NUR 624 - Emergency Lecture Exam questions
and answers
what antigen is associated with anaphylaxis?
IgE
For anaphylaxis to occur the pt must have had a previous exposure
True or False
True
What is the most common allergic agent
bees, then foods (shellfish and nuts), then meds (PCN, lisinopril)
S/S of anaphylactic shock
RED face, low BP, ^^ HR, flushed, compromised airway
What is the only treatment for anaphylaxis?
What is the significance of beta blockers with this treatment?
Epinephrine (steroids and antihistamines can be used with Epi)
BB reduce effectiveness; pt may need more Epi
Degrees of burns:
1st: epidermis only; sunburns, scalds, stream; RED, DRY and PAINFUL
2nd: epidermis & part of dermis; BLISTERS, RED, may take couple weeks to heal
3rd: all skin layers and SQ fat; painful on parameter, leathery/dry - requires skin grafting
4th: deep tissue (tendons/bones)
burn treatment
rule of nines, % of body surface (adult palm is ~1%)
-tetanus (but not if just 1st deg)
-1st: under cool water for 20 min
-pain control
-wound cleansing (betadine, dial soap, sterile water)
-blisters: <6mm leave alone, >6mm pop, debrid and keep open
-aquaphor, silvadine (but must wash prev layer off), bactroban, bacitracin, sulfamylon ($$$)
, What are the problem areas for burns?
face (airway)
hands (need hands for everything)
circumferential extremities (circulation)
genital (hard to keep clean)
What % of total BSA would require admitting to burn unit?
adult?
peds?
adult: >20%
peds: >15%
what should be a priority with a pt with smoke inhalation?
pt in ICU, intubate early to protect airway
What physical finding would you expect to find in a pt who was struck by lightning?
ruptured TM
two types of electrical burns: direct and indirect
Direct: only has entrance
Indirect: low/high voltage
entrance and exit --> will have damage throughout body --> muscle contraction = rhabdo
What labs should be checked with electrical burns?
RENAL!!, CBC, CCP, UA, serum myoglobin, PT
How should myoglobinuria be treated?
need to alkanalize the urine; hang bicarb (prevents kidney damage)
why is manitol given to electrical burn pts
helps prevent renal failure
What chemical burn is the worst, acid or alkaline?
Alkali bc it is very penetrating, dangerous to mucous membranes; wet concrete, oven cleaner, draino
acid is poorly penetrating (won't hurt skin as much)
How do you treat acid burns? alkali burns?
Acid: irrigation
Alkali: hours of irrigation
and answers
what antigen is associated with anaphylaxis?
IgE
For anaphylaxis to occur the pt must have had a previous exposure
True or False
True
What is the most common allergic agent
bees, then foods (shellfish and nuts), then meds (PCN, lisinopril)
S/S of anaphylactic shock
RED face, low BP, ^^ HR, flushed, compromised airway
What is the only treatment for anaphylaxis?
What is the significance of beta blockers with this treatment?
Epinephrine (steroids and antihistamines can be used with Epi)
BB reduce effectiveness; pt may need more Epi
Degrees of burns:
1st: epidermis only; sunburns, scalds, stream; RED, DRY and PAINFUL
2nd: epidermis & part of dermis; BLISTERS, RED, may take couple weeks to heal
3rd: all skin layers and SQ fat; painful on parameter, leathery/dry - requires skin grafting
4th: deep tissue (tendons/bones)
burn treatment
rule of nines, % of body surface (adult palm is ~1%)
-tetanus (but not if just 1st deg)
-1st: under cool water for 20 min
-pain control
-wound cleansing (betadine, dial soap, sterile water)
-blisters: <6mm leave alone, >6mm pop, debrid and keep open
-aquaphor, silvadine (but must wash prev layer off), bactroban, bacitracin, sulfamylon ($$$)
, What are the problem areas for burns?
face (airway)
hands (need hands for everything)
circumferential extremities (circulation)
genital (hard to keep clean)
What % of total BSA would require admitting to burn unit?
adult?
peds?
adult: >20%
peds: >15%
what should be a priority with a pt with smoke inhalation?
pt in ICU, intubate early to protect airway
What physical finding would you expect to find in a pt who was struck by lightning?
ruptured TM
two types of electrical burns: direct and indirect
Direct: only has entrance
Indirect: low/high voltage
entrance and exit --> will have damage throughout body --> muscle contraction = rhabdo
What labs should be checked with electrical burns?
RENAL!!, CBC, CCP, UA, serum myoglobin, PT
How should myoglobinuria be treated?
need to alkanalize the urine; hang bicarb (prevents kidney damage)
why is manitol given to electrical burn pts
helps prevent renal failure
What chemical burn is the worst, acid or alkaline?
Alkali bc it is very penetrating, dangerous to mucous membranes; wet concrete, oven cleaner, draino
acid is poorly penetrating (won't hurt skin as much)
How do you treat acid burns? alkali burns?
Acid: irrigation
Alkali: hours of irrigation
