Prep U CH 67 Emergency Nursing Flashcards | Knowt

Which solid abdominal organ is most frequently injured in penetrating trauma, such as from a gunshot wound?

The liver, due to its large size and anterior placement in the right upper quadrant of the abdomen.

What activities or circumstances are most commonly associated with decompression sickness ("the bends")?

Diving in a lake or ocean, high-altitude flying, or flying in a commercial aircraft within $24\,\text{hours}$ of diving.

How is a stab wound characterized on physical inspection?

An incision of the skin with well-defined, distinct edges that is typically deeper than it is long, usually caused by a sharp instrument.

What monitoring interventions are required while rewarming a client experiencing severe hypothermia?

Continuous ECG monitoring and assessment of core body temperature using an esophageal probe, bladder thermometer, or rectal thermometer.

What is the immediate priority intervention for a client who has sustained a chemical burn?

Immediately drench and rinse the area with copious amounts of running water, unless the chemical is lye or white phosphorus (which must be brushed off first).

How is an avulsion wound defined?

The tearing away of tissue from its supporting structures.

What specific nursing assessments and actions are included during the secondary survey of a trauma client?

Performing a head-to-toe assessment, reviewing diagnostic and laboratory test results, obtaining a history of the current event, applying ECG electrodes, and splinting suspected fractures.

What respiratory complication should a nurse suspect in a client with a history of opioid/narcotic overdose who presents with sudden wheezing, restlessness, and frothy, pink sputum?

Pulmonary edema (noncardiogenic pulmonary edema).

What is considered an early clinical sign of shock?

An increasing heart rate (tachycardia) while blood pressure initially remains normal.

What are the primary clinical indications for performing endotracheal intubation?

To establish an airway when ventilation with an oropharyngeal or nasopharyngeal airway is inadequate, bypass an upper airway obstruction, prevent aspiration, connect to mechanical ventilation or a resuscitation bag, and facilitate tracheobronchial secretion removal.

What essential safety assumption must the nurse make when caring for any client who has sustained multiple trauma?

The client must be assumed to have a spinal cord injury until proven otherwise.

Which narcotic antagonist medication is administered to reverse severe opioid-induced respiratory depression and coma?

Naloxone hydrochloride.

What bath temperature and duration are recommended when rewarming an extremity affected by frostbite?

Placement in a circulating water bath maintained between $37^\circ\text{C}$ and $40^\circ\text{C}$ ($98.6^\circ\text{F}$ to $104^\circ\text{F}$) for $30$ to $40\,\text{minute}$ spans until circulation is restored.

What is the primary pathophysiologic effect of saltwater aspiration in near-drowning victims?

Development of pulmonary edema caused by the osmotic pressure of salt drawing fluid into the lungs, frequently accompanied by hypernatremia.

What is the initial nursing action for controlling acute external hemorrhage from a limb wound?

Applying firm, direct pressure over the bleeding site or over the involved artery at a location proximal to the wound.

Why is inducing vomiting strictly contraindicated after the ingestion of corrosive substances like toilet bowl cleaner?

Vomiting causes re-exposure of the esophagus, pharynx, and oral tissues to caustic (acid or alkaline) chemicals, causing severe additional tissue destruction.

What findings constitute a positive diagnostic peritoneal lavage (DPL)?

The presence of gross bile, feces, or food matter; a red blood cell count exceeding $100{,}000/\text{mm}^3$; or a white blood cell count exceeding $500/\text{mm}^3$.

Which metabolic condition must be ruled out immediately because it directly mimics acute alcohol intoxication?

Hypoglycemia (assessed via a bedside blood glucose check).

At what threshold is an ingested dose of acetaminophen considered toxic for a patient weighing $70\,\text{kg}$?

A level greater than or equal to $140\,\text{mg/kg}$, which equals $9800\,\text{mg}$ for a $70\,\text{kg}$ adult (e.g., $10{,}500\,\text{mg}$).

Within what duration of complete airway obstruction will hypoxia cause permanent brain injury or death?

Within $3$ to $5\,\text{minutes}$.

What clinical manifestations and timeframe characterize Stage III Lyme disease?

Beginning weeks to more than a year after the initial tick bite, Stage III manifests with chronic sequelae including arthritis, neuropathy, myalgia, and myocarditis.

How is the "urgent" triage category defined in the traditional three-tier emergency triage system?

Clients presenting with serious, non-life-threatening conditions who require care and resource utilization within $1\,\text{hour}$.

In Critical Incident Stress Management (CISM), when is a debriefing session scheduled and what is its goal?

Held $1$ to $10\,\text{days}$ following a critical event to allow participating staff to explore emotional reactions and receive reassurance that their responses are normal.

To what laboratory threshold must carboxyhemoglobin fall before discontinuing $100\%$ oxygen therapy in carbon monoxide poisoning?

Oxygen therapy is continued until the carboxyhemoglobin level drops below $5\%$.

Which combination of findings differentiates heat stroke from heat exhaustion?

A core body temperature of $105^\circ\text{F}$ ($40.5^\circ\text{C}$ to $40.6^\circ\text{C}$) or higher, anhidrosis (absence of sweating), and severe central nervous system dysfunction such as delirium, bizarre behavior, or coma.