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NUR 443 - EXAM 2 QUESTIONS AND ANSWERS
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NUR 443 - EXAM 2 QUESTIONS AND ANSWERS
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NUR 443 - EXAM 2 QUESTIONS ANDANSWERS
Thermal burns - answer-grease, fire, radian heat
Thermal burns depends on - answer-temp
Time (duration of contact)
Chemical burns - answer-acid, alkalis, organic compound (heavy industrial cleaners)
Electrical burns - answer-lightning, electrical current -- deep and deceiving (internal)
Radiation burns - answer-sunlight, radiation tx for cancer
Inhalation burns - answer-exposure of upper airway and lung to burn source (ex house
fire breathing in air; noxious chemicals)
Defining burns - answer-"depth & degree"
1º burn - answer-superficial partial thickness
Blanching (white) on pressure, pain and mild swelling, no blisters
Ex. Sunburn, quick heat flash
2º burn - answer-deep partial thickness
Deep... Fluid filled vesicles red shiny wet severe pain. Scald contact burn, chemical,
electric current
3º & 4º burn - answer-full thickness (down to fat, muscle, and bone)
Dry, waxy, leathery.
Which #º burn has insensitivity to pain due to nerve damage? - answer-4º
During the emergent phase of burn mgmt, you would expect what lab values? - answer-
↓na, ↑k, ↑bg, ↑hematocrit
Rule of nines (adult) - answer-9% per arm
9% for head
18% each leg
18% anterior trunk
18% posterior trunk
1% genitalia
What are pt priorities during the emergent phase of burn mgmt - answer-respiratory
status
, Fluid volume
Watch for burns to the face, neck, chest, and back as they may... - answer-interfere with
breathing
Just inhaling toxic fumes... - answer-can cause respiratory issues
Emergent/resuscitative phase - answer-greatest risk for shock
Major concerns: hypovolemic, edema formation
Acute phase - answer-lasts until wound healing/skin graft (weeks-months)
Rehabilitation phase - answer-goal is to return the client to a productive life
Mobility limitations: positioning, skin care, exercise, ambulation, adl's
(patho of burn) massive edema - answer-a major physiologic response to burn injury
during the emergent phase, is the massive shift of fluids from vascular space to
interstitial space as a result of ↑capillary permeability
(patho of burn) systemic injury - answer-burn shock - hypovolemia
Organ injury - can't perfuse as well
Blood does what from a burn - answer-↑viscosity (thickening of blood)
Emergent phase burn patho - answer-f&e shift ↑hr, ↓bp
Edema
3rd spacing
Emergent phase nursing mgmt - answer-fluid therapy: 2 large-bore ivs
Parkland (baxter) formula - answer-tbsa% * body wt (kg) * 4 = ml given over first 24
hours (half of which is the first 8hrs)
Urinary output... - answer-the most accurate assessment in determining effectiveness
and titrating *fluid resuscitation*
Fluid resuscitation end points - answer-mentation, skin color/temp, hr, bp (map >65),
urine output, spec. Gravity, hemoconcentration, gi fxn
Other priorities: - answer-stop burn, airway, fluid replacement, analgesics, monitor for
shock, prevent infxn, nutrition skin care
Skin care emergent phase - answer-watch infxn...
-open method: burn is covered with topical antimicrobials, but no dressing over wound
-closed dressing: use gauze w/ antimicrobials & medications
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