Deck 75: Emergency Preparedness: Bioterrorism and Management of Poisoning

Question 1

As a school nurse, you have been asked to speak to a group of mothers about accidental poisonings in young children.
Outline the information you need to present to this audience.

Answer 1

Accidental poisoning is a condition in which the individual causes harm to their body unknowingly and unwantedly. This condition is mostly seen in young children as they are enthusiastic and try to recognize the things by keeping them into their mouth.
Accidental poisoning in young children may occur due to a number of factors, which includes ingestion of drugs, household cleaning compounds, cosmetic, etc.
The following are the some of the practices that help in prevention of poisoning and to decrease the severity of poisoning.
• Keep all the drugs reach out of children
• Remove the cloths and flush the skin of the cloths, which is contaminated
• Administer the adsorbents such as charcoal to decrease or prevent the absorption,
• Do not administer ipecac syrup
• Make a call to an emergency health care unit or a poison control center
• Try to identify the exact cause of poisoning
• Allow the patient to have fresh air
• Do not induce vomiting by tickling at the back of the throat

Question 2

From what you learned in Chapter 49, name the antibiotic class to which ciprofloxacin belongs and describe its mechanism of bactenocidal action.

Answer 2

Ciprofloxacin belongs to the class of fluoroquinolone antibiotics, which is used in the treatment of different bacterial infections.
Ciprofloxacin is a broad-spectrum bactericidal, which acts by inhibiting the enzyme DNA gyrase (topoisomerase II) and topoisomerase IV. It acts against both gram positive and gram negative bacteria.
The over-winding and under-winding of DNA is regulated by an enzyme called topoisomerases. The different functions of the topoisomerases are accessing DNA, removing DNA super coils, strand breakage during recombination, chromosome condensation, and disentangling interwined DNA.
During DNA replication and transcription, the DNA over winds after the replication fork in the absence of topoisomerases. This prevents the binding of proteins that allow the process to continue. Thus, the premature termination of process occurs.
The premature termination of replication and transcription results in lack of formation of new cells. It also affects the production of proteins that are required to maintain the body. Thus, inhibition of topoisomerase causes cell death in bacterial cells.
Thus, the essential events such as bacterial cell division, gene repair, and recombination are affected by ciprofloxacin.

Question 3

Remember the nurse manager "Carol Boler" at the beginning of the chapter? Now read the remainder of the case study. Based on the information presented within this chapter, respond to the critical thinking questions that follow.

As an emergency department nurse in a busy urban hospital, Carol Boler participates in frequent emergency practice drills to be prepared for mass casualty events and acts of bioterrorism. Although there have been no incidents yet, she knows that with a military base nearby, there is a chance that such an incident could occur. She is working with unit staff to plan a series of staff education meetings to discuss bioterrorism threats.
When discussing the bioterrorism threat with a group of staff nurses, which informatron regarding smallpox should be included?

Answer 3

According to the U.S. Centers for Disease Control and Prevention, the intentional release of biological agents such as bacteria, viruses, or toxins as a terroristic attack where the harmful agents either cause illness or death of people, animals, or plants is called bioterrorism.
Smallpox is an infectious disease, which is caused by two virus variants such as Variola major and Variola minor. It is a highly contagious disease, which may be used as a biological weapon. The contaminated air with few viral droplets can spread the disease. This disease was eradicated in the world in 1970s through vaccination.
So, when discussing about smallpox, the following points need to be considered:
• All the people who do not receive the vaccination will be at risk of developing the infection
• Vaccination is the only possible treatment and prevention option for smallpox
• The vaccine can work for 3 to 5 years
• The smallpox vaccine is contraindicated for the children below the age of 1 year, pregnant women, people with suppressed immune system, and people that are allergic to components of vaccine
• Military persons, health care professionals, and those concerned with the law enforcement must take the vaccination

Question 4

As a school nurse, you have been asked to speak to a group of mothers about accidental poisonings in young children.
What recommendations should you give to the group about the use of ipecac syrup?

Question 5

From what you learned in Chapter 67, describe the therapeutic use of 1-131 in treating thyroid disease.

Question 6

Remember the nurse manager "Carol Boler" at the beginning of the chapter? Now read the remainder of the case study. Based on the information presented within this chapter, respond to the critical thinking questions that follow.

As an emergency department nurse in a busy urban hospital, Carol Boler participates in frequent emergency practice drills to be prepared for mass casualty events and acts of bioterrorism. Although there have been no incidents yet, she knows that with a military base nearby, there is a chance that such an incident could occur. She is working with unit staff to plan a series of staff education meetings to discuss bioterrorism threats.
Identify the nursing assessments and interventions that the nurse should initiate when a patient is exposed to anthrax.

Question 7

From what you learned in Chapter 14, identify the cholinergic antagonist used to treat organophosphate poisoning.

Question 8

Remember the nurse manager "Carol Boler" at the beginning of the chapter? Now read the remainder of the case study. Based on the information presented within this chapter, respond to the critical thinking questions that follow.

As an emergency department nurse in a busy urban hospital, Carol Boler participates in frequent emergency practice drills to be prepared for mass casualty events and acts of bioterrorism. Although there have been no incidents yet, she knows that with a military base nearby, there is a chance that such an incident could occur. She is working with unit staff to plan a series of staff education meetings to discuss bioterrorism threats.
Discuss the mode of transmission and symptoms associated with Y. pestis exposure.