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Exam 1 NRS 202 > Emergency Nursing > Flashcards

Emergency Nursing Flashcards

1
Q

Two types of triage systems

A

Basic system 3 categories
Emergency Severity Index (ESI)

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2
Q

3 categories of the basic system of triage

A

Emergent
Urgent
Nonurgent

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3
Q

Urgent category means

A

serious health problem but not life threatening

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4
Q

How many levels are in the ESI?

A

5 levels
1 - most urgent to 5 - least urgent

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5
Q

ESI stands for

A

Emergency Severity Index

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6
Q

The primary survey in the ER focuses on

A

stabilizing life-threatening conditions

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7
Q

AVPU mnemonic

A

Alert
Verbal
Pain
Unresponsive

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8
Q

A
B
C
D
E

A

Airway
Breathing
Circulation
Disability
Exposure (undress to assess)

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9
Q

The secondary survey in the ER consists of what components

A

health hx
head-to-toe assessment
Diagnostics/labs
Monitoring devices: ECG, ABGs
Splinting of fractures
Wound care

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10
Q

Types of airway and ventilation interventions

A

Oropharyngeal and nasopharyngeal airway insertion
Endotracheal intubation
King tube or laryngeal mask
Cricothyroidotomy

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11
Q

Once an airway is established, how is adequate ventilation assessed?

A

Listen to bilateral lung sounds
Check O2 sats
ABGs
Rise & fall of chest

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12
Q

Priorities of care for trauma patients

A

Determine extent of injury and est priorities of treatment
Stabilize C-spine
Injuries interfering with vital physiologic function

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13
Q

Assessment of intra-abdominal injuries

A

Obtain hx of injury
Assess for referred pain to indicate spleen or liver injury
Labs
US and CT scan
Abdominal assessment and other body systems

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14
Q

What assessment is specifically used for stab wounds?

A

sinography

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15
Q

Management of pt with intra-abdominal injury

A

Ensure ABCs
Immobilize C-spine
If viscera protruding, cover w sterile, moist saline dressing
Hold oral fluids
NG tube to aspirate stomach contents
Tetanus and abx prophylaxis
Rapid transport to sx if indicated

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16
Q

Complications of crush injuries

A

hypovolemic shock
spinal cord injury
erythema and blistering
fractures
AKI

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17
Q

Symptoms of shock

A

cool, moist skin
increase HR
decreased BP
decreased urine output
decreased cap refill

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18
Q

Management of hemorrhage

A

Assess for changes - SHOCK
Fluid replacement - isotonic, colloids, blood products
Control of bleeding

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19
Q

Patients in shock with low blood volume are at risk for what

A

MI

20
Q

Goals of treating hemorrhage

A

control bleeding
maintain adequate circulation
prevent shock

21
Q

Types of heat stroke

A

non-exertional
exertional

22
Q

type of heat stroke with prolonged exposure to an environmental temperature of >39.2 C (102.5 F)

A

nonexertional

23
Q

heat stroke caused by strenuous activity that occurs in hot environments

A

exertional

24
Q

Who is at highest risk of heat stroke?

A

people not acclimated to heat
older or very young
ill or debilitated people
people taking certain meds

25
Q

Manifestations of heat stroke

A

CNS dysfunction
elevated temp of 40.6 C (105 F) or higher
hot, dry skin
anhidrosis
tachypnea
hypotension
tachycardia

26
Q

Management of heat stroke

A

ABCs
Reduce temperature as fast as possible using cool water and ice on back of neck, armpits, groin and chest
Monitor temp, VS, ECG, LOC, I&O
IVs to replace fluid
Meds: anticonvulsants, potassium, bicarb, benzos

27
Q

Manifestations of frost bite

A

hard, cold and insensitive to touch
appears white or mottled
turns red and painful when rewarmed

28
Q

Management of frostbite

A

Controlled but rapid rewarming; 37-40 C circulation water for 30-40 min intervals
Analgesics for pain

29
Q

What should you NOT do with frostbite?

A

Rub or massage the area as it can cause more damage

30
Q

Condition in which core body temperature is 35 C or less

A

hypothermia

31
Q

Who is at highest risk for hypothermia

A

older adults
infants
persons with concurrent illness
homeless
trauma patients

32
Q

Management of hypothermia

A

ABCs
Remove wet clothing
Rewarm
Cardiac monitoring

33
Q

How can patients be internally rewarmed with hypothermia?

A

cardiopulmonary bypass, warm fluid admin, warm humified oxygen, warm peritoneal lavage

34
Q

How can patients externally rewarmed with hypothermia?

A

Warm blankets
over-the-bed heaters

35
Q

What happens when cold blood returns from the extremities in hypothermia?

A

it can cause cardiac dysrhythmias and electrolyte disturbances because of the high lactic acid content

36
Q

Why is cardiac monitoring important in patients with hypothermia?

A

The return of cold blood from extremities has a high content of lactic acid which can cause dysrhythmias and electrolyte imbalances

37
Q

condition in which any substance that when ingested, inhaled, absorbed, applied to the skin injures the body by its chemical action

A

poisoining

38
Q

Treatment goals of poisoning

A

Remove or inactivate poison before absorbed
Provide supportive care in maintaining vital organ function

39
Q

Assessment of the patient with poisoning

A

ABCs
Monitor VS, LOC, ECG, UO
Labs
Determine what, when, and how much substance was ingested
S/s of tissue damage
Health hx
Age and weight

40
Q

Why is age and weight important to assess with poisoning?

A

Determines treatment such as amount of antagonist medication given

41
Q

Management of poisoned patient

A

Use of emetics
Gastric lavage
Admin of specific antagonist as early as possible
Diuresis
Dialysis
Hemoperfusion

42
Q

When do you not use emetics with a poisoning?

A

if it is a corrosive agent such as lye or drain cleaner

43
Q

Patients with chemical burns are re-examined at what intervals?

A

24 hrs
72 hrs
7 days

44
Q

Management of food poisoning

A

ABCs
Determine causative agent if possible
Treat fluid and electrolyte imbalances
Control N/V/D
Clear liquid diet, progress as tolerated

45
Q

Management of overdose

A

ABCs
Support respiratory and CV function
Enhance clearance of causative agent using gastric lavage, activated charcoal, Narcan
Provide safety of patient and staff

46
Q

Management of acute intoxication

A

ABCs
Monitor of CNS depression and hypotension
Watch for withdrawal symptoms

47
Q

Management of psychiatric emergencies

A

Maintain safety of all
Determine if patient is at risk of injuring self or others
Maintain patient self-esteem
Determine psychiatric hx if any
Determine if has current care by psychiatrist or therapist

Exam 1 NRS 202 (7 decks)

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