A previously healthy 87kg patient presents to the burn unit with 25% TBSA partial
thickness and full thickness burns. In the first 8 hours of fluid resuscitation, how much
lactated Ringer's solution would the burn nurse expect to infuse?
- 2,175 ml
- 8,900 ml
- 1,087 ml
- 6,780 ml
Give this one a try later!
- 2,175 ml
The Consensus Formula recommends 2 ml of Lactated Ringer's solution per
kg/% TBSA burned during the first 24 hours after the burn. This formula
advocates giving half of the fluid in the first 8 hours after burn and the
other half in the subsequent 16 hours._____Reference: Total Burn Care, 5th Ed.
(2018), p. 5
,An adult patient is consented and scheduled for excision and grafting of the face at
0730. At 0430, the burn nurse is reviewing the patient's laboratory data.
Serum sodium 140 mEq/L;
Serum potassium 3.5 mEq/L
Hemoglobin 7.3 g/dL
Hematocrit 22.8 %
Platelet count 100 ×103/μL
White blood count 15 x thousand/mm3
Prothrombin time (PT) 12 seconds
Partial thromboplastin time (PTT) 28 seconds
International normalized ratio (INR) 1.48
The nurse anticipates which order prior to surgery?
- Transfusion of packed red blood cells.
- transfusion of cryoprecipitate.
- Administration of potassium replacement.
- Administration of Vitamin K.
Give this one a try later!
- Transfusion of packed red blood cells.
Comments: While the hemoglobin and hematocrit are within normal limits
and without information about the patient's hemodynamic status,
transfusion of PRBCs should be anticipated related to the abundance of
blood vessels in the face. The nurse would expect blood loss significant
enough to decrease hemoglobin below 7 g/dL. _____Reference: Total Burn
Care, 5th Ed. (2018), p. 128
A patient is admitted from a house fire with facial burns and singed nasal hair. Pulse
oximetry reads 97% on room air and carboxyhemoglobin is 24%. The burn nurse's
PRIORITY is to:
- administer hydroxocobalamin.
- apply oxygen via nonrebreather mask.
,- prepare for a bronchoscopy.
- suction secretions from the airway.
Give this one a try later!
- apply oxygen via nonrebreather mask.
Comments: Elevated carboxyhemoglobin causes a false elevation in
displayed pulse oximetry. Actual oxygen saturation is likely much lower due
to known circumstances of the burn injury occurring in a housefire and
presence of facial burns. To ensure patient safety, 100% humidified oxygen
should be applied as true oxygen saturation is unknown. Bronchoscopy is
valuable in definitive diagnosis, but is not the best first action. Administering
hydroxocobalamin may be necessary but should not take priority over
appropriate tissue oxygenation. There is nothing to indicate that the
patient's airway requires suctioning at this time._____Reference: Total Burn
Care, 5th Ed. (2018), p. 58
A patient has sustained a facial burn and is refusing to shave his face. The MOST
important rationale to provide to the patient is that shaving will:
- prevent chondritis.
- reduce the risk of keratopathy.
- minimize scar formation.
- prevent infections.
Give this one a try later!
- prevent infections.
Comments: Folliculitis is a common infection of the face and scalp. Shaving
the hair can often prevent and treat infections of the face and scalp. While
shaving can also reduce the risk of scar formation, it is not the most
important reason to shave. The prevention of infection takes priority over
scar formation. _____Reference: Burn Nursing: Injury Prevention to
Rehabilitation and After Care, 1st Ed. (2023), p. 217
, An adult patient presents with partial and full thickness burns to the head, chest, right
upper extremity, and half of the right lower extremity. What is the estimated TBSA
percentage for this patient?
- 45%
- 40%
- 36%
- 54%
Give this one a try later!
- 36%
Comments: Using the rule of nines, the patient's anterior chest accounts for
9%, head for 9%, right upper extremity for 9%, and half the right lower
extremity is also 9%. This accounts for a 36% TBSA burn._____Reference:
Advanced Burn Life Support Course Provider Manual (2023), p. 14
An adult admitted with 25% TBSA burns from a house fire six hours prior is reporting
blurred vision. What is the next BEST action by the burn nurse?
- Administer artificial tears
- Administer ophthalmic antibiotics
- Prepare for a fluorescein exam
- Prepare for a tarsorrhaphy
Give this one a try later!
Prepare for a fluorescein exam
In newly admitted patients with burn injury to the face around the eyes,
with explosion mechanism, or any reported vision changes or eye pain, an
ophthalmic exam is indicated. This exam includes initially visually ruling out
open globe injury in mechanisms which include flying debris. Once that is
excluded, the next step is exam with fluorescein to highlight any debris,
abrasions, or ulcerations on the cornea. Once identified, a treatment plan
will be made. Tarsorrhaphy would be premature at this step as it could
potentially enclose debris in the eye. Artificial tears may be indicated, but
thickness and full thickness burns. In the first 8 hours of fluid resuscitation, how much
lactated Ringer's solution would the burn nurse expect to infuse?
- 2,175 ml
- 8,900 ml
- 1,087 ml
- 6,780 ml
Give this one a try later!
- 2,175 ml
The Consensus Formula recommends 2 ml of Lactated Ringer's solution per
kg/% TBSA burned during the first 24 hours after the burn. This formula
advocates giving half of the fluid in the first 8 hours after burn and the
other half in the subsequent 16 hours._____Reference: Total Burn Care, 5th Ed.
(2018), p. 5
,An adult patient is consented and scheduled for excision and grafting of the face at
0730. At 0430, the burn nurse is reviewing the patient's laboratory data.
Serum sodium 140 mEq/L;
Serum potassium 3.5 mEq/L
Hemoglobin 7.3 g/dL
Hematocrit 22.8 %
Platelet count 100 ×103/μL
White blood count 15 x thousand/mm3
Prothrombin time (PT) 12 seconds
Partial thromboplastin time (PTT) 28 seconds
International normalized ratio (INR) 1.48
The nurse anticipates which order prior to surgery?
- Transfusion of packed red blood cells.
- transfusion of cryoprecipitate.
- Administration of potassium replacement.
- Administration of Vitamin K.
Give this one a try later!
- Transfusion of packed red blood cells.
Comments: While the hemoglobin and hematocrit are within normal limits
and without information about the patient's hemodynamic status,
transfusion of PRBCs should be anticipated related to the abundance of
blood vessels in the face. The nurse would expect blood loss significant
enough to decrease hemoglobin below 7 g/dL. _____Reference: Total Burn
Care, 5th Ed. (2018), p. 128
A patient is admitted from a house fire with facial burns and singed nasal hair. Pulse
oximetry reads 97% on room air and carboxyhemoglobin is 24%. The burn nurse's
PRIORITY is to:
- administer hydroxocobalamin.
- apply oxygen via nonrebreather mask.
,- prepare for a bronchoscopy.
- suction secretions from the airway.
Give this one a try later!
- apply oxygen via nonrebreather mask.
Comments: Elevated carboxyhemoglobin causes a false elevation in
displayed pulse oximetry. Actual oxygen saturation is likely much lower due
to known circumstances of the burn injury occurring in a housefire and
presence of facial burns. To ensure patient safety, 100% humidified oxygen
should be applied as true oxygen saturation is unknown. Bronchoscopy is
valuable in definitive diagnosis, but is not the best first action. Administering
hydroxocobalamin may be necessary but should not take priority over
appropriate tissue oxygenation. There is nothing to indicate that the
patient's airway requires suctioning at this time._____Reference: Total Burn
Care, 5th Ed. (2018), p. 58
A patient has sustained a facial burn and is refusing to shave his face. The MOST
important rationale to provide to the patient is that shaving will:
- prevent chondritis.
- reduce the risk of keratopathy.
- minimize scar formation.
- prevent infections.
Give this one a try later!
- prevent infections.
Comments: Folliculitis is a common infection of the face and scalp. Shaving
the hair can often prevent and treat infections of the face and scalp. While
shaving can also reduce the risk of scar formation, it is not the most
important reason to shave. The prevention of infection takes priority over
scar formation. _____Reference: Burn Nursing: Injury Prevention to
Rehabilitation and After Care, 1st Ed. (2023), p. 217
, An adult patient presents with partial and full thickness burns to the head, chest, right
upper extremity, and half of the right lower extremity. What is the estimated TBSA
percentage for this patient?
- 45%
- 40%
- 36%
- 54%
Give this one a try later!
- 36%
Comments: Using the rule of nines, the patient's anterior chest accounts for
9%, head for 9%, right upper extremity for 9%, and half the right lower
extremity is also 9%. This accounts for a 36% TBSA burn._____Reference:
Advanced Burn Life Support Course Provider Manual (2023), p. 14
An adult admitted with 25% TBSA burns from a house fire six hours prior is reporting
blurred vision. What is the next BEST action by the burn nurse?
- Administer artificial tears
- Administer ophthalmic antibiotics
- Prepare for a fluorescein exam
- Prepare for a tarsorrhaphy
Give this one a try later!
Prepare for a fluorescein exam
In newly admitted patients with burn injury to the face around the eyes,
with explosion mechanism, or any reported vision changes or eye pain, an
ophthalmic exam is indicated. This exam includes initially visually ruling out
open globe injury in mechanisms which include flying debris. Once that is
excluded, the next step is exam with fluorescein to highlight any debris,
abrasions, or ulcerations on the cornea. Once identified, a treatment plan
will be made. Tarsorrhaphy would be premature at this step as it could
potentially enclose debris in the eye. Artificial tears may be indicated, but
