Complete Solutions
A 4 year old brought into the hospital from a home fire who has
partial thickness burn and full thickness burns of left arm,
anterior neck, upper chest left area, 18% of her body. Her temp
is 99, HR is 150, RR is 32, BP is 100/52 and her oxygen
saturation is 89. What would you want to address immediately?
Correct Answer oxygen saturation, HR, and burns
A nurse is administering ibuprofen 5 mg/kg every 6 hrs for a
temp of 100.5. Child weighs 17.6 lbs. You have 100 mg per 5
mL, how much mL are you going to give per dose? Correct
Answer 2 mL
Burn pt has been in hospital about 14 days, she is post
procedure, she has had skin grafting, skin grafted site is left
thigh, temp is 98.6 in morning, HR is 100, RR is 20, 98/56 for
BP, and 97 for oxygen saturation. It is now 1:00 in the
afternoon, her temp is 96.4, 88 for HR, 14 for RR, BP is 90/50,
and oxygen saturation is 88. What would be nursing actions
after her skin grafts? Correct Answer monitor respirations,
give oxygen, warming blanket, watch for bleeding in neck and
chest, make sure head is kept in neutral position; do not remove
graft site dressing, make sure checking oxygen saturation at least
every 2 hrs
Burn pt is getting ready for discharge, home care and supplies
are arranged, you are doing discharge teaching with mom about
medications and how to cope at home, what kind of things
would you need to ensure she knows that tells she understands?
, Correct Answer make sure she knows she can add moisturizer
to scar area, get hydroxazine which is high antihistamine and
give that by measuring spoon to give accurate dose, give every 6
hrs and no need to hold it for bedtime, do puppet play to get
child to talk, assess left arm for redness and open sores every
time splint is put on, wear compression garment to decrease
blood supply to decrease scar to tissue, there is no massaging of
scar tissue at this time
Dietary for celiac disease, what would you tell the family that
they could eat? Correct Answer anything with no wheat,
barley, or rye (they can eat white rice)
Following a tonic clonic seizure, what would you do for that pt?
Correct Answer note times, assess neurologic status, make sure
they are okay breathing (main one)
How would you describe the murmur you hear with a VSD?
Correct Answer loud harsh murmur
Now continuing care on burn pt, after her hydrotherapy, she got
morphine about 8:15 and got medazolim and fentanyl about
8:30. She is back in her room, what orders would you anticipate
from the provider and which ones would be contraindicated?
Correct Answer continue monitor for temp and treat temp, put
her on pressure reduction mattress, allow family to control PCA
pump and teach family about PCA pump (anticipated); limit
protein diet (contraindicated)
Now it is 4 days later for burn pt and her IV site is good, some
serosanguinous spots on her gauze and moderate saturation to