NSG 233 - Medical -Surgical Nursing III Final Exam Question: Bite Priority Answer: Human bite: know what to do first with a human bite! Animal: rabies prophylaxis Snakebite: lie down, removing constrictive items, providing warmth, cleansing the wound, covering the wound with a light sterile dressing, and immobilizing the injured body part below the level of the heart. CABs (Circulation, Airway Breathing) NO: Ice, in cision and suction, or a tourniquet Tetanus and analgesia should be given as necessary. Meds: FabAV or CroFAb: no limit on how much to give S&S: necrosis, edema, ecchymosis Tick: remove with tweezers, straight up pull, (try to get close to skin as poss ible) S&S: bulls eye rash Question: Poisoning in the house Answer: Carbon Monoxide: 100% O2 Atmospheric/hyperbaric chamber Ingested Poison: ABC, Call poison control, try to describe what was ingested Charcoal: most effective, do not use if heavy metals were ingested. Corrosives: give water/milk Cathartics: sorbitol: give w/ 1st dose of charcoal syrup ipecac: Induces vomiting, only give to alert patients -and NO patients who ingested a corrosive agent Gastric emptying: intubate before lavage (if -LOC/ -gag reflex) with in 1 hour of ingestion. Question: Overdose - multiply organ dysfunction syndrome Answer: Find out what Patient OD'd on. Give antidote if there is one Treatment goals for a patient with a drug overdose are to support the respiratory and cardiovascular functions, to enhance clearance of the agent, and to provide for safety of the patient and staff. Question: Abuse - interpersonal violence Answer: Priorit y: ask questions IN PRIVATE, separate from person who is abusive/neglectful referral to shelter adults are free to accept or refuse help safety plans should be explored Mandatory report: children and elderly abuse - only need to suspect abuse, do not nee d to prove it Question: PTSD - rape and stabbing Answer: Keep patient comfortable Offer therapeutic communication -listen Avoid triggers **ask if patient plans to harm self - Question: Chest -Blunt trauma complications ** Answer: Flail chest: paradoxical chest movement, hypoxemia, resp acidosis Pulmonary contusion: abnormal accumulation of fluid, - lung sounds, cough, frank blood, mucus, chest pain, atelectasis, -BP, resp acidosis Monitor: fluid intake, fluid replacement and pai n Management : airway, O2, treat pain, bronchoscopy Meds: morphine Medical Management• ABC -oxygen, possible endotracheal intubation, ventilatory support• Replace fluid volume• Restore negative intrapleural pressure if needed• Needle decompression• Chest tub e if needed• Hemothorax• Pneumothorax• Hemo -pneumothorax Question: Crush injuries and trauma Answer: Hypovolemic shock Spinal Cord Injury Fractures Acute Kidney Injury Priority: ABC's SATA: Rhabdomyolysis: Triad: muscle cramps, muscle weakness, dark ur ine Labs: CK levels, serum lactic acid levels
