A nurse is caring for an oldest patient.

Exhibits

For each potential provider’s prescription, click to specify if the potential prescription is anticipated or contraindicated for the client.

Choice A reason: A Client Who Has a Small Circular Partial-Thickness Burn of the Left Calf

A small circular partial-thickness burn of the left calf is considered a minor injury in the context of a mass casualty event. This type of injury does not pose an immediate threat to life and can be managed after more critical cases are addressed. In mass casualty triage, patients with minor injuries are often categorized as “green” or “minimal” and are treated last.

Choice B reason: A Client Who Has Severe Respiratory Stridor and a Deviated Trachea

A client with severe respiratory stridor and a deviated trachea should be assessed first. These symptoms indicate a potential airway obstruction, which is a life-threatening condition requiring immediate intervention. In mass casualty triage, patients with compromised airways are given the highest priority and are categorized as “red” or “immediate” because their condition is critical and requires urgent medical attention.

Choice C reason: A Client Who Has a Splinted Open Fracture of the Left Medial Malleolus

A splinted open fracture of the left medial malleolus is a serious injury but not immediately life-threatening if properly splinted. This client would be categorized as “yellow” or “delayed” in mass casualty triage, meaning they require medical attention but can wait until more critical patients are stabilized.

Choice D reason: A Client Who Has a Massive Head Injury and Is Experiencing Seizures

A client with a massive head injury and experiencing seizures is in a critical condition. However, in the context of mass casualty triage, the immediate priority is to secure the airway, breathing, and circulation. While this client is in dire need of medical attention, the presence of severe respiratory stridor and a deviated trachea in another client takes precedence due to the immediate threat to life.

The correct answers are:

Condition:

• a. Pneumothorax
  (After a thoracotomy and chest tube insertion, pneumothorax is a potential complication as air can accumulate in the pleural space, compromising lung expansion.)

Actions:

• b. Administer oxygen as prescribed.
  (To ensure adequate oxygenation while resolving the pneumothorax)
• b. Ensure the chest tube is functioning properly.
  (Ensuring the chest tube is removing air from the pleural space to restore lung expansion)

Parameters to Monitor:

• c. Respiratory rate and effort.
  (To assess the client's respiratory status and detect any changes indicating distress or worsening pneumothorax)
• c. Oxygen saturation levels.
  (To continuously assess oxygenation and detect any hypoxia)

Rationale:

A pneumothorax is more likely post-thoracotomy, especially with a chest tube insertion, as air is a primary concern in the pleural space. Monitoring respiratory parameters like oxygen saturation and respiratory effort helps evaluate the client's respiratory function and chest tube efficacy.