Chp 11 - Environmental Emergencies

Start an intravenous line and infuse 0.9% saline solution

On a hot humid day, an emergency department nurse is caring for a client who is confused and has these vital signs: temperature 104.1° F (40.1° C), pulse 132 beats/min, respirations 26 breaths/min, and blood pressure 106/66 mm Hg. What action would the nurse take?

Cardiopulmonary

A client admitted to the emergency department following a lightning strike. What is the priority assessment the nurse focuses on?

Administer warmed intravenous fluids to the client.

A client presents to the emergency department after prolonged exposure to the cold. The client is difficult to arouse and speech is incoherent. What action would the nurse take first?

- Bilateral crackles - Bradycardia - Cyanosis of the lips - Hypotension

A client resuscitated after drowning is admitted to the emergency department. What assessment findings does the nurse recognize as symptoms of a drowning? (Select all that apply.)

- Seek shelter inside a building or vehicle - Do not take a bath or shower. - Turn off the television. -Put down golf clubs or gardening tools

A nurse is providing health education at a community center. Which instructions does the nurse include in teaching about prevention of lightning injuries during a storm? (Select all that apply.)

"I can go swimming all by myself because I am a certified lifeguard."

A nurse teaches a community health class about water safety. Which statement by a participant indicates that additional teaching is needed?

Administer an epinephrine autoinjector and call 911.

While at a public park, a nurse encounters a person immediately after a bee sting. The person's lips are swollen, and wheezes are audible. What action would the nurse take first?

Electrocardiogram (ECG)

An emergency department nurse assesses a client admitted after a lightning strike. The client is awake but somewhat confused. Which assessment would the nurse complete first?

Administer oxygen via a nonrebreather mask

A middle-age mountain hiker is admitted to the emergency department exhibiting a cough with pink, frothy sputum and cyanosis of lips and nail beds. What priority action would the nurse implement?

Monitor the client's temperature every 4 hours.

A nurse assesses a client admitted with a brown recluse spider bite. Which assessment does the nurse perform to identify complications of this bite?

Cardiopulmonary status

A nurse assesses a client recently bitten by a coral snake. Which assessment would the nurse complete first?

- Have the client lie down in a cool place - Apply cold packs to neck, arm pits, and groin. - Encourage drinking a sports drink.

A nurse is in charge of a first-aid tent at an all-day outdoor sports event on a hot and humid day. A participant comes to the tent reporting a headache, weakness, and nausea. What actions would the nurse take? (Select all that apply.)

- "Wear synthetic clothing instead of cotton to keep your skin dry." - "Wear sunglasses to protect skin and eyes from harmful rays." e. - "Know your physical limits. Come in out of the cold when limits are reached." - "Change your gloves and socks if they become wet."

A nurse is teaching a wilderness survival class. Which statements would the nurse include about the prevention of hypothermia and frostbite? (Select all that apply.)

The poison control center

A nurse plans care for a client admitted with a snakebite to the right leg. With whom would the nurse collaborate?

- "Consult an exterminator to control bugs in and around your home." - "Do not swat at insects or wasps." - "Use screens in your windows and doors to prevent flying insects from entering." - "Identify and remove potential nesting sites in your yard."

A nurse teaches a client who has severe allergies ways to prevent insect bites. Which statements does the nurse include in this client's teaching? (Select all that apply.)

Administer intravenous morphine

A primary health care provider prescribes a rewarming bath for a client who presents with Grade 3 frostbite. What action would the nurse take prior to starting this treatment?

"It will relieve your muscle rigidity and spasms."

A primary health care provider prescribes diazepam to a client who was bitten by a black widow spider. The client asks, "What is this medication for?" How does the nurse respond?

"My partner and I will plan to sleep at a higher elevation to acclimate more quickly."

After teaching a client how to prevent altitude-related illnesses, a nurse assesses the client's understanding. Which statement indicates that the client needs additional teaching?

Administer dexamethasone

An emergency department nurse cares for a middle-age mountain climber who is confused, ataxic, and exhibits impaired judgement. After administering oxygen, which intervention would the nurse implement next?

- Crackles in both lung fields - Persistent dry cough

An emergency department nurse is caring for a client who had been hiking in the mountains for the past 2 days. What are the most important indicators that a client is experiencing high-altitude pulmonary edema (HAPE)? (Select all that apply.)

- Homeless individuals - People with substance abuse disorders - Older adults - Obese individuals

An emergency department nurse moves to a new city where heat-related illnesses are common. Which clients does the nurse anticipate being at highest risk for heat-related illnesses? (Select all that apply.)

- Administer oxygen via mask or nasal cannula - Infuse 0.9% sodium chloride via a large-bore intravenous cannula. - Obtain baseline serum electrolytes and cardiac enzymes

An emergency department nurse plans care for a client who is admitted with heat stroke. Which interventions does the nurse include in this patient's plan of care? (Select all that apply.)

- Take cool baths or showers after outdoor activities. - Check on the older adult daily in hot weather. - Drink plenty of liquids throughout the day

The nurse is teaching participants in a family-oriented community center ways to prevent their older relatives and friends from getting heat-related illnesses. What information does the nurse include? (Select all that apply.)

- Confusion and bizarre behavior - Hypotension - Tachycardia and tachypnea - Body temperature more than 104° F (40° C)

Which assessment findings would indicate to the nurse that a client has suffered from a heat stroke? (Select all that apply.)

Deliver rescue breaths.

While on a camping trip, a nurse cares for an adult client who had a drowning incident in a lake and is experiencing agonal breathing with a palpable pulse. What action would the nurse take first?