NSG 233 - Medical-Surgical Nursing III
Final Exam
Question:
Bite Priority
Answer:
Human bite: know what to do first with a human bite!
Animal: rabies prophylaxis
Snakebite: lie down, removing constrictive items, providing warmth,
cleansing the wound, covering the wound with a light sterile dressing, and immobilizing the injured body part below the level of the heart.CABs (Circulation, Airway Breathing)
NO: Ice, incision and suction, or a tourniquet
Tetanus and analgesia should be given as necessary.Meds: FabAV or CroFAb: no limit on how much to give
S&S: necrosis, edema, ecchymosis
Tick: remove with tweezers, straight up pull, (try to get close to skin as
possible)
S&S: bulls eye rash
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Question:
Poisoning in the house
Answer:
Carbon Monoxide: 100% O2 Atmospheric/hyperbaric chamber
Ingested Poison: ABC, Call poison control, try to describe what was ingested
Charcoal: most effective, do not use if heavy metals were ingested.
Corrosives: give water/milk
Cathartics: sorbitol: give w/ 1st dose of charcoal
syrup ipecac: Induces vomiting, only give to alert patients-and NO patients
who ingested a corrosive agent
Gastric emptying: intubate before lavage (if -LOC/-gag reflex) with in 1 hour
of ingestion.
Question:
Overdose- multiply organ dysfunction syndrome
Answer:
Find out what Patient OD'd on. Give antidote if there is one Treatment goals for a patient with a drug overdose are to support the respiratory and cardiovascular functions, to enhance clearance of the agent, and to provide for safety of the patient and staff.
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Question:
Abuse- interpersonal violence
Answer:
Priority: ask questions IN PRIVATE, separate from person who is
abusive/neglectful referral to shelter adults are free to accept or refuse help safety plans should be explored
Mandatory report: children and elderly abuse - only need to suspect abuse,
do not need to prove it
Question:
PTSD- rape and stabbing
Answer:
Keep patient comfortable Offer therapeutic communication -listen Avoid triggers **ask if patient plans to harm self-
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Question:
Chest-Blunt trauma complications **
Answer:
Flail chest: paradoxical chest movement, hypoxemia, resp acidosis
Pulmonary contusion: abnormal accumulation of fluid,
- lung sounds, cough, frank blood, mucus, chest pain, atelectasis, -BP, resp
acidosis
Monitor: fluid intake, fluid replacement and pain
Management: airway, O2, treat pain, bronchoscopy
Meds: morphine
Medical Management• ABC-oxygen, possible endotracheal intubation, ventilatory support• Replace fluid volume• Restore negative intrapleural pressure if needed• Needle decompression• Chest tube if needed• Hemothorax• Pneumothorax• Hemo-pneumothorax
Question:
Crush injuries and trauma
Answer:
Hypovolemic shock Spinal Cord Injury Fractures Acute Kidney Injury
Priority: ABC's
SATA: Rhabdomyolysis: Triad: muscle cramps, muscle weakness, dark urine
Labs: CK levels, serum lactic acid levels
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