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Questions and Answers
What is a primary danger of carbon monoxide poisoning?
What is a primary danger of carbon monoxide poisoning?
Which symptom typically presents first in carbon monoxide poisoning?
Which symptom typically presents first in carbon monoxide poisoning?
What is a common complication associated with thermal injury to the airway?
What is a common complication associated with thermal injury to the airway?
What is a characteristic of smoke poisoning?
What is a characteristic of smoke poisoning?
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What should be monitored as a key indicator of cardiovascular health in burn patients?
What should be monitored as a key indicator of cardiovascular health in burn patients?
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What condition is characterized by pulmonary edema following severe injury?
What condition is characterized by pulmonary edema following severe injury?
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What intervention may be necessary when tight eschar from burns restricts breathing?
What intervention may be necessary when tight eschar from burns restricts breathing?
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What effect does myoglobin release from damaged muscle have in the context of renal assessment?
What effect does myoglobin release from damaged muscle have in the context of renal assessment?
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What is the primary risk associated with rhabdomyolysis in burn patients?
What is the primary risk associated with rhabdomyolysis in burn patients?
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Why is monitoring kidney function critical during the resuscitation of burn patients?
Why is monitoring kidney function critical during the resuscitation of burn patients?
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What substance can lead to obstruction in the renal tubules and impair kidney function?
What substance can lead to obstruction in the renal tubules and impair kidney function?
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What is a crucial intervention for patients with burns covering at least 25% of their total body surface area?
What is a crucial intervention for patients with burns covering at least 25% of their total body surface area?
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What are expected changes in gastrointestinal function during the emergent phase of burn treatment?
What are expected changes in gastrointestinal function during the emergent phase of burn treatment?
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Which condition is characterized by coffee ground emesis and melena in burn patients?
Which condition is characterized by coffee ground emesis and melena in burn patients?
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What method is used to assess the percentage of total body surface area affected by burns?
What method is used to assess the percentage of total body surface area affected by burns?
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What is an essential nursing intervention for skin care of burn patients?
What is an essential nursing intervention for skin care of burn patients?
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What is a local indicator of infection in burn wounds?
What is a local indicator of infection in burn wounds?
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Which topical medication is contraindicated in patients with sulfonamide allergies?
Which topical medication is contraindicated in patients with sulfonamide allergies?
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What is the purpose of hydrotherapy in mechanical debridement?
What is the purpose of hydrotherapy in mechanical debridement?
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What is a systemic indicator of infection related to kidney function?
What is a systemic indicator of infection related to kidney function?
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Which condition is characterized by changes in vital signs, including tachycardia and temperature instability?
Which condition is characterized by changes in vital signs, including tachycardia and temperature instability?
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What type of graft is harvested from the patient's own body?
What type of graft is harvested from the patient's own body?
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What is a key function of biosynthetic dressings in burn care?
What is a key function of biosynthetic dressings in burn care?
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Which complication is associated with silver sulfadiazine?
Which complication is associated with silver sulfadiazine?
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How does enzymatic debridement assist in wound management?
How does enzymatic debridement assist in wound management?
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What characterizes the lesions in uninvolved skin of a burn patient?
What characterizes the lesions in uninvolved skin of a burn patient?
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What condition is indicated by impaired tissue perfusion from neurogenic shock?
What condition is indicated by impaired tissue perfusion from neurogenic shock?
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Which symptom is NOT associated with spinal shock syndrome?
Which symptom is NOT associated with spinal shock syndrome?
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What is the first priority in the initial assessment of a patient with spinal cord injury?
What is the first priority in the initial assessment of a patient with spinal cord injury?
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Which of the following is a characteristic of complete injuries to the spinal cord?
Which of the following is a characteristic of complete injuries to the spinal cord?
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What is the Glasgow Coma Scale used for in spinal cord injury assessment?
What is the Glasgow Coma Scale used for in spinal cord injury assessment?
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Which of these symptoms is a direct result of neurogenic shock?
Which of these symptoms is a direct result of neurogenic shock?
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What does paraplegia primarily result in?
What does paraplegia primarily result in?
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What is a potential consequence of local edema in spinal cord injury?
What is a potential consequence of local edema in spinal cord injury?
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What might result from an injury above the 6th thoracic vertebra?
What might result from an injury above the 6th thoracic vertebra?
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Which of the following best describes hypopesthesia?
Which of the following best describes hypopesthesia?
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What is a key characteristic of a transient ischemic attack (TIA)?
What is a key characteristic of a transient ischemic attack (TIA)?
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Which treatment option is NOT typically recommended for managing TIA?
Which treatment option is NOT typically recommended for managing TIA?
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Which condition is the most common cause of an embolic stroke?
Which condition is the most common cause of an embolic stroke?
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What distinguishes a thrombotic stroke from an embolic stroke?
What distinguishes a thrombotic stroke from an embolic stroke?
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Which of the following is a classic sign of intracranial pressure (ICP) increase after a hemorrhagic stroke?
Which of the following is a classic sign of intracranial pressure (ICP) increase after a hemorrhagic stroke?
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What is a common risk factor for developing an intracerebral hemorrhage?
What is a common risk factor for developing an intracerebral hemorrhage?
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Which symptom is NOT typically associated with a TIA?
Which symptom is NOT typically associated with a TIA?
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What is the primary distinction between hemorrhagic and ischemic strokes?
What is the primary distinction between hemorrhagic and ischemic strokes?
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Which measure is NOT typically part of lifestyle changes recommended for TIA patients?
Which measure is NOT typically part of lifestyle changes recommended for TIA patients?
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What is the role of antiplatelet therapy in stroke prevention?
What is the role of antiplatelet therapy in stroke prevention?
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Study Notes
Carbon Monoxide Poisoning
- Leading cause of fire-related deaths due to its colorless, odorless nature.
- Binds to hemoglobin, forming carboxyhemoglobin (COHb), impacting oxygen delivery.
- Cherry red skin indicates vasodilation associated with poisoning.
- Symptoms associated with varying COHb levels: headache, altered mental status, unconsciousness, coma, and potentially death.
Thermal Injury
- Affects upper airway structures (nasopharynx, oropharynx, larynx).
- Edema can lead to upper airway obstruction; epiglottitis a significant risk.
- Early intubation may be necessary if heat exposure is confirmed.
Smoke Poisoning
- Results from inhalation of toxic combustion by-products, particularly from burning plastics and furnishings.
- Can impair respiratory cell function.
Pulmonary Fluid Overload
- Characterized by pulmonary edema due to inflammatory mediators causing capillary leaks.
- Congestive heart failure (CHF) can contribute to circulatory overload.
- Symptoms include shortness of breath (SOB), dyspnea, and crackles upon auscultation.
Edema Post Fluid Resuscitation
- Common after aggressive rehydration in burn patients.
Nasal Intubation - Blind Intubation
- Useful in emergencies where airway access is critical.
External Factors
- Circumferential chest burns can lead to tight eschar, restricting breathing and chest movement.
- Increased airway pressure may necessitate an escharotomy.
Cardiovascular Assessment
- Hypovolemic shock can lead to high mortality in the emergent phase after serious injuries.
- Monitor vital signs for tachycardia, hypotension, decreased peripheral pulses, and slow capillary refill.
- Observe for edema, abnormal heart sounds (S3), and crackles.
Renal/Urinary Assessment
- Kidney function can be compromised due to cellular debris and decreased blood flow.
- Myoglobin from damaged muscles can lead to rhabdomyolysis, with significant effects on kidneys.
- High fluid intake is critical to dilute myoglobin and prevent kidney damage.
- Monitor urine output; less than 30ml/hr indicates acute kidney injury.
Gastrointestinal Assessment
- Decreased GI function is common following severe burn injuries due to reduced blood flow.
- Symptoms may include nausea, vomiting, abdominal distention, and hypoactive bowel sounds.
- NG tube may be inserted in cases of 25% total body surface area (TBSA) burns for decompression.
- Watch for GI bleeding, notably coffee ground emesis or melena.
Skin Assessment
- Assess burn size, depth, and total body surface area (TBSA) using the "Rule of Nines."
- Maintain strict hygiene, cover wounds, and ensure a warm environment of 85°F.
- Monitor for localized infection indicators, such as excessive drainage and abnormal granulation tissue.
Local and Systemic Indicators of Infection
- Look for signs like wound breakdown, odor, tachycardia, altered consciousness, hypotension, oliguria, and gastrointestinal dysfunction.
Nonsurgical Management: Acute Phase
- Focus on removing necrotic tissue, cleaning wounds, and applying appropriate dressings.
- Techniques include hydrotherapy and enzymatic debridement (e.g., collagenase).
Topical Medications
- Silver sulfadiazine (Silvadene) is effective but contraindicated in patients with sulfonamide allergies. Monitor white blood cell counts.
- Gentamicin sulfate (Garamycin) is nephrotoxic and ototoxic.
Dressing the Burn Wounds
- Options include standard dressings, biologic dressings (human skin, porcine skin), and synthetic materials.
- Biosynthetic dressings provide exudate management and wound inspection capabilities.
Surgical Management
- Grafting is essential for closing full-thickness injuries, preventing joint dysfunction or cosmetic issues.
- Early intervention reduces infection risk.
Vascular Problems of the Brain
- Transient Ischemic Attack (TIA) indicates potential stroke risk; symptoms include visual deficits and motor/sensory issues.
- Treatment focuses on preventing hypertension, managing diabetes, and promoting lifestyle changes.
Stroke - Brain Attack (CVA)
- Classified as ischemic (thrombotic or embolic) or hemorrhagic (intracerebral or subarachnoid).
- Thrombotic strokes stem from atherosclerosis; embolic strokes often result from cardiac issues.
Hemorrhagic Stroke
- Hemorrhagic types involve rupture of vessels, leading to bleeding in the brain tissue or subarachnoid space.
- Important symptoms include decreased LOC, headache, nausea, and cranial nerve dysfunction.
Spinal Cord Injury (SCI): Assessment
- Initial priority is airway management, particularly for injuries affecting the phrenic nerve (C3-C5).
- Monitor for neurologic status using the Glasgow Coma Scale; assess for hypotension and bradycardia.
Spinal Shock Symptoms
- Flaccid paralysis and loss of reflexes are common post SCI; can last from hours to several weeks.
Assessing Sensory/Motor Function
- Evaluate for disruptions in sensory pathways and assess motor capabilities using the American Spinal Injury Association (ASIA) scale.
Cardiovascular and Respiratory Assessment in SCI
- Autonomic nervous system disruption is prominent in injuries above T6, warranting close monitoring of cardiovascular stability.
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Description
This quiz covers the critical aspects of carbon monoxide poisoning, including its symptoms, causes, and effects on the human body. Additionally, it explores thermal injuries related to fire incidents, focusing on the impact on the upper airway. Test your knowledge on these important health topics.
