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Advanced Med/Surg > Environmental Emergencies > Flashcards

Environmental Emergencies Flashcards

1
Q

Factor that cause Heat Related Illnesses

A
  • Humidity above 80%
  • Temperature above 95º F
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2
Q

Those at Risk for Heat Related Illness

A
  • Older adults
  • Blacks (poverty)
  • Construction/Agricultural workers
  • Men
  • Homeless
  • Illicit Drug Users
  • Outdoor athletes
  • Military personnel in countries w/ hot climates
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3
Q

Prevention of Heat Related Illness

A
  • Avoid alcohol & caffeine
  • Rest frequently
  • Limit activity at hottest time of day
  • Wear light weight & light color clothing
  • Check on elderly twice daily
  • Stay in air conditioning
  • Take cool showers
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4
Q

heat related syndrome due to dehydration caused by heavy perspiration and inadequate fluid intake w/ symptoms of HA, weakness, N&V in which the body temperature is not significantly elevated

A

Heat Exhaustion

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5
Q

Treatment for Heat Exhaustion

A

Monitor V/S

Monitor labs (Na+ & K+)

Give cooled IV fluids (NS)

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6
Q

medical emergency in which body temperature exceeds 104º F and heat regulatory systems fail leading to organ dysfunction & death

A

Heat Stroke

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7
Q

type of heat stroke that is suddenly onset as a result of strenuous activity in hot, humid conditions

A

Exertional Heat Stroke

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8
Q

type of heat stroke that occurs over a period of time due to exposure to hot, humid conditions generally affecting the ill & elderly

A

Class Heat Stroke or “Non-exertional” Heat Stroke

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9
Q

Key Features of Heat Stroke

A
  • Temp > 104º F
  • hot, dry skin
    • may or may not perspire
  • mental status change
  • V/S change
  • electrolyte imbalance
  • abnormal clotting
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10
Q

Treatment for Heat Stroke

A
  • Aggressive cooling until rectal temp reads 100º F
  • High concentration O2
  • cooled IV fluids (NS)
  • Foley
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11
Q

Labs Monitored in Heat Stroke

A
  • Electrolytes
  • Cardiac Enzymes
  • Hepatic Enzymes
  • CBC
  • UA
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12
Q

Why do we treat shivering in Heat Stroke patients?

A

because it burns energy and raises body temp…it can also lead to seizures

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13
Q

Pit Vipers include:

A

rattlesnakes, copperheads, & cottonmouths

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14
Q

traingular headed snakes with two retractable, curved fangs that can regulate the amount of venom in their bite

A

Pit Vipers

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15
Q

Envenomation results in:

A
  • local & systemic toxic effects
  • local tissue necrosis
  • massive tissue swelling
  • fluid shifts
  • pulmonary edema
  • DIC
  • death
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16
Q

Sequence of Symptoms in Pit Viper Bites

A
  1. pain
  2. bruising
  3. vesicles/bullae
  4. weakness/ N&V/ hypotension/ seizures
  5. chest pain
  6. anxiety
  7. minty/ rubbery/ metallic taste
  8. twitching
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17
Q

Pit Viper Bite vicitims need to be on ________ because _______ may occur.

A

cardiac monitor; dysrhythmias

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18
Q

Before coming to the hospital, victims of pit viper bites should:

A
  • immobilize the area of body bitten
  • maintain that area at level of the heart
  • keep calm
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19
Q

Treatment of Pit Viper Bite

A
  • O2
  • 2 large-bore IVs
  • Cardiac Monitoring
  • BP Monitoring
  • Tetanus Prophylaxis
  • Pain Medication
  • Measure & Document bite site q 15-30 min
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20
Q

drug given to snake bite victims made from sheep so that antibody fragments of IgG break down venom toxins

A

Crotalidae Polyvalent Immune Fab (Crofab)

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21
Q

Type III hypersensitivity reaction to Crofab that occurs 3-21 days after administration resulting in rash, fever, joint pain, pruiritus & urticaria

A

Serum Sickness

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22
Q

Crofab is contraindicated if the patient is allergic to _______.

A

papaya

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23
Q

Give Crofab cautiously to patients with:

A
  • prior known allergy to Crofab
  • Hypersensitivity to pineapples
  • pregnancy
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24
Q

Crofab vials are initially reconstituted with ___ mL of NS.

A

18

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25
Q

Crofab is further diluted into ___ mL of NS.

A

250

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26
Q

Initial Crofab dose should be administered over ___ minutes.

A

60

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27
Q

Initial Crofab administration rate is ___mL/ hour for observation of allergic reaction then increased to _____ mL/hour.

A

25 - 50; 250

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28
Q

The recommended initial dose of Crofab is __ to ___ vials.

A

4 - 6

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29
Q

Crofab should be administered within ___ hours of the bite.

A

6

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30
Q

Careful observation is needed during the infusion and for ___ after treatment.

A

1 hour

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31
Q

After Crofab administration, measure ___, _____, & _____ once daily in the hospital and immediately if bleeding occurs.

A

PT, fibrogen, & platelets

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32
Q

After discharge, patients having had Crofab need PT, fibrogen, & platelets measured ___ to ___ days & ____ to ___ days after last dose.

A

2 - 3; 5 - 7

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33
Q

After discharge after Crofab, avoid NSAIDS for ___ weeks.

A

2

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34
Q

snake found in the SE & SW part of the US that are non-aggressive & burrow in the ground with small, upright maxillary fangs

A

coral snakes

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35
Q

coral snakes have _____ & ______ toxins in their venom

A

nerve & muscle

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36
Q

coral snake venom is spread through the ______ system

A

lymphatic

37
Q

coral snake bites are mildly painful because the vecom affects the ____________.

A

neurotransmission perception of pain

38
Q

coral snake venom may be delayed ___ to ____ hours

A

12 -18

39
Q

In severe cases of coral snake bites, ______ & _______ can occur.

A

respiratory problems & cardiac collapse

40
Q

Early Signs of Coral Snake Bite

A
  • N&V
  • HA
  • abdominal pain
41
Q

Neurological Symptoms of Coral Snake Bite

A
  • paresthesias
  • mental status change
  • cranial nerve deficits
  • peripheral nerve deficits
42
Q

Cardiac Symptom of Coral Snake Bite

A

elevation in CK-Myoglobinuria

43
Q

Before coming to the hospital, victims of coral snake bites should:

A
  • try to ID & kill snake
  • pressure immobilization of bite area
44
Q

Treatment of Coral Snake Bite

A
  • continuous monitoring
  • 2 large-bore IVs
  • cross-match for blood products
  • airway support
  • intubation
45
Q

For coral snake bite victims, the nurse should contact _______.

A

poison control

46
Q

spiders known as fiddleback or violin spiders that hide in dark areas whose bite is either painless or sharply painful and can produce skin ulcers (classic “red, white & blue sign”)…some victims show no reaction while others develop necrotic wound in 1-3 days

A

Brown Recluse Spider

47
Q

First Aid for Brown Recluse Spider bite

A
  • apply ice during 1st 4 days
  • elevate affected extremity
  • local wound care
  • rest
48
Q

Treatment for Brown Recluse Spider Bite

A
  • topical antiseptic & dressing
  • pain medication
  • antihistamines
  • antibiotics
  • tetanus prophylaxis
  • skin grafting
49
Q

spider that is shiny black with red hourglass pattern on the abdomen (female) or black with gray & white markings (male) who bite in self-defense with neurotoxic venom who bite is painless or sharply painful leaving tiny red puncture marks with usually no progression besides local reaction

A

Black Widow Spider

50
Q

Symptoms of Reaction to Black Widow Spider Bite

A
  • severe abdominal pain***
  • muscle rigidity/ spasm
  • HTN
  • N&V
  • facial edema
  • eyelid drooping
  • twitching
51
Q

Treatment for Black Widow Spider Bites

A
  • monitor V/S especially BP
  • monitor for seizures
  • give O2
  • pain medication
  • muscle relaxers
  • tetanus prophylaxis
52
Q

insect found in most states that injects venom through their tail producing mild symptoms of pain & inflammation

A

scorpion

53
Q

Treatment of scorpion bite

A
  • pain medication
  • wound care
54
Q

scorpion whose bite can produce a potentially fatal systemic response that are found in trees & woodpiles or personal items left on the ground like shoes or clothes

A

bark scorpion

55
Q

Symptoms of Bark Scorpion Bite

A
  • pain at site upon gentle tapping***
  • cranial nerve deficits
  • skeletal muscle deficits
  • high fever
  • HTN
  • GI disorders
  • pulmonary edema
  • cardian dysrhythmias
    • death (rarely)
56
Q

Treatment for Bark Scorpion Bite

A
  • monitor V/S
  • give O2
  • IV fluids
  • ice compress
  • tetanus prophylaxis
  • pain medication
  • wound care
  • contact poison control
  • intubation
57
Q

Systemic effects from bee/wasp stings develop based on _________ & __________.

A

venom load & patient’s sensitivity

58
Q

Symptoms of Systemic Response to Bee/Wasp Sting

A
  • Nausea/Vomiting
  • Diarrhea
  • Destruction of red/white blood cells and platelets
59
Q

If the patient has an allergy to bee or wasp, the sting will result in:

A
  • Itching
  • Hives
  • Swelling of lips/tongue rapidly leading to ANAPHYLAXIS!
60
Q

First Aid for Bee/Wasp Stings

A
  • Quick removal of stinger by tweezers but also by gently scraping it off with edge of knife blade, credit card, or needle
  • Apply ice
61
Q

Treatment for Bee/Wasp Stings

A
  • Large bore IV
  • Oxygen support
  • Benadryl
  • Epi pen
  • Protonix
  • Steroids- Solu-medrol
62
Q

For Animal or Human Bites, the Nurse must:

A

Notify Authorities

63
Q

Most lighting strikes occur during:

A

summer afternoons/evenings

64
Q

First Aid for Lightning Strikes:

A
  • A, B, C’s
  • CPR if in cardiac arrest
  • Spinal Immobilization
65
Q

Prevention of Hypothermia & Frostbite:

A
  • Layer clothing
    • Wear synthetic instead of cotton
  • Sunscreen
  • Sunglasses
  • Hat
66
Q

core temperature of below 95º F

A

Hypothermia

67
Q

Conditions that promote hypothermia:

A
  • Cold water immersion (drowning)
  • Acute illness
  • Advanced age
  • Medications
  • Malnutrition
  • Inadequate shelter
68
Q

First Aid for Hypothermia:

A
  • Remove wet clothing
  • Apply warm, dry clothes
  • Heating blankets
  • High carb drinks
  • No alcohol or caffeine
69
Q

Treatment for Hypothermia

A
  • Monitor ABC’s
  • Warm IV fluids
    • Internal rewarming methods (warm fluids in all ways)
  • Oxygen
  • Heated bladder lavage
70
Q

In patient with hypothermia, do not give any drugs until core body temp is above _____ ºF

A

86

71
Q

least severe type of frostbite consisting of increased blood flow & edema

A

1st Degree Frostbite

72
Q

type of frostbite consisting of arge fluid filled blisters with skin necrosis

A

2nd Degree Frostbite

73
Q

type of frostbite with small blisters containing dark fluid affecting body part that is numb, blue or red and does not blanch and necrosis occurs

A

3rd Degree Frostbite

74
Q

Most severe type of frostbite with no blisters or edema & affected body is numb, cold and bloodless. Necrosis extends to muscle and bone. Gangrene develops and amputation may occur.

A

4th Degree Frostbite

75
Q

First sign of frostbite that means you must get inside and get warm:

A

white, waxy appearance on nose, cheeks, & ears

76
Q

Treatment of Frostbite:

A
  • Rapid rewarming in a water bath of 104 to 108 degrees
  • IV fluids
  • IV opiates
  • Keep affected extremity above heart level
  • Assess hourly for compartment syndrome
  • Tetanus prophylaxis
77
Q

syndrome occuring at high elevations resulting in hypoxia

A

High Altitude Disease (HAD)= Altitude Sickness

78
Q

Supplemental O2 is needed at elevations over _________ feet to prevent illnesses including death.

A

18,000

79
Q

Risk Factors for High Altitude Disease

A
  • Obesity
  • Chronic illnesses
  • Cardiovascular disease
  • Alcohol use
  • Dehydration
80
Q

High Altitude Disease becomes common above _______ feet.

A

8,200

81
Q

Altitude related illness that is the most common cause of death

A

High Altitude Pulmonary Edema (HAPE)

82
Q

Altitude related illness that is rare but life threatening & has occurred at altitudes as low as 8200 feet

A

High Altitude Cerebral Edema (HACE)

83
Q

In high altitudes, early recognition of __________ or __________ is crucial for quick descent to lower levels.

A

ataxia or change in LOC

84
Q

occurs when water washes out alveolar surfactant leading to alveolar collapse and shunting, shunting leads to hypoxemia & acidosis…air replaced by water

A

Drowning

85
Q

In drowning, death occurs from ___________ & ___________.

A

bronchospasm and cerebral edema

86
Q

Questions to ask about drowning victim:

A
  • How long were they under?
  • Fresh or salt water?
  • Any injuries?
  • Were they drinking alcohol?
  • Temperature of water?
87
Q

First Aid for Drowning

A
  • Spine stabilization
  • Airway clearance
  • Ventilatory support
  • CPR if needed
88
Q

Treatment for Drowning

A
  • ABCs
  • NG tube
  • PICC line
89
Q
A

Advanced Med/Surg (10 decks)

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