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Chapter 32: Principles of Disaster Management

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Chapter 32: Principles of Disaster Management

14 problems · 0 figures

Case Study 32.4.1 §32.4 source ↗

Read the scenario, and then answer the questions that follow.

Juanita, a public health nurse on the Florida Coast, is a member of the disaster management team. In anticipation of the approaching hurricane season, Juanita reviews disaster prevention and mitigation plans for the community. She assesses the community for the most vulnerable individuals (those with physical and mental disabilities) and maps their locations. She also plans nursing interventions to mitigate the effects of the hurricane.

Juanita meets with the multiagency, interprofessional team during a tabletop exercise on hurricane disasters. She shares the location of the most vulnerable individuals in the community because they may require well-being checks or evaluation during power and phone outages. She provides input from a nursing perspective on potential sheltering locations, shelter resource needs, and the triage and transport process. Juanita suggests including surrounding communities in the hurricane disaster plan to prepare for increased population and health needs in their communities due population displacement before and following hurricane landfall.

What is another vulnerable population that may require well-being checks during emergency events and disasters?
  1. a.
    Older adults
  2. b.
    Single parents
  3. c.
    Persons with substance-use disorder
  4. d.
    Young adults

Answer

A. Older adults
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).

Case Study 32.4.2 §32.4 source ↗

Read the scenario, and then answer the questions that follow.

Juanita, a public health nurse on the Florida Coast, is a member of the disaster management team. In anticipation of the approaching hurricane season, Juanita reviews disaster prevention and mitigation plans for the community. She assesses the community for the most vulnerable individuals (those with physical and mental disabilities) and maps their locations. She also plans nursing interventions to mitigate the effects of the hurricane.

Juanita meets with the multiagency, interprofessional team during a tabletop exercise on hurricane disasters. She shares the location of the most vulnerable individuals in the community because they may require well-being checks or evaluation during power and phone outages. She provides input from a nursing perspective on potential sheltering locations, shelter resource needs, and the triage and transport process. Juanita suggests including surrounding communities in the hurricane disaster plan to prepare for increased population and health needs in their communities due population displacement before and following hurricane landfall.

Which nursing intervention would be appropriate to mitigate the effects of a hurricane disaster?
  1. a.
    Conduct a simulation to practice triage in mass casualty situations.
  2. b.
    Teach classes on family safety planning prior to hurricane season.
  3. c.
    Draw a shelter blueprint to prepare for mass food, water, and health needs.
  4. d.
    Lead a tabletop exercise on hurricanes with health department staff.

Answer

B. Teach classes on family safety planning prior to hurricane season.
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.

Case Study 32.5.3 §32.5 source ↗

Read the scenario, and then answer the questions that follow based on all the case information provided in the chapter thus far. This case study is a follow-up to Case Study Part A.

A major hurricane makes landfall in Juanita’s community, causing widespread damage, loss of electricity, flooding, and mass injury. The community activates the hurricane disaster plan and mobilizes the emergency response team. Juanita is dispatched with the first wave of emergency responders to assist in client triage on-scene. She tags victims using the START method for adults and JumpSTART for children and provides lifesaving interventions to red-tagged victims prior to moving them for transport.

The following day Juanita works at a shelter receiving community members displaced from their homes. She finishes set-up of the temporary health center, organizes and tracks supplies, assesses community members as they enter the shelter, and provides interventions to prevent communicable disease such as setting up handwashing stations, monitoring for signs of infection, and providing clean clothing, food, and water.

What action should Juanita complete prior to on-scene triage?
  1. a.
    Confirm victim transport has arrived
  2. b.
    Activate the Incident Command center
  3. c.
    Ensure the scene is safe
  4. d.
    Provide report to the emergency room

Answer

C. Ensure the scene is safe
The verification that the scene is safe prior to first responders providing care prevents secondary incidents and subsequent injuries (Alpert & Kohn, 2023).

Case Study 32.5.4 §32.5 source ↗

Read the scenario, and then answer the questions that follow based on all the case information provided in the chapter thus far. This case study is a follow-up to Case Study Part A.

A major hurricane makes landfall in Juanita’s community, causing widespread damage, loss of electricity, flooding, and mass injury. The community activates the hurricane disaster plan and mobilizes the emergency response team. Juanita is dispatched with the first wave of emergency responders to assist in client triage on-scene. She tags victims using the START method for adults and JumpSTART for children and provides lifesaving interventions to red-tagged victims prior to moving them for transport.

The following day Juanita works at a shelter receiving community members displaced from their homes. She finishes set-up of the temporary health center, organizes and tracks supplies, assesses community members as they enter the shelter, and provides interventions to prevent communicable disease such as setting up handwashing stations, monitoring for signs of infection, and providing clean clothing, food, and water.

What finding will Juanita expect when assessing community members entering the shelter?
  1. a.
    Malnutrition
  2. b.
    Stress
  3. c.
    Communicable disease
  4. d.
    Confusion

Answer

B. Stress
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.

32-1 §32.RQ source ↗

Which action would the nurse perform while engaged in the mitigation phase of disaster management?
  1. a.
    Simulating the planned response to a hurricane event
  2. b.
    Placing sandbags at a river’s edge prior to flooding
  3. c.
    Preparing a local school for temporary housing for flood victims
  4. d.
    Completing a tabletop exercise to plan for flooding

Answer

B. Placing sandbags at a river’s edge prior to flooding
Mitigation is an action that reduces the severity of a disaster, such as stacking sandbags along a river’s edge to prevent flooding.

32-2 §32.RQ source ↗

Using the START triage system, which victim would the nurse triage as immediate or red during a disaster response?
  1. a.
    A victim who is not breathing after two attempts to open the airway
  2. b.
    A victim who has a broken arm and can obey commands
  3. c.
    A victim who has multiple lacerations on extremities and chest
  4. d.
    A victim who has a respiratory rate greater than 30 beats/minute with flail chest

Answer

D. A victim who has a respiratory rate greater than 30 beats/minute with flail chest
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.

32-3 §32.RQ source ↗

The nurse is assessing the victims of a train derailment using the Sort, Assess, Life-saving Interventions, and Triage/treatment (SALT) system. Which action will the nurse take during the Sort phase of this triage system?
  1. a.
    Moving victims who cannot walk to a staging area
  2. b.
    Placing color-coded triage tags on victims
  3. c.
    Opening the airway of victims who are not breathing
  4. d.
    Asking victims to walk to a staging area

Answer

D. Asking victims to walk to a staging area
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.

32-4 §32.RQ source ↗

Using the six steps of disaster risk assessment to determine a community’s hazard risk, which question would the nurse ask during step 3, vulnerability assessment?
  1. a.
    Is the hazard risk high, moderate, or low?
  2. b.
    Is the risk of disaster seasonal?
  3. c.
    What are the estimated damages that would occur with the hazard?
  4. d.
    What road might be impacted during the hazard?

Answer

C. What are the estimated damages that would occur with the hazard?
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.

32-5 §32.RQ source ↗

Which characteristic of a Category A biological agent will guide the nurse’s actions during an outbreak?
  1. a.
    They have low mortality rates.
  2. b.
    They are highly transmissible.
  3. c.
    They are not a threat to the community.
  4. d.
    They are difficult to disperse.

Answer

B. They are highly transmissible.
A Category A biological agent is highly transmissible, easy to disperse, and associated with high mortality rates.

32-6 §32.RQ source ↗

Which action would the nurse perform as Logistics Section Chief following the activation of the Incident Command System after a hurricane?
  1. a.
    Provide boats for rescue from flooded areas
  2. b.
    Set objectives for hurricane response
  3. c.
    Create press releases regarding hurricane safety
  4. d.
    Conduct missing persons investigations

Answer

A. Provide boats for rescue from flooded areas
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.

32-7 §32.RQ source ↗

The nurse is assessing a 6-year-old child at the scene of a school bus accident and notes that the child has a respiratory rate of 14 breaths/minute. Which color triage tag will the nurse assign to the child using the JumpSTART triage system?
  1. a.
    Black
  2. b.
    Green
  3. c.
    Yellow
  4. d.
    Red

Answer

D. Red
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.

32-8 §32.RQ source ↗

Which action will the community health nurse take during the primary prevention stage of bioterrorism preparedness?
  1. a.
    Participating in disaster simulations
  2. b.
    Recognizing signs and symptoms of a bioterrorist attack
  3. c.
    Immediately treating disease caused by a biologic agent
  4. d.
    Responding to the psychological aftermath of the bioterrorism event

Answer

A. Participating in disaster simulations
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.

32-9 §32.RQ source ↗

A community health nurse conducting a class for high school parents and teachers on mass violence would include which adolescent behavior as a warning sign for potential school violence?
  1. a.
    Participation in class activities
  2. b.
    Withdrawing from social interaction
  3. c.
    Crying after failing an exam
  4. d.
    Visiting the school counselor during lunch

Answer

B. Withdrawing from social interaction
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.

32-10 §32.RQ source ↗

Which activity would the community nurse perform during the recovery phase of the disaster management cycle?
  1. a.
    Performing triage and emergency care
  2. b.
    Educating families on disaster preparedness
  3. c.
    Reducing the spread of communicable disease
  4. d.
    Performing triage and transport victims to services

Answer

C. Reducing the spread of communicable disease
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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Problems and answers are adapted from Population Health for Nurses by Jessica Ochs, Sherry L. Roper and Susan M. Schwartz, OpenStax, and are used under the CC BY-NC-SA 4.0 licence. Access for free at https://openstax.org/books/population-health/pages/1-introduction. Illustrations: Copyright Rice University, OpenStax, under CC BY-NC-SA 4.0 license. This adaptation is released under the same licence, is non-commercial, and is neither affiliated with nor endorsed by OpenStax or Rice University.