Thats
Which action would you question by EMS for a burn injury?
a) poured cold water onto burn injury
b) cut jewelry and clothes away from burn injury
c) covered with tap-water dampened towel
d) wrapped in dry blanket
a) poured cold water onto burn injury
During pre-hospital care, what would you expect EMS to do? SATA
A) Elevate burned limbs above the heart
B) Focus on ABCs
C) Ventilate the patient
D) Stop the burning process
A, B, D
What are your primary concerns in the emergent phase with a patient who has burn injury and inhalation injury?
A)Hypovolemic shock
B) Ambulation
C) Electrolyte balance
D) Intubation if necessary
A, D
What would be the nurses responsibility in the emergent phase for a patient was 33% TBSA affected? SATA
A) Start a central line
B) Start an arterial line for blood sampling, ABGs
C) Start Lactated ringers
D) Administer tetanus immunization
A,B,C,D Suckers
A patient is admitted to the burn unit with burns to the head, face, and hands. Initially wheezes are heard, but an hour later, the lung sounds are decreased and can no longer hear the wheeze. What's the best action for the nurse to take?
A. Encourage pt to cough and ausculate lungs.
B. Notify HCP for endotracheal incubation.
C. Document and monitor the patients RR.
D. Reposition the pt to high Fowlers and reasses breath sounds.
B. Notify HCP for endotracheal incubation.
What is a major predictor of mortality in burn patients? What should you do?
smoke inhalation, RAPID assessment is critical
Your patient comes in with burns, they are in a lot of pain, there are blistering forming. What depth of burn would you expect this to be?
Deep partial thickness, 2nd degree burn
When does emergent phase end?
A) When diuresis begins
B) When blisters form
C) When independence is regained
D) When intubation is stopped
A) When diuresis begins
Your burn patient is high risk for sludging. They still have a lot of open wounds and are at a high risk for bleeding. Which orders would you question? SATA
A) SCDs and Zoloft
B) Oxandrolone and Lovenox
C) Systemic antibiotics, SCDs
D) Sterile gauze dressings laid over topical antimicrobial, wrapped proximal to distal and Oxandrolone
B, C, D
Your patient experienced a chemical burn while cleaning her house. What would be your first step in treating this patient?
A) place clean blanket over burns
B) start debridement process
C) rinse well to stop the burn
D) remove any clothes that are adhered to the patient
C) rinse well to stop the burn
Your burn patient is working towards independence, and are ready to leave the hospital. What are some patient teaching for your patient? SATA
A) Maintain a high protein diet and include vitamin supplements such as zinc, vitamin E, selenium.
B) Use scented lotions to help with tightness and itching
C) Skin may be hypo or hypersensitive to touch
D) Cover up when going outside, stay in the shade when possible.
A) Maintain a high protein diet and include vitamin supplements such as zinc, vitamin E, selenium.
C) Skin may be hypo or hypersensitive to touch
D) Cover up when going outside, stay in the shade when possible.
A) PCA 50 mg fentanyl
B) PO extended release oxycontin
C) central venous line placement 12 hours prior
D) 4 mg subs lovenox q 12h
B) PO extended release oxycontin
Possible paralytic ileus
Your patient arrives to the ED with 18% left arm burns. The arm looks waxy white. The patient is not complaining of pain. What classification of burn would you expect this to be?
Your patient with partial thickness burns around their neck, back, and left arm has been in the hospital for 72 hours. Which statement would need further teachings?
A) I will use a rolled up towel under my neck instead of a pillow when I sleep
B) Since all of my burns have presented themselves, I should prepare for my skin graft.
C) I know I will need to have my wounds cleaned with soap and water to remove and loose tissue and scabs.
D) I will wait for PT to come to my room to learn my new range of motion exercises to avoid contractures.
B) Since all of my burns have presented themselves, I should prepare for my skin graft.
A patient is in the hospital with severe burns to their chest, neck, and arms. They are ventilated and sedated. The high pressure alarm on the ventilator begins to go off. What would you expect is happening and what would be the plan of action?
A) The skin on the patient's chest is tightening over lungs, impairing ventilation. Escharotomy is recommended.
B) The edema in the patient's lungs has expanded and is impairing ventilation. Lasixs is recommended.
C) The patient is experiencing fluid overload, the LR infusion should be stopped.
D) The patient's lung may be infiltrated with soot, perform bronchoscopy and wash out lungs.
A) The skin on the patient's chest is tightening over lungs, impairing ventilation. Escharotomy is recommended.
A) Upper airway injury from prolonged inhalation of smoke (injury to mouth, oropharynx, larynx)
B) Lower airway injury from prolonged inhalation of smoke (trachea, bronchioles, alveoli)
C) Burns and blisters that haven't fully presented themselves
D) The patient seems fine
B) Lower airway injury from prolonged inhalation of smoke (trachea, bronchioles, alveoli)
prolonged inhalation of smoke can cause further damage, tissue damage may be more extreme
Which of the following patients would require a burn unit referral? SATA
A) A patient with 2nd degrees on face and hands after throwing gasoline on a bonfire.
B) A patient that was scalded by hot water resulting in partial thickness burns over 6% of their torso and 11% of the left leg
C) A patient that was involved in a three car crash on the highway and was burned on the right side of their body.
D) A patient that was burning brush in their yard and suffered partial thickness burns to 8% of their left ankle and leg
A,B,C
When caring for a patient brought into the ED with burns, you see some black around the patient's mouth and in their oral mucosa. The patient is conscious and talking to you, but sounds hoarse. What should you do?
A) Monitor the patient q 15 min
B) Intubate immediately, swelling can happen suddenly
C) Intubate immediately, patient is about to lose consciousness
D) Schedule a trach immediately.
B) Intubate immediately, swelling can happen suddenly
A) Skin contractures
B) hypertrophic scarring
C) joint contractures
D) Paralytic ileus
A) Skin contractures
B) hypertrophic scarring
C) joint contractures
Your patient arrives in the ED with minimal burns on their hands and arm after escaping a house fire overnight. They do not have a smoke detector so they were in the house for a while before leaving. They are conscious and talking. Their pain is a 10/10. They sound hoarse and you notice that their skin is cherry red. What would be a primary concern?
A) carbon monoxide poisoning
B) infection in the burns on their hands
C) hypovolemic shock
D) they should have an immediate chest X-ray.
A) carbon monoxide poisoning
Your patient at the burn center just experienced an electric burn at a high voltage. What would be some of the risks for this type of injury? SATA
A) Risk of acute kidney injury
B) Risk of cardiac arrest
C) Risk of spinal injury
D) Risk of upper airway injury
A) Risk of acute kidney injury
B) Risk of cardiac arrest
C) Risk of spinal injury
Your burn patient will need to receive 9480 ml of fluid replacement. How much fluid would be given during the second 8 hours? What would you set the pump to?
2370 ml
296 ml/hr
Burn patient weighing 176 lbs with affected area: 23% torso, 5.6% right arm, 12% right leg. How much fluids would you need for this patient? How much in the first 8 hours? What would you set the pump to?
176/2.2= 80 kg
23+5.6+12= 40.6
4 x 80= 320
320 x 40.6= 12992
First 8 hours= 6496
Pump= 812 ml/hr
A child is brought into the burn unit. They weight 57 lbs and has back (14%), left arm (8%), left leg (10%). How much fluid would you give in the 3rd 8 hours, what would the pump be set to?
25.8 x 4 = 103.2
14+8+10= 32
103.2 x 32= 3302 ml
3rd 8= 826 ml
pump= 103 ml/hr
As the nurse on a burn unit, what would you expect to do for wound care for your patient? SATA
A) daily showers with dressing changes in the AM and PM
B) Using silver impregnated dressing that can be left in place for 3-14 days
C) Protect graft with a greasy gauze, and a wet to dry dressing
D) include family or other support systems especially with wound care
ABCD