NR 574 FINAL EXAM CONTENT. WEEK 4 HYPOTHERMIA, BURNS & NEAR DROWNING QUESTIONS WITH CORRECT VERIFIED ANSWERS | 100% PASS (A+ CERTIFIED)

NR 574 FINAL EXAM CONTENT. WEEK 4 HYPOTHERMIA, BURNS & NEAR DROWNING QUESTIONS WITH CORRECT VERIFIED ANSWERS | 100% PASS (A+ CERTIFIED) 1. indicators for poor prognosis following near drowning situation Correct Answer Submersion or resuscitation lasting more than 25 minutes, apnea, pH 7.41, and Glasgow coma scale (GCS) 5 are poor prognostic signs. 2. clinical findings of near drowning patient Correct Answer panic and agitation lethargy, stupor, or coma hypothermia hypotension cyanosis pulmonary edema bradycardia or tachycardia arrhythmia cardiac arrest secondary traumatic injuries (paresthesia, paralysis, extremity deformity, etc.) 3. Management near drowning and post drowning Correct Answer intubation/supplemental 02 -remove all wet clothes -fluid and electrolyte replacement as needed w/ serial BMP -NG/OG for gastric decompression (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 hours ago after a near-drowning incident. EMS reports that she fell into a swimming pool at a party and was unable to swim. It was reported that a family member rescued her from underwater after she had been submerged for approximately 2 minutes. She arrived with oxygen at 5 Liters (L) via nasal cannula. Now, Guiselle reports shortness of breath and anxiousness. She has difficulty talking in complete sentences. Vital signs are: Blood pressure 122/72; Heart rate 122; Respiratory rate 32; Oxygen saturation 88% on 5 L oxygen. What is the most likely underlying cause of Guiselle's distress? a. Viral pneumonia b. Bacterial pneumonia c. Pulmonary embolism d. Adult respiratory distress syndrome (ARDS) Correct Answer d. Adult respiratory distress syndrome (ARDS) Rationale: Although Guiselle is at risk for bacterial pneumonia due to near-drowning, the onset of her distress was too quick to be caused by bacterial pneumonia. Her shortness of breath and anxiousness are most likely caused by direct irritation of the lung parenchyma that leads to ARDS. ARDS is characterized by sudden non-cardiogenic pulmonary edema, hypoxia, and respiratory failure. 5. LaVelle was brought to the emergency department by EMS. He arrived on a backboard with a cervical collar in place. LaVelle was found submerged in a pool by a family member; the circumstances surrounding the event are unknown. The family reports that LaVelle is a good swimmer and often swims in the home pool alone. You note that his breaths are shallow and slow. He is minimally conscious and does not answer questions or follow commands. Pupils are 2 mm and slow to react. Vital signs are Blood pressure 98/42; Heart rate 138; Respiratory rate 10; Oxygen saturation 88 on 100% non-rebreather mask. What is the AGACNP's most appropriate action for LaVelle? a. Intubation and mechanical ventilation b. Head CT c. 1 L fluid bolus of normal saline (NS) d. Cervical spine x-rays Correct Answer a. Intubation and mechanical ventilation Rationale: LaVelle is unable to protect his airway. He is lethargic, in shock, and hypoxic. He requires emergent intubation to protect his airway. Without airway support, total respiratory collapse may occur, which may lead to cardiopulmonary arrest. ABCs are always the priority. 6. risk factors for drowning Correct Answer summer months access to water children lower socioeconomic status ethnic minority rural population