NURS 2873 Exam 3 Questions With Complete Solutions
_____ acts like a growth hormone to the fetus? Correct Answer
Insulin. Increased glucose levels means baby grows more. Fetus
responds to maternal hyperglycemia by secreting large amounts
of insulin.
1st Trimester insulin needs ____ ? 2nd Trimester insulin needs
____? Correct Answer 1st trimester: insulin need is
REDUCED because of increased insulin production. *More
episodes of hypogyclemia* 2nd and 3rd Trimester: insulin needs
INCREASE, may need insulin drip during labor
Acute Phase: Lab Values Correct Answer Follow closely as
body attempts to establish balance. Hyponatremia: from
excessive GI suction, diarrhea, dilutional hyponatremia (water
intoxification). Offer juices and nutritional supplements instead
of water. Hypernatremia: if large amounts of hypertonic fluids
administered, may need Na restrictions. Hyperkalemia: large
amounts of K released from damaged cells TALL TENTED T
WAVES. Hypokalemia: not replacing K loss (decreased
reflexes).
Acute Phase: Pathophysiology Correct Answer Diuresis,
patient is less edematous. Bowel sounds should return. Depth of
wound bed more apparent. Some healing, WBC's surround
wound. Necrotic tissue begins to slough. Fibroblasts start
collagen > granulation tissue. Healing spontaneous and takes 10-
21 days. Wounds will heal from edges and dermal bed if kept
from infection and desiccation (dryness).
,An increased hematocrit is commonly caused by? Correct
Answer Hemoconcentration is d/t fluid loss. After fluid balance
is restored hematocrit levels drop.
Analgesic management for burn patients Correct Answer
Morphine, hydromorphone (dilaudid) *extended release options
too*, Fentanyl, Oxycodone/Acetaminophen (Percocet),
Methadone (Dolophine), NSAID's (Ketorolac), Adjuvant
analgesics (Gabapentin).
Anion Gap Correct Answer Na - (Bicarb + Chloride) = Anion
Gap. Normal 8-12. Elevated with DKA = metabolic acidosis.
Increased if associated with acid gain. Normal if associated with
bicarb loss.
Antimicrobial Agents for Burn Patients Correct Answer
CHECK FOR SULFA ALLERGIES. Many burn ATB creams
are sulfas. After wound cleansed, topical ATB then dressing.
Systemic ATB not used because little to no blood supply on
burn area. Silver-impregnated dressing can be left on 3-14 days
per pt/per product. Silver sulfadiazine (Silvadene). Mafenide
acetate (sulfamylon)
Assessment Findings: Full-Thickness (3rd and 4th Degree
Burns) Correct Answer Dry, Leathery eschar, waxy, white to
dark brown charred. Strong burn odor. Impaired sensation when
touched, absence of pain with severe pain in surrounding tissues.
Lack of blanching with pressure.
Assessment Findings: Partial-Thickness (Deep/2nd Degree
Burn) Correct Answer moist blebs, blisters. molted white, pink
, to cherry red. hypersensitivity to touch/air, moderate to severe
pain, blanching with pressure
Assessment Findings: Partial-Thickness (Superficial/1st Degree
Burn) Correct Answer redness, pain, moderate/severe
tenderness, minimal edema, blanching with pressure
Assult Correct Answer Threat or attempt to make bodily
contact with another person without that person's consent.
Baby starts producing insulin at week _____ ? Correct Answer
ten
Burn Considerations: Endocrine System Correct Answer
Watch for transient increase in blood glucose levels. Relative
insulin insensitivity. Treat with IV or subQ insulin, do not
decrease feedings. Serum glucose testing more accurate.
Burn patients special care: EARS Correct Answer Keep free
from pressure because of poor vascularization and tendency to
become infected. Do not use pillows if patient has ear burns.
Pressure on cartilage may cause chondritis. Ear may stick to
pillowcase = bleeding and pain. Raise head using rolled towel
under shoulders, be careful to void pressure necrosis. Follow
same strategy for the patient with neck burns to hyperextend the
neck to prevent contracture.
Burn patients special care: Extremities Correct Answer Extend
burned hands and arms and raise them on pillows or plastic
foam wedges to reduce edema. Remove splints often and inspect
skin and bony prominences to void areas of pressure. Ask
_____ acts like a growth hormone to the fetus? Correct Answer
Insulin. Increased glucose levels means baby grows more. Fetus
responds to maternal hyperglycemia by secreting large amounts
of insulin.
1st Trimester insulin needs ____ ? 2nd Trimester insulin needs
____? Correct Answer 1st trimester: insulin need is
REDUCED because of increased insulin production. *More
episodes of hypogyclemia* 2nd and 3rd Trimester: insulin needs
INCREASE, may need insulin drip during labor
Acute Phase: Lab Values Correct Answer Follow closely as
body attempts to establish balance. Hyponatremia: from
excessive GI suction, diarrhea, dilutional hyponatremia (water
intoxification). Offer juices and nutritional supplements instead
of water. Hypernatremia: if large amounts of hypertonic fluids
administered, may need Na restrictions. Hyperkalemia: large
amounts of K released from damaged cells TALL TENTED T
WAVES. Hypokalemia: not replacing K loss (decreased
reflexes).
Acute Phase: Pathophysiology Correct Answer Diuresis,
patient is less edematous. Bowel sounds should return. Depth of
wound bed more apparent. Some healing, WBC's surround
wound. Necrotic tissue begins to slough. Fibroblasts start
collagen > granulation tissue. Healing spontaneous and takes 10-
21 days. Wounds will heal from edges and dermal bed if kept
from infection and desiccation (dryness).
,An increased hematocrit is commonly caused by? Correct
Answer Hemoconcentration is d/t fluid loss. After fluid balance
is restored hematocrit levels drop.
Analgesic management for burn patients Correct Answer
Morphine, hydromorphone (dilaudid) *extended release options
too*, Fentanyl, Oxycodone/Acetaminophen (Percocet),
Methadone (Dolophine), NSAID's (Ketorolac), Adjuvant
analgesics (Gabapentin).
Anion Gap Correct Answer Na - (Bicarb + Chloride) = Anion
Gap. Normal 8-12. Elevated with DKA = metabolic acidosis.
Increased if associated with acid gain. Normal if associated with
bicarb loss.
Antimicrobial Agents for Burn Patients Correct Answer
CHECK FOR SULFA ALLERGIES. Many burn ATB creams
are sulfas. After wound cleansed, topical ATB then dressing.
Systemic ATB not used because little to no blood supply on
burn area. Silver-impregnated dressing can be left on 3-14 days
per pt/per product. Silver sulfadiazine (Silvadene). Mafenide
acetate (sulfamylon)
Assessment Findings: Full-Thickness (3rd and 4th Degree
Burns) Correct Answer Dry, Leathery eschar, waxy, white to
dark brown charred. Strong burn odor. Impaired sensation when
touched, absence of pain with severe pain in surrounding tissues.
Lack of blanching with pressure.
Assessment Findings: Partial-Thickness (Deep/2nd Degree
Burn) Correct Answer moist blebs, blisters. molted white, pink
, to cherry red. hypersensitivity to touch/air, moderate to severe
pain, blanching with pressure
Assessment Findings: Partial-Thickness (Superficial/1st Degree
Burn) Correct Answer redness, pain, moderate/severe
tenderness, minimal edema, blanching with pressure
Assult Correct Answer Threat or attempt to make bodily
contact with another person without that person's consent.
Baby starts producing insulin at week _____ ? Correct Answer
ten
Burn Considerations: Endocrine System Correct Answer
Watch for transient increase in blood glucose levels. Relative
insulin insensitivity. Treat with IV or subQ insulin, do not
decrease feedings. Serum glucose testing more accurate.
Burn patients special care: EARS Correct Answer Keep free
from pressure because of poor vascularization and tendency to
become infected. Do not use pillows if patient has ear burns.
Pressure on cartilage may cause chondritis. Ear may stick to
pillowcase = bleeding and pain. Raise head using rolled towel
under shoulders, be careful to void pressure necrosis. Follow
same strategy for the patient with neck burns to hyperextend the
neck to prevent contracture.
Burn patients special care: Extremities Correct Answer Extend
burned hands and arms and raise them on pillows or plastic
foam wedges to reduce edema. Remove splints often and inspect
skin and bony prominences to void areas of pressure. Ask
