#3 EXAM 305 Flashcards
What should an Emergency plan include?
Response to casualties caused by crisis.
Plan to return to normal operations afterwards.
Evacuate/Escape plan.
Location of Emergency supplies.
Organizational skills.
Coordination of community researches.
What does the CDC suggest for intervention?
Control of records of who comes in contact with infected patient
PPE
Hospital equipment dedicated and clean
Limit needle use/sharp objects
Avoid Aerosol-generating prodedures
Proper Hand Hygiene
Safe environment infection control techniques
Safe injection practices
Proper infection control precautions
Manage exposure to support hospital staff.
What does the CDC categorize biological threats by?
Potential impact on public health.
Category A: Describe it.
Easily transmitted, person to person, high mortality rate with potential for major public health impact. Might cause public health impact. Might cause public panic, social disruption and special action for public health preparedness.
EX:
Bacillus anthracis (Anthrax)
Clostridium botulisim toxin (Botulisim)
Ebola
Yersinia pestis (Plague)
Variola major (small pox)
Category B: Describe it.
Moderately easy to disseminate moderate morbidity, decrease mortality.
EX:
Brucella species (brucellosis)
Coxiella brunette (Q fever)
Category C: Describe it.
Emerging pathogens that could be engineered for mass dissemination because of availability ease of production and dissemination and their ease of production and dissemination and their increased potential for morbidity and mortality rates and major health impacts.
EX:
Hantaviruses
Nipah virus (NiV)
Yellow Fever.
What is the nurses role in relation to biological agents, chemical substances, radiation that cause widespread harm or illness?
There are 4 of them:
1. Learn the signs/symptoms of the chemical/bio agent attack and treatment
2. Maintain current list of health/law enforcement contacts.
3. Obtain current knowledge of emerging management and assist in development of management plans.
4. Assist in development of management plans.
What does SNS stand for
Strategic National Stockpile
What does the SNS have a stockpile of?
Vaccines
Antibiotics
Medical and Surgical supplies and patient support supplies like bandages, airway, supplies, and IV equipment.
What is the reason we don’t stockpile local hospitals, clinics and individuals?
The expiration dates.
What are the bioterrorism attack agents?
- Anthrax
- Viral
- Chemical
- Ionizing
What bacteria is responsible for Anthrax?
Bacillus Anthhracis
Anthrax symptoms?
-Tissue Necrosis
-Swelling and Hemorrhage
Treatment for Anthrax?
Ciprofloxacin (Abx)
What are inhalation anthrax symptoms?
-Fever
-Cough
-Sob/Dyspnea
Example of viral bio-terroist that are viral?
-Polio
-Small Pox
-Ebola
Treatment for viral bioterrorists?
-Vaccines
-Viral agents are a real threat
Examples of chemical bioterrosist?
Nerve Gasses, Blood agents, choking/Vomiting agents
Overstimulation by acetylcholine
What is the antidote for nerve agents?
Atropine.
4 examples of nerve agents?
- Convulsations
- Loss of consciousness
- Salivation
- Involuntary urination
What are acute radiation syndrome symptoms?
-Nausea
-Vomiting
-Diarrhea
-Weight loss
-Anorexia
-Fatigue
-Bone Marrow Suppression
Treatment for acute radiation syndrome?
-Potassium Iodine, Why?
It helps prevent Thyroid Cancer.
Primary mineral for bone and joint formation?
Calcium
Who is involved with the regulation of Calcium?
Parathyroid hormone, calcitonin, Vitamin D.
How does the presence/Absence of Vitamin D affect calcium absorption?
Increase VIT D=Increase absorption
Decrease VIT D=Decreased absorption
What is the inactive form of Vitamin D called?
Cholecalciferol
How does cholecalciferol interact with the skin?
-It’s synthesized to form cholesterol.
Calcium ion influences the ———–of all neurons?
Excitability.
What other functions does calcium play in the body?
-Blood coagulation
-Muscle Contraction
What is hypocalcemia?
Lack of dietary calcium or Vitamin D is a common cause.
Symptoms of hypocalcemia?
-Seizures
-Confusion
-Memory loss
Drug therapy for hypocalcemia
-Lasix
-Bisphosphonates
Hypocalcemia therapy?
Calcium Salts
How to administer calcium salts?
-Give with meal or 1 hour after meal.
-Administer slowly with IV calcium.
Side effects of Alendronate (Fosamax)
-Dyspepsia
-N/V
-Diarrhea
-Muscle Spasms
What is Alendronate (Fosamax)?
-Inhibits bone reabsorption and used for Metabolic Bone disorders
Patient education for Alendronate?
-Encourage exercise
-No caffeine/carbonation
-Take with empty stomach and 1 glass of H20
-At least 30 before food, stay upright position for 30 minutes and until after 1st food of the day.
-Diet must have Ca and VIT D
-Follow up with DEXA scan.
-
What is osteoarthritis?
Degenerative joint disease that breaks down articular cartilage.
What is rheumatoid arthritis?
Chronic and progressive disease causing inflammation of multiple joints, autoimmune.
Treatment of osteoarthritis?
NSAID’S
Risk of NSAID’S?
Increased risk of bleeding
Risk for HTN development
Risk of Hypercalcemia
Increased risk for infection.
What is the goal of treatment for Rheumatoid Arthritis?
Decrease inflammation and pain. Increase of mobility.
What are DMARD’S?
Modifying anti-rheumatic drugs.
Is Hydroxychloroquine (Plaquenil) Non Biologic? (T/F)
True
Is Adalimumab (Humira) Biological?
True
Adverse effects of Hydroxychloroquine?
-Retinopathy
-Anorexia
-N/V
Adverse effects of Adalimumab?
-Increase risk of serious infections
-HF exacerbation.
Acute arthritis cause by uric acid accumulation in the body (blood and joints)
Gout.
Needle like uric acid crystals accumulate in the joint?
Acute gouty arthritis.
Symptoms of acute gouty arthritis?
-Pain
-Redness
-Inflammation
-Attacks occur at night.
Triggers for gouty arthritis?
-Alcohol
-Dehydration
-Stress
-Injury to joint
-Fever
-Drugs that cause gout attacks.
What are drugs that cause gout attacks?
-Thiazide diuretics
-Asprin
-Cyclosporine
-EtOH
Pharmacotherapy for skin disorders?
-PO
-Topical
-Parenteral
What skin disorders need prolonged therapy?
-Eczema
-Psoriasis
-Dermatitis
What are the classifications of skin disorders?
-Infectious
-Inflammatory
-Neoplastic
Examples of infectious skin disorders?
- Bacterial infections: Boils, Impetigo
- Fungal infections: Ring Worm, Jock Itch.
- Parasitic infections: Lice, tic, mite.
- Viral infections: Herpes simplex, shingles, chicken pox, fever blisters.
Examples of inflammatory skin disorders?
Sun exposure injuries
Overactive glands, increase hormone production, acne, rosacea, dermatitis, psoriasis (itch/cracks)
Examples of neoplastic?
Skin cancers: Squamous cell carcinoma, basal cell carcinoma, malignant melanoma.
Benign neoplasms: keratosis, keratoacanthoma
Ringworm of the scalp-fungal?
Tinea Capitis?
Tinea Capitis treatment?
OTC anti fungal drugs
-Undecylenic acid.
Lice
-Need human blood
-Lay egg-nits
-Treated with permethrin
Permethrin, how does it work?
-Treatment for lice and mites
-Leave on 10 minutes.
Permethrin teaching points?
-Itch can last 2-3 weeks after mites/lice.
-Do not use if sensitive to chrysanthemums.
Disorder of hair and sebaceous glands that affect up to 80% of adolescents?
Acne vulgar
Pharmacotherapy goals for acne?
1.Inhibit sebaceous gland activity
2.Decrease bacterial colonization
3.Prevent follicles from becoming plugged with keratin
4.Decrease inflammation of lesions
Anti-Acne drug, Retinoid
Tretinoin (Avita)
Decreases inflammation and redness?
Doxycycline
What are the 3 types of Dermatitis?
1.Atopic dermatitis/Eczema
2.Contact dermatitis
3.Seborrheic dermatitis
What is Isotretinoin?
-Category X- Monitor patient for pregnancy
-Vision checks every 6 months
-Access lab value q2 month
Hypersensitive response?
Contact Dermatitis
Chronic, inflammatory skin disorder with genetic predisposition
Atopic dermatitis
Symptoms of Atopic dermatitis?
Family HX
75% had initial onset before 1 year of age
Symptoms of seborrheic dermatitis?
-Greasy scales affect scalp, central face and anterior chest.
Symptoms of contact dermatitis?
Exposure to allergens
Varying degree of cracking/blisters.
What’s the most effective way to treat itching dermatitis?
Topical corticosteroids (Glucocorticoids)
Low potency topical agents ( 2 of them)
-Dexamethasone
-Hydrocortisone
Inflammation skin disorders of unknown etiology with lesions affecting mainly the face
Rosacea
What is rosacea exacerbated by?
-Sunlight
-Stress
-Temperature
-Anything that dilates blood vessels including: Alcohol , spicy foods, skin care products, warm beverage.
Chronic inflammation skin disorder; red, raised patches of skin with flaky, tick, silver scales called plaques.
Psoriasis
Psoriasis triggers
-Stress
-Smoking
-Infections
-ACE Inhibitors, beta blockers, tetracyclines, NSAIDS
Small papule or inflammatory bumps without pus that swell, thicken, and become painful
Rosacea
Requires long-term treatment and is most common form of this skin disorder?
Psoriasis Vulgaris
