Study Guide for Brunner and Suddarth Textbook of
Medical-Surgical Nursing chapter 57 Exam questions
and Answers.
Mortality rate of lightning strikes - ANSWER-Approximately 10%, with many survivors
experiencing permanent morbidity.
Resuscitation fluid calculations - ANSWER-Inaccurate in conductive electrical injuries,
making it difficult to quantify tissue injury without surgical exploration.
Myoglobinuria - ANSWER-A condition common with muscle damage that may cause
kidney failure if not treated.
IV fluid administration - ANSWER-Titrated to a higher target of urine output per hour
than usual until urine is no longer red.
Sodium bicarbonate in IV fluids - ANSWER-Common practice to add 50 mEq per liter to
assist in alkalinizing the urine.
Serum and urine myoglobin levels - ANSWER-Monitored as indicators of the need for
continued resuscitation.
Surgical treatment of electrical injury - ANSWER-As complex as the injury itself,
requiring careful consideration and management.
Electrical current effects on muscles - ANSWER-Causes immediate contraction of
muscles, potentially leading to skeletal and joint injuries.
Psychological morbidity from electrical injuries - ANSWER-Includes symptoms such as
depression, sleep disorders, and chronic pain.
Neurologic disabilities from lightning strikes - ANSWER-Survivors may report memory
loss, attention deficits, and other neurological issues.
Edema from electrical injuries - ANSWER-Results from injured tissue and can
complicate treatment and recovery.
Fasciotomies - ANSWER-Invasive decompressive therapies that may be required in the
management of compartment syndrome.
Nerve releases - ANSWER-Surgical procedures that may be necessary in the treatment
of electrical injuries.
,Ocular releases - ANSWER-Surgical interventions that may be indicated in the
management of electrical injuries.
Laparotomies - ANSWER-Surgical procedures that may be required in the complex
treatment of electrical injuries.
Surgical treatment of electrical injury - ANSWER-As complex as the injury itself, with
progressive tissue necrosis occurring over time.
Cardiovascular alterations after burn injury - ANSWER-Immediate decrease in cardiac
output precedes the loss of plasma volume.
Intravascular fluid leak - ANSWER-Greatest volume occurs in the first 24 to 36 hours
after burn injury, peaking at approximately 6 to 8 hours.
Intrinsic diuresis - ANSWER-Begins and continues for several days to 2 weeks in
previously healthy adults after burn injury.
Edema formation - ANSWER-A superficial burn causes localized edema within 4 hours,
while a deeper burn continues to form edema up to 18 hours post injury.
Capillary permeability - ANSWER-Increased perfusion to the injured area reflects the
amount of microvascular and lymphatic damage.
Pathophysiologic changes with severe burns - ANSWER-Includes cardiac depression,
edema, hypovolemia, vasoconstriction, impaired motility, and immunodepression.
Magnitude of injuries - ANSWER-Higher with burn injuries compared to trauma injuries.
Fluid and electrolyte alterations - ANSWER-Rapid edema formation occurs after a burn
injury.
Peripheral edema - ANSWER-Occurs as water migrates to the interstitium due to
increased capillary permeability.
Vasoconstrictive compensatory responses - ANSWER-Increase workload of the heart
and oxygen demand due to plasma volume loss.
Bacterial translocation - ANSWER-Loss of mucosal barrier function leads to increased
risk of infection.
Thermoregulation alterations - ANSWER-Altered thermoregulation occurs as a systemic
response to severe burns.
TBSA - ANSWER-Total Body Surface Area affected by burns.
,Inflammatory mediators - ANSWER-Substances that stimulate local and systemic
reactions in response to burns.
Primary survey - ANSWER-An initial assessment to monitor circulation in burn patients
during the emergent phase.
Circumferential burn - ANSWER-A burn that encircles a limb or torso, which can act like
a tourniquet.
Tissue ischemia - ANSWER-Insufficient blood flow to tissue, potentially leading to
damage.
Acute compartment syndrome - ANSWER-A condition resulting from increased
pressure within a muscle compartment, leading to tissue ischemia.
Venous thromboembolism (VTE) - ANSWER-A condition where blood clots form in
veins, requiring monitoring in burn patients.
Hematocrit - ANSWER-The proportion of blood volume that is occupied by red blood
cells, which may be elevated due to plasma loss.
Thrombocytopenia - ANSWER-A decrease in platelets in the blood, often occurring after
burn injuries.
Inhalation injuries - ANSWER-Injuries resulting from inhaling thermal or chemical
irritants, categorized as upper or lower airway injuries.
Upper airway injury - ANSWER-Obstructive injury caused by severe edema in the upper
airway due to thermal injury.
Lower airway injury - ANSWER-Injury resulting from inhaling products of combustion or
noxious gases, often leading to severe complications.
Bronchoscopy - ANSWER-The standard test for diagnosing inhalation injuries, as initial
chest x-rays may appear normal.
Ciliary action - ANSWER-The movement of cilia in the airways that helps clear mucus
and debris, which is lost in smoke inhalation.
Atelectasis - ANSWER-Collapse of alveoli in the lungs, often due to reduced surfactant
production after inhalation injury.
Carbonaceous sputum - ANSWER-Sputum containing carbon particles, indicating a
lower airway inhalation injury.
, Aggressive pulmonary toilet - ANSWER-Techniques used to maintain airway patency
and clear viscous sputum in patients with inhalation injuries.
Carbon monoxide (CO) - ANSWER-A noxious gas that displaces oxygen in hemoglobin,
contributing to fatalities in fire situations.
Carboxyhemoglobin - ANSWER-A complex formed when carbon monoxide binds with
hemoglobin, reducing oxygen transport.
Affinity of hemoglobin for CO - ANSWER-Hemoglobin's binding strength for carbon
monoxide, which is 200 times greater than that for oxygen.
Hypersecretion - ANSWER-Excessive secretion of mucus, often triggered by inhalation
injuries.
Noxious gases - ANSWER-Harmful gases, such as carbon monoxide and hydrogen
cyanide, that contribute to lower airway injuries.
Treatment for CO poisoning - ANSWER-Administration of 100% oxygen to displace the
CO molecules bound to hemoglobin, bringing the half-life of CO down to 45 minutes.
Hydrogen cyanide - ANSWER-A rapid systemic toxin associated with mortality, with
signs and symptoms similar to CO poisoning, including shortness of breath, headache,
vertigo, confusion, and mucous membrane irritation.
Cardiopulmonary effects of hydrogen cyanide poisoning - ANSWER-Initially cause a
hyperdynamic response followed by bradycardia and hypotension leading to death.
Persistent lactic acidosis - ANSWER-May indicate hydrogen cyanide poisoning after
resuscitation.
Gaseous cyanide - ANSWER-Results from incomplete combustion of many items found
in homes today.
Bronchoconstriction - ANSWER-Caused by release of histamine, serotonin, and
thromboxane, and can contribute to deterioration.
Hypoxia postburn - ANSWER-May be present even without pulmonary injury.
Catecholamine release postburn - ANSWER-Alters peripheral blood flow, reducing
oxygen delivery to the periphery.
Hypermetabolism postburn - ANSWER-Leads to increased tissue oxygen consumption,
which can also lead to hypoxia.
Medical-Surgical Nursing chapter 57 Exam questions
and Answers.
Mortality rate of lightning strikes - ANSWER-Approximately 10%, with many survivors
experiencing permanent morbidity.
Resuscitation fluid calculations - ANSWER-Inaccurate in conductive electrical injuries,
making it difficult to quantify tissue injury without surgical exploration.
Myoglobinuria - ANSWER-A condition common with muscle damage that may cause
kidney failure if not treated.
IV fluid administration - ANSWER-Titrated to a higher target of urine output per hour
than usual until urine is no longer red.
Sodium bicarbonate in IV fluids - ANSWER-Common practice to add 50 mEq per liter to
assist in alkalinizing the urine.
Serum and urine myoglobin levels - ANSWER-Monitored as indicators of the need for
continued resuscitation.
Surgical treatment of electrical injury - ANSWER-As complex as the injury itself,
requiring careful consideration and management.
Electrical current effects on muscles - ANSWER-Causes immediate contraction of
muscles, potentially leading to skeletal and joint injuries.
Psychological morbidity from electrical injuries - ANSWER-Includes symptoms such as
depression, sleep disorders, and chronic pain.
Neurologic disabilities from lightning strikes - ANSWER-Survivors may report memory
loss, attention deficits, and other neurological issues.
Edema from electrical injuries - ANSWER-Results from injured tissue and can
complicate treatment and recovery.
Fasciotomies - ANSWER-Invasive decompressive therapies that may be required in the
management of compartment syndrome.
Nerve releases - ANSWER-Surgical procedures that may be necessary in the treatment
of electrical injuries.
,Ocular releases - ANSWER-Surgical interventions that may be indicated in the
management of electrical injuries.
Laparotomies - ANSWER-Surgical procedures that may be required in the complex
treatment of electrical injuries.
Surgical treatment of electrical injury - ANSWER-As complex as the injury itself, with
progressive tissue necrosis occurring over time.
Cardiovascular alterations after burn injury - ANSWER-Immediate decrease in cardiac
output precedes the loss of plasma volume.
Intravascular fluid leak - ANSWER-Greatest volume occurs in the first 24 to 36 hours
after burn injury, peaking at approximately 6 to 8 hours.
Intrinsic diuresis - ANSWER-Begins and continues for several days to 2 weeks in
previously healthy adults after burn injury.
Edema formation - ANSWER-A superficial burn causes localized edema within 4 hours,
while a deeper burn continues to form edema up to 18 hours post injury.
Capillary permeability - ANSWER-Increased perfusion to the injured area reflects the
amount of microvascular and lymphatic damage.
Pathophysiologic changes with severe burns - ANSWER-Includes cardiac depression,
edema, hypovolemia, vasoconstriction, impaired motility, and immunodepression.
Magnitude of injuries - ANSWER-Higher with burn injuries compared to trauma injuries.
Fluid and electrolyte alterations - ANSWER-Rapid edema formation occurs after a burn
injury.
Peripheral edema - ANSWER-Occurs as water migrates to the interstitium due to
increased capillary permeability.
Vasoconstrictive compensatory responses - ANSWER-Increase workload of the heart
and oxygen demand due to plasma volume loss.
Bacterial translocation - ANSWER-Loss of mucosal barrier function leads to increased
risk of infection.
Thermoregulation alterations - ANSWER-Altered thermoregulation occurs as a systemic
response to severe burns.
TBSA - ANSWER-Total Body Surface Area affected by burns.
,Inflammatory mediators - ANSWER-Substances that stimulate local and systemic
reactions in response to burns.
Primary survey - ANSWER-An initial assessment to monitor circulation in burn patients
during the emergent phase.
Circumferential burn - ANSWER-A burn that encircles a limb or torso, which can act like
a tourniquet.
Tissue ischemia - ANSWER-Insufficient blood flow to tissue, potentially leading to
damage.
Acute compartment syndrome - ANSWER-A condition resulting from increased
pressure within a muscle compartment, leading to tissue ischemia.
Venous thromboembolism (VTE) - ANSWER-A condition where blood clots form in
veins, requiring monitoring in burn patients.
Hematocrit - ANSWER-The proportion of blood volume that is occupied by red blood
cells, which may be elevated due to plasma loss.
Thrombocytopenia - ANSWER-A decrease in platelets in the blood, often occurring after
burn injuries.
Inhalation injuries - ANSWER-Injuries resulting from inhaling thermal or chemical
irritants, categorized as upper or lower airway injuries.
Upper airway injury - ANSWER-Obstructive injury caused by severe edema in the upper
airway due to thermal injury.
Lower airway injury - ANSWER-Injury resulting from inhaling products of combustion or
noxious gases, often leading to severe complications.
Bronchoscopy - ANSWER-The standard test for diagnosing inhalation injuries, as initial
chest x-rays may appear normal.
Ciliary action - ANSWER-The movement of cilia in the airways that helps clear mucus
and debris, which is lost in smoke inhalation.
Atelectasis - ANSWER-Collapse of alveoli in the lungs, often due to reduced surfactant
production after inhalation injury.
Carbonaceous sputum - ANSWER-Sputum containing carbon particles, indicating a
lower airway inhalation injury.
, Aggressive pulmonary toilet - ANSWER-Techniques used to maintain airway patency
and clear viscous sputum in patients with inhalation injuries.
Carbon monoxide (CO) - ANSWER-A noxious gas that displaces oxygen in hemoglobin,
contributing to fatalities in fire situations.
Carboxyhemoglobin - ANSWER-A complex formed when carbon monoxide binds with
hemoglobin, reducing oxygen transport.
Affinity of hemoglobin for CO - ANSWER-Hemoglobin's binding strength for carbon
monoxide, which is 200 times greater than that for oxygen.
Hypersecretion - ANSWER-Excessive secretion of mucus, often triggered by inhalation
injuries.
Noxious gases - ANSWER-Harmful gases, such as carbon monoxide and hydrogen
cyanide, that contribute to lower airway injuries.
Treatment for CO poisoning - ANSWER-Administration of 100% oxygen to displace the
CO molecules bound to hemoglobin, bringing the half-life of CO down to 45 minutes.
Hydrogen cyanide - ANSWER-A rapid systemic toxin associated with mortality, with
signs and symptoms similar to CO poisoning, including shortness of breath, headache,
vertigo, confusion, and mucous membrane irritation.
Cardiopulmonary effects of hydrogen cyanide poisoning - ANSWER-Initially cause a
hyperdynamic response followed by bradycardia and hypotension leading to death.
Persistent lactic acidosis - ANSWER-May indicate hydrogen cyanide poisoning after
resuscitation.
Gaseous cyanide - ANSWER-Results from incomplete combustion of many items found
in homes today.
Bronchoconstriction - ANSWER-Caused by release of histamine, serotonin, and
thromboxane, and can contribute to deterioration.
Hypoxia postburn - ANSWER-May be present even without pulmonary injury.
Catecholamine release postburn - ANSWER-Alters peripheral blood flow, reducing
oxygen delivery to the periphery.
Hypermetabolism postburn - ANSWER-Leads to increased tissue oxygen consumption,
which can also lead to hypoxia.
