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Emergency, Trauma, Disaster, and Critical Care Nursing: Comprehensive Guide, Exams of Nursing

This comprehensive document covers emergency, trauma, disaster, and critical care nursing. It provides details on emergency nursing, the role of the emergency nurses association, certifications, EMTALA, triage, assessments, airway/breathing/circulation management, neurological status, common ER problems, end-of-life care, and environmental emergencies. The document delves into pathophysiology, signs/symptoms, and evidence-based treatments, equipping nurses with knowledge and skills for high-acuity settings. This resource serves as a valuable reference for nursing students, emergency/critical care nurses, and healthcare professionals.

Typology: Exams

2023/2024

Available from 08/12/2024

JanneyGuru01
JanneyGuru01 🇺🇸

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Emergency, Trauma, Disaster, Critical

Care Nursing- Questions and Answers.

How does the ANA define emergency nursing? - \The ANA defines emergency nursing as " the care of individuals across the lifespan with perceived or actual physical or emotional alterations of health that are undiagnosed or require further interventions. Emergency nursing care is episodic, primary, typically short-term and occurs in a variety of settings." What is the ENA, what does it stand for, and what does it provide? - \ENA is the Emergency Nurses Association. It is a specialty nursing organization aimed at advancing emergency nursing practice. The ENA provides standards of care for nurses working in the ED- scope of practice and position statements. What is the BCEN, and what does it provide? - \The BCEN is the Board of Certification for Emergency Nurses and it provides process/testing for nurses to become nationally certified in emergency nursing and subspecialties What are some Emergency Nursing CErtifications/Roles? - \Certified Emergency Nurse (CEN) Certified Pediatric Emergency Nurse (CPEN) Certified Transport Registered Nurse (CTRN) Certified Flight Registered Nurse (CFRN) Acute Care Nurse Practitioner (ACNP) Clinical Nurse Specialist (CNS) What does EMTALA stand for? - \Emergency Medical Treatment and Active Labor Act What are some different dispositions for a patient in the ER? - \1. Discharge

  1. AMA- Against Medical Advice
  2. LWBS- Left without being seen
  3. Admission 5.Transfer
  4. Deceased Define triage - \Process of rapidly determining patient acuity Represents a critical assessment skill for emergency nurses What is the Triage System? - \A system that categorizes patients so most critical are treated first

What does ESI stand for and what does it do? - \ESI stands for Emergency Severity Index and it is a five-level triage system that incorporates illness severity and resource utilization What does the primary survey of the assessment compose of? - \Assessing a patients: -A-Airway -B-Breathing -C-Circulation -D-Disability -E-Exposure -Vitals, EKG, Assessing for any gross bleeding, pallor, neuro status, GCS -Identifying life-threatening conditions If during the primary survey, you find an issue with ABCDE, do you continue on to secondary and so on? - \NO! Interventions are started immediately before proceeding to the next step of the survey What are some signs and symptoms of a patient with a compromised airway? - ~Dyspnea ~Inability to vocalize ~Presence of foreign body in airway ~Trauma to face or neck What are some ways to maintain an airway? - ~Open airway ~Suction and/or remove foreign body ~Insert nasopharyngeal/oropharyngeal airway ~Provide endotracheal intubation What are some assessments to make during the primary survey regarding breathing? - -Assess work of breathing: rate, depth, effort, equal rise and fall -Assess for dyspnea, cyanosis paradoxical/asymmetric chest wall movement, decreased/absent breath sounds, retractions What do you do as a nurse when a patient has a breathing emergency? - -Administer O -Bag-valve-mask (BVM) ventilation with 100% O2 and intubation for life-threatening conditions -Monitor patient response What do you assess in regards to circulation? - -Skin signs

-Pulses: check central pulse (peripheral pulses may be absent because of injury or vasoconstriction) -Capillary refill- 2-3 seconds What are some emergency actions to take in regards to circulation? - -chest compressions -IV/IO access- large bore if volume concerns -Initiate aggressive fluid resuscitation using normal saline or LR if indicated What does AVPU stand for? - \A: Alert V: Responsive to voice P: Responsive to pain U: unresponsive What is part of the secondary assessment? - -Brief, systematic process to identify all injuries -full set of vitals -Application of devices -Cardiac monitor -Continuous O2 monitoring -ETCO -History using SAMPLE -Head to toe assessment What does it mean when the CVP is elevated? - \It means there is Right Ventricular Failure What does a low CVP mean? - \Hypovolemia What are some OBJECTIVE signs of hypoxemia? - -Agitation -ALOC -Anxious -Confused -Dusky skin -Dysrhythmias What are some late signs of hypoxia? - -Bluish discoloration especially to the mouth What is part of the tertiary assessment? - -Pertinent labs and diagnostic studies -Detailed assessment of affected systems -Consulation if applicable

What are some common problems of ER patients? - -Pain -Anxiety/fear -Coping -Risk of injury -Infection -Nutrition -Mobility -Disposition What is involved when a death occurs in the ER? - -End of life care -Family presence -Coroner's case -Organ donation What are some examples of environmental emergencies? - -Heat related emergency -Cold related emergency -Submersion -Stings and bites -Toxicology How does heat exhaustion occur? - \Caused by prolonged exposure to heat What is heat exhaustion characterized by? - \Characterized by: -Fatigue -Nausea/vomiting -Thirst -Anxiety -Hypotension -Tachycardia -Diaphoresis Elevated temp- 99.4- HOT AND WET What is a major difference between heat exhaustion and heat stroke? - \Heat exhaustion, the patient will be hot and wet. Heat stroke, the patient will be Hot and dry. How do you treat a patient with heat exhaustion? - -Stop activity -Cooling measures

-Monitoring -IV fluids -Elderly or people with chronic illness may require admission How is heat stroke defined? - -Most serious form of heat stress, results from failure of the hypothalamic thermoregulatory processes -Core temp rises rapidly <104, altered mentation, absence of perspiration, and circulatory collapse How do you treat heat stroke? - -Manage ABCs -Cooling measures- not too fast and prevent shivering -IV fluids for volume and electrolyte replacement -Monitor for Rhabodmyolysis What is Rhabdomyolisis? - \A serious medical condition that can be fatal or result in permanent disability. Rhabdo occurs when damaged muscle tissue releases its proteins and electrolytes into the blood. These substances can damage the heart and kidneys and cause permanent disability or even death. What is a common test done to identify Rhabdo? - \CPK- Creatine Phosphokinase- when elevated, it means CPK has leaked into the bloodstream and there has been damage to the heart, skeletal muscle or brain. Define hypothermia. - \When the core temperature is <95 F (35 C) What are risk factors for hypothermia? - -elderly -Certain drugs -Alcohol -Diabetes -Poor circulation What is a life threatening core temperature for hypothermia? - <86 F (30C) What are the three different types of hypothermia? - \Mild moderate and severe What are characteristics of mild hypothermia? - -Core temp of 96.8-93.3 F (34-36C) -Shivering -Lethargy

-Confusion -Rational to irrational behavior -Minor heart rate changes What are characteristics of moderate hypothermia? - -Core temp 93.2-86 F (34-30C) -Rigidity -BP by doppler -Metabolic and respiratory acidosis -Hypovolemia At what temperature does shivering disappear? - \86 F (30C) What are characteristics of severe hypothermia? - -Makes the person appear dead -Bradycardia -Asystole -V-Fib What are the two warming techniques for mild hypothermia? - \Passive external warming: -Move patient to warm dry place -Remove damp clothing -Place warm blankets on patient Active external warming: -body-to-body contact -Fluid or air-filled warming blanket -radiant heat lamps How do you warm a patient with moderate to severe hypothermia? - -Active core warming -Use of heated, humidified oxygen -Warmed IV fluids -Warming blankets -peritoneal, gastric, or colonic lavage with warmed fluids What are risks of rewarming a patient with hypothermia? - -Afterdrop, a further drop in core temperature -Hypotension -Dysrhythmias At what temperature should warming be discontinued? - \95 F or 35 C What is a submersion injury? -

\Results when a person becomes hypoxic as the results of submersion in substance, usually water Define drowning. - \Death from suffocation after submersion in fluid How do you treat a patient that has drowned or near drowned? - -Address hypoxia -Mechanical ventilation with PEEP or CPAP to improve gas exchange when pulmonary edema is present -Preserve neurological functioning and manage cerebral edema -Monitor and manage fluid, electrolyte, and acid base balance

Emergency, Trauma, Disaster, Critical

Care Nursing