Sherpath Peds-Pediatric Thermal Injury
The nurse is educating new parents on environmental safety concerns to make in the home. A new mother states that she uses the microwave to heat the infant's bottles because it is convenient and quick. Which response by the nurse is most appropriate? "Place ice cubes in the bottle to decrease the temperature." "It is alright to give the baby a bottle right out of the refrigerator." "Breastfeeding is the best method of feeding and has no risk for injury." "The microwave heats unevenly and can cause scalding injuries to the mouth and throat."
"The microwave heats unevenly and can cause scalding injuries to the mouth and throat." The nurse should inform the patient that the microwave can lead to scalding injury.
The parent of a 7-year-old with deep partial thickness burns on the legs from a camping accident asks the nurse about the healing time for the child's injury. Which response by the nurse is most appropriate? "With proper care, the wound should heal in the next 1-3 weeks." "The wound will not heal without skin grafting and other surgeries." "You can expect the wound to heal in the next 3-7 days without treatment." "You can expect it to take 30 days to several months for complete healing."
"You can expect it to take 30 days to several months for complete healing." A deep partial thickness burn will heal in 30 days as long as it does not become infected.
A 5-year-old with severe burns weighs 25 kg. The child has a urine output 30 mL in the last two hours, serum sodium of 122, and serum potassium of 5.1. Which action is most important for the nurse to take? Administer IV fluids as ordered Assess serum glucose as ordered Administer Kayexalate PO as ordered Assess serum calcium level as ordered
Administer IV fluids as ordered The child with 30 mL of urine output in two hours, hyponatremia, and hyperkalemia has a fluid and electrolyte imbalance that should be treated with IV fluids.
Upon entering the room of a child with minor burns on the back and anterior trunk after a trip to the beach, the child complains of itching to the area. Which actions should the nurse take? Select all that apply. Begin wound debridement Apply warm compress to the area Administer PO Benadryl as ordered Encourage parents to apply lotion to the area Explain that itching is a sign of normal healing
Administer PO Benadryl as ordered The nurse should administer an antihistamine to a child with itching over a minor burn. Correct Encourage parents to apply lotion to the area The nurse should encourage parents to apply lotion to the area of a minor burn that itches. Correct Explain that itching is a sign of normal healing The nurse should teach parents that itching is a normal sign of healing for patients with minor burns.
A 9-year-old child with severe burns on the face, trunk, and abdomen is lethargic and pale 24 hours after the initial burn. The nurse notes edema in the extremities, heart rate 135, urine output 60 mL over the past four hours. Which actions should the nurse take? Select all that apply. Obtain chest x-ray as ordered Administer colloids as ordered Apply silvadene cream as ordered Administer pain medication as ordered Increase the rate of IV fluids as ordered
Administer colloids as ordered Pallor, tachycardia, decreased urine output and edema indicate poor organ perfusion and third spacing of fluid into the interstitial space. Colloids should be administered to help decrease cell permeability and force fluids back into the cell. Increase the rate of IV fluids as ordered Pallor, tachycardia, decreased urine output and edema indicate poor organ perfusion and third spacing of fluid into the interstitial space. The IV fluid rate should be increased to help improve renal perfusion.
A child who sustained an electrical burn reports shortness of breath and chest heaviness. The nurse notes diaphoresis, and pallor. Which additional assessment(s) are a priority for the nurse to obtain? Select all that apply. Heart rate Serum glucose Serum sodium level Abdominal ultrasound Obtain an order for an ECG
Heart rate When a child with electrical burns complains of shortness of breath and chest heaviness, the heart rate should be assessed along with a full cardiac assessment. Obtain an order for an ECG When a child with electrical burns complains of shortness of breath and chest heaviness, an ECG is a priority because the electricity can disrupt the electrical activity of the heart.
The nurse is caring for an 8-year-old patient with second degree burns over 15% of the total body surface area (TBSA). On assessment, the nurse notes the following vital signs: HR 134, RR28, BP 82/48, Temp 97.4. Which action should the nurse take first? Give IV antibiotics as ordered Administer IV dopamine as ordered Initiate IV fluid resuscitation as ordered Administer IV pain medication as ordered
Initiate IV fluid resuscitation as ordered A child with second degree burns and tachycardia should have IV fluid resuscitation.
A child recovering from major burns four weeks ago complains of nausea, vomiting, and epigastric pain that worsen with eating. The nurse notes tenderness on palpation and a positive gastric aspirate positive for blood. Which provider orders should the nurse anticipate? Select all that apply. NPO Endoscopy Hemoccult IV protonix Administer PO acetaminophen
NPO If a child with burn injury complains of epigastric pain that worsens with eating, the nurse would anticipate making the patient NPO to prevent pain. Correct Endoscopy If a child with burn injury complains of epigastric pain that worsens with eating, the nurse would anticipate sending the patient for an endoscopy to determine if a stress ulcer is present. IV protonix If a child with burn injury complains of epigastric pain that worsens with eating, the nurse would anticipate giving IV protonix to decrease the risk for worsening stress ulcer.
Question 17 of 18 A child with electrical burns from touching an active power line reports numbness in the fingers. The nurse notes the hands and arms are edematous. Which actions should the nurse take? Select all that apply. Assess capillary refill Assess the peripheral pulses Perform neurovascular checks Assess the toes and lower extremity Administer pain medication as ordered
Assess capillary refill When a child with electrical burns to the arm complains of numbness in the fingers, the nurse should assess the capillary refill. Assess the peripheral pulses When a child with electrical burns to the arm complains of numbness in the fingers, the nurse should assess the peripheral pulses. Perform neurovascular checks When a child with electrical burns to the arm complains of numbness in the fingers, the nurse should perform neurovascular checks.
A patient who sustained an electrical injury from a toaster complains of pain 9/10 to the right arm. Lab results show pH of 7.2, HCO3 of 17, and PCO2 of 40. Normal saline is running at 125 mL/hr, IV pain medications are ordered for every four hours. Which action should the nurse take first? Administer oxygen via nasal cannula Administer IV pain medication as ordered Increase IV fluid rate to 250ml/hr as ordered Change IV fluids to Ringer's Lactate as ordered
Change IV fluids to Ringer's Lactate as ordered The patient's lab results indicate metabolic acidosis. The nurse should change the fluids to ringer's lactate because it has a higher concentration of electrolytes and will help correct the problem.
What is the extent of injury for a 1-year-old with burns to the posterior trunk, buttocks, and bilateral thighs? 9% 13% 29% 42%
29% The extent of injury for a 1-year-old with burns to the posterior trunk, buttocks, and bilateral thighs is 29% according to the Lund and Browder chart.
The nurse is educating parents of a child with sunburn on the upper back and shoulders. Which statement, made by the parents, indicates the need for further teaching? "I can expect itching as the area starts to heal." "Cool compresses are effective for pain relief." "My child needs to be on bedrest for 3-4 days." "I will apply lotion when the skin begins to peel."
"My child needs to be on bedrest for 3-4 days." When educating a parent about sunburn, the nurse knows further teaching is necessary if the parents say they will keep the child with minor burns on bed rest for 3-4 days.
The nurse is caring for a child with circumferential burns to the abdomen. On assessment, the nurse notes tachycardia, tachypnea, and diminished bowel sounds. Which additional questions should the nurse ask? Select all that apply. "Have you expelled any gas?" "How did you get this burn?" "Are you experiencing any pain?" "Will your family come visit today?" "When was your last bowel movement?"
"Have you expelled any gas?" Circumferential burns to the abdomen and diminished bowel sounds, tachycardia, and tachypnea indicate abdominal compartment syndrome. The nurse should ask the patient about other GI activity such as expulsion of gas. "Are you experiencing any pain?" The nurse would conduct a thorough pain assessment on a patient with circumferential burns to the abdomen and diminished bowel sounds, tachycardia, and tachypnea. "When was your last bowel movement?" Circumferential burns to the abdomen and diminished bowel sounds, tachycardia, and tachypnea indicate abdominal compartment syndrome. The nurse should ask the patient about other GI activity such as bowel elimination patterns.
A 17-year-old girl has burns to the face and neck after a kitchen accident. The parents tell the nurse that the girl does not interact with friends or family, spends most of her time in her room, and avoids going to school. Which actions should the nurse take? Select all that apply. Assess for suicidal ideation. Consult with a child life specialist. Recommend home schooling through graduation. Encourage the patient to verbalize feelings about her appearance. Discuss ways to use cosmetics to minimize the perceived disfigurement.
Assess for suicidal ideation. If a 17-year-old is self-isolating after a burn injury, the nurse would assess for suicidal ideation. Incidence of suicide is high in adolescents. Correct Consult with a child life specialist. If a 17-year-old is self-isolating after a burn injury, the nurse would consult a child life specialist to help the child explore their feelings. Encourage the patient to verbalize feelings about her appearance. If a 17-year-old is self-isolating after a burn injury, the nurse would encourage the patient to verbalize feelings about her appearance. Correct Discuss ways to use cosmetics to minimize the perceived disfigurement. If a 17-year-old is self-isolating after a burn injury, the nurse would discuss ways to use cosmetics to minimize the perceived disfigurement.
A 12-year-old child has burns to the face, hands, legs, and palms after a house fire. Which action by the nurse is most important? Determine the TBSA Assess the airway for patency Begin IV fluid bolus as ordered Administer pain medication as ordered
Assess the airway for patency The priority nursing action is to assess the airway for all patients with facial burns.
A child recovering from a moderate burn to the anterior trunk and abdomen has Hgb 12, Na 140, K 4.7, and serum albumin 2.8. Which action is most important for the nurse to take? Transfuse 1 unit PRBCs as ordered Give albumin intravenously as ordered Provide high-calorie, high-protein foods Administer 1 gram of Potassium chloride as ordered
Provide high-calorie, high-protein foods A serum albumin of 2.8 indicated malnutrition. Protein is necessary for wound healing. The nurse should offer a high-calorie, high-protein diet to promote healing.
A patient with burns on the face and neck has an order to apply moist sterile gauze and silver sulfadiazine to all burns. Which action should the nurse take first? Question the order for Silvadene. Change the order to moist gauze. Apply bacitracin ointment to face as ordered. Apply Silvadene as ordered, but avoid the eyes.
Question the order for Silvadene. Silvadene cream is not typically used on facial burns. The nurse should question the order.
Parents of a 6-year-old comment that their son enjoys playing outside most of the day during summer break. They apply SPF 10 sunscreen in the morning, and provide beverages to maintain the child's hydration. Which information is important to include in teaching for these parents? Select all that apply. Sunscreen should be reapplied frequently. Avoid sun exposure between 1000 and 1500. Encourage the child to wear multiple layers of clothing. Juice and cola are acceptable for maintaining hydration. Sunscreen should be SPF 15 or higher and have UVA and UVB protection.
Sunscreen should be reapplied frequently. Parents should be told to reapply sunscreen frequently when their child is outside for an extended time. Avoid sun exposure between 1000 and 1500. The nurse should teach parents to keep children out of the sun between 1000 and 1500 during the summer months. Sunscreen should be SPF 15 or higher and have UVA and UVB protection. Parents should be encouraged to use sunscreen with SPF of at least 15 with UVA and UVB protection.
