A licensed practical nurse works for a physician who is employed by the Indian Health Service at a..

A licensed practical nurse works for a physician who is
employed by the Indian Health Service at a Navajo reservation. The nurse and
physician are not Native American but have worked in the clinic for 8 years and
know most of the residents. They have a trusting relationship with the tribal
elders and, through them, with the people, many of whom are elderly. Within the
past 36 hours, 37 persons have come into the clinic with the following
symptoms: vomiting, diarrhea that has become bloody in some cases, dehydration,
hallucinations, and fainting. The persons who initially showed symptoms now
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A licensed practical nurse works for a physician who is
employed by the Indian Health Service at a Navajo reservation. The nurse and
physician are not Native American but have worked in the clinic for 8 years and
know most of the residents. They have a trusting relationship with the tribal
elders and, through them, with the people, many of whom are elderly. Within the
past 36 hours, 37 persons have come into the clinic with the following
symptoms: vomiting, diarrhea that has become bloody in some cases, dehydration,
hallucinations, and fainting. The persons who initially showed symptoms now
have hematuria. Two of the first persons who demonstrated symptoms died. The
elders are concerned because their people are generally healthy and not had any
flu outbreaks or other mass illness in many years. The nurse suspects ricin
poisoning.

1. What symptoms led the nurse to her conclusion?

2. What assessment questions would the nurse ask the clients
and elders?

3. What precautions would the nurse, physician, and other
health care personnel take in caring for the clients?

4. What interventions would the nurse and physician continue
for those who are ill?

5. What interventions can be done to prevent others
(including health care workers) from becoming ill with the same symptoms?

6. What reassurances could the nurse give to the tribal
elders?

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