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Questions and Answers
What is a key characteristic that differentiates heat stroke from heat exhaustion?
What is a key characteristic that differentiates heat stroke from heat exhaustion?
Which intervention is essential for treating heat stroke?
Which intervention is essential for treating heat stroke?
What should be monitored in a patient with hypothermia?
What should be monitored in a patient with hypothermia?
What is the desired body temperature before declaring time of death in a hypothermic patient?
What is the desired body temperature before declaring time of death in a hypothermic patient?
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What physiological impacts does drowning in cold water have compared to warm water?
What physiological impacts does drowning in cold water have compared to warm water?
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What is a common concern specific to cat bites?
What is a common concern specific to cat bites?
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Why is it important to know the vaccination status of an animal that bites a human?
Why is it important to know the vaccination status of an animal that bites a human?
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Which of the following is NOT considered an active warming method for treating hypothermia?
Which of the following is NOT considered an active warming method for treating hypothermia?
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What is the immediate action to take after a person is stung by a bee?
What is the immediate action to take after a person is stung by a bee?
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What is a potential consequence of a T6 and above spinal injury?
What is a potential consequence of a T6 and above spinal injury?
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Which characteristic is associated with anomic dysreflexia in patients with T6 injuries or above?
Which characteristic is associated with anomic dysreflexia in patients with T6 injuries or above?
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What should be assessed regarding a patient who has been poisoned after decontamination?
What should be assessed regarding a patient who has been poisoned after decontamination?
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In the case of opioid overdose, which of the following symptoms is NOT typically associated?
In the case of opioid overdose, which of the following symptoms is NOT typically associated?
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What should be done when encountering an impaled object in an abdominal injury?
What should be done when encountering an impaled object in an abdominal injury?
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Which is a critical sign of tension pneumothorax?
Which is a critical sign of tension pneumothorax?
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What defines a primary spinal cord injury?
What defines a primary spinal cord injury?
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What can result from edema to the spinal cord?
What can result from edema to the spinal cord?
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What is a major risk associated with long bone fractures?
What is a major risk associated with long bone fractures?
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What does FAST stand for in the context of abdominal trauma assessment?
What does FAST stand for in the context of abdominal trauma assessment?
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What does spinal shock entail after a spinal cord injury?
What does spinal shock entail after a spinal cord injury?
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Which condition can lead to rhabdomyolysis following compartment syndrome?
Which condition can lead to rhabdomyolysis following compartment syndrome?
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Why is it crucial to not give activated charcoal to patients with abdominal issues?
Why is it crucial to not give activated charcoal to patients with abdominal issues?
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What should be done first when treating a patient for poisoning?
What should be done first when treating a patient for poisoning?
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What is a recommended strategy for managing symptoms of traumatic brain injury (TBI)?
What is a recommended strategy for managing symptoms of traumatic brain injury (TBI)?
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What condition can result from chemotherapy leading to an imbalance of electrolytes, specifically hyperkalemia and hyperphosphatemia?
What condition can result from chemotherapy leading to an imbalance of electrolytes, specifically hyperkalemia and hyperphosphatemia?
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Which of the following is a key action to take prior to administering chemotherapy to protect kidney function?
Which of the following is a key action to take prior to administering chemotherapy to protect kidney function?
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What symptoms indicate a potential issue with SIADH that must be addressed carefully?
What symptoms indicate a potential issue with SIADH that must be addressed carefully?
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In the context of spinal cord compression, when does the pain often worsen?
In the context of spinal cord compression, when does the pain often worsen?
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What is the recommended action for patients with burns affecting the mouth and throat due to potential swelling?
What is the recommended action for patients with burns affecting the mouth and throat due to potential swelling?
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Which level in the ESI indicates the most severe condition?
Which level in the ESI indicates the most severe condition?
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During a primary survey, which assessment should be prioritized first?
During a primary survey, which assessment should be prioritized first?
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What is the appropriate action to take if a patient shows uncontrolled circulation?
What is the appropriate action to take if a patient shows uncontrolled circulation?
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What condition is indicated by a lactate level greater than 4?
What condition is indicated by a lactate level greater than 4?
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In cases of neutropenia, which of the following is critical to monitor?
In cases of neutropenia, which of the following is critical to monitor?
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What is a common complication of severe sepsis that affects the respiratory system?
What is a common complication of severe sepsis that affects the respiratory system?
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What is the primary reason for administering bisphosphonates to patients with hypercalcemia related to bone cancer?
What is the primary reason for administering bisphosphonates to patients with hypercalcemia related to bone cancer?
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What effects can occur from acute kidney failure in cancer patients treated with antibiotics?
What effects can occur from acute kidney failure in cancer patients treated with antibiotics?
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Study Notes
Environmental Emergencies
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Heat Stroke vs. Heat Exhaustion: Heat stroke is worse; the body cannot sweat, while heat exhaustion allows for some sweating.
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Heat Stroke Treatment: Lower core body temperature with cold water immersion (if possible), ice packs, and cold fluids. Monitor temperature, dysrhythmias, and breathing.
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Hypothermia Treatment: Remove cold clothing, use warm blankets and warm fluids, Active and passive warming. Warm the room to a temperature between 86-90 degrees Fahrenheit. Monitor ABCs, cardiac function, and urine output.
Treating Heat Stroke
- Lower Core Temperature: Use cold water immersion if possible and ice packs.
- Monitor Vital Signs: Monitor temperature, heart rhythm (dysrhythmias), and breathing (ABCs).
- Fluid Administration: Ensure cold fluids are administered.
- Shivering Prevention: Shivering can make the body work harder; thus, minimize it.
- Urine Output Monitoring: Monitor for dark (tea-colored) urine, which indicates dehydration.
Hypothermia
- Cause of Thick Blood: Hypothermia can lead to blood clotting, heart attacks, and pulmonary emboli (PE).
- Cold Clothing Removal: Take cold clothes off immediately
- Active Warming: Utilize warm blankets, fluids, and bear huggers to warm the body
- Passive Warming: Passive warming involves strategies like manipulating the room temperature. Aim for 86-90 degrees Fahrenheit for patient warming.
- Monitor for Death: Check patient temperature to confirm whether death was from cold or heat; warm patient before declaring death.
Cold Water Drowning
- Cooling Effect: Cold water slows down the body's processes, increasing the chances of resuscitation.
- Drowning Injuries: Injuries like pulmonary edema and acute respiratory distress syndrome (ARDS) can occur.
- Treatment Focus: Immediate airway management and warming the body. Use a cervical collar and monitor ABCs.
- Water Type Considerations: The type of water where the incident occurs is relevant to treatment.
Bites
- Cat Bites: Cat bites can cause deep puncture wounds, increasing the risk of infection. Prophylactic antibiotics are often prescribed.
- Dog Bites: Dog bites tend to be more problematic due to larger, more extensive wound areas, and infection risk is higher.
- Dental Issues (Puncture wounds): Wounds located on hands, feet, or over joints should receive antibiotic therapy 6 to 12 hours after the bite.
- Rabies Exposure: The animal's vaccine history is crucial information to determine whether or not rabies prophalaxis (vaccination) is appropriate.
Stings
- Removal Technique: Remove the stinger with a flat object or a blade.
- Allergy Assessment: Determine if the person has any allergies.
- Medication Administration: EPI, antihistamines, and steroids may be required.
- Jewelry Removal: Remove any tight jewelry that can restrict blood flow due to swelling.
Poisoning
- Decontamination: Brush away powder before showering.
- Poison Control: Call for expert counsel.
- Treatment Strategies: Use charcoal to bind to toxins.
Opioid Overdose
- Vital Signs: Monitor pupils (which may be pinpoint), breathing, and responsiveness.
- Treatment: Administer naloxone (Narcan) as required and monitor ABCs.
- Monitor closely: Observe and document for any and all changes.
Spinal Cord Injuries
- Common Cause: Automobile accidents are a common cause
- Primary Injuries: Head lacerations are usually the initial or primary injuries.
- Secondary Injuries: These are more concern for permanent damage: Edema, ischemia, and inflammation of the spinal cord are potential issues.
- Spinal Shock: Immediate loss of reflex below the injury is notable with potential long-term damage if not addressed quickly.
- Neurogenic Shock: Signs include warm, flushed extremities, systolic blood pressure below 90, and potential issues regulating temperature.
- T6 and Higher Injuries: These result in temperature regulation problems, cardiac output issues and respiratory distress.
Trauma
- Tension Pneumothorax: Tension pneumothorax has the potential to be life-threatening; it can shift the trachea and affect circulation and breathing. Immediate decompression with a needle or chest tube is crucial.
- Flail Chest: Multiple rib fractures can result in flail chest; it causes paradoxical chest wall movement.
Abdominial Injuries
- Caution: Do not pull out impaled objects.
Fractures
- Blood Loss: Long bone fractures can cause significant blood loss.
- Infection Potential: Open fractures increase the chance of infection.
- Compartment Syndrome Risk: Crush injuries can lead to compartment syndrome, an acute limb-threatening complication.
- AKI: Rhabdomyolysis can cause acute kidney injury (AKI).
- Urine Appearance: Red or tea-colored urine is often a sign of rhabdomyolysis.
TBI- Traumatic Brain Injury
- Long-term Effects: TBI can cause chronic issues.
- Routine Needs: Maintain a routine that supports daily health and well-being.
- Support Networks: Utilize support groups for stress management and symptom monitoring.
- Avoid Irritants: Try to avoid substances that might worsen or trigger symptoms (alcohol, drugs, etc.)
Trauma Nursing
- ESI Levels: Trauma care prioritizes the patient based on the ESI level.
- Patient Considerations: Patient care needs may vary based on the ESI level.
TBI- Traumatic Brain Injury
- Lifelong Care: Some TBI injuries may require care for the rest of the patient's life.
Sepsis
- Severity Stages: Includes SIRS, sepsis, severe sepsis, and septic shock; this is noted by lactate levels, if above 4, immediate action is needed.
- Critical Issues: Assess for and address severe metabolic acidosis, inadequate urinary output, and complications like acute kidney injury.
- GI Involvement: Observe for gut symptoms like slowed bowel sounds, which are often caused by stress and/or lack of sufficient hydration; use caution and monitor closely.
- Kidney Failure: Kidney injury or failure needs careful attention, usually requiring medication or assistance.
Oncology Emergencies
- Neutropenia: Low white blood cell count increases susceptibility to infections.
- Infections: Monitor for infections and take appropriate action to prevent or treat them.
- Antibiotic Therapy: Follow antibiotic protocols meticulously to ensure correct application and monitoring.
- Thrombocytopenia: Reduced platelet count requires close monitoring; avoid procedures that may increase bleeding risk.
- Hypercalcemia: High calcium levels may result in many symptoms; carefully evaluate, treat as needed, and monitor for complications.
Tumor Lysis Syndrome
- Chemo Effects: Chemotherapy treatment can cause the death of numerous cells; closely monitor for subsequent side effects.
- Metabolic Acidosis: Monitor for metabolic acidosis.
- Kidney and Fluid Balance: Ensure adequate fluids and monitor kidney function.
- Electrolyte Imbalances: Be sure to check for electrolyte imbalances.
SIADH
- Water Excess: Excessive water intake is common.
- Assessment: Assess for mental status, reflex changes, and elevated sodium levels—critical to detect and address swiftly.
Superior Vena Cava Syndrome
- Symptoms: Symptoms of the obstruction include higher blood pressure in the upper body.
- Causes: Various factors or complications can cause the obstruction.
Spinal Cord Compression
- Pain Changes: Worsening pain, especially in the supine position, often marks the onset of spinal cord compression.
Burns
- Parkland formula: A formula to determine fluid requirements in burn patients.
- Intubation: Intubate patients who are having a burn injury to the mouth or airway, quickly.
- swelling issues in esophageal area: Early intubation is crucial to prevent further issues.
Lab work & monitoring
- Vital monitoring: vital signs including temperature and rhythm.
- Lab Work: lab tests such as blood work and urine.
- Other Tests: NG tubes or OG tubes may be used for patients with facial trauma.
- Medication Management: Provide pain management and other necessary medications.
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Description
Test your knowledge on environmental emergencies, focusing on heat-related conditions like heat stroke and heat exhaustion. This quiz covers treatment protocols, including lowering core temperature and monitoring vital signs. Assess your understanding of hypothermia treatment as well.
