NRS 440 - Final Exam Questions with Correct Solutions Graded to Pass!!!

thermal burns - caused by flame, flash, scald, or contact with hot objects most common type of burn severity of injury depends on: -temperature of burning agent -duration of contact time smoke inhalation burns - from inhalation of hot air or noxious chemicals cause damage to respiratory tract major predictor of mortality in burn victims need to be treated quickly more prone to ARDS and pneumonia monitor ABGs types of inhalation injuries: metabolic asphyxiation - carbon monoxide (CO) poisoning CO is produced by incomplete combustion of burning materials inhaled CO displaces oxygen: hypoxia, carboxyhemoglobinemia, death hypoxia and ultimately death when CO levels are 20% or greater treat with 100% humidified O2 CO poisoning may occur in the absence of burn injury to the skin -can look fine on outside, but dying on inside suspect when person was in closed area w/ fire types of inhalation injuries: upper airway injury - injury to mouth, oropharynx, and/or larynx thermally produced hot air, steam, or smoke swelling may be massive and rapid onset -eschar and edema may compromise breathing -swelling from scald burns can be lethal damage to mucus membranes; may need immediate intubation reliable clues to this injury: -presence of facial burns -singed nasal hair -hoarseness, painful swallowing (new) -darkened oral and nasal membranes -carbonaceous sputum (blackish) -history of being burned in enclosed space -clothing burns around chest and neck types of inhalation injuries: lower airway injury - injury to trachea, bronchioles, and alveoli injury is r/t length of exposure to smoke or toxic fumes pulmonary edema may not appear until 12-24hrs after burn -dyspnea, tachycardia, chest pain, cough, fatigue, SOB, tachypnea, wheezing, sweating, water retention -manifests as ARDS - capillary permeability severity of injury - determined by: -depth of burn -extent of burn in % of TBSA -location of burn -patient risk factors depth of burn - used to be 1st, 2nd, 3rd, ad 4th degree, but is now according to depth of skin destruction -superficial partial-thickness burn: involves the epidermis (sunburn) -deep partial-thickness burn: involves the dermis -full-thickness burn: involves all skin elements, nerve endings, fat, muscle, bone (initially no pain)` extent of burn: lund-browder chart - determines the total body surface area (TBSA) more accurate bc considers body size extent of burn: rule of nines - determines the total body surface area (TBSA) used for initial assessment sage burn diagram location of burn - severity of burn injury is determined by location of burn wound -face, neck, chest - respiratory obstruction (edema & eschar) -hands, feet, joints, eyes - self-care (ROM & self-esteem) -ears, nose, buttocks, perineum - infection (poor circulation & infection) circumferential burns of extremities can cause circulation problems distal to burn (watch swelling bc decreased circulation in distal areas - O2 and pulses) pts may also develop compartment syndrome complications: dyspnea, pneumonia, delirium patient risk factors - pre-existing CV, respiratory, and renal disease contribute to poorer px DM and PVD contribute to poor healing and gangrene physical debilitation renders pt less able to recover: alcoholism (liver and poor nutrition), drug abuse, malnutrition (poor healing) concurrent fx, head injuries, or other trauma leads to a more difficult time recovering