Ch. 51: Coordinating Care for Patients with Burns

A patient recovering from full-thickness burns rates pain as a 9 on a scale of 0 to 10 when hydrotherapy is performed. For which type of pain should this patient be treated?

Procedural

The nurse is preparing an educational tool to instruct community members on burn prevention. What should the nurse include as the most common injury in children under age 5?

Scald

A patient is ending the first year of recovery after having burns to both legs. Which observation indicates that the patient needs to be encouraged to wear the pressure garment?

Scattered areas of scarring noted

A patient with deep partial-thickness wounds is receiving enzymatic debridement. What assessment made by the nurse would indicate that wound care treatment has been successful?

Separation of eschar

The nurse is evaluating nutritional teaching provided to a patient recovering from 24% total body surface area burns. Which information indicates that teaching has been effective?

Serum protein level 7.1 g/dL

A victim of a house fire is brought to the emergency department for burn treatment. What assessment finding indicates that the patient may have an inhalation injury?

Singed facial hair

A patient with 55% total body surface area burned received two-thirds of the required fluid resuscitation. For which potential problem should the nurse prepare to provide care to this patient?

Increased zone of coagulation

A patient has full-thickness burns over 30% of total body surface area. Which intervention will least likely provide comfort initially to this patient?

Medicate for pain around the clock

A patient recovering from deep and full thickness burns is nauseated. Which medication should the nurse provide to help this patient?

Metoclopramide (Reglan)

The nurse is assisting with the secondary survey of a patient with 50% total body surface area electrical burns. Which test would be a priority for this patient?

12-lead electrocardiogram

A patient with several deep partial-thickness burns asks how long it will take for the burn to heal. What should the nurse respond to this patient?

"More than two weeks."

A patient has been recovering for 18 months from burns that affected 60% total body surface area. For which problems should the nurse anticipate providing continuing care to this patient? Select all that apply

-Anxiety -Depression -Body image disorder -PTSD

A patient is diagnosed with several superficial partial-thickness burns. What treatment would be indicated for this patient? Select all that apply

-Apply bacitracin ointment -Cover with a nonadherent bandage -Wash with antiseptic soap and warm water

The nurse is caring for a patient who sustained chemical burns. What would have caused these injuries? Select all that apply

-Lime -Gasoline -Bleach -Hydrofluoric acid

The school nurse is preparing material for National Fire Prevention week. What information should be added to the classroom posters? Select all that apply

-Never leave a burning candle unattended -Keep a flashlight and telephone near the bed -Check smoke alarm batteries every six months -Never use the oven as a method to warm the home

A patient weighing 187 lbs. has 38% total body surface area burns. Using the Parkland formula, how much fluid should this patient receive over the first eight hours after the burn occurred? Record your answer as a whole number. ______

6460 mL

An 11-year-old child received burns over both upper and lower arms, both hands, anterior upper and lower legs, anterior chest, and the neck. Using the following as a guide, what is this child's total body surface area burned?

65 %

A patient with 35% total body surface area burns is in the rehabilitative phase of care. Which approach should be used to reduce the risk of developing contractures?

Apply splints

A victim of a car fire is confused, dizzy, and nauseated. What diagnostic test should be done to determine if this patient is experiencing carbon monoxide poisoning?

Carboxyhemoglobin level

The nurse is evaluating care provided to a patient with burns during the emergent phase. Which data indicates that additional fluid resuscitation is required?

Central venous pressure 2 mm Hg

It is documented that a patient has superficial partial-thickness burns over both anterior lower arms. What should the nurse expect when assessing this patient?

Open or closed blisters, mild edema, easily blanches

A patient is admitted for a suspected inhalation injury. What should the nurse emphasize when caring for this patient?

Deep breathing and coughing every hour

The nurse is caring for a patient with 70% total body surface area chemical burns. Which approach should the nurse anticipate to meet this patient's nutritional needs?

Duodenal tube feedings

The nurse is caring for a patient who sustained electrical burns. Why should the nurse monitor this patient for compartment syndrome?

Fluid seeps from intravascular spaces into the interstitium

A patient recovering from 25% total body surface area burns has a low-grade fever. What should the nurse do to reduce this patient's risk of developing an infection?

Follow contact precautions

The nurse is caring for a patient with 45% total body surface area thermal burns. Which laboratory value change would be expected?

Increased potassium

A patient comes into the emergency room seeking treatment for radiation burns. What should be considered prior to providing care to this patient?

Type, dose, and length of exposure

The nurse is caring for a patient with 50% total body surface area burns. Which finding indicates that burn shock is resolving?

Urine output 800 mL over 2 hours