NUR 430 FINAL EXAM | COMPREHENSIVE NURSING STUDY GUIDE,
PRACTICE QUESTIONS & ANSWERS 2026/2027
resuscitation phase of burns - ANS ✔✔cardiopulmonary instability, life-threatening airway and breathing
problems, hypovolemia (until about day 4)
- o2 alterations from CO poisoning, upper airway obstruction, chemical pneumonitis
- focus on ABCs
- assess breath sounds, administer O2, monitor HbCO levels, elevate HOB, prepare for intubation
- fluid resuscitation using parkland formula. can give colloids one capillary leak seals to decrease edema -
ANS ✔✔interventions for resuscitative phase
acute care phase of burns - ANS ✔✔- Lasts until complete wound closure (begins day 4 and ends in
about 2 weeks)
- Inflammatory response with large fluid shifts
- Focus on wound cleaning and infection prevention. Infection most common cause of death after
resuscitation phase
- Pain management, prevent hypothermia
rehab phase of burns - ANS ✔✔focus on healing, scar management, and psychosocial issues
- contractures, pressure ulcers, DVT
biosynthetics (biobrane) - ANS ✔✔porous allowing for absorption of topical antibiotics, adhere to wound
fibrin
synthetic (tegaderm) - ANS ✔✔semi occlusive, coverage of donor sites, fluid may collect
hydrocolloidal (duoderm) - ANS ✔✔occlusive, partial thickness wound, cannot see wound, odor and
exudate, but rapid healing and decreased pain
4 ml x TBSA x weight (kg)
give 50% of calculated fluid need in 8 hours, 25% in seconds 8 hours, and 25% in third eight hours - ANS
✔✔parkland formula and how it is separated
- facial burns
- face and skin may appear cherry red
- look for impaired oxygenation or upper airway obstruction
- singed eyebrows and nose hair, soot in throat - ANS ✔✔how do we know to intubate with burns?
- need O2 even if O2 stat is okay
- o2 can't bind to hgb
- CO poisoning can cause headache, CNS disturbances, unresponsiveness
- need high flow 100% o2 - ANS ✔✔carbon monoxide poisoning considerations
o Hyperkalemia from breakdown of muscles and tissue, or hypokalemia because of overdilution of
vascular space and hyponatremia - ANS ✔✔electrolyte concerns in burns
, chemical burns - ANS ✔✔- acids, alkalis, compounds. either pH or concentration determines injury
- overall treatment is copious flushing or irrigation of water to the burn
- remove source without injuring rescuer and make sure scene is safe
- much more serious than what is observed because damage to inner tissues
- monitor ECG, cardiac dysrhythmias common - ANS ✔✔electrical burn considerations
initial stage of shock - ANS ✔✔- decreased tissue perfusion leads to decreased O2 and decreased cardiac
output and increased lactic acid
- at this stage many people don't seek treatment
compensatory stage of shock - ANS ✔✔- HR increased to try to increase cardiac output and get blood to
where it needs to go. SNS kicks in and lactic acid continues to increase
- need to treat aggressively in this stage
- SNS puts out epi, vasoconstriction, increased HR and contractility, bronchodilation
- RAAS (vasoconstriction and retention of Na and H20)
- BP low due to low volume
- O2 down
- hyperventilation, respiratory alkalosis
- urine output low - ANS ✔✔things that occur during compensatory stage of shock
progressive stage of shock - ANS ✔✔cells swell causing worsening tissue perfusion and oxygen perfusion
so more cells die. cells cannot utilize oxygen
- SNS compensatory mechanism doesn't work anymore
- become even more hypotensive and start to vasodilate because of acidosis
- won't breath well, respiratory and metabolic acidosis at same time
refractory stage of shock - ANS ✔✔organs fail from cell death. multisystem organ failure occurs. patient
death.
MODS - ANS ✔✔two more more organ systems have failed
decreased tissue perfusion and decreased CO - ANS ✔✔main nursing diagnosis of shock
hypovolemic shock - ANS ✔✔problem is overall circulating blood volume. inadequate fluid volume in the
intravascular space. can be absolute or relative
- skin pale and cool
- decreased peripheral pulses
- increased RR
- hyperventilation
- confused (if bleeding)
- tachy
- respiratory alkalosis during compensation then acidosis during progressive - ANS ✔✔s/s of
hypovolemic shock
PRACTICE QUESTIONS & ANSWERS 2026/2027
resuscitation phase of burns - ANS ✔✔cardiopulmonary instability, life-threatening airway and breathing
problems, hypovolemia (until about day 4)
- o2 alterations from CO poisoning, upper airway obstruction, chemical pneumonitis
- focus on ABCs
- assess breath sounds, administer O2, monitor HbCO levels, elevate HOB, prepare for intubation
- fluid resuscitation using parkland formula. can give colloids one capillary leak seals to decrease edema -
ANS ✔✔interventions for resuscitative phase
acute care phase of burns - ANS ✔✔- Lasts until complete wound closure (begins day 4 and ends in
about 2 weeks)
- Inflammatory response with large fluid shifts
- Focus on wound cleaning and infection prevention. Infection most common cause of death after
resuscitation phase
- Pain management, prevent hypothermia
rehab phase of burns - ANS ✔✔focus on healing, scar management, and psychosocial issues
- contractures, pressure ulcers, DVT
biosynthetics (biobrane) - ANS ✔✔porous allowing for absorption of topical antibiotics, adhere to wound
fibrin
synthetic (tegaderm) - ANS ✔✔semi occlusive, coverage of donor sites, fluid may collect
hydrocolloidal (duoderm) - ANS ✔✔occlusive, partial thickness wound, cannot see wound, odor and
exudate, but rapid healing and decreased pain
4 ml x TBSA x weight (kg)
give 50% of calculated fluid need in 8 hours, 25% in seconds 8 hours, and 25% in third eight hours - ANS
✔✔parkland formula and how it is separated
- facial burns
- face and skin may appear cherry red
- look for impaired oxygenation or upper airway obstruction
- singed eyebrows and nose hair, soot in throat - ANS ✔✔how do we know to intubate with burns?
- need O2 even if O2 stat is okay
- o2 can't bind to hgb
- CO poisoning can cause headache, CNS disturbances, unresponsiveness
- need high flow 100% o2 - ANS ✔✔carbon monoxide poisoning considerations
o Hyperkalemia from breakdown of muscles and tissue, or hypokalemia because of overdilution of
vascular space and hyponatremia - ANS ✔✔electrolyte concerns in burns
, chemical burns - ANS ✔✔- acids, alkalis, compounds. either pH or concentration determines injury
- overall treatment is copious flushing or irrigation of water to the burn
- remove source without injuring rescuer and make sure scene is safe
- much more serious than what is observed because damage to inner tissues
- monitor ECG, cardiac dysrhythmias common - ANS ✔✔electrical burn considerations
initial stage of shock - ANS ✔✔- decreased tissue perfusion leads to decreased O2 and decreased cardiac
output and increased lactic acid
- at this stage many people don't seek treatment
compensatory stage of shock - ANS ✔✔- HR increased to try to increase cardiac output and get blood to
where it needs to go. SNS kicks in and lactic acid continues to increase
- need to treat aggressively in this stage
- SNS puts out epi, vasoconstriction, increased HR and contractility, bronchodilation
- RAAS (vasoconstriction and retention of Na and H20)
- BP low due to low volume
- O2 down
- hyperventilation, respiratory alkalosis
- urine output low - ANS ✔✔things that occur during compensatory stage of shock
progressive stage of shock - ANS ✔✔cells swell causing worsening tissue perfusion and oxygen perfusion
so more cells die. cells cannot utilize oxygen
- SNS compensatory mechanism doesn't work anymore
- become even more hypotensive and start to vasodilate because of acidosis
- won't breath well, respiratory and metabolic acidosis at same time
refractory stage of shock - ANS ✔✔organs fail from cell death. multisystem organ failure occurs. patient
death.
MODS - ANS ✔✔two more more organ systems have failed
decreased tissue perfusion and decreased CO - ANS ✔✔main nursing diagnosis of shock
hypovolemic shock - ANS ✔✔problem is overall circulating blood volume. inadequate fluid volume in the
intravascular space. can be absolute or relative
- skin pale and cool
- decreased peripheral pulses
- increased RR
- hyperventilation
- confused (if bleeding)
- tachy
- respiratory alkalosis during compensation then acidosis during progressive - ANS ✔✔s/s of
hypovolemic shock
