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chapter 24

Emergency, First Aid

What are the effects of blood loss?(#12) 1)decrease in oxygen supply to the body 2)blood pressure falls, heart pumps faster 3)the body will attempt to clot the blood to halt bleeding4)uncontrolled bleeding results in shock and death
The average adult man has approximately __ pints of blood circulating in his bloodstream?(753) book 12
Blood is necessary to transport ________ and _______ to all parts of the body? (pg 753)book oxygen, nutrients
The most common type of external hemmorrhage that results from damaged or broken capillaries?(#13) Study guide capillary bleeding
What are the three sources for bleeding?(#13) study guide Capillary, venous, arterial
Type of bleeding when a vein is severed or punctured with the result of slow, even flow of dark red blood.(#13) venous bleeding
an abnormal circulatory condition in which an blood clot travels through the blood stream and becomes lodged in a blood vessel, traveling to the vital 754 book embolism
What bleeding is the least common type of injury? Why? (#13)SG pg754 book Arterial bleeding. Because arteries are located deep in the body and are usually protected by bones, fat, and other structures.
What are two dangers of venous bleeding?pg 754 book shock from blood volume lossthe entrance of air in the severed vein (embolism)
This type of bleeding is characterized by heavy spurting of bright red blood in the rhythm of the heartbeat. (#13)SG arterial bleeding
This bleeding is characterized by the oozing of minor cuts, scratches, and abrasions. capillary bleeding
The most effective general treatment of bleeding is to apply?(#13) direct pressure over the bleeding site using dressing or the cleanest material possible over the wound and firm pressure with gloved hand
If bleeding continues after the bandage is applied what should you do?(#13)SG apply pressure with the hand as well as the bandage.
Bleeding should be controlled in ___ to ____ mins? (#13)SG 10-30
Even if the bandage supplying pressure becomes saturated with blood, it should only be removed by? a physician
Raising the bleeding part of the body above the level of the heart will do what?(#13)SG decrease the amount of blood flow and increase the body's ability to clot at this site.
can a bleeding part of the body be raised above the level of the heart if there are fractures? no
If direct pressure and elevation do not control bleeding, what type of pressure is applied to any of the pressure points situated along main arteries?(#13)SG Nursing Inter: indirect pressure
How do you apply indirect pressure? By using the fingers or heel of the hand to compress the artery against the underlying bone between the heart and the wound.
What are the most common pressure point for indirect pressure? carotid, subclavian, brachial, femoral arteries.
If bleeding cannot be controlled by direct, indirect pressure or elevation, what is the last resort method to be used if the persons life is in danger? application of a tourniquet
What damages may a tourniquet cause? damage nerves and vessels directly below/under tourniquet
An improperly, loosely applied tourniquet will not stop arterial flow but will hinder what? venous flow, causing bleeding to increase.
A nose bleed is called what? epitaxis
profuse bleeding from the nose can lead to? shock
what are some causes of epitaxis? trauma (e.g.,direct blow to nose)infections, high blood pressure,strenous activity,low humidity in winter months
self-inflicted local digital trauma from nasal picking is called? epistaxis digitorum
You should always assess older adult's blood pressure if epitaxis is present because? it may be caused by hypertension
Nursing Intervention: epitaxis The person with epitaxis must be kept ____ and in a ____ position, doing what? quiet, sitting, leaning forward
Why should you keep a person with epitaxis head tilted slightly forward? so that blood will not run down the back of the throat and cause choking and vomiting
steady pressure should be applied to the nose of a person with epitaxis using steady pressure for how long before releasing? 10-15 minutes
You should remind the victim of what with epitaxis? What type of compress should you apply over the nose? remind to breathe and expectorate any accumulated blood.Apply ice
If bleeding continues form the nose despite interventions, medical assistance should be sought because? the victim possibly is bleeding from a posterior site, and fluid replacement and possible surgery may be needed.
A type of bleeding that is potentially life-threatening and difficult to diagnose and can progress rapidly is? Internal bleeding
What are come common causes of internal bleeding? fractures, knife or bullet wounds, crush injuries, organ injuries, ruptured aneurysms
When a person expectorates blood it is called? hemoptysis
Vomiting blood is called hematemesis
Dark, tarry stools are called melena
blood in the urine is called hematuria
What should you assess when looking for internal bleeding? vertigo, hemoptysis, hematemesis, melena, hematurial. Pain, tenderness, dislocation where injury is suspected.
A person with internal bleeding should be placed on a ___ surface with legs ______? flat, slightly elevated
what type of nursing interventions should be applied for internal bleeding? establish airway, treatment of shock instituted, cold compress on area of suspected injury.
Why should ice not be directly applied to the skin for an injury? it can burn the skin, place cloth or towel between ice and skin
A person with internal bleeding body's temp can be maintained with blankets and vital signs are assessed every _ mins? 5
Should a person with internal bleeding be given anything to eat or drink? no
The basic rules for first aid treatment after the ABC's are? 1. stop bleeding 2. treat for shock 3. prevent infection
What types of wounds involve the underlying tissues of the body and does not break the top layer of skin?(#15) SG closed wounds
Examples of closed wounds are? ecchymoses, contusions
discolorations of an area of the skin or mucous membrane caused by the extravasation of blood into the subcutaneous tissues; also called a bruise? ecchymoses
injuries that do not break the skin, caused by a blow and have edema, discoloration, and pain. Examples are strains, sprains are? contusions
What signs and symptoms are most likely to occur with a closed wound? edema 24-48hrs, discoloration due to hematoma, deformity of limbs, shock, pain and tenderness, internal bleeding
Nursing interventions for a closed wound would be to? apply ice packs, padding, soft roller bandage, elastic bandage,
wounds that are openings or breaks in the mucous membrane or skin? open wounds
Infection is more common in wound that do not what? Why? bleed freely, because active bleeding tends to flush bacteria from the wound.
What are the five types of open wounds? abrasions, incisions, lacerations, punctures, avulsions
An active immunizing agent prepared from detoxified tetanus toxin that produces an antigenic response in the body, conferring permanent immunity to tetanus infection tetanus toxoid
type of wound caused by rubbing or scraping the outer layers of the skin? abrasions
Example of abrasions are? rope, road burns, scratches, scrapes of the knees and elbows
What interventions should be performed for abrasions? removal of dirt with normal saline from the inside out
Should strong antiseptics be used on an abrasions? Why? no, they may irritate the skin
Signs and symptoms of infection with abrasions are? edema, erythema, pain, purulent exudate.
piercing wounds of the skin that can be made by knives, nails, wood, glass? puncture wounds
If an object punctures the skin and remains firmly in the skin, should it be removed? Why? No, it may cause bleeding. Wait for physician to remove it
All puncture wounds must be thoroughly ____ to remove as much debris and microorganisms as possible. Pt's will usually require what? irrigated, tetanus booster
smoothly divided wounds made by sharp instruments, such as knives, glass, razors, paper edges incisions
Are infections likely to occur with incisions? Why? no, because blood flow freely removing debris
Bleeding may be extensive with incisions, and what can possibly be damaged? muscles, tendons, and nerves
Nursing interventions for incisions would include? cleaning, cover with sterile dressing
What type of bandage can be used on an incision? butterfly bandage, steri-strips
When should medical attention be sought with an incision? if it is deep, bleeding is profuse, function is limited
wounds that are torn with jagged, irregular edges are? lacerations
lacerations are often caused by? Auto accidents, blunt objects, heavy machinery accidents
Nursing interventions for lacerations should include? cleaning, control bleeding by applying pressure,
what are used to close the edges of lacerations? adhesive strips, steri-strips, or butterfly bandages
a torn piece of tissue that results in a section being completely removed or left hanging by a flap. Avulsions
why are avulsions more difficult to heal than other types of wounds? because wound edges may not be well approximated when repaired
What nursing interventions should be used with avulsions? control of bleeding with direct pressure, cleaning, suturing possible, close observation of healing
extremely dangerous wounds that need immediate medical attention? chest wounds
What happens with many wounds of the chest with the pleural space? air or blood escapes into the pleural space and can cause atelectasis.
the potential space between the visceral and parietal layers of the pleurae pleural space
What should the nurse assess for with a chest injury? part 1 sharp pain at site, pain with breathing, difficult/labored breathing, failure of expansion of one/both sides of chest, expectoration of bright red/frothy blood, shock, cyanosis of skin and mucous membranes,
what should the nurse assess for with a chest injury? part 2 sucking hissing sound as air flows in and out of chest, distention or edema of the neck and arm veins, anxiety, tracheal deviation.
Why should a sharp object that is causing a chest wound not be removed? it could result in further bleeding and the entrance of air into the chest wound.
What should you do with an object penetrating a chest wound? immobilize with dressings and tape
If there is a sucking chest wound (without the penetrating object in place) what must be applied? an airtight dressing with any available material, gauze plastic wrap, clothing or nurses hand.
The dressing for a sucking wound needs to be? larger than the wound so it is not sucked into the hole, and should be airtight as possible.
The victim of a sucking chest wound should be monitored for any signs and symptoms of? developing pneumothorax
If the victim shows any signs of increased respiratory distress, what may be developing? What should be done? a tension pneumothorax, one side of the dressing should be left untaped. Liquids withheld.
The most common injury to the chest is? fractured ribs
Severe blunt trauma to the chest may result in? which is two or more ribs fractured in two or more places. This results in paradoxic motion of the chest with respiratory distress. flail chest
What should be done for a person with flail chest? head and shoulders elevated to facilitate breathing if spinal injury is not suspected
Dressing for a flail chest should be applied carefully to any open wounds to avoid? pressure to the chest that might impair breathing
Tight bandages can do what to a wound? interfere with circulation to the tissue and can act as a tourniquet, causing tissue and nerve damage
loose ends on bandages can be? caught on objects
should a joint be bent after it is bandaged? no
what should be exposed to check for circulation when applying a bandage? tips of fingers and toes
The nurse should assess for what with bandages? edema, circulation
knots should be tied where over a wound? Why over the top, to control bleeding
the most common type of dressing that consists of several thicknesses of gauze, covered with tape or gauze? bandage compress
bandage made of a piece of cloth that it folded diagnally and cut along the fold, used most commonly as a sling to support injured bones. triangular
This bandage is used to support an injured part, apply pressure to a dressing for control of bleeding, secure a splint to immobilize a part. roller bandage
a roller bandage should be applied uniformly to ensure even pressure. It is safer to use greater number of evenly spaced overlapping turns than? fewer tighter turns of the bandage
The roller bandage is started at the point of dressing or at the part of the limb with the? smallest circumference (wrist, ankle)
Any substance (solid, liquid or gas)that even small amounts cause damage to the body or interferes with the function of its systems. poison
what information do the poison control centers needs? weight, age, substance ingested,inhaled,injected,amount, when, other drugs, status of pt.
The most common type of poisoning is by? mouth
Common ingested substances that are poisonus are? household cleaning products, garden/garage supplies, drugs, medications, food, plants
After immediately calling poison control what should be the first step with the victim? maintain airway
For a child how much water may the poison control instruct the nurse to give?For an adult? 1-glass child1-2 glasses adult
What may be contraindicated when giving water to a victim that had ingested poison? when the cause is a drug, because water would increase the rate of absorption.
what is the most commonly abused drug in the world? alcohol
Four major types of injuries that occur with bone, tendons, muscles, and ligaments? fractures, dislocations, strains, sprains
What are the common sources of inhaled poisons? carbon monoxide, carbon dioxide, chlorine
What are some nursing interventions for inhaled poisons? assess danger, remove victim from area, loosen clothing from throat and chest, maintain airway or CPR
Emergency care for injected poisoning involves minimizing the travel of poison to the? heart
If an individual has been stung by a bee, the stinger should be removed with? the side of a knife or credit card in a scraping motion.
What happens when a barbed stinger is grasped with tweezers? venom may be forced into the skin
What nursing interventions should be performed with an insect bite/sting? wash with soap and water, apply cold pack to relieve pain and slow absorption of poison.
A paste of baking soda and water may relieve what at the site of a sting/bite? pruitus
Should meat tenderizer be used for a sting or bite? no, it can irritate the skin
within how long may a victim of a bite or sting may experience a severe allergic reaction? 60 min or several hours
What are some common signs of anaphylactic shock? Urticaria, wheezing, edema of the lips and tongue, generalized pruritus, repiratory arrest
Alcohol is what type of depressant? CNS
Signs and symptoms of mild intoxication are? nausea, comiting, diarrhea, lack of coordination, poor muscle control. flushing of the face and eyes, slurred speech, lethargy, inappropriate behavior
Serious alcohol intoxication signs and symptoms are? drowsiness that progresses to coma, rapid weak pulse, depressed labored breathing, respiratory arrest, loss of urinary/bowel functions, disorientation, restlessness, hallucinations, loss of memory...
Signs and symptoms of a drug abuser are? loss of reality orientation, hallucinations, varying degrees of consciousness, coma, slurred speech, extremes in mood swings, anxiety, pulse may increase or decrease, pupils may constrict or dilate.
Created by: lpnjuly2010
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