NURS 2873 Exam 3 With
Complete Solution
Major causes of Negligence - ANSWER Failure to follow standards of care.
Failure to use equipment in a responsible manner. Failure to communicate.
Failure to document. Failure to assess/reassess/monitor. Failure to act as a pt
advocate.
Smoke inhalation: Metabolic Asphyxiation. What is it? What's the tx? -
ANSWER CO2 poisoning. CO2 produced by incomplete causation of burning
materials: hypoxia and carboxyhemoglobinemia. Tx: 100% humidified O2 via
non-rebreather
Smoke Inhalation Injuries: Lower Airway Injury - ANSWER trachea,
bronchioles, alveoli. May not appear for 12-48hrs. Pneumonia leading cause
of death.
Emergent Phase Complications - ANSWER Cardiovascular: impaired
microcirculation (increased viscosity > sludging) Give LMWH, SCD's and
tedhose. Urinary: renal ischemia, acute tubular necrosis from myoglobinuria
and hemoglobinurea caused by breakdown.
Drug Therapy for Emergent Phase - ANSWER Morphine, hydromorphone
(dilaudid), haloperidol, midazolam, Lorazepam (Ativan), tetanus shot. ATB:
antimicrobials silver sulfadiazine, mafenide acetate ASSESS FOR SULFA
ALLERGIES. Topical administered vs IV or PO d/t low blood supply to burn
area.
Emergent Phase: Burn Care - ANSWER Facial care: open method. Eyes: ATB
,ointment. No use of pillows, no pressure on ears (ears may stick and cause
bleeding/extensive damage). Elevate and extend extremities. Pericare: keep
clean, contamination issues.
Assessment Findings: Partial-Thickness (Superficial/1st Degree Burn) -
ANSWER redness, pain, moderate/severe tenderness, minimal edema,
blanching with pressure
Assessment Findings: Partial-Thickness (Deep/2nd Degree Burn) - ANSWER
moist blebs, blisters. molted white, pink to cherry red. hypersensitivity to
touch/air, moderate to severe pain, blanching with pressure
Assessment Findings: Full-Thickness (3rd and 4th Degree Burns) - ANSWER
Dry, Leathery eschar, waxy, white to dark brown charred. Strong burn odor.
Impaired sensation when touched, absence of pain with severe pain in
surrounding tissues. Lack of blanching with pressure.
Emergency Management Thermal Burns - ANSWER Unresponsive
CAB/responsive ABC. Stabilize spin, assess for inhalation injury, O2.
Anticipate intubation. Vitals, LOC, resp. status, O2 and heart rhythm. Remove
nonadherent clothing, jewelry and contacts. Cover concurrent burns with dry
dressings/clean sheet. 2 large bore IV access. Fluid replacement. Elevate
limbs. IV analgesics frequently, insert foley cath if TBSA > 15%. Identify and
treat other injuries.
What is the purpose of law and legislation? - ANSWER To protect the patient
and the nurse. They define the scope of acceptable practice and protect
individual rights. Nurses that know their rights and duties in legal matters are
able to protect themselves against liability or loss of licensure.
Nursing Organizations that provide guidance? - ANSWER American Nurses
, Association, Ohio Nurses Association
Five traditional Legal Disciplines - ANSWER Tort Law, Contract Law, Property
law, Constitutional Law, Criminal Law
Federal Law: Patient-Self Determination Act 1991 (PSDA) - ANSWER Required
to present patient with rights (rights to refuse treatment, medications,
procedure, ect.). Duty to document advanced directive and durable power of
attorney.
State Board of Nursing - ANSWER Purpose: protect the public. They: Issue
licenses, determine scope of practice, set minimum education standards,
responsible for Nurse Practice Act. Have power over: LPN's, RN's, Advanced
Practice Nurses. Decisions are made on current trends/best practices. They
have the power to discipline a license.
Process of State Board of Nursing action - ANSWER Complaint: no statue of
limitations. Investigations: done by well-trained staff, accused nurse may be
asked to answer details regarding allegations. Consultation: investigator tells
board how to proceed. Charges issued: board members vote on issue, once
charged, info becomes public. Hearing/Consent Agreement: sanctions. Board
Determination: denial, supervision, revoke, restrictions, reprimand, fines,
retirement, continuing education.
What is the section of Ohio Law 4723.28 of the Ohio Revised Code? -
ANSWER Lists 32 Actions that can result in board sanctions. Sets out process
to be used when taking action against a nurse.
Establishing Liability - ANSWER 1. Duty: to exercise ordinary care to avoid
harm. 2. Breach: of duty, fall below standard of care. 3. Causation: link
between the breach and harm. 4. Injury/Harm: physical or combo of
Complete Solution
Major causes of Negligence - ANSWER Failure to follow standards of care.
Failure to use equipment in a responsible manner. Failure to communicate.
Failure to document. Failure to assess/reassess/monitor. Failure to act as a pt
advocate.
Smoke inhalation: Metabolic Asphyxiation. What is it? What's the tx? -
ANSWER CO2 poisoning. CO2 produced by incomplete causation of burning
materials: hypoxia and carboxyhemoglobinemia. Tx: 100% humidified O2 via
non-rebreather
Smoke Inhalation Injuries: Lower Airway Injury - ANSWER trachea,
bronchioles, alveoli. May not appear for 12-48hrs. Pneumonia leading cause
of death.
Emergent Phase Complications - ANSWER Cardiovascular: impaired
microcirculation (increased viscosity > sludging) Give LMWH, SCD's and
tedhose. Urinary: renal ischemia, acute tubular necrosis from myoglobinuria
and hemoglobinurea caused by breakdown.
Drug Therapy for Emergent Phase - ANSWER Morphine, hydromorphone
(dilaudid), haloperidol, midazolam, Lorazepam (Ativan), tetanus shot. ATB:
antimicrobials silver sulfadiazine, mafenide acetate ASSESS FOR SULFA
ALLERGIES. Topical administered vs IV or PO d/t low blood supply to burn
area.
Emergent Phase: Burn Care - ANSWER Facial care: open method. Eyes: ATB
,ointment. No use of pillows, no pressure on ears (ears may stick and cause
bleeding/extensive damage). Elevate and extend extremities. Pericare: keep
clean, contamination issues.
Assessment Findings: Partial-Thickness (Superficial/1st Degree Burn) -
ANSWER redness, pain, moderate/severe tenderness, minimal edema,
blanching with pressure
Assessment Findings: Partial-Thickness (Deep/2nd Degree Burn) - ANSWER
moist blebs, blisters. molted white, pink to cherry red. hypersensitivity to
touch/air, moderate to severe pain, blanching with pressure
Assessment Findings: Full-Thickness (3rd and 4th Degree Burns) - ANSWER
Dry, Leathery eschar, waxy, white to dark brown charred. Strong burn odor.
Impaired sensation when touched, absence of pain with severe pain in
surrounding tissues. Lack of blanching with pressure.
Emergency Management Thermal Burns - ANSWER Unresponsive
CAB/responsive ABC. Stabilize spin, assess for inhalation injury, O2.
Anticipate intubation. Vitals, LOC, resp. status, O2 and heart rhythm. Remove
nonadherent clothing, jewelry and contacts. Cover concurrent burns with dry
dressings/clean sheet. 2 large bore IV access. Fluid replacement. Elevate
limbs. IV analgesics frequently, insert foley cath if TBSA > 15%. Identify and
treat other injuries.
What is the purpose of law and legislation? - ANSWER To protect the patient
and the nurse. They define the scope of acceptable practice and protect
individual rights. Nurses that know their rights and duties in legal matters are
able to protect themselves against liability or loss of licensure.
Nursing Organizations that provide guidance? - ANSWER American Nurses
, Association, Ohio Nurses Association
Five traditional Legal Disciplines - ANSWER Tort Law, Contract Law, Property
law, Constitutional Law, Criminal Law
Federal Law: Patient-Self Determination Act 1991 (PSDA) - ANSWER Required
to present patient with rights (rights to refuse treatment, medications,
procedure, ect.). Duty to document advanced directive and durable power of
attorney.
State Board of Nursing - ANSWER Purpose: protect the public. They: Issue
licenses, determine scope of practice, set minimum education standards,
responsible for Nurse Practice Act. Have power over: LPN's, RN's, Advanced
Practice Nurses. Decisions are made on current trends/best practices. They
have the power to discipline a license.
Process of State Board of Nursing action - ANSWER Complaint: no statue of
limitations. Investigations: done by well-trained staff, accused nurse may be
asked to answer details regarding allegations. Consultation: investigator tells
board how to proceed. Charges issued: board members vote on issue, once
charged, info becomes public. Hearing/Consent Agreement: sanctions. Board
Determination: denial, supervision, revoke, restrictions, reprimand, fines,
retirement, continuing education.
What is the section of Ohio Law 4723.28 of the Ohio Revised Code? -
ANSWER Lists 32 Actions that can result in board sanctions. Sets out process
to be used when taking action against a nurse.
Establishing Liability - ANSWER 1. Duty: to exercise ordinary care to avoid
harm. 2. Breach: of duty, fall below standard of care. 3. Causation: link
between the breach and harm. 4. Injury/Harm: physical or combo of
