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VN 42 Med Surg 3 > Test 2 Spinal Shock And Disaster > Flashcards

Test 2 Spinal Shock And Disaster Flashcards

1
Q
  1. Botulism manifestations and complications(Slide 11)
A

Early signs 4D: diplopia, Dysarthria, Dysphonia, Dysphagia

  • Paralysis of motor and autonomic nerves
    • Drooping of eyes
    • Generalized muscle weakness.
    • Paralysis of respiratory muscles
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2
Q
  1. Smallpox manifestations(Slide 12)
A

• Asymptomatic for first 7 to 14 days before rash develops: high fever (101 to 104F)
• Rash begins on face, progresses to extremities similar to chickenpox lesion.

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3
Q
  1. Anthrax nursing considerations and medical management(Slide 8)
A

• Treated with antibiotic therapy.
- Cipro, Levaquin: treatment lasts 4 weeks or longer.

• Use standard precaution/hand hygiene and appropriate PPE.

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4
Q
  1. Nerve agent manifestation
A

• Cholinergic crisis including bilateral miosis.
• Increased gastrointestinal motility.
• Nausea and vomiting
• Bradycardia
• Bronchoconstriction
• Weakness

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5
Q
  1. Nerve agent medical management
A

• Drugs administered: atropine sulfate, diazepam.

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6
Q
  1. Gas, radiological nursing management and priority
A

• Priority will be to direct client to decontamination area and assess for respiratory function.
• Administer substances that interfere with organ concentration (lead) or speed up removal of radioactive substance.
• Limit external contamination
- Stay indoors, go to centrally located room or basement with few windows, turn off all fans, air conditioners, forced-air heating units, remove and place clothing and shoes in plastic bag, shower/wash with soap and water. Keep outdoor pets outside.

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7
Q

Chemical exposure nursing management

A

• Avoid fatality by assisting victims to fresh air. Higher ground: remove victims clothing, wash skin with soap and water and remove contact lens.

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8
Q
  1. Cyanide medical management(Slide 17)
A

• Wear protective garments and respirator masks.
• Administer cyanide antidote: amyl nitrite, sodium nitrite IV route, intravenous sodium thiosulfate.

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9
Q
  1. Triage steps for disasters(Slide 2)
A
  1. Evaluate the emergency or disaster: type of incident, number of victims, resources.
  2. Ask questions: sort victims, find emergency team and plan.
  3. Follow the systematic route to victims: start in and work out quickly.
  4. Evaluate and tag each victim.
  5. Treat victims
  6. Document triage results
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10
Q
  1. Know what each color represents for disaster triage and be able to ID them.
A

• Red- Immediate
- Airway and breathing difficulties.
- Uncontrolled or severe bleeding
- Decreased level of consciousness
- Severe medical problems
- Shock (hypoperfusion)
- Severe burns

• Yellow -Delayed
- Burns w/o airway problems.
- Major or multiple bone or joint injuries
- Back injuries with or without spinal cord damage

• Green-Minor
- Minor fractures
- Minor soft tissue injuries

• Black-Deceased
- Obvious death
- Obviously non-survivable injury, such as major open brain trauma
- Full cardiac arrest

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11
Q
  1. CSF leakage manifestations(Slide 15)
A

• Monitor for leakage of CSF.
- Clear drainage from nose-look for halo sign

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12
Q
  1. Epidural hematoma manifestations
A

• Most deadly medical emergency due to increased ICP
• Bleeding between dura mater and skull-usually arterial blood

Manifestations immediately
• Loss of consciousness then a brief period of alertness, followed again by LOC-Coma
• Nausea/ vomiting, increased ICP

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13
Q
  1. Epidural/ Cerebral hematoma medical management and surgical management (Slide 13)
A

Medical Management:
• Indications of surgical emergency: rapid change in LOC; signs of uncontrolled increased ICP

Surgical Management:
• Burr holes/Trephining: often with epidural hematoma
• Intracranial surgery: craniotomy, craniectomy, and cranioplasty

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14
Q
  1. Post intracranial surgery priority assessment.(Slide 16)
A

• Supine or side lying position.
• Regular monitoring; observe for increased ICP.
• Monitor temperature: elevate can increases brain metabolism and damage.
• Control thrombus or embolus; cerebral edema- limit fluids

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15
Q
  1. Subdural hematoma manifestations(Slide 14)
A

• Bleeding between dura mater and arachnoid-usually venous blood
• CSF may leak into subdural space.
• Increased ICP
• N/V
• Change in LOC
• Later Bradycardia and decreased heart rate
• Headache can come 24-48hrs after injury.
• Some neurological deficits/ confusion can still develop months after injury.

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16
Q
  1. Autonomic dysreflexia(hyperreflexia)manifestations
A

• Severe hypertension
• Slow heart rate
• Pounding headache
• Nausea
• Blurred vision
• Flushed skin.
• Sweating
• Goosebumps (erection of pilomotor muscles in the skin)
• Nasal stuffiness
• Anxiety
• Uncontrolled autonomic dysreflexia can lead to seizures, stroke, and death.

  • Long term effect after spinal shock has resolved.
  • Spinal cord injuries above T6
  • Diaphoresis, Severe headache, Nausea
17
Q
  1. ICP manifestations
A

• Change in level of consciousness
• Pupils change
• Impaired extra ocular movements

18
Q
  1. Spinal shock manifestation
A

A loss of sympathetic reflex activity below the level of injury within 30 to 60 minutes of a spinal injury
Manifestations
• Paralysis
• Hypotension
• Bradycardia
• Warm, dry skin.
• Bowel and bladder distention
• Poikilothermia (condition in which the temperature of the body varies with that of the environment.)

If the level of injury is in the cervical or upper thoracic region
• Respiratory failure

19
Q
  1. Spinal shock client education
A

• Will often repair within 1 week to months after injury.

20
Q
  1. What are the primary survey triage letters and what do they stand for?
A

• A: airway
• B: breathing
• C: circulation
• D: disability
• E: exposure

21
Q

C1-C3

A

-Breathe with assistance of ventilator
-Swallow and speak
-Use a power wheelchair with movement of head and neck control
-Operate computer or appliances, such as TV or lights, using voice-activation
device or mouth stick

22
Q

C4-C5

A

-Breathe with ventilator assistance or possibly independently
-Use a power wheelchair with sip-and-puff or hand control
-Drink independently using a long straw and bottle

23
Q

C6-C8

A

-Eat, groom, bathe, and attain bed mobility with assistive devices
-Transfer from bed to chair using a slide board
-Perform self-catheterization (men); more difficult for women
-Use manual wheelchair in flat environment
-Drive with hand controls

24
Q

T1-T6

A

-Perform personal care and household activities independently
-Use manual wheelchair, including up and down curbs
-Stand between bars with leg splints

25
Q

T7-T12

A

-Transfer from bed to wheelchair independently
-Propel wheelchair over uneven surfaces and rough terrain
-Care for bowel and bladder independently
-Perform light housekeeping and meal preparation
-Balance on legs
-Walk with splints or long leg braces

26
Q

L1-L2

A

Drive a car with hand controls

27
Q

L3-L5

A

Walk with support of walker or crutches

28
Q

S1-S5

A

-Walk normally without assistive devices
-Control bladder, bowel, and sexual functions

29
Q
  1. Spinal cord injury complications during recovery period(Slide 20)
A

• Respiratory arrest
• Spinal shock (areflexia): no cord function below injury; body will adjust and return; poikilothermia.
• Autonomic dysreflexia (hyperreflexia)
• Orthostatic hypotension
• Pressure ulcers
• DVT

30
Q
  1. Concussion client education(slide 3)
A

• Contact primary provider.
• Return to ED if symptoms of increased ICP occurs.
• Severe headache, Slurred speech, vomiting, unilateral weakness

31
Q
  1. Role of Nursing Disaster
A

Preparation pf public in case of disaster
Triage
• Divide in to triage categories-triage system.
• Immediate, delayed, minimal, and expectant.
Nursing Interventions based on priority ABC’s.
• Administer first aid to victims in immediate category by keeping airway open, covering wounds, controlling bleeding, splinting fractures.
• Delegate the care of those with minimal health needs to volunteers with first aid skills.

VN 42 Med Surg 3 (13 decks)

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