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Questions and Answers
What is a potential side effect of administering Epogen for red blood cell growth?
What is a potential side effect of administering Epogen for red blood cell growth?
What electrolyte imbalance is commonly associated with tumor lysis syndrome?
What electrolyte imbalance is commonly associated with tumor lysis syndrome?
Which condition is characterized by excessive water retention and low sodium levels?
Which condition is characterized by excessive water retention and low sodium levels?
What is a common first symptom of spinal cord compression?
What is a common first symptom of spinal cord compression?
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What should be done immediately for burn patients with potential airway injury?
What should be done immediately for burn patients with potential airway injury?
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What is the first step in managing a person who has been stung?
What is the first step in managing a person who has been stung?
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What is the primary concern for a poisoning victim before decontamination?
What is the primary concern for a poisoning victim before decontamination?
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What should be avoided when administering activated charcoal?
What should be avoided when administering activated charcoal?
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What is a common sign of opioid overdose?
What is a common sign of opioid overdose?
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Which of the following accurately describes primary injuries in spinal cord injuries?
Which of the following accurately describes primary injuries in spinal cord injuries?
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What is a potential consequence of spinal shock?
What is a potential consequence of spinal shock?
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Why is time critical in treating a spinal cord injury?
Why is time critical in treating a spinal cord injury?
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What is a notable complication of spinal edema?
What is a notable complication of spinal edema?
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What is the primary goal when treating a patient with heat stroke?
What is the primary goal when treating a patient with heat stroke?
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What is a common symptom of neurogenic shock in patients with T6 and above injuries?
What is a common symptom of neurogenic shock in patients with T6 and above injuries?
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Which symptom indicates a patient might be experiencing dehydration due to heat stroke?
Which symptom indicates a patient might be experiencing dehydration due to heat stroke?
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What is an appropriate method for active warming in a hypothermic patient?
What is an appropriate method for active warming in a hypothermic patient?
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Which level of spinal injury is critical for keeping the diaphragm functional?
Which level of spinal injury is critical for keeping the diaphragm functional?
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What does an increase in vagal stimulation in patients with T6 and above injuries commonly result in?
What does an increase in vagal stimulation in patients with T6 and above injuries commonly result in?
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Why is drowning in cold water considered less dangerous than drowning in warm water?
Why is drowning in cold water considered less dangerous than drowning in warm water?
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What is the most significant concern regarding cat bites?
What is the most significant concern regarding cat bites?
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What is a primary concern of tension pneumothorax?
What is a primary concern of tension pneumothorax?
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What is a critical step to take for a drowning victim before any further treatment?
What is a critical step to take for a drowning victim before any further treatment?
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How should a healthcare provider address an impaled object in a trauma setting?
How should a healthcare provider address an impaled object in a trauma setting?
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Which condition is associated with long bone fractures that can lead to serious complications?
Which condition is associated with long bone fractures that can lead to serious complications?
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In cases of hypothermia, what temperature range should the body reach before determining time of death?
In cases of hypothermia, what temperature range should the body reach before determining time of death?
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What is indicated by the presence of sweet tea-colored urine?
What is indicated by the presence of sweet tea-colored urine?
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What approach should be taken for wound care within 6 to 12 hours of a puncture wound?
What approach should be taken for wound care within 6 to 12 hours of a puncture wound?
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What strategy can help individuals with traumatic brain injury manage symptoms?
What strategy can help individuals with traumatic brain injury manage symptoms?
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What is the first step in the primary survey of a trauma patient?
What is the first step in the primary survey of a trauma patient?
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What does a lactate level greater than 4 indicate in a patient with severe sepsis?
What does a lactate level greater than 4 indicate in a patient with severe sepsis?
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Under the Good Samaritan law, what obligation does a bystander have if they stop to assist at an accident scene?
Under the Good Samaritan law, what obligation does a bystander have if they stop to assist at an accident scene?
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What is a critical initial action when addressing uncontrolled hemorrhage in a trauma patient?
What is a critical initial action when addressing uncontrolled hemorrhage in a trauma patient?
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In the context of oncology emergencies, what does thrombocytopenia signify?
In the context of oncology emergencies, what does thrombocytopenia signify?
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What intervention should be initiated for a patient exhibiting hypercalcemia?
What intervention should be initiated for a patient exhibiting hypercalcemia?
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Which vital system is most affected in severe sepsis leading to respiratory complications?
Which vital system is most affected in severe sepsis leading to respiratory complications?
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What is the appropriate response if a patient's temperature rises in the context of neutropenia?
What is the appropriate response if a patient's temperature rises in the context of neutropenia?
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Study Notes
Environmental Emergencies
- Heat Stroke vs. Heat Exhaustion: Heat stroke is worse; individuals are unable to sweat.
- Heat Stroke Treatment: Lower core temperature with cold water immersion (if possible), ice packs, and fluids. Monitor temperature and for dysrhythmias. Ensure adequate oxygenation.
- Hypothermia Treatment: Remove cold clothes, use warm blankets and fluids. Actively warm the body (bear huggers). Passive warming with warm blankets in a warm room. Aim for a body temperature of 86-90°F. Monitor ABCs (airway, breathing, and circulation) and urine output.
- Cold Water Drowning: Cold water slows drownings, increasing survival possibility. Evaluate for possible drowning injuries (pulmonary edema, ARDS). Critical treatment includes managing the airway and breathing, and warming the body.
Bites
- Cat bites can cause deep puncture wounds, increasing infection risk. Prophylactic antibiotics are typically given.
- Dog bites can be more extensive, involving larger areas. Antibiotics are often necessary.
- Wounds near joints or on extremities require antibiotics due to higher infection risk.
- Rabies: Evaluate the animal and its vaccination history to prevent rabies.
Stings
- Remove the stinger with a blade or flat object.
- Assess for allergies (and administer the appropriate medications).
- Administer epinephrine, antihistamines, and steroids (as indicated)
- Remove restrictive items like rings to prevent swelling.
Poisoning
- Decontaminate with a shower or water before performing ABCs(airway, breathing, and circulation)
- Call poison control centers to gather and provide relevant information about the ingested substance(s).
- Carbon activated charcoal can be used to bind to toxins. Rectal, oral, or NG administration is possible. If there are any concerns about the patient's GI system or issues like obstruction, administer charcoal with caution.
Opioid Overdoses
- Signs include pinpoint pupils, loss of consciousness, respiratory depression, seizures, and hypoxia.
- Administer Narcan (naloxone) and monitor ABCs (airway, breathing, and circulation) closely.
Spinal Cord Injuries
- Increased risk in males with vehicle-related accidents.
- Immediate care focuses on primary injuries (e.g., head lacerations) followed by secondary injuries.
- Spinal shock can cause the loss of deep tendon reflexes and sphincter reflexes below the injury site. Loss of sensation and paralysis can occur quickly and can persist for days/weeks.
- Monitor for potential neurological deterioration and monitor for increased blood pressure and potentially a headache.
- Stabilize, assess airway, breathing and circulation- the goal is to determine if a breathing tube or other interventions are required while keeping patients stable.
Neurogenic Shock
- Patients with injuries above T6 are at risk.
- Venous pooling, hypotension (systolic <90mm Hg) and temperature dysregulation(flushed and warm skin in extremities, followed by cold extremities) may occur
- Monitor for complications due to autonomic dysfunction in the upper body.
Respiratory Issues
- Issues concerning C3, C4 and C5, and above T6 require respiratory support.
Traumatic Injuries
- Tension pneumothorax (shifting of the mediastinum) is a life-threatening presentation.
- Pneumothorax is an injury in the chest that also requires immediate medical attention.
- Flail chest is a life-threatening injury presenting as paradoxical chest wall movement, and multiple broken ribs.
- Do not pull out an impaled object from the abdomen.
TBI (Traumatic Brain Injury)
- Treatment for TBI often involves a long-term course, involving lifestyle changes, including sleep, diet, and stress management, and support groups for sustained recovery. Recognize triggers.
- Symptoms are typically evaluated along with other factors.
Trauma Nursing
- ESI (Emergency Severity Index): Classifies patients based on their severity and acuity level. Use a 5-tiered system
- Primary survey: Includes assessing airway, breathing, circulation, disability and exposure. Treatment focuses on airway, breathing and circulation first.
- Secondary survey: Comprehensive physical exam to identify all injuries.
Burns
- The Parkland formula guides fluid resuscitation.
- Intubation is crucial for any burn involving the mouth, throat or esophagus to avoid airway complications.
Sepsis
- SIRs (System Inflammatory Response Syndrome): is a clinical syndrome that is characterized by a prolonged inflammatory response.
- Sepsis: Defined by SIRs and a possible infection, severe sepsis is characterized by SIRs, infection, and organ dysfunction, sepsis shock is the most severe sepsis, characterized by SIRs, infection, organ dysfunction, and decreased blood pressure.
- MODS (Multiple Organ Dysfunction Syndrome): Indicates widespread organ failure. A significant concern with high lactate levels (above 4 mEq/L).
Oncology Emergencies
- Neutropenia: Low white blood cell count.
- Infections: Increased risk of infections.
- Thrombocytopenia: Low platelet count; increased bleeding risk.
- Hypercalcemia: High calcium level, potentially due to cancer.
- Decreased kidney function: Monitor kidney function closely, and ensure adequate hydration and blood flow.
Tumor Lysis Syndrome
- Chemo is killing cells leading to hyperkalemia, hyperphosphatemia and hypocalcemia 24-48 hours after receiving the treatment, that can go into metabolic acidosis, leading to kidney damage.
- Prevent kidney damage by monitoring the hydration status. (hydration is KEY)
SIADH (Syndrome of Inappropriate Antidiuretic Hormone)
- Excessive water retention (can lead to hyponatremia) Requires correction of the sodium level, but avoid correcting too quickly. Requires accurate monitoring and timely adjustments of the sodium level.
Superior Vena Cava Syndrome (SVC syndrome)
- Blood flow obstruction in the superior vena cava.
- Higher blood pressure in the upper versus lower extremities, and potential dyspnea may occur.
Spinal Cord Compression
- Pain is potentially worse when the person is supine, and relieved with upright positioning.
- Establish pain management to reduce acute pain.
- Neuroimaging (MRI) is the most effective tool to identify and diagnose spinal cord compression and to determine any other complications.
- Treatments should be determined due to the possible cause of injury.
Burns (Continued)
- Rule of Nines: Estimate burn size.
- Parkland formula: Guides fluid resuscitation.
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Description
This quiz covers crucial information about environmental emergencies such as heat stroke, hypothermia, and treatment for cold water drowning. Additionally, it explores the risks and treatments associated with animal bites, particularly from cats and dogs. Test your knowledge on these vital emergency care topics.
