Emergency Care and Assessment

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Questions and Answers

What is the first thing that Arthur, a registered nurse, should do at the scene of the accident?

Administer first aid to the old woman's injuries

Assess the old woman's airway, breathing, and circulation (correct)

Provide oxygen therapy

Call for emergency medical services

What symptom would lead Arthur to suspect that the old woman has a hip fracture?

Pain in the knee

Inability to move the affected leg

Deformity of the affected leg

Shortening of the affected leg (correct)

What is the likely cause of the old woman's knee symptoms?

Blood clot in the leg

Infection of the knee joint

Injury to the surrounding soft tissues (correct)

Fracture of the femur

What factor does not contribute to osteoporosis?

Excess calcium intake Signup and view all the answers

What should the ER nurse closely monitor Martha for after her accident?

All of the above Signup and view all the answers

How should Mr. Rojas hold his cane?

In the hand opposite his weakness Signup and view all the answers

Why is it important for Mr. Rojas to use a cane?

To provide additional support and balance Signup and view all the answers

What is the Mantoux Test also known as?

Tuberculin Skin Test Signup and view all the answers

What is the next action the nurse should take after Mang Alfred's Mantoux test result is positive?

Conduct a chest X-ray Signup and view all the answers

Why is the Mantoux test not routinely done in the Philippines?

It is not recommended by the DOH Signup and view all the answers

What is the category of Mang Alfred according to the DOH?

New TB patient with active disease Signup and view all the answers

How long is the maintenance phase of Mang Alfred's treatment?

6 months Signup and view all the answers

Which of the following drugs is unlikely to be given to Mang Alfred during the maintenance phase?

Streptomycin Signup and view all the answers

What is the most hazardous period for development of clinical disease according to the DOH?

First 6 months after exposure Signup and view all the answers

What behavior of Michiel indicates the best initial step in learning to care for his colostomy?

Wanting to learn how to irrigate the colostomy Signup and view all the answers

What is the maximum height of irrigation solution for colostomy?

24 inches Signup and view all the answers

Study Notes

Initial Assessment

As a registered nurse, the first thing to do at the scene is to assess the situation and ensure the safety of the patient and others.
A hip fracture is suspected when the leg is shortened or externally rotated.

Signs and Symptoms

Reddened, warm to touch, and swollen knee are signs and symptoms likely related to inflammation.
Osteoporosis is a contributing factor to fractured bones, and factors that contribute to osteoporosis include aging, genetics, and lack of calcium.

Immobilization and Emergency Care

The ER Nurse should carefully monitor the patient for signs and symptoms of shock, bleeding, or further injury.

Using a Cane

To teach a patient to use a cane, hold the cane on the unaffected side, with the hand grip at the level of the wrist.
Hold the cane with the elbow flexed at a 30-degree angle.

Rehabilitation Phase

During the rehabilitation phase, the nurse should intervene if the patient uses the cane incorrectly.

Mantoux Test

The Mantoux Test is also known as the Tuberculin Skin Test.
The solution is injected intradermally.
A positive result is indicated by an induration of 10 mm or more.
The patient should return after 48-72 hours to read the test result.
If the result is positive, the nurse should refer the patient to a doctor for further evaluation and treatment.

TB Management

In the Philippines, Mantoux test is not routinely done due to the high prevalence of Latent TB Infection.
A patient with an active disease is categorized as Category 1 by the DOH.
The duration of the maintenance phase of treatment is 4-6 months.
Ethambutol is unlikely to be given during the maintenance phase.
The most hazardous period for development of clinical disease is during the first 2 years.
The DOH program to control TB in the country is called the National Tuberculosis Control Program (NTP).
Susceptibility for the disease is increased markedly in those with HIV/AIDS, except for those with DM.

Level of Prevention

Direct sputum examination and Chest X-ray of TB symptomatic is in the secondary level of prevention.

Colostomy Care

A patient shows the best adaptation with the new colostomy if they show acceptance and independence in caring for the colostomy.
The nurse should teach the patient about colostomy irrigation, using a colostomy irrigation set, and inserting the tube at approximately 15-20 cm from the stoma.
The maximum height of irrigation solution for colostomy is 12-18 inches.
The best initial step in learning to care for the colostomy is to practice and demonstrate the ability to care for the colostomy.
If the patient complains of severe cramping during irrigation, the nurse should stop the irrigation and consult with a doctor.
A prolapsed stoma is evident if the stoma is protruding from the abdomen.
Foods that will help lessen the odor of the colostomy include yogurt, buttermilk, and parsley.
The nurse should start to teach the patient about the techniques for colostomy care, including irrigation and stoma care.

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Description

A registered nurse, Arthur, responds to an emergency situation where an old woman is hit by a motorcycle and assesses her injuries. This quiz tests his knowledge of emergency care procedures and injury assessment.