Emergency Nursing and Disaster Situations

Question Answered step-by-step Emergency Nursing and Disaster Situations1. Case scenario:Questions:You are called in to help the ED where three UPS workers have just arrived by ambulance that was involved in a package being dropped, discharging a white powder into the air. Two of the workers inhaled the powder and got it on their skin and uniforms. Victim 1, who was catching the box tossed when it dropped, is in respiratory distress, coughing, and wheezing. He states he may also have swallowed some of the substance. Victim 2 has a rash with blisters on his face, hands, and arms. He also inhaled some of the white substance when the box broke open. Victim 3 was a little farther away unloading the van and only inhaled the substance.A. You are to triage these three clients and decide who the physician sees first. What levels would you triage these victims?B. What is your assessment of victim 1, victim 2, and victim 3?2. Case Scenario:A couple of 8-year-olds were playing in the attic and decided to go through one of their grandpa’s old chests of WWI “treasures.” Digging deep down to the bottom, they found what looked like an old bombshell, which seemed to be leaking around the edges. As they were handling it and looking it over, they got the substance on themselves and on their pants. They heard their mom call them for lunch and quickly went down to eat. Later that day, both developed itching, rashes, and lesions with blisters. They began to get worse and were taken to the ED.Questions:A. What is the first assessment of these two clients upon entering the ED?B. What is the treatment for blistering agents?C. Are you and others at risk for contamination? Who needs to be contacted, if any?D. What other chemical agents are considered possible agents of human disaster?3. Key concept Discussion:Shock is a life-threatening condition occurring in a body when oxygen to tissues and cells are inadequate, usually from disrupted blood flow. Shock develops in three stages or events for one reason or another; blood volume decreases, which then causes the heart to fail as a pump, causing blood vessels to dilate peripherally, leading the body to try to compensate. As compensation ensues, shock progresses, and if left uncorrected, organs become damaged and death is ultimate.A. What are the four types of shock and how do they affect the body?B. What are the three categories of distributive shock?C. What are the stages of shock?4. Case scenario:JP, an 85-year-old male client weighing 78 kg, was admitted to a medical-surgical unit from a nursing home with recent mental status changes. He is confused to place and time and is restless. He reports seeing spiders and kids playing, and he knows they are not there. He has a 16f Foley catheter in place from the nursing home because he is incontinent of urine, and there is cloudy foul-smelling dark amber urine with sediments of 100 mL present for the past 12 hours according to the nursing home report. He has crackles and rhonchi in the right lower lobe of his lung and coughs up yellow sputum.Vital signs: T, 95° F; BP, 88/60 mm Hg; HR, 130 beats/minute; RR, 32 breaths/minute; pulse oximeter, 88% on room air. The client denies any pain or discomfort. The physician ordered blood cultures × 2 separate sites 20 minutes a part, sputum and urine cultures, which were obtained and sent to the lab. Oxygen was ordered 2 L per nasal cannula; titrated to keep SaO2 92% or above. The nurse provided the oxygen, and the SaO2 is 92%. The physician wants to be called with the CBC and BMP results.The ordered labs are on the chart and as follows: CBC: WBC, 15,000 mcL; RBC, 4.1 million; Hgb, 15 g/100 mL; Hct, 37%; Plt, 150,000. BMP: BUN, 40 mg/dL; serum creatinine, 1.8 mg/dL; Na+, 135 mEq/L; Cl, 95 mEq/L; K+, 4 mEq/L, CO2, 21 mmol/L, Glucose, 195 mg/dL.The LPN/LVN needs to determine the necessary nursing management for the client, update the RN, and talk with the physician for further orders.Questions:A. What is possibly causing the underlying shock symptoms, and why is the client afebrile?B. What nursing management is needed for Mr. P? Health Science Science Nursing NURSING 245 Share QuestionEmailCopy link Comments (0)