Concepts of Emergency Nursing Flashcards
1
Q
Trauma Hospitals
A
- Designation vs Verification
- Levels 1-5
- Level 1 Most comprehensive
— UCLA Level 1
— Henry Mayo level II
— Providence Holy Cross Level II
— Dignity Health Northridge Level II
2
Q
Emergency Department (ED) Environment
A
Characterized by:
- Rapid change
- Multispecialty care
- Crowded, noisy conditions
- Crucial communications pre-hospital helicopter personnel
- Complex age and demographic range of patients
3
Q
Interdisciplinary Team Members
A
- Prehospital care providers
- Emergency medical technicians (EMTs)/ paramedics- Basic Life Support
- Emergency medicine physician
- Nurse practitioners and physician assistants
- Support staff – Radiology, Ultz, Resp Therapist, Lab, SW, CNA’s, Clerical Staff
- Nurses, including:
— Forensic nurse examiners (for victims of rape, child abuse, domestic violence)
— Psychiatric crisis nurse team
4
Q
Scope and Practice of Emergency Nursing
A
- Emergency management traditionally refers to urgent and critical care needs.
- Has increasingly been used for nonurgent problems
Emergency management broadened to include concept an emergency is whatever the patient or family considers it to be - ER nurse needs special training, education, experience, and expertise in assessing and identifying health care problems in crisis situations
- The emergency department (ED) staff works as a team
5
Q
Assessment of the ED Patient
A
- Most important task of ER Nurse
- Rapid assessment of normal vs abnormal data
- Interpretation of assessment findings
- Communication
- Priority setting
- Technical and procedural skills
6
Q
Training and Certification
A
- Basic Cardiac Life Support (BCLS)
- Advanced Cardiac Life Support ( ACLS)
- Pediatric Advanced Life Support (PALS)
- Certified Emergency Nurse (CEN)
7
Q
Reasons People Seek ED Care
A
- Pain (most common)
- Injuries (especially falls in older adults)
- Abdominal pain
- Chest pain
- Breathing difficulty
- Headache
- Fever
- SNF’s
8
Q
Issues in Emergency Care
A
- Patient identification/Patient Privacy
- Consents to treat
- Injury prevention for patients
- Risk for errors and adverse events
- Injury prevention for staff
- Limiting exposure to Health Risks
9
Q
Staff & Patient Safety Considerations
A
- Violence can come from patients and families
- Drugs and alcohol use
- Gang membership
- Long wait times
- Crowded conditions
- Patients in custody
- Health Care workers are 4 times more likely to be attacked at work than any other occupation.
10
Q
Providing Holistic Care
A
- Patients have variety of heath care needs
- Cultural considerations
- Care of patients with mental illness/homelessness
- *Disposition and (difficult) discharge needs
— some pts cant go home;
— is their house suitable/ can they perform ADLs - Case management
- Patient/family teaching
- Death in the ED
11
Q
Cultural Awareness
A
- Customize discharge instructions to address patient needs
- Consider patient’s reading level, primary language, visual acuity
- Educational materials/instructions at 6th-grade reading level
- Materials available in Spanish, other regional languages; use interpreters
12
Q
*Discharge Planning
A
- Depends on nature of injury, facility’s resource capability
- Transport immediately to OR or interventional radiology suite
- Admit to trauma critical care unit, step-down unit, or surgical floor for continued care
- Transfer to facility with higher level of care
- *Senate Bill 1152 – Effective Jan 1, 2019
- *discharge with:
— *a place to go w/ transportation
— *medications in their hand
— *Clothes
— *meal
13
Q
*Care of the Elderly ED Patient
A
- *½ of all older adults who visit ED are admitted
- *Focus on preventing and reducing risks to older adults like falls, med errors, skin breakdown, HAI’s.
- *Communication challenges
- *Complicated medical histories
- *Comorbid conditions that make care difficult
- *Memory impairment may cause difficult history taking
- *May have difficult discharge needs
- *Consider safety issues after discharge
14
Q
Patient and Family Interventions
A
- Provide Comfort
- Relieve Anxiety
- Reassurance
- Treat the unconscious as if conscious
- Ensure patient safety
- Keep Family informed
15
Q
Death in the ED
A
- Sudden/unexpected” death
- Family presence during resuscitation
- Special circumstances when medical examiner case involved
- Dealing with family members in crisis
- ED personnel dealing with death
- coroner’s case: need of an autopsy/ unknown cause of death
— leave all tubes/ drains in
23
Q
Airway Obstruction
A
Oropharyngeal/Nasopharyngeal
Airway Insertion
24
Q
Endotracheal Intubation
A
25
Q
ET tube
A
