Chapter 35

According to the American College of Surgeouns, burns to which body surfaces are best treated in a burn center? (SATA)

- Perineum - Genitalia - Face

A patient is brought to the ED after a house fire. The patient sustained an inhalation injury. The nurse is aware that this injury predisposes the patient to the development of what complication?

Acute respiratory distress syndrome (ARDS)

A patient involved in a house fire is brough by ambulance to the ED. The patient is breathing spontaneously but appears agitated and does not respond appropriately to questions. The nurse knows the patient was inhaled carbon monoxide and probably has carbon monoxide (CO) poisoning. What action should the nurse take next?

Administer 100% high-flow oxygen via a nonrebreathing mask

A patient is brought to the ED after a house fire. He fell asleep with a lit cigarette, and the couch ignited. What is the nurse's frist priority?

Assess the airway and provide 100% oxygen

The nurse and new graduate nurse are caring for a patient w/extensive burns. They are discussing skin grafts. Which statement indicates the new graduate understood the information?

Autografts provide permanent coverage and are the least expensive

The nurse is caring for a patient w/extensive burns. Which intervention should be included in the nursing management plan to prevent cross-contamination and decrease the risk of infection in the burn-injured patient?

Changing gloves and handwashing should be done when moving from area to area on the same patient

Contracture development leading to impaired physical mobility can occur after a major burn injury. Splints are applied to prevent or correct contractures. Priority nursing interventions concerning this therapy include which action?

Daily assessment for proper fit and effectiveness

The nursing management plan for a patient w/full-thickness burns include which intervention?

Daily wound care w/premedication

Less than 24 hours ago a patient sustained full-thickness burns to his face, chest, back, and bilateral upper arms in a house fire. He also sustained an inhalation injury. The patient was intubated and ventilated and is now showing signs of increasing agitation and rising peak airway pressures. The nurse suspects the patient's change in condition is due to which problem?

Decreased pulmonary compliance

A patient is admitted after being burned in a car fire. The wound surface is red w/patchy white areas that blanch w/pressure but no blister formation. What kind of burn would the nurse document in the patient's record?

Deep dermal partial-thickness burn

A patient is admitted to the burn unit after a house fire. The patient sustained extensive burns to the chest, back, left arm, right arm, right upper leg, and areas on the face. The nurse is unable to obtain a palpable pulse or a Doppler pulse in the right arm. What procedure should the nurse anticipate next?

Escharotomy

A patient is admitted to the burn unit w/extensive burns after a house fire. The patient's VS and physical exam include a heart rate of 140 bpm, a urine output of 25 mL/h, and clear lung sounds What adjustment, if any, needs to be made to the fluid resuscitation plan?

IV rate should be increased and fluid status closely watched

What is a leading cause of death in the hospitalized burn patient?

Infection

A patient is brought to the ED w/extensive burns after a house fire. What is an important nursing intervention for this patient during the resuscitation phase?

Intravenous opiates and assesment of pulses in both arms

A patient has a partial-thickness burn wound that is being treated w/porcine xenograft (pigskin). The nurse knows that pigskin usually dissolves in 5-7 days because of what reason?

Lack of blood supply

A patient is admitted after being burned while lighting the barbecue. The injuries appear moist and red w/some blister formation and the patient states they are very painful. What kind of burn would the nurse document in the patient's record?

Partial-thickness, second-degree burn

What psychiologic process can result in excessive burn edema and shock in a pt w/injuries totaling more than 50% total body surface area (TBSA) burn?

Plasma colloid osmotic pressure is decreased because of protein leakage into the extravascular space

A patient is admitted to the burn unit after an electrocution. The patient sustained extensive burns. The nurse should have a high degree of suspicion for what complication associated with this type of burn injury?

Pneumothorax

A nurse is caring for a patient who was burned 2 weeks ago. The nurse knows the patient has entered the next phase of healing, which is characterized by rapid synthesis of collagen. What phase is the patient in?

Proliferative phase

What are the goals of the rehabilitation phase of burn management?

Recuperation and healing physically and emotionally

Which topical antimicrobial agent is commonly used as a broad-spectrum and fights against gram-positive and -negative bacteria?

Silver sulfadiazine

A patient w/extensive burns is undergoing skin grafting. The nurse understands pain control is best achieved with what strategies during the early phase of recovery?

Small doses of intravenous opioids titrated to effect

A patient is admitted after being burned in a house fire. The nurse feels that the patient should be transferred to a burn center. Which factor is most important when determining whether or not to refer a patient to a burn center?

The medical history of the patient and the size and depth of the burn injury

Roughly 80% of burns in children are classified as what type of burn?

Thermal

A patient is admitted to the burn unit w/extensive burns after a house fire. The patient's VS and physical exam include a HR of 140 bpm, a urine output of 25 mL/h, and clear lung sounds. The nurse knows that the patient's symptoms are most likely attributable to what cause?

Underresuscitation because of probable wound conversion

The nurse is caring for a patient w/extensive burns. Which zone of injury is the site of the most severe damage?

Zone of coagulation