DN QUIZZES
Goals for a patient with rabies include:
Dog Bites Post Quiz
Contact with what part of an infected animal
transmits the rabies virus?*
Saliva
You're looking after a patient who was bitten by a
dog. What medication do you think the doctor will
prescribe for this patient?
Tetanus vaccine
A mother of a 3-year-old who has been bitten by
the family dog approaches the nurse for advice on
how to treat the bite. What is the nurse supposed to
tell the mother?
“Wash the bite area thoroughly under running water
before inspecting the injury."
Level 1- It is a canine instinct that shows aggression
and bites the person's clothes.
Level 2- It is when the teeth make contact, but do
not break the skin. It marks without cuts.
Level 3- It is a single bite with shallow wounds with
lacerations in one direction
Level 4- It is a single bite with deep wounds with
one to four perforations
Level 5- It is a multiple bite with deep wounds in a
single attack.
Level 6- It is the death of the victim and/or flesh is
consumed.
Watch for signs of infection.. Step 6
Seek help if you suspect infection or possible
exposure to rabies, or if the wound is severe.
Step 5
Cover with a sterile bandage.Step 4
Apply an antibacterial ointment to the wound.Step 3
Gently press a clean cloth over the wound to stop
the flow of bloodStep 2
Wash the wound with soap and warm water.
Step 1
Assessment. The following are the clinical
manifestations of rabies, exceptSwelling
Nursing DIagnosis. Choose the appropriate
diagnosis for patient with rabies.
Hyperthermia related to viremia.
Plan.
Patient displays improvement in breathing pattern.
Patient takes adequate amount of calories or
nutrients.
Patient remains free of injuries.
Interventions. The following are interventions to
prevent patient injury, except:Use restraints if
needed.
Interventions. The following are interventions to
improve nutritional intake, except:
Place the client in a supine position while eating.
Quiz in Snake Bite
1. A type of snake that can either spit or inject
venom through their fangs punctured to skin.
venomous snake
2. It is a type of snake that has a rounded head,
relatively narrow or thin, no fangs, and has rounded
pupils*Nonvenomous snake
3-6. Select all physical characteristics that are
present in a venomous snake.
broad, triangular head, elliptical pupils with rattle,
pit between the eye and nostril
It is the part of the snake which secreted venom.
salivary gland
8. In providing emergency intervention, level the
wound from snake bite with the heart or higher.
False
9. Suction the venom from the snake bite to
prevent them from spreading into the blood
stream.False
10. Remove accessories or use tourniquet that may
impede circulation of the snake bite victim
False
11. Immobilize the patient, away from the range of
snake attack to prevent additional injury or snake
bite.True
12-16. If you are to witness someone bitten by a
snake what will you do? Select all that applies. Take
a picture or remember the appearance of the snake
that had bitten the victim
Clean the wound with water without rubbing and
massaging the bitten area
Call for an ambulance to immediately transport the
patient to hospital for treatment
Take the patient away from the attack range of the
snake and immobilize them to prevent another injury
Remove rings and constrictive items.
6. What do you call the only antivenim available in
the Philippines?
Philippine Cobra Antivenom (PCAV)
17. Aside from a snake bite, some cobras can inject
venom into the body when they spit like the
equatorial spitting cobras in the eye from a distance
of up to 3 meters. What is the necessary action in
order to prevent venom from circulating in the
body's system?
Rinse the eyes with clean water immediately.
19. Why should we need to assist victims of the
snake bite in moving and immobilizing them?
To prevent the possibility of another injury from
falling due to some possible manifestations such as
dizziness and weakness.
20. Why would we need to take note of the snake's
appearance once it bitten a victim?
To be able to report to the healthcare teams and
helps in identifying the appropriate antivenom or
treatment for the patient.
QUIZ 6 – ELECTROCUTION
1. Which of the following should you NOT do if a
person is in contact with a source of electricity and
suffering from electrical shock?
Touch him or her directly with your body
2. When moving a source of electricity away from a
victim of electrical shock, you can use an object
made of which of the following materials?
Cardboard, Plastic ,Wood
3. A current even as low as ______ can be felt by
the body.1 mAmp
4. Which part of the human body offers the most
resistance to electricity?
Thick and/or dry skin
5. Extreme pain, respiratory arrest, severe
muscular contractions and death is possible.
50 to 150 mA
6. Slight shock felt. Not painful but disturbing.
Average individual can let go. Strong involuntary
reactions to shocks in this range may lead to
injuries.1 to 5 mA
7. It is often a consequence of faulty or misuse of
electrical appliances Burns on the skin surface
8. The first and most important management in
helping someone who has suffered from electrical
shock. Turn off the power supply
9. When treating electrical and lightning burns it is
important to avoid; EXCEPT Removing dead skin or
break blisters
10. The following nursing diagnoses apply to
patients who have been suffering from electrical
shock. EXCEPT
Decreased cardiac output related to uncompensated
electric shock
11. It's a type of natural electric shock that travels
through a tall feature in the landscape to reach the
ground.Lightning strike
12. When an electric current passes through the
body and causes death, it is referred to as
_____.Electrocution
13. ________ occurs when an electric current
passes through the body, causing injuries.Electric
shock
14. As the first priority of care, a patient with
electric burn injury will initially need:
A patent airway established.
15. The administration of electric shocks to the
heart in order to reset normal heart rhythm in
persons who are experiencing cardiac arrest or
whose heart function is endangered because of
severe arrhythmia.Defibrillation
16. What intervention will the nurse implement to
reduce a client’s pain after a burn injury?
Administering morphine intravenously
17. It may cause the heart to stop pumping,
neurological damage, and death.1,000 to 4,300 mA
18. The intensity of shock is influenced by
differences in muscle and fat levels.True
19. Painful shock and loss of muscular control are
possible side effects. 6 to 30 mA
20. Only about 10% of people who are struck by
lightning are killed, leaving 90% with various
degrees of disability.True
Vehicular Accident
1. It is a collection of blood, usually clotted, outside
of a blood vessel that may occur because of an
injury to the wall of a blood vessel allowing blood to
leak out into tissues where it does not belong.
Hematoma
2. It is caused by a direct blow to the body that can
cause damage to the surface of the skin and to
deeper tissues as well depending on the severity of
the blow. Contusion
3. These are the clinical manifestations of
hematoma. EXCEPT Bleeding
5. It is a simple self-care technique that helps
reduce swelling, ease pain, and speed up healing.
RICE Method
6. A 15-year-old male student was hit by a motor
vehicle while going to school. Severe bruising,
swelling, and discoloration of the skin are present,
but no external bleeding. Which type of injury does
this describe? Hematoma
7. The primary reason for applying a sterile
dressing to an open injury is to: Control external
bleeding
8. How long should you ice the injury to reduce the
pain and swelling? 20 minutes
9. The nurse is caring for a patient with abrasion.
The nurse assigns which of the following nursing
diagnoses? Impaired skin integrity
11. TRUE OR FALSE: Encourage the patient to not
scrub at embedded dirt, as this can traumatize the
site even more. TRUE
12. Which of the following is NOT a common cause
of vehicular accidents? Driving without the
influence of alcohol
13. Which effects will the application of an ice pack
have on a hematoma? Vasoconstriction and
decreased bleeding
14. How long should the RICE method be used on
a patient with a minor contusion? 24 hours
15. TRUE OR FALSE: A contusion is an open injury
that occurs whenever a large blood vessel is
damaged and bleeds rapidly?
16. These are the other injuries from vehicular
accidents. EXCEPT Electrical injury
17. An accident happens when a vehicle hits a
person, an object, or another vehicle, causing
bodily injury, death, or property damage.
Vehicular accidents
18. How high should you elevate a limb after an
injury? 6-10 inches
19. A physical trauma or impactful force to a body
part. Blunt Trauma
20. You are treating a 16-year-old student who was
hit by a motor vehicle on a gravel road. The wound
on her arm is seeping blood. It is about 7 inches
long and has a lot of dirt and gravel in it. How
should you treat this injury? Apply sterile dressing
Bee Sting & Exposure to Hairy Caterpillars
The most common type of bee Honey bee
The antibody that is produced by the immune
system upon exposure to an allergen. IgE
Bee venom contains:
Amino acids, Pheromones, Histamine
Male bees can sting False
There are 5,000 types of bees worldwide. False
What is the first thing you need to do after being
stung by a bee?*
Remove the stinger
Examples of inflammatory response:*
Redness , Swelling, Pain
These are hair-like bristles that cover the body of
the caterpillar. Setae
The older the caterpillar, the more potent its sting will
be.* True
Caterpillars have 2 types of hair: urticating and
stinging.*True
Avoid scratching the area when exposed to a hairy
caterpillar.*True
Cells that contain histamine and heparin. Mast cells
What are the manifestations of anaphylaxis?
Difficulty breathing
Loss of consciousness
Swelling of throat
Tachycardia
Quiz for today's lesson: Stab Wound
The ______ of the stab wound is more than the
length and width.* Depth
Stab wound are mostly Homicidal
When an object enters the body on one side and
comes out from the other side is known as:
Perforating wound
All are signs and symptoms of Stab wound, except
Bradycardia
What are the possible complications of Stab
wound? (Choose all that applies:)*
Internal hemorrhage, Organ damage, Sepsis, Death
First aid: What would be the rationale for not
removing the foreign object from the entry wound of
a victim with stab wound?*
The foreign object will serve as a seal to stop the
bleeding.
A 25-year-old male patient arrived at the ER with
an embedded object on his abdomen. What will be
your nursing care treatment? (Choose all that
applies:) 1.) Apply Direct pressure to any bleeding
wound 2.) Examine wounds for contamination,
devitalized tissue, and foreign bodies 3.) Cleanse
the wound periphery with soap and sterile water
and provide anesthesia or analgesic if possible.
4.) Irrigate wounds with saline solution 5.) Cover
wound with dry dressing 6.)Close the wound with
stitches 1,2,3,4,5
1. Wear disposable gloves if you have them.
2. Check the victim's ABC's
3. Remove victims clothing around the affected
area.
4. Do NOT remove the stabbing object if it is
embedded.
5. Re-position the victim so the wound is above the
heart
6. Cover the dressing
HACK/KNIFE WOUND AND LACERATION
1. It is a non-medical term used to describe cuts or
wounds caused by irregular blows. = Hack/Knife
wound
2-4. First Aid Management of Hack Wounds= Rest
Compression
Ice application
5. Accidental or sudden hack wounds may be a
cause of panic and shock. Resting the patient and
the injured body part to minimize blood flow to the
cut area and prevent excessive blood loss.= true
6. It is not important to get detailed history as
possible from the patient, witnesses or ambulance
personnel of how the injury occurred.
False
7. Important part of the initial wound assessment is
to not determine if important structures that lie deep
to the wound have been damaged - for example,
tendons, bones or nerves.= False
8. Signs of an infected wound include swelling,
redness, throbbing, pus, and fever= True
9-12. History taking. Once the patient has been
stabilized, a more detailed history should be taken
How did the injury occur?
Where was the wound sustained?
Current health status
When did the wound occur?
13. A type of mechanical injury caused by hard and
blunt force impact characterized by the splitting or
tearing of tissues =Laceration
14-17. If you suspect infection in a laceration,
you’ll need to get medical attention immediately.
Signs of infection include:
Swelling
Increased pain or tenderness a day or more after
the injury
Redness
Draining pus
Which statement about disasters is true?
a. They can be natural or human-made.
b. They can be relieved without assistance.
c. There is always injury and death when a
disaster occurs.
d. The timing of a disaster does not influence
the types of injuries that will occur. - ANS: A
A disaster is any natural or human-made
incident that causes disruption, destruction,
and/or devastation requiring external
assistance. Although natural incidents like
earthquakes of hurricanes trigger many
disasters, predictable and preventable
human-made factors can further affect the
disaster. In the disaster response phase, the
incident type and time predict subsequent
injuries and illnesses.
Acts of bioterrorism or natural disasters, such
as earthquakes, will often have more
casualties because:
a. they cause the most widespread
destruction.
b. victims have little time to make evacuation
preparations.
c. those with chronic conditions cannot
escape in time.
d. the early warning systems are not effective.
- ANS: B
The use of weapons of mass destruction or
natural disasters, such as earthquakes, will
often have more casualties because victims
have little time to make evacuation
preparations. The other answers are false.
A nurse responds to a natural disaster. Which
of the following is the nurse most likely
responding to?
a. Transportation accident
b. Pollution
c. Communicable disease epidemic
d. Fire - ANS: C
A communicable disease epidemic would be
considered a natural disaster. Transportations
accidents, pollution, and fire are considered
human-made disasters.
A nurse responds to a human-made disaster.
Which of the following describes what the
nurse is responding to?
a. Structural collapse
b. Communicable disease epidemics
c. Mud slides
d. Floods - ANS: A
A structural collapse would be considered a
human-made disaster. Communicable
disease epidemics, mud slides, and floods
are considered to be natural disasters.
A nurse is working with an older person
following a disaster. Which of the following
emotions of the client should be anticipated
by the nurse?
a. Anger
b. Fear of loss of independence
c. Violence
d. Regression - ANS: B
A common reaction of older persons
experiencing disaster may be fear of loss of
independence. Young children may respond
with regression. The community in general
may respond will feelings of anger, sorrow,
guilt, and perceived blame for the disaster or
the outcomes of the disaster. Violence should
not be anticipated with any of the populations
discussed in the text.
A nurse experiences a stress reaction while
working with the survivors of a disaster.
Which of the following best describes what
has happened?
a. The nurse makes decisions to assist with
care coordination of the survivors.
b. The nurse tells the supervisor of the
disaster the details of the care that was
provided.
c. The nurse cries after returning home at the
end of the day.
d. The nurse refuses to follow orders. - ANS:
D
Symptoms that may signal a need for stress
management assistance include the following:
being reluctant or refusing to leave the scene
until the work is finished; denying needed rest
and recovery time; feelings of overriding
stress and fatigue; engaging in unnecessary
risk-taking activities; difficulty communicating
thoughts, remembering instructions, making
decisions, or concentrating; engaging in
unnecessary arguments; having a limited
attention span; and refusing to follow orders.
A nurse is working in a temporary shelter for
victims following a natural disaster. Which
condition is the nurse most likely to
encounter?
a. Stress
b. Communicable disease
c. Depression
d. Injuries requiring first aid - ANS: A
Causes of stress can be the shock of the
disaster itself, loss of personal possessions,
fear of the unknown, living in close proximity
to total strangers, and boredom. Illnesses
requiring first aid and communicable diseases
are not the primary concern of the nurse
working in the shelter. Immediately following
the disaster, it is unlikely that the victims will
immediately encounter depression because of
the shock of the disaster.
A riverfront community builds a retaining wall
to divert flood water away from the town.
Which term describes what has happened?
a. Mitigation
b. A natural disaster
c. Community resilience
d. Rapid needs assessment - ANS: A
Mitigation is defined as actions or measures
that can either prevent the occurrence of a
disaster or reduce the severity of the effects.
A natural disaster, such as an earthquake or
hurricane, causes disruption, destruction,
and/or devastation requiring external
assistance. Community resilience is defined
as the sustained ability of a community to
withstand and recover from adversity. A rapid
needs assessment is based on the traditional
model of community assessment where there
is a rapid appraisal of a sector or region's
population, social systems, and geophysical
features.
Community preparedness is being used to
plan for a disaster. Which of the following
tasks is being implemented?
a. Assembling emergency supplies
b. Understanding the workplace disaster plan
c. Taking a disaster training course
d. Developing an evacuation plan to remove
individuals from danger - ANS: D
Community preparedness involves
developing an evacuation plan to remove
individuals from danger. Assembling
emergency supplies is an example of
individual preparedness. Understanding the
workplace disaster plan is an example of
preparedness in the workplace within the
community. Taking a disaster training course
is an example of professional preparedness.
A nurse is participating in the preparedness
stage of disaster management. Which of the
following describes what is happening?
a. Heightened inspection and increased
security in the community
b. Incorporation of provision of pets into local
disaster plans
c. Purchase of personal protective equipment
for all citizens
d. Assembly of disaster kits for the home,
workplace, and car - ANS: D
Disaster kit assembly for the home,
workplace, and car, especially by nurses,
occurs during the preparedness phase.
Heightened inspection and increased security
in the community is part of the prevention
activities. Purchase of personal protective
equipment for all citizens and incorporation of
provision of pets into local disaster plans are
not realistic plans for preparedness.
A public health nurse (PHN) is working with a
community during the recovery phase of a
disaster. Which of the following attributes
would be most important for the nurse to
possess?
a. Flexibility
b. Organization skills
c. Personable
d. Sense of humor - ANS: A
Flexibility is key to a successful recovery
operation. The role of the PHN in the recovery
phase of a disaster is as varied as in the
preparedness and response phases, but the
PHN's connection to the community puts the
PHN in an incredible position of knowledge
and awareness on the interprofessional
recovery team. The attributes of being
organized, personable, and having a sense of
humor are not as important as flexibility when
dealing with this phase of the disaster.
A nurse is working in a community that is
experiencing the Honeymoon Phase after a
disaster. Which of the following is
characteristic of this phase?
a. First responders work tirelessly to save
others.
b. Survivors share their stories.
c. Medical personnel experience exhaustion.
d. Community organizations rebuild the
community. - ANS: B
During the Honeymoon Phase, survivors
rejoice for their survival and may share their
experiences and stories. First responders
work tirelessly to save others during the
Heroic Phase. Medical personnel experience
exhaustion during the Disillusionment Phase.
The community begins to rebuild during the
Reconstruction Phase.
A nurse is assessing persons arriving at an
alternate care center following a disaster.
Which of the following actions should the
nurse take first?
a. Assess the amount of equipment and
medications needed for each client
b. Determine if the client has a psychological
condition requiring special attention
c. Assess whether this type of facility is
appropriate for the client
d. Determine if the client has a support
system to assist with additional care needs -
ANS: C
Alternate care centers may be used to shelter
patients with medical needs designated as
"non-ambulatory care/hospital overflow" e.g.,
care of non-ambulatory patients with less
intense medical needs. After determination of
the appropriateness of the facility, the nurse
can then provide medical care as needed. It
should not be necessary to initially determine
if the client has a psychological condition or
limit the amount of equipment or medications.
A nurse is triaging victims following a disaster.
Which of the following describes the action
the nurse would take?
a. Allocation of treatment based on the
victim's potential for survival
b. Assignment of tasks to the appropriate
disaster response personnel
c. Determination of the level of disaster and
agency involvement
d. Participation in community preparedness
for the disaster response - ANS: A
The triage process in disaster involves
separating the casualties and allocating
treatment based on the victim's potential for
survival. Assignment of tasks to the
appropriate disaster response personnel,
determination of the level of disaster and
agency involvement, and participation in
community preparedness for the disaster
response are not part of the triage process.
A nurse is volunteering on a disaster medical
assistant team as a first responder. Which of
the following tasks would the nurse be
prepared to perform?
a. Set up immunization clinics
b. Assist in triaging disaster victims
c. Provide all the medical care for disaster
victims
d. Complete a needs assessment of the
community - ANS: B
As a first responder arriving on the scene, the
plans for triaging of disaster victims should
begin immediately. Setting up immunization
clinics would not be a priority following a
disaster. In responding to a disaster, it may be
impossible to provide all of the medical care
for disaster victims. It would not be
appropriate to start with completing a needs
assessment of the community following a
disaster; this should be done before the
disaster occurs.
A public health worker had displayed a
competency in disaster medicine and public
health. Which of the following describes what
the worker has done?
a. Communicate effectively with others
b. Get involved in the chain of command
c. Use a set of preplanned activities for every
disaster
d. Implement a community assessment -
ANS: A
Communicating effectively with others in a
disaster or public health emergency is one of
the competencies demonstrated in disaster
medicine and public health. Involvement in
the chain of command, using a set of
preplanned activities for every disaster, and
implementing a community assessment are
not part of these competencies.
What is the purpose of the National Incident
Management System (NIMS)?
a. Create a new branch of government that
deals with bioterrorism
b. Establish a way for the Red Cross to carry
out its mission
c. Develop a nationwide all-hazards approach
to domestic incident management
d. Extend presidential power to act quickly
upon acts of bioterrorism - ANS: C
The National Response Framework is a
unified, all-discipline, all-hazards approach to
domestic incident management. It is built
upon scalable, flexible, and adaptable
coordinating structures to align key roles and
responsibilities linking all levels of
government and organizations. The
Homeland Security Act of 2002 created a new
branch of government that deals with
bioterrorism, the U.S. Department of
Homeland Security. The NIMS did not impact
the Red Cross or extend presidential power to
act upon bioterrorism.
A nurse is developing and coordinating an
emergency response plan for a community.
With which of the following organizations
would the nurse collaborate?
a. American Red Cross (ARC)
b. National Disaster Medical System (NDMS)
c. Centers for Disease Control and Prevention
(CDC)
d. Emergency Management Agency (EMA) -
ANS: D
The EMA is responsible for developing and
coordinating emergency response plans in a
defined area. The ARC works with
communities in the preparedness, response,
and recovery phases of a disaster. The CDC
studies the effect that disasters have on
population health and continuously develops
new prevention strategies. The NDMS
provides nurses the opportunity to work on
specialized disaster response teams.
A nurse is responding to a disaster. Which of
the following is the priority of the disaster
response?
a. Clean up the environment
b. Handle the stress reaction of the victims
c. Bring in as many aid workers and nurses
as possible
d. Reestablish sanitary barriers and focus on
basic needs - ANS: D
Reestablishing sanitary barriers and focusing
on water, food, waste disposal, vector control,
shelter, and safety are the first goals. After
this has been established, the nurse can
address the cleanup of the environment, the
stress reactions of the victims, and the need
to bring in additional workers.
A bioterrorism attack has occurred in the
United States. Which of the following
programs would be used to provide large
quantities of medications to the American
public?
a. Cities Readiness Initiative
b. Strategic National Stockpile (SNS)
c. Public Health Information Network (PHIN)
d. Project BioShield - ANS: B
The SNS has the capacity to provide large
quantities of medicine and medical supplies to
protect the American public in a public health
emergency. The Cities Readiness Initiative
aids cities in increasing their capacity to
deliver medicines and medical supplies during
a public health emergency. The PHIN helps
ensure information access and sharing.
Project BioShield is a program to develop and
produce new drugs and vaccines against
potential bioweapons.
A nurse is examining the future of disaster
management. Which of the following should
the nurse anticipate?
a. Vague and unorganized future due to
constant emergence of new disasters
b. Increasing sophistication in technology and
surveillance
c. Lack of involvement by national and state
officials
d. Decreasing need for public health workers
to provide care - ANS: B
The terrorist event of September 11, 2001,
and the anthrax cases have increased the
awareness for the need to plan for disasters.
Technology and surveillance will continue to
advance. Disaster management continues to
change and become more organized as
learning occurs after each incident, producing
progressive best practices. National and state
officials are very involved in disaster
management. PHNs are particularly critical
members of the multidisciplinary disaster
health team given their population-based
nursing focus and specialty knowledge in
epidemiology and community assessment
skills.
Which populations are at greatest risk for
disruption after a disaster? (Select all that
apply.)
a. Single-parent families
b. Children
c. Substance abusers
d. Middle-class families
e. Young adults - ANS: A, B, C
Single-parent families, children, and
substance abusers are all at greater risk for
disruption after disaster than a middle-class
family or young adults.
Which organizations offer volunteer What are examples of mitigation? - Car
opportunities in disaster work for nurses? seatbelts
(Select all that apply.) Airbags
a. ARC Community meetings
b. Citizens Corps Floodwalls
c. American Nurses Association Proper land use
d. National Public Health Training Centers Building codes
e. Sigma Theta Tau International - ANS: A, B
What is the nurse's role in mitigation? -
ARC and Citizens Corps offer volunteer Review resources and services
opportunities. The American Nurses Identify risks and hazards
Association and National Public Health Problem solving
Training Centers offer education and training Advocacy
opportunities. Sigma Theta Tau International
is an honor society for nurses. What acts on the longest timescale in disaster
mgmt? - Preparedness

Disaster - Any event that causes destruction What is the nurse's role in preparedness? -
and devastation that can't be relieved without Initiate disaster plan, prepare community,
assistance provide record of vulnerable populations

Multiple casualty - More than 2 and less than
100
Mass Casualty - more than 100
Primary agent - physical item that causes the
damage
What is the highest priority in triage? - Life-
threatening injury with high probability of
survival
Was is the secondary priority in triage? -
Injury with systemic complication that aren't
life-threatening

Example of primary agents - Fire and What is the third priority in triage? - No
earthquake immediate complications

Secondary agent - damage as result of What is the last priority in triage? - Severe
primary agent injury

Examples of secondary agents - Burning Red - immediate

building that causes fractures
Internal damage Yellow - Delayed

What are the 5 dimensions of a disaster? - Green - Minor

Predictability
Time Black - Dead
Frequency
Controllability What to check first in triage? - Airway and
Scope and intensity breathing rate

What are the stages of disaster What do rapid respirations indicate? - Shock
management? - 1. Mitigation
2.Preparedness What to check second in triage? - Circulation
3.Response and bleeding control
4.Recovery
How to check circulation? - Blanch test-no
What is Mitigation? - Planning to decrease the longer than 2 sec
potential risk and consequences to reduce the
severity of disasters Arterial bleed - Spurting

Venous bleed - Excessive blood flow


Capillary bleed - Oozing
What is the last area to check in triage? -
Mental status with ability to follow commands
1974 Disaster Relief Act - President can
declare natural disaster
FEMA - Coordination of federal assistance
2001 Homeland security - Directs plans
through state and local health dept
What areas are the State govt involved in? -
Emergency operations plan
Emergency management agency
Emergency Operations center
What is the transmission of anthrax? -
Cutaneous
Inhalation
Digestion
What are s/s of anthrax poisioning? - Sores,
blisters, ulcers with black centers
N/A/D/F
Stomach pain
Cold, flu, sore throat, mild fever, muscle
aches, cough, chest discomfort, SOB,
tiredness
What is the incubation of Anthrax? - 7-42
days
What are the triangle components of Epi? -
Agent-Host-Environment
What is the purpose of the epi triangle? -
Determination of relationships
Endemic - High levels of disease are present
all the time
Epidemic - Observed number of ill individuals
is great than the expected number
Pandemic - Endemic turned pandemic
Bacteremia - Invasion of viable bacteria into
bloodstream with high fever and high mortality
rates
Incidence rate - Number of new cases during
a time period
Prevalence Rate - Existing cases divided by
defined population
Define emergency - Events that require a
swift, intense response on the part of existing
community resources
Define disaster - Occurrence, either natural or
man-made, that causes human suffering and
creates human needs that victims cannot
alleviate without assistance
4 types of disasters? - Natural: Flooding,
Hurricanes, Earthquakes, Tornadoes, etc.
Man=made Disasters: Intentional, Wars,
Terrorist Attacks, Forest fires- arson
Accidental: Forest Fires-lightning
Environmental Contamination: Oil spills
What are agents of harm/damage? Can be
either? examples of each? - Item that actually
causes injury or destruction
primary or secondary
primary: hurricane with rising water (flooding
and high winds)
secondary: damaged building's infrastructure
With disasters, mass causality vs multiple
causality? - Mass Casualty Incident: 100 or >
significantly overwhelms ER Med services,
resources
Multiple Casualty Incident: >2 but < 100
injured
may strain, sometimes overwhelm ER
resources
Vulnerability of individuals depends on? - age:
the elderly, the young
pre-existing health conditions: physically
handicapped, respiratory/cardiac, degree of
mobility, emotional stability, resources
Environmental factors that matter? - Those
without power for short time (1-2 days) cope
better than those out for longer
Those with support do better that those
without
In regards to warning and proximity,
psychological distress increases when? -
longer exposed
closer to site
little or no warning
With individual perception, severe
psychological consequences are greater if? -
emotionally close to those affected
has compromised coping abilities
has experienced many personal losses
in role overload
never before experienced disaster
Disasters vary by? (4) - Type of onset:
sudden or predictable?
Duration of immediate crisis: how long?
Scope/magnitude
Extent
Most damage when? (3) - no time for warning
long period of impact
rapid onset
Disaster management includes? (3) -
preimpact
impact
postimpact
Describe the pre-impact period. - preimpact:
phase before a disaster. This is the time for
disaster planning and mitigation before the
actual occurrence. the time for assessment of
probabilities and risks of occurrence of certain
types of disasters. Based on risk assessment
and hazard vulnerability analyses, specific
action plans should be designed to reduce the
effects of predicted disasters. Mitigation might
involve legislating specific building codes and
land-use restrictions
Describe the impact period. - During this
phase, there should be a preliminary
assessment of the nature, extent, and
geographical area of the disaster. The
number of persons requiring shelter, the type
and number of anticipated disaster health
care services, and the general health status
and needs of the community must be
determined. It is important to have an
estimate of the needed emergency resources
as soon as possible after a disaster event to
activate mutual aid plans and ensure a timely
response from emergency medical services
and other vital community support services.
Describe the post-impact period - Has two
components: emergency and recovery.
Emergency phase begins at the end of the
impact phase and ends when there is no
longer any immediate threat of injury or
destruction. This phase is the time of rescue
and first aid. Incident command is established
if it was not established in the warning phase.
An assessment is made to establish the
extent and types of emergency resources
needed.
Recovery begins during the emergency phase
and ends with the return of normal community
order and functioning. The disaster planning
cycle should begin again during the recovery
phase.
5 components of disaster management
continuum? - Preparedness
Mitigation
Response
Recovery
Evaluation
What is the goal of preparedness? Includes? -
Goal: reduce Impact Includes: Identifying
hazards, proactive planning, & evaluating
possible damage.
Components of the preparedness stage? - ID
Hazards: Existing & potential; unique to
community
Analyze vulnerability: Who affected most;
resources
Assess risk: Use comprehensive assessment,
rate ( ie, low, medium, or high risk)
Some characteristics of an effective disaster
plan? - Realistic, concise, official, developed
with local input, responds to direct needs, has
central control, collects & integrates data,
gets data to necessary source, avoids
duplication and addresses resources
available
Role of community nurse in preparedness? -
Know community agency and social agency
resources available
know where equipment & supplies stored
know prearranged role, rendezvous site (&
alternative)
Role of ER personnel during preparedness? -
be familiar with equipment/supplies
keep them updated
practice
have protective gear & know how to use
have previous knowledge/training on hazard
assessment
know chain of command
What is the national response framework
(Office of Homeland Security: FEMA & others)
used? Its purpose? - Used when disaster is
more than local and state governments can
manage
Helps to coordinate efforts
Responds to all moderate and massive
disasters
Provides direct aid (supplies & personnel)
Provides indirect aid (funding & coordination)
In regards to emergency preparedness, what
is the job of the Red Cross? - Primary
voluntary national disaster relief agency
Damage Assessment
Mass Care
Health Services
Family Services
Disaster welfare inquiry service
Job of CDC is emergency preparedness? -
Disaster prevention/mitigation of epidemics,
biochemical hazards
Job of the states in emergency
preparedness? - Usually one agency
designated as Emergency Management
Agency
Coordinates state plan, resources, requests
for help
Supplement/facilitate local efforts
Role of local government in emergency
preparedness? - Where response begins
Primary responsibility for preparedness &
response
Responsible for safety and welfare of the
citizens
Protects lives, health, property
Carry out evacuation rescues
Maintain public works
Role of the individual in emergency
preparedness? - Reduce hazards
Prepare emergency supply kits
Prepare emergency plans
Monitor emergency communications
Items individuals/families should have in an
emergency kit? - Water (1 gallon per person
per day)
Food (stock up on non-perishable items that
you eat regularly)
Medications (this includes prescription and
non-prescription meds)
Tools and Supplies (utility knife, duct tape,
battery powered radio, etc.)
Sanitation and Hygiene (household bleach,
soap, towels, etc.)
Clothing and Bedding (a change of clothes for
each family member and blankets)
Important documents (copies of your driver's
license, passport, and birth certificate to name
a few)
First Aid supplies (to treat basic cuts and
lacerations that you might get during a
tornado or hurricane)
Things individuals/families should consider
when forming an emergency plan? - ID types
of emergencies
Pick a meeting place
outside home for sudden emergencies
outside neighborhood if unable to return
home right away.
ID emergency contacts.
police,
fire department
out-of-state contact that you can call to let the
rest of your family know you are ok.
Plan your evacuation route.
Within the disaster management continuum,
describe what goes on during mitigation. -
Effort to prevent risks from causing disaster
Taking action to limit damage, disease, etc.
Within the disaster management continuum,
describe what goes on during response. -
implement disaster plan
provide emergency care
restore communication & transportation
In regards to response, what are components
of the emergency response network? -
Incident Command System: Command
Center for coordination of community wide
response at the scene
Emergency Operation Center/Medical Center
Command Center for coordination of
community wide response
P.O.D- Point of Distribution
Strategic National Stockpile
Incident Command Structure
Examples of nursing roles in regards to
response? - Remain in place until situation
stabilized
survey assessment (often CHN)
crucial information needed asap
Determining immediacy of care (triage)
ER aid stations
Shelters
Issues nurses may experience when
responding? - duty vs. family need
want to render immediate care when not your
role
Major health concerns in regards to
response? - Disruption: decreases in personal
hygiene, sanitation and privacy; increases in
overcrowding, malnutrition and personal
injury; increased potential for food and water
contamination, spread of communicable
disease
Preparedness key to mitigation
Epidemics not automatic
Purpose of the recovery phase of the nursing
continuum? - Stabilization of the community
Return to previous/normal status
Possible issues during recovery? - Continuing
death
Population shift
Contamination: food, water
Increased need for psychological first aid
The American Red Cross (ARC) recognizes
what 4 stages of recovery? - Heroic: help
others
Honeymoon: pull together
Disillusionment: disappointment, self care
Reconstruction: reaffirm faith in community
Describe the heroic phase. - This occurs
immediately after a disaster strikes. The
community is often shell-shocked and in dire
need of basic emergency needs such as food
and shelter - because the red cross is there
and providing assistance they are perceived
by the community as the heroes
Describe the honeymoon phase. - Occurs in
first few days after the disaster. Usually it
carries with it a great deal of public support
and media coverage. This is also the time
when ARC receives the most praise from
public officials.
Fundraising/volunteer recruitment are easiest.
In addition to helping people know how to
GET help, in this phase the messages
expand to help people know how to GIVE
help (and how NOT to help)
Describe the disillusionment phase. - By this
time, the community and survivors are getting
tired. They are being worn thin by the stress
of the ongoing recovery efforts.
People sometimes begin to question ARC and
its service delivery, fundraising methods or
community partnerships. During this phase,
media, elected officials, partners or the
general public are more apt to vocalize
criticism.
Describe Reconstruction phase. - This is the
long-term phase of the disaster where we
must manage the expectations of the public
regarding the ongoing recovery process. By
now, the news media will likely have shifted
their focus somewhere else. Likewise, the
public's attention moves from Red Cross
services to the work of our partners.
The nurse's role during recovery? - Goal:
restore community to normal
-referrals for rehab, convalescence
-continued psychological status assessment
-referrals for food, clothing, shelter,
counseling
-evaluate & revise disaster plan (all phases)
Components of the evaluation phase of the
disaster continuum? - Review, report, improve
Evidence based practice
Define disaster nursing. Its goals? -
Adaptation of professional nursing skills to
recognize and meet the nursing, physical, and
emotional needs resulting from a disaster
Goal: achieve best level of health for people
and community
Roles of disaster nurse management? - PHN:
ongoing community assessment, first
responder, public education
Field Triage
Point of Distribution (POD) plans
Personal protective equipment
Documentation
Skill building
Examples of volunteer opportunities in
disaster nursing? - Disaster Medical
Assistance Team (DMAT)
volunteers: nurses, ER personnel, physicians
rapid response team: can go nationwide
Medical Reserve Corps
Red Cross Disaster Assistance Team (DAT)
Examples of disaster nursing roles? - US
PHS Nurse Corp & US Military Nurse Corps:
-first responders
Local ER & ICU Nurses:
-own facility or sent as team close to site
-disaster response, damage assessments,
mass care, shelter care
What are some jobs of the nurse when
considering the psychological needs of
victims? - Assess for those at greatest risk
Anticipate and prepare for crisis intervention
Recognize that victims have legitimate reason
for reaction/emotions
Some psychological needs of victims? - Use
simple support measures at triage/disaster
site:
families together
assign companion as needed
give tasks
communicate
encourage sharing of feelings/support
isolate those with hysterical or panic behavior
Myth: Any kind of assistance is needed & its
needed now - Reality: Wait until genuine
needs assessment has been done
Give the reality
Myth: The affected population is too shocked
and helpless to take responsibility for their
own survival - Reality: Many find new strength
and volunteerism is high
Give the reality
Myth: Disaster is a random killer - Reality: The
vulnerable are the hardest hit:
the poor, especially women, children, &
elderly
Give the reality
Myth: Locating victims in temporary
settlements is best solution - Reality: Usually
should be last choice: need funds for
permanent construction

What are some psychological needs of the Give the reality

first responders? - Psychological response Myth: things are back to normal within a few
overwhelmed weeks - Reality: may last years; may never
overworked, understaffed recover
feeling unqualified
burnout
work/family conflict

What are legal and ethical implications of

disaster nursing? - No laws specifically
defining scope of practice in disaster
guidelines
Nurse practice act
standards of practice
state attorney opinions
Good Samaritan Acts

Give the reality

Myth: Epidemics and Plagues are inevitable -
Reality: Do not occur spontaneously or lead
to outbreaks of exotic disease

Give the reality

Myth: Brings out the worst in human behavior
- Reality: Majority respond spontaneously and
generously

Give the reality

Myth: Medical volunteers with any kind of
medical background are needed - Reality:
Only those with skills not available in affected
area may be needed

Give the reality