Patients with Common
Environmental Emergencies
(Concepts for
Interprofessional
Collaborative Care College
Test Bank)
, On a hot humid day, an emergency department nurse is caring for a client who is
confused
and has these vital signs: temperature 104.1° F (40.1° C), pulse 132 beats/min,
respirations 26
breaths/min, and blood pressure 106/66 mm Hg. What action would the nurse take?
a. Encourage the client to drink cool water or sports drinks.
b. Start an intravenous line and infuse 0.9% saline solution.
c. Administer acetaminophen (Tylenol) 650 mg orally.
d. Encourage rest and reassess in 15 minutes.
ANS: B
The client demonstrates signs of heat stroke. This is a medical emergency and priority
care
includes oxygen therapy, IV infusion with 0.9% saline solution, insertion of a urinary
catheter,
and aggressive interventions to cool the patient, including external cooling and internal
cooling methods. Oral hydration would not be appropriate for a client who has
symptoms of
heat stroke because oral fluids would not provide necessary rapid rehydration, and the
confused client would be at risk for aspiration. Acetaminophen would not decrease this
patient's temperature or improve the patient's symptoms. The client needs immediate
medical
treatment; therefore, rest and reassessing in 15 minutes are inappropriate.
While at a public park, a nurse encounters a person immediately after a bee sting. The
person's lips are swollen, and wheezes are audible. What action would the nurse take
first?
a. Elevate the site and notify the person's next of kin.
b. Remove the stinger with tweezers and encourage rest.
c. Administer diphenhydramine and apply ice.
d. Administer an epinephrine autoinjector and call 911.
ANS: D
The client's swollen lips indicate that anaphylaxis may be developing, and this is a
medical
emergency. The nurse would call 911 would immediately, and the client transported to
the
emergency department as quickly as possible. If an EpiPen is available, it would be
administered at the first sign of an anaphylactic reaction. The other answers do not
provide
adequate interventions to treat airway obstruction due to anaphylaxis, although the
nurse
would remove the stinger as soon as possible after administering the autoinjector.
A client presents to the emergency department after prolonged exposure to the cold.
The client