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Emergency Nursing
| Question | Answer |
|---|---|
| focuses on providing immediate, efficient and organize care to individuals | Emergency and Disaster Nursing |
| Sudden Event | Disaster |
| 2 types of Disaster | Natural and Manmade |
| Phases of Disaster | Mitigation Preparedness Response Recovery |
| To reduce or lessen the impact of disaster before they occur | Mitigation |
| organizing resources effectively to respond when disaster occurs | Preparedness |
| Provide immediate or actual care and lifesaving interventions during disaster | Response |
| To rehabilitate, prevent complications and return to normal life | Recovery |
| Education on fire hazards Strengthening buildings for earthquake | Mitigation |
| Disaster Drills Trainings in Triage | Preparedness |
| Performing triage providing first aid | Response |
| Helping patient in evacuation center offer psychological support/first aid | Recovery |
| If a patient cannot write, he/she can put an __ mark or ___ on the consent form | x and thumb mark |
| Consent if assumed based on patients condition | Implied consent |
| Acting for patients good when they cant decide (done by the doctor) | Paternalism |
| Severe form of Asthma | Status Asthmaticus |
| Fracture vs crying | fracture |
| fracture vs crying with suicidal cues | crying with suicidal cues |
| laceration vs chest pain | chest pain |
| bacterial infection > fever | expected |
| IV antibiotics > rashes | unexpected |
| bleeding vs hypertension | bleeding |
| mild bleeding vs hypertensive crisis | hypertensive crisis |
| Primary Survey | ABCDE |
| Secondary Survey | FGHI |
| Airway problem: patient can still breath and talk | Partial Obstruction |
| harsh inspiratory sound in partial obstruction causing noisy breathing | Stridor |
| In partial obstruction, what vital signs compensate | HR, RR |
| In partial obstruction, encourage __ to clear airway. Place patient in ___ | Coughing High Fowlers/Upright Position. Second option is Semi Fowler |
| Airway problem: patient can't breath, talk and cough | Complete Obstruction |
| Silent Chest | Complete Obstruction |
| Universal sign of obstruction/choking | Clutching the neck |
| In complete obstruction, patient in conscious. The right action to perform is ___ | Heimlich Maneuver or Abdominal Thrust |
| Arm is across chest if chest pain is present is knows as | Levine Sign |
| In complete obstruction, patient in UNconscious. The right action to perform is ___ | Position head midline or neutral |
| Maneuver easier to perform and is contraindicated with SCI and Neck Trauma | Head Tilt Chin Lift |
| Maneuver that is difficult to perform and for patient with SCI and Neck Trauma | Jaw Thrust |
| From mouth to oropharnyx CIRCULAR TUBE LIKE PLASTIC for unconscious patient with SPONTANEOUS BREATHING prevent TONGUE FALL BACK mount to mandible in size Short Term | Oropharyngeal Airway |
| From nostrils to nasophraynx SOFT FLEXIBLE RUBBER For CONSCIOUS/SEMI-CONSCIOUS with no gag stimulation nose to earlobe in size short term | Nasopharyngeal Airway |
| From mouth to trachea STRONG BENDABLE PLASTIC For patient with RESPI INSUFFICIENCY > connect to mechvent inflate BALLOON/CUFF > prevent dislodgement and maintain intact long term | Endotracheal Tube |
| Are injuries that can damage skin, tissues, organs and bones | Burns |
| Types of Burns | CERT Chemical: Bleach, Acid Electrical: Circuits Radiation:, UV rays. radiation Thermal: Fires |
| Most common type of burns | Thermal |
| Priority Action in case of Fire | RACE |
| How to use the fire extinguishers | PASS |
| Epidermis Reddish Intact Skin Painful | First Degree Burn |
| Dermis Moist Surface Fluid filled blisters Most Painful Example. contact with freshly boiled water | Second Degree Burn |
| Subcutaneous Pearly white Painless due to nerve ending and pain receptor destruction | Third Degree Burn |
| Muscle to Bone Blackish/Charred (Charcoal like in color) Painless | Fourth Degree Burn |
| varies according to degree of burns | Depth |
| If burns located in face > high risk for | airway obstruction due to swelling or edema |
| Patient factors in burns | old age and comobidities |
| 3 Phases of Burns and Management | 1. Emergent/resuscitation phase 2. Acute/immediate phase 3. Rehabilitative/recovery phase |
| Occurs during the first 48 hours (2days) | Emergent/resuscitation phase |
| Fluid Shift from Intravascular space to Interstitial space leads to | Generalized Dehydration > hypovolemia > dec. cardiac output > dec. perfusion > ischemia > necrosis |
| What happens of there is fluid shift | Hemoconcentration |
| Hypoperfusion > anaerobic metabolism = | Inc. lactic acid |
| In Emergent/resuscitation phase, assess | Singed nasal hair and hoarseness of voice (indication of nasal injury) > risk for narrowing airway due to swelling or edema = AIRWAY OBSTRUCTION |
| Antidote for carbon monoxide poisoning | Oxygen |
| Carbon monoxide binds stronger in hemoglobin than oxygen for about | 200x |
| In Emergent/resuscitation phase, IV fluid resuscitation | Insert 2 Large IV Bores 1. BT: Isotonic: PNSS 2. Meds and Fluid: Isotonic: LRS |
| Most sensitive indication of effectiveness of perfusion | Urine Output |
| In Emergent/resuscitation phase, what meds be given for severe pain | Opioids: Morphine Sulfate |
| what phase happens after 48 hours post burns/after fluid resuscitation | 2. Acute/immediate phase |
| Fluid shifts from Interstitial Space to Intravascular Space = | Hypervolemia and Hemodilution Polyuria, Hypokalemia, Hyponatremia as dilutional effect and Low Sodium Bicarbs = Metabolic Acidosis |
| Monitor for fluid overload in Emergent/resuscitation phase > | Crackles and dyspnea = Pulmonary Edema |
| Most reliable indicator for edema | Body Weight; 1kg=1l of fluid retention |
| Happens 5th Day Onwards | Rehabilitative/recovery phase |
| What type of moisturizer to prevent dryness (less irritant), use ___ for scratching | Water Based moisturizer, Knuckles |
| Nursing Diagnosis for Burns | Disturbed Body Image |
| in Pneumothorax, air enters the | pleural space |
| Occurs when air enters the pleural space > lung compression due to pressure > lung collapse > impaired gas exchange | Pneumothorax |
| Types of Pneumothorax | Closed Open Tension |
| air leaks from the pleural space but the CHEST WALL IS STILL INTACT no open wound usually from BLEB RUPTURE | Closed Pneumothorax |
| Ex. blunt forced causes bleb rupture, car accident | Closed Pneumothorax |
| Air enters the pleural space through an OPEN CHEST WOUND chest wall is EXPOSED air moves in and out | Open Pneumothorax |
| Sucking chest wound | Open Pneumothorax |
| Ex. Stabbed causing an open chest wound | Open Pneumothorax |
| Air enters the pleural space but CAN NOT ESCAPE CAUSING THE PRESSURE TO BUILD UP FASTER Cause is from worsening OPEN OR CLOSED pneumothorax Heart and blood vessel compression | Tension Pneumothorax |
| Tracheal Deviation in Unaffected Side | Tension Pneumothorax |
| Most Dangerous type of Pneumothorax | Tension Pneumothorax |
| In open pneumothorax, how many sides to tape | 3 sides to allow air to exit but not re enter |
| For rapid evacuation of excess air in pleural space | Needle Compression |
| what intercostal space is for chest tube insertion | 4th-6th = 5th intercostal space |
| Intervention to promote lung expansion | Raise Head of the Bed |
| Incentive Spirometer effective during | Inspiration |
| the higher the ball gets, the better the pulmonary function | |
| Positive lung sound means | The lung has re expanded |
Created by:
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