NR 341 Week 5 Nursing Care: Trauma and Emergency

Student Name

Chamberlain University

NR-341 Complex Adult Health

Prof. Name:

Date

Nursing Care for Trauma: Key Considerations

Comprehensive Assessment and Management

Nursing care for trauma patients, especially in emergency settings, requires detailed assessment and prompt interventions. For a homeless client presenting with hypothermia and a core body temperature of 87ºF (30.5ºC), a thorough evaluation should anticipate findings such as bradypnea, lethargy, absent patellar reflex, dilated pupils, shivering, hypertension, elevated hematocrit levels, Kussmaul respirations, and tachycardia. Submersion injuries, predominantly seen in children, are critical considerations. They result in hypoxia and fluid imbalances due to water aspiration. Freshwater exposure can cause pulmonary edema through alveolar absorption, while saltwater leads to fluid withdrawal from the circulatory system, impairing gas exchange and causing hypoxia.

Interventions focus on oxygen supplementation, monitoring for respiratory distress, and correcting fluid imbalances. For hypothermic patients, rewarming strategies and shock prevention are essential. Trauma care also includes addressing penetrating injuries, which often involve gunshot or stab wounds. Stabilization, cervical spine immobilization, and IV access are critical for managing such injuries.

Emergency Preparedness and Triage

Emergencies, whether internal (e.g., power outages) or external (e.g., chemical or radiological events), necessitate efficient triage. The Simple Triage and Rapid Treatment (START) system categorizes injuries by severity, assigning color tags to prioritize care. For instance, a patient with shallow breathing and a weak pulse receives a red tag, indicating immediate attention. Patients admitted with traumatic injuries should be closely monitored for vital signs, and interventions should include removing wet clothing, conducting laboratory tests, and initiating ECG monitoring.

Trauma Types and Resuscitation

Trauma types include penetrating injuries, compartment syndrome, and rhabdomyolysis. Effective resuscitation involves achieving hemodynamic stability, maintaining a pH between 7.35 and 7.45, and ensuring normal hemoglobin levels. Pain management and stabilization of vital signs are also crucial.

Table: Nursing Care Considerations

Assessment Area	Assessment Findings	Interventions
Hypothermia Symptoms	Bradypnea, lethargy, absent reflexes, dilated pupils	Monitor vitals, initiate warming measures, assess for shock
Submersion Injuries	Hypoxia, fluid imbalances, cerebral injury	Administer oxygen, monitor respiratory distress, correct fluid imbalances
Trauma Assessment	Penetrating wounds, neurological deficits	Stabilize spine, manage bleeding, establish IV access
Emergency Triage	Life-threatening, urgent, minor injuries	Use START method for triage; prioritize interventions based on severity
Resuscitation Indicators	Stable vitals, normal pH, adequate hemoglobin	Monitor labs, manage pain, ensure fluid resuscitation and electrolyte balance

References

American Heart Association. (2022). Advanced cardiovascular life support (ACLS) provider manual.

Chamberlain, R. S., & Sarin, E. (2023). Principles of trauma management.

Harris, J. D., & Miller, D. J. (2021). Management of traumatic brain injury. Journal of Neurotrauma, 38(7), 1012–1024.