NRAN 865 - Burns Exam 3 Questions and
Verified Answers Detailed Answers Latest 2026
Top Rated A+
Hypermetabolic Phase: BMR and persistance after injury
•Basal metabolic rate ↑ & may peak at 7-10 days
•Can persist for up to 1-2 years post-injury
The hypermetabolism is a compensatory response to ...
•maintain organ function & whole-body homeostasis
•Associated with catabolism, multi-organ failure, & death
Endocrine changes d/t hypermetabolic phase
•Hyperglycemia is common
•Insulin resistance occurs
•Glycosuria is common
•Prone to non-ketotic hyperosmolar coma
•Serum catecholamine & antidiuretic hormone levels ↑ dramatically
•Levels peak @ 3-4 days post burn
•Leads to intense vasoconstriction
Acute cardiac changes s/p burn injury
•Lasts 48 hours
•Initially CO ↓ d/t ↓ preload & direct myocardial depressant effects of burn
toxins
•The magnitude of the ↓ is proportional to the size of the burn area
Fluid/cardiac changes s/p burn injury
•Hypovolemia occurs because:
•Inflammatory mediators are released that ↑ capillary permeability
•Fluid & protein are lost into the extravascular space
•Tissue perfusion is ↓ leading to metabolic acidosis
Cardiac function acute phase changes r/t chambers
•↓ LV contractility d/t myocardial depression
•RV function may be impaired d/t ↑ PA pressures as a result of inhalational
injury
•Myocardial edema may lead to diastolic dysfunction
Cardiac Hypermetabolic phase changes
, •Characterized by a dramatic ↑ in blood flow to tissues
•Leads to edema formation
•CO ↑, HR ↑, myocardial oxygen consumption ↑
Acute airway: Inhalational injuries cause...
1.Thermal injury to the airway
2.Chemical irritation to the respiratory tract
3.Systemic effects from toxic gases
•Smoke inhalation produces an inflammatory reaction in the lungs
that can persist for up to 5 days
•Changes can include:
1.PA hypertension
2.Bronchial constriction
3.↑ airway resistance
4.↓ pulmonary compliance
5.Atelectasis
Pulmonary thermal injury - how does it result in upper airway
obstruction?
1.Normally the nasopharynx clears inspired gases of particulate matter
2.During a fire victims breathe through their mouths d/t nasopharyngeal
irritation
3.Toxic, particulate matter is deposited into the airway
4.Heat damages the epithelial layer & activates complement & histamine
5.Histamine stimulates NO & forms a reactive nitrogen species
6.Upper airway swelling & airway obstruction result
7.May be complicated by scarring & contractures
8.Ciliary function is impaired increasing the risk of infection
Steam inhalation damage
1.Often damages the tracheobronchial tree
2.Mucosal sloughing occurs
3.Airway irritability follows
4.Activation of the systemic inflammatory response
5.Leads to intense bronchoconstriction
Acute lung changes s/p burn
•Functional residual capacity is reduced
•Lung and chest wall compliance is decreased
Renal failure s/p burn
•Hypovolemia
•Low CO
Verified Answers Detailed Answers Latest 2026
Top Rated A+
Hypermetabolic Phase: BMR and persistance after injury
•Basal metabolic rate ↑ & may peak at 7-10 days
•Can persist for up to 1-2 years post-injury
The hypermetabolism is a compensatory response to ...
•maintain organ function & whole-body homeostasis
•Associated with catabolism, multi-organ failure, & death
Endocrine changes d/t hypermetabolic phase
•Hyperglycemia is common
•Insulin resistance occurs
•Glycosuria is common
•Prone to non-ketotic hyperosmolar coma
•Serum catecholamine & antidiuretic hormone levels ↑ dramatically
•Levels peak @ 3-4 days post burn
•Leads to intense vasoconstriction
Acute cardiac changes s/p burn injury
•Lasts 48 hours
•Initially CO ↓ d/t ↓ preload & direct myocardial depressant effects of burn
toxins
•The magnitude of the ↓ is proportional to the size of the burn area
Fluid/cardiac changes s/p burn injury
•Hypovolemia occurs because:
•Inflammatory mediators are released that ↑ capillary permeability
•Fluid & protein are lost into the extravascular space
•Tissue perfusion is ↓ leading to metabolic acidosis
Cardiac function acute phase changes r/t chambers
•↓ LV contractility d/t myocardial depression
•RV function may be impaired d/t ↑ PA pressures as a result of inhalational
injury
•Myocardial edema may lead to diastolic dysfunction
Cardiac Hypermetabolic phase changes
, •Characterized by a dramatic ↑ in blood flow to tissues
•Leads to edema formation
•CO ↑, HR ↑, myocardial oxygen consumption ↑
Acute airway: Inhalational injuries cause...
1.Thermal injury to the airway
2.Chemical irritation to the respiratory tract
3.Systemic effects from toxic gases
•Smoke inhalation produces an inflammatory reaction in the lungs
that can persist for up to 5 days
•Changes can include:
1.PA hypertension
2.Bronchial constriction
3.↑ airway resistance
4.↓ pulmonary compliance
5.Atelectasis
Pulmonary thermal injury - how does it result in upper airway
obstruction?
1.Normally the nasopharynx clears inspired gases of particulate matter
2.During a fire victims breathe through their mouths d/t nasopharyngeal
irritation
3.Toxic, particulate matter is deposited into the airway
4.Heat damages the epithelial layer & activates complement & histamine
5.Histamine stimulates NO & forms a reactive nitrogen species
6.Upper airway swelling & airway obstruction result
7.May be complicated by scarring & contractures
8.Ciliary function is impaired increasing the risk of infection
Steam inhalation damage
1.Often damages the tracheobronchial tree
2.Mucosal sloughing occurs
3.Airway irritability follows
4.Activation of the systemic inflammatory response
5.Leads to intense bronchoconstriction
Acute lung changes s/p burn
•Functional residual capacity is reduced
•Lung and chest wall compliance is decreased
Renal failure s/p burn
•Hypovolemia
•Low CO
