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Disaster Considerations - DISASTER CONSIDERATIONS Physical...

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DISASTER CONSIDERATIONS Physical effects of a catastrophic event can vary depending on the type of disaster. For example, explosive devices, transportation accidents, hurricanes, or floods might result in burns and crush injuries, release of chemical agents, or use of biological weapons/reemerging infections (e.g., pandemic influenza) causing mass infections that may result in various physical problems depending on the agent involved. Disaster events can exacerbate any chronic condition, such as heart or lung problems, and/or precipitate emergent conditions such as premature births, seizures, and psychiatric conditions, panic disorders, and suicidal thoughts. Following any disaster, those involved, victims, rescuers, and the surrounding community, suffer from a variety of responses. The bigger the disaster/catastrophe, the greater the number of people involved and the wider the effect. With the playing and replaying of the events, the effects can be magnified and people far removed from the scene may also suffer. CARE SETTING Wherever disaster occurs, to include triage areas, aid stations, hospital/emergency centers, shelters. RELATED CONCERNS Burns: thermal/chemical/electrical Craniocerebral trauma Fractures Pneumonia, microbial Sepsis/septicemia Psychosocial aspects of care Patient Assessment Database Data depend on specific injuries incurred/presence of chronic conditions (refer to specific plans of care for data reflecting burns, multiple trauma, cardiac and respiratory conditions, etc.) ACTIVITY/REST May report: Sleep disturbances, recurrent intrusive dreams of the event, nightmares, difficulty in falling or staying asleep; hypersomnia (intrusive thoughts, flashbacks) Fatigue, listlessness CIRCULATION May report: Palpitations or tachycardia Sweating, hot flashes, or chills May exhibit: Cold clammy hands Increased blood pressure (anxiety), decreased blood pressure (dehydration/hypovolemia) EGO INTREGRITY May report: Excessive worry about events, avoidance of circumstances/locations associated with incident Sense of inner turmoil Dry mouth, upset stomach, lump in throat Threat to physical integrity or self-concept Questioning of God’s purpose/abandonment May exhibit: Facial expression in keeping with level of anxiety (furrowed brow, strained face, eyelid twitch) ELIMINATION May report: Frequent urination; diarrhea FOOD/FLUID
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May report: Lack of interest in food; dysfunctional eating pattern Nausea, vomiting NEUROSENSORY May report: Anticipation of misfortune to self or others, feeling stuck Absence of other mental disorder May exhibit: Motor tension; shakiness, jitteriness, trembling, easily startled Apprehensive expectation; rumination Excessive vigilance/hyperattentiveness; distractibility, difficulty concentrating, irritability, impatience, psychic numbing PAIN/DISCOMFORT May report: Muscle aches, headaches, chest pain (in addition to pain related to physical injuries/conditions) RESPIRATORY May report: Shortness of breath, smothering sensation May exhibit: Increased respiratory rate SEXUALITY May report: Decreased libido
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