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NURS 362 Exam 2 with complete solutions 2024_2025.
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NURS 362 Exam 2 with complete solutions 2024_2025.
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NURS 362 Exam 2 with complete solutions2024/2025
cope and practice of emergency nursing - ANSWER- Emergency management
traditionally refers to urgent and critical care needs. However, the ED has
increasingly been used for nonurgent problems, and emergency management
has broadened to include the concept that an emergency is whatever the patient
or family considers it to be
The emergency nurse has special training, education, experience, and expertise
in assessing and identifying health care problems in crisis situations
The emergency department (ED) staff works as a team
issues in emergency nursing - ANSWER- Legal issues
Occupational health and safety risks for ED staff
Challenge of providing holistic care in context of fast-paced, technology driven
environment
Treat patients exposed to biologic and other weapons
Mass casualty incident due to natural causes or terrorist event
priority emergency measures for all patients - ANSWER- Safety is the first priority
Sentinel events in the ED: delay in care and medication errors
Patient- and family-focused interventions
patient and family focused interventions - ED - ANSWER- Actions to relieve
anxiety and provide a sense of security
Allow family to stay with patient, if possible, to alleviate anxiety
Provide explanations and information
Additional interventions are provided depending on the stage of crisis
Triage - ANSWER- sorts patients by hierarchy based on the severity of health
problems and the immediacy with which these problems must be treated
,The triage nurse collects data and classifies the illnesses and injuries to ensure
that the patients most in need of care do not needlessly wait
Protocols may be initiated in the triage area
ED triages differs from disaster triage in that patients who are the most critically
ill receive the most resources, regardless of potential outcome
triage systems: basic system 3 categories - ANSWER- Emergent: highest priority
Urgent: serious health problems but not life threatening
Nonurgent: episodic illness
emergency severity index (ESI) - ANSWER- assigns patients to five levels:
Level 1 (most urgent) to Level 5 (least urgent)
primary survey: ABCDE - ANSWER- Focus on stabilizing life-threatening
conditions:
A: airway: establish airway
B: breathing: provide adequate ventilation
C: circulation: evaluate and restore cardiac output; control hemorrhage, prevent
and treat shock
D: disability: determine neurologic status; AVPU mnemonic (alert, verbal, pain,
unresponsive)
E: exposure: undress to assess wounds or areas of injury
A: airway - ANSWER- establish airway
B: breathing - ANSWER- provide adequate ventilation
C: circulation - ANSWER- evaluate and restore cardiac output; control
hemorrhage, prevent and treat shock
D: disability - ANSWER- determine neurologic status; AVPU mnemonic (alert,
verbal, pain, unresponsive)
E: exposure - ANSWER- undress to assess wounds or areas of injury
secondary survey: FGHI - ANSWER- F: Full set of VS, Family
G: Get adjunctive testing such as diagnostic and labs, ECG, arterial lines, urinary
catheters
H: Head-to-toe assessment: reassess airway, breathing, VS
I: Inspect the posterior surface
,priority emergency measures - ANSWER- Airway obstruction and establishing an
airway and ventilation
Hemorrhage
Hypovolemic shock
Wounds
Trauma and multiple trauma
airway and ventilation - ANSWER- Partial and complete obstruction
Oropharyngeal or nasopharyngeal airway insertion
Endotracheal intubation
King tube or laryngeal mask
Cricothyroidotomy
Ventilation
hemorrhage - ANSWER- Assessment changes
Fluid replacement
Control of bleeding: external and internal
what type of solution would we administer to a pt who is hemorrhaging? -
ANSWER- isotonic solutions to increase blood volumes
wounds - ANSWER- Cleaning
Primary closure
Delayed primary closure
Tetanus prophylaxis
pressure points to hemorrhage control - ANSWER- temporal, facial, carotid,
subclavian, brachial, radial and ulnar, femoral
level 1 trauma center - ANSWER- a comprehensive regional resource that is a
tertiary care facility central to the trauma system. A Level I Trauma Center is
capable of providing total care for every aspect of injury - from prevention
through rehabilitation.
level II trauma center - ANSWER- able to initiate definitive care for all injured
patients.
- UHS wilson
level III trauma center - ANSWER- has demonstrated an ability to provide prompt
assessment, resuscitation, surgery, intensive care and stabilization of injured
patients and emergency operations.
, - Lourdes
level IV trauma center - ANSWER- has demonstrated an ability to provide
advanced trauma life support (ATLS) prior to transfer of patients to a higher level
trauma center. It provides evaluation, stabilization, and diagnostic capabilities for
injured patients.
level V trauma center - ANSWER- provides initial evaluation, stabilization and
diagnostic capabilities and prepares patients for transfer to higher levels of care.
trauma assessment - ANSWER- Start with primary assessment with a slight
tweak...
C- A-B-C
Circulation - stop any uncontrolled external hemorrhage
Then A-B-C-D-E
List some ways to stop bleeding
In addition to your ABCDE.....
Does your pt need a c-collar?
What is the GCS?
"<8 intubate"
Intervene during this assessment as needed.
Consider the nature of the emergency.
i.e. MVC, GSW, fall, burn, etc.
What is the c/c?
What caused the injury?
Any treatment initiated?
›From pt or EMS
›Did it help?
Is unlawful activity suspected?
What is reportable to law enforcement?
what is the first step in a TRAUMA assessment? - ANSWER- assess the
circulation and stop any uncontrolled external hemorrhage
under what score on the GCS would we have to intubate a pt? - ANSWER- GCS <
8
MOI - ANSWER- mechanism of injury
trauma - ANSWER- Collection of forensic evidence
Injury prevention
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