Nurse's Pocket Guide

• Obtain/assist with diagnostic studies, as indicated. Provides
information about type and degree of exposure/organ
involvement or damage.
• Identify psychological response (e.g., anger, shock, acute anxiety,
confusion, denial) to accidental or mass exposure incident.
Although these are normal responses, they may recycle
repeatedly and result in post-trauma syndrome if not dealt
with adequately.
• Alert proper authorities to presence/exposure to contamination,
as appropriate. Depending on agent involved, there
may be reporting requirements to local/state/national agencies,
such as the local health department and Centers for
Disease Control and Prevention (CDC).
NURSING PRIORITY NO.2.To assist in treating effects of exposure:
• Implement a coordinated decontamination plan (e.g.,
removal of clothing, showering with soap and water), when
indicated, following consultation with medical toxicologist,
hazardous materials team, and industrial hygiene and safety
officer to prevent further harm to client and to protect
healthcare providers.
• Insure availablity of/use of personal protective equipment
(PPE) (e.g., high-efficiency particulate air [HEPA] filter
masks, special garments, and barrier materials including
gloves/face shield) to protect from exposure to biological,
chemical, and radioactive hazards.
• Provide for isolation or group/cohort individuals with same
diagnosis/exposure, as resources require. Limited resources
may dictate open ward-like environment; however, the need
to control the spread of infection still exists. Only plague,
smallpox, and viral hemorrhagic fevers require more than
standard infection-control precautions.
• Provide/assist with therapeutic interventions, as individually
appropriate. Specific needs of the client and the level
of care available at a given time/location determine
response.
• Refer pregnant client for individually appropriate diagnostic
procedures/screenings. Helps to determine effects of teratrogenic
exposure on fetus, allowing for informed choices/
preparations.
• Screen breast milk in lactating client following radiation
exposure. Depending on type and amount of exposure,
breastfeeding may need to be briefly interrupted or, occasionally,
terminated.
Information in brackets added by the authors to clarify and enhance
the use of nursing diagnoses.
Diagnostic Studies Pediatric/Geriatric/Lifespan Medications 209
CONTAMINATION