Emergency Nursing Primary Survey and Airway Management

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Questions and Answers

What is the most significant sign of shock to monitor for in a patient?

  • Delayed capillary refill (correct)
  • Decreased breath sounds
  • Paradoxical chest wall movement
  • Tachycardia

In a cold environment, what should be taken into account when evaluating capillary refill?

  • It is not affected by cold temperatures
  • It is delayed (correct)
  • It indicates allergic reactions
  • It is faster due to cold temperatures

Regarding Disability assessment, what level of consciousness does 'A' represent in the AVPU scale?

  • Unresponsive
  • Responsive to voice
  • Responsive to pain
  • Alert (correct)

What is the primary cause of injury for older adults according to the text?

<p>Environmental hazards (D)</p> Signup and view all the answers

Which condition occurs when thermoregulatory mechanisms cannot compensate for exposure to increased ambient temperatures?

<p>Heat exhaustion (B)</p> Signup and view all the answers

What is the recommended initial oxygen therapy delivery method for a patient in an emergency situation?

<p>High-flow O2 via a nonrebreather mask (C)</p> Signup and view all the answers

What is the primary focus of the emergency nursing primary survey?

<p>Airway, breathing, circulation, and disability (C)</p> Signup and view all the answers

Which of the following is a sign/symptom of a patient with a compromised airway?

<p>Inability to vocalize (C)</p> Signup and view all the answers

What is the preferred procedure for managing an unprotected airway during rapid-sequence intubation?

<p>Involving sedation or anesthesia and paralysis (C)</p> Signup and view all the answers

What is the least to most invasive method for maintaining an airway in emergency nursing?

<p>Open airway using jaw-thrust maneuver, then suction and remove foreign body (D)</p> Signup and view all the answers

What is used to immobilize the cervical spine during assessment of the airway at the scene of injury?

<p>Cervical collar or cervical immobilization device (CID) (D)</p> Signup and view all the answers

When identifying life-threatening conditions during the primary survey, what should be done immediately?

<p>Start interventions related to ABCD (B)</p> Signup and view all the answers

What is the most serious form of heat stress described in the text?

<p>Heatstroke (B)</p> Signup and view all the answers

Which of the following symptoms is NOT associated with heatstroke?

<p>Profuse diaphoresis (C)</p> Signup and view all the answers

What is a key intervention for managing heatstroke?

<p>Rapidly reducing temperature (D)</p> Signup and view all the answers

Which condition may occur due to direct thermal injury to the brain in heatstroke?

<p>Cerebral edema (A)</p> Signup and view all the answers

What is a potential complication of treating heatstroke in a patient with shivering?

<p>Complicated cooling efforts (D)</p> Signup and view all the answers

In hypothermia, what is a complication that should be monitored for?

<p>Rhabdomyolysis (C)</p> Signup and view all the answers

What is a characteristic of the skin in a patient experiencing heatstroke?

<p>Hot, dry, and ashen (C)</p> Signup and view all the answers

Why is it essential to rapidly reduce the core temperature in a patient with heatstroke?

<p>To prevent complications like cerebral edema (B)</p> Signup and view all the answers

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Study Notes

  • Emergency Nursing Primary survey focuses on ABCDE: airway, breathing, circulation, disability, and exposure to identify life-threatening conditions.
  • Interventions are immediately started if life-threatening conditions related to ABCD are identified during the primary survey.
  • Airway management includes techniques like jaw-thrust maneuver, suctioning, airway insertion, endotracheal intubation, and rapid-sequence intubation for trauma to face or neck.
  • Breathing assessment involves checking for dyspnea, cyanosis, chest wall movement, breath sounds, and administering high-flow O2 or bag-valve-mask ventilation for life-threatening conditions.
  • Circulation assessment includes checking central pulse, skin color/temperature/moisture, mental status, capillary refill, IV line insertion, and direct pressure for bleeding sites.
  • Disability is measured through the patient's level of consciousness using scales like AVPU and Glasgow Coma Scale.
  • Exposure/environmental control involves removing clothing for assessment, preventing heat loss, and a systematic process to identify all injuries.

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