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Common Emergencies (ETOH, carbon monoxide, HIPAA, EMTALA, Consent) Flashcards | StudBud
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Common Emergencies (ETOH, carbon monoxide, HIPAA, EMTALA, Consent)
Common Emergencies (ETOH, carbon monoxide, HIPAA, EMTALA, Consent)
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1
thiamine is needed to convert _________ in brain.
sodium
glucose
calcium
potassium
2
HIPAA:
does not allow for fake names or alias names
protects patient insurance information and address only
protects all patient info (may limit gifts, visitors)
3
delirium tremens can increase the risk of ________, seizure, & arrhythmias.
hypervolemia
blood loss
stroke
death
4
precautions for carbon monoxide poisoning:
fall & seizure
contact, fall, seizure
fall only
seizure only
5
A patient is in a psych hold. Consent is necessary/implied to
allow pt to leave AMA when feeling better
prevent danger to self/others & cannot leave facility
prevent danger to self and others but can leave once calm
hold the patient until police arrive
6
A patient intoxicated usually will receive what type of imaging?
MRI head
MRI spine
CT spine
CT head
7
lithium, __________, & haloperidol are medications for delirium tremens management.
atropine
clonadine
amiodarone
dextrose
8
A patient arrives at ED with headache, confusion, dyspnea, N/V. What % is the carboxyhemoglobin likely to be?
15-30%
40-80%
15-20%
10-20%
9
If a patient has high risk use of alcohol intoxication, SBIRT would include:
referral to tx
brief intervention
10
delirium tremens can occur ______ -_______hrs after last drink.
24-72 (autonomic overactivity/hallucinations)
48-96 (autonomic overactivity/hallucinations)
11
alcohol intoxication risks include:
falls, hypoxia, death
falls, aspiration, respiratory depression
bleeding/hemorrhage, hypoxia, tremors
12
alcohol can cause:
hypoglycemia
hypernatremia
13
carboxyhemoglobin % with symptoms of lethargy, confusion, tachypnea, & chest pain?
30-40%
20-40%
greater than 80%
20-30%
14
what conditions can mimic intoxication?
hyperthyroidism & hypothyroidism
hyperkalemia & hypokalemia
hypoglycemia & hyperglycemia
15
carboxyhemoglobin % of a patient with seizures, EKG changes and coma?
60-70%
40-50%
30-40%
40-60%
16
EMTALA Act: a patient must.....
must have a chief complaint or problem of focus
be screened & not turned away
must be unstable
17
consent: non-emergent pediatrics
contact case management for consent verification
contact parents/guardian (only need 1 RN to talk)
contact parents/guardian (2 RNs must talk to parents)
18
carbon monoxide poisoning serial readings until:
less than 2-5%
less than 10-15%
less than 1.5%
less than 5-10%
19
____________ & __________ are usually low in alcoholics.
sodium & calcium
fat & carbohydrates
potassium & magnesium
20
HIPAA: a celebrity arrives at ED. What can the hospital implement for protecting information?
call the police for backup
release information after shift to tik tok, instagram, & X
not allow any press or media into the hospital
fake name/alias for protection
21
EMTALA Act:
prior to transfer: handoff report, may be unstable, implied consent always
prior to transfer: must stabilize, have bed, physician, RN handoff, consent
allows pt to leave AMA
can d/c pt at anytime
22
A patient has carbon monoxide poisoning. The pt is A&O x4. What can be implemented to improve pt oxygen?
room air & monitoring oxygen sat
deep breathing & 100% oxygen
breathing into paper bag & 100% oxygen
ambulation & A/C vent monitoring
23
carbon monoxide poisoning: low level of circulation oxygen due to
non-binding carbon monoxide to hemoglobin
binding carbon monoxide to hydrogen
non-binding carbon monoxide to hydrogen
binding carbon monoxide to hemoglobin
24
normal level of carboxyhemoglobin % is less than
5%
2%
1.5%
3%
25
A patient is unconscious & requires an invasive procedure. What is documented for the consent?
the state the patient is in
the nurse signs the consent for the patient
nothing is documented & nothing can be done until awake
26
A patient with alcohol withdrawal may be placed on a _______ _______ diet.
high protein
low protein
low sodium
high carbohydrate
27
Consent: informed consent includes:
invasive procedures, peds, vulnerable, psych hold, unconscious
invasive procedures, unconscious, emancipated
28
oxygen can be discontinued if carbox. hemoglobin level is below
4%
10%
8%
5%
29
A patient arrives at the ED with potential carbon monoxide poisoning. The charge nurse intervenes if she notices:
a student nurse documents multiple skin discoloration as reliable findings
a student nurse is using symptoms of N/V and confusion as reliable findings
a student nurse documents the hallmark sign of s/s intoxication
30
What would urine look like in a chronic alcoholic with liver involvement
clear & textured
dark & foamy
blood in urine
31
alcohol intoxication management:
thiamine, folic acid, IVF, antiemetics
thiamine, vitamin D, antipyretics
IVF, vitamin A, vitamin B1 thiamine, antipyretics
32
a patient with a carboxyhemoglobin level that is at 10% will likely be:
symptomatic
N/V and HA
mild headache
asymptomatic
33
EMTALA Act implements:
a patient can have physical exam performed by nurse then d/c
once pt on hospital property, must be seen by physician within cetain time
once pt on hospital property, pt can be discharged without being seen
34
alcohol withdrawal manifestations:
insomnia, N/V, anxiety, restless, irritable, tremors
fatigue, tremors, confusion, N/V
weakness, insomnia, diarrhea, oliguria
35
consent: pediatrics: in an emergency
treat immediately
must call case management if parents cannot be reached to sign consent
not allowed to treat until consent is signed
36
A patient arrives with alcohol withdrawal, which type of medication can be given to prevent potential for seizure?
antiseizure like Keppra
fluids including NS
benzodiazepine like ativan/diazepam
37
A student nurse documents a patient with high oxygen sat with carbon monoxide poisoning. Why would this be concerning?
not concerning; it is a normal finding with carbon monox. poisoning
can be a false-high reading
should never take oxygen sat reading with carbon monox. poisoning
38
chronic alcohol intoxication can cause:
brain damage due to low level of thiamine (B1)
brain damage due to low vitamin D
brain damage due to low B12
brain damage due to hemorrhaging
39
"hallmark sign" of carboxyhemoglobin/carbon monoxide poisoning:
drooling
chorea
intoxication
asymptomatic
40
One exception to EMTALA Act includes: diversion BIBA to go to other facility.
true
false
41
alcohol withdrawal vitals:
high/increased
low/decreased
42
A pt in delirium tremens can be given librium.
true (given IV)
false (PO only, used later as a taper)
43
A patient with a carboxyhemoglobin % greater than 60% likely will cause:
death
coma
ventilation support
may be asymptomatic
44
delirium tremens:
increase of HR & BP, hyperthermia, hallucinations
increase of BP, hypothermia
decrease of HR & RR, hypothermia, hallucinations
45
Pt w/ carbon monox poisoning receiving oxygen, on cardiac monitor,&assessed for brain damage. What should be at bedside?
glucose
CPR equipment & ambu bag
lidocaine vial & ambu bag
