Older CH55 BURN
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The nurse is assisting with the care of an older adult patient who is hospitalized for second-degree burns of the legs and feet acquired when hot oil spilled on him. Which factor is most concerning regarding the patient's recovery?

  • The skin texture is moist and healthy
  • The nature of the substance causing the burns
  • The patient history of having diabetes mellitus (correct)
  • The patient was wearing lightweight cotton pajamas
  • The nurse is providing care for a patient with burns covering the entire surface of one arm and the posterior trunk. Approximately what percentage of the patient's body surface area has been affected?

  • 18%
  • 27% (correct)
  • 36%
  • 45%
  • The nurse is providing care for a patient in the emergent stage of treatment for a partial-thickness burn. The patient has been stabilized, with blood pressure(BP) 140/88 mm Hg, pulse 78 beats/minute, respirations 22 breaths/minute, and temperature 97.4 F(36.3 C) orally. Which new finding should the nurse immediately communicate to the health-care provider(HCP)?

  • Report of increasing pain
  • Temperature 99 F
  • Serum-filled blister formation
  • BP 102/74 mm Hg (correct)
  • A child is brought to the emergency department with burns from hot liquid pulled from the stove. Which information is most important for the nurse to acquire from the accompanying adult?

    <p>Duration of exposure</p> Signup and view all the answers

    The licensed practical nurse/licensed vocational nurse(LPN/LVN)is receiving fluid replacement after being burned on 37% of the body. Nursing assessment reveals a BP of 80/60 mm Hg, pulse of 120 beats/minute, and urine output of 10 mL over the past hour. What should the LPN/LVN anticipate will occur as a result?

    <p>Increase the amount of IV fluid administered per hour</p> Signup and view all the answers

    The nurse is providing care for a patient who received synthetic dressings over partial-thickness burns. Which comment by the patient is concerning?

    <p>If these grafts begin to grow, I won't need more surgery</p> Signup and view all the answers

    The nurse is providing care for a patient admitted to the burn unit with burns to 15% of the body. After 3 days, the nurse notes that the patient's temperature is newly elevated to 100.2 F, and the patient exhibits new-onset agitation and confusion. Which action should te nurse take first?

    <p>Notify the RN or HCP</p> Signup and view all the answers

    The nurse is assisting in the care of a patient with a circumferential burn to the leg. The HCP determines that an escharotomy is necessary. What is the nurse's priority action?

    <p>Checking for the return of distal pulses</p> Signup and view all the answers

    The nurse notes that a patient with full-thickness burns has an increase in hematocrit level. What is the cause for this change?

    <p>Loss of intravascular fluid</p> Signup and view all the answers

    The nurse is assisting with the care of a patient with second-degree burns to 35% of the body. Five hours after the burn occurs, the HCP prescribes nasogastric(NG)enteral feedings. For which reason does the nurse understand the value of the NG feeding and the importance of the timeframe?

    <p>Incidence of mortality and infectious morbidity are reduced</p> Signup and view all the answers

    The nurse is working on the rehabilitation unit in a burn facility. The nurse has been reinforcing the importance of returning the patient to an optimal level of physical functioning. Which statement by the patient is concerning?

    <p>I can now feed myself and that makes me independent enough</p> Signup and view all the answers

    A patient receives extensive burns to the face, chest, and hands from a random act of violence. The patient states, "I was doing so well, but I will never fit in again with my family, friends, or coworkers." What collaborative referral should the nurse inquire about?

    <p>Professional psychiatric counseling to regain self-esteem</p> Signup and view all the answers

    The nurse on a burn rehabilitation unit presents information from researching the topic should be included?

    <p>Applying pressure in certain locations can be beneficial</p> Signup and view all the answers

    The nurse is assisting with the care of a patient admitted to the emergency department with chemical burns across the chest and hands. Which actions are included in the plan of care?(Select all that apply)

    <p>Remove all contaminated clothing</p> Signup and view all the answers

    The nurse is preparing a patient with 46% total body surface area burned for graft placement. Which anatomical locations does the nurse expect to have a lower rate of graft success than other areas of the body?

    <p>Axillae</p> Signup and view all the answers

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