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M/S 3 > Exam 3 - Emergency > Flashcards

Exam 3 - Emergency Flashcards

1
Q

the triage process means to ___

A

sort

process of rapidly determining pt acuity using emergency severity index (ESI)

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2
Q

after initial focused assessment, what assessment approach is used

A

H2T

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3
Q

ABCDEFGH

A

airway
breathing
circulation
disability
exposure
facility adjuncts, family
get resuscitation adjuncts
hx, H2T assessment

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4
Q

primary survey focuses on

A

ABCDEFGH

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5
Q

uncontrolled external hemorrhage reprioritized ABC to

A

CAB

applied direct pressure, pressure dressing

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6
Q

what must be done prior to moving past primary survey

A

interventions must be started

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7
Q

___ ___ protection is always a priority

A

cervical spine

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8
Q

AVPU

A

alert
responds to voice
responds to pain
unresponsive

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9
Q

must know Glasgow coma scale

A

must know Glasgow coma scale

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10
Q

s/sx of compromised airway

A

dyspnea
inability to speak
gasping, agonal breathing
foreign body in airway
trauma to face or neck

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11
Q

nasopharyngeal or oropharyngeal airway is obtained on ___ pts only

A

unconscious

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12
Q

what can indicate partial open airway

A

minor talking

no coughing or talking = true airway obstruction

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13
Q

what should be applied with suspected face, head, or neck trauma

A

c-collar

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14
Q

universal donor

A

O -

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15
Q

universal receiver

A

AB

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16
Q

where to assess the central pulse

A

carotid artery

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17
Q

should impaled objects be removed

A

no

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18
Q

when removing clothing, what do you need to be mindful of/assess?

A

what environment they were in - water, hot, chemicals, snow

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19
Q

T or F. family is allowed in the room during trauma or code settings

A

true

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20
Q

resuscitation adjuncts - LMNOP

A

lab studies
monitor EKG
NGT, or orogastric tube
O2 and vent assessment
Pain management

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21
Q

what kind of medication is used re: pain managment

A

start with NSAID, move to opioids later (do not want to compromise LOC)

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22
Q

what occurs during secondary survery

A

when you begin to identify all injuries

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23
Q

SAMPLE - secondary survery

A

symptoms
allergies
medication hx
PMH
last mean/PO in take
events, environment factors leading up to injury

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24
Q

how to apply a bandage with sunken chest wounds

A

close off only on 3 sides

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25
Q

abdominal assessment order

A

look
listen
percuss
palpate

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26
Q

Turners vs. McCullens bruising

A

T: flank bruising

M: around umbilicus

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27
Q

how many people must assist with log rolling

A

3-4 people

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28
Q

where must lungs be assessed during secondary survery

A

posterior

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29
Q

do you asses above or below injury

A

both

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30
Q

what must you ask regarding tetanus

A

has this been administered within the last 10 years

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31
Q

when are autopsies performed

A

upon family request
death within 24 hours of ED admission
suspected trauma or violence
all children

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32
Q

do nurses speak with families about organ donation

A

No, only the organ donation center - must contact them whether the pt is an organ donor or not

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33
Q

when does heat stress occur

A

themoregulatory mechanisms can not compensate for exposure to increase temps

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34
Q

heat-related compensating measures

A

sweating
vasodilation

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35
Q

causes of hyperthermia

A

environment
trauma
metabolic
drugs (tranquilizers, anticholinergics, BB, diuretics)
alcohol
CVD
DM
CNS disorders (ie: stroke)

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36
Q

severe cramps in large muscle groups fatigued by heavy work often seen in healthy athletics with inadequate fluid intake

A

heat cramps

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37
Q

how to resolve heat cramps

A

resolves rapidly with rest
oral, parental replacement of Na, water

elevate, gental massage, analgesia
avoid strenuous activity x12 hours

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38
Q

this occurs with prolonged exposure to heat over hours or days

A

heat exhaustion

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39
Q

s/sx of heat exhaustion

A

fatigue
N/V
extreme thirst
feelings of anxiety
tachycardia
dilated pupils
mild confusion
ashen color
profuse diaphoresis
hypotension
temp: 99.6-105.8

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40
Q

heat exhaustion interventions

A

cool (NOT cold) area, remove restrictive clothing
IVF: NS
moisture sheet
fan spiriting water

41
Q

most serious form of heat stress

A

heat stroke

42
Q

heat stroke temp

A

> 105.8

43
Q

core temp with heat stroke will rise within __ to __ minutes

A

10 to 15 minutes

44
Q

s/sx of heat stroke

A

temp > 105.8
AMS
absent perspiration
circulatory collapse
-hot, dry, ashen skin
-range of neuro symptoms

45
Q

are antipyretics effective with heat stroke

A

No

46
Q

why should reducing temperature with heat stroke be done gradually

A

to prevent hypothermia

47
Q

what to monitor for with a heatstroke

A

rhabdo
myoglobinuria
DIC

48
Q

what occurs with tissue in the vascular space with frostbite

A

fluid is actually freezing

49
Q

most common areas for frostbite

A

hands
feet
toes
ears
nose

50
Q

depth of frostbite depends on which 4 things

A

ambient temp
length of exposure
type of condition (wet/dry)
contact with metal surface

51
Q

superficial frostbite s/sx

A

waxy, pale yellow to blue, mottled
feels crunchy and frozen
tingling, numbness, burning

52
Q

superficial frostbite interventions

A

immerse area in circulating water (98.6-100.4)
warm soaks for facial areas
blisters form within hours
avoid heavy blankets, clothing
feels warm, stinging as it thaws
rewarming is extremely painful
never squeeze, massage or scrub
remove clothing, jewelry

53
Q

deep frostbite s/sx

A

muscle, bone, tendon
skin is white, hard, insensitive to touch
mottling gradually turns to gangrene

54
Q

deep frostbite interventions

A

immerse in temp controlled bath (98.6-104)
elevate (significant edema within 3 hours)
blisters in 6 hrs to days
IV analgesia
tetanus
evaluate for hypothermia
—hospitalization may be indicated; amputation

55
Q

hypothermia core temp is < ___

A

95

56
Q

where is most body heat lost

A

head
thorax
lungs
wet clothing

57
Q

core temp < __ is life threatening

A

89.6

58
Q

mild hypothermia

A

temp: 96.8
shivering**
lethargy
confusion
rational to irrational behavior
minor HR changes

59
Q

moderate hypothermia

A

temp: 89.6-93.2
rigidity
bradycardia, bradypnea
BP only by doppler
metabolic, respiratory acidosis

60
Q

when will shivering decrease

A

core temp of 89.6

61
Q

severe hypothermia makes the person appear ___

A

dead

every effort is made to warm the pt to at least 86 before pronouncing dead

62
Q

goal for moderate and severe hypothermia

A

raise core temp

63
Q

mild hypothermia: passive external (spontaneous) rewarming

A

move to warm, dry place
remove damp clothes
radiant lights
warm blankets

64
Q

mild hypothermia: active external (surface) rewarming

A

fluid, air filled warming blankets
warm water immersion

65
Q

what is afterdrop

A

drop in core temp after rewarming

66
Q

rewarm the ___ before extremities

A

core

67
Q

risks of rewarming

A

afterdrop
hypotension
dysrhythmias

68
Q

when to DC rewarming

A

once core temp reaches 89.6-93.2

69
Q

submission injury is aka

A

nonfatal drowning or near drowning

70
Q

do victims of drowning aspirate liquid

A

no, d/t laryngospasms

71
Q

assessment finding/end result of drowning

A

compromised pulmonary and cardiac function

72
Q

submission injuries require hospital admission for at least __ hour observation

A

23

73
Q

hymenopteran stings occur from what

A

bees
yellow jackets
hornets
wasps
fire ants

74
Q

hymenopteran stings venom can be which 4 things

A

cytotoxic
hemolytic
allergenic
vasoactive

75
Q

when may symptoms of hymenopteran stings occur

A

immediately or delayed for 48 hours

76
Q

who is at greatest risk for animal bites

A

children

77
Q

which animal bite is most common

A

dog

78
Q

which animal bite has greatest incidence of infection

A

cat

Pasteurella organism

79
Q

what infection can occur d/t cat bites

A

septic arthritis
osteomyelitis
tenosynovitis

80
Q

abx for cat bite

A

Augmentin

81
Q

human bites can cause __ and __ infection or ___ virus

A

staph, strep
hepatitis

82
Q

infection rate is __% if human bite is not treated within 24 hours

A

50%

83
Q

prophylactic abx for any bite at risk for infection

A

wounds over joints
wounds > 6-12 hours old
puncture wounds
bites on hands, feet

84
Q

all warm blooded mammals can carry ___

A

rabies

85
Q

how is rabies spread

A

saliva, secretions

86
Q

when must rabies treatment begin

A

before symptoms appear

87
Q

when is human diploid cell vaccine administered for rabies

A

day 0, 3, 7, 14

active immunity

88
Q

2 injection sites for rabies meds

A

deltoid
anteriolateral thigh

89
Q

should you administer rabies meds in the gluteal

A

No

90
Q

what should be administered within 1 hour of poison ingestion

A

gastric lavage

91
Q

gastric lavage contraindications

A

caustic agents
co-ingested sharp objects
ingested nontoxic substances

92
Q

most affective intervention for posioning

A

activated charcoal

gastric lavage within 60 minutes of ingestion

93
Q

activated charcoal contraindications

A

diminished bowel sounds
paralytic ileus
ingestion of substance poorly absorbed by charcoal

94
Q

can mustard gas be irrigated

A

No

95
Q

what do you use to flush eyes

A

NS

96
Q

does decontamination take priority over all interventions except basic life support measures

A

Yes

97
Q

what must be done prior to flushing the eye of chemicals

A

wiping way dry substances

98
Q

remember to review the ppt for additional information

A

remember to review the ppt for additional information

M/S 3 (17 decks)

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