Bio chem and poisons Flashcards
Three forms of Anthrax
inhalation, cutaneous, and gastrointestinal
How does inhalation anthrax start off
fever, cough, malaise, and weakness then progresses to sudden increase of fever, respiratory distress, septicemia, hemorrhagic meningitis and shock
How does cutaneous anthrax start off
small vesicle or papule that itches that forms within 1-7 days of exposure, then becomes an ulcer with necrosis with a black scab by day 10; scab falls off by day 12-14
INHALATION TX
IV ciprofloxacin is choice along with IV doxycycline
Tx last 60 days
Can be given antibiotics if resistant; patient can switch to oral antibiotics when clinically stable
CUTANEOUS TX
oral ciprofloxacin and oral doxycycline
duration of treatment will last 60 days
Vaccine for Anthrax (BIOTHRAX)
3 Subq injections 2 weeks apart then for 6, 12, 18 months w/annual boosters;
Usually for people at high risk–> deal with large animals, military, veterinarians
lab workers where anthrax is worked with
Adverse effect of Biothrax vaccine
muscle and joint aches, HA, local redness/tenderness, or itching, fatigue, nausea, chills/fever
When will you treat anthrax with gentamicin and streptomycin
when you have a few people exposed to anthrax you will give it to the pregnant person
Botulism S/Sx
symmetric flaccid paralysis beginning 12-72 hours after exposure, may last for weeks to months
Boutlism Tx
supportive care with fluid and nutritional support; mechanical ventilation;
* infusion of botulism antitoxin (should be given immediately to minimize damage to nerves)
YERSINIA PESTIS
acquired by inhaling aerosolized Yersinia pestis
w/out tx it rapidly increases to respiratory failure and death
Yersinia Pestis tx
doxycycline or ciprofloxacin for 7 days
no vaccine
Tularemia
most infectious bacteria known; 10 microbes can cause disease; Acquired through skin and mucous membrane, GI tract, and lungs–>most likely spread as an aerosol
Tularemia S/Sx
develop in 3-5 days
acute flu-like illness
fever/chills, body aches, sneezing, sore throat, can progress to a hemorrhagic inflammation of the airway;
pneumonia, respiratory failure, shock, or death
Tularemia TX
SMALL GROUP
IM streptomycin, gentamicin (alternate)
MASS OUTBREAK oral doxycycline (14-21 days) or ciprofloxacin (10 days)
Sarin causes
sever muscle weakness
As nurse what would you do for a pt exposed to Sarin
re-hydrate*
wash chemical off skin, remove clothing, flush with soap and water, use bleach for contamination, flush with soap and water, patient may need ventilator support
What antidote reverses chollinergic effects
ATROPINE
SARIN TX
remove clothing Flush with soap and water objects can be flushed with 5% bleach & water *mechanical ventilation *atropine *diazepam
PRIORITY CARE FOR SARIN
1. maintain airway and ventilation
after breathing you check circulation
(ON EXAM DO NOT PUT IV AS PRIORITY)
drugs used to treat radiation exposure
Prussian blue & potassium iodide
Potassium Iodide
should be given immediately after exposure; If not immediately then within 48 hours; each dose will protect patient for 24 hours;
Repeated does should be avoided during lactation/pregnancy and in newborns
Prussian Blue
increases excretion time of radioactive substances (prevents re absorption in small intestines)
Nursing considerations for Prussian Blue
assess Bowel sounds before patient is given this; Use laxative longside with prussian blue because it may cause constipation; Good hand hygiene and sanitation;
