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A patient presents to the ER with erythema, warmth to the shoulders along with pain, swelling, and loss of function to the area. What kind of burn does the nurse suspect?
A patient presents to the ER with erythema, warmth to the shoulders along with pain, swelling, and loss of function to the area. What kind of burn does the nurse suspect?
A patient presents to the ER with a burn which has blistering, erythema, warmth, pain, edema, and serous exudate. What kind of burn does the nurse suspect?
A patient presents to the ER with a burn which has blistering, erythema, warmth, pain, edema, and serous exudate. What kind of burn does the nurse suspect?
A patient presents to the ER with a burn as well as erythema, eschar formation, edema, and exudate. What kind of burn does the nurse suspect?
A patient presents to the ER with a burn as well as erythema, eschar formation, edema, and exudate. What kind of burn does the nurse suspect?
Treatment of RA involves a careful balance of pharmacologic and nonpharmacologic treatment strategies.
Treatment of RA involves a careful balance of pharmacologic and nonpharmacologic treatment strategies.
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Nonpharmacologic strategies for RA include balance of rest and activity, PT, splints, hot/cold therapy, and if needed synovectomy (total joint replacement surgery).
Nonpharmacologic strategies for RA include balance of rest and activity, PT, splints, hot/cold therapy, and if needed synovectomy (total joint replacement surgery).
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Patient presents to the ER with mild to severe abdominal pain, indigestion/heartburn, loss of appetite, nausea, hiccups, hematemesis (vomiting blood), and anemia. What does the nurse suspect?
Patient presents to the ER with mild to severe abdominal pain, indigestion/heartburn, loss of appetite, nausea, hiccups, hematemesis (vomiting blood), and anemia. What does the nurse suspect?
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Patient presents to the ER with Upper abdominal pain of sudden onset, growing in intensity, and leading to a dull, steady ache often radiating to the back as well as Nausea, vomiting, anorexia, and/or diarrhea. What does the nurse suspect?
Patient presents to the ER with Upper abdominal pain of sudden onset, growing in intensity, and leading to a dull, steady ache often radiating to the back as well as Nausea, vomiting, anorexia, and/or diarrhea. What does the nurse suspect?
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To diagnose acute pancreatitis, the patient may need CT, MRI, CBC, ESR, and CRP tests. Also testing would measure serum amylase and lipase elevation levels along with Serum alkaline phosphate, total bilirubin, and AST/ALT elevation levels.
To diagnose acute pancreatitis, the patient may need CT, MRI, CBC, ESR, and CRP tests. Also testing would measure serum amylase and lipase elevation levels along with Serum alkaline phosphate, total bilirubin, and AST/ALT elevation levels.
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A patient with __________ may exibit severe intermittent episodes of abdominal pain (mid or upper right-sided radiating to the back) lasting several hours and at unpredictable intervals, diarrhea, steatorrhea (fatty stools), and weight loss.
A patient with __________ may exibit severe intermittent episodes of abdominal pain (mid or upper right-sided radiating to the back) lasting several hours and at unpredictable intervals, diarrhea, steatorrhea (fatty stools), and weight loss.
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_______ is located in the small intestine and ascending colon, has skip lesions, is primarily submucosa, accompanied by watery diarrhea and abdominal pain commonly with bowel obstruction and increased risk for cancer.
_______ is located in the small intestine and ascending colon, has skip lesions, is primarily submucosa, accompanied by watery diarrhea and abdominal pain commonly with bowel obstruction and increased risk for cancer.
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________ is located in the descending colon, is continuous, is primarily mucosa, with bloody diarrhea and abdominal pain and a higher risk of cancer although bowel obstruction is uncommon.
________ is located in the descending colon, is continuous, is primarily mucosa, with bloody diarrhea and abdominal pain and a higher risk of cancer although bowel obstruction is uncommon.
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_______ may occur when there is an injury to the acinar cells, pancreatic duct, or protective digestive feedback mechanisms in the exocrine pancreas. Common causes include duct blockage by gallstones or excessive alcohol use.
_______ may occur when there is an injury to the acinar cells, pancreatic duct, or protective digestive feedback mechanisms in the exocrine pancreas. Common causes include duct blockage by gallstones or excessive alcohol use.
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In a patient with ______ a nurse may expect to see elevated ESR and CRP levels, presence of RF (IgG), a positive ANA, inflammatory products in a synovial joint fluid analysis, and joint damage seem on a radiograph.
In a patient with ______ a nurse may expect to see elevated ESR and CRP levels, presence of RF (IgG), a positive ANA, inflammatory products in a synovial joint fluid analysis, and joint damage seem on a radiograph.
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Rheumatoid factor (RF), a substance that can be found in the blood, synovial fluid, and synovial membranes, signifies that antibodies (IgM, IgG, or IgA) are acting against other antibodies (mainly IgG).
Rheumatoid factor (RF), a substance that can be found in the blood, synovial fluid, and synovial membranes, signifies that antibodies (IgM, IgG, or IgA) are acting against other antibodies (mainly IgG).
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With RA, CD4+ helper T cells have been implicated as activating the inflammatory response along with the release of cytokines. Lymphocytes and plasma cells then form antibodies in the synovial membrane and cartilage.
With RA, CD4+ helper T cells have been implicated as activating the inflammatory response along with the release of cytokines. Lymphocytes and plasma cells then form antibodies in the synovial membrane and cartilage.
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- Although the exact cause of ___________ is unknown, the etiology is likely a combination of genetics, immune triggering event, and subsequent development of autoimmunity against synovial cells.
- Although the exact cause of ___________ is unknown, the etiology is likely a combination of genetics, immune triggering event, and subsequent development of autoimmunity against synovial cells.
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The degree of damage for full thickness burns is considered minor with less than 2%, moderate with 2%-5%, and major with greater than 5% TBSA.
The degree of damage for full thickness burns is considered minor with less than 2%, moderate with 2%-5%, and major with greater than 5% TBSA.
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With young or old patients TBSA is minor when less than 5%, Moderate with 5%-10%, and major for greater than 10%.
With young or old patients TBSA is minor when less than 5%, Moderate with 5%-10%, and major for greater than 10%.
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With Adult burns TBSA is minor when it is less than 10%, Moderate when it is 10-20%, and major for over 20%.
With Adult burns TBSA is minor when it is less than 10%, Moderate when it is 10-20%, and major for over 20%.
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Any burn involving the face, hands, feet, or perineum as well as electrical, inhalation, or trauma can sometimes be classified as minor burns.
Any burn involving the face, hands, feet, or perineum as well as electrical, inhalation, or trauma can sometimes be classified as minor burns.
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Body fluid shifts that cause impaired blood circulation, edema, and dehydration, Microorganism invasion that leads to infection, overwhelming metabolic demands that increase the risk for malnutrition, and Problems with temperature regulation are all potential complications caused by the loss of skin function in severe burn injuries.
Body fluid shifts that cause impaired blood circulation, edema, and dehydration, Microorganism invasion that leads to infection, overwhelming metabolic demands that increase the risk for malnutrition, and Problems with temperature regulation are all potential complications caused by the loss of skin function in severe burn injuries.
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Which is not a primary factor that determines the extent of damage from chemical injuries?
Which is not a primary factor that determines the extent of damage from chemical injuries?
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Which type of burn affects the epidermis and penetrates into the dermis?
Which type of burn affects the epidermis and penetrates into the dermis?
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What defines severe burn injuries in terms of body surface area coverage?
What defines severe burn injuries in terms of body surface area coverage?
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Why is lactated ringers used as the fluid of choice with burns?
Why is lactated ringers used as the fluid of choice with burns?
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What does the nurse need to know about Eschar?
What does the nurse need to know about Eschar?
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How are wound depths classified in the context of burns?
How are wound depths classified in the context of burns?
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What is the initial treatment required for minor and moderate burns?
What is the initial treatment required for minor and moderate burns?
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How is erythema defined in the context of the text?
How is erythema defined in the context of the text?
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What is ankylosis as described in the text?
What is ankylosis as described in the text?
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Which medications are commonly used for Rheumatoid Arthritis (RA) according to the text?
Which medications are commonly used for Rheumatoid Arthritis (RA) according to the text?
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What is the first step in treating acute gastritis according to the text?
What is the first step in treating acute gastritis according to the text?
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What is usually the tell-tale sign of chronic gastritis?
What is usually the tell-tale sign of chronic gastritis?
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What type of burn damages both the epidermis and dermis, and can penetrate subcutaneous layers as well?
What type of burn damages both the epidermis and dermis, and can penetrate subcutaneous layers as well?
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How much of an adult's body surface area do the front and back of the trunk represent each in the context of burns?
How much of an adult's body surface area do the front and back of the trunk represent each in the context of burns?
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What is the purpose of administering fluids in cases of moderate to severe burns?
What is the purpose of administering fluids in cases of moderate to severe burns?
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What percentage of body surface area do the front and back of each leg represent in adult burn cases?
What percentage of body surface area do the front and back of each leg represent in adult burn cases?
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In diagnosing gastritis, what sign is often observed in cases of chronic gastritis?
In diagnosing gastritis, what sign is often observed in cases of chronic gastritis?
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What type of burn is characterized by damage to the epidermis only?
What type of burn is characterized by damage to the epidermis only?
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How much of an adult's body surface area do the genitals represent in the context of burns?
How much of an adult's body surface area do the genitals represent in the context of burns?
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Which diagnostic method is considered the gold standard for diagnosing chronic pancreatitis?
Which diagnostic method is considered the gold standard for diagnosing chronic pancreatitis?
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What is a significant factor in diagnosing acute gastritis according to the text?
What is a significant factor in diagnosing acute gastritis according to the text?
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Which medication type is NOT commonly used for treating Rheumatoid Arthritis (RA) based on the provided information?
Which medication type is NOT commonly used for treating Rheumatoid Arthritis (RA) based on the provided information?
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What is a potential cause of malalignment described in the text?
What is a potential cause of malalignment described in the text?
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What is one diagnostic method is used for chronic gastritis according to the text?
What is one diagnostic method is used for chronic gastritis according to the text?
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How is chronic pancreatitis different from acute pancreatitis based on the text?
How is chronic pancreatitis different from acute pancreatitis based on the text?
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What percentage of body surface area do the front and back of an adult's head each represent in burn cases according to the text?
What percentage of body surface area do the front and back of an adult's head each represent in burn cases according to the text?
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With burns you will lose sodium and water.
With burns you will lose sodium and water.
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Burns can result from thermal injury, electrical injury, caustic chemical injury, radiation exposure, or inhalation of noxious fumes.
Burns can result from thermal injury, electrical injury, caustic chemical injury, radiation exposure, or inhalation of noxious fumes.
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Patient education for ulcerative colitis includes ________________, and drinking lots of water as well as taking anti-inflammatory, antidiarrheal, and immunosuppressive medications.
Patient education for ulcerative colitis includes ________________, and drinking lots of water as well as taking anti-inflammatory, antidiarrheal, and immunosuppressive medications.
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With adult burns, the front and back of the arms represent 4.5% per arm per side.
With adult burns, the front and back of the arms represent 4.5% per arm per side.
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Study Notes
Burns
- Burns can result from thermal injury, electrical injury, caustic chemical injury, radiation exposure, or inhalation of noxious fumes.
- Superficial partial-thickness burns (first-degree burns) damage the epidermis.
- Deep partial-thickness burns (second-degree burns) damage the epidermis and penetrate into the dermis.
- Full-thickness burns (third-degree burns) damage the epidermis and dermis and can penetrate subcutaneous layers as well.
- Severe burn injuries are defined as full-thickness burns covering greater than 20% of the adult body surface area.
- With burns, you will lose sodium and water.
- Lactated ringers are the fluid of choice for burns because they help shift from inter to extracellular fluids.
- Eschar is a thick, coagulated crust stemming from dead-tissue and exudate in full-thickness burns and must be surgically removed.
- Wound depths (superficial, deep partial, or full thickness) are classified according to the affected tissue layers.
- Body surface areas affected by burns:
- Head: 4.5% each (front and back)
- Arms: 4.5% per arm per side (front and back)
- Genitals: 1% each
- Legs: 9% each per leg per side (front and back)
- Trunk: 18% each (front and back)
Treatment of Burns
- Initial treatment for minor and moderate burns requires removing the source of injury and stopping the burning process.
- With moderate to severe burns, administering fluids helps to restore the circulating blood volume and improves perfusion of vital organs.
Other Conditions
- Malalignment is caused by a combination of cartilage and bone erosion, fibrosis, ankylosis, muscle spasms, and muscle atrophy.
- Ankylosis is a debilitating fixation of a joint from extensive fibrosis / joint stiffness.
- Erythema is redness caused by increased blood flow to the tissues.
- Medications for RA include anti-inflammatory, immunosuppressants, and remission inducing.
Gastritis
- To diagnose gastritis, you will likely see the patient's history of aspirin, NSAIDs, excessive alcohol intake, contaminated food intake, abdominal tenderness, and occult (hidden) blood in the stool.
- Treatment of acute gastritis begins with removal of the gastric irritant.
- In chronic gastritis, you will often see H.Pylori.
- Diagnosis of chronic gastritis is done through endoscopy, breath test, and H.pylori blood test.
- Dyspepsia, a vague epigastric discomfort associated with nausea and heartburn, is a possible clinical manifestation of chronic gastritis, although most people are asymptomatic carriers.
Chronic Pancreatitis
- Chronic pancreatitis differs from acute pancreatitis in duration, and its impact on both the endocrine and exocrine functions of the pancreas.
- Endoscopic retrograde cholangiopancreatography (ERCP) is considered the gold standard for diagnosing chronic pancreatitis.
Ulcerative Colitis
- Patient education for ulcerative colitis includes avoiding milk, caffeine, spicy foods, and drinking lots of water as well as taking anti-inflammatory, antidiarrheal, and immunosuppressive medications.
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Description
Test your knowledge on identifying burn types based on patient presentation. In this scenario, a nurse assesses a patient with erythema, warmth, pain, swelling, and loss of function to the shoulders in the ER.
