Thickness
What are the types of burns?
Thermal
Electrical
Chemical
Radiation
Friction
Cold
What skin color does Carbon Monoxide poisoning present as and what is the treatment? Why is pulse ox not accurate?
Cherry Red skin
carbon binds faster than oxygen, so the patient needs to be on 15 L NRB even if oxygen shows 100% (remember pulse ox is NOT accurate!!!)
What is the Parkland Formula and why?
4 ml x KG x TBSA
Fluid replacement
A nurse is teaching a patient who has recently been diagnosed with HIV about antiretroviral therapy (ART). Which statement by the patient indicates correct understanding?
A. “I can stop taking my medications when my viral load becomes undetectable.”
B. “My medications will eliminate HIV from my body.”
C. “Taking my medications consistently can reduce my viral load and help prevent disease progression.”
D. “I don't need to use precautions because treatment cures HIV.”
C
Antiretroviral therapy (ART) suppresses HIV replication, which:
↓ Viral load
↑/preserves CD4 T-cell count
↓ Risk of opportunistic infections
↓ Risk of HIV transmission when viral suppression is maintained
Which intervention is most effective for preventing human papillomavirus (HPV) infection?
A. Taking antibiotics before sexual activity
B. Receiving the HPV vaccine
C. Using antiviral medication daily
D. Avoiding sexual activity only when symptoms are present
B
HPV vaccine is huge in helping decrease at-risk strains
provides protection against HPV types responsible for many cancers and genital warts. Condoms reduce transmission risk but do not provide complete protection because HPV can infect areas not covered by a condom.
Circumferential burns are at a risk of what?
Compartment syndrome requiring a fasciotomy
Remember your Ps (pulseless, pallor, pain...)
A nurse is caring for a patient who sustained facial burns during a house fire. The patient has soot around the mouth, a hoarse voice, and increasing difficulty breathing. Oxygen sats are dropping. Which action should the nurse take first?
A. Apply a nonrebreather mask at 15 L/min
B. Prepare for early endotracheal intubation
C. Obtain a chest X-ray
D. Administer IV morphine for pain
B
Facial burns + hoarseness + soot + respiratory distress = AIRWAY FIRST → prepare for early intubation.
At first, fluid third spaces, so hematocrit increases and blood becomes thicker as this is more concentrated. Remember, blood is fluid and plasma- lower plasma more hematocrit and thicker
Then when fluid is rescucitated, hematocrit is lower as there is added fluid- this can lead to anemia
Why do we want to try and avoid subcutaneous and intramuscular injections for burns?
The soft tissue is unreliable with hypovolemia and large fluid shifts. There is also tissue damage with burns.
A patient is diagnosed with primary syphilis. Which finding would the nurse expect?
A. Painful vesicular lesions
B. Painless chancre at the site of infection
C. Thick, frothy vaginal discharge
D. Painful genital ulcers
B
Primary syphilis commonly presents with a single painless ulcer (chancre). It may heal without treatment, but the infection can progress to secondary and tertiary stages.
Name the key assessments for each type of burn:
(1-4)
First-Degree (Superficial) Burns
Skin layers: Affects only the outer layer (epidermis).
Appearance: Red, dry skin without blisters (erythema).
Pain level: High and painful to the touch.
Blanching: Turns white (blanching) rapidly when pressed and refills quickly.
Second-Degree (Partial-Thickness) BurnsSkin layers: Affects the outer layer and part of the underlying layer (dermis).
Appearance: Wet, moist, or mottled skin with fluid-filled blisters (vesicles).
Pain level: Extremely sensitive and painful (hypo-aesthetic or normal pain response).
Blanching: Superficial areas blanch slowly; deep partial-thickness areas have very slow or absent capillary refill and may show red or white patches.
Third Degree (full thickness)
Fourth degree is through bone- no pain at site due to no nerve endings, but this DOES NOT mean that the patient has no pain- surrounding tissue will still be affected at different levels
facial burns
hoarse voice
swelling
singed nasal hairs
stridor !!!!! Priority
Soot in mouth and sputum
tachycardia
agitation
anxiety
!!! AIRWAY TOP PRIORITY !!! Prepare to intubate
A patient with major burns is at risk for significant fluid loss during the first several hours after the injury. Which finding would the nurse recognize as a sign of inadequate fluid resuscitation?
A. Urine output of 35 mL/hr
B. Blood pressure of 86/52 mmHg
C. Warm skin with strong peripheral pulses
D. Decreasing heart rate
B
Inadequate fluid loss means low volume, low volume causes low blood pressure- less to circulate
A patient with recurrent genital herpes is prescribed acyclovir. Which statement is correct?
A. “This medication will permanently eliminate the herpes virus.”
B. “I should take the medication only when I have no symptoms.”
C. “The medication can help decrease the duration and severity of outbreaks.”
D. “Once I start this medication, I can no longer transmit herpes.”
C
Acyclovir is an antiviral medication that can reduce the duration and severity of outbreaks. It does not eradicate HSV, and transmission can still occur.
A nurse is teaching a patient who has been diagnosed with gonorrhea. Which statement by the patient indicates correct understanding?
A. "I can stop treatment when my symptoms disappear."
B. "My partner does not need treatment if they have no symptoms."
C. "I should avoid sexual activity until treatment is completed as instructed."
D. "Once treated, I cannot get gonorrhea again."
C
Gonorrhea can be asymptomatic, particularly in some patients, so sexual partners need evaluation and treatment as appropriate. Reinfection can also occur.
SATA: A client is brought in to the hospital with partial thickness burns to head, face, neck, arms, and chest from a car fire. What nursing interventions should be done for this client?
A. Restrict Fluids
B. Assess airway patency
C. Oxygen
D. Cooling blanket
E. Elevate extremities
F. Pain meds PO
B, C, E.
AIRWAY ALWAYS TOP PRIORITY (ABCs)
airway compromised if burns on face
Oxygen d/t airway
Elevating extremities prevents edema and further fluid shift
We DO NOT want to restrict fluids (Parkland formula) and we want to preserve heat, IV pain meds work faster and better as GI system may be compromised in burns
A nurse is caring for a patient rescued from a car that was left running in the garage for too long. The patient reports a headache and dizziness. The pulse oximeter reads 99% on room air. Which action is the nurse's priority?
A. Reassure the patient because the oxygen saturation is normal
B. Administer 100% oxygen as prescribed
C. Encourage the patient to drink fluids
D. Place the patient in a supine position
B
Bonus points if the rationale stated that oxygen is not a good indicator and will be a false positive
List as many prehospital/ initial care items as you can for burns
Remove source of burning!!!
ABCs
Conserve body heat
Check for inhalation injury
Cover in STERILE gauze
remove constrictive clothing
IV access
Evaluate degree and extent
Check airway thoroughly
Urine output!!!!!! Best indicator of fluid status- can be done with foley
Tetanus
pain meds
wound care
Constantly reassess
HOB elevated
Cardiac monitoring (bonus kudos if they mention hyperkalemia)
PPE
daily weights
antacids
check bowel sounds
pillows (NO pillows for ear burns)
keep them warm
A patient with BPH is prescribed tamsulosin (Flomax). Which statement indicates the patient understands the medication?
A. “This medication will shrink my prostate immediately.”
B. “I should change positions slowly because this medication can cause dizziness.”
C. “I should take an extra dose if I cannot urinate.”
D. “This medication will increase my blood pressure.”
B
Tamsulosin is an alpha-1 blocker that relaxes smooth muscle in the prostate and bladder neck. It can cause orthostatic hypotension and dizziness, especially when starting therapy.
BPH enlarges the prostate and compresses the urethra, causing hesitancy, weak stream, dribbling, urinary frequency, urgency, and nocturia.
What assessment findings would you see in the following:
Syphilis
Genital herpes
Gonorrhea
Chlamydia
HPV
Trichomoniasis
And which ones can't be cured
Syphilis → painless chancre
Genital herpes → painful vesicles/ulcers; lifelong infection
Gonorrhea → purulent discharge; may be asymptomatic
Chlamydia → often asymptomatic; can cause PID/infertility
HPV → genital warts + cervical and other cancers; vaccine prevents infection
Trichomoniasis → frothy, yellow-green discharge and "strawberry cervix"
Viruses CANT be cured- warts, Herpes, HPV, HIV, AIDS
SATA! A nurse is caring for a patient who sustained major thermal burns. Which interventions are appropriate during the initial management of the patient? Select all that apply.
A. Assess the airway for signs of inhalation injury.
B. Administer IV fluids as prescribed to maintain adequate perfusion.
C. Remove jewelry and restrictive clothing from burned areas.
D. Apply ice directly to the burned skin to reduce swelling.
E. Monitor urine output as an indicator of fluid resuscitation.
F. Cover the burns with clean, dry dressings or sheets.
G. Break intact blisters to prevent infection.
A B C E F
NEVER break blisters
Never apply ice- vasoconstricive and we want to ensure heat
Think ABCDE:
A — Airway → especially with facial/respiratory burns
B — Breathing → assess for inhalation injury
C — Circulation → IV fluids and perfusion
D — Disability → neurological status
E — Exposure → assess burns while preventing hypothermia
A nurse is caring for a patient who was rescued from a house fire. Which findings are concerning for an inhalation injury and require immediate attention? Select all that apply.
A. Hoarseness or a change in voice
B. Soot or carbonaceous material around the mouth or nose
C. Singed facial or nasal hairs
D. Persistent coughing or wheezing
E. Facial burns
F. Oxygen saturation of 99% on room air
G. Stridor
A B C D E G
Facial burns → Hoarseness → Soot → Cough/wheeze → Stridor = airway emergency.
Oxygen sat of 99% is good, unless Carbon Monoxide poisoning
Phases of management of a burn injury
Emergent phase
Resuscitative phase
Acute phase
Rehabilitative Phase
Emergent- time of injury -48-72 hours post. Prehospital care and arrival that includes airway, IVF, prevent hypovolemic shock, and preserve organs
Rescucitative- precent shock and maintain blood volume to vital organs
Acute- emphasis on restorative therapy until wound closure
Rehabilitative- achieve maximum functioning post burn
SATA! A nurse is providing discharge teaching to a patient following a hysterectomy. Which instructions should the nurse include? Select all that apply.
A. Report heavy vaginal bleeding or passage of large clots.
B. Avoid heavy lifting until cleared by the provider.
C. Report fever, increasing pain, or foul-smelling drainage.
D. Follow instructions regarding activity and sexual intercourse.
E. Expect severe abdominal pain for several weeks.
F. Monitor the incision for redness, swelling, or drainage.
A B C D F
After hysterectomy, think bleeding + infection + urinary complications + activity restrictions.
SEVERE PAIN IS NOT NORMAL!!!!
SATA! A nurse is providing education to patients diagnosed with sexually transmitted infections (STIs). Which statements demonstrate correct understanding? Select all that apply.
A. “I should notify my recent sexual partners so they can be evaluated and treated.”
B. “I can get an STI again even after I have been successfully treated.”
C. “If I don't have symptoms, I cannot transmit an STI.”
D. “I should avoid sexual activity until I have completed treatment as instructed.”
E. “Using condoms consistently can reduce my risk of acquiring many STIs.”
F. “Once my symptoms disappear, I no longer need to take my medication.”
G. “The HPV vaccine can help protect against HPV infections that can cause certain cancers.”
A B D E G
“No symptoms ≠ No infection.”
“Treatment ≠ immunity.”
“Finish your meds + treat partners.”