Exam 3 (Final) OF Notes PDF

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! PTSD! ! When talking about PTSD, major depressive disorder (MDD) is a common occurrence; they go hand in hand ! ! When taking care of a PTSD patients, if they express survivor's guilt or death, this could be a red flag for suicidal ideation. "It should have been me"! ! When a patient has gone through a traumatic event, when should the nurse screen them for PTSD?! • It should be an ongoing process! ! Another issue related with PTSD is avoidance! ! Caregiver role strain - address it if caregiver expresses exhaustion! ! STRESS & COPING! ! What are some nursing diagnoses for stress and coping?! • Ineffective coping! ! Know steps of nursing process! • ADPIE! ! When someone is shy and has poor social skills! • They could be suffering from social isolation! ! A diagnosis for someone who refuses talk or make eye contact with you! • Impaired communication! ! When speaking to a patient in crisis, the best way to communicate with the patient?! • short, specific sentences! ! If a patient is going through a crisis, ask if they plan on harming themselves! ! If a patient makes statements such as "I give up" or "I can't take it," the nurse would:! • Clarify the statement! ! Patients may talk about previous crises in the past. However, the most important issue is the most recent event on hand! ! It is important to find out how patients handled crises in the past! ! A crisis represents a struggle for balance when problems seem unsolvable; therefore, all patients in crisis experience disequilibrium ! ! With a patient in crisis, you as the nurse should ask the patient about their support system! ! Know statements that indicate a patient is expressing powerlessness! • "How am I supposed to..."! • "I can't ... ! ! ABUSE! ! As a nurse, it is common to have sympathy for the victim and anger towards the abuser; you must keep those feelings in check! ! When dealing with a patient who has gone through violence, you need to keep your feelings in check because it could affect your assessment and judgement of the patient!

! Know some signs of partner violence! • Ex) victim's significant other doesn't let the victim speak! ! Know role of occupational therapist vs physical therapist vs nurse! • A nurse can deal with psychological effects of violence! • OT treats entire body to improve ADLs! • PT treats specific areas to improve body movement! ! Abuse isn't just about physical injury; neglect is a physical form of abuse! ! Regarding the elderly, the role of the nurse is to secure resources for patients and caregivers! ! As a nurse, you should help a patient separate vulnerability from blame! ! Reflective communication techniques are helpful! ! Before a a rape victim is discharged, make sure they agree to seek counseling! • The nurse should also give referral information both verbally and in writing! • The nurse will also educate these patients on what reactions may occur! ! Most therapeutic interventions for victims of assault would be to use unconditional ! • Unconditional acceptance! • Nurturing! • Empathy! ! Never let rape victims wash off before investigation because they would destroy the evidence! ! Rape trauma syndrome - know the phases (p. 438)! • Acute, chronic, and integration phase! ! Priority for rape victims is to make them feel safe! ! Know problem-based strategies VS emotion-based strategies! • For victims of violence: problem-focused strategies are used to find solutions!

! ! Bioterrorism! • NIMS agency notified in the event of a terrorist attack! ! What can management do to prevent stress amongst staff during mass casualty events ! • Water and snacks! ! During a mass casualty event, the charge nurse is responsible for directing staff! ! Therapeutic communication includes active listening and honesty! ! What is the point of the black tag?! • So you don't exhaust resources on them! ! What is the medical reserve core?! • Built up of volunteers and health care professionals that help the community during times of need! ! National Guard provides search and rescue operations and lawn enforcement! ! DMAT - deploys to disastrous areas with enough supplies to last up to 72 hours; they are considered agents of the federal government; they have licensure in all 50 states

! Health department: tracks, treats and prevents communicable diseases ! ! Incident Command Center! • "Stand down" means that management needs to ensure that enough staff and supplies are available! ! Debriefing is a critical process that must occur after a traumatic event or disaster! ! If a person is suspected of sepsis, obtain cultures first! ! Know the signs and symptoms of small pox! • Rash on face, palm soles of of feet! • Airborne precautions! ! Tell family that it's okay to visit the patient, but they need to put proper PPE! ! When a patient is on isolation precautions and is being transferred, ensure the receiving department is aware of it! ! Anthrax isn't just a bioterrorist agent; you can also get it from animal wool, bone meal, Hydes, and skin! ! Know the signs of sepsis! • Fever! • Increased wbc ! • Decreased blood pressure! • Increased HR! ! What kind of precautions do anthrax patients receive?! • Standard! ! Tx for inhalation anthrax ! • Amoxicillin! • Ciprofloxacin! • Doxycycline! ! How is infection transmitted?! • Portal of entry, a host, reservoir! ! Phrases of PTSD! • Acute phase, reorganization phase! • Develop phobia, numbness, flashbacks! ! Neutral-nonjudgmental care and emotional support are critical in crisis management! ! What are forensic nurses in charge of doing?! • Rape kits, collect and preserving evidence, take photographs, examinations, a variety of tests! ! During a mass casualty event, you would transfer non-critical patients out of the hospital! • Who you can discharge: 3-day post op patients, ! • Cannot transfer: chest pain, infection! ! Question will be like "which ones are matched correctly?"! Hospital Incident Commander: leads the emergency plan! Triage officer: evaluates patients and prioritizes treatment! Paramedics: provides advance life support! Public information officer: liaison between hospital and media! Medical command physician: decides number and acuity and resources needed by the patients! !...