Provision of a Safe Environment

Question 1

Event of Fire: RACE and PASS

Answer 1

Rescue clients who are in immediate danger
Activate the fire alarm
Confine the fire
Extinguish the fire
--
Pull the pin on the fire extinguisher
Aim at the base of the fire
Squeeze the extinguisher handle
Sweep from side to side to coat the area

Question 2

Types of fire extinguisher

Answer 2

A - Wood, cloth, paper, plastic…
B - Flammable liquids or gases, grease, tar, oil based paint.
C - Electrical equipment

Question 3

Restraints (safety devices)

Answer 3

The use of side rails is not considered a restraint when used to prevent a sedated client from falling.
The client must be able to exit the bed easily in case of an emergency when using the side rails. Only the top two side rails should be used.
Bed must be kept in the lowest position.
If restraints are necessary, the PHCP’s prescriptions should state the type, the reasons and time frame for use.
The prescription should be renewed within a specif time frame (agency policy).
A reason should be given to the client and family, and their permission should be sought and documented.
Assess skin and and circulatory status every 30 min and remove safety devices at least every 2 hours.

Question 4

Airborne precautions: Diseases and barrier protection

Answer 4

Measles (sarampo), Chickenpox (varicella), Pulmonary or laryngeal tuberculosis
Private room with negative pressure and door closed.
Health cares use N95

Question 5

Droplet precautions: Diseases and barrier protection

Answer 5

Adenovirus, diphtheria (pharyngeal), epiglottitis, influenza, meningitis, mumps (caxumba), mycoplasmal or meningococcal pneumonia, parvovirus B19, pertussis (coqueluche), pneumonia, rubella, scarlet fever, sepsis, streptococcal pharyngitis.
Private room or cohort client.
Wear surgical mask when within 3 feet of patient.

Question 6

Contact precautions: Diseases and barrier protection

Answer 6

Colonization or infection with a multidrug-resistant organism, Clostridium difficile, respiratory infections (such as syncytial virus), influenza (objects), wound infections, skin infections (cutaneous diphtheria, herpes simplex, impetigo, pediculosis, scabies, staphylococci, varicella), eye infections (conjunctivitis).
Private room or cohort client.
Use gloves and gown.

Question 7

Biological Warfare Agents: Anthrax

Answer 7

Caused by Bacillus anthracis.
Transmission: Skin (through cuts and abrasions handling contaminated animals), GI (ingestion of undercooked meat), and inhalation (of bacterial spores).
Symptoms:
-Skin: starts with a itchy bump, progress to liquid sac, that becomes a painless ulcer with dead tissue in the middle. Toxins destroys surrounding tissue.
-GI: nausea, vomiting, that progress to severe abdominal pain, vomiting of blood, and severe diarrhea.
Lungs: begins with same symptoms as flu, with fever, muscle aches and fatigue. Progress to breathing problems and shock. Toxins cause hemorrhage and decay of lung tissue.
Usually treated with antibiotics such as ciprofloxacin, doxycycline, or penicilin. A blood test is available to detect infection, and vaccine has limited availability.

Question 8

Biological Warfare Agents: Smallpox (varicella)

Answer 8

Transmitted in air droplets and highly contagious.
Symptoms begin 7 to 17 day after exposure and include: fever, back pain, vomiting, malaise, and headache. Papules develop 2 days after symptoms develop and progress to pustular vesicles.
Vaccine is available.

Question 9

Biological Warfare Agents: Botulism

Answer 9

Serious paralytic illness caused by nerve toxin produced by the bacterium Clostridium botulinum (death can occur within 24hs).
Spores are found in the soil and can spread through the air or food. Can’t be spread person to person.
Symptoms: abd cramps, diarrhea, nausea, vomiting, double or blurred vision, drooping eyelids, difficulty swallowing or speaking, dry mouth, and muscle weakness.
Neurological symptoms begin 12 to 36 hours after ingestion of food-borne botulism and 24 to 72 hours after inhalation and can progress to paralysis of the arms, legs, trunk or respiratory muscles.
If diagnosed early, can be treated with antitoxin and wound botulism may be surgically removed.
No vaccine available.

Question 10

Biological Warfare Agents: Plague

Answer 10

Caused by Yersinia pestis, bacteria found in rodents and fleas (contracted by being bitten or ingestion of contaminated meat or by handling an animal infected.
Transmission is by direct person-to-person spread. Forms include bubonic, pneumonic and septicemic.
Symptoms usually begin within 1 to 3 days and include fever, chest pain, lymph node swelling and a productive cough (hemoptysis).
The disease rapidly progresses to dyspnea, stridor, and cyanosis, death occur from respiratory failure, shock and bleeding.
Antibiotics are effective only if administered immediately, the usual choice include streptomycin or getamicin. A vaccine is available.

Question 11

Biological Warfare Agents: Tularemia

Answer 11

Also called deer fly fever or rabbit fever. Is a infectious disease of animals caused by the bacillus Francisella tularensis.
Transmitted by ticks, deer flies, or contact with infected animal.
Symptoms: fever, headache, and an ulcerated skin lesion with localized lymph node enlargement, eye infections, GI ulcerations, or pneumonia.
Treatment: antibiotics such as streptomycin, getamicin, doxycycline, and ciprofloxacin.
Recovery produces lifelong immunity (vaccine is available).

Question 12

Biological Warfare Agents: Hemorrhagic fever

Answer 12

Caused by several viruses, including Malburg, Lassa, Junin, and Ebola.
Carried by rodents and mosquitoes and can be transmitted directly by person-to-person spread via body fluids.
Symptoms include fever, headache, malaise, conjunctivitis, nausea, vomiting, hypotension, hemorrhage of tissues and organs, and organ failure.
No known specific treatment is available (use of symptomatics).

Question 13

Chemical Warfare Agents: Sarin

Answer 13

A highly toxic nerve gas that can cause death within minutes of exposure.
It enters the body through the eyes and skin and acts by paralyzing the respiratory muscles.

Question 14

Chemical Warfare Agents: Phosgene

Answer 14

A colorless gas normally used in chemical manufacturing that if inhaled at high concentrations for a long enough period will lead to severe respiratory distress, pulmonary edema, and death.

Question 15

Chemical Warfare Agents: Mustard gas

Answer 15

is yellow to brown and has a garlic-like odor that irritates the eyes and causes skin burns and blisters.

Question 16

Nuclear Warfare

Answer 16

Acute radiation exposure develops after a substantial exposure.
Can occur from internal or external absorption.
Symptoms depend on the amount of exposure to the radiation and range from nausea, vomiting, diarrhea, fever, electrolyte imbalances, neurological and cardiovascular impairment to leukopenia, purpura, hemorrhage, and death.