Disaster and Emergency Nursing

A licensed practical nurse (LPN) attends a session about bioterrorism agents including anthrax. Which statement by an attendee demonstrates the need for further teaching about anthrax? -Anthrax can be transmitted by consumption of meat from an infected animal. -The most lethal form of anthrax is contacted by inhalation of the spores. -Anthrax bacteria produces a neurotoxin leading to a serious, possibly fatal paralysis. -Anthrax is treated with antibiotic medications

-Anthrax bacteria produces a neurotoxin leading to a serious, possibly fatal paralysis. Anthrax is caused by Bacillus anthracis, and it can be contracted through the digestive system, abrasions in the skin, or inhalation. Antibiotics are administered. Botulism is caused by a neurotoxin that causes severe paralysis and can be fatal.

A nurse is communicating with the rapid response team after a client reports sudden right calf pain and shortness of breath. Which of the following client data should the nurse report to the team? -History of cancer -Vital signs -Insurance provider -Discontinued medications

-Vital signs When following the SBAR framework for communication, the nurse should report the client's vital signs as part of the physical assessment data. The other answers are not relevant to the client's immediate risk of rapid decline.

The emergency department nurse receives a telephone call and is informed that a tornado has hit a local residential area and numerous casualties have occurred. The victims will be brought to the emergency department. Which should be the initial nursing action? -Obtain additional nursing staff to assist with treating the casualties. -Prepare the triage rooms -Obtain additional supplies from the central supply department. -Activate the agency emergency response plan.

-Activate the agency emergency response plan. During a widespread disaster, many people will be brought to the emergency department for treatment. Health care institutions are required to have an emergency response plan in place and perform practice drills. The initial nursing action should be to activate the emergency response plan. The plan entails the other options, which include preparing triage rooms to take casualties, and obtaining sufficient supplies and medical personnel.

The nurse enters the nursing lounge and discovers that a chair is on fire. The nurse activates the alarm, closes the lounge door, and obtains the fire extinguisher to extinguish the fire. The nurse pulls the pin on the fire extinguisher. Which is the next action the nurse should perform? -Aim at the base of the fire. -Sweep the fire from top to bottom with the extinguisher. -Squeeze the handle on the extinguisher. -Sweep the fire from side to side with the extinguisher.

-Aim at the base of the fire. A fire can be extinguished by using a fire extinguisher. To use the extinguisher, the pin is pulled first. The extinguisher should then be aimed at the base of the fire. The handle of the extinguisher is squeezed, and the fire is extinguished by sweeping from side to side to coat the area evenly. Remember that the safety of anyone present is more important than extinguishing the fire. Remember the mnemonic RACE: R (Rescue) A (Alarm) C (Confine) E (Extinguish).

A mother calls a neighborhood nurse and tells the nurse that her 3-year-old child has just ingested liquid furniture polish. Which action should the nurse instruct the mother to take first? -Call the poison control center. -Call an ambulance. -Bring the child to the emergency department. -Induce vomiting

-Call the poison control center. If a suspected poisoning occurs, the poison control center should be contacted immediately. The nurse can assist the mother with contacting the poison control center. Vomiting should not be induced without instructions from the poison control center. Inducing vomiting is not done if the client is unconscious or the substance ingested is a strong corrosive or petroleum product. Bringing the child to the emergency department or calling an ambulance would delay treatment. The poison control center may advise the mother to bring the child to the emergency department; if this is the case, the mother should call an ambulance.

A nurse in a long-term care facility is caring for a client who is unresponsive. The client's roommate states, "He was walking in the yard and dropped to the ground." Which of the following techniques should the nurse use to open the client's airway? -Flexion of the head -Hyperextension of the head -Head-tilt/chin-lift -Modified jaw thrust

-Head-tilt/chin-lift The nurse should open the client's airway by the head-tilt/chin-lift because the client is unresponsive without suspicion of trauma. The nurse should not open the client's airway with the modified jaw thrust because this method is used for a client who is unresponsive with suspected traumatic neck injury. The nurse should not open the client's airway with hyperextension of the head because hyperextension of the head can close off the airway and cause injury. The nurse should not open the client's airway with flexion of the head because flexion of the head does not open the airway.

A nurse is contributing to the plan of care for a client who was bitten by a snake. Which of the following should the nurse expect to include in the plan of care? -Measure edema every hour. -Monitor WBC count. -Administer NSAIDs for pain. -Maintain cardiac monitoring.

-Maintain cardiac monitoring. The nurse should expect to administer opioid medication for pain when caring for the client who has a snake bite. The nurse should measure tissue edema every 15 minutes when caring for the client who has a snake bite. The nurse should expect to monitor ABGs, glucose, and coagulation values when caring for the client who has a snake bite. The nurse should maintain continuous cardiac monitoring because the client is at increased risk of arrhythmia.

A nurse is caring for a client who has ingested a toxic agent. Which of the following actions should the nurse plan to take? (Select all that apply.) -Instill activated charcoal. -Administer syrup of ipecac. -Perform a gastric lavage with aspiration. -Complete a whole-bowel irrigation. -Induce vomiting

-Instill activated charcoal. -Perform a gastric lavage with aspiration. -Complete a whole-bowel irrigation. Vomiting places the client at risk for aspiration.This is an appropriate action by the nurse because activated charcoal adsorbs drugs and other chemicals, and the charcoal does not pass into the bloodstream. This is an appropriate action by the nurse because gastric lavage with aspiration removes the toxic substance when the instilled fluid is suctioned from the gastrointestinal tract. Administering syrup of ipecac induces vomiting, which increases the client's risk for aspiration. This is an appropriate action by the nurse because a solution of polyethylene glycol with electrolytes is ingested or administered through an nasogastric tube, and the toxic agent and solution are eliminated from the bowels.

The nurse is educating a new nurse about mass casualty events (disasters). Which statement by the new nurse indicates a need for further teaching? Select all that apply. -"Mass casualty events do not require an increase in the number of staff that are needed." -"A mass casualty event occurs if a fight between visitors occurs in the emergency department." -"A mass casualty event occurs only within the heath care facility and could endanger staff." -"An event is termed a mass casualty when it overwhelms local medical capabilities."

-"Mass casualty events do not require an increase in the number of staff that are needed." -"A mass casualty event occurs if a fight between visitors occurs in the emergency department." -"A mass casualty event occurs only within the heath care facility and could endanger staff." Mass casualty events, also known as disasters, overwhelm local medical capabilities and may require the collaboration of multiple agencies and health care facilities to handle the crises. This type of event can occur in the health care facility or outside of it. Fights in the emergency department are not termed mass casualty events but are agency security and local enforcement issues. Mass casualty events almost always require an increase in staffing to ensure safe client care.

A nurse in an urgent care clinic is caring for a client who fell through the ice on a pond and is unresponsive and breathing slowly. Which of the following are appropriate actions by the nurse? (Select all that apply.) -Remove wet clothing. -Maintain normal room temperature. -Apply a heat lamp. -Apply warm blankets. -Infuse warmed IV fluids.

-Remove wet clothing. -Apply a heat lamp. -Apply warm blankets. -Infuse warmed IV fluids. This is an appropriate action by the nurse because the body temperature can rise more quickly when heat is applied to dry skin. The nurse should increase the temperature of the room to help return the client to a normal body temperature. This is an appropriate action by the nurse because the client's body temperature can rise more quickly when warm blankets are applied. This is an appropriate action by the nurse because the client's body temperature can rise more quickly when a heat lamp is safely applied. This is an appropriate action by the nurse because the client's body temperature can rise more quickly when warmed IV fluids are infused.