BOOK
Emergency Nursing Core Curriculum - E-Book
(2017)
Additional Information
Book Details
Abstract
Emergency Nursing Core Curriculum, 7th Edition, presents a clear, concise, and thorough overview of emergency nursing. Authored by the Emergency Nurses Association (ENA), this new edition includes updated information on cancer guidelines, diabetes, HIPAA information and more! Building upon the strengths of previous editions, new photographs and illustrations make content more accessible, bringing essential concepts to life This edition provides nurses with an invaluable resource for certification review. Used by practicing emergency nurses at all levels, this highly-respected resource is essential for gaining knowledge, developing practice standards, and improving quality of care.
- Authored by ENA, you can rely on this text to be the most authoritative and up-to-date resource available.
- The text's outline format and alphabetical listing of the Clinical Emergencies chapters mean you can find the information you need - fast!
- NEW! Updated content incorporates the latest information about:
- New types of insulin
- Cancer statistics
- Stroke guidelines
- HIPAA information
- Healthy People 2020
- Sepsis protocols
- Forensic Aspects of Emergency Nursing
- Violence in the ED
- Palliative care
- ENA-authored ensures text is the most authoritative and up-to-date resource available.
- NEW! Reorganized unit on trauma emergencies makes facts more easy to find.
- Updated outline and alphabetical listing of the Clinical Emergencies chapters makes information quickly accessible.
- NEW! Additional illustrations and tables enhance your understanding of key information.
Table of Contents
| Section Title | Page | Action | Price |
|---|---|---|---|
| Front Cover | Cover | ||
| Emergency Nursing CORE CURRICULUM | i | ||
| Emergency Nursing CORE CURRICULUM | iii | ||
| copyright | iv | ||
| CONTRIBUTORS | v | ||
| REVIEWERS | vii | ||
| Dedication | ix | ||
| PREFACE | xi | ||
| ACKNOWLEDGMENTS | xiii | ||
| CONTENTS | xv | ||
| 1 - Clinical Foundations | 1 | ||
| 1 - Nursing Assessment and Resuscitation | 1 | ||
| I. Primary Assessment | 1 | ||
| A. OVERVIEW OF MAJOR COMPONENTS | 1 | ||
| B. INDIVIDUAL COMPONENTS OF PRIMARY ASSESSMENT | 2 | ||
| II. Resuscitation | 7 | ||
| A. AIRWAY/CERVICAL SPINE PROTECTION | 7 | ||
| B. BREATHING | 8 | ||
| C. CIRCULATION/BLEEDING | 10 | ||
| D. DISABILITY (NEUROLOGIC STATUS) | 11 | ||
| E. EXPOSURE/ENVIRONMENTAL CONTROLS | 11 | ||
| III. Secondary Assessment | 11 | ||
| A. FULL SET OF VITAL SIGNS/FACILITATE FAMILY PRESENCE | 12 | ||
| B. GET RESUSCITATION ADJUNCTS (LMNOP MNEMONIC) | 12 | ||
| C. HISTORY AND HEAD-TO-TOE ASSESSMENT | 12 | ||
| D. INSPECT POSTERIOR SURFACES | 19 | ||
| IV. Focused Assessment | 19 | ||
| V. Diagnostic Procedures | 19 | ||
| VI. Analysis: Differential Nursing Diagnoses/Collaborative Problems | 19 | ||
| VII. Planning and Implementation/Interventions | 19 | ||
| VIII. Evaluation and Ongoing Monitoring | 20 | ||
| IX. Documentation of Nursing Assessments and Resuscitation | 20 | ||
| A. SUBJECTIVE DATA COLLECTION | 20 | ||
| B. OBJECTIVE DATA COLLECTION | 20 | ||
| C. ANALYSIS: DIFFERENTIAL NURSING DIAGNOSES/COLLABORATIVE PROBLEMS | 20 | ||
| D. PLANNING AND IMPLEMENTATION/INTERVENTIONS | 20 | ||
| E. EVALUATION AND ONGOING MONITORING | 20 | ||
| X. Age-Related Considerations | 20 | ||
| A. PEDIATRIC | 20 | ||
| B. GERIATRIC | 21 | ||
| C. BARIATRIC PATIENT | 22 | ||
| Reference | 22 | ||
| Bibliography | 22 | ||
| 2 - Triage | 23 | ||
| I. Triage Overview | 23 | ||
| A. OBJECTIVES | 23 | ||
| B. NURSING QUALIFICATIONS | 23 | ||
| C. ASSESSMENT | 24 | ||
| D. ACUITY RATING SYSTEMS | 24 | ||
| E. LOCATION OF CARE ASSIGNMENT | 24 | ||
| G. DECISION-MAKING PROCESS | 26 | ||
| H. INTERFACILITY TRANSFERS | 26 | ||
| II. Additional Triage Responsibilities | 26 | ||
| A. WAITING ROOM MANAGEMENT | 26 | ||
| B. COMMUNICATION ISSUES | 26 | ||
| III. Administrative Responsibilities | 27 | ||
| A. SAFETY | 27 | ||
| B. INFECTION CONTROL | 27 | ||
| C. TRIAGE LEGALITIES | 28 | ||
| D. TRIAGE PERFORMANCE IMPROVEMENT | 28 | ||
| E. TRIAGE DATA UTILIZATION | 28 | ||
| IV. Selected Considerations | 29 | ||
| A. POPULATIONS | 29 | ||
| B. ILLNESS/INJURY | 30 | ||
| References | 35 | ||
| Bibliography | 35 | ||
| 3 - Abuse and Neglect | 36 | ||
| I. General Strategy | 36 | ||
| A. ASSESSMENT | 36 | ||
| B. ANALYSIS: DIFFERENTIAL NURSING DIAGNOSES/COLLABORATIVE PROBLEMS | 37 | ||
| C. PLANNING AND IMPLEMENTATION/INTERVENTIONS | 37 | ||
| D. EVALUATION AND ONGOING MONITORING | 37 | ||
| E. DOCUMENTATION OF INTERVENTIONS AND PATIENT RESPONSE | 38 | ||
| F. AGE-RELATED CONSIDERATIONS | 38 | ||
| II. Specific Abuse/Assault Emergencies | 38 | ||
| A. CHILD MALTREATMENT | 38 | ||
| B. ELDER ABUSE/NEGLECT | 40 | ||
| C. INTIMATE PARTNER VIOLENCE (DOMESTIC VIOLENCE) | 42 | ||
| D. SEXUAL ASSAULT | 43 | ||
| Bibliography | 46 | ||
| 4 - Complementary/Alternative Therapies | 47 | ||
| I. Introduction | 47 | ||
| II. Types of Complementary/Alternative Therapies | 47 | ||
| A. ACUPUNCTURE | 47 | ||
| B. AROMATHERAPY | 47 | ||
| D. HOMEOPATHY | 48 | ||
| E. HYPNOTHERAPY/GUIDED IMAGERY | 48 | ||
| F. NATUROPATHY | 48 | ||
| III. General Strategy | 48 | ||
| A. ASSESSMENT | 48 | ||
| B. PLANNING AND IMPLEMENTATION/INTERVENTIONS | 48 | ||
| C. EVALUATION AND ONGOING MONITORING | 51 | ||
| D. DOCUMENTATION OF INTERVENTIONS AND PATIENT RESPONSE | 51 | ||
| Bibliography | 51 | ||
| 5 - Palliative and End-of-Life Care | 52 | ||
| I. Overview | 52 | ||
| II. Palliative Care Symptom Management | 53 | ||
| A. ADVANCED PREPARATION BEFORE DECIDING ON A PLAN OF CARE17 | 53 | ||
| B. COMMON SYMPTOMS (TABLE 5.1) | 54 | ||
| III. Possible Triggers for Obtaining a PalliativeCare Consult | 62 | ||
| IV. Family Presence During Resuscitation | 63 | ||
| A. BENEFITS OF FAMILY PRESENCE | 63 | ||
| B. POTENTIAL RISKS OF FAMILY PRESENCE25 | 63 | ||
| C. CORE ELEMENTS OF FAMILY PRESENCE PROGRAMS30,34,35 | 63 | ||
| V. Death Notification | 63 | ||
| A. BEREAVEMENT CARE | 63 | ||
| VI. End-of-Life Legalities/Ethics | 64 | ||
| A. ADVANCE DIRECTIVES16 (SEE CHAPTER 45) | 64 | ||
| B. ORGAN AND TISSUE DONATION (SEE CHAPTER 7) | 65 | ||
| C. POSTMORTEM PROCEDURES | 65 | ||
| D. AUTOPSY | 66 | ||
| E. WITHHOLDING/WITHDRAWING LIFE-SUSTAINING MEASURES | 66 | ||
| F. PRINCIPLE OF DOUBLE EFFECT | 66 | ||
| G. PARTICULARLY SIGNIFICANT DEATHS | 66 | ||
| H. BURNOUT AND POSTTRAUMATIC STRESS | 67 | ||
| References | 67 | ||
| Bibliography | 68 | ||
| 6 - Invasive Hemodynamic Monitoring | 70 | ||
| I. Invasive Hemodynamic Monitoring Basics | 70 | ||
| A. CONCEPTS | 70 | ||
| B. TYPES OF MONITORING SYSTEMS | 71 | ||
| C. PRESSURE MONITORING SYSTEM COMPONENTS | 71 | ||
| D. OBTAIN ACCURATE DATA | 72 | ||
| E. SETTING UP PRESSURE MONITORING SYSTEM WITH TRANSDUCER | 72 | ||
| G. COMPLICATIONS | 75 | ||
| II. Specific Pressure Monitoring Systems | 75 | ||
| A. CENTRAL VENOUS PRESSURE MONITORING | 75 | ||
| B. ARTERIAL PRESSURE MONITORING | 77 | ||
| C. SCVO2, SVO2 MONITORING | 77 | ||
| D. PASSIVE LEG RAISE MONITORING | 78 | ||
| E. INTRACRANIAL PRESSURE MONITORING | 78 | ||
| Bibliography | 79 | ||
| 7 - Organ and Tissue Donation | 80 | ||
| I. Overview | 80 | ||
| II. Legislation and Regulation | 81 | ||
| A. UNIFORM ANATOMICAL GIFT ACT (UAGA) | 81 | ||
| B. UNIFORM DETERMINATION OF DEATH ACT (UDDA) | 82 | ||
| C. OMNIBUS RECONCILIATION ACT OF 1986 | 82 | ||
| D. NATIONAL ORGAN TRANSPLANT ACT (NOTA) | 82 | ||
| E. HEALTH CARE FINANCING ADMINISTRATION (HCFA) | 82 | ||
| F. ROLE OF THE LOCAL OPO | 83 | ||
| III. Donation Opportunities | 83 | ||
| A. LIVING DONATION | 83 | ||
| B. DECEASED DONATION | 83 | ||
| C. IMPACT OF DONATION ON MEDICAL RESEARCH | 84 | ||
| IV. Safety in Donation | 84 | ||
| A. INFECTIOUS DISEASE TESTING | 84 | ||
| B. TISSUES | 84 | ||
| C. DONOR/RECIPIENT MATCHING | 84 | ||
| V. Donation Referrals | 85 | ||
| A. DONATION REFERRAL CRITERIA | 85 | ||
| VI. OPO Donor Evaluation | 86 | ||
| A. ORGAN/TISSUE (SEE FIG. 7.2) | 86 | ||
| B. EYE7 | 86 | ||
| VII. Determination of Brain Death | 86 | ||
| A. GUIDELINES | 86 | ||
| VIII. Donor Family Authorization | 87 | ||
| A. CORE ELEMENTS FOR AUTHORIZATION | 87 | ||
| B. AUTHORIZING PERSON | 87 | ||
| IX. Interacting with and Supporting Donor’s Family | 88 | ||
| A. ASSESS | 88 | ||
| B. ADDITIONAL ANALYSIS | 88 | ||
| C. NEXT OF KIN | 88 | ||
| X. Maintaining Viability of Potential Organ Donors | 88 | ||
| A. MAINTAIN ADEQUATE INTRAVASCULAR VOLUME | 88 | ||
| B. MAINTAIN NORMAL BLOOD PRESSURE (BP) AND NORMOTHERMIA | 88 | ||
| C. ESTABLISH DIURESIS | 88 | ||
| D. OPTIMIZE OXYGENATION AND ACID-BASE BALANCE | 88 | ||
| XI. Maintaining Viability of Potential Tissue/Ocular Donor | 88 | ||
| A. COOLING OF THE BODY | 88 | ||
| B. DOCUMENTATION | 88 | ||
| C. COORDINATION | 88 | ||
| D. OCULAR TISSUE DONATION | 88 | ||
| XII. Pre- and Posttransplantation Emergencies (see Chapter 25) | 88 | ||
| A. REJECTION AND INFECTION | 88 | ||
| References | 89 | ||
| Bibliography | 89 | ||
| 8 - Pain Management | 90 | ||
| I. Pain Overview | 90 | ||
| II. Definitions | 90 | ||
| A. PAIN | 90 | ||
| B. ADDICTION | 91 | ||
| C. ALLODYNIA | 91 | ||
| D. CO-ANALGESICS | 91 | ||
| E. DEPENDENCE | 91 | ||
| F. PAIN MANAGEMENT | 91 | ||
| G. PAIN THRESHOLD | 91 | ||
| H. TOLERANCE | 91 | ||
| I. SUFFERING | 91 | ||
| J. OLIGOANALGESIA3-5 | 91 | ||
| III. Pain Physiology | 91 | ||
| A. NEUROANATOMY6 | 91 | ||
| B. EFFECT OF MEDICATIONS ON MODULATING PAIN7 | 92 | ||
| C. PAIN THEORIES6,8 | 92 | ||
| D. TYPES OF PAIN6 | 93 | ||
| IV. General Strategy | 94 | ||
| A. ASSESSMENT | 94 | ||
| B. ANALYSIS: DIFFERENTIAL NURSING DIAGNOSES/COLLABORATIVE PROBLEMS | 97 | ||
| C. PLANNING AND IMPLEMENTATION/INTERVENTIONS | 97 | ||
| D. EVALUATION AND ONGOING MONITORING | 101 | ||
| E. DOCUMENTATION OF INTERVENTIONS AND PATIENT RESPONSE | 101 | ||
| F. AGE-RELATED CONSIDERATIONS | 101 | ||
| V. Pain Management Practice | 106 | ||
| A. BARRIERS TO EFFECTIVE PAIN MANAGEMENT27-29 | 106 | ||
| B. ACUTE PAIN MANAGEMENT MYTHS30 | 106 | ||
| C. ENABLERS TO EFFECTIVE PAIN MANAGEMENT 27-29 | 106 | ||
| D. IMPROVING PAIN MANAGEMENT PRACTICE | 106 | ||
| VI. Procedural Sedation | 106 | ||
| A. INDICATIONS FOR PROCEDURAL SEDATION: DIAGNOSTIC AND THERAPEUTIC PROCEDURES | 107 | ||
| B. ASSESSMENT | 107 | ||
| C. PROCEDURE | 107 | ||
| D. POSTPROCEDURE DISCHARGE CRITERIA | 107 | ||
| E. INSTITUTIONAL RESPONSIBILITIES | 107 | ||
| References | 108 | ||
| Bibliography | 108 | ||
| 9 - Isolation and Personal Protective Equipment | 109 | ||
| I. General Strategy | 109 | ||
| A. DETECTION OF INFECTIOUS ILLNESS AND RELATED SIGNS AND SYMPTOMS | 109 | ||
| B. HAND HYGIENE1,3-5 | 109 | ||
| C. USE OF PERSONAL PROTECTIVE EQUIPMENT | 111 | ||
| D. ISOLATE PATIENT IF INDICATED | 111 | ||
| E. NOTIFICATION, DOCUMENTATION, AND COMMUNICATION | 111 | ||
| II. Personal Protective Equipment1,6-13 | 111 | ||
| A. GLOVES | 111 | ||
| B. PROTECTIVE COVERS/GOWNS/COVERALLS | 112 | ||
| C. SURGICAL AND PROCEDURE MASKS | 112 | ||
| D. FACE AND EYE PROTECTION | 113 | ||
| E. RESPIRATORY PROTECTION1,7-14 | 113 | ||
| III. Precautions to Prevent Transmission of Infectious Agents1 | 115 | ||
| A. STANDARD PRECAUTIONS | 115 | ||
| B. TRANSMISSION-BASED PRECAUTIONS AND ISOLATION1 | 116 | ||
| C. PROTECTIVE PRECAUTIONS | 117 | ||
| IV. Organizational Infection Control Recommendations1,2,16-18 | 117 | ||
| A. ADMINISTRATIVE MEASURES | 117 | ||
| References | 119 | ||
| 10 - Children with Special Health Needs (CSHN) | 121 | ||
| I. Legislation | 121 | ||
| A. INDIVIDUALS WITH DISABILITIES EDUCATION IMPROVEMENT ACT OF 2004 | 121 | ||
| B. AMERICANS WITH DISABILITIES ACT OF 19901 | 121 | ||
| C. REHABILITATION ACT OF 1973, SECTION 504 | 121 | ||
| D. PATIENT PROTECTION AND AFFORDABLE CARE ACT (PPACA) OF 2010 | 121 | ||
| II. Demographics | 122 | ||
| A. DEFINITION | 122 | ||
| B. PREVALENCE | 122 | ||
| III. General Strategy | 122 | ||
| A. HEALTH HISTORY CONSIDERATIONS IN CSHN | 122 | ||
| B. PRIMARY ASSESSMENT CONSIDERATIONS IN CSHN | 122 | ||
| C. SECONDARY/FOCUSED ASSESSMENT CONSIDERATIONSIN CSHN | 123 | ||
| D. DIFFERENCES IN HEAD TO TOE ASSESSMENT | 123 | ||
| E. AGE-RELATED CONSIDERATIONS | 123 | ||
| IV. Specific Special Health Care Needs | 123 | ||
| A. AUTISM SPECTRUM DISORDERS (ASD)17 | 123 | ||
| B. CONGENITAL HEART DISEASE | 124 | ||
| C. SPINA BIFIDA | 124 | ||
| V. Special Considerations | 125 | ||
| A. EMERGENCY INFORMATION FORM | 125 | ||
| B. DISASTER PLANNING | 125 | ||
| References | 125 | ||
| 2 - Clinical Emergencies | 126 | ||
| 11 - Abdominal Emergencies | 126 | ||
| I. General Strategy | 126 | ||
| A. ASSESSMENT | 126 | ||
| B. ANALYSIS: DIFFERENTIAL NURSING DIAGNOSES/COLLABORATIVE PROBLEMS | 127 | ||
| C. PLANNING AND IMPLEMENTATION/INTERVENTIONS | 127 | ||
| D. EVALUATION AND ONGOING MONITORING | 128 | ||
| E. DOCUMENTATION OF INTERVENTIONS AND PATIENT RESPONSE | 128 | ||
| F. AGE-RELATED CONSIDERATIONS | 128 | ||
| II. Specific Abdominal Emergencies | 128 | ||
| A. APPENDICITIS | 128 | ||
| B. BOWEL OBSTRUCTION | 129 | ||
| C. CHOLECYSTITIS | 130 | ||
| D. DIVERTICULITIS | 131 | ||
| E. ESOPHAGEAL VARICES | 132 | ||
| F. ESOPHAGITIS | 133 | ||
| G. GASTRITIS | 133 | ||
| J. INTUSSUSCEPTION | 136 | ||
| K. IRRITABLE BOWEL SYNDROME | 137 | ||
| L. PANCREATITIS | 137 | ||
| M. PYLORIC STENOSIS | 139 | ||
| N. ULCERS | 140 | ||
| Bibliography | 141 | ||
| 12 - Cardiovascular Emergencies | 142 | ||
| I. General Strategy | 142 | ||
| A. ASSESSMENT | 142 | ||
| B. ANALYSIS: DIFFERENTIAL NURSING DIAGNOSES/COLLABORATIVE PROBLEMS | 144 | ||
| C. PLANNING AND IMPLEMENTATION/INTERVENTIONS | 145 | ||
| D. EVALUATION AND ONGOING MONITORING | 145 | ||
| E. DOCUMENTATION OF INTERVENTIONS AND PATIENT RESPONSE | 145 | ||
| F. AGE-RELATED CONSIDERATIONS | 145 | ||
| II. Specific Medical Cardiovascular Emergencies | 146 | ||
| A. ACUTE AORTIC ANEURYSM—NONTRAUMATIC | 146 | ||
| B. ACUTE AORTIC DISSECTION | 147 | ||
| C. ACUTE ARTERIAL OCCLUSION | 149 | ||
| D. ACUTE CORONARY SYNDROMES | 150 | ||
| E. ANGINA, STABLE AND UNSTABLE | 154 | ||
| F. CARDIAC DYSRHYTHMIAS | 156 | ||
| Atrial Flutter. Atrial flutter, like all atrial tachycardias, occurs when an irritable focus within the atria takes over as the ... | 157 | ||
| Atrial Fibrillation. Atrial fibrillation is characterized by a chaotic atrial rhythm associated with an irregular ventricular re... | 157 | ||
| Supraventricular Tachycardia/Narrow Complex Tachycardia. The term supraventricular tachycardia is used to describe any rapid rhy... | 159 | ||
| First-Degree Atrioventricular Block. First-degree AV block is characterized by a prolonged PR interval in an otherwise normal-ap... | 160 | ||
| Second-Degree Atrioventricular Block. There are two types of second-degree AV heart blocks: Mobitz type I and Mobitz type II. Mo... | 160 | ||
| Second-Degree Atrioventricular Block: Mobitz Type II. A Mobitz type II second-degree AV block is caused by a conduction delay be... | 160 | ||
| Third-Degree (Complete) Atrioventricular Block. Third-degree AV block is characterized by a complete absence of conduction betwe... | 160 | ||
| Junctional Rhythm and Junctional Tachycardia. Junctional rhythms occur when the AV node takes over from the sinoatrial (SA) node... | 162 | ||
| Sinus Tachycardia. Sinus tachycardia is characterized by a sinus node discharge rate of >100 beats/minute (Box 12.12). Sinus tac... | 163 | ||
| Premature Ventricular Contractions. A premature ventricular complex or contraction (PVC) is a beat initiated by one of the ventr... | 165 | ||
| Ventricular Tachycardia. Ventricular tachycardia (VT) is a dysrhythmia characterized by a series of three or more successive ven... | 166 | ||
| Torsades de Pointes. Torsades de pointes (TdP or torsades) is a distinctive form of polymorphic VT distinguished by QRS complexe... | 166 | ||
| Ventricular Fibrillation. Ventricular fibrillation (VF) is a lethal dysrhythmia characterized by disorganized electrical activit... | 166 | ||
| Ventricular Asystole. Asystole is the complete absence of electrical and mechanical cardiac function (Box 12.16). It generally r... | 167 | ||
| G. CARDIAC ARREST AND POSTRESUSCITATION CARE | 167 | ||
| H. CARDIAC IMPLANTABLE ELECTRONIC DEVICE MALFUNCTION | 168 | ||
| I. CARDIOGENIC SHOCK (SEE CHAPTER 29) | 168 | ||
| J. CARDIOMYOPATHY | 168 | ||
| L. HYPERTENSIVE CRISES | 172 | ||
| M. INFECTIVE ENDOCARDITIS | 173 | ||
| N. MYOCARDITIS | 175 | ||
| O. PERICARDITIS | 176 | ||
| P. PERIPHERAL VASCULAR DISEASE | 177 | ||
| Q. RIGHT VENTRICULAR INFARCTION | 179 | ||
| R. VENOUS THROMBOEMBOLISM | 179 | ||
| References | 181 | ||
| 13 - Dental, Ear, Nose, and Throat Emergencies | 183 | ||
| I. General Strategy | 183 | ||
| A. ASSESSMENT | 183 | ||
| B. ANALYSIS: DIFFERENTIAL NURSING DIAGNOSES/COLLABORATIVE PROBLEMS | 185 | ||
| C. PLANNING AND IMPLEMENTATION/INTERVENTIONS | 185 | ||
| D. EVALUATION AND ONGOING MONITORING | 185 | ||
| E. DOCUMENTATION OF INTERVENTIONS AND PATIENT RESPONSE | 185 | ||
| F. AGE-RELATED CONSIDERATIONS | 185 | ||
| II. Specific Dental Emergencies | 186 | ||
| A. ACUTE NECROTIZING ULCERATIVE GINGIVITIS (TRENCH MOUTH) | 186 | ||
| B. DENTAL ABSCESS | 186 | ||
| C. LUDWIG ANGINA | 187 | ||
| D. ODONTALGIA | 188 | ||
| E. PERICORONITIS | 189 | ||
| F. POSTEXTRACTION PAIN AND BLEEDING | 190 | ||
| G. TOOTH ERUPTION | 190 | ||
| III. Specific Ear Emergencies | 191 | ||
| A. ACUTE OTITIS EXTERNA | 191 | ||
| B. ACUTE OTITIS MEDIA | 192 | ||
| C. LABYRINTHITIS | 193 | ||
| D. MENIERE DISEASE | 194 | ||
| E. OTIC FOREIGN BODY | 195 | ||
| F. RUPTURED TYMPANIC MEMBRANE | 196 | ||
| IV. Specific Nose Emergencies | 196 | ||
| A. EPISTAXIS | 196 | ||
| B. NASAL FOREIGN BODY | 198 | ||
| C. RHINITIS | 198 | ||
| V. Specific Throat Emergencies | 199 | ||
| A. EPIGLOTTITIS | 199 | ||
| B. EXUDATIVE PHARYNGITIS | 200 | ||
| C. LARYNGEAL FOREIGN BODY | 201 | ||
| D. LARYNGITIS | 202 | ||
| E. PERITONSILLAR ABSCESS | 203 | ||
| F. PHARYNGITIS | 204 | ||
| G. RETROPHARYNGEAL ABSCESS | 204 | ||
| References | 206 | ||
| Bibliography | 206 | ||
| 14 - Endocrine Emergencies | 207 | ||
| I. General Strategy | 207 | ||
| A. ASSESSMENT | 207 | ||
| B. ANALYSIS: DIFFERENTIAL NURSING DIAGNOSES/COLLABORATIVE PROBLEMS | 208 | ||
| C. PLANNING AND IMPLEMENTATION/INTERVENTIONS | 208 | ||
| D. EVALUATION AND ONGOING MONITORING | 208 | ||
| E. DOCUMENTATION OF INTERVENTIONS AND PATIENT RESPONSE | 208 | ||
| F. AGE-RELATED CONSIDERATIONS | 208 | ||
| II. Specific Endocrine Emergencies | 209 | ||
| A. ADRENAL CRISIS | 209 | ||
| B. DIABETIC KETOACIDOSIS | 211 | ||
| C. HYPERGLYCEMIC HYPEROSMOLAR SYNDROME | 212 | ||
| D. HYPOGLYCEMIA | 214 | ||
| E. MYXEDEMA CRISIS | 215 | ||
| F. THYROID STORM | 216 | ||
| Bibliography | 218 | ||
| 15 - Environmental Emergencies | 219 | ||
| I. General Strategy | 219 | ||
| A. ASSESSMENT | 219 | ||
| B. ANALYSIS: DIFFERENTIAL NURSING DIAGNOSES/COLLABORATIVE PROBLEMS | 221 | ||
| C. PLANNING AND IMPLEMENTATION/INTERVENTIONS | 221 | ||
| D. EVALUATION AND ONGOING MONITORING | 221 | ||
| E. DOCUMENTATION OF INTERVENTIONS AND PATIENT RESPONSE | 221 | ||
| F. AGE-RELATED CONSIDERATIONS | 221 | ||
| II. Specific Environmental Emergencies | 222 | ||
| A. AQUATIC ORGANISM INJURIES | 222 | ||
| B. BITES AND STINGS | 224 | ||
| Snakes. Venomous snakebites are estimated at 7,000–8,000 in the United States per year with an annual incidence of 10 to 15 deat... | 226 | ||
| Insects. The most common sources of venomous insects are members of the order Hymenoptera, including bees, wasps, and ants.8 An ... | 227 | ||
| Ticks. Ticks are arthropods that attach and feed on the blood of mammals. Tick bites are often asymptomatic. Victims are frequen... | 229 | ||
| Spiders. Awareness of the differential diagnosis is important for the management of suspected spider bites because the spider is... | 231 | ||
| C. COLD-RELATED EMERGENCIES | 232 | ||
| Frostbite. Frostbite is tissue freezing, which is the formation of ice crystals in deep and/or superficial tissue. Ninety percen... | 232 | ||
| Hypothermia. Hypothermia has been defined as a core body temperature of less than 95°F (35°C). It is both a symptom and a clinic... | 234 | ||
| Barotrauma. Barotrauma is related to pressure changes in gas-filled structures of the body such as ear, tooth, sinus, gut, or ch... | 236 | ||
| Decompression Sickness (Table 15.3). Deco | 236 | ||
| Arterial Gas Embolism (see Table 15.3). Arte | 236 | ||
| E. HEAT-RELATED EMERGENCIES | 238 | ||
| Heat Cramps. Heat cramps are usually brief but can cause agonizing pain in the skeletal muscles of the extremities and trunk. Cr... | 238 | ||
| Heat Exhaustion (see Table 15.5). Heat exhaustion is a mild to moderate form of heat illness often precipitated by major exertio... | 239 | ||
| Heat Injury and Heat Stroke (see Table 15.5). Heat injury is a moderate to severe condition characterized by tissue (e.g., skele... | 239 | ||
| Exertional Heatstroke. Exertional heatstroke (EHS) has a different etiology than classic heatstroke and typically affects young ... | 240 | ||
| F. HIGH-ALTITUDE ILLNESS | 241 | ||
| Acute Mountain Sickness. Acute mountain sickness (AMS) is the most common form of altitude illness, reported to affect 25% of vi... | 241 | ||
| High-Altitude Cerebral Edema. High-altitude cerebral edema (HACE) is the clinical progression of the neurologic and cerebral sig... | 241 | ||
| High-Altitude Pulmonary Edema. High-altitude pulmonary edema (HAPE) is a life-threatening condition that occurs at altitudes >8,... | 241 | ||
| G. WATER-RELATED EMERGENCIES | 242 | ||
| Drowning. Each year in the United States, more than 3,000 people die from drowning. Drowning is the leading cause of death for i... | 242 | ||
| Submersion Injuries. The true incidence of submersion injuries is unknown because many cases are not reported; however, it is es... | 242 | ||
| References | 244 | ||
| Bibliography | 245 | ||
| 16 - Facial and Ocular Emergencies | 246 | ||
| I. General Strategy | 246 | ||
| A. ASSESSMENT | 246 | ||
| B. ANALYSIS: DIFFERENTIAL NURSING DIAGNOSES/COLLABORATIVE PROBLEMS | 249 | ||
| C. PLANNING AND IMPLEMENTATION/INTERVENTIONS | 249 | ||
| D. EVALUATION AND ONGOING MONITORING | 249 | ||
| E. DOCUMENTATION OF INTERVENTIONS AND PATIENT RESPONSE | 249 | ||
| F. AGE-RELATED CONSIDERATIONS | 249 | ||
| II. Specific Facial Emergencies | 250 | ||
| A. BELL PALSY (IDIOPATHIC FACIAL PARALYSIS) | 250 | ||
| B. HERPES ZOSTER OTICUS (RAMSAY HUNT SYNDROME) | 250 | ||
| C. PAROTITIS | 251 | ||
| D. SINUSITIS | 252 | ||
| III. Specific Medical Ocular Emergencies | 254 | ||
| A. ACUTE ANGLE-CLOSURE GLAUCOMA | 254 | ||
| B. ANTERIOR UVEITIS/IRITIS | 255 | ||
| D. CONJUNCTIVITIS | 256 | ||
| E. PERIORBITAL/ORBITAL CELLULITIS | 257 | ||
| References | 258 | ||
| 17 - Fluid and Electrolyte Abnormalities | 259 | ||
| I. General Strategy | 259 | ||
| A. ASSESSMENT | 259 | ||
| B. ANALYSIS: DIFFERENTIAL NURSING DIAGNOSES/COLLABORATIVE PROBLEMS | 260 | ||
| C. PLANNING AND IMPLEMENTATION/INTERVENTIONS | 261 | ||
| D. EVALUATION AND ONGOING MONITORING | 261 | ||
| E. DOCUMENTATION OF INTERVENTIONS AND PATIENT RESPONSE | 261 | ||
| F. AGE-RELATED CONSIDERATIONS | 261 | ||
| II. Specific Fluid Emergencies | 261 | ||
| A. DEHYDRATION | 261 | ||
| III. Specific Electrolyte Emergencies | 263 | ||
| A. CALCIUM | 263 | ||
| Hypocalcemia. Hypocalcemia can occur primarily as a result of deficits of calcium intake, inhibition of calcium absorption from ... | 263 | ||
| Hypercalcemia. Serum calcium levels are maintained in a narrow range by the kidneys and the parathyroid gland. Any decrease in r... | 264 | ||
| B. MAGNESIUM | 265 | ||
| Hypomagnesemia. The primary causes of hypomagnesemia are related to decreased or insufficient intake of magnesium; chronic alcoh... | 265 | ||
| Hypermagnesemia. Conditions such as adrenal insufficiency and renal failure reduce excretion of magnesium through the kidneys. P... | 267 | ||
| C. PHOSPHORUS | 267 | ||
| Hypophosphatemia. The primary causes of hypophosphatemia are alcoholism, burns, starvation, and diuretic use. Other causes of hy... | 268 | ||
| Hyperphosphatemia. Hyperphosphatemia is serum phosphate (PO4) concentration >4.5 mg/dL (>1.46 mmol/L). Causes include chronic re... | 268 | ||
| Hypophosphatemia Treatment | 269 | ||
| Hyperphosphatemia Treatment | 269 | ||
| D. POTASSIUM | 269 | ||
| Hypokalemia. Hypokalemia refers to serum potassium levels <3.5 mEq/L. Potassium decreases can result from inadequate potassium i... | 270 | ||
| Hyperkalemia. Hyperkalemia is characterized by excess serum potassium, exceeding 5.5 mEq/L. Effects of elevated serum potassium ... | 271 | ||
| E. SODIUM | 271 | ||
| Hyponatremia. Hyponatremia may result from either actual sodium deficits or dilutional causes. Sodium deficits resulting from di... | 272 | ||
| Hypernatremia. Hypernatremia is less common than hyponatremia and can be caused by actual sodium excess or, indirectly, by decre... | 273 | ||
| IV. Parenteral Administration | 274 | ||
| Bibliography | 276 | ||
| 18 - Genitourinary Emergencies | 277 | ||
| I. General Strategy | 277 | ||
| A. ASSESSMENT | 277 | ||
| B. ANALYSIS: DIFFERENTIAL NURSING DIAGNOSES/COLLABORATION PROBLEMS | 278 | ||
| C. PLANNING AND IMPLEMENTATION/INTERVENTIONS | 278 | ||
| D. EVALUATION AND ONGOING MONITORING | 279 | ||
| E. DOCUMENTATION OF INTERVENTIONS AND PATIENT RESPONSE | 279 | ||
| F. AGE-RELATED CONSIDERATIONS | 279 | ||
| II. Specific Genitourinary Emergencies | 279 | ||
| A. ACUTE KIDNEY INJURY (ACUTE RENAL FAILURE) | 279 | ||
| B. EPIDIDYMITIS | 281 | ||
| C. FOREIGN BODIES | 282 | ||
| D. PRIAPISM | 283 | ||
| E. PROSTATITIS | 284 | ||
| F. PYELONEPHRITIS | 284 | ||
| G. TESTICULAR TORSION | 285 | ||
| H. URINARY CALCULI | 286 | ||
| I. URINARY TRACT INFECTION | 287 | ||
| Bibliography | 289 | ||
| 19 - Hematologic/Oncologic Emergencies | 290 | ||
| I. General Strategy | 290 | ||
| A. ASSESSMENT | 290 | ||
| B. ANALYSIS: DIFFERENTIAL NURSING DIAGNOSES/COLLABORATIVE PROBLEMS | 291 | ||
| C. PLANNING AND IMPLEMENTATION/INTERVENTIONS | 291 | ||
| D. EVALUATION AND ONGOING MONITORING | 292 | ||
| E. DOCUMENTATION OF INTERVENTIONS AND PATIENT RESPONSE | 292 | ||
| F. AGE-RELATED CONSIDERATIONS | 292 | ||
| II. Specific Hematologic/Oncologic Emergencies | 293 | ||
| A. DISSEMINATED INTRAVASCULAR COAGULATION | 293 | ||
| B. HEMOPHILIA | 294 | ||
| C. IMMUNE COMPROMISE | 296 | ||
| D. INCREASED INTRACRANIAL PRESSURE | 297 | ||
| F. SICKLE CELL CRISIS | 299 | ||
| G. SPINAL CORD COMPRESSION | 300 | ||
| H. SUPERIOR VENA CAVA SYNDROME | 301 | ||
| I. THROMBOCYTOPENIA PURPURA | 302 | ||
| J. TUMOR LYSIS SYNDROME | 303 | ||
| III. Hematologic/Oncologic Complications | 305 | ||
| A. SEPSIS | 305 | ||
| B. SYNDROME OF INAPPROPRIATE ANTIDIURETIC HORMONE | 305 | ||
| C. HYPERSENSITIVITY REACTIONS | 305 | ||
| Bibliography | 305 | ||
| 20 - Communicable and Infectious Disease Emergencies | 306 | ||
| I. General Strategy | 306 | ||
| A. ASSESSMENT | 306 | ||
| B. ANALYSIS: DIFFERENTIAL NURSING DIAGNOSES/COLLABORATIVEPROBLEMS | 308 | ||
| C. PLANNING AND IMPLEMENTATION/INTERVENTIONS | 308 | ||
| D. EVALUATION AND ONGOING MONITORING | 308 | ||
| E. DOCUMENTATION OF INTERVENTIONS AND PATIENT RESPONSE | 308 | ||
| F. AGE-RELATED CONSIDERATIONS | 308 | ||
| II. Specific Communicable and Infectious Disease Emergencies | 309 | ||
| A. DIPHTHERIA | 309 | ||
| B. GLOBAL/PANDEMIC ILLNESSES | 310 | ||
| Severe Acute Respiratory Syndrome. Severe acute respiratory syndrome (SARS) is a viral respiratory disease of zoonotic origin ca... | 311 | ||
| Middle Eastern Respiratory Syndrome | 311 | ||
| Middle Eastern respiratory syndrome is caused by a recently identified coronavirus, MERS-CoV. The zoonotic virus was initially i... | 311 | ||
| Avian Influenza. There has been growing concern that a new avian virus will become pandemic. The pathogen, also known as bird fl... | 312 | ||
| C. HEMORRHAGIC FEVERS | 313 | ||
| D. HEPATITIS | 314 | ||
| E. HERPES: DISSEMINATED | 316 | ||
| G. MEASLES | 319 | ||
| H. MENINGITIS | 320 | ||
| I. MONONUCLEOSIS | 323 | ||
| J. MUMPS | 324 | ||
| K. PERTUSSIS | 325 | ||
| L. SHINGLES (HERPES ZOSTER) | 326 | ||
| M. SKIN INFESTATIONS | 327 | ||
| Lice. Three types of lice infest humans: Pediculus humanus var corporis (human louse, body lice); P. humanus var capitis (human ... | 327 | ||
| Scabies. Scabies is a highly contagious infestation of the skin caused by the itch mite Sarcoptes scabiei var hominis. Eggs are ... | 328 | ||
| N. TUBERCULOSIS | 329 | ||
| O. VARICELLA (CHICKENPOX) | 331 | ||
| P. VIRAL ENCEPHALITIS | 332 | ||
| Bibliography | 333 | ||
| 21 - Medical Emergencies | 334 | ||
| I. General Strategy | 334 | ||
| A. ASSESSMENT | 334 | ||
| B. ANALYSIS: DIFFERENTIAL NURSING DIAGNOSES/COLLABORATIVE PROBLEMS | 335 | ||
| C. PLANNING AND IMPLEMENTATION/INTERVENTIONS | 335 | ||
| D. EVALUATION AND ONGOING MONITORING | 335 | ||
| E. DOCUMENTATION OF INTERVENTIONS AND PATIENT RESPONSE | 335 | ||
| F. AGE-RELATED CONSIDERATIONS | 335 | ||
| II. Specific Medical Emergencies | 336 | ||
| A. ALLERGIC REACTION/ANAPHYLAXIS | 336 | ||
| B. CHRONIC FATIGUE SYNDROME | 338 | ||
| C. FEVER | 339 | ||
| D. FIBROMYALGIA | 341 | ||
| E. GOUT/PSEUDOGOUT | 342 | ||
| F. REYE SYNDROME | 344 | ||
| G. RHEUMATOID ARTHRITIS | 346 | ||
| H. SYSTEMIC LUPUS ERYTHEMATOSUS | 347 | ||
| Bibliography | 348 | ||
| 22 - Neurologic Emergencies | 349 | ||
| I. General Strategy | 349 | ||
| A. ASSESSMENT | 349 | ||
| B. ANALYSIS: DIFFERENTIAL NURSING DIAGNOSES/COLLABORATIVE PROBLEMS | 352 | ||
| C. PLANNING AND IMPLEMENTATION/INTERVENTIONS | 352 | ||
| D. EVALUATION AND ONGOING MONITORING | 352 | ||
| E. DOCUMENTATION OF INTERVENTIONS AND PATIENT RESPONSE | 352 | ||
| F. AGE-RELATED CONSIDERATIONS | 352 | ||
| II. Specific Neurologic Emergencies | 353 | ||
| A. DEMENTIA | 353 | ||
| B. GUILLAIN-BARRÉ SYNDROME | 354 | ||
| C. HEADACHES | 356 | ||
| D. SEIZURES | 359 | ||
| E. STROKE | 361 | ||
| F. VENTRICULAR SHUNT | 364 | ||
| References | 364 | ||
| 23 - Obstetric and Gynecologic Emergencies | 366 | ||
| I. General Strategy | 366 | ||
| A. ASSESSMENT | 366 | ||
| B. ANALYSIS: DIFFERENTIAL NURSING DIAGNOSES/COLLABORATIVE PROBLEMS | 368 | ||
| C. PLANNING AND IMPLEMENTATION/INTERVENTIONS | 368 | ||
| D. EVALUATION AND ONGOING MONITORING | 368 | ||
| E. DOCUMENTATION OF INTERVENTIONS AND PATIENT RESPONSE | 368 | ||
| F. AGE-RELATED CONSIDERATIONS | 368 | ||
| II. Specific Obstetric Emergencies | 368 | ||
| A. ECTOPIC PREGNANCY | 368 | ||
| B. EMERGENCY DELIVERY | 369 | ||
| C. GESTATIONAL HYPERTENSION: PREECLAMPSIA, ECLAMPSIA, AND HEMOLYSIS, ELEVATED LIVER ENZYMES, LOW PLATELETS (HELLP) | 371 | ||
| D. HYPEREMESIS GRAVIDARUM | 372 | ||
| E. NEONATAL RESUSCITATION | 373 | ||
| F. PLACENTA PREVIA AND ABRUPTIO PLACENTAE | 374 | ||
| G. POSTPARTUM HEMORRHAGE | 376 | ||
| H. SPONTANEOUS ABORTION | 376 | ||
| III. Specific Gynecologic Emergencies | 378 | ||
| A. PELVIC INFLAMMATORY DISEASE | 378 | ||
| B. PELVIC PAIN | 379 | ||
| C. SEXUALLY TRANSMITTED INFECTIONS | 380 | ||
| D. VAGINAL BLEEDING/DYSFUNCTIONAL UTERINE BLEEDING | 380 | ||
| E. VAGINITIS | 385 | ||
| Bibliography | 386 | ||
| 24 - Orthopedic Emergencies | 387 | ||
| I. General Strategy | 387 | ||
| A. ASSESSMENT | 387 | ||
| B. ANALYSIS: DIFFERENTIAL NURSING DIAGNOSES/COLLABORATIVE PROBLEMS | 390 | ||
| C. PLANNING AND IMPLEMENTATION/INTERVENTIONS | 390 | ||
| D. EVALUATION AND ONGOING MONITORING | 390 | ||
| E. DOCUMENTATION OF INTERVENTIONS AND PATIENT RESPONSE | 390 | ||
| F. AGE-RELATED CONSIDERATIONS | 390 | ||
| II. Specific Soft Tissue Emergencies | 391 | ||
| A. LOW BACK PAIN | 391 | ||
| B. OVERUSE/CUMULATIVE TRAUMA DISORDERS | 392 | ||
| III. Specific Bony Skeleton Emergencies | 394 | ||
| A. COSTOCHONDRITIS | 394 | ||
| B. JOINT EFFUSIONS | 395 | ||
| C. OSTEOARTHRITIS | 396 | ||
| D. OSTEOPOROSIS | 396 | ||
| Bibliography | 397 | ||
| 25 - Pre- and Post-Transplant Emergencies | 398 | ||
| I. General Strategy | 398 | ||
| A. ASSESSMENT | 398 | ||
| B. ANALYSIS: DIFFERENTIAL NURSING DIAGNOSES/COLLABORATIVE PROBLEM | 398 | ||
| C. PLANNING AND IMPLEMENTATION/INTERVENTIONS | 398 | ||
| II. Pre-Solid Organ Transplant Emergencies | 398 | ||
| A. NOTIFICATION OF PATIENT’S ARRIVAL | 398 | ||
| B. SPECIAL CONSIDERATIONS | 399 | ||
| III. Post-Solid Organ Transplant Emergencies | 399 | ||
| A. GENERAL STRATEGY | 399 | ||
| B. SOLID ORGAN TRANSPLANT REJECTION AND INFECTION | 401 | ||
| Bibliography | 402 | ||
| 26 - Toxicologic Emergencies | 404 | ||
| I. General Strategy | 404 | ||
| A. ASSESSMENT | 404 | ||
| B. ANALYSIS: DIFFERENTIAL NURSING DIAGNOSES/COLLABORATIVE PROBLEMS | 408 | ||
| C. PLANNING AND IMPLEMENTATION/INTERVENTIONS | 408 | ||
| D. EVALUATION AND ONGOING MONITORING | 408 | ||
| E. DOCUMENTATION OF INTERVENTIONS AND PATIENT RESPONSE | 408 | ||
| F. AGE-RELATED CONSIDERATIONS | 408 | ||
| II. Specific Toxicologic Emergencies | 409 | ||
| A. ACETAMINOPHEN POISONING | 409 | ||
| B. ALCOHOL USE | 410 | ||
| C. AMPHETAMINE USE | 411 | ||
| D. BETA-BLOCKER TOXICITY | 413 | ||
| F. CARBON MONOXIDE POISONING | 415 | ||
| G. COCAINE USE | 416 | ||
| H. CYANIDE POISONING | 417 | ||
| I. DIGOXIN TOXICITY | 418 | ||
| K. GAMMA-HYDROXYBUTYRATE USE | 420 | ||
| L. HEAVY METAL POISONING | 420 | ||
| M. INHALANT USE | 422 | ||
| N. IRON POISONING | 422 | ||
| P. MARIJUANA | 425 | ||
| Q. OPIATE USE | 425 | ||
| R. ORGANOPHOSPHATE POISONING | 427 | ||
| T. PHENCYCLIDINE USE | 428 | ||
| U. PLANT POISONING | 430 | ||
| V. SALICYLATE POISONING | 431 | ||
| Y. SYNTHETIC DRUGS OF ABUSE | 434 | ||
| Z. TRICYCLIC ANTIDEPRESSANT POISONING | 435 | ||
| References | 436 | ||
| Bibliography | 436 | ||
| 27 - Psychiatric/Psychosocial Emergencies | 437 | ||
| I. General Strategy | 437 | ||
| A. SAFETY | 437 | ||
| B. ASSESSMENT | 437 | ||
| C. ANALYSIS: DIFFERENTIAL NURSING DIAGNOSES/COLLABORATIVE PROBLEMS | 438 | ||
| D. PLANNING AND IMPLEMENTATION/INTERVENTIONS | 438 | ||
| E. EVALUATION AND ONGOING MONITORING | 438 | ||
| F. DOCUMENTATION OF INTERVENTIONS AND PATIENT RESPONSE | 438 | ||
| G. AGE-RELATED CONSIDERATIONS | 438 | ||
| II. Specific Psychosocial Emergencies | 439 | ||
| A. ANXIETY AND PANIC REACTIONS | 439 | ||
| B. BIPOLAR DISORDER | 441 | ||
| C. DEPRESSION | 442 | ||
| D. EATING DISORDERS | 444 | ||
| E. GRIEF | 445 | ||
| F. HOMICIDAL OR VIOLENT BEHAVIOR | 446 | ||
| I. SUICIDE OR SUICIDAL BEHAVIOR | 449 | ||
| 28 - Respiratory Emergencies | 452 | ||
| I. General Strategies | 452 | ||
| A. ASSESSMENT | 452 | ||
| B. ANALYSIS: DIFFERENTIAL NURSING DIAGNOSES/COLLABORATIVE PROBLEMS | 454 | ||
| C. PLANNING AND IMPLEMENTATION/INTERVENTIONS | 454 | ||
| D. EVALUATION AND ONGOING MONITORING | 454 | ||
| E. DOCUMENTATION OF INTERVENTIONS AND PATIENT RESPONSE | 455 | ||
| F. AGE-RELATED CONSIDERATIONS | 455 | ||
| II. Specific Respiratory Emergencies | 455 | ||
| A. ACUTE BRONCHITIS | 455 | ||
| B. ACUTE RESPIRATORY DISTRESS SYNDROME | 456 | ||
| C. ASTHMA | 458 | ||
| D. BRONCHIOLITIS | 460 | ||
| G. HYPERVENTILATION SYNDROME | 464 | ||
| H. PLEURAL EFFUSION | 465 | ||
| I. PNEUMONIA | 466 | ||
| K. PULMONARY EMBOLISM | 470 | ||
| Bibliography | 471 | ||
| 29 - Shock Emergencies | 473 | ||
| I. General Strategy | 473 | ||
| A. ASSESSMENT | 473 | ||
| B. ANALYSIS: DIFFERENTIAL NURSING DIAGNOSES/COLLABORATIVE PROBLEMS | 475 | ||
| C. PLANNING AND IMPLEMENTATION/INTERVENTIONS | 475 | ||
| E. DOCUMENTATION OF INTERVENTIONS AND PATIENT RESPONSE | 476 | ||
| F. AGE-RELATED CONSIDERATIONS | 476 | ||
| II. Specific Shock Emergencies | 476 | ||
| A. CARDIOGENIC | 476 | ||
| B. DISTRIBUTIVE | 477 | ||
| C. HYPOVOLEMIA | 479 | ||
| D. OBSTRUCTIVE | 480 | ||
| References | 481 | ||
| Bibliography | 482 | ||
| 30 - Wounds and Wound Management | 483 | ||
| I. General Strategy | 483 | ||
| A. ASSESSMENT | 483 | ||
| B. ANALYSIS: DIFFERENTIAL NURSING DIAGNOSES/COLLABORATIVE PROBLEMS | 484 | ||
| E. DOCUMENTATION OF INTERVENTIONS AND PATIENT RESPONSE | 485 | ||
| F. AGE-RELATED CONSIDERATIONS | 485 | ||
| II. Specific Wound Management Emergencies | 486 | ||
| A. ABRASIONS | 486 | ||
| B. AVULSIONS | 486 | ||
| C. FOREIGN BODIES | 488 | ||
| D. HUMAN BITES | 488 | ||
| E. LACERATIONS | 489 | ||
| F. MISSILE INJURIES | 491 | ||
| G. PUNCTURE WOUNDS | 492 | ||
| H. WOUND COMPLICATIONS | 493 | ||
| Bibliography | 495 | ||
| 3 - Trauma Emergencies | 497 | ||
| 31 - Mechanism of Injury | 497 | ||
| I. Biomechanics and Kinematics | 497 | ||
| A. DEFINITIONS | 497 | ||
| B. PHYSICS LAWS AND APPLICATION | 497 | ||
| II. Types of Injuries | 498 | ||
| A. BLAST FORCES | 498 | ||
| B. BLUNT FORCES | 499 | ||
| C. PENETRATING FORCES | 499 | ||
| D. PREDICTABLE INJURIES | 500 | ||
| References | 500 | ||
| 32 - Nursing Assessment and Trauma Resuscitation | 501 | ||
| I. Primary Assessment1–6 | 501 | ||
| A. OVERVIEW OF MAJOR COMPONENTS | 501 | ||
| B. INDIVIDUAL COMPONENTS OF PRIMARY ASSESSMENT | 502 | ||
| II. Resuscitation1-6 | 504 | ||
| A. AIRWAY MANAGEMENT4 | 504 | ||
| B. BREATHING MANAGEMENT | 505 | ||
| C. CIRCULATION MANAGEMENT | 505 | ||
| D. DISABILITY MANAGEMENT | 505 | ||
| III. Secondary Assessment3 | 506 | ||
| A. MAJOR COMPONENTS OF SECONDARY ASSESSMENT | 506 | ||
| B. REEVALUATION ADJUNCTS2 | 507 | ||
| IV. Consider Need for Transfer2,3 | 508 | ||
| A. INDICATIONS | 508 | ||
| V. Analysis: Differential Nursing Diagnoses/Collaborative Problems | 508 | ||
| A. RISK FOR INEFFECTIVE AIRWAY CLEARANCE | 508 | ||
| B. INEFFECTIVE BREATHING PATTERN | 508 | ||
| C. DEFICIENT FLUID VOLUME | 508 | ||
| D. ACUTE PAIN | 508 | ||
| E. RISK FOR INFECTION | 508 | ||
| F. ANXIETY/FEAR | 508 | ||
| VI. Planning and Implementation/Interventions | 508 | ||
| A. DETERMINE PRIORITIES OF CARE | 508 | ||
| B. RELIEVE ANXIETY/APPREHENSION | 508 | ||
| C. ALLOW SIGNIFICANT OTHERS TO REMAIN WITH PATIENT IF SUPPORTIVE | 508 | ||
| D. EDUCATE PATIENT AND SIGNIFICANT OTHERS | 508 | ||
| VII. Evaluation and Ongoing Monitoring | 508 | ||
| A. CONTINUOUSLY MONITOR AND TREAT AS INDICATED | 509 | ||
| B. MONITOR PATIENT RESPONSE/OUTCOMES, AND MODIFY NURSING CARE PLAN AS APPROPRIATE | 509 | ||
| C. IF POSITIVE PATIENT OUTCOMES ARE NOT DEMONSTRATED, REEVALUATE ASSESSMENT AND/OR PLAN OF CARE | 509 | ||
| VIII. Documentation of Interventions and Patient Response | 509 | ||
| A. SUBJECTIVE DATA COLLECTION | 509 | ||
| B. OBJECTIVE DATA COLLECTION | 509 | ||
| C. ANALYSIS: DIFFERENTIAL NURSING DIAGNOSES/COLLABORATIVE PROBLEMS | 509 | ||
| D. PLANNING AND IMPLEMENTATION/INTERVENTIONS | 509 | ||
| E. EVALUATION AND ONGOING MONITORING | 509 | ||
| IX. Age-Related Considerations | 509 | ||
| A. PEDIATRIC | 509 | ||
| B. GERIATRIC | 509 | ||
| References | 509 | ||
| 33 - Abdominal and Urologic Trauma | 510 | ||
| I. General Strategy | 510 | ||
| A. ASSESSMENT | 510 | ||
| B. ANALYSIS: DIFFERENTIAL NURSING DIAGNOSES/COLLABORATIVE PROBLEMS | 512 | ||
| C. PLANNING AND IMPLEMENTATION/INTERVENTIONS | 512 | ||
| D. EVALUATION AND ONGOING MONITORING | 512 | ||
| E. DOCUMENTATION OF INTERVENTIONS AND PATIENT RESPONSE | 512 | ||
| F. AGE-RELATED CONSIDERATIONS | 512 | ||
| II. Specific Abdominal Injuries | 513 | ||
| A. GASTRIC | 513 | ||
| B. LIVER | 514 | ||
| C. PANCREATIC/DUODENAL | 515 | ||
| D. SMALL BOWEL/LARGE BOWEL | 516 | ||
| E. SPLEEN | 517 | ||
| III. Specific Urologic Injuries | 518 | ||
| A. BLADDER | 518 | ||
| B. RENAL | 519 | ||
| C. URETHRA | 520 | ||
| Bibliography | 521 | ||
| 34 - Burn Trauma | 523 | ||
| I. General Strategy | 523 | ||
| A. ASSESSMENT | 523 | ||
| B. ANALYSIS: DIFFERENTIALNURSING DIAGNOSES/COLLABORATIVEPROBLEMS | 525 | ||
| C. PLANNING AND IMPLEMENTATION/INTERVENTIONS | 525 | ||
| D. EVALUATION AND ONGOING MONITORING | 525 | ||
| E. DOCUMENTATION OF INTERVENTIONS AND PATIENT RESPONSE | 525 | ||
| F. AGE-RELATED CONSIDERATIONS | 525 | ||
| II. Specific Burn Injuries | 526 | ||
| A. CHEMICAL BURNS | 526 | ||
| B. ELECTRICAL/LIGHTNING BURNS | 527 | ||
| C. THERMAL AND INHALATION BURNS | 528 | ||
| Bibliography | 532 | ||
| 35 - Neurologic Trauma | 533 | ||
| I. General Strategy | 533 | ||
| A. ASSESSMENT | 533 | ||
| B. ANALYSIS: DIFFERENTIAL NURSING DIAGNOSES/COLLABORATIVE PROBLEMS | 535 | ||
| C. PLANNING AND IMPLEMENTATION/INTERVENTIONS | 535 | ||
| D. EVALUATION AND ONGOING MONITORING | 535 | ||
| E. DOCUMENTATION OF INTERVENTIONS AND PATIENT RESPONSE | 535 | ||
| F. AGE-RELATED CONSIDERATIONS | 535 | ||
| II. Specific Traumatic Neurologic Injuries | 536 | ||
| A. AUTONOMIC DYSREFLEXIA IN SPINAL CORD INJURY | 536 | ||
| B. CONCUSSION—MILD TRAUMATIC BRAIN INJURY | 536 | ||
| C. INCREASED INTRACRANIAL PRESSURE | 537 | ||
| D. SKULL FRACTURES | 539 | ||
| E. SPINAL CORD INJURIES | 540 | ||
| F. TRAUMATIC BRAIN INJURY: CEREBRAL CONTUSION | 541 | ||
| G. TRAUMATIC BRAIN INJURY: DIFFUSE AXONAL INJURY (MODERATE TO SEVERE) | 542 | ||
| H. TRAUMATIC BRAIN INJURY: EPIDURAL HEMATOMA | 543 | ||
| I. TRAUMATIC BRAIN INJURY: PENETRATING HEAD INJURY | 544 | ||
| J. TRAUMATIC BRAIN INJURY: SUBDURAL HEMATOMA | 545 | ||
| K. TRAUMATIC SUBARACHNOID HEMORRHAGE | 546 | ||
| Bibliography | 547 | ||
| 36 - Ocular and Maxillofacial Trauma | 549 | ||
| I. General Strategy | 549 | ||
| A. ASSESSMENT | 549 | ||
| B. ANALYSIS: DIFFERENTIAL NURSING DIAGNOSES/COLLABORATIVE PROBLEMS | 550 | ||
| C. PLANNING AND IMPLEMENTATION/INTERVENTIONS | 550 | ||
| D. EVALUATION AND ONGOING MONITORING | 550 | ||
| E. DOCUMENTATION OF INTERVENTIONS AND PATIENT RESPONSE | 551 | ||
| F. AGE-RELATED CONSIDERATIONS | 551 | ||
| II. Specific Traumatic Ocular Injuries | 551 | ||
| A. CHEMICAL BURNS | 551 | ||
| B. CORNEAL ABRASION | 552 | ||
| C. EXTRAOCULAR FOREIGN BODIES | 553 | ||
| D. EYELID LACERATION | 553 | ||
| E. GLOBE RUPTURE | 554 | ||
| F. HYPHEMA | 555 | ||
| G. ORBITAL FRACTURE | 555 | ||
| H. RETINAL DETACHMENT | 556 | ||
| III. Specific Traumatic Maxillofacial Injuries | 557 | ||
| A. FACIAL LACERATIONS AND SOFT TISSUE INJURIES | 557 | ||
| B. FRACTURED LARYNX | 558 | ||
| C. FRACTURED TOOTH | 559 | ||
| D. MANDIBULAR FRACTURES | 561 | ||
| E. MAXILLARY FRACTURES | 561 | ||
| F. NASAL FRACTURE | 563 | ||
| G. SUBLUXED/AVULSED TEETH | 564 | ||
| I. ZYGOMATIC FRACTURES | 565 | ||
| References | 566 | ||
| 37 - Trauma in Pregnancy | 567 | ||
| I. General Strategy | 567 | ||
| A. ASSESSMENT | 567 | ||
| B. ANALYSIS: DIFFERENTIAL NURSING DIAGNOSES/COLLABORATIVE PROBLEMS | 569 | ||
| C. PLANNING AND IMPLEMENTATION/INTERVENTIONS | 570 | ||
| D. EVALUATION AND ONGOING MONITORING | 571 | ||
| E. DOCUMENTATION OF INTERVENTIONS AND PATIENT RESPONSE | 571 | ||
| F. AGE-RELATED CONSIDERATIONS | 571 | ||
| II. Specific Injuries of the Pregnant Trauma Patient | 571 | ||
| A. MATERNAL CARDIOPULMONARY ARREST | 571 | ||
| B. PLACENTAL ABRUPTION | 572 | ||
| C. POSTTRAUMATIC PRETERM LABOR | 573 | ||
| D. UTERINE RUPTURE | 573 | ||
| References | 574 | ||
| Bibliography | 574 | ||
| 38 - Orthopedic Trauma | 575 | ||
| I. General Strategy | 575 | ||
| A. ASSESSMENT | 575 | ||
| B. ANALYSIS: DIFFERENTIAL NURSING DIAGNOSES/COLLABORATIVE PROBLEMS | 578 | ||
| C. PLANNING AND IMPLEMENTATION/INTERVENTIONS | 578 | ||
| D. EVALUATION AND ONGOING MONITORING | 578 | ||
| E. DOCUMENTATION OF INTERVENTIONS AND PATIENT RESPONSE | 578 | ||
| F. AGE-RELATED CONSIDERATIONS | 578 | ||
| II. Specific Soft Tissue Injuries | 580 | ||
| A. CONTUSIONS/HEMATOMAS | 580 | ||
| B. STRAINS AND SPRAINS | 581 | ||
| III. Specific Injuries of Bony Skeleton | 583 | ||
| A. DISLOCATIONS | 583 | ||
| B. FRACTURES | 585 | ||
| C. TRAUMATIC AMPUTATIONS | 589 | ||
| IV. Specific Life-Threatening Complications Associated with Orthopedic Injuries | 591 | ||
| A. COMPARTMENT SYNDROME | 591 | ||
| B. FAT EMBOLISM SYNDROME | 592 | ||
| C. HEMORRHAGE FROM FRACTURES | 594 | ||
| D. OSTEOMYELITIS | 594 | ||
| E. SEPTIC ARTHRITIS | 595 | ||
| V. Assistive Walking Devices and Splinting | 596 | ||
| A. ASSISTIVE WALKING DEVICES | 596 | ||
| B. SPLINTS (BOX 38.15) | 596 | ||
| Bibliography | 597 | ||
| 39 - Thoracic Trauma | 598 | ||
| I. General Strategy | 598 | ||
| A. ASSESSMENT | 598 | ||
| B. ANALYSIS: DIFFERENTIAL NURSING DIAGNOSES/COLLABORATIVE PROBLEMS | 599 | ||
| C. PLANNING AND IMPLEMENTATION/INTERVENTIONS | 599 | ||
| D. EVALUATION AND ONGOING MONITORING | 599 | ||
| E. DOCUMENTATION OF INTERVENTIONS AND PATIENT RESPONSE | 599 | ||
| F. AGE-RELATED CONSIDERATIONS | 599 | ||
| II. Specific Thoracic Emergencies | 600 | ||
| A. AORTIC INJURIES | 600 | ||
| B. BLUNT CARDIAC INJURY | 601 | ||
| C. CARDIAC TAMPONADE | 602 | ||
| D. FLAIL CHEST | 603 | ||
| E. HEMOTHORAX | 604 | ||
| F. PNEUMOTHORAX | 605 | ||
| G. PULMONARY CONTUSION | 606 | ||
| H. RIB AND STERNAL FRACTURES | 607 | ||
| I. RUPTURED DIAPHRAGM | 607 | ||
| J. TENSION PNEUMOTHORAX | 609 | ||
| K. TRACHEOBRONCHIAL INJURY | 610 | ||
| Bibliography | 611 | ||
| 40 - Sexual Assault | 612 | ||
| I. Definitions | 612 | ||
| A. SEXUAL VIOLENCE | 612 | ||
| B. SEXUAL ASSAULT | 612 | ||
| C. RAPE | 612 | ||
| D. EVIDENCE | 612 | ||
| E. LOCARD PRINCIPLE | 612 | ||
| F. CHAIN OF CUSTODY | 612 | ||
| II. General Strategy | 612 | ||
| A. CLINICAL FORENSIC ISSUES | 613 | ||
| B. ANALYSIS: DIFFERENTIAL NURSING DIAGNOSES/COLLABORATIVE PROBLEMS | 616 | ||
| C. PLANNING AND IMPLEMENTATION/INTERVENTIONS | 616 | ||
| D. EVALUATION AND ONGOING MONITORING | 617 | ||
| E. DOCUMENTATION OF INTERVENTIONS AND PATIENT RESPONSE | 617 | ||
| F. AGE AND DEVELOPMENT RELATED CONSIDERATIONS | 617 | ||
| References | 619 | ||
| Bibliography | 620 | ||
| 4 - Professional Components | 621 | ||
| 41 - Disaster Preparedness and Response | 621 | ||
| I. Disasters | 622 | ||
| A. DISASTER DEFINITION | 622 | ||
| B. TYPES OF DISASTER | 622 | ||
| II. Disaster Phases | 623 | ||
| A. WARNING | 623 | ||
| B. IMPACT | 623 | ||
| C. ISOLATION | 623 | ||
| D. RESCUE | 623 | ||
| E. RESTORATION | 623 | ||
| F. NORMAL OPERATIONS | 623 | ||
| III. General Strategy | 623 | ||
| A. NATIONAL PREPAREDNESS | 624 | ||
| B. REGIONAL AND LOCAL PREPAREDNESS | 624 | ||
| IV. Specific Weapons of Mass Destruction | 627 | ||
| A. BIOLOGIC AGENTS | 627 | ||
| Bacillus anthracis (Anthrax). Anthrax is a gram-positive, spore-forming bacterium that affects both humans and animals. The spor... | 627 | ||
| Clostridium botulinum (Botulism). Clostridium botulinum is the only toxin that is listed as one of the six category A biologic a... | 629 | ||
| Yersinia pestis (Bubonic, Septicemic, and Pneumonic Plague). Yersinia pestis is infamous for killing millions of people in pande... | 630 | ||
| Francisella tularensis (Tularemia). Francisella tularensis is a highly infectious organism that does not form spores; however, i... | 631 | ||
| Smallpox. Smallpox was eradicated in an aggressive campaign by the WHO in the 1970s. Today, a single case would become a global ... | 632 | ||
| Filovirus, Arenavirus (Hemorrhagic Fevers). These fevers include Ebola, Marburg, Rift Valley, yellow, dengue, and Lassa fevers. ... | 632 | ||
| Ricin. Ricin is widely available and easily produced. Made from the beans of the castor plant, this biological agent is largely ... | 633 | ||
| B. CHEMICAL WEAPONS | 634 | ||
| Nerve Agents. Nerve agents are the best known, and most toxic, type of chemical agent; however, they are the most difficult to a... | 634 | ||
| Vesicants. Vesicants often result in skin blistering, hence the military’s nomenclature of blister agent. Examples are mustard g... | 635 | ||
| Cyanide. Named a “blood agent” by the military because of its physiologic target of oxygen-carrying capacity on a cellular level... | 636 | ||
| Pulmonary Agents: Phosgene, Chlorine, Anhydrous Ammonia. These are the most feared chemical agents for first responders because ... | 637 | ||
| V. Four Stages of Disaster Management | 638 | ||
| A. PREPAREDNESS | 638 | ||
| B. MITIGATION | 641 | ||
| C. RESPONSE | 641 | ||
| D. RECOVERY | 643 | ||
| VI. United States Federal Disaster Response | 643 | ||
| A. GOVERNMENTAL PREPAREDNESS AND RESPONSE | 643 | ||
| B. NATIONAL RESPONSE FRAMEWORK | 643 | ||
| C. NATIONAL INCIDENT MANAGEMENT SYSTEM | 644 | ||
| D. NATIONAL TERRORISM ADVISORY SYSTEM | 644 | ||
| E. DISASTER RESILIENCE14 | 644 | ||
| F. DISASTER RISK REDUCTION15,16 | 644 | ||
| VII. Special Topics | 644 | ||
| A. WOMEN’S HEALTH | 644 | ||
| B. VULNERABLE POPULATIONS | 644 | ||
| References | 644 | ||
| Bibliography | 645 | ||
| 42 - Education: Professional, Patient, and Community | 647 | ||
| I. Educational Principles | 647 | ||
| A. THEORETICAL FOUNDATIONS IN KNOWLEDGE AND LEARNING | 647 | ||
| B. ADULT LEARNING CONCEPTS | 647 | ||
| II. Professional Education | 648 | ||
| A. EMERGENCY NURSING KNOWLEDGE AND SKILLS | 648 | ||
| B. LEARNING FACILITATOR ROLES AND RESPONSIBILITIES | 649 | ||
| C. DEPARTMENT ORIENTATION | 650 | ||
| D. EMERGENCY NURSING CREDENTIALS | 650 | ||
| E. EDUCATIONAL APPROACHES | 650 | ||
| F. CONTINUING EDUCATION | 652 | ||
| III. Patient Education | 652 | ||
| A. ESSENTIAL ELEMENTS | 652 | ||
| B. LEGAL CONSIDERATIONS | 653 | ||
| C. PROCESS | 653 | ||
| D. TEACHING METHODS | 653 | ||
| E. TEACHING EFFECTIVENESS | 653 | ||
| IV. Community Education | 654 | ||
| A. GENERAL APPROACH TO COMMUNITY HEALTH EDUCATION | 654 | ||
| B. OTHER COMMUNITY OPPORTUNITIES | 655 | ||
| Bibliography | 655 | ||
| 43 - Emergency Patient Transfer and Transport | 657 | ||
| I. Emergency Medical Services System | 657 | ||
| A. COMPONENTS | 657 | ||
| A - Coma Scales | 711 | ||
| B - Age-Specific Vital Signs | 713 | ||
| C - Infant Pain Scales | 714 | ||
| D - Revised Trauma Score | 716 | ||
| INDEX | 717 | ||
| A | 717 | ||
| B | 718 | ||
| C | 719 | ||
| D | 721 | ||
| E | 722 | ||
| F | 724 | ||
| G | 725 | ||
| H | 725 | ||
| I | 726 | ||
| J | 727 | ||
| K | 727 | ||
| L | 727 | ||
| M | 728 | ||
| N | 729 | ||
| O | 730 | ||
| P | 731 | ||
| Q | 733 | ||
| R | 733 | ||
| S | 734 | ||
| T | 735 | ||
| U | 737 | ||
| V | 737 | ||
| W | 737 | ||
| Y | 738 | ||
| Z | 738 |