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Unfolding Case Study

1.
a. Older adults are more likely to have chronic conditions or mobility, sensory, cognitive, social, and economic limitations that can hinder their response to disaster and negatively affect their health (Humanitarian Global, 2021).
2.
b. Educational classes on family safety planning and other educational interventions prior to hurricane season can assist families in preventing injury and minimizing the impact of the disaster.
3.
c. The verification that the scene is safe prior to first responders providing care prevents secondary incidents and subsequent injuries (Alpert & Kohn, 2023).
4.
b. The nurse working in a disaster shelter should expect to monitor physical and mental health of victims. Stress is common for all victims of a disaster due to displacement from homes, loss of possessions, loss of employment, fear of the future, and living closely with strangers. Signs of stress include headache, nausea, worry, fatigue, insomnia, irritability, nervousness, fear, and racing thoughts.

Review Questions

1.
b. Mitigation is an action that reduces the severity of a disaster, such as stacking sandbags along a river’s edge to prevent flooding.
2.
d. The START algorithm places this victim in the red category, in need of immediate care. The victim in the red category can be helped by immediate intervention and transport, requires medical attention within minutes for survival (up to 60 minutes), and has a compromised airway, breathing, or circulation. This client with tachypnea (rapid respiratory rate) and a flail chest has breathing difficulties that require immediate intervention.
3.
d. During the Sort stage of the Sort, Assess, Life-saving Interventions, and Triage/treatment (SALT), the nurse asks the victims at the scene to walk to a designated casualty collection area if possible and wave an arm or leg if they need help. Those who cannot move or follow commands are assessed first.
4.
c. During step 3, vulnerability assessment, the nurse determines the probability that the community will be negatively affected by a hazard. This includes an estimation of damages and the community’s capacity to reverse or combat those damages.
5.
b. A Category A biological agent is highly transmissible, easy to disperse, and associated with high mortality rates.
6.
a. The Logistics Section Chief provides resources and services to support an incident, such as facilities, transportation, communications, supplies, equipment maintenance, food services for responders, and medical services for responders. Providing boats to rescue survivors from flooded waters would fall under the duties of the Logistics Section Chief.
7.
d. JumpSTART is a modification to the START system to assess and triage pediatric victims up to 8 years old. This method considers the difference in normal respiratory rates for children up to 8 years old. Respirations of more than 15 and less than 45 breaths/minute are considered normal. Since this child’s respiratory rate is 14 breaths/minute, it is abnormal, and the child should be given a red tag indicating they require immediate attention.
8.
a. In primary prevention for bioterrorism preparedness and response, the community health nurse engages in disease surveillance and preparation. Creating, updating, and implementing a disaster plan and participating in tabletop exercises and disaster simulations are strategies the community health nurse can take to mitigate injury and mortality from biological attacks.
9.
b. Warning signs of potential school violence include having behavioral problems or difficulty connecting with others, being noncommunicative, having aggressive or violent verbalizations, being withdrawn, harming self or others, and being emotionally labile.
10.
c. Nursing assessment and intervention during the recovery stage include monitoring and screening for communicable and infectious diseases, educating on water and food safety, educating on clean-up and disposal of debris and deceased livestock/animals, eliminating safety risks, and screening and treatment for mental health issues.
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