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Nursing 202 - Midterm > Emergency Nursing > Flashcards

Emergency Nursing Flashcards

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1
Q

ABCDE

A

D: disability - determine neuro status, AVPU
E: exposure - undress to assess wounds or areas of injury

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2
Q

AVPU

A

Alert
Verbal
Pain
Unresponsive

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3
Q

Secondary survey

A
  • Health HX
  • Head-to-toe assessment: reassess airway, breathing, VS
  • DX and labs
  • Monitoring devices: ECG, arterial lines, urinary catheters
  • Splinting of FX’s
  • Wound care
  • Any other necessary interventions based on condition
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4
Q

Hemorrhage

Assessment changes

A

BP, HR, RR, SaO2, skin color, cap refill, pain (location, intensity, mechanism)

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5
Q

Hemorrhage

Fluid replacement

A

LR, NS, blood transfusion

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6
Q

Hemorrhage

Pressure points

A 
Temporal
Facial
Carotid
Subclavian
Brachial 
Radial & ulnar
Femoral
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7
Q

Multiple trauma

Priorities

A

Assume cervical spine injury

Injuries interfering w/vital physiologic function have highest priority

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8
Q

Intra-abdominal injuries

Assessment

A
  • Obtain HX
  • Abd assessment, referred pain may indicate spleen, liver, intraperitoneal injury
  • Labs, CT, abdominal US, diagnostic peritoneal lavage
  • Stab = sonography
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9
Q

Intra-abdominal injuries

Management

A
  • Ensure airway, breathing, circulation
  • Immobilize C-spine
  • Continuous monitoring
  • Document ALL wounds
  • If viscera protruding, cover w/sterile, moist, saline dressing
  • Hold PO fluids
  • NG tube to aspirate stomach contents
  • Tetanus & prophylactic ABX
  • Rapid transport to SX if indicated
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10
Q

Crush injuries

Complications

A
  • Hypovolemic shock
  • Spinal cord injury
  • Erythema, blistering
  • FX
  • AKI
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11
Q

Heat stroke

@ risk

A

People not acclimated to heat, older/very young, ill/debilitated, certain medications increase risk

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12
Q

Heat stroke

S/S

A

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

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13
Q

Heat stroke

Management

A
  • Reduce temp to 102 F (39.2 C) as quick as possible
  • Monitor temp, VS, ECG, LOC, I&O
  • Cooling methods
  • IVF
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14
Q

Heat stroke

Cooling methods

A
  • Cool sheets, towels, sponging w/cool water
  • Ice to neck, groin, chest, axillae
  • Cooling blankets
  • Immersion in cold water bath
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15
Q

Heat stroke

RX

A

Anticonvulsant, potassium, sodium bicarb, Benzos

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16
Q

Frostbite

S/S

A

Hard, cold, and insensitive to touch
May appear white or mottled
May turn red and painful as re-warmed

17
Q

Frostbite

Management

A
  • 37-40 C circulating bath for 30-40 min @ a time
  • Analgesics for pain
  • Do not massage or handle; if feet involved - no walking
18
Q

Hypothermia

A

Internal core temp < 35 C

@ risk : older adults, infants, persons w/concurrent illness, homeless, trauma, alcohol increases susceptibility

19
Q

Hypothermia

Management

A
  • Remove wet clothing, rewarm, supportive care

- Rewarming methods

20
Q

Hypothermia

Complications

A

Cold blood returning from extremities has high lactic acid level —> cardiac dysrhythmias & lyte disturbances

21
Q

Hypothermia

Rewarming methods, active

A

Bypass, warm fluid admin, warm humidified O2, warm peritoneal lavage

22
Q

Hypothermia

Rewarming methods, passive

A

Warm blankets, over the bed heaters

23
Q

Poisoning

Assessment

A
  • ABCs
  • Monitor VS, LOC, ECG, UO
  • Labs
  • Determine what, when, & how much was ingested
  • S/S of poisoning/tissue damage
  • Age & weight
24
Q

Poisoning

Measures to remove toxins

A
  • Emetics
  • Gastric lavage
  • Activated charcoal
  • Cathartic when appropriate
  • Admin of specific antagonist ASAP
  • Diuresis, dialysis, hemoperfusion
25
Q

When is induced vomiting contraindicated?

A

Corrosive agents such as acids and alkalines —> destruction of tissues in esophagus

26
Q

Carbon monoxide poisoning

S/S

A

CNS SYMPTOMS - headache, muscular weakness, palpitations, dizziness, confusion, coma

Skin color not reliable sign (can range from pink to cherry-red)

27
Q

Carbon monoxide poisoning

Treatment

A

Get fresh air immediately
CPR as needed
Admin oxygen, 100% or under hyperbaric pressure

28
Q

Chemical burns

Management

A
  • Immediately flush skin w/running water from shower, hose, faucet
  • *lye or white phosphorus should be brushed off skin (activated by water)
  • Some substances may require prolonged flushes or irrigation
  • Reexamination of areas in 24 hrs, 72 hrs, and 7 days
29
Q

Victims of human trafficking

Presentation to ED

A
  • Injury, accompanied by boyfriend or travel partner (generally older)
  • Hx of chronic runaways, homelessness, self-mutilation
  • Common behaviors: cowering, frightened, agitated, deferring to person accompanying them
  • Common complaints: injuries, poor healing, abd pain, dizziness, HAs, rashes/sores
  • Addiction, panic attacks, impulse control, hostility, SI
30
Q

What is a positive finding on a diagnostic peritoneal lavage?

A
  • Bile, feces, blood in specimen

- RBC greater than 100,000, WBC greater than 500

Nursing 202 - Midterm (12 decks)

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