Exam 2 Study Guide & TP questions

an increase in body temp without other manifestations of infection in a patient with large burn wounds during the acute stage indicated infection. True or False

False

T/F: It is OK to abruptly stop TPN

False, can cause hypoglycemia

T/F: Change TPN every 48 hours

False, every 24

empty circle

Female

Stasis Zone

Focus of burn care

Parkland formula

4mL/ kg/ % 1/2 in first 8 hrs 1/2 over next 16 hrs

Plasma is what percentage of the blood?

55%

PTT/APTT

60-70 seconds/30-40 seconds

lifespan of platelets

9-12 days

Thermal burn

90% Flash/flame/scald

Spontaneous bleeding

<20,000

As the nurse for the following patients, who do you anticipate will need a referral to a genetic counselor? (Select all that apply) A.Parent of a child with Cystic Fibrosis B.30 yr old with Type 2 Diabetes C.21 yr old with developmental delays D.40 yr old that developed a pulmonary embolism after surgery

A&C

A patient diagnosed with moderate to severe Alzheimer's disease (AD) is being discharged home. Which instructions by the nurse are most appropriate to give to the caregiver(s)? Select all that apply. A."Be aware that pain may be manifested in changes in behavior." B."Be alert to any changes in behavior, fevers, cough, or urinary pain." C."If the patient wanders away and cannot be found within an hour, call 911." D."Check that the patient swallows the food that is chewed because patients with AD can have difficulty swallowing." E."A reduced-calorie diet is preferred because after the primary stage of the disease, AD patients tend to gain too much weight."

A, B, D

The nurse is providing care to a patient with Alzheimer's disease (AD) who is hospitalized for an appendectomy. Which actions are appropriate when providing care to the patient? Select all that apply. A.Providing reassurance to the patient B.Using restraints to prevent wandering C.Assessing closely for safety concerns D.Orienting frequently to place and time E.Alternating staff assigned to the patient

A, C, D

Which factors would the nurse consider risk factors for developing Alzheimer's disease? Select all that apply. A.Aging B.Viral infection C.Family history D.Diabetes mellitus E.Irritable bowel disease

A, C, D

Which family history questions should the nurse ask to determine a patient's risk for developing a genetic disease? (Select all that apply) A."Are there any diseases that occurred at an earlier age than expected?" B."Are there any diseases that cause severe and debilitating symptoms?" C."Are there any diseases in the family that generally affect only one gender?" D."Are there any diseases that affect more than one first-degree or close relative?"

A, C, D

Which of these strategies are appropriate to manage GI dysfunction that CF patients often experience? Select all that apply A.Administer pancreatic enzymes with meals and snacks B.Restrict fat intake C.Encourage a high-protein diet D.Encourage snacks between meals

A, C, D

Emergent phase of burn

Airway, Breathing, circulation

Deep full thickness burn

All layers, muscle and bone blackened or charred, dry, leathery no pain, damaged nerves

DIC

Always complication of another disease

Clinical manifestations of Sickle cell?

Anemic, pain with sickling d/t ischemia of tissue

A patient with cystic fibrosis (CF) may experience which conditions? Select all that apply A.Increased risk for obesity B.Recurring lung infections C.Decreased life expectancy D.Abundant bronchial mucus

B, C, D

Autosomal Recessive examples

Disorders are caused by a mutation in 2 gene pairs on a chromosome CF, sickle cells

Cryoprecipitate

contains fibrinogen, factor VIII, factor XIII, vWF, and fibronectin. Each unit 10-20 ml Treat coagulation factor deficiencies involving fibrinogen and factor VIII

DIC thrombotic manifestations

cyanosis, paralytic ileus, tachypnea, ECG changes, oliguria, coma

Nursing interventions for emergent phase of burns

IV, Fluids, O2, assess breathing, foley, fluid overload, labs, meds

Which factors put a patient at risk for developing acute disseminated intravascular coagulation (DIC)? Select all that apply. Septicemia An extensive burn Abruption placentae Severe head trauma Stroke

Septicemia An extensive burn Abruption placentae Severe head trauma

why is anemia common in patients with SCD?

Sickled RBC are friable & rupture more easily than normal RBC. They die after 20 days instead of 120.

Diagnostic test for CF

Sweat test

What happens when platelets are too high? What is this? When will you see this?

Thrombocythemia: high amounts of clots Maligignancy, Rheumatoid artritis

DIC manifestations

Thrombosis in the skin, resp, CV, GI, kidneys. Bleeding in the skin, resp, CV, GI, urinary, neurologic, & musculoskeletal systems.

Extrinsic pathway

Tissue injury TF is released

What do RBC do in the body? When are they high and low?

Transport oxygen in the body High: hypoxia Low: anemia or hemorrhage

Couples in which both partners are carriers of the disease-causing CF mutations have a 1 in 4 risk of having a child with CF. True or False

True

Cystic fibrosis is the most common life-shortening genetic disease among whites in the U.S.'s. true or false

True

On average, patients remain in the ICU for 1/2-1 day per % TBSA burned. True or False

True

T/F: A filter is added to TPN tubing

True

T/F: Nothing can be added to TPN

True

T/F: Verify the prescription of the TPN bag with another nurse

True

T/F: You cannot administer or piggyback medications into a line used for TPN

True

WHEN TAP WATER REACHES 140o F, IT CAN CAUSE A THIRD DEGREE (FULL THICKNESS) SCALD BURN IN JUST 5 SECONDS. True or false

True

genetic disorder involving platelets

Willebrand disease

Nursing interventions for acute phase of burns

assess CV & resp, vital signs, wound care, meds, education

Glutamine

SBS improves absorption

Teduglutide

SBS increases surface area

clinical manifestations of excessive bleeding in the lungs (PE)

SOB, chest pain

TPN (total parenteral nutrition)

administered though CVC/PICC and IV pump. Contains protein, fat, carbs, vitamins, minerals

Labs & DIC

Low: platelets & plasma fibrinogen High: time aPTT & fibrin degradation ^D-Dimer

deep partial thickness burn

epidermis and deep into dermis wet or waxy, red to white, painful scalds

superficial partial thickness burn

epidermis and some dermis blister, pink to red, moist, edema painful scalds

3 layers of the skin

epidermis, dermis, subcutaneous

Which statement made by a student nurse indicates the need for additional teaching regarding the etiology and pathophysiology of disseminated intravascular coagulation (DIC)? "It is stimulated by a disease process or disorder." "Bleeding occurs as a result of depletion of platelets." "It results from the surplus production of clotting factors." "DIC results from abnormally initiated and accelerated clotting

"It results from the surplus production of clotting factors." results from depletion of coagulation or CF

primary clinical manifestion of hemophilia

Bleeding

late onset alzheimers

- begins after 65 years - more common - greater environmental contribution - slowly progressive

Hemophilia Labs

-prolonged PTT -low factor VIII:C levels -normal vWF

INR normal range

0.8-1.1 seconds

Normal bleeding time

1-9 minutes

3 phases of burn care

1. Emergent 2. Acute 3. Rehabilitation

Nursing care for hemophilia

1. Stop topical bleeding 2. Give coag factor 3. RICE protocol 4. Manage any life-threatening complications

PT time

11-12.5 seconds

How many inactive clotting factors?

13

Normal platelet count

150,000-400,000

sickle cell abnormal genes

2 abnormal, 1 from each parent

Fibrinogen (CF1) Normal

200-400 mg/dL

Large burn in adult

25%+ of body

A client with severe burns is receiving ranitidine hydrochloride (Zantac) 50 mg IV every 6 hours. What is the rationale for this therapy? 1. Ongoing treatment for a client history of gastritis 2. Management of moderate pain 3. Prevention of Curling ulcers 4. Vitamin supplementation

3

Moderate Alzheimer's

3-5 years after symptom onset Agitation Agnosia, apraxia, aphasia Significant memory deficits Paranoia (e.g. loses keys, thinks someone stole them) Need for assistance with Activities of Daily Living (e.g. leaves water boiling on stove & forgets)

Heparin drip example Heparin 25,000 units in 50 ml D5W aPTT: 65 What rate on the IV pump should be programed now?

32 ml/hr (1600 units/hr)

Which nursing intervention decreases the risk for cross-contamination in the client with a severe burn injury? SATA A. Place client in isolation. Encourage multiple visitors to support client. B. Ensure that no plants or flowers are in the client's room. C. Keep the room temperature at 70° F at all times. D. Wear gown, cap, mask, & gloves during care.

A,C,E

during the early emergent phase of burn injury, the patients lab results would most likely be..? A. ↑ Hct, ↓serum Na, ↑ serum K+ B. ↓ Hct, ↑ serum Na, ↓ serum K+ C. ↓ Hct, ↑ serum Na, ↑ serum K+ D. ↓ Hct, ↓serum Na, ↓ serum K+

A.

Which diagnostic finding would the nurse expect to find in a patient with acute disseminated intravascular coagulation (DIC) who experiences bleeding? A. Elevated D-dimer B. Elevated fibrinogen C. Reduced prothrombin time (PT) D. Reduced fibrin degradation products (FDPs)

A. Elevated D-dimer

Which parameters would the nurse assess while monitoring a patient for the development of disseminated intravascular coagulation (DIC) disorder? Select all that apply. A. Fibrinogen levels B. Blood urea nitrogen levels C. Red blood cell count (RBC) D. White blood cell count (WBC) E. Partial thromboplastin time (PTT)

A. Fibrinogen levels E. Partial thromboplastin time (PTT)

In considering the genetics of sickle cell anemia, you understand that V.L.'s inheritance of sickle cell anemia could have occurred? A. If both of her parents had 1 gene for the HgSS B. if both of her parents have the CFTR gene. C. if one of her parents had the gene for HgSS. D. if one of her parents have the CFTR gene and one did not.

A. If both of her parents had 1 gene for the HgSS

Risks for Coagulation disorders?

Age, genetics, immobility, smoking, medications (NSAIDS, Aspirin)

vas-occlusive crisis

Aggregation of sickled cells within a vessel reducing flow of blood

Which manifestation of malabsorption is associated with folic acid deficiency? A. Tetany B. Anemia C. Night blindness D. Muscle wasting

B

When providing community health care teaching regarding the early warning signs of Alzheimer's disease, which key signs would the nurse advise family members to report? Select all that apply. A.Misplacing car keys B.Losing sense of time C.Difficulty performing familiar tasks D.Problems with performing basic calculations E.Becoming lost in a usually familiar environment

B, C, D, E

The nurse assesses a patient with disseminated intravascular coagulation (DIC) and expects to find which signs of hemorrhage? Select all that apply. A. azotemia B. Hemoptysis C. Hypotension D. Focal ischemia E. Abdominal distention

B, C, E

Total parenteral nutrition (TPN) is being initiated on a client with malabsorption syndrome. Prior to starting the infusion, what nursing responsibilities should the nurse complete? (select all that apply). A. Calculating the nutrients for an individualized formula B. Obtaining the client's baseline weight C. Performing an EKG on client prior to starting infusion D. Checking for allergies to wheat E. Confirming the availability of an electronic delivery device

B, E

The nurse would recognize which as a clincial manifestation of a lower airway lung injury? SATA A. Blisters B. Dyspnea C. Wheezing D. AMS

B,C,D

A patient with thrombocytopenia presents to the primary care center. During assessment, the nurse notices petechiae. Which laboratory result best support's the presence of this disorder of hemostasis? A. Decreased erythrocyte count B. A platelet count below 150,000/mm3 C. An elevated lymphocyte count D. A hemoglobin values of 14 or more

B. A platelet count below 150,000/mm3 Thrombocytopenia is low platelet counts

A patient with a platelet count of 50,000/mm3 is diagnosed with thrombocytopenia. The nurse would expect which clinical manifestations? (Select all that apply.) A. Weakness B. Bruising C. Dizziness D. Vomiting E. Petechiae

B. Bruising E. Petechiae bleeding may occur with 50,000 count, mild bleeding may occur.

A patient with sepsis develops petechiae, ecchymosis, mucosal oozing, hematuria, and a prolonged prothrombin time (PT) and activated partial thromboplastin time (aPTT). What is the most likely cause of these findings? A. Sickle cell anemia (SCA) B. Disseminated intravascular coagulation (DIC) C. Heparin induced thrombocytopenia (HIT) D. Tumor lysis syndrome (TLS)

B. Disseminated intravascular coagulation (DIC)

The nurse is teaching a group of community members about fire safety. A participant asks, "What should I do if I got hot grease burn on my hand?". Which statement is the nurses best response? A. Apply an ice pack B. Place hand under cold water C. Burn ointment D. Go to Dr office

B. Place hand under water

A nurse is caring for a patient who has hemophilia. The patient reports pain and swelling in a joint following an injury. Which of the following actions should the nurse take? A. Obtain blood samples to test platelet function. B. Prepare for replacement of the missing clotting factor. C. Administer aspirin for the client's pain. D. Place the bleeding joint in the dependent position.

B. Prepare for replacement of the missing clotting factor

A child with cystic fibrosis does not like taking a pancreatic enzyme supplement with meals and snacks. The most important reason the child is to take the pancreatic enzyme with meals and snacks is? A.The child ill become dehydrated if the supplement is not taken with meals and snacks. B.The child needs these pancreatic enzymes to help the digestive system absorb fats, carbs and proteins. C.The child needs the pancreatic enzymes to aid in liquefying mucus to keep the lungs clear. D.The child will experience severe diarrhea if the supplement is not taken as prescribed.

B.The child needs these pancreatic enzymes to help the digestive system absorb fats, carbs and proteins.

Which nursing intervention would the nurse use with a patient who has been diagnosed with the mild cognitive impairment stage of Alzheimer's disease? A.Treat disruptive behavior with antipsychotic drugs. B.Use a calendar and family pictures as memory aids. C.Use a writing board to communicate with the patient. D.Use a wander guard mechanism to keep the patient in the area.

B.Use a calendar and family pictures as memory aids.

Which instructions would the nurse include when teaching a group of caregivers to manage a patient in a late stage of Alzheimer's disease? Select all that apply. A.Do not correct misstatement B.Get the person to stop driving C.Provide a regular schedule for toileting D.Continue communication through talking and touching E.Register with the Alzheimer's Association Safe Return

C, D

You are working in an intermediate Neurological Intensive Care Unit (NICU). You have 4 patients that are on Heparin gtt. After receiving report, which of the following patients would you see 1st? A. A patient with an INR of 2.0 . B. A patient with a platelet count of 80,000 . C. A patient with an aPTT of 41 seconds. D. A patient with a PT time of 9 seconds

C. A patient with an aPTT of 41 seconds. Normal aptt is 30-40 needs inc heparin dose

A client admitted with malnutrition has received TPN for 2 weeks. What is the nurse's best evaluation for the effectiveness? A. Monitor recent blood glucose levels B. Check for recent weight gain C. Check prealbumin levels D. Evaluate skin turgor

C. Check prealbumin levels

A patient with possible DIC arrives in the ER with a BP of 82/40, T-102°F, & severe back pain. Which prescribed action will the nurse implement first? A. Administer morphine sulfate 4mg IV. B. Give acetaminophen (Tylenol) 650 mg. C. Infuse normal saline 500 mL over 30 minutes. D. Obtain blood for CBC & coagulation studies.

C. Infuse normal saline 500 mL over 30 minutes.

The nurse has received the morning report. Which patient should she see first? A. The patient who is 6 hours post op small bowel resection who has hypoactive bowel sounds. B. The patient who is scheduled for an abdominal peritoneal resection this morning & is crying. C. The patient who is 1 day postop for abdominal surgery & has a rigid, hard abdomen. D. The patient who is 2 days post op for emergency appendectomy & is reporting abdominal pain, 8 (1-10 scale).

C. The patient who is 1 day postop for abdominal surgery & has a rigid, hard abdomen.

A healthcare provider admitted a client with second and third- degree burns over 60% of the body. Fourteen hours later, the client is receiving lactated Ringer's at 200 mL/hr. Which intervention is the priority currently? A. Administer morphine sulfate PRN. B. Assess burned areas for signs and symptoms of infection. C. Monitor hourly urine output. D. Begin hourly range of motion.

C. Urine output

The nurse is caring for patients on the burn unit. After the shift report, which patient should the nurse see first? A. full&deeppartial-thicknessburnswhohaspain rated 8 on 1-10 pain scale. B. full-thickness burns who has a urinary output of 235 mL in the past 8 hours. C. full-thickness burns on the chest who is having difficulty breathing. D. full- thicknessburnstotherightlegwithdiminished pedal pulse.

C. full-thickness burns on the chest who is having difficulty breathing.

A nurse is providing discharge teaching about nutrition to the parents of a child who has cystic fibrosis (CF). Which of the following responses by the parents indicates an understanding of the teaching? A."I will limit my child's fluid intake." B."We will restrict the amount of salt in our child's food." C."We will give our child pancreatic enzymes with snacks and meals." D."I will prepare low-fat meals with limited protein for my child."

C."We will give our child pancreatic enzymes with snacks and meals."

A nurse in a long-term care facility is caring for a patient with Alzheimer's disease. The patient, who is usually cooperative and calm, is agitated and refusing care from the nursing assistant. Which action would the nurse do first? A.Notify the health care provider and obtain a medication to treat the agitation B.Notify the patient's family and ask if someone could come in and sit with the patient C.Perform a physical assessment, including vital signs and signs of pain D.Ask the nursing assistant to distract the patient with an activity

C.Perform a physical assessment, including vital signs and signs of pain

What two minerals are coagulation factors dependent on?

Calcium and Vitamin K

Match the following types of burns with the characteristics of burns: causes skin and its proteins to liquify

Chemical

Match the following types of burns with the characteristics of burns: indicated by facial burns

Chemical

Fresh Frozen Plasma

Contains all coagulation factors present in plasma each unit is 250 ml

When monitoring initial fluid replacement for the patient with 40% TBSA deep partial thickness and full thickness burns, which finding is of most concern? A. SerumK+of4.5mEq/L B. Urine output of 35 mL/hr C. Decreased bowel sounds D. Blood pressure of 86/50mmHg

D

Which patient will the nurse apply pressure to an injection site for 5 minutes because of an increased risk for bleeding? A. A 28-year-old who has had type 1 diabetes for 15 years. B. A 42-year-old newly diagnosed with type 2 diabetes. C. A 58-year-old with chronic hypertension and heart failure. D. A 62-year-old with extensive liver damage from cirrhosis

D. A 62-year-old with extensive liver damage from cirrhosis The liver is important in blood clotting.

The nurse is carefully monitoring a postpartum patient who experienced abruptio placentae for which sign of DIC? A. Pain and swelling in the leg B. Rapid clotting times C. Increased platelet levels D. Oozing from the injection sites

D. Oozing from the injection sites

Which patient is most likely to experience hemophilia? Patient finding of: A. Bleeding time is 7 minutes B. Prothrombin time (PT) is 12 seconds C. Platelet level is 150,000/ mm3 D. Partial thromboplastin time (PTT) is 90 seconds

D. Partial thromboplastin time (PTT) is 90 seconds

The spouse of a patient, just diagnosed with Alzheimer's disease in the mild stage, asks the nurse how to plan for the future and make treatment decisions. Which response by the nurse is appropriate? A."Medicine is researching treatments for Alzheimer's disease actively, and a cure may be near." B."Discussing advanced directives may cause the Alzheimer's disease to progress more quickly." C."Disease progression is uniform, and decisions about treatment can be made after the patient is comfortable with the diagnosis." D."Health care decisions, including advanced directives, should be made while the patient is able to participate in the decision making."

D."Health care decisions, including advanced directives, should be made while the patient is able to participate in the decision making."

A 72-year-old female patient is brought to the clinic by the patient's spouse, who reports that she is unable to solve common problems around the house. To obtain information about the patient's current mental status, which question should the nurse ask the patient? A."Are you sad?" B."How is your self image?" C."Where were you born?" D."What did you eat for breakfast?"

D."What did you eat for breakfast?"

Rule of 9

Each arm & leg 9% Head 9% Upper and lower back each 9% Upper and lower abd each 9% Genitals 1%

Match the following types of burns with the characteristics of burns: Risk for cardiac dysrhythmias or arrest

Electrical

J.B. who was diagnosed with cystic fibrosis as an infant, tells you that if he is able to have children, he would like to have his wife genetically tested for CF because he knows that it is possible to be a carrier and not know it, as his parents were. J.B. shares with you that he is fearful that he will lose his health insurance if the genetic test for his wife is positive as carrier. Is J.B., right? True or False

False

Only people of african ancestry have sickle cell?

False

T/F: No need to monitor blood glucose when regular insulin is added to TPN

False

T/F: TPN is hypo osmotic solution

False

Which therapy should the nurse expect to be prescribed first by the healthcare provider for a patient who is bleeding from acute disseminated intravascular coagulation (DIC)? A. Aspirin. B. Whole Blood. C. Low molecular weight heparin D. Fresh frozen plasma.

Fresh plasma

What foods are rich in vitamin K? Does this effect warfarin dose?

Green leafy veggies Increase warfarin

Full shape

Have disorder

The nurse would monitor a patient with thrombocytopenia for which major complication? A. Fatigue B. Weakness C. Hemorrhage D. Abdominal pain

Hemorrhage

what is PPT/APTT used to monitor?

Heparin therapy

When will Fibrinogen be high and low?

High: inflammation, acute infection, heart disease Low: Liver disease, advanced cancer, malnutrition

smoke/inhalation burn

Hot air damage to resp tract

Most used medication for sickle cell

Hydroxyurea Mainstay therapy

What does WBC do in the body? When are they high and low?

Immune system, fights infection. High: infection, autoimmune, leukemia Low: immunosuppression

what triggers SC?

Low O2 in blood

Deficiency issues in SBS?

Iron, Folate, Bile salt, Low b12

diagnostic test for SBS

Labs, Abd X-ray, endoscopy, bone density

Where are inactive clotting factors produced? Why?

Liver Vitamin K & Ca

Prolonged PT time is indicative of what?

Liver disease, warfarin therapy, DIC, Vit k defic

empty square

Male

Hemophilia B

Missing factor IX

2 required blood components?

Platelets and clotting factors

2 required blood components? why?

Platelets: platelet plug Clotting factors: fibrin mesh/strands

what does defective HgbSS cause?

RBC to become rigid & deformed taking on a crescent shape in response to low O2

blood is composed of which 3 cells & percent of blood

RBC, WBC, Platelets 45%

Labs for sickle cell anemia

RBC, hct, hgb, liver function High: RBC, Bilirubin Low: Hemoglobin

Match the following types of burns with the characteristics of burns: Cancer radiotherapy

Radiation

Acute splenic sequestration crisis & treatment

Rapid accumulation of sickled RBC trapped in spleen restore blood volume, IV resection

Somatropin

SBS enhances intestinal adaption

systemic response to burn

Release of cytokines, histamines and other inflammatory mediators at the site of injury has a systemic effect once the burn reaches 20-30% of total body surface area.

Idarcizumab

Reversal agent for dabigatran

Protamine Sulfate

Reverse effects of heparin

body response to burn

Small: local Large: Systemic

Match the following types of burns with the characteristics of burns: May cause carbon monoxide poisoning

Smoke inhalation

Match the following types of burns with the characteristics of burns: Associated with flames, hot liquids, steam

Thermal

Match the following types of burns with the characteristics of burns: Hot cooking oil

Thermal

What happens when platelets are too low? What is this? When will you see this?

Thromboctyopenia: bleeding bone marrow suppression, hemorrhage, DIC, leukemia

Vitamin K

Used in nutritional deficiency or warfarin reversal

what is a prolonged APTT/PTT indicative of?

Vit K dific, hemophilia, DIC, liver disease, heparin therapy

PT time used to monitor which therapy?

Warfarin

Which part of a burn is the site of greatest heat transfer and has been damaged most severely? A. Zone of coagulation B. Zone of hyperemia C. Zone of stasis D. Peripheral zone

Zone of Coagulation

Superficial burn

a burn that involves only the epidermis pink to red, no blisters sunburn

A client is evaluated after suffering severe burns to the torso and upper extremities. The nurse notes edema at the burned areas. Which best describes the underlying cause for this manifestation? a.Decreased osmotic pressure in the burned tissue b. Reduced vascular permeability at the site of the burned area c. Increased fluids in the extracellular compartment d. Inability of the damaged capillaries to maintain fluids in the cell wall

a.Decreased osmotic pressure in the burned tissue

What lab would you check when a patient is receiving heparin?

aPTT

A patient is admitted to the burn unit with burns to the head, face, and hands. Initially, wheezes are heard, but an hour later, the lung sounds are decreased and no wheezes are audible. What is the best action for the nurse to take? a. Encourage the patient to cough and auscultate the lungs again. b. Notify the health care provider and prepare for endotracheal intubation. c. Document the results and continue to monitor the patient's respiratory rate. d. Reposition the patient in high-Fowler's position and reassess breath sounds.

b. Notify the health care provider and prepare for endotracheal intubation.

early onset alzheimers

before age 65 rare 10% caused by 1 to 3 genes

half full shape

carrier

Chemical burn

caustic agent like acids/alkalis

clinical manifestations of excessive bleeding in the heart (MI)

chest pain, SOB, back, neck, jaw, pain

What do platelets do? When are they high and low?

clot formation High: malignancy Low: autoimmune disease, bone marrow suppression, enlarged spleen

Which assessment data indicates that fluid resuscitation has been adequate in a 35-year-old, 75kg, burn patient? a. HR 105 b. POX 99 c. Burn dressings require Q2 hr changes due to serous fluid accumulation d. 37.5 - 75 ml urine/hour in the indwelling urinary catheter

d. 37.5 - 75 ml urine/hour in the indwelling urinary catheter

Intrinsic pathway

damage to inside of vessel platelets come into contact with collagen

Acute DIC

develops quickly over hours and days

Autosomal Dominant and examples

disorders are caused by a mutation of a single gene pair on a chromosome breast cancer, huntingtons

X-linked recessive examples

disorders caused by a mutation in 2 gene pairs hemophilia

compartment syndrome in burns

edema acts as tourniquet high pain, tightness, numbness, low pulse

clinical manifestations of excessive bleeding in the extremity (DVT)

edema, pain, redness

Hallmark of Cf

effect on the airways

partial thickness burn

entire epidermis & Dermis Blisters & weeps

full thickness burns

epidermis and complete dermis skin does not regrow waxy-white, yellow brown, severe edema, no pain

Complications with TPN

fluid overload, Hyperglycemia, Hypoglycemia

Electrical burns

frequently associated with significantly greater internal injuries than would be suspected from the appearance of entrance and exit wounds. May cause arrest through ventricular fibrillation activity Damage to nerves, vessels

Labs for burns

high: hgb, hct, BUN, glucose, K, Cl- Low: Na+, protein, albumin

Hemophilia

inherited X-linked recessive disorder

anticoagulant

inhibit certain clotting factors warfarin and heparin

Antiplatelets

interfere with platelet function Aspirin Clopidogrel

Severe Alzheimer's

losing ability to converse with others -assistance required for ADLs -incontinence -eventually loses all ability to move -death frequently related to choking or infection

Acute chest syndrome in sickle cell & treatment

lung injury brought on by infection O2, IV, Antibiotics

Mild Alzheimer's

memory loss & cognitive difficulties

Hemophilia A

missing factor VIII

Can males with hemophilia A or B transmit the defective gene to a son?

no

can you reply on a pulse ox to determine oxygen saturation in a patient with carbon monoxide poisening?

no

Hyperemia zone

outer zone- unburned area

Radiation burn

radiation causing damage to skin sunburn, MRI, Xray

treatment of hemophilia

replace missing CF

Andexxa

reversal agent for xarelto and eliquis

S/S of CF

salt-tasting skin Chronic coughing Mucus Lung infections Malnutrition Male infertility

S/S of SBS

severe diarrhea, Steatorrhea, pain

DIC bleeding manifestations

spontaneous bleeding, OOZING, hemoptysis, tachycardia, hypotension, AMS, headache, dizziness

Causes of SBS

surgical removal, functional, birth defects

pediatric considerations for sickle cell?

symptoms usually occur at 5-6 months to 1 yr. High risk of stroke

D-Dimer

test for blood clot Normal: non-detected Abnormal: <500 ng/mL

Meds for SBS

vitamins, antidiarrheal, pancreatic enzyme

clinical manifestations of excessive bleeding in the brain (stroke)

weak 1 side of body, numbness, confusion

Patho of CF

•Mutation in the CFTR gene on chromosome 7