Question 1

A patient,being treated for burns over 40% of the total body surface area,is experiencing a hypermetabolic state.The nurse anticipates the addition of which type of medication to help reduce muscle wasting and accelerate healing time?

Accepted Answer

The medication that can help reduce muscle wasting and accelerate healing time in a hypermetabolic state is insulin. Insulin promotes protein synthesis, inhibits protein degradation, and increases glucose uptake by cells, which can counteract the catabolic effects of the hypermetabolic state. Antibiotics are used to treat infections, cardiac glycosides are used to treat heart failure, and calcium channel blockers are used to treat hypertension and angina. These medications are not indicated for treating the hypermetabolic state in burn patients.

Question 2

A patient,recovering from being struck by lightning 36 hours prior to admission,is demonstrating an acute onset of confusion and muscle weakness.Which rationale would the nurse provide for this assessment?

Accepted Answer

Delayed onset of neurological symptoms, including confusion and muscle weakness, is common after a lightning injury. These symptoms may not appear until several hours or even days after the initial injury.

Question 3

A patient comes into the emergency department with severe burns over the face,arms,legs,and back after spending the day boating with friends.The skin is dry and very red with brisk capillary refill.How would the nurse classify this patient's burn injuries?

Accepted Answer

A

Question 4

The nurse is preparing to ambulate a patient who sustained burns over 20% of his lower extremities.Which intervention is most important to facilitate the success of the patient's ambulation?

Accepted Answer

Applying compression wraps to the lower extremities before getting out of bed will help reduce the risk of edema and aid in the patient's ability to ambulate. Transferring the patient to a chair before ambulating may also be helpful but is not the most important intervention for success in ambulation. Being well hydrated and performing incentive spirometry are important interventions for overall patient care but are not directly related to success in ambulation for a patient with burns on the lower extremities.

Question 5

The nurse caring for a patient admitted for burns over his torso and upper arms has clothing adhered to the skin.Which nursing action is indicated?

Accepted Answer

Leaving the clothing in place and flushing the areas with cooled water is the best choice as attempting to remove clothing adhered to burned skin can cause further trauma and pain to the patient. Flushing the areas with cooled water can help to cool the burn and prevent further injury. It is important to seek medical attention for burns, and a healthcare provider may need to assess and treat the patient's wounds.

Question 6

A patient with severe,deep partial-thickness burns experiences procedural,background,and breakthrough pain.What is the nurse's most important plan for controlling this patient's pain?

Accepted Answer

The answer of A patient with severe,deep partial-thickness burns experiences...

Question 7

A civilian patient admitted with frostbite burns to her feet is receiving pain medication and fluid replacement and is being monitored for any signs of organ dysfunction.What rationale would the nurse provide for this conservative management?

Accepted Answer

Frostbite injuries can be deceptive, and it may not be immediately clear how much tissue damage has occurred. For this reason, conservative management that includes close monitoring of the patient's condition and frequent reassessment of the affected area is often preferred over more aggressive treatments. Additionally, frostbite can put the patient at risk of complications such as organ dysfunction, so fluid replacement and pain management are important parts of the patient's care.

Question 8

A patient is admitted with partial-thickness burns over the entire left arm and neck.Superficial burns are present on the face and scalp.The anterior trunk has patches of superficial burns.There are deep partial-thickness burns on the legs with full-thickness burns on both feet.The nurse using the Lund and Browder chart to estimate the total body surface area burned will include the burns on which body areas? Note: Credit will be given only if all correct choices and no incorrect choices are selected.
Select all that apply.

Accepted Answer

The answer of A patient is admitted with partial-thickness burns...

Question 9

Victims of a house fire are being admitted through the emergency department.Of the patients,the nurse realizes that which will have the greatest general risk for mortality from the burn injuries?

Accepted Answer

The 75-year-old female with arthritis is at the greatest general risk for mortality from the burn injuries due to her advanced age. Older adults have a higher risk of complications and mortality from burns due to factors like decreased skin elasticity, slower healing, and potential comorbidities.

Question 10

A patient recovering from a burn to the left side of his face tells the nurse that he has no idea how he is going to return home and resume his regular life since he is so "ugly and disfigured." What nursing response is indicated?

Accepted Answer

Referring the patient to the Phoenix Society, a support organization for burn survivors, would be the best option as it provides resources for coping with the physical and emotional effects of burns. The other options do not address the patient's concerns and may even minimize their feelings.

Question 11

A patient is rehabilitating after a severe burn 6 months ago that left her with scars across her chest and abdomen.She says,"I don't care what people think,I am going to the beach in a bikini next week." What most important information should the nurse provide?

Accepted Answer

The nurse should advise the patient to avoid sun exposure to her scars for at least one year as it may cause hyperpigmentation and worsening of the scars. It is important to protect the scars from the sun with clothing or sunscreen.

Question 12

A patient has been treated in the burn unit for 3 months.What characteristics of wound healing would the nurse evaluate as normal? Note: Credit will be given only if all correct choices and no incorrect choices are selected.
Select all that apply.

Accepted Answer

The answer of A patient has been treated in the...

Question 13

The nurse is providing emergency care to patients injured in a house fire.Which patient would the nurse prepare for transfer to a burn center for additional care and treatment?

Accepted Answer

Patients with partial-thickness burns to the face and hands require specialized care, including possible intubation to prevent airway swelling, and may benefit from transfer to a burn center for advanced treatment. The other patients have less severe burns that can be managed at a local hospital.

Question 14

The nurse is planning the care of a patient who has burns to the face,neck,upper chest,and both upper arms.To prevent contracture development,the nurse should include which interventions in the patient's plan of care? Note: Credit will be given only if all correct choices and no incorrect choices are selected.
Select all that apply.

Accepted Answer

The answer of The nurse is planning the care of...

Question 15

A 45-year-old patient who weighs 50 kg sustained partial thickness burns over 60% total body surface area (TBSA).This morning the patient's urine has a reddish brown color.Which interventions would the nurse anticipate? Note: Credit will be given only if all correct choices and no incorrect choices are selected.
Select all that apply.

Accepted Answer

The answer of A 45-year-old patient who weighs 50 kg...

Question 16

The nurse caring for a patient who sustained burns of 30% of the total body surface area 7 days ago is assessing the status of the patient's wounds.Which phase of wound healing would the nurse expect to be occurring?

Accepted Answer

The answer of The nurse caring for a patient who...

Question 17

The nurse is caring for a patient admitted with thermal burns.The nurse will plan to monitor the patient closely over the next 2 to 3 days for development of which most serious complication?

Accepted Answer

Burn shock is a potentially life-threatening complication that can occur within the first 24-48 hours after burn injury. It is characterized by hypovolemia, decreased cardiac output, and decreased tissue perfusion, which can lead to organ failure and death if not promptly treated. Pain, continuation of the burn process, and hypervolemia are also important to monitor, but burn shock is the most serious complication.

Question 18

A patient is being admitted for treatment of deep partial-thickness burns.When doing this patient's initial assessment,the nurse would expect which burn characteristics? Note: Credit will be given only if all correct choices and no incorrect choices are selected.
Select all that apply.

Accepted Answer

The answer of A patient is being admitted for treatment...

Question 19

The nurse is caring for a 154-pound patient with 50% total body surface area (TBSA)burns.If using the Parkland formula,the nurse will calculate which amount of intravenous solution to provide this patient in the first 24 hours of care?

Accepted Answer

The Parkland formula for burn patients is 4 mL x patient's weight in kg x %TBSA. First, convert pounds to kilograms (154 lbs / 2.2 = 70 kg). Then, apply the formula: 4 mL x 70 kg x 50 = 14,000 mL.

Question 20

A patient has full-thickness burns of the right chest area,entire right arm,and deep partial-thickness burns of both upper anterior legs.Based on the rule of nines,which estimate of total body surface area burn would the nurse record?

Accepted Answer

The rule of nines divides the body into sections that are approximately 9% of the body surface area. The entire arm is 9%, the chest area is 9%, and each leg (anterior portion only considered here) is 9%. Therefore, the total is 9% (right arm) + 9% (right chest) + 4.5% (right upper leg) + 4.5% (left upper leg) = 27%.

Quiz 36: Acute Burn Injury