MDC 4 FINAL EXAM ACTUAL UPDATED QUESTIONS AND
SOLUTIONS RATED A+
✔✔is dehydration common in heat exhaustion? - ✔✔YES
✔✔what can major diaphoresis cause? - ✔✔severe dehydration and hyponatremia
✔✔if heat exhaustion goes untreated, what can it cause? - ✔✔heat stroke
✔✔what are the s/s of heat exhaustion - ✔✔-dehydration
-decrease in blood volume
-decrease in BP
-tachycardia
✔✔what is the first intervention for a person expected to have heat exhaustion? -
✔✔stop their physical activity and transfer to a cool place
✔✔what is the quickest way to reduce someone's temperature? - ✔✔- remove clothing
- remove bed linen
✔✔what interventions are there for cooling patients down? - ✔✔- cold pack on the neck,
chest, abdomen, and groin
- soak in cool water
✔✔when rehydrating someone with heat exhaustion, should you use water or a sports
drink/oral reydration solution? - ✔✔Sports drink/oral hydration solution
✔✔why is a sports drink better at rehydrating patients with heat exhaustion? - ✔✔plain
water can worsen sodium deficits
✔✔nursing care for patients hospitalized with heat exhaustion - ✔✔- monitor vitals
- administer .9% NS in N/V is present
- draw labs to check electrolytes
✔✔how is heat stroke defined? - ✔✔body temperature greater than 104F
✔✔T/F: heat stroke is a medical emergency - ✔✔TRUE
✔✔T/F: if heat stroke is left untreated it becomes fatal - ✔✔TRUE
✔✔s/s of heat stroke - ✔✔- tachycardia
- hallucinations
- irregular pulse
- decreased urin output
,- hot and dry skin
✔✔nursing care for heat stroke - ✔✔- 02 and .9% NS via IV
- continuous cooling, IVF, and cooling blankets.
✔✔when should continuous cooling, IVF, and cooling blankets be stopped? - ✔✔when
core temperature reaches 102F
✔✔what should you do if your patient is shivering while being cooled from heat stroke? -
✔✔administer benzos because they provide sedation, control convulsions, and control
shivering
✔✔what should you NOT administer for a person with a high body temperature - ✔✔-
aspirin
- antipyretics
✔✔at what temperature does hypothermia occur? - ✔✔less than 95F
✔✔nursing care for hypothermia - ✔✔- find shelter away from cold
- remove wet clothing
- monitor for cardio issues, ARDS, pneumonia
- focus on rewarming slowly
✔✔in hypothermia, why should cardo issues be monitored? - ✔✔dysrhythmias could
result from lactic acid build up
✔✔what is frostbite - ✔✔freezing of body tissue
✔✔how many degrees of frostbite are there? - ✔✔4
✔✔what happens with 1st degree frostbite? - ✔✔hyperemia and edema
(hyperemia: increased blood flow)
✔✔what happens with 2nd degree frostbite? - ✔✔- red area
- blisters with clear/milky fluid
- partial thickness necrosis
✔✔what happens with 3rd degree frostbite - ✔✔- small blisters with dark fluid
- body is cold, numb, blue/red, and NO blanching
✔✔what happens with 4th degree frostbite? - ✔✔- NO blisters or edema
- numb, cold, bloodless
- in muscle and bone
, ✔✔what happens when frostbite reaches the muscle and bone? - ✔✔gangrene
(4th degree frostbite)
✔✔how is a person warmed after frostbite? - ✔✔rapid rewarming with a water bath
that's temperature is 104-108F
✔✔how is a frostbit injury handled after rewarming has taken place? - ✔✔injury should
be handled above heart level
✔✔nursing care of frostbite - ✔✔- pain control with analgesics and IV rehydration
- loose, non adherent sterile dressings
✔✔what pain medication should be used for frostbite? - ✔✔IV opiates
✔✔T/F: for a person with frostbite, the nurse should tightly wrap the patients wound -
✔✔FALSE
**compression should be avoided
✔✔what are arthropods - ✔✔- spiders
- scorpions
- bees
- wasps
✔✔nursing care for a patient injured by an arthropod - ✔✔- remove stinger
- cold compress
- Epi pen and oxygen for anaphylaxis
✔✔what is affected by a lightning injury? - ✔✔heart and CNS
✔✔who is most at risk for a lightning injury - ✔✔young adult males
✔✔what nursing care is needed for a lightning injury - ✔✔- immediate CPR
- ECG
- CT
- tetanus prophylaxis
✔✔what system is used during a mass casualty to sort patients into priority of care? -
✔✔tag system
✔✔what information do you write on the triage tags? - ✔✔- color/priority
- age/DOB (identifying characteristics)
SOLUTIONS RATED A+
✔✔is dehydration common in heat exhaustion? - ✔✔YES
✔✔what can major diaphoresis cause? - ✔✔severe dehydration and hyponatremia
✔✔if heat exhaustion goes untreated, what can it cause? - ✔✔heat stroke
✔✔what are the s/s of heat exhaustion - ✔✔-dehydration
-decrease in blood volume
-decrease in BP
-tachycardia
✔✔what is the first intervention for a person expected to have heat exhaustion? -
✔✔stop their physical activity and transfer to a cool place
✔✔what is the quickest way to reduce someone's temperature? - ✔✔- remove clothing
- remove bed linen
✔✔what interventions are there for cooling patients down? - ✔✔- cold pack on the neck,
chest, abdomen, and groin
- soak in cool water
✔✔when rehydrating someone with heat exhaustion, should you use water or a sports
drink/oral reydration solution? - ✔✔Sports drink/oral hydration solution
✔✔why is a sports drink better at rehydrating patients with heat exhaustion? - ✔✔plain
water can worsen sodium deficits
✔✔nursing care for patients hospitalized with heat exhaustion - ✔✔- monitor vitals
- administer .9% NS in N/V is present
- draw labs to check electrolytes
✔✔how is heat stroke defined? - ✔✔body temperature greater than 104F
✔✔T/F: heat stroke is a medical emergency - ✔✔TRUE
✔✔T/F: if heat stroke is left untreated it becomes fatal - ✔✔TRUE
✔✔s/s of heat stroke - ✔✔- tachycardia
- hallucinations
- irregular pulse
- decreased urin output
,- hot and dry skin
✔✔nursing care for heat stroke - ✔✔- 02 and .9% NS via IV
- continuous cooling, IVF, and cooling blankets.
✔✔when should continuous cooling, IVF, and cooling blankets be stopped? - ✔✔when
core temperature reaches 102F
✔✔what should you do if your patient is shivering while being cooled from heat stroke? -
✔✔administer benzos because they provide sedation, control convulsions, and control
shivering
✔✔what should you NOT administer for a person with a high body temperature - ✔✔-
aspirin
- antipyretics
✔✔at what temperature does hypothermia occur? - ✔✔less than 95F
✔✔nursing care for hypothermia - ✔✔- find shelter away from cold
- remove wet clothing
- monitor for cardio issues, ARDS, pneumonia
- focus on rewarming slowly
✔✔in hypothermia, why should cardo issues be monitored? - ✔✔dysrhythmias could
result from lactic acid build up
✔✔what is frostbite - ✔✔freezing of body tissue
✔✔how many degrees of frostbite are there? - ✔✔4
✔✔what happens with 1st degree frostbite? - ✔✔hyperemia and edema
(hyperemia: increased blood flow)
✔✔what happens with 2nd degree frostbite? - ✔✔- red area
- blisters with clear/milky fluid
- partial thickness necrosis
✔✔what happens with 3rd degree frostbite - ✔✔- small blisters with dark fluid
- body is cold, numb, blue/red, and NO blanching
✔✔what happens with 4th degree frostbite? - ✔✔- NO blisters or edema
- numb, cold, bloodless
- in muscle and bone
, ✔✔what happens when frostbite reaches the muscle and bone? - ✔✔gangrene
(4th degree frostbite)
✔✔how is a person warmed after frostbite? - ✔✔rapid rewarming with a water bath
that's temperature is 104-108F
✔✔how is a frostbit injury handled after rewarming has taken place? - ✔✔injury should
be handled above heart level
✔✔nursing care of frostbite - ✔✔- pain control with analgesics and IV rehydration
- loose, non adherent sterile dressings
✔✔what pain medication should be used for frostbite? - ✔✔IV opiates
✔✔T/F: for a person with frostbite, the nurse should tightly wrap the patients wound -
✔✔FALSE
**compression should be avoided
✔✔what are arthropods - ✔✔- spiders
- scorpions
- bees
- wasps
✔✔nursing care for a patient injured by an arthropod - ✔✔- remove stinger
- cold compress
- Epi pen and oxygen for anaphylaxis
✔✔what is affected by a lightning injury? - ✔✔heart and CNS
✔✔who is most at risk for a lightning injury - ✔✔young adult males
✔✔what nursing care is needed for a lightning injury - ✔✔- immediate CPR
- ECG
- CT
- tetanus prophylaxis
✔✔what system is used during a mass casualty to sort patients into priority of care? -
✔✔tag system
✔✔what information do you write on the triage tags? - ✔✔- color/priority
- age/DOB (identifying characteristics)
