NURS 4000 EXAM GUIDE WITH COMPLETE
SOLUTIONS
Ch 21
Skin Conditions (BURNS)
Priority for burn patient
- prevent infection
- close the burn wound
Superficial Burns (First degree)
Above or reaching the epidermis -> Looks pink or red
- No edema, blistering, or eschar
- Yes: Pain
It can heal within 1 week
Superficial Burns (Second Degree or Partial Thickness
Goes into dermis -> Looks moist, red, blanching, blistering
-NO: eschar
- YES: Blistering, pain, some edema
Can heal within 2 weeks
DEEP Burns: Deep partial thickness
Goes deeper into dermis (less blanching, blisters, and less pain)
,-NO: blisters
-YES: Edema, pain, eschar
Heals in 2-6 weeks
DEEP Burns: Full thickness/third degree
All skin is destroyed and can go into SUB-Q fat (it will be any color and dry)
- NO: blistering, pain
- YES: SEVERE EDEMA, eschar
Heals in months
DEEP Burns: fourth degree
Damage goes into muscle/tendons/bones (will be black)
- NO: blistering, pain
- YES: SEVERE EDEMA and eschar
Heals in months or never
Important concepts for a burn patient
- their self image will change
- rule of NINES
CHAPTER 22
O2 Therapy Requirements
,Respiratory system
includes upper airways, lungs, lower airways and alveolar sacs - and requires gas exchange to
ensure that all tissues have adequate oxygenation
Gas Exchange
the overall transportation of oxygen!
O2 travels into cells and CO2 out through ventilation/diffusion
O2 Delivery
Ventilation
air moving in and out of lungs
- This part also includes the removal of CO2 (which is a major part of cellular metabolism)
Respiratory Diffusion
the movement of gases down their concentration gradients across the alveolar and capillary
membranes
Perfusion
The actual flow of blood into tissues
Can come peripherally (body) or centrally (heart)
What is the purpose of oxygen therapy
, to relieve hypoxemia
What is hypoxemia?
- hypo = "Below Average"
-emia = "Blood"
Low levels of oxygen in blood
What is hypoxia?
Hypoxia is when there is less oxygen in the tissues than there should be !
Arterial Blood Gas Levels
Blood sample that you take to measure gas levels in blood
- PaO2, PaCO2, pH, and HCO3
Results can tell you lung function, metabolic issues, DKA, or sepsis
A pt has increased ICP, normal pH, and increased PaCO2. The HCP orders and increase
in Respiratory Rate on the ventilator. What changes will this cause
Too much CO₂ makes causes vasodilation/ICP
HCP says "hey turn up RR" so PT will breathe out more CO2
SOLUTIONS
Ch 21
Skin Conditions (BURNS)
Priority for burn patient
- prevent infection
- close the burn wound
Superficial Burns (First degree)
Above or reaching the epidermis -> Looks pink or red
- No edema, blistering, or eschar
- Yes: Pain
It can heal within 1 week
Superficial Burns (Second Degree or Partial Thickness
Goes into dermis -> Looks moist, red, blanching, blistering
-NO: eschar
- YES: Blistering, pain, some edema
Can heal within 2 weeks
DEEP Burns: Deep partial thickness
Goes deeper into dermis (less blanching, blisters, and less pain)
,-NO: blisters
-YES: Edema, pain, eschar
Heals in 2-6 weeks
DEEP Burns: Full thickness/third degree
All skin is destroyed and can go into SUB-Q fat (it will be any color and dry)
- NO: blistering, pain
- YES: SEVERE EDEMA, eschar
Heals in months
DEEP Burns: fourth degree
Damage goes into muscle/tendons/bones (will be black)
- NO: blistering, pain
- YES: SEVERE EDEMA and eschar
Heals in months or never
Important concepts for a burn patient
- their self image will change
- rule of NINES
CHAPTER 22
O2 Therapy Requirements
,Respiratory system
includes upper airways, lungs, lower airways and alveolar sacs - and requires gas exchange to
ensure that all tissues have adequate oxygenation
Gas Exchange
the overall transportation of oxygen!
O2 travels into cells and CO2 out through ventilation/diffusion
O2 Delivery
Ventilation
air moving in and out of lungs
- This part also includes the removal of CO2 (which is a major part of cellular metabolism)
Respiratory Diffusion
the movement of gases down their concentration gradients across the alveolar and capillary
membranes
Perfusion
The actual flow of blood into tissues
Can come peripherally (body) or centrally (heart)
What is the purpose of oxygen therapy
, to relieve hypoxemia
What is hypoxemia?
- hypo = "Below Average"
-emia = "Blood"
Low levels of oxygen in blood
What is hypoxia?
Hypoxia is when there is less oxygen in the tissues than there should be !
Arterial Blood Gas Levels
Blood sample that you take to measure gas levels in blood
- PaO2, PaCO2, pH, and HCO3
Results can tell you lung function, metabolic issues, DKA, or sepsis
A pt has increased ICP, normal pH, and increased PaCO2. The HCP orders and increase
in Respiratory Rate on the ventilator. What changes will this cause
Too much CO₂ makes causes vasodilation/ICP
HCP says "hey turn up RR" so PT will breathe out more CO2
