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Emergency AssessmentMedical-Surgical Nursing-7th edition

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What are risk factors for a cold related emergency?
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DM, homeless, smoking/ETOH, use of narcotics, heroin, antiemetics, and psychotropic agents.
How are drowning victims treated?
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Stabilize C spine, warm (if hypothermic), mechanical vent with PEEP or CPAP, diuretics (Lasix and Mannitol), ABG's, BUN, CBC, CXR, skull with c-spine x-ray, electrolytes, creatinine.
How is heat stroke treated?
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Same treatment as heat exhaustion plus: 100% O2, cooling blankets, avoid shivering with Thorazine. *Monitor for rhabdomyolysis or D/C.
What is immersion syndrome r/t drowning?
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Immersion in cold water leads to vagal stimulation and bradycardia.
What should you monitor for during re-warming of a hypothermic patient?
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Vasodilation leading to hypotension, after-drop caused by a return of cold peripheral blood to central circulation that decreases core temperature further. *Can lead to hypotension and dysrhythmias.
What complications develop as a result of hypothermia?
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Irritability of myocardium leads to v. fib with any movement, dehydration, increased risk of thrombus, PE, stroke, ATN, ARF, and anaerobic metabolism leads to acidosis.
Hypothermia is defined as a core temperature below _______.
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95 degrees F/35 degrees C
How is frostbite treated?
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Handle carefully and remove clothes, soak in 102-108 degree water, blisters should be covered with sterile dressing, elevate extremity, analgesics, tetanus shot, and amputation if necessary.
A core body temperature below _______ is life threatening and death occurs when it is below _______.
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below 87 degrees is life threatening; below 78 degrees = death
What cold emergency? Pale to blue skin, mottled appearance, crunchy skin, tingling, numbness or burning.
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Superficial frost bite.
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Fresh or salt water drowning? Hypotonic, decreased surfactant, decreased surface tension leads to atelectasis, alveoli collapse, pulmonary edema, hypoxia, acidosis. Fluid absorbed into circulation.
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Fresh
Why does PEEP or CPAP need to be removed slowly from drowning victims?
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Surfactant levels can be decreased for up to 48-72 hours afterwards.
Fresh or salt water drowning? Hypertonic, triggers a rapid shift of water and proteins into alveoli which leads to pulmonary edema, hypoxia, V/Q mismatch and respiratory failure.
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Salt
What is the difference between dry and wet drowning?
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Dry: reflexive laryngospasm and bronchospasm which causes airway obstruction. Wet: fluid is swallowed and aspirated.
All near drowning victims should be observed for _______.
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4-6 hours
Resuscitation of a hypothermic patient should continue for _______ after the core temperature reaches 89.6 degrees.
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1 hour
Which heat emergency? Fatigue, n/v/d, light-headed, tachypnea, tachycardia, raised body temperature, dilated pupils, confusion, hypotension.
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Heat exhaustion
Which heat emergency? Core temperature over 104 degrees, no perspiration, decreased LOC, hot dry ashen skin.
Show Answer
Heat stroke
How is heat exhaustion treated?
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Remove clothing, cool environment, monitor ABC's, F and E replacement orally or with 0.9% NS via IV.
Which heat emergency? Large muscle groups, nausea, tachycardia, pallor, diaphoresis, r/t exercise or exertion...
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Heat cramps
  
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