MED SURG 3 (FINAL EXAM) - Burns
During the early phase of burn care, the nurse should assess the client for? A) Hypernatremia B) Hyponatremia C) Metabolic alkalosis D) Hyperkalemia
D) Hyperkalemia - The patient with a burn will exhibit hyperkalemia due to cell destruction.
Using the Parkland formula, calculate the hourly rate of fluid replacement with lactated Ringer's solution during the first 8 hours for a client weighing 75 kg with total body surface area (TBSA) burn of 40%.
750 mL / hr Parkland Formula: (4 mL of LR) x body weight in KG x total BSA burned (%)
There has been a fire in an apartment building. All residents have been evacuated, but many are burned. Which clients should be transported to a burn center for treatment? Select all that apply. A) A 6-year-old with third-degree burns over 10% of his body surface area (BSA) B) A 20-year-old who inhaled the smoke of the fire C) A 50-year-old diabetic with first- and second-degree burns on his left forearm (about 5% of his BSA) D) A 30-year-old with second-degree burns on the back of his left leg E) A 40-year-old with second-degree burns on his right arm (about 10% of his BSA)
A) A 6-year-old with third-degree burns over 10% of his body surface area (BSA) B) A 20-year-old who inhaled the smoke of the fire C) A 50-year-old diabetic with first- and second-degree burns on his left forearm (about 5% of his BSA)
The nurse should plan to begin rehabilitation efforts for the burn client: A) Immediately after the burn has occurred B) After the client's circulatory status has been stabilized C) After grafting from the burn wounds has occurred D) After the client's pain has been eliminated
B) After the client's circulatory status has been stabilized
In the acute phase of a burn injury, which pain medication would most likely be given to a client to decrease the perception of the pain? A) Oral analgesics such as ibuprofen (Motrin) or acetaminophen (Tylenol) B) Intravenous opioids C) Intramuscular opioids D) Oral anti-anxiety agents such as lorazepam (Ativan)
B) Intravenous opioids - Patients with burns often exhibit severe pain, and therefore need opioids to relieve. IV opioids work fastest.
The rate at which IV fluids are infused is based on the burn client's: A) Lean muscle mass and body surface area (BSA) burned B) Total body weight and BSA burned C) Total BSA and BSA burned D) Height and weight and BSA burned
B) Total body weight and BSA burned
A client is receiving fluid replacement with lactated Ringer's after 40% of the body was burned 10 hours ago. The assessment reveals temperature of 36.2, heart rate of 122, blood pressure of 84/32. Central venous pressure (CVP) is 2 mm Hg, and the urine output is 25 mL for the last two hours. The IV rate is currently 375 mL/hr. Using the SBAR technique for communication, the nurse calls the HCP with a recommendation for: A) Furosemide (Lasix) B) Fresh frozen plasma C) IV rate increase D) Dextrose 5%
C) IV rate increase - The patient is exhibiting symptoms of hypovolemia, and therefore needs an increase in the IV rate.
The nurse is assessing an 80-year-old client who has scald burns on the hands and both forearms (first- and second-degree burns on 10% of the body surface area). What should the nurse do first? A) Clean all wounds with warm water B) Apply antibiotic cream C) Refer the client to a burn center D) Cover the burns with a sterile dressing
C) Refer the client to a burn center
