Deck 41: Smoke Inhalation and Thermal Injuries

Question 1

Your patient with carbon monoxide poisoning has a COHb level of 20%. If he is given 100% oxygen, what will be the approximate COHb level be at 1 hour?

A) 15%
B)10%
C)5%
D)2.5%

Answer 1

10%

Question 2

After the correction of any hypoxemia, the next pulmonary complication seen in the fire victim with extensive body and facial burns is:

A) acute respiratory distress syndrome (ARDS).
B)upper airway obstruction.
C)pneumonia.
D)pulmonary embolism.

Answer 2

upper airway obstruction.

Question 3

Your patient has ARDS and is in acute ventilatory failure. As the respiratory therapist, what would you recommend be done?

A) Apply continuous positive airway pressure (CPAP)
B)Provide 100% oxygen
C)Begin mechanical ventilation with positive end-expiratory pressure (PEEP)
D)Begin extracorporeal membrane oxygenation (ECMO)

Answer 3

Begin mechanical ventilation with positive end-expiratory pressure (PEEP)

Question 4

All of the following will be typically found in the air of an enclosed house fire, EXCEPT:

A) steam.
B)carbon monoxide.
C)hydrogen cyanide.
D)hydrogen chloride.

Question 5

All of the following classes of medications are commonly used in the care of patients with a smoke inhalation injury, EXCEPT:

A) parasympatholytics.
B)mucolytics.
C)sympathomimetics.
D)xanthines.

Question 6

Clinical signs that a patient has a thermal injury to the upper airway include:
1) wheezing.
2) inspiratory stridor.
3) pulmonary edema.
4) painful swallowing.

A)1, 3
B)2, 4
C)2, 3, 4
D)1, 2, 3, 4

Question 7

Clinical signs of an upper airway thermal injury include:
1) facial burns.
2) atelectasis.
3) mucosal edema.
4) epithelial sloughing.

A)3
B)1, 4
C)1, 3, 4
D)1, 2, 3, 4

Question 8

Your patient is in the intermediate stage of recovery from a serious smoke inhalation injury. What radiographic finding should be expected?

A) Pulmonary edema/ARDS
B)Patchy or segmental infiltrates
C)Empyema
D)Normal/full recovery

Question 9

The long term effects of a smoke inhalation injury are:

A) obstructive lung disease.
B)restrictive lung disease.
C)obstructive and restrictive lung disease.
D)neither, there is normally complete healing.

Question 10

A throbbing headache, nausea, vomiting, and impaired judgment are common clinical manifestations when the blood COHb is at what level?

A) 0% to 10%
B)10% 20%
C)20% to 30%
D)30% to 50%

Question 11

A 65-year-old patient has third-degree skin burns over 30% of his body and a smoke inhalation injury. How does the combination of skin burns and smoke inhalation affect his prognosis?

A) It quadruples the mortality rate.
B)It more than triples the mortality rate.
C)It almost doubles the mortality rate.
D)There is no mortality change between having one or two problems.

Question 12

A patient has been brought to the Emergency Department after inhaling super heated steam. Pulmonary injuries unique to this situation include:
1) atelectasis.
2) pulmonary edema.
3) thick secretions.
4) pharyngeal edema.

A)3
B)1, 2
C)2, 3, 4
D)1, 2, 3, 4

Question 13

A patient who inhaled low water solubility gases (hydrogen chloride and phosgene) will have effects in what area(s)?

A) Distal airways and alveoli
B)Pulmonary vascular bed
C)Upper airway
D)Pulmonary lymphatic system

Question 14

A 10-year-old patient has inhaled hot gases and an inspection of her mouth shows edema and blisters. What should be done?

A) Perform a bronchoscopy to evaluate the trachea.
B)Perform endotracheal intubation.
C)Check her pulse oximeter value.
D)Give her a breathing treatment with racemic epinephrine.

Question 15

Late stage complications of extensive body surface burns include:
1) sepsis.
2) cyanide poisoning.
3) pneumonia.
4) pulmonary embolism.

A)1, 2
B)3, 4
C)2, 3
D)1, 3, 4