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  • What are the priority assessment data to obtain from this client on admission? The client has experienced an electrical injury, with the entrance site on the left hand and the exit site on the...
    What are the priority assessment data to obtain from this client on admission? The client has experienced an electrical injury, with the entrance site on the left hand and the exit site on the...
    If a person comes into direct exposure with an electrical current, damage can occur to the skin and internal organs. Electrical shock takes place upon contact of a human body part with any source of electricity that causes a sufficient magnitude of current to pass through the victim's flesh, viscera, or hair. More intense currents may induce involuntary muscle contraction, preventing the victim from breaking free of the source electricity. The range of motion is the measurement of the amount of movement around a specific joint or body part. Evaluation of the whole person is crucial beginning with heart functions, breathing, progressing to brain function, and extremity function.

  • What are the four types of burns?
    What are the four types of burns?
    Electrical, thermal, chemical, radiation burn

  • Which of the following statements reflect the nursing management of the patient with a white phosphorus chemical burn?
    Which of the following statements reflect the nursing management of the patient with a white phosphorus chemical burn?
    The chemical white phosphorous comes from the common element phosphorous. It is an allotrope of that. One result of white phosphorous is through burning. Deep burns can actually occur. Unfortunately, the reason the burn is so severe is due to the fact that the chemical attaches to the skin and continues to burn. The white phosphorous burns kill more than other burns. It is that severe and deadly. Like many burns, the same treatment should occur with the management of a patient who has a white phosphorous chemical burn. This includes taking off the patient’s clothing. Some suggestions include flushing the phosphorous particles out with water or a saline solution whereas others suggest that flushing out a wound with chemical burn should not happen.

  • Which type of fluid should the nurse expect to prepare and administer as fluid resuscitation during the emergent phase of burn recovery?
    Which type of fluid should the nurse expect to prepare and administer as fluid resuscitation during the emergent phase of burn recovery?
    1. crystalloids-although not universally true, most fluid resuscitation for burn injuries starts with crystalloid solutions, such as normal saline and ringers lactate. the burn client rarely requires blood during the emergent phase unless the burn is complicated by another injury that involved hemorrhage. colloids and plasma are not generally used during the fluid shift phase because these large particles pass through the leaky capillaries into the interstitial fluid, where they increase the osmotic pressure. increased osmotic pressure in the interstitial fluid can worsen the capillary leak syndrome and make maintaining the circulating fluid volume even more difficult.dif: cognitive level: comprehensiontop: nursing process step: implementation/interventionmsc: client needs category: safe, effective care environment;

  • What is the most important reason to administer the opioid analgesic to this client by the intravenous route? The burned client newly arrived from an accident scene is prescribed to receive 4 mg...
    What is the most important reason to administer the opioid analgesic to this client by the intravenous route? The burned client newly arrived from an accident scene is prescribed to receive 4 mg...
    The danger of an overdose during fluid remobilization is reduced.Although providing some pain relief has a high priority, and giving the drug by the IV route instead of IM, SC, or orally does increase the rate of effect, the most important reason is to prevent an overdose from accumulation of drug in the interstitial space during the fluid shift of the emergent phase. When edema is present, cumulative doses are rapidly absorbed when the fluid shift is resolving. This delayed absorption can result in lethal blood levels of analgesics. DIF: Cognitive Level: Comprehension TOP: Nursing Process Step: Implementation/Intervention MSC: Client Needs Category: Safe, Effective Care Environment;

  • What point after a burn injury should the nurse be most alert for the complication of hypokalemia?
    What point after a burn injury should the nurse be most alert for the complication of hypokalemia?
    1. During fluid remobilizationHypokalemia is most likely to occur during the fluid remobilization period as a result of dilution, potassium movement back into the cells, and increased potassium excreted into the urine with the greatly increased urine output. DIF: Cognitive Level: Comprehension TOP: Nursing Process Step: Assessment MSC: Client Needs Category: Safe, Effective Care Environment;

  • What is the nurse’s best action? Ten hours after the client with 50% burns is admitted, her blood glucose level is 90 mg/dL.
    What is the nurse’s best action? Ten hours after the client with 50% burns is admitted, her blood glucose level is 90 mg/dL.
    Document the finding as the only action.Neural and hormonal compensation to the stress of the burn injury in the emergent phase increases liver glucose production and release. An acute rise in the blood glucose level is an expected client response and is helpful in the generation of energy needed for the increased metabolism that accompanies this trauma. DIF: Cognitive Level: Application or higher TOP: Nursing Process Step: Implementation/Intervention MSC: Client Needs Category: Safe, Effective Care Environment;

  • How many fluids should the patient receive in the first 24 hours post-injury using the Parkland Formula for fluid resuscitation? You are called to a rural medical facility to transport a 80kg,...
    How many fluids should the patient receive in the first 24 hours post-injury using the Parkland Formula for fluid resuscitation? You are called to a rural medical facility to transport a 80kg,...
    1. 8,640cc fluidsThe Parkland Formula is four times weight in kilograms times the percentage area of burn. This patient would get 4cc x 80kg = 320, x 27% area of burn = 8,640cc, to be administered in the first 24 hours following the burn injury. Half of these fluids should be given within the first eight hours, with the remaining fluids administered in the following sixteen hours. Note that if treatment were started 2 hours after the burn time, half would be given in the first SIX hours.

  • How should this injury be categorized? The newly admitted client has burns on both legs. The burned areas appear white and leather-like. No blisters or bleeding are present, and the client states...
    How should this injury be categorized? The newly admitted client has burns on both legs. The burned areas appear white and leather-like. No blisters or bleeding are present, and the client states...
    SuperficialThe characteristics of the wound meet the criteria for a full-thickness injury (color that is black, brown, yellow, white or red; no blisters; pain minimal; outer layer firm and inelastic). DIF: Cognitive Level: Application or higher TOP: Nursing Process Step: Assessment MSC: Client Needs Category: Safe, Effective Care Environment/Physiological Integrity;

  • What is the nurse’s best action? The client, who is 2 weeks postburn with a 40% deep partial-thickness injury, still has open wounds. On taking the morning vital signs, the client is found to...
    What is the nurse’s best action? The client, who is 2 weeks postburn with a 40% deep partial-thickness injury, still has open wounds. On taking the morning vital signs, the client is found to...
    Notify the burn emergency team.These findings are associated with systemic gram-negative infection and sepsis. This is a medical emergency and requires prompt attention. DIF: Cognitive Level: Application or higher TOP: Nursing Process Step: Implementation/Intervention MSC: Client Needs Category: Safe, Effective Care Environment;

  • Is the following true or false? In severe burns involving the face or airway, it is best to use nasotracheal intubation.
    Is the following true or false? In severe burns involving the face or airway, it is best to use nasotracheal intubation.
    FalseGenerally it is best to use the largest ET possible for intubating a burn patient with a compromised airway, because there will be swelling of tissues which may tend to reduce ET tube diameter. Larger tubes can be placed by the oral route than by the nasal.

  • Which position is most important to be emphasized by the nurse that the client maintain to retain maximum function of this joint? The client has severe burns around the right hip.    This...
    Which position is most important to be emphasized by the nurse that the client maintain to retain maximum function of this joint? The client has severe burns around the right hip.    This...
    Hip at zero flexion with leg flatMaximum function for ambulation occurs when the hip and leg are maintained at full extension with neutral rotation. Although the client does not have to spend 24 hours at a time in this position, he or she should be in this position (in bed or standing) more of the time than with the hip in any degree of flexion. DIF: Cognitive Level: Application or higher TOP: Nursing Process Step: Implementation/Intervention MSC: Client Needs Category: Safe, Effective Care Environment/Health Promotion and Maintenance;

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