COMMUNITY EXAM 4

recovery

- Focuses on stabilization - Returning community to pre-impact status - Rehabilitation - Reconstruction - Epidemiological surveillance as needed

preparedness

1. look for prevention! - Disaster planning o Address needs assessment o Event management o Recovery efforts - Support systems; vital for: o Medical treatment and supplies o Shelter o Food o Water - Prevent mortalities and morbidities - Involves improving community and individual reaction and responses, so that the effects of the disaster are minimized - Plans for communication, evacuation, rescue, victim care, and recovery

The nurse is helping a triage officer evaluate the victims of a large scale disaster. Which client does the nurse anticipate will be given a black tag?

A client with extensive full-thickness body burns

Botulism treatment

Antitoxin Supportive care Maybe mechanical ventilation

Anthrax treatment

Cipro

Which client should be treated first, according to the disaster triage tagging system?

Client with red tag

Anthrax s/s

Cutaneous: sores = blisters = ulcer with black center GI: nausea, anorexia, bloody diarrhea, fever, severe stomach pain Inhaled: cold/flu symptoms

pneumonic plague s/s

Fever Weakness Rapidly developing pneumonia Bloody or watery sputum n/v abdominal pain rapid death if not treated early

Botulism transmission

Food or wound with toxin NOT person to person

The nurse is triaging clients arriving at the hospital after a large-scale disaster. Which condition is most likely to be categorized with a black tag?

Massive head trauma

smallpox treatment

No proven treatment Supportive Antibiotics for secondary infections

For which type of injury would the nurse classify a client with a black tag during a disaster situation?

Older adult with massive head trauma and multiple open fractures

Hemorrhagic fever transmission

Viral reservoirs (rodents, arthropods, animal host) Person to person (contact or bodily fluids)

The nurse is caring for clients who were brought to the hospital following a large-scale disaster. Which client would be suitable for the nurse to triage with a "green" tag?

client who is injured but able to ambulate

Which phase of disaster management involves attempts to limit the disaster's impact on the population?

mitigation

5 phases of emergency and disaster planning

preparedness, prevention, response, recovery and mitigation

response

- Actual implementation of the plan - Activities used to address the event - Focuses on emergency relief - Saving lives - First aid - Minimizing/restoring damaged systems - Care and basic life requirements to victims (food, water, shelter)

Health hazards in the home

- Asbestos - Arsenic - Carbon monoxide - Environmental tobacco smoke - Formaldehyde - Lead - Mold - Pests - Pesticides - Radon - Solvents such as paint thinners, varnishes, and resins (ethers) - Personal care products - Volatile organic compounds (VOCs)

Primary Health care

- Education concerning prevailing health problems and methods of preventing and controlling them - Promotion of food supply and proper nutrition - Adequate supply of safe water and basic sanitation - Maternal and child health, including family planning - Immunization against major infectious diseases - Prevention and control of locally endemic diseases - Appropriate treatment of common diseases and injuries - Provision of essential drugs

National Response Framework

- National Incident Management System o Each key element of NIMS involves an intricate process and directly affects the overall effectiveness of the systems o A guide for comprehensive incident response o Provides direction for all responders

Emerging infections

- Severe acute respiratory syndrome (SARS) - HIV/AIDS - H5N1 - H7N9 (bird flus) - H1N1 (swine flu) influenzas - Middle Eastern respiratory syndrome (MERS) - Variant Creutzfeldt-Jakob disease (mad cow disease)

evaluation/prevention

- What worked? - What didn't? - Problems - Issues - Challenges - Quality assurance - Revisions

Smallpox transmission

Aerosol release Contact with person, bodily fluids, contaminated object Air in enclosed settings

pneumonic plague transmission

Aerosol release Respiratory droplets (person in 6 feet) Untreated bubonic plague sequelae

Which color tag is used for a client who is expected to die after a disaster with mass casualties?

Black

A client is admitted with dysphasia, dry mouth, drooping eyelids, blurred vision, vomiting, and diarrhea, and within 24 hours develops bilateral cranial nerve impairment and descending weakness. Which bioterrorism agent results in these clinical manifestations?

Botulism

Botulism s/s

Double/blurred vision Drooping eyelids Slurred speech Difficulty swallowing Descending muscle weakness

Anthrax transmission

Inhalation of powder or spores from infected animal product (inhaled) Handling infected animal (cutaneous) Undercooked meat from infected animal (digestive) NOT person to person

Which statement by the registered nurse is true regarding the mitigation phase of disaster management?

It is a process of minimizing of the disaster's influence on human health and community.

The disaster management team is evaluating the damage that can happen due to a disaster. They also attempt to limit the influence of the disaster on the health community's function. Which phases of disaster management would the nurse state represents these actions? Select all that apply.

Mitigation and preparedness

Which tag is suitable for a client with high priority during a disaster with mass casualties?

Red

Hemorrhagic fever treatment

Supportive therapy No established cure Ribavirin with Lassa fever

Hemorrhagic fever s/s

Varies depending on virus Fever Exhaustion Muscle aches Loss of strength

complex emergency

a multifaceted "humanitarian crisis in a country, region, or society where there is a total or considerable breakdown of authority resulting from internal or external conflict and which requires a multi-sectorial, international response" (disproportionately impact women and children)

Air Quality Index

a tool to report daily air quality in communities; calculated for four of the six criteria air pollutants (ground-level ozone, particle pollution, carbon monoxide, and sulfur dioxide) with an emphasis on how these affect health

Pneumonic plague treatment

antibiotics

According to the disaster triage tag system, which color tag would the nurse feel is most suitable for a client who died in an earthquake?

black

Epidemiologic surveillance

collect data prevent morbidity and mortality •NNDSS

Era of chronic health

o With decrease in infectious disease, increased life expectancy degenerative disease o Epidemiologic transition: replacement of infectious disease morbidity and mortality with that of chronic disease

precautionary principle

states that in the absence of clear data that indicate the safety of an action, chemical, or material that poses a threat to human health, it should not be used

Which conditions are given a green tag according to triage disaster tag system? Select all that apply.

strains sprains abrasions

scope of disaster

the range of its effect, either geographically or in terms of the number of people impacted (collapse of 500-unit high-rise apartment building has a greater scope than the collapse of a bridge that occurs while only 2 cars are crossing)

CBRNE terrorism

types of weapons that have the ability to create both mass causalities as well as mass disruption of society - Chemical - Biological - Radiological - Nuclear - Explosive

Incident Command System

- A management system that is applicable to small incidents as well as very large, complex incidents/disasters - Consists of procedures for controlling personnel, equipment, and communications during disasters - Designed to begin developing from the time an incident occurs and continues until the incident/disaster does not require management - An Emergency Management System which employs a logical management structures, defined responsibilities, clear reporting channels, and a common nomenclature to help unify hospitals with other emergency responders

3 C's of disaster response

- Communication - Coordination - Collaboration

Limitations of CBRNE

- Effective dissemination difficult o Many attempts have been made, very few successfully o Chemical agents must be used in relatively large quantities, especially if released in an open area. For chemicals, this requires quantities measured in pounds and gallons for a massive effect. This requirement creates manufacturing problems and increases the risk of detection. - Potentially hazardous to the terrorist o Suicide bombers o Infected disease carriers - Development and use require skill

Major issues nurses face today

- Emerging infectious diseases - Human trafficking - Maternal-newborn health - Health inequities - Maldistribution of health workers

Global health objectives

- Eradicating extreme poverty and hunger - Achieving universal primary education (health literacy) - Empowering women - Reducing child mortality rates - Improving maternal health - Combating HIV, malaria, and other diseases - Ensuring environmental sustainability - Global partnerships *bolded are Millennium Development Goals

IPREPARE

- I: INVESTIGATE potential exposures (when in contact with something, when at home or work) - P: PRESENT WORK (what exposed to, MSDS location, PPE, coworkers with health problems) - R: RESIDENCE (age, location, heating type, stored chemicals, drinking water source) - E: ENVIRONMENTAL concerns (concerns about air, water, soil in neighborhood; industries/farms/landfill/waste-site nearby) - P: PAST WORK (experience, longest work period, military, farm, seasonal or volunteer work) - A: ACTIVITIES (hobbies, burn/solder/melt, garden/fish/hunt, eat what grown or hunted, alternative healing) - R: REFERRALS & RESOURCES - E: EDUCATE (materials available to client, plan for follow-up)

2 key measures of global health

- Life expectancy - Infant mortality

mitigation

- Measures taken to reduce harmful effects - Preventions - Occurs before incident - Adjust the plan as needed

Global burden of disease

- Questions related to value of a life - Disparities, verified with quantifiable data, in the burden of disease worldwide among the developing countries, especially among children - As more people around the world are living longer, the number of years lived with disability (YLD) increases (back pain and depression are the mostly commonly cited causes of disability in countries worldwide) - Disability-adjusted life year: to compare across conditions and risk factors; the combination of years of life lost because of premature mortality and years of life lived with disability adjusted for the severity of disability

Category A Bio terrorism Agents

- Smallpox - Inhalation Tularemia - Viral Hemorrhagic Fever - Anthrax - Pneumonic Plague - Botulism

Build environment

- refers to all aspects of our human environment that are not naturally occurring and includes not only the physical structures (e.g., dams, roadways, buildings) but also the features that contribute to social cohesiveness or disruption - Environmental justice: the fair treatment and meaningful involvement of all people regardless of race, color, national origin, or income with respect to the development, implementation, and enforcement of environmental laws, regulations, and policies

smallpox s/s

High fever Head/body aches Vomiting Progressive rash

The registered nurse is teaching a student nurse about the disaster triage tag system. Which statement made by the student nurse indicates ineffective learning?

I will use a yellow tag for a client in shock

life cycle of disaster

Pre-incident Trans-incident Post-incident

correct order for emergency preparedness

Preparedness Response .Recovery Mitigation Evaluation

Which tag color according to the disaster triage tag system is assigned to a client who has an immediate threat to life?

Red

Tularemia s/s

Skin ulcers Swollen/painful lymph glands Sore throat Mouth sores Diarrhea Pneumonia Inhaled: abrupt onset fever, chills, headache, muscle aches, joint pain, dry cough, progressive weakness

Tularemia transmission

Tick, deerfly Sick/dead infected animal Contaminated food/water Inhalation NOT person to person

Tularemia treatment

antibiotics

Which would the nurse describe as an example of an internal disaster?

fire or explosion

Which color tag should be given to "walking wounded" clients according to the disaster triage tag system?

green

Which client conditions require the nurse to tag with red according to the disaster triage tag system? Select all that apply.

hemorrhage airway obstructuion

Which phase in the disaster management continuum does the nurse understand as including the attempt to limit a disaster's impact on human health and community function?

mitigation

`Era of Infectious diseases

o Communicable diseases - 5 of 10 leading causes of death, major preventive measure of immunization o Interventions such as integrated management of childhood illness (IMCI), polio endgame, and oral rehydration therapy o Eradication, elimination, and control of communicable diseases

Natural disasters

o Earthquake o Tornado o Floods o Hurricanes o Blizzards o Wildfires o Tsunamis o Nuclear

The geographic location of a community makes it vulnerable to storms. The community health nurse teaches the community about safety measures to be taken during a storm. Which phase of disaster management is this action?

preparedness

intensity of disaster

the level of destruction and devastation it causes (an earthquake centered in a large metro area and one centered in a desert have same Richter scale rating yet have very different intensities in terms of the destruction they cause

Tertiary prevention emergency preparedness

• Decrease complications and disabilities due to infectious disease through treatment and rehab • Monitory treatment compliance • Identify and link clients to needed community resources

Secondary preventions emergency preparedness

• Increase early detection through screening and case findings • Refer suspected cases of communicable disease for reporting and confirmation • Provide postexposure prophylaxis • Quarantine clients when necessary

Primary prevention emergency preparedness

• Prevent the occurrence of infectious disease • Educate the public regarding the need for immunizations, and vaccination programs • Counsel clients travelling to other countries about protection from infectious diseases. Refer client to health department about mandatory immunizations • Educate the public regarding prevention of disease and ways to eliminate risk factors for exposure

HP2020`

o Outdoor air quality o Surface and groundwater quality o Toxic substances and hazardous wastes o Homes and communities o Infrastructure and surveillance o Global environmental health