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Burn: Case Study
Transcript of Burn: Case Study
MC Questions Adapted from:
40 yo, 78kg pt presents to ED pose house fire. PT's chest and anterior trunk is red and blistered, back and right arm are pale and waxy, and right thigh is reddened. GCS 14. Placed immediately in Resus 1.
Calculate his TBSA?
What are some of your immediate concerns?
When evaluating your patients intake and output, which of the following should you take in to account?
a) The amount of urine will be decreased in the first 24-48hrs, and should increase after
b) The amount of urine output will be the greatest in the first 24hrs post burn
c)The amount of urine will be dec. in the first 8hrs, and then increased as fluid resuscitation is successful
d)The amount of urine will slowly decreased between day 3-5
What should your nursing priorities be?
What lab work would be your priority and why?
You have applied O2 to the pt and O2 sats are hovering around 92%. You have also drawn blood work and started the Ringers solution bolus. What other possible orders might you expect to be given?
- Resp concern from initial insult?
- Resp Concern 2-5 days later?
- Fluid Status?
Which of the following lab values could be anticipated post burn? Why?
a) Decreased Hb & Increased HCT
b) Inc. Hb & HCT
c) Inc Hb. & Dec. HCT
d) Dec. Hb & HCT
e) Normal Hb & HCT
During the acute phase of burn treatment which of the following are important goals:
a) providing for patient comfort
b) preventing infection
c) providing adequate nutrition for healing
d) splinting, positioning, and exercising affected joints
e) assesing home maintenance management
Your patients family want to know why the "scabs" are being cut off. What is the most appropriate response of the nurse to the family?
a) "the scabs are really old burned tissue and need to be removed to promote healing"
b) "Ill ask the doctor to come and talk to you about the treatment plan"
c) "the patient asked for the scabs to be removed"
d)"the scabs are removed to check for blood flow to the burned area"
It is day 4 post burn and you are noticing that serum K+ is starting to drop. This finding is consistent with:
a) resolution of burn shock
b) the onset of burn shock
c) the onset of renal failure
d) the onset of liver failure
Which of the following assessment is the most appropriate indicator to determine respiratory effectiveness:
a) pt is able to talk
b) SPO2 97%
c) Pt is alert and oriented
d) No accessory muscle use
Your health hx on the patient reveals the following. Which is of most concern to you and why?
a) had Hep B 10 years ago
b) has seasonal asthma
c) had an MI 1 year ago
d) Hx of kidney stones
What clinical manifestation would best alert you to CO poisoning?
a) SPO2 80%
b) Exp. stridor and nasal flaring
c) cherry red tinge to mucous membranes
d) prescence of carbonaceous particles in the sputum
On initial assessment of this client 6 hours post burn you noted wheezes laterally. You now hear no wheezes at all. What is the most appropriate course of action:
a) Document the findings as the only course of action
b) Elevate the head of the bed
c) Notify the burn team immediately
d) Loosen the dressings to the chest to allow for better lung filling
Your patient has just learnt he will have extensive scarring once the burn heals. Which would be an appropriate nursing diagnosis for this patient at this time?
b) potential for infection
c) fluid volume deficit
d)risk for ineffective airway clearance
Which statement by your patient indicated correct understanding of the rehab process after the burn?
a) "I will never be fully recovered from the burn"
b) "I will be considered fully recovered once all the wounds have healed"
c) "I will be fully recovered when I can perform all the activities I did before the burn"
d) "I will be fully recovered when I can achieve the highest level of functioning that I can"
Nurselabs. (2012). Medical surgical nursing exam: Burns. Retrieved from http://nurseslabs.com/medical-surgical-nursing-exam-13-burns-40-items/
Quizlet. (2013). NCLEX style practice questions: Burns. Retrieved from http://quizlet.com/20904243/nclex-style-practice-questions-burns-flash-cards/