, rest

36
Q

open wound

A

control bleeding
cover w/ sterile (dry/saline soaked) dressing
clean w/ sterile saline
tetanus immunization within 5 years

37
Q

burns

A
  • primary survey: ABCDE
    -airway/respiratory monitoring
  • treatment
38
Q

treatment for burns

A
  • oxygen
  • IV fluid resuscitation
  • temperature regulation
  • pain control
  • wound care/infection control: silver sulfadiazine
39
Q

hypothermia

A
  • core temp below 95 degrees Fahrenheit
  • rewarming (active/passing)
  • stabilizing vital functions
  • prevent further heat loss
40
Q

frostnip vs frostbite

A
  • frostnip: extremities cold, not frozen
  • frostbite: extremities frozen. protect, never rub. dry, sterile dressing. no weight bearing. elevate.
41
Q

hyperthermia

A
  • heat cramps
  • heat exhaustion
  • heatstroke
  • treatment
42
Q

heat cramps

A

muscle spasms

43
Q

heat exhaustion

A
  • excessive sweating
  • hypovolemia
44
Q

heatstroke

A
  • inability to sweat
  • temp 106 degrees Fahrenheit
45
Q

treatment for hyperthermia

A
  • cool environment
  • loosen clothing
  • oral or IV fluids/electrolytes
46
Q

poisoning and drug overdose

A
  • ingested
  • inhaled
  • injected drugs, stings
  • venom bites
  • treatment
47
Q

poisoning and drug overdose: ingested

A

drugs
plants
chemicals

48
Q

poisoning and drug overdose: inhaled

A

natural gas
carbon monoxide
chlorine

49
Q

treatment for poisoning and drug overdose

A
  • identify substance
  • contact poison control center
  • treat as indicated
50
Q

near drowning

A
  • water submersion w/ survival
  • respiratory failure
  • neurological injury
51
Q

treatment for near drowning

A

primary survey: abcde
airway, oxygen
rewarm

52
Q

nursing diagnosis for near drowning

A

ineffective tissue perfusion related to severe anoxia

53
Q

disaster response

A
  • overwhelming event
  • institutional disaster plan activated
  • casualties are triaged
  • disaster drills
54
Q

bioterrorism agents

A

bacteria
viruses
toxins

55
Q

anthrax

A
  • bacterial disease
  • three forms
  • no isolation; use standard precautions
  • fatal if not treated
  • antibiotic therapy
56
Q

three forms of anthrax

A

inhalation
cutaneous
gastrointestinal

57
Q

botulism

A
  • caused by clostridium botulinum
  • most potent lethal toxin known
  • potent neurotoxin
  • paralytic illness: blocks neurotransmission
  • not contagious
58
Q

botulism signs and sympms

A
  • classic triad of botulism:
    1. afebrile
    2. symmetrical descending flaccid paralysis w/ prominent bulbar palsies
  • clear mentation
59
Q

botulism treatment: trivalent ABE quine antitoxin

A

prevents progression of disease

60
Q

supportive care for botulism treatment

A

monitor airway, gag reflex, cough, swallowing, oxygenation

61
Q

botulism infection control

A
  • standard precautions: wash exposed clothes, shower if aerosol exposure, use 0.1% hypochlorite bleach solution for surfaces
62
Q

plague

A
  • coccobacillus yersinia pestis
  • biological attack: primary pneumonic plague
  • incubation per8iod 2-4 days
63
Q

plague signs and symptoms

A
  • high fever, chills
  • headache
  • chest discomfort
  • dyspnea
  • cough, hemoptysis
  • GI symptoms
  • rapidly progressive respiratory failure and sepsis 2-4 days after onset
64
Q

treatment for plague

A

antibiotics

65
Q
A

PNC 102 lecture (38 decks)

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