Oh NOOO
Explain the inflammatory response in a burn victim- what cause the severe edema?
Massive shift of water, electrolytes, and protein into the tissues. This causes severe edema.
What is the most important lifestyle modification a patient can do with chronic pancreatitis?
Stop drinking alcohol
For patients with thrombocytopenia- how long should you apply pressure when taking out an IV?
10 minutes
Explain why burn victims can develop curling ulcers
Breakdown in the stomach's protective mucosal barrier from the burn
What 3 components are needed for RBC production?
Protein, Iron and Folic Acid
What are 4 common over the counter vitamins for treating anemias?
Iron, vitamin C, folic acid, and vitamin B12
Signs and symptoms of respiratory distress in burn victims
Watch for increasing restlessness, coughing, hoarseness, rapid shallow respirations, stridor (high-pitched musical sound on inspiration), and falling oxygen saturation (below 95%).
CD 4 counts determine what ?
What is a target ranges for HIV patient showing a "good immune function" for CD4
When does the CD4 indicate possible AIDS?
CD 4 is a protein on the surface of immune cells, specifically T helper cells-WHICH FIGHT INFECTION!
Target range for HIV= above 500
Less than 200= AIDs
What is the purpose of giving the Tetanus shot to burn victims? What does it prevent?
Tetanus shot- an extra layer of protection against the organisim Clostridium Tetani. A burn victim is severely compromised and is a risk of further infection.
In burn victims compartment syndrome can happen due to the fluid shifting and edema. What are the signs and symptoms?
Increasing pain, paleness and tenseness of the tissue, numbness or tingling, discoloration in the distal portion of the extremity, and decreased sensation (paresthesia).
Your patient is receiving a unit of packed RBCs. When you assess them after the first hour of the transfusion, the pulse rate has increased from 78 to 84 bpm, they are slightly restless, and they are complaining of discomfort in the back. The temperature has risen from 98.4° F to 99° F. They have no skin rash and deny nausea. What would you do?
Stop the infusion. Call the MD
While you are performing an initial assessment, a patient with extensive burn injuries suddenly develops increasing hoarseness and stridor. Pulse oximetry is 86%. What is the priority nursing action?
1. Encourage the patient to take deep breaths.
2. Provide humidified oxygen.
3. Administer respiratory treatments.
4. Suction respiratory secretions.
Provide humidified oxygen
For burn victims- how do we assess for carbon monoxide inhalation?
Mucus membranes are a cherry red color
What are 2 major complications of leukemia?
Infection and hemmorhage
Signs and Symptoms of Pancreatitis
Locallized pain in the epigastric area or left upper quadrant. It can spread and radiate to the back and flank.
Eating makes the pain worse.
Nausea, vomiting, sweating, jaundice, and weakness
After the first few minutes of transfusing packed RBCs, the patient has a temperature of 101.5° F (38.6° C), heart rate of 120 bpm, and blood pressure of 90/50 mm Hg with complaints of back pain. The priority nursing action would be:
1. flush the line with normal saline.
2. stop the transfusion.
3. notify the health care provider.
4. administer diphenhydramine (Benadryl).
2
What are lab test used to diagnose blood disorders?
CBC with Differential (peripheral smear)
You make a home health visit 1 year after a patient was burned on more than 30% of their body. What problem may the patient be experiencing at this stage? (Select all that apply.)
1. Concern with body image due to extensive scarring.
2. Chronic pain due to contractures and nerve compartmentalization.
3. Continued risk for infection due to reconstruction wounds.
4. Increased risk for falls due to joint contractures.
1,2,3
Explain escharatomy
An incision into the burn eschar with a scalpel or electrocautery relieves pressure caused by circumferential burns that encircle an extremity or that constrict movement of the chest.
Just in case you forgot..... lupus patients are what? High risk for ?
IMMUNOCOMPRIMISED
INFECTIONS
What do the labs look like in a burn victim? Explain the cascade of issues that happen metabolically
Hyperkalemia occurs when potassium is released from the damaged cells.
Hyponatremia is caused by the stress response and potassium shifts.
Metabolic acidosis develops.
The loss of fluids from the vascular space leads to hypovolemia with low blood pressure and possible hypovolemic shock. Hematocrit will be increased because of concentration of the blood, which is missing the components that have shifted into the tissues. The increased viscosity of the blood causes slowing of blood flow in the small vessels, which in turn causes tissue hypoxia.
There is danger of kidney failure from both the hypovolemia and the cellular debris that the kidneys must clear from the body.
What does Epogen (erythropoietin) do ?
Stimulates the bone marrow, functioning as a growth factor.
Boost RBC production instead of a blood transfusion
While reviewing the laboratory results for a patient who had gastric bypass surgery last year, you note that the amount of red blood cells has decreased remarkably. You suspect that the anemia is related to:
1. vitamin B12 deficiency.
2. chronic renal failure.
3. iron deficiency.
4. bone marrow suppression.
Vitamin B12 deficiency
How do you differentiate malignant and benign tumors?
Malignant tumors:
•Appearance different, undifferentiated, Nonfunctional, Not recognized, Abnormal surface proteins, Random, disorganized, uncontrolled growth pattern, grows despite lack of space
Benign:
•Relatively harmless, do not spread, create pressure on or obstruct body organs, surgically removed
Which anemia are gastric bypass patients at risk for ?Why?
Megaloblastic anemia from the decrease of intrinsic factor