HESI MED SURG III FINAL EXAM QUESTIONS AND ANSWERS 2023/2024 GRADED A+.

HESI MED SURG III FINAL EXAM QUESTIONS AND ANSWERS 2023/2024 GRADED A+. HESI: med surg III 2023 1. Burns: Tissue injury or necrosis caused by transfer of energy from a heat source to the body 2. Categories of Burns: Thermal radiation electrical chemical 3. Tissue destruction results from: Coagulation protein denaturation ionization of cellular contents 4. Critical systems affected include: Respiratory integumentary cardiovascular renal G.I. neurologic 5. Severity is determined by: Burn depth 6. 1st° burn: Superficial partial thickness, injury to the epidermis, leaves skin pink or red but no blisters, dry, painful, slight edema, no scarring or skin graft required 7. 2nd° burn: Deep partial thickness destruction of epidermis and upper layers of dermis, injury to deeper portions of the dermis, painful, appears red or white, weeps fluid, blisters present, hair follicles intact, very edematous, blanching followed by capillary refill, heals without surgical intervention 8. 3rd° burn: Full thickness and deep full thickness involves total destruction of dermis and epidermis, skin cannot regenerate, require skin grafting, underlying tissue may be involved, wound appears dry and leathery as eschar develops, painless 9. Severity is determined by:: Rule of nines, Lund and browder method 10. Rules of Nines: head/neck: 9% 11. Rule of Nines: upper extremities: 9% each 4.5% anterior&posterior 12. Rule of Nines: lower extremities: 18% each 9% anterior/posterior 13. Rule of Nines: Front trunk: 18% 14. Rule of Nines: back trunk: 18% 15. Rule of Nines: perineal area: 1% for adults 16. Three stages of burn care: Resuscitative/emergent acute rehabilitation 17. Resuscitative/emergent stage: 48-72 hrs: Begins at time of injury and concludes with the restoration of capillary permeability. Characterized by fluid shift 1 / 17 HESI: med surg III 2023 from intravascular to interstitial and Candid Expect to administer large volumes of fluid. Fluid replacement formulas calculated from time of injury. 18. Acute phase: 48-72 hrs after injury: Occurs from beginning of diuresis to near completion of wound closure. Characterized by fluid shift from interstitial to intravascular. Focus on infection control wound care & closure, pain management, nutritional support, physical therapy 19. Rehabilitation phase: Occurs from Major wound closure to return to optimal level of physical and psychosocial adjustment. Characterized by grafting and rehabilitation specific to the client. 20. Absence of bowel sounds indicate: Paralytic ileus 21. Urine output in first 72 hours after injury: Radically decreased with increased specific gravity 22. Urine output 72 hours to two weeks after injury: Radically increased 23. Signs of inhalation burn: Red or burned face, cinched facial and nasal hairs, conjunctivitis, sooty nasal mucosal or bloody sputum, hoarseness, rails or wheezing denoting smoke inhalation 24. Nursing plans for emergent phase: admission care, monitor hydration status, monitor respiratory functioning, asses for paralytic ileus, wound care, pain management, asses for circulatory compromise, proper nutrition. 25. Nursing plans for acute phase: Provide infection control, no live plants or flowers in room, perform ROM, prevent contractures, provide fluid therapy, provide adequate nutrition ( up to 5000 calories per day) 26. Pain management: Provide pain medication before dressing change 27. Dietary interventions with burn clients: High calorie, high protein, high carb, no free water, tube feeding at night, weigh daily 28. Hyperthyroidism: Excessive activity of thyroid gland. graves disease or goiter. 29. Treatment for hyperthyroidism: Thyroid ablation by medication, radiation, thyroidectomy, adenectomy of portion of anterior pituitary where TSH producing tumor is located = hormone replacement 30. Signs and symptoms for h