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MED SURG III

EXAM 1 - EMERGENCY CARE

QuestionAnswer
Family Focused Interventions Encourage family members to stay with the patient. ep the family informed, as much as possible. many facilities, it is permitted that family stays during CPR
Complications of Rapid IV Infusions Air Embolism, Infection, Phlebitis, Infiltration, Extravasation, thrombophlebitis, Hematoma, Clotting & Obstruction. Cardiovascular Overload
TRIAGE Prioritizes incoming patients, to identify those who cannot wait to be seen.
Emergent Triage Highest Priority
Urgent Triage Serious health problems, but not immediately life-threatening
Nonurgent Triage Episodic Illnesses
Emergency Severity Index (ESI) Assigns patients from level 1 to level 5 with 1 being the most urgent.
Canadian Triage & Acuity Scale (CTAS) Five levels, including time parameters that guide how frequently patients must be reassured by either a nurse or provider. Includes resuscitation, emergent, urgent, less urgent, nonurgent
Resuscitation Category Assessed continuously
Emergent Category Assessed every 15 minutes
Urgent Category Assessed every 30 minutes
Less Urgent Category Assessed every 60 minutes
Nonurgent Category Assessed every 120 minutes.
Nursing Responsibilities of Triage Perform a physical assessment, reassess those waiting, initiate emergency treatment if necessary, manage communication with patients in the waiting room, provide education to patients and families if needed, sort patients into priorities groups according to guidelines, and transport patients to appropriate treatment areas.
Intimate Partner Violence Assessment When people who have been abused seek treatment, they may present with physical injuries or health problems such as anxiety, insomnia, or GI symptoms related to stress. The possibility of IPV should be investigated whenever a person presents with multiple injuries that are in various stages of healing, when injuries are unexplained, and when the explanation does not fit the physical picture.
Intimate Partner Violence Nursing Interventions If the patient is in immediate danger, they should be separated from the person who is abusive or neglectful whenever possible. Referral to a shelter may be the most appropriate action, but many shelters are inaccessible to people with mobility limitations.
Colposcopy Facilitates assessment by magnifying tissues and looking for evidence of microtrauma. Evidence is collected through photography, videography, and analysis of specimens.
Light-Staining Microscope Enables the examiner to identify motile and nonmotile sperm and infectious organisms.
Acute Disorganization Phase May manifest as an expressed state in which shock, disbelief, fear, guilt, humiliation, anger, and other such emotions are encountered or as a controlled state in which feelings are masked or hidden and the victim appears composed.
Denial & Unwillingness Phase Not willing to talk about the incident
Heightened Anxiety Phase Anxiety, fear, flashbacks, sleep disturbances, hyper alertness, and psychosomatic reactions that is consistent with PTSD
Reorganization Phase The incident is put into perspective. Some victims never fully recover and go on to develop chronic stress disorders and phobias.
Examination After Sexual Assault Head to toe for injuries, especially injuries to the head, neck, breasts, thighs, back, and buttocks. External Evidence of trauma (bruises, contusions, stab wounds), Dried Semen Stains, Broken Finger Nails, Material found under nails, Oral Examination, including specimen of saliva and cultures of gum and tooth areas. Pelvic & Rectal Exams
Specimen Collection In Sexual Assault Vaginal Aspirate (sperm), secretions (vaginal pool for semen, blood, and sperm), STD screening, Pregnancy Test, Foreign Materials, Pubic Hair.
Prophylaxis Antibiotics in Sexual Assault Offered, not required, such as Ceftriaxone given IM with 1% lidocaine, to prevent gonorrhea. Single oral dose of Metronidazole and Azithromycin for syphilis and chlamydia.
Antipregnancy Medications in Sexual Assault Prescribed after a pregnancy test. To promote effectiveness, it should be given within 12-24 hours, but no later than 72 hours after intercourse.
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