p. 141, Physiological Integrity Show
The nurse is triaging clients arriving at the hospital after a large scale disaster. Which of these clients is correctly classified? A. Young adult with closed fractures of her right leg and arm: Yellow tag D Rationale: The young adult with bruises can walk and get away from the disaster; this is characteristic of green tag clients. The young adult with fractures should be classified as green, the older adult with severe abdominal pain should be classified as yellow, and the middle-aged adult should be black-tagged as there is no chance for survival with that injury. p. 144, Safe and Effective Care Environment The ED charge nurse is assigning duties to nurses who have been floated to the ED or who have volunteered to help staff the ED during a mass casualty situation. Which assignments are most appropriate? Select all that apply. A. GI laboratory nurse assigned to orthopedic clients having sedation procedures A, B, E Rationale: The most useful nurses in a mass casualty situation are those who can assist with the type of patients that would be seen in this type of event. Nurses would be needed to communicate with families and to assist with direct care and triage.
p. 146, Patient-Centered Care An ED nurse has gone on a medical mission trip to a Third World country after an earthquake with multiple building collapses in a remote rural area. Hundreds are reported missing, and even more are injured. Medical resources in this country are scarce. 1. What challenges does this nurse face in terms of his or her own safety and health? First, the nurse must maintain personal safety. As tempting as it may be, unless the nurse has had special training, he or she should not enter unstable buildings or try to extract persons who are trapped. The nurse needs to maintain vigilance and a high degree of situational awareness. Illness is common after disasters, and the nurse should follow protocols for taking prophylactic medications, keep vaccinations up to date (including vaccinations for emergent travel), and maintain basic standard precautions. p. 146, Patient-Centered Care An ED nurse has gone on a medical mission trip to a Third World country after an earthquake with multiple building collapses in a remote rural area. Hundreds are reported missing, and even more are injured. Medical resources in this country are scarce. 2. How can the nurse manage basic hygiene and meet basic needs? Water safety is crucial; unless the medical mission team brought a large supply of bottled water, the nurse will be drinking local water, which will need to be decontaminated using commercial devices, boiling the water, or adding 10 to 20 drops of chlorine bleach to each gallon of water. Food, especially meat, should be cooked thoroughly. Sanitation can be maintained by lining buckets with plastic bags that are then buried after bleach has been added. Toilet "pits" can be dug into the ground. The nurse should ensure that he or she follows good handwashing procedures.
p. 146, Patient-Centered Care An ED nurse has gone on a medical mission trip to a Third World country after an earthquake with multiple building collapses in a remote rural area. Hundreds are reported missing, and even more are injured. Medical resources in this country are scarce. 3. Some local residents are so distraught that they are unable to function and are not eating or sleeping. What assistance can the nurse provide? First the nurse should recognize the extreme stress the local residents are under. They may be overwhelmed by the catastrophic nature of the event, feel guilty for having survived when so many others have died, and feel vulnerable and afraid if they have lost their homes and belongings. The nurse can convey caring, acceptance, and safety either verbally or nonverbally. The nurse might be able to assist with establishing temporary shelters. If there are interpreters available, some basic education on response to stress and healthy ways of managing it may be useful. The nurse might also be able to assess residents with the Impact of Event Scale—Revised if there is no language barrier and the population is literate. If mental health capacity is available, the nurse should refer anyone scoring highly on the entire test or on any subscale to a qualified counselor or mental health provider. p. 146, Patient-Centered Care An ED nurse has gone on a medical mission trip to a Third World country after an earthquake with multiple building collapses in a remote rural area. Hundreds are reported missing, and even more are injured. Medical resources in this country are scarce. 4. After returning from the mission trip, the nurse feels apathetic and disengaged with regular employment and is often short tempered with coworkers and staff. What resources exist for the nurse? After an extreme incident, the services of the Critical Incident Stress Foundation are useful to provide services that range from debriefing to ongoing education on stress management and coping skills. Optimally, members of the mission team have ready access to team members who have been trained in Critical Incident Stress Management techniques. Without appropriate processing of critical incidents, responders are vulnerable to posttraumatic stress disorder. Question 1 of 10 A client comes to the emergency department covered with coagulated blood and a white powder. The client is hysterical and fears that it is anthrax. What does the nurse do first? a. Administers antibiotics c Takes the client to the decontamination room Decontamination should precede triage. Only the most basic life-sustaining interventions should be performed before or during decontamination. The coagulated blood indicates that any major active bleeding has likely subsided. Taking antibiotics unnecessarily will promote the growth of resistant bacteria and may cause serious drug-related side effects. In addition, anthrax exposure has not yet been verified. Emotional support is important but is not the priority here. Triage is important but is not the first action that should be taken. Question 2 of 10 After losing her home to a hurricane several years ago, the client says, "I get very nervous during a thunderstorm and want to hide under the bed." What is the nurse's best response? a. "But it's just a thunderstorm. You would have warning if a hurricane was approaching." d "What do you do when you feel this way?" Check to see whether the thought is causing maladaptive behavior, and then assess whether it is normal or abnormal. Minimizing the client's fears by saying "it's just a thunderstorm" or it's "nothing to worry about" is not therapeutic. Weather-related concerns, particularly stemming from past experience, can be normal for one's life and are not necessarily an indication of maladaptive behavior, such as that seen in post-traumatic stress disorder. Question 3 of 10 After successful treatment of clients involved in a mass casualty incident, the incident commander deactivates the emergency response plan. Which activity is most important for the emergency department (ED) charge nurse to initiate at this time? a. Analyze the ED response to the mass casualty incident. b Take inventory and restock the ED with supplies and equipment. The priority is to restock the ED to return to normal operation. Analysis of the ED response, CISD debriefing, and follow-up with survivors and referrals can occur after the ED is restored. Question 4 of 10 During a mass casualty, staff roles are defined. If the triage officer is incapacitated, who is the best choice for replacement? a. Communications officer d Triage nurse When physician resources are limited, an experienced nurse may assume this role. Whoever can best meet the needs of the clients is the best choice. The communications officer serves as the liaison between the health care facility and the media, and would not be the best choice in a triage scenario. Typically, the hospital incident commander and the medical command physician are too busy. Question 5 of 10 During a mass casualty, which injury receives care first? a. Abdominal evisceration d Sucking chest wound The sucking chest wound is a red tag, or emergent, injury because it can be quickly resolved until further help can be given. The abdominal evisceration is a black tag, or is emergent for too much time, and resources are needed elsewhere in a disaster. The open fracture of the left forearm casualty is a yellow tag, or immediate, needing treatment in 30 minutes to 2 hours. The sprained ankle is a green tag, or "walking wounded," and does not require care for over 2 hours. Question 6 of 10 Which essential item is added to a personal-readiness supplies "go bag?" a. Fruits and vegetables b Potable water The go bag should contain 1 gallon of potable water per person per day. Potable water is required to prevent dehydration. Any foods included in a go bag should be non-perishable. A television would not be practical; a radio (battery-powered or hand-crank generated) would be better. A laptop computer would also not be practical. Question 7 of 10 The nurse has a suggestion for improving response in the next mass casualty event. Which channel does the nurse use to introduce this idea? a. The administrative review a The administrative review The goal of the administrative review is to discern what went right and what went wrong during activation and implementation of the emergency preparedness plan. In this way, changes can be made. CISB programming addresses pre-crisis through post-crisis interventions for small to large groups, including communities. Going through the supervisor and using the suggestion box are not the best ways to introduce a change of this type. Question 8 of 10 The emergency department charge nurse is making client assignments and delegating care after a mass casualty event. Which of these clients could be delegated to a nursing assistant? a. Client who has multiple left rib fractures and reports dyspnea d Client who is unconscious with massive aortic bleeding from the chest The client who is unconscious and has massive aortic bleeding is unlikely to survive and would be "black-tagged" and assigned to a nursing assistant. The client with rib fractures and dyspnea, the client with chest pain, and the client with a femoral fracture with palpable pulses are likely to survive and should be delegated to licensed staff members. Question 9 of 10 How does the high school nurse react directly after a random shooting at a high school? a. Actively listens to students b Assesses his or her own individual feelings Assessing his or her individual feelings is the best answer; one must be able to support oneself before supporting others. Active listening, allowing students to express their feelings, and facilitating community cohesion are important, but are not what should be done first. Question 10 of 10 A school bus overturns in a small, rural community that is served by a critical access hospital and one volunteer fire department. How is the incident of the overturned school bus categorized? a. Not a mass casualty b May be a mass casualty A mass casualty event overwhelms local medical capabilities. It may require the collaboration of multiple agencies and health care facilities to handle the crisis. Depending on the community, available resources, and the quantity and severity of those injured, this may be a mass casualty. The overturned school bus will likely require the hospital to activate their disaster plan; however, since it occurred outside of the facility, this would be an external disaster. Which tag is suitable for a client with high priority during a disaster with mass casualties quizlet?Which tag is suitable for a client with high priority during a disaster with mass casualties? The red tag is assigned to a client who requires immediate emergent treatment since he or she has a life-threatening condition.
In which order would clients receive care based on triage tag color quizlet?Red-tagged clients have major injuries, black-tagged clients are expected and allowed to die, and yellow-tagged clients have major injuries.
Which conditions are given a green tag according to triage disaster tag system quizlet?Which color tag should be given to "walking wounded" clients according to the disaster triage tag system? Green tagged clients are referred to as "walking wounded" because they may evacuate themselves from the mass casualty scene and go to the hospital in a private vehicle.
Which color tag should be given to walking wounded clients according to the disaster triage tag system?Green tag: These victims are referred to as the “walking wounded.” Their injuries are not life-threatening, and they should receive care after those with red or yellow tags.
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Which condition is most likely to be categorized with a black tag among clients arriving at the hospital after a large scale disaster quizlet?
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