NR574 FINAL EXAM CONTENT. WEEK 4 Hypothermia, Burns & Near
Drowning UPDATED ACTUAL Questions and CORRECT Answers
1. indicators for poor prognosis following near drowning Submersion or resuscita-
situation. tion lasting more than 25
minutes, apnea, pH < 7.41,
and Glasgow coma scale
(GCS) < 5 are poor prog-
nostic signs.
2. clinical findings of near drowning patient panic and agitation
lethargy, stupor, or coma
hypothermia
hypotension
cyanosis
pulmonary edema
bradycardia or tachycar-
dia
arrhythmia
cardiac arrest
secondary traumatic in-
juries (paresthesia, paral-
ysis, extremity deformity,
etc.)
3. Management near drowning and post drowning -intubation/supplemental
02
-remove all wet clothes
-fluid and electrolyte re-
placement as needed w/
serial BMP
-NG/OG for gastric de-
compression (if aspirated,
can quickly lead to PNA)
, -minimum of 6-8 hrs tele
monitoring
-
4. Guiselle is an 18-year-old female who was admitted 8 d. Adult respiratory dis-
hours ago after a near-drowning incident. EMS reports tress syndrome (ARDS)
that she fell into a swimming pool at a party and was
unable to swim. It was reported that a family member Rationale: Although
rescued her from underwater after she had been sub- Guiselle is at risk for bac-
merged for approximately 2 minutes. She arrived with terial pneumonia due to
oxygen at 5 Liters (L) via nasal cannula. Now, Guiselle near-drowning, the onset
reports shortness of breath and anxiousness. She has of her distress was too
difficulty talking in complete sentences. Vital signs are: quick to be caused by
Blood pressure 122/72; Heart rate 122; Respiratory bacterial pneumonia. Her
rate 32; Oxygen saturation 88% on 5 L oxygen. What is shortness of breath and
the most likely underlying cause of Guiselle's distress? anxiousness are most like-
a. Viral pneumonia ly caused by direct irrita-
b. Bacterial pneumonia tion of the lung parenchy-
c. Pulmonary embolism ma that leads to ARDS.
d. Adult respiratory distress syndrome (ARDS) ARDS is characterized by
sudden non-cardiogenic
pulmonary edema, hypox-
ia, and respiratory failure.
5. LaVelle was brought to the emergency department by a. Intubation and mechan-
EMS. He arrived on a backboard with a cervical collar ical ventilation
in place. LaVelle was found submerged in a pool by
a family member; the circumstances surrounding the Rationale: LaVelle is un-
event are unknown. The family reports that LaVelle is able to protect his air-
a good swimmer and often swims in the home pool way. He is lethargic, in
alone. You note that his breaths are shallow and slow. shock, and hypoxic. He re-
quires emergent intuba-
Drowning UPDATED ACTUAL Questions and CORRECT Answers
1. indicators for poor prognosis following near drowning Submersion or resuscita-
situation. tion lasting more than 25
minutes, apnea, pH < 7.41,
and Glasgow coma scale
(GCS) < 5 are poor prog-
nostic signs.
2. clinical findings of near drowning patient panic and agitation
lethargy, stupor, or coma
hypothermia
hypotension
cyanosis
pulmonary edema
bradycardia or tachycar-
dia
arrhythmia
cardiac arrest
secondary traumatic in-
juries (paresthesia, paral-
ysis, extremity deformity,
etc.)
3. Management near drowning and post drowning -intubation/supplemental
02
-remove all wet clothes
-fluid and electrolyte re-
placement as needed w/
serial BMP
-NG/OG for gastric de-
compression (if aspirated,
can quickly lead to PNA)
, -minimum of 6-8 hrs tele
monitoring
-
4. Guiselle is an 18-year-old female who was admitted 8 d. Adult respiratory dis-
hours ago after a near-drowning incident. EMS reports tress syndrome (ARDS)
that she fell into a swimming pool at a party and was
unable to swim. It was reported that a family member Rationale: Although
rescued her from underwater after she had been sub- Guiselle is at risk for bac-
merged for approximately 2 minutes. She arrived with terial pneumonia due to
oxygen at 5 Liters (L) via nasal cannula. Now, Guiselle near-drowning, the onset
reports shortness of breath and anxiousness. She has of her distress was too
difficulty talking in complete sentences. Vital signs are: quick to be caused by
Blood pressure 122/72; Heart rate 122; Respiratory bacterial pneumonia. Her
rate 32; Oxygen saturation 88% on 5 L oxygen. What is shortness of breath and
the most likely underlying cause of Guiselle's distress? anxiousness are most like-
a. Viral pneumonia ly caused by direct irrita-
b. Bacterial pneumonia tion of the lung parenchy-
c. Pulmonary embolism ma that leads to ARDS.
d. Adult respiratory distress syndrome (ARDS) ARDS is characterized by
sudden non-cardiogenic
pulmonary edema, hypox-
ia, and respiratory failure.
5. LaVelle was brought to the emergency department by a. Intubation and mechan-
EMS. He arrived on a backboard with a cervical collar ical ventilation
in place. LaVelle was found submerged in a pool by
a family member; the circumstances surrounding the Rationale: LaVelle is un-
event are unknown. The family reports that LaVelle is able to protect his air-
a good swimmer and often swims in the home pool way. He is lethargic, in
alone. You note that his breaths are shallow and slow. shock, and hypoxic. He re-
quires emergent intuba-
