STUDY GUIDE EXAM 1 NUR-243
Crisis/Disaster Management
1. What are the 5 phases of Disaster Management? Do you only know what each is
called, or can you analyze and apply your knowledge to assess, plan and implement care
during each phase?
● Phase 1: Preparedness
○ Ex: Having a disaster plan in place that involves multiple people and agencies
○ Based on previous experiences knowledge
○ BEFORE occurrence of disaster
● Phase 2: Mitigation
○ Measures taken to reduce harmful effects of disaster when there is knowledge
about impending disaster but it has not occured yet
○ Ex: Warning messages, evacuation
● Phase 3: Response
○ After the disaster has occured
○ Immediate response to effects
○ Ex: fire dept, police dept, EMS, hospital and Red Cross work together (local)
○ Involves triage, emergency medical services, first aid, rescue operations,
restoration of communication, assessment
● Phase 4: Recovery
○ Rebuilding, replacing lost or damaged property
○ Ex: going back to school/work to try to get back to “normal” life and
reconstruction
● Phase 5: Evaluation
○ What worked and what didn’t work
○ Ex: should have more masks available for the next pandemic :)
2. Triage is a prioritization of client care, in a disaster how are the triage decisions
made?
, ● Treat in groups, do not do one-on-one patient car, reverse triage if mass casualty (mass
casualty = involves 100 people or more)
● Red (emergent)
○ Critically injured, need immediate intervention, RR of 30 or more, cap refill of 2
sec or longer, altered LOC (cannot follow simple commands)
● Yellow (urgent)
○ Will not die if care is delayed for a few hours
○ Require stretcher (broken bones) but can follow simple commands
● Green (ambulatory)
○ Can walk and can wait for medical care
○ Walk them to a safe place
● Black (expectant)
○ Deceased or not breathing, critical brain injury
Hot Zone - zone of danger, contaminated/trauma site
Warm Zone - superficial treatment (pressure on a wound)
Cold Zone - where treatment happens
3. Review the disasters that were worked up during the in class activity
● Hurricanes and tornadoes
○ Asphyxia due to drowning
○ Bone, joint, muscle injuries
○ Upper respiratory infections
○ Injuries from flying debris (eye injuries)
● Thunderstorms
○ Very little skin breakdown but major BURN to muscles, nerves and blood vessels
● Earthquakes and tsunamis
○ High incidence of mortality and morbidity
○ Wounds, bone, joint, muscle injuries, breathing injuries, drowning, death
● Snowstorms
○ Myocardial infarctions
● Hazardous materials
○ Varies
○ Inhalation problems?
● Explosives
○ Abdominal, lung injuries
○ Penetrating injuries, blunt injuries, traumatic amputations, burns
○ High risk for hemorrhage and death
○ Radiation sickness (dirty bomb)
, Endocrine Review
Pituitary:
1. What are the functions of: hypothalamus, anterior pituitary, posterior pituitary?
(hormones released, target, action)
● Hypothalamus
○ Controls autonomic nervous system and pituitary gland
○ Controls temperature, thrist, hunger, sleep, emotions, etc.
● Anterior pituitary
○ Somatotropic cells secrete Growth Hormone (GH) -
■ Stimulates growth of the body
■ Increases protein production
■ Stimulates epiphyseal plates of long bones
○ Gonadotropic cells secrete gonadotropin hormones, follicle stimulating
hormone (FSH), and luteinizing hormone (LH)
■ Stimulate the ovaries and testes
○ Thyrotropic cells secrete thyroid-stimulating hormone (TSH)
■ Stimulates the synthesis and release of thyroid hormones from the thyroid
gland
○ Corticotropic cells secrete adrenocorticotropic hormone (ACTH)
■ Stimulates the release of hormones from adrenal cortex
○ Lactotrophic cells secrete prolactin (PRL)
■ Stimulates production of breast milk
● Posterior pituitary “Little Storehouse”
○ Store and release ADH and oxytocin
○ Antidiuretic hormone (vasopressin)
■ Decreases urine production
○ Oxytocin
■ Induces contraction of smooth muscles in reproductive organs
■ In women, stimulates uterus to contract during labor, and induces milk
ejection from breasts
2. What manifestations can be linked to a pituitary disorder? i.e. dwarfism, acromegaly
● Hypersecretions
○ FSH/LH → ovarian cysts, polycystic ovaries
○ PRL → amenorrhea, galactorrhea(milky nipple discharge)
○ ACTH → Cushing’s (too much cortisol)
○ TSH → Hyperthyroidism
○ GH → Gigantism (child), acromegaly (adult)
, ● Hyposecretions
○ ACTH → Adrenal insufficiency (ADI), Addison’s disease (low cortisol, low
aldosterone)
○ GH → dwarfism
3. What is diabetes insipidus? S/S?
● Posterior pituitary gland disorder
● Too little ADH secretion
● Results in large amounts of dilute urine output, can be 12L a day
● Extreme thirst
● Polyuria, polydipsia, dehydration, hypernatremia, low specific gravity, hypovolemia,
seizures
● Osmolality high >295
● Isotonic solution 0.9% NaCl
4. What is a hypophysectomy? Post assessment?
● Removal of pituitary gland. May cause DI so assess all the stuff from #3 above. Look out
for all hypothyroid stuff?
SIADH
● Water retention, hyponatremia, and serum hypo-osmolality, urine hyper-osmolality
● Blood volume expands, but the plasma is diluted
● Aldosterone is suppressed
● Renal excretion of sodium increases
● Urinary output decreases and the urine becomes very concentrated
● Brain cells swell, causing irritability, confusion
● Weight gain
● Hyponatremia from increased extracellular fluid and dilution of extracellular (serum) Na
level
● Decreased serum Na <120meq/L.
● Water intoxication
● Patients have LOW serum osmolality and HIGH urine osmolality
Diabetes Insipidus (DI)
● Polydipsia (2-20 liters/d)
● Large volumes of dilute urine
● Low specific gravity of urine 1.001-1.005
● Urine osmolality LOW <200mOsm/kg
Crisis/Disaster Management
1. What are the 5 phases of Disaster Management? Do you only know what each is
called, or can you analyze and apply your knowledge to assess, plan and implement care
during each phase?
● Phase 1: Preparedness
○ Ex: Having a disaster plan in place that involves multiple people and agencies
○ Based on previous experiences knowledge
○ BEFORE occurrence of disaster
● Phase 2: Mitigation
○ Measures taken to reduce harmful effects of disaster when there is knowledge
about impending disaster but it has not occured yet
○ Ex: Warning messages, evacuation
● Phase 3: Response
○ After the disaster has occured
○ Immediate response to effects
○ Ex: fire dept, police dept, EMS, hospital and Red Cross work together (local)
○ Involves triage, emergency medical services, first aid, rescue operations,
restoration of communication, assessment
● Phase 4: Recovery
○ Rebuilding, replacing lost or damaged property
○ Ex: going back to school/work to try to get back to “normal” life and
reconstruction
● Phase 5: Evaluation
○ What worked and what didn’t work
○ Ex: should have more masks available for the next pandemic :)
2. Triage is a prioritization of client care, in a disaster how are the triage decisions
made?
, ● Treat in groups, do not do one-on-one patient car, reverse triage if mass casualty (mass
casualty = involves 100 people or more)
● Red (emergent)
○ Critically injured, need immediate intervention, RR of 30 or more, cap refill of 2
sec or longer, altered LOC (cannot follow simple commands)
● Yellow (urgent)
○ Will not die if care is delayed for a few hours
○ Require stretcher (broken bones) but can follow simple commands
● Green (ambulatory)
○ Can walk and can wait for medical care
○ Walk them to a safe place
● Black (expectant)
○ Deceased or not breathing, critical brain injury
Hot Zone - zone of danger, contaminated/trauma site
Warm Zone - superficial treatment (pressure on a wound)
Cold Zone - where treatment happens
3. Review the disasters that were worked up during the in class activity
● Hurricanes and tornadoes
○ Asphyxia due to drowning
○ Bone, joint, muscle injuries
○ Upper respiratory infections
○ Injuries from flying debris (eye injuries)
● Thunderstorms
○ Very little skin breakdown but major BURN to muscles, nerves and blood vessels
● Earthquakes and tsunamis
○ High incidence of mortality and morbidity
○ Wounds, bone, joint, muscle injuries, breathing injuries, drowning, death
● Snowstorms
○ Myocardial infarctions
● Hazardous materials
○ Varies
○ Inhalation problems?
● Explosives
○ Abdominal, lung injuries
○ Penetrating injuries, blunt injuries, traumatic amputations, burns
○ High risk for hemorrhage and death
○ Radiation sickness (dirty bomb)
, Endocrine Review
Pituitary:
1. What are the functions of: hypothalamus, anterior pituitary, posterior pituitary?
(hormones released, target, action)
● Hypothalamus
○ Controls autonomic nervous system and pituitary gland
○ Controls temperature, thrist, hunger, sleep, emotions, etc.
● Anterior pituitary
○ Somatotropic cells secrete Growth Hormone (GH) -
■ Stimulates growth of the body
■ Increases protein production
■ Stimulates epiphyseal plates of long bones
○ Gonadotropic cells secrete gonadotropin hormones, follicle stimulating
hormone (FSH), and luteinizing hormone (LH)
■ Stimulate the ovaries and testes
○ Thyrotropic cells secrete thyroid-stimulating hormone (TSH)
■ Stimulates the synthesis and release of thyroid hormones from the thyroid
gland
○ Corticotropic cells secrete adrenocorticotropic hormone (ACTH)
■ Stimulates the release of hormones from adrenal cortex
○ Lactotrophic cells secrete prolactin (PRL)
■ Stimulates production of breast milk
● Posterior pituitary “Little Storehouse”
○ Store and release ADH and oxytocin
○ Antidiuretic hormone (vasopressin)
■ Decreases urine production
○ Oxytocin
■ Induces contraction of smooth muscles in reproductive organs
■ In women, stimulates uterus to contract during labor, and induces milk
ejection from breasts
2. What manifestations can be linked to a pituitary disorder? i.e. dwarfism, acromegaly
● Hypersecretions
○ FSH/LH → ovarian cysts, polycystic ovaries
○ PRL → amenorrhea, galactorrhea(milky nipple discharge)
○ ACTH → Cushing’s (too much cortisol)
○ TSH → Hyperthyroidism
○ GH → Gigantism (child), acromegaly (adult)
, ● Hyposecretions
○ ACTH → Adrenal insufficiency (ADI), Addison’s disease (low cortisol, low
aldosterone)
○ GH → dwarfism
3. What is diabetes insipidus? S/S?
● Posterior pituitary gland disorder
● Too little ADH secretion
● Results in large amounts of dilute urine output, can be 12L a day
● Extreme thirst
● Polyuria, polydipsia, dehydration, hypernatremia, low specific gravity, hypovolemia,
seizures
● Osmolality high >295
● Isotonic solution 0.9% NaCl
4. What is a hypophysectomy? Post assessment?
● Removal of pituitary gland. May cause DI so assess all the stuff from #3 above. Look out
for all hypothyroid stuff?
SIADH
● Water retention, hyponatremia, and serum hypo-osmolality, urine hyper-osmolality
● Blood volume expands, but the plasma is diluted
● Aldosterone is suppressed
● Renal excretion of sodium increases
● Urinary output decreases and the urine becomes very concentrated
● Brain cells swell, causing irritability, confusion
● Weight gain
● Hyponatremia from increased extracellular fluid and dilution of extracellular (serum) Na
level
● Decreased serum Na <120meq/L.
● Water intoxication
● Patients have LOW serum osmolality and HIGH urine osmolality
Diabetes Insipidus (DI)
● Polydipsia (2-20 liters/d)
● Large volumes of dilute urine
● Low specific gravity of urine 1.001-1.005
● Urine osmolality LOW <200mOsm/kg
