Indicate whether The following questions are either a) metabolic acidosis, b)
respiratory acidosis, c) both
____ can occur with burns
____ results of too much acid and not enough base
____ most likely occurs during the emergent stage, when fluid shifts occur with
resulting hyperkalemia and hypovolemia
____ also caused by cellular hypoxia, a part of cellular hypoxia is due to hypovolemia;
Cellular hypoxia also causes a loss of bicarbonate which worsens acidosis
____ very life-threatening; firefighters are at risk
____ can occur with sepsis, common complication of burns due to the lactic acidosis of
sepsis
,____ kidney and liver damage can cause this because kidney damage causes
hyperchloremic acidosis, or Low bicarb acidosis
____ children are more susceptible to this
____ can occur with inhalation burns and the extreme version of ARDS
____Less likely but more life-threatening than other acidosis type
Give this one a try later!
Metabolic Acidosis
__a__ results of too much acid and not enough base
__a__ most likely occurs during the emergent stage, when fluid shifts occur
with resulting hyperkalemia and hypovolemia
__a__ caused by cellular hypoxia, a part of cellular hypoxia is due to
hypovolemia;Cellular hypoxia also causes a loss of bicarbonate which
worsens acidosis
__a__ can occur with sepsis, common complication of burns due to the lactic
acidosis of sepsis
__a__ kidney and liver damage can cause this because kidney damage
causes hyperchloremic acidosis, or Low bicarb acidosis
__a__ children are more susceptible to this
Resp Acidosis
__b__ very life-threatening; firefighters are at risk
__b__ can occur with inhalation burns and the extreme version of ARDS
__b__Less likely but more life-threatening than other acidosis type
both
__c__ can occur with burns
Calculate fluid resuscitation of a 22lb child with a 45% tbsa burn for a rate @ 6 hrs
post burn _____ ml/hr then rate at 18 hrs post burn _____ ml/hr
Give this one a try later!
84.4 ml/hr; 422.2 ml/hr
,What is the initial fluid resuscitation if TSA >20%?
Give this one a try later!
-massive fluid shifts occur soon after burn from inflammatory response
-use crystalloids ex: isotonic fluids (not colloids) for first 24 hrs
-measure success of hydration by UP 30-50 ml to 100 ml/hr
-decrease initial HR to HR<100-110 is sign of hydration improvement
-central pressure preferred over external BP like CVC; anticipate decrease
CO & BP
-rising serum lactate indicates problems but NOT measurement of
hydration/rehydration
-use of opioids can mask fluid resuscitation
-more fluids with electrical & inhalation burns
-too much fluids can cause ARDS or death so use specific fluid calculation
The nurse is assessing a 4-year-old child in a health clinic. Which of the following
situations would cause the nurse to explore for possible abuse?
a) Being brought to the clinic from daycare
b) Recent scrapes and bruises on both knees
c) The caregiver reporting angry outbursts from the child while they were in a store
d) Different explanations of the injury from the child's parents
Give this one a try later!
d) Different explanations of the injury from the child's parents
*Inconsistent explanations from parents for how injuries occurred is a cause
for further investigation. Being brought in from daycare, school, camp, or
other public areas does not automatically indicate abuse. Scrapes on the
knees are a common developmental injury for a 4 year old. Angry outbursts
or tantrums in children in this age-group are still expected developmental
behaviors.
, Which states have the highest rate of domestic violence? (select all that apply)
a) Texas
b) Michigan
c) New York
d) California
e) Texas
f) Nevada
Give this one a try later!
a) Texas
d) California
e) Texas
Which nursing assessment is good for all ages to determine TBSA from burns?
A) Rule of 9's
B) Lund-Browder Chart
C) physical assessment
D) None of the above
Give this one a try later!
B) Lund-Browder Chart
*rule of 9's has a chart for children then a chart for adults; Lund-Browder is
good for all ages so can be used in peds bc it is more detailed for different
ages; it's most accurate
What lab value is used to detect inhalation burns or any smoke or fire but may also be
elevated with smokers
A) anion gap
respiratory acidosis, c) both
____ can occur with burns
____ results of too much acid and not enough base
____ most likely occurs during the emergent stage, when fluid shifts occur with
resulting hyperkalemia and hypovolemia
____ also caused by cellular hypoxia, a part of cellular hypoxia is due to hypovolemia;
Cellular hypoxia also causes a loss of bicarbonate which worsens acidosis
____ very life-threatening; firefighters are at risk
____ can occur with sepsis, common complication of burns due to the lactic acidosis of
sepsis
,____ kidney and liver damage can cause this because kidney damage causes
hyperchloremic acidosis, or Low bicarb acidosis
____ children are more susceptible to this
____ can occur with inhalation burns and the extreme version of ARDS
____Less likely but more life-threatening than other acidosis type
Give this one a try later!
Metabolic Acidosis
__a__ results of too much acid and not enough base
__a__ most likely occurs during the emergent stage, when fluid shifts occur
with resulting hyperkalemia and hypovolemia
__a__ caused by cellular hypoxia, a part of cellular hypoxia is due to
hypovolemia;Cellular hypoxia also causes a loss of bicarbonate which
worsens acidosis
__a__ can occur with sepsis, common complication of burns due to the lactic
acidosis of sepsis
__a__ kidney and liver damage can cause this because kidney damage
causes hyperchloremic acidosis, or Low bicarb acidosis
__a__ children are more susceptible to this
Resp Acidosis
__b__ very life-threatening; firefighters are at risk
__b__ can occur with inhalation burns and the extreme version of ARDS
__b__Less likely but more life-threatening than other acidosis type
both
__c__ can occur with burns
Calculate fluid resuscitation of a 22lb child with a 45% tbsa burn for a rate @ 6 hrs
post burn _____ ml/hr then rate at 18 hrs post burn _____ ml/hr
Give this one a try later!
84.4 ml/hr; 422.2 ml/hr
,What is the initial fluid resuscitation if TSA >20%?
Give this one a try later!
-massive fluid shifts occur soon after burn from inflammatory response
-use crystalloids ex: isotonic fluids (not colloids) for first 24 hrs
-measure success of hydration by UP 30-50 ml to 100 ml/hr
-decrease initial HR to HR<100-110 is sign of hydration improvement
-central pressure preferred over external BP like CVC; anticipate decrease
CO & BP
-rising serum lactate indicates problems but NOT measurement of
hydration/rehydration
-use of opioids can mask fluid resuscitation
-more fluids with electrical & inhalation burns
-too much fluids can cause ARDS or death so use specific fluid calculation
The nurse is assessing a 4-year-old child in a health clinic. Which of the following
situations would cause the nurse to explore for possible abuse?
a) Being brought to the clinic from daycare
b) Recent scrapes and bruises on both knees
c) The caregiver reporting angry outbursts from the child while they were in a store
d) Different explanations of the injury from the child's parents
Give this one a try later!
d) Different explanations of the injury from the child's parents
*Inconsistent explanations from parents for how injuries occurred is a cause
for further investigation. Being brought in from daycare, school, camp, or
other public areas does not automatically indicate abuse. Scrapes on the
knees are a common developmental injury for a 4 year old. Angry outbursts
or tantrums in children in this age-group are still expected developmental
behaviors.
, Which states have the highest rate of domestic violence? (select all that apply)
a) Texas
b) Michigan
c) New York
d) California
e) Texas
f) Nevada
Give this one a try later!
a) Texas
d) California
e) Texas
Which nursing assessment is good for all ages to determine TBSA from burns?
A) Rule of 9's
B) Lund-Browder Chart
C) physical assessment
D) None of the above
Give this one a try later!
B) Lund-Browder Chart
*rule of 9's has a chart for children then a chart for adults; Lund-Browder is
good for all ages so can be used in peds bc it is more detailed for different
ages; it's most accurate
What lab value is used to detect inhalation burns or any smoke or fire but may also be
elevated with smokers
A) anion gap
