NR442 week 6 Emergencies in the community edapt

The hospital facility where a nurse works in Oregon is part of a system of hospitals and the facility is sending volunteer nurses to assist another facility impacted by a disaster in Florida. What should the nurse do before volunteering?

-Ensure they can legally practice nursing in Florida

As an individual, what is the most important step you can take to be prepared for a terrorist attack?​

-Have a personal plan​

Botulism is an example of what type of agent?

-a biological agent.​

When reviewing the current employee information, which factors should alert the department heads that additional planning is needed to assure continuity of services if the infectious organism impacts their area? Select all that apply.

-71% of colleagues report that part of their household income is generated within industries likely to be closed -44% of employees' household income is less than $100,000 per year -56% of employees identify as Latino or African American -67% of direct care providers have children attending elementary or high school

Which populations are most likely to be at high risk during a disaster? Select all that apply.

-ALL -Families living on a ranch -Retirement village -Prison inmates -English language learners -Inner-city apartment dwellers

Which disaster response roles are appropriate for nurses? Select all that apply.

-ALL -Incident commander -Shelter manager -Clinical nurse -Public health coordinator -Transportation coordinator

Nurses can participate in which stages of emergency management? Select all that apply.

-ALL -Planning -Mitigation/Prevention -Preparedness -Recovery -Response

The nurse is working with city planners on a disaster recovery plan for a neighborhood destroyed by a tornado. Which action should be completed first?

-Acquire recreational vehicles (RVs) and set up in a local RV park

Which actions are part of disaster response?​

-Actions taken after a disaster occurs to save lives and reduce the damage to property and the environment​.

Which actions are part of disaster recovery?

-Begins during response, help restore and resume normal operations​​​

Which types of device are weapons of mass destruction (WMDs)? Select all that apply.

ALL -Nuclear -Chemical -Explosive -Radiological -Biological

Having completed a functional exercise to determine if incident command personnel know how to activate the emergency operations plan, John and the group conduct a small after-action review to assess their readiness. Which findings indicate incident command personnel are proficient in disaster management skills?

Proficient: -The after-action team creates a process to add new personnel to the call list after discovering a nursing supervisor was not on the current list. -Personnel immediately access the emergency operations plan. -Personnel continue to refer to the emergency operations plan throughout the exercise. Needs Follow-up: -Radios are found not charged and lying on tables in the emergency operations center. -Personnel stopped using radios when the channel became busy.

The planning team is discussing educational needs to help employees prepare for the pandemic. Which four (4) items should they include related to home and family preparedness?

Take measures to stay healthy, manage stress, and eat right. Store extra water, food, medicine, and supplies now. Create an emergency contact list and have each family member always carry it. Explore working from home with family and manager.

When discussing tertiary prevention measures with the nursing staff of the long-term care facility, Michael includes information related to

treating the sick preventing complications of the illness documenting evidence of the residents responses to treatment

Which issue might preclude Mei from responding to a disaster?

-Broken big toe

Which action is most appropriate for John to take next?

-Conduct a functional exercise

How often should facility leadership update their emergency operations plan?

-Continuously

You are notified by the emergency department director that there are multiple people being brought in with a variety of signs and symptoms that seem to point to a biological agent of some kind. What is your first priority?

-Employing the appropriate level of precautions and personal protective equipment​

A mudslide strikes a small community after torrential rains following a large wildland fire. The community is just an hour away and you know many of the people living there and want to help. Which action is most appropriate?

-Get prepared to respond and check in with the medical reserve corps (MRC) leadership per protocol

To decrease the risk of infection, which public health recommendations for Phase 4 should Michael encourage staff and residents of the long-term care facility to take? Select all that apply.

-Isolate symptomatic residents in their rooms -Limit visitors who are symptomatic -Install hand sanitation stations -All staff wear masks -Stagger mealtimes

Which event is most likely to become a disaster?

-Large resort hotel fire during peak tourist season in a remote area

The team is deployed to a city after a large wildland fire destroys the local hospital. Once on scene, the team must set up their operation in the parking lot of the former hospital. Mei is given a list of tasks. ​In what order should Mei complete these tasks? The highest priority task should come first.

-Locate team water supply -Distribute incident action plan -Assemble treatment tent -Identify local medical clinics that are operational

A community health nurse is working with community leaders on disaster mitigation efforts. Which at-risk populations should the nurse be most concerned about?

-Low-security prison work-release program -Laotian immigrants -Inner-city low-income housing residents -Food pantry customers -55 and over community

Which terms are stages in the process of emergency management? Select all that apply.

-Mitigation -Planning -Recovery -Response

You are notified by the emergency department director that there are multiple people being brought in with a variety of signs and symptoms. Which might indicate a biological agent is involved?

-Most present with a fever​​ -Most attended a festival over the weekend and ate homemade cookie dough ice cream​

Which characteristics can define "community spread" (of illness)? Select all that apply.

-No known contact with infected individual -Contagious disease -Within a specific location

Which activities require immediate action from Mei?

-Notify the nursing unit supervisor ​-Refill prescription medications so she has at least a 21-day supply. -Update her family plan.​

Which positions are part of the incident command system (ICS) command and general staff? Select all that apply.

-Planning section chief -Public information officer -Incident commander -Operations section chief -Logistics section chief

John understands which stage(s) of disaster management are dependent on a good emergency operations plan? Select all that apply

-Preparedness -Mitigation -Response -Recovery

The school nurse wants to help at-risk students and their families prepare for the upcoming hurricane season. Which is the most critical action for the nurse to take?

-Provide information and resources on planning

What dangers are associated with the use of a dirty bomb?​ Select all that apply.

-Radioactive dust contamination​ -Fear and panic -​Major trauma from an explosion​

What would the first step be in decontaminating a victim covered in a chemical powder?​

-Remove the victim's clothing to encapsulate it​

Which words or phrases are used to describe public health measures? Select all that apply.​

-Required by health laws -Voluntary -Imposed -Prevent spread

You are a public health nurse in a large city public health department, reviewing reports of infectious agents from the area healthcare facilities. Which reports might indicate bioterrorism?​

-Several incidents of anthrax in adult citizens​

The hospital's decontamination unit is activated after a chemical agent is released using a pipe bomb in a subway tunnel, and friends and family are bringing in many victims. What is most important for the unit's nurse manager to know?​

-The chemical agent (or type) utilized​

What information can Mei use to understand if her efforts to prevent further death or serious injury are successful?

-There are fewer citizens seeking treatment for cuts. -The percentage of those being treated who have received tetanus shots has gone up. -Citizens are asking about the information during public information meetings.

Why is it important to address companion animals (pets) in disaster planning?

-Those living in disaster areas may not evacuate without their pets

A chemical agent is released in a subway tunnel using a pipe bomb. What treatments would you anticipate from this event?​ Select all that apply.

-Treatment with atropine and pralidoxime chloride (2-PAM Cl)​ -Prepare clients for surgery to remove shrapnel​ -Transfer clients to a burn center​

Which chemical agents are considered nerve agents?​ Select all that apply.

-VX -GB -Sarin

Team Rubicon is an organization of mostly veteran volunteers who respond to help with disasters around the world. This group is an example of which type of agency?

-Voluntary organizations active in disaster (VOAD)

Which prevention activity is most appropriate for the nurse to take in a flood-prone community?

-Work with city leaders to find new housing for families living in a flood-prone housing development

What would be the appropriate level of precautions for someone suspected of being infected with smallpox?​

-airborne

Which cues should concern John? Select all that apply.​

-annual review of the emergency operations plan -John has never seen the plan -asked several members of the committee where to locate the plan -the plan is in a locked cabinet

Select the best option from each drop-down box to complete the sentence correctly.​ -------- is a form of protection from-------------- that occurs when a large percentage of a population has become------------to an infection, whether through previous infections or vaccination, thereby providing a measure of protection for individuals who are---------

-herd immunity -infectious disease -immune -not immune

Mei notices many clients with cuts are being treated by the DMAT. She notifies the ----- of the issue and requests permission to open a tetanus vaccination site. She consults the---------guide for information on how to contact the resources she needs to help put together the site. Mei works with the --------- on identifying an appropriate site and setting up the needed equipment. She reaches out to the -------------r to put together an informational flyer to help prevent injuries and notify citizens of the vaccination site.

-operations section chief -incident action plan -logistics section chief -information officer

The department heads should first address the potential for------------------followed by the potential for--------

-reduction in workforce -insufficient acute care capacity

Helen is a unit charge nurse who is called in to help with receiving those injured from a building collapse. She is asked to monitor for hazardous situations in the emergency department, which she understands is the role of the-------. She notices that personal protective equipment is running low and so she coordinates with the -------- to restock the supply.​

-safety officer -logistics section chief

Click to specify those factors which increase the rate at which an infectious disease spreads through a community. Select all that apply.​ Maria and Michael are first generation Hispanic-American citizens. Both are employedand, along with their three school-aged children, live with Michael's parents and grandfather to provide physical and economic support to their family. Maria's job involves international travel to Asian countries four times per year. Michael is a nurse practitioner working on the city's board of public health. Although their children are fully vaccinated, neither Maria or Michael have had their routine vaccinations out of respect to their parent's belief that vaccines are harmful. ​ The family lives in a comfortable home in a socioeconomically stable neighborhood impacted by drought and numerous wildfires. The smoke from the fires have increased the exacerbation of asthma in two of their childr

international travel neither maria or michael have had their routine vaccinations drought and numerous wildfires exacerbation of asthma

A community health nurse is working with community leaders on disaster mitigation efforts. The nurse has identified at-risk populations that may need assistance. What activities can be used while working with vulnerable populations? Select all that apply.

-Ask community leaders what would be important -Translate materials into community languages -Meet them where they are

Which actions should each nurse take to be prepared at work when a global pandemic has spread to the community? Select all that apply.

-Be aware of the disaster plan at place of employment and in the community. -Participate in mock disaster and pandemic drills. -Maintain professional license and certifications. -Prepare professional emergency response items.

When consulting with the nurse manager of the long-term care facility, Michael includes several secondary prevention actions to be taken to minimize the impact of widespread infection. Click to specify if the secondary prevention action is indicated, nonessential, or contraindicated. Select only one answer in each row.

Indicated: Isolate residents at the first sign of infection Establish clear lines of communication with residents' families Increase in resident mental health assessments Identify transmission chains for facility acquired infections Nonessential: Increase frequency of bathing residents Contraindicated: Test all residents weekly

What other preparedness activities are appropriate now?

Appropriate Preparedness Activity​ -Schedule training sessions -Ensure emergency radios are working and accessible -Prepare a contact list of incident command staff Not Appropriate Preparedness Activity: -Move personal protective equipment carts to every room -Conduct an after-action review -Install new smoke detectors to replace those over 10 years old

The team is deployed to a city after a large wildland fire destroys the local hospital. The DMAT has set up operations in the parking lot of the former hospital, including emergency and urgent care treatment areas and team housing.​ Mei is assigned to identify needed response activities. Which are appropriate response activities for the DMAT?

Appropriate Response Activity: -Set up a triage area for clients entering the DMAT treatment site -Notify the operations section chief on the number of clients treated -Distribute dust masks to citizens Inappropriate Response Activity: -Form a survivor support group -Start a shingles vaccination site

For each action below, click to specify if it is appropriate for a biological, chemical, and/or radiologic incident, or if it is not appropriate for any of the incidents. Note that some actions may be appropriate for multiple types of incidents.

Biological​: -Ensure decontamination equipment is accessible​ -Order N-95 masks​ Chemical​: -Ensure decontamination equipment is accessible​ -Check supplies of atropine and pralidoxime chloride (2-PAM Cl) kits​ Radiologic​: -Ensure decontamination equipment is accessible​ Not Appropriate: -Gather a supply of lead aprons

For each finding in the left column, click to specify if the client should be decontaminated or does not need decontamination. Select only one answer in each row.

Decontamination Needed​: -A victim from the subway station, who was quickly loaded into an ambulance and transported to the emergency department​ -A person who walked home from the damaged subway station was brought in by the family​ No Decontamination Needed​: -A person found sitting on a bench in the subway station was decontaminated by the fire department on scene​ -A family driving in the street above the subway who crashed their car two blocks away due to a damaged tire​ -One with respiratory distress from a subway station across town​

For each employee information fact, click to specify if it impacts social determinants of health (SDOH) for economic stability, healthcare access, and/or educational access during the pandemic. Each employee factor may impact more than one SDOH factor.

Economic Stability: -56% of employees identify as Latino or African American. -44% of employees' household income is less than $100,000 per year. -71% of colleagues report that part of their household income is earned in industries likely to close to decrease the spread of an infectious disease.​ -67% of direct care providers have children attending elementary or high school. Health Care Access: -56% of employees identify as Latino or African American. -44% of employees' household income is less than $100,000 per year. -71% of colleagues report that part of their household income is earned in industries likely to close to decrease the spread of an infectious disease. Educational Access: -67% of direct care providers have children attending elementary or high school.

Community health nurses are reviewing the facilities' pandemic response plan, focusing on social determinants of health (SDOH). Using the drop-down menu, select the social determinant of health to match the community finding.

Education Stability - Fewer than 22% of community residents own their homes. Built Environment​ - Aging water system contains lead pipes carrying water to homes. Healthcare Access - More than 50% of residents do not have employer-supplemented health insurance. ​Community Context - Faith-based groups are housing refugees from foreign countries. Education Access - One-fourth of homes do not have a working computer.

One month into the healthcare system's response to increasing infections, the department heads are reviewing targeted goals. For each outcome listed in the left column, click to specify if the outcome exceeds, meets, or does not meet the indicated goal. Select only one answer in each row.

Exceeds: -Employee infection rate 9.7% lower than general population (Goal = at or below rate in population) -95% of employees have contributed to colleague food pantry (Goal = 60%) Meets: -100% of direct care employees are vaccinated (Goal = 100% vaccinated) Does Not Meet: -Employee absentee rate equals pre-pandemic levels (Goal = 2% lower than pre-pandemic levels) -Mental health consultations for employees increased 3.7% from pre-pandemic levels (Goal = No increase)

For the purpose of preparation, where would you locate the information on the type of incident?

Facility emergency operations plan​

Michael is planning a community presentation to educate a long-term care facility about a new strain of the influenza virus that has been documented in the community. Which example should he use to help others understand each phase? ​ Identify the phases of a pandemic described by the relevant data on each line of the table.​

Post Peak ​ Infection rates are declining in some countries. Individuals previously infected are experiencing recurrent infection with minor symptoms. ​ Phases 5-6 33 countries have documented human influenza infections from the new variant. ​ Phases 1-3 ​ A new variant of the influenza virus has been identified in farmers in a southern Asian country. Livestock who have become ill have the same variant. ​. Post Pandemic Influenza rates are at seasonal levels in all countries. ​ Phase 4 Individuals who have not been in contact with infected livestock have been infected with the new influenza variant in a handful of countries on the Asian continent. ​

The clinic nurse is concerned about the death of several clients due to carbon monoxide poisoning after a recent two-week power outage due to a hurricane. The nurse identifies several activities that might make a positive impact in the community. Click to specify in which stage of disaster management the nurse implements each activity. More than one stage may apply to each activity.

Preparedness: -Acquire and hand out flyers on generator safety -Advocate for a state law requiring educational material to be attached to generators sold in the state Mitigation/Prevention: -Acquire and hand out flyers on generator safety Response: -Acquire and hand out flyers on generator safety -Accompany a Community Emergency Response Team (CERT) to identify dangerous generator usage Recovery: -Acquire and hand out flyers on generator safety -Accompany a Community Emergency Response Team (CERT) to identify dangerous generator usage

John reviews the emergency operations plan and has several suggestions for the committee. Select the correct phase of disaster management for each procedure listed on the left.

Preparedness: -Arrange a series of emergency operations plan walkthrough sessions for all hospital personnel Mitigation: -Provide fire extinguisher training Response: -Ensure a 3-day supply of personal protective equipment is available Recovery: -Contract with a critical incident stress debriefing (CISD) team for care after a disaster

For each action in the left column, click to specify if the action is primary, secondary, or tertiary prevention for the influenza pandemic. Select only one answer in each row.

Primary Prevention: -Institute public health measures, including social distancing​ -Provide vaccinations to employees and their families Secondary Prevention: -Open testing centers -Identify chains of transmission Tertiary Prevention: -Organize resources to support employees -Enact policies that support flexibility in staffing