Burns

the nurse is caring for an 8yo who arrived to the ER with chemical burns to both legs. What is the priority intervention for this child 1. diluting the chemicals 2. applying sterile dressings 3. applying topical antibiotics 4. debriding and frafting the burns

1

the nurse is caring for a 4yo admitted to the burn unit with a circumferential burn to the left forearm. Which findings should be reported to the provider 1. numbness of fingers 2. +2 radial and ulnar pulses 3. full ROM and no pain 4. bilateral capillary refill less than 2 seconds

1 circumferential burns can compromise blood flow to an extremity causing numbness.

a nurse is in the ER caring for a child who arrives after sustaining a major burn injury. Which conditions should the nurse asses this child for within the first 8 hours of admission 1. hyponatremia and hypokalemia 2. hyponatremia and hyperkalemia 3. hypernatremia and hypokalemia 4. hypernatremia andhyperkalemia

2 capillary ermeability increases during the first 48 hours postburn allowing fluids to shift from the plasma to the interstitial spaces. This fluid is high in sodium, causing the clients serum sodium level to decrease. Potassium also leaks from the cells into the plasma causing hyperkalemia

a child weighing 22lb has a deep partial thickness burn to 40% of his body surface. While titrating the childs iv fluids, the nurse works to maintain which desired hourly urinary output 1. 5ml 2. 10ml 3. 30ml 4. 50ml

2. fluid resuscitation should be started on all clients with burns over more than 20% of their body surface. In children an hourly urine output of 1-2ml/kg shows adequate kidney perfusion

A 9yo is brough to the ER with extensive burns sustained in a restruant fire. What is the nruses most important intervention 1. admisnter prescribed antibiotics to prevent superimposed infections 2. conduct a wound assessment 3. administer liquirs orally to replace lost fluid 4. administer frequent, small meals to support nutritional requirements

2. the most important aspect of care for a child with burns is wound management

the nruse in the ER is caring for a 12 year old with full thickness circumferential burns to the chest has difficulty breathing. What is the priority intervention 1. chest tube insertion 2. escharotomy 3. intubation 4. needle thoracocentesis

3

the nurse in the ER is caring for a 5yo male who sustained 3rd degree burns to his right upper extremitiy after tipping over a frying pan. Which skin structures would the nurse include when explaining a 3rd degree full thickness burn to the childs mother 1. epidermis only 2. epidermis and dermis 3. all sin layers and nerve endings 4. skin layers, nerve endings, muslces, tendons and bones

3

a team of nurses is preparing a trauma room for the arrival of a child with partial thickness burns to both lower extremities and portions of the trunk. Which IV fluid should the nurse be prepared to administer to this client 1. albumin 2. dextrose 5% and ½ NS 3. LR solution 4. NS with 2meq KCL/100ml

3 LR is recommended bc it replaced the lsot sodium and corrects the metabolic acidosis

a 10yo has just spilled hot liquit on his arm, and a 4inch area on his forearm is severely burned. His mother calls the emergency department what should the nurse advise the mother to do 1. Keep the child warm 2. Cover the burned area with an antibiotic cream 3. Apply cool water to the burned area 4. Call 911 to transport the child to the hospital

3 applying cool causes vasoconstriction, retards further damage to tissues and decreases fluid loss

the nurse is caring for a child who arrives at the ED 20 minutes after sustaining a major burn injury to 40% of his body. What is the priority action by the nurse 1. insert an indwelling catheter 2. apply silvadene cream to the burn 3. initiate iv access 4. obtain cultures from the deepest burn area

3.iv fluids must be started immediately on all children who sustain a major burn injury to preven the child from going into hypovolemic shock

when caring for a child with moderate burns from the waist down, what should the nurse do when positioning the child 1. Place the child in a position of comfort 2. Allow the child to lie on the abdomen 3. Ensure the application of left splints 4. Have the child flex the hips and knees

3a child with moderate burns is at high risk for contractures, spilints need to be applied to maintain proper positioning and joint function

the nurse is providing care for a 6yo who is beign evaluated for sustaining burns to his left shoulder. The parents are instructed to use moisturizing cream and to protect the burn from sunlight. The parents question the nurse about the purpose of this treatment. The nurse explains that this treatment will decrease 1. keloids 2. lichenification 3. hypopigmentation 4. hyperpigmentation

4

The nurse is caring for a child with burns. Which statement by the nurse, best describes the nutritional needs of this child a. a child will need 100cal/kg during the initital hospitalization b. caloric intake will need to be increased to help with wound healing c. caloric needs can be lowered by controlling environmental temperature d. maintaining a hypermetabolic rate will help meet nutritional needs

B

the nurse is assessing a 9yo admitted to the hospital with 2nd degree partial thickness burns to 25% of his body. What would the nurse expect to assess. Select all that apply a. report of moderate to severe pain b. moist blebs, blisters c. minimal damage to the epidermis d. necrosis through all layers of the skin e. tissue necrosis through most of the dermis f. mottled white, pnk to cherry red color

a,b,e,f

the nurse is caring for an 18mo admitted to the hospital for full thickness burns to the anterior chest. The mother asks the nurse how the burn will heal. What is the nurses best response a. surgical closure and grafting are usually required b. healing will take 10-12 days and there will be little or no scarring c. pigment in darker skinned clients will eventually return to the injured area d. healing can take up to 6 weeks and there will likely be scarring

a. full thickness burns usually require surgical closure and grafting

What is the most accurate way for the nurse to measure the burn size of a 2yo who sustained a thermal burn to the anterior surface of the left hand a. the rule of nines b. percentage based on the childs weight c. the childs hand equals 1.25% of the childs body surface area d. percentage cant be determined without knowing the type of burn

c rule of 9's is used for children 14 and up.