Emergency Nursing Made Incredibly Easy! PDF
Preview Emergency Nursing Made Incredibly Easy!
(c) 2015 Wolters Kluwer. All Rights Reserved. Emergency Nursing m ade Incredibly Easy! Second Edition Clinical Editors Beverly Ann Tscheschlog, , MS RN Amy Jauch, , MSN RN (c) 2015 Wolters Kluwer. All Rights Reserved. 000000ii--vviiiiii__TTsscchheesscchhlloogg__FFMM__ffiinnaall..iinndddd ii 99//2200//1144 44::4422 AAMM Staff This work is provided “as is,” and the publisher disclaims any and all warranties, express or implied, including any warranties as Acquisitions Editor: to accuracy, comprehensiveness, or currency of the content of this work. Shannon W. Magee Product Development Editor: This work is no substitute for individual patient assessment based Maria M. McAvey upon healthcare professionals’ examination of each patient and consideration of, among other things, age, weight, gender, current Senior Marketing Manager: or prior medical conditions, medication history, laboratory data, Mark Wiragh and other factors unique to the patient. The publisher does not provide medical advice or guidance, and this work is merely a Editorial Assistant: reference tool. Healthcare professionals, and not the publisher, Zachary Shapiro are solely responsible for the use of this work including all medi- cal judgments and for any resulting diagnosis and treatments. Production Project Manager: Priscilla Crater Given continuous, rapid advances in medical science and health Design Coordinator: information, independent professional verification of medical diagnoses, indications, appropriate pharmaceutical selections Elaine Kasmer and Joan Wendt and dosages, and treatment options should be made, and health- Manufacturing Coordinator: care professionals should consult a variety of sources. When Kathleen Brown prescribing medication, healthcare professionals are advised to consult the product information sheet (the manufacturer’s Prepress Vendor: package insert) accompanying each drug to verify, among other Absolute Service, Inc. things, conditions of use, warnings, and side effects and identify any changes in dosage schedule or contradictions, particularly 2nd edition if the medication to be administered is new, infrequently used or has a narrow therapeutic range. To the maximum extent permit- Copyright © 2015 Wolters Kluwer Health. ted under applicable law, no responsibility is assumed by the publisher for any injury and/or damage to persons or property, as Copyright © 2007 Lippincott Williams & Wilkins. All rights a matter of products liability, negligence law or otherwise, or from reserved. This book is protected by copyright. No part of this book any reference to or use by any person of this work. may be reproduced or transmitted in any form or by any means, including as photocopies or scanned-in or other electronic copies, LWW.com or utilized by any information storage and retrieval system without written permission from the copyright owner, except for brief quotations embodied in critical articles and reviews. Materials appearing in this book prepared by individuals as part of their official duties as U.S. government employees are not covered by the above-mentioned copyright. To request permission, please Library of Congress Cataloging-in-Publication Data contact Wolters Kluwer Health at Two Commerce Square, 2001 Emergency nursing made incredibly easy! / clinical editors, Market Street, Philadelphia, PA 19103, via email at permissions Beverly Tscheschlog, Amy Jauch. — Second edition. @lww.com, or via our website at lww.com (products and p. ; cm. services). Includes bibliographical references and index. ISBN 978-1-4511-9354-1 (alk. paper) 9 8 7 6 5 4 3 2 1 I. Tscheschlog, Beverly Ann, editor. II. Jauch, Amy, editor. [DNLM: 1. Emergency Nursing—methods—Handbooks. Printed in China 2. Emergency Nursing—methods—Outlines. 3. Emergencies— nursing—Handbooks. 4. Emergencies—nursing—Outlines. 5. Emergency Treatment—nursing—Handbooks. 6. Emergency Treatment—nursing—Outlines. WY 49] RT120.E4 610.73’6—dc23 2014035719 (c) 2015 Wolters Kluwer. All Rights Reserved. 000000ii--vviiiiii__TTsscchheesscchhlloogg__FFMM__ffiinnaall..iinndddd iiii 99//2200//1144 44::4422 AAMM Contributors Julie Briggs, RN, BSN, MHA Sharon L. Lee, APRN, MSN, FNP-C Jane Von Dohre, MSN, RN, CEN RN Care Coordinator Clinical Educator Adjunct Faculty Providence Health Plans Bryan Health Center Kettering College Providence Health & Services Lincoln, NE Dayton, OH Portland, OR Lisa Matamoros, RN-BC, DNP, CEN, CPEN Melissa S. Wafer, RN, MSN, CEN Laura M. Criddle, PhD, RN, CEN, CFRN, FAEN Advanced Educational Specialist Instructor Clinical Nurse Specialist All Children’s Hospital Southeastern Louisiana University The Laurelwood Group St. Petersburg, FL Hammond, LA Scappoose, OR Donna M. Roe, DNP, APRN, BC, CEN Robin Walsh, RN, BSN Laurie Donaghy, BSN, RN, CEN Clinical Magnet Program and Nurse Clinical Nurse Manager Staff Registered Nurse Resource Director University of Massachusetts Temple University Hospital St. Joseph Hospital Amherst, MA Aurora, CO Nashua, NH Mary Jones, DNP, CNM, ENP-BC, FNP-BC Assistant Professor Frontier Nursing University Hyden, KY iii (c) 2015 Wolters Kluwer. All Rights Reserved. 000000ii--vviiiiii__TTsscchheesscchhlloogg__FFMM__ffiinnaall..iinndddd iiiiii 99//2200//1144 44::4422 AAMM Previous edition contributors Cynthia Francis Bechtel, RN, MS, Lisa Kosits, RN, BC, MSN, CCRN, CEN, CNA Donna M. Roe, DNP, APRN, BC, CEN CEN, EMT-1 Charles Kunkle, PHRN, BSN, CCRN, CEN, Mellisa S. Wafer, RN, MSN, CEN Laura M. Criddle, PhD, RN, CEN, CFRN, CNA Robin Walsh, RN, BSN FAEN Sharon L. Lee, APRN, MSN, FNP-C Laurie Donaghy, BSN, RN, CEN Ruthie Robinson, RN, PhD(C), CEN, CCRN, Nancy A. Emma, RN, BSN FAEN iv (c) 2015 Wolters Kluwer. All Rights Reserved. 000000ii--vviiiiii__TTsscchheesscchhlloogg__FFMM__ffiinnaall..iinndddd iivv 99//2200//1144 44::4422 AAMM Foreword The need for emergency nursing to remain incredibly easy continues as we look un- knowingly into the future of health care. Each year adds to the list of new health care challenges and issues. With individual health care management options in flux and still unpredictable, a projected extension of health insurance to 30 million more people in the next 5 years, and tenuous reimbursement for physicians in primary care fields, it’s no wonder that there will be more people turning to emergency departments for their health care than ever before. The 2014 National Report Card on the State of Emergency Medicine from the Amer- ican College of Emergency Physicians (http://www.emreportcard.org/), which evaluates each state’s emergency care systems, emphasizes the integral role that knowledgeable emergency nurses will play in “raising the grade,” both nationally and locally. As such, it’s crucial that emergency nurses ensure they’re providing the best possible care. One key step in emergency nursing is to quickly assess the patient’s chief complaint and act if necessary. Emergency Nursing Made Incredibly Easy, Second Edition will help the nurse hone these vital skills. This book covers the basics of triage, such as the evidence-based triage process, and holistic care issues, such as cultural and pain considerations. Subsequent chapters focus on physiologic systems, covering neurologic, cardiac, respiratory, gastrointestinal, and musculoskeletal emergencies. It also dis- cusses wound care management, genitourinary and gynecologic emergencies, maxil- lofacial and ocular emergencies, shock and multisystem trauma, and environmental emergencies. Emergency Nursing Made Incredibly Easy, Second Edition addresses the challenge of switching into “disaster mode,” providing concise guidelines on mo- bilization and management for nurses facing natural and manmade events that cause mass-casualty incidents. The clear language and illustrations will help readers anticipate and assess certain diagnoses and prevent predictable complications. Recurring topics for each section in- clude how to assess the patient, diagnostic tests that should be done, treatment options, and common disorders for each body system. A Quick quiz at the end of each chapter tests the reader’s knowledge on the information presented. In addition, icons draw your attention to important issues: Ages and stages—highlights age-related changes and how they affect your patient’s health. v (c) 2015 Wolters Kluwer. All Rights Reserved. 000000ii--vviiiiii__TTsscchheesscchhlloogg__FFMM__ffiinnaall..iinndddd vv 99//2200//1144 44::4422 AAMM FOREWORD vi Stay on the ball—focuses on critical areas involving possible dangers, risks, complications, or contraindications. Education edge—offers patient-teaching tips. This book can help practicing emergency department nurses learn more about their current position. It can also help nurses from other departments (or student nurses) build enough confidence to consider joining this extremely worthwhile specialty. I am proud to be able to introduce you to the newest edition of Emergency Nursing Made Incredibly Easy—a wonderful tool that will help you navigate the challenging but re- warding world of emergency nursing. Enjoy! Ann White, MSN, RN, CCNS, CEN, CPEN Clinical Nurse Specialist Emergency Services Department of Advanced Clinical Practice Duke University Health System Clinical Associate Faculty Duke University School of Nursing Durham, NC vi (c) 2015 Wolters Kluwer. All Rights Reserved. 000000ii--vviiiiii__TTsscchheesscchhlloogg__FFMM__ffiinnaall..iinndddd vvii 99//2200//1144 44::4422 AAMM Contents 1 Emergency department basics 1 Jane Von Dohre, MSN, RN, CEN 2 Holistic care 28 Jane Von Dohre, MSN, RN, CEN 3 Neurologic emergencies 44 Laura M. Criddle, PHD, RN, CEN, CFRN, FAEN 4 Cardiac emergencies 97 Donna M. Roe, DNP, APRN, BC, CEN 5 Respiratory emergencies 197 Robin Walsh, RN, BSN 6 Gastrointestinal emergencies 262 Laurie Donaghy, BSN, RN, CEN 7 Musculoskeletal emergencies and wound management 304 Lisa Matamoros, RN-BC, DNP, CEN, CPEN 8 Genitourinary and gynecologic emergencies 348 Sharon L. Lee, APRN, MSN, FNP-C 9 Maxillofacial and ocular emergencies 397 Mary Jones, DNP, CNM, ENP-BC, FNP-BC 10 Environmental emergencies 437 Julie Briggs, RN, BSN, MHA 11 Shock and multisystem trauma emergencies 472 Melissa S. Wafer, RN, MSN, CEN vii (c) 2015 Wolters Kluwer. All Rights Reserved. 000000ii--vviiiiii__TTsscchheesscchhlloogg__FFMM__ffiinnaall..iinndddd vviiii 99//2200//1144 44::4422 AAMM CONTENTS viii Appendices and index Emergency delivery 511 Recording the Apgar score 514 Sharon L. Lee, APRN, MSN, FNP-C, and Lisa Matamoros, RN-BC, DNP, CEN,CPEN Glossary 515 Index 519 viii (c) 2015 Wolters Kluwer. All Rights Reserved. 000000ii--vviiiiii__TTsscchheesscchhlloogg__FFMM__ffiinnaall..iinndddd vviiiiii 99//2200//1144 44::4422 AAMM 1 Emergency department basics Just the facts In this chapter, you’ll learn: ♦ roles and responsibilities of an emergency nurse ♦ credentials for emergency nurses ♦ ways to work with a multidisciplinary team ♦ ways to incorporate clinical tools and best practices into your care. What is emergency nursing? Emergency nursing is the delivery of specialized care to a va- Emergency riety of ill or injured patients. Such patients may be unstable, complaints come have complex needs, and require intensive and vigilant nurs- in all makes and ing care. Others may have minor problems. No matter the models. This reason for coming to the emergency department (ED), all chapter will tune patients feel that their problems are emergencies. up your ED Common illnesses and injuries seen in patients in EDs expertise! include: (cid:129) orthopedic injuries, including fractures, strains, and sprains (cid:129) traumatic injuries from such events as car collisions and falls (cid:129) cardiovascular disorders, such as heart failure and acute coro- nary syndromes (unstable angina and myocardial infarction [MI]) (cid:129) respiratory disorders, such as acute respiratory failure, pulmo- nary embolism, and asthma (cid:129) gastrointestinal (GI) and hepatic disorders, such as acute pan- creatitis, GI bleeding, acute liver failure, acute cholecystitis, and bowel obstructions (cid:129) renal disorders, such as acute and chronic renal failure, kidney stones, and urinary tract infections (cid:129) shock due to hypovolemia, sepsis, cardiac dysfunction, acute spinal cord injury, and anaphylaxis (cid:129) metabolic disorders, such as diabetic ketoacidosis (c) 2015 Wolters Kluwer. All Rights Reserved. 000011--002277__TTsscchheesscchhlloogg__CCHH0011__ffiinnaall..iinndddd 11 99//1199//1144 44::5500 AAMM
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