16 terms

Community Health (ATI NCLEX Review)

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How should a nurse prioritize in a non-mass-casualty situation?
Patients who have conditions of highest acuity are evaluated and treated first:

emergent > urgent > nonurgent
How should the nurse prioritize patients in a mass casualty disaster triage?
In a situation with a number of casualties and unable to treat everyone, triage according to providing the greatest good fro the greatest number:

1) Emergent/Class 1 (red tag)
2) Urgent/Class II (yellow tag)
3) Nonurgent/Class III (green tag)
4) Expectant/Class IV (black tag)
Identify what it means to have each of these levels of injury in a non-mass-casualty situation:

A) Emergent
B) Urgent
C) Nonurgent
A) immediate threat to life; critically injured
B) major injuries that require immediate tx
C) minor injuries that do not require immediate tx; slightly injured
Identify what it means to have each of these levels of injury in a mass casualty disaster triage:

1) Emergent/Class 1
2) Urgent/Class II
3) Nonurgent/Class III
4) Expectant/Class IV
1) Immediate threat to life; do not delay treatment
2) Major injuries that require tx but can delay for 30 min-2 hr
3) Minor injuries that do not require immediate tx but can delay 2-4 hr
4) Expected and allowed to die; prepare for morgue p9
Which diseases must be reported?
VRE (but not MRSA)
HIV
syphilis
gonorrhea
chlamydia
active (not latent) TB
Lyme disease
Ebola virus
anthrax
typhoid fever
cholera
SARS-CoV
Legionnaire's disease
In which order should a nurse evacuate patients?
1. Ambulatory (independently)
2. Ambulatory with assistance (usually not acutely ill, but may have lines & drains)
3. Wheelchair users
4. Bed-bound patients
Name & briefly define the 3 categories of bioterrorism agents, with examples of each.
Category A highest priority, risk to national security b/c easily transmitted & high mortality (smallpox, anthrax. plague, tularemia, botulism toxin, hemorrhagic viral fevers)

Category B moderately easy to disseminate, high morbidity/low mortality (typhus, cholera)

Category C emerging pathogens, mass dissemination, easy to produce and/or high morbidity & mortality potential (hantavirus)
What are the 4 levels of disaster management?
1. Disaster prevention
2. Disaster preparedness
3. Disaster response
4. Disaster recovery
inhalation anthrax
Common manifestations? Tx?
- HA, fever, muscle aches, sore throat, chest discomfort, cough, dyspnea, meningitis, shock
- oral or IV ciprofloxacin, plus other antibiotics (e.g., vancomycin, penicillin)
botulism
Common manifestations? Tx?
- dysphagia, diplopia, slurred speech descending progressive weakness, N/V, abdominal cramps, dyspnea
- antitoxin/elimination of toxin, airway mgmt., supportive care (nutrition, fluids, prevent complications)
smallpox
Common manifestations? Tx?
- high fever, fatigue, chills, severe HA, vomiting, descending rash (face to feet) that turns to pus-filled lesions, delirium
- no cure; supportive care (hydration, pain meds, antipyretics, skin care)
Ebola virus
Common manifestations? Tx?
- sore throat, cough, HA, high fever, internal/external hemorrhage, N/V, diarrhea, jaundice, shock
- no cure; supportive care, minimize invasive procedures
cutaneous anthrax
Common manifestations? Tx?
- itchy lesion becomes vesicular, then necrotic with black eschar; fever & chills
- oral ciprofloxacin, doxycycline
plague
Common manifestations? Tx?
- pneumonic plague infects lungs; fever, HA, weakness, SOB, chest pain, cough, bloody/watery sputum; after 2-4 days, respiratory failure & shock
- bubonic plague: swollen, tender lymph glands, fever, HA, chills, weakness
- septicemic plague: fever, chills, abdominal pain, shock, bleeding into skin & other organs
- early Tx of pneumonic plague essential; give Abx (e.g., streptomycin, gentamicin, tetracyclines, chloramphenicol) w/i 24hr of first S/S
tularemia
Common manifestations? Tx?
- sudden fever & chills, HA, diarrhea, dry cough, muscle aches, joint pain, progressive weakness; if airborne, life-threatening pneumonia & systemic infection
- IV streptomycin or IV/IM gentamicin; in mass casualty, doxycycline or ciprofloxacin
Name & briefly define the 3 categories of bioterrorism agents, with examples of each.
Category A highest priority, risk to national security b/c easily transmitted & high mortality (smallpox, anthrax. plague, tularemia, botulism toxin, hemorrhagic viral fevers)

Category B moderately easy to disseminate, high morbidity/low mortality (typhus, cholera)

Category C emerging pathogens, mass dissemination, easy to produce and/or high morbidity & mortality potential (hantavirus)