Chapter 62-book questions

C

A patient will be receiving biologic dressings. The nurse understands that biologic dressings, which use skin from living or recently deceased humans, are known by what name? A. Autografts B. Heterografts C. Homografts D. Xenografts

A

A person experiences leg burns from spilled charcoal lighter fluid. A family member extinguishes the flames. While waiting for an ambulance, what should the burned person do? A. Be assisted into a bath of cool water while waiting for emergency personnel B. Lie down, be covered with a blanket, and cover legs with petroleum jelly C. Remove the burned pants so that the air can help cool the wound D. Sit in a chair, elevate the legs, and have someone cut the pants off around the burned area

2400

A sample consensus formula for fluid replacement recommends that a balanced salt solution be administered in the first 24 hours of a burn in the range of 2 to4 mL/kg% of burn, with 50% of the total given in the first 8 hours post burn. A 176 lb. man with a 30% burn should receive a minimum of ____________ mL fluid replacement in the first 8 hours.

the depth of the injury, the extent of the injured body surface area

Burn injuries are classified according to ____________________________and ________________________

one third

Burns that exceed ________________ of the total body surface area are considered major burn injuries and produce both a local and a systemic inflammatory response.

Escharotomy

Linear excision made through eschar to release constriction of underlying tissue

contracture

Shrinkage of burn scar through collagen maturation

A,B,D

The nurse is monitoring for fluid and electrolyte changes in the emergent phase of burn injury for a patient. Which will be an expected outcome? (select all that apply) A. Base-bicarbonate deficit B. Elevated hematocrit level C. Potassium deficit D. Sodium deficit E. Magnesium deficit

B

The nurse is planning the care of a patient with a major burn. What outcome will be optimal during fluid replacement? A. A urinary output of 10 mL/hr B. A urinary output of 30 mL/hr C. A urinary output of 80 mL/hr D. A urinary output of 100 mL/hr

C

The nurse is providing wound care for a client with burns to the lower extremities. Which topical antibacterial agent carries a side effect of leukopenia that the nurse should monitor for within 48 hours after application? A. Cerium nitrate solution B. Gentamicin sulfate C. Sulfadiazine, silver D. Mafenide

D

The nurse is reviewing the laboratory studies for a patient during fluid remobilization after a major burn. What laboratory value observed by the nurse should be immediately reported? A. Hematocrit level of 45% B. A pH of 7.2, PaO2 of 38 mm Hg, and bicarbonate level of 15 mEq/L C. Serum potassium level of 3.2 mEq/L D. Serum sodium level of 140 mEq/L

C

The nurse knows that which topical antibacterial agent does not penetrate eschar? A. Acticoat B. Mafenide acetate C. Silver nitrate 0.5% D. Silver sulfadiazine 1%

0.5 to 1.0 mL/kg/h

The resuscitation goal of fluid replacement therapy, postburn injury, is a urinary output of _____________________ to _________________ for adults.

pseudomonas, methicillin-resistant Staphylococcus, Acinetobacter

The three major bacteria responsible for infection in burn centers are ______________________, __________________________, and ____________________.

silver sulfadiazine (Silvadene), silver nitrate, mafenide acetate (Sulfamylon)

Three commonly used topical antibacterials for skin care are __________________________, _______________________, and ______________________.

C

To meet early nutritional demands for protein, a 198 lb burned patient will need to ingest a minimum of how much protein every 24 hours? A. 90 g/day B. 110 g/day C. 180 g/day D. 270 g/day

young children, older adults

Two groups that have increased morbidity and mortality from burn injuries are ______________________ and ________________________

acute respiratory failure, acute respiratory distress syndrome (ARDS)

Two pulmonary complications that occur secondary to inhalation injuries are ________________________ and ______________________

debridement

removal of foreign material and devitalized tissue until surrounding healthy tissue is exposed

Eschar

Devitalized tissue resulting from a burn or wound

increased temperature, tachycardia, widened pulse pressure, flushed, dry skin in nonburned areas

Four signs of postburn sepsis include ________________________, ________________, _________________, and ____________________.

Homograft

Graft transferred from one human ( living or cadaveric) to another human: also called allograft

Faciotomy

Incision made through the fascia to release constriction of underlying muscle

A,B,D

The nurse is monitoring a patient during the fluid remobilization phase of a burn injury. What expected findings should the nurse monito for? (select all that apply) A. Hemodilution B. Increased urinary output C. Metabolic alkalosis D. Sodium deficit E. Hypoglycemia

sepsis

The leading cause of death in thermally injured patients is ________________

A

The nurse in the emergency department receives a patient who sustained a severe burn injury. What is the priority action by the nurse in this situation? A. Establish a patient airway B. Insert an indwelling catheter C. Replace fluids D. Administer pain medication

B

The nurse is administering an analgesic to a patient with major burns. What is the recommended route for administration for this patient? A. Intramuscular B. Intravenous C. Oral D. Subcutaneous

A

The nurse is applying an occlusive dressing to a burned foot. What position should the foot be placed in after application of the dressing? A. dduction B. Dorsiflexion C. External rotation D. Plantar flexion

D

The nurse is assessing a patient for signs of potassium shifting during the acute phase of burn injury. During which time frame should the nurse assess for signs of potassium shifting? A. within 24 hours B. between 24 and 48 hours C. At the beginning of the third day D. Beginning on day 4 or day 5

B

The nurse is caring for a patient who sustained a full-thickness burn to the arm after being scalded with boiling water. How did the nurse determine that the patients burns are full-thickness burns? A. Classification by the appearance of blisters B. Identification by the destruction of the dermis and epidermis C. Not associated with edema formation D. Usually very painful because of exposed nerve endings

C

The nurse is caring for a patient who sustained a major burn. What serious gastrointestinal disturbance should the nurse monitor for that frequently occurs with a major burn? A. diverticulitis B. hematemesis C. paralytic ileus D. ulcerative colitis

C

The nurse is caring for a patient who sustained severe burns to 50% of the body 3 days previously. What should the nurse report immediately when reviewing laboratory studies indicating massive cell destruction? A. hypernatremia B. hypokalemia C. hyperkalemia D. hypercalcemia

hypovolemia

________________________ is the immediate consequence of ensuing fluid loss and results in decreased perfusion and oxygen delivery.

Xenograft

graft obtained from an animal of a species other than that of the recipient: also called a heterograft