meg surg

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meg surg
2013-05-20 04:45:54
chapter 13

pt with disaster/bioterrorism response
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  1. essential to nursing
    • ability to recognize an emergent condition, prioritize, and provide quick(rapid) assessment and interventions.
    • for appropriate level of care.
  2. airway
    • most important.
    • dont flex or extend neck.
  3. components of primary survey
    • Airway
    • Breathing
    • Circulation
    • Disability/cns
  4. disability/cns
    neuro logic test is preformed
  5. second survey
    • head
    • chest
    • abdomen
    • extremities
  6. shock
    a condition of acute peripheral circulatory failure, decreasing b/p and failing tissue perfusion.
  7. 4 types of shock
    • hypovolemic-decrease blood volume.
    • cardiogenic-heart failure.
    • obstructive-blocked blood flow outside heart,reduced oxygen.
    • distributive-dilation of venules and artyerioles, decreased b/p.
  8. treat shock
    • maintain open airway
    • control bleeding
    • supine position
    • record v/s
    • give iv fluid
    • give no food or drinks till no surgery
  9. abdomal trauma
    • injury to spleenand liver can cause rapid loss of blood leading to hypovolemic shock.
    • intra abd. hemorrhage
  10. glasgo coma scale (GCS)
    • used to rate a pt level of consciousness.
    • score lower then 13 may indicate the need for immediate treatment.
    • dialated or nonreactive pupils indicate increased ICP and a need for immediate intervention. INTER CRANIAL PRESSURE
    • score 8 or lower is death
  11. burns
    • partial thickness burn: superficial(epidermas of skin) or deep(entire epidermal layer& dermis).
    • -clean w/steralsaline, cover with 1/8inch layer of anti infective cream(silver sulfadiazine), cover w/dry bulky fluffy dressing.
    • full thickness burn: involves all skin layers and subcutaneous tissue.
  12. heat exhaustion
    • occurs when the body looses so much water and electrolytes thru heavy sweating that hypovolemia occurs.
    • lead to heat stroke if heat exhaustion not treated.
    • s/s cool clammy skin, grey face,irritability,poor judgment.
    • body temp is normal or slightly elevated 100.4-102.2
    • other signs dizzy vomit diarrhea weak and fiat.
  13. heat stroke
    • heat exhaustion not treated.
    • sign unable to sweat.
    • can develop seizures.
    • hot dry flush skin.
    • temp 106F
    • seizues, cerebral ischemia, renal failure,late cardic decoprensation and GI bleeding. (effects heart,renal, brain, intestines.)
  14. poisoning
    • 1/3caused by cleaners,soaps, insecticides,acids,alkalis
    • cant make pt vomit d/t burning of gastric poison.
  15. ipecac
    • syrup to make you vomit, no longer recommended.
    • servour cases use activated charcoal.
  16. anxiety lead to panic
    • complete disorganization/loss of control.
    • pt in panic is terrified and needs external controls to avoid harm.
  17. manic behavior
    • most common result is manic depressive(bipolar) disorder.
    • exhibits bizarre, extreme, hyperactive behaviors.
    • high risk of injury to self and others.
    • drug Haldol 5
  18. heighten psychiatric emergency
    use of alcohol and illicit drugs.
  19. rapid tranquilizer
  20. bio terrorism small box
    • breakout in community, disease3.
    • small pox caused by variola virus, an orthopoxvirus unque to humans.
    • small pox fatality 30%.
    • rash occurs 2-3 days later first on face and for arms.
    • pustules(airborne) wear N95 mask.