NSG 252 Exam 2 Test Blueprint BR.docx

Exam 2 Test Key Points Parkland formula calculation Rule of nines -- BSA calculation Medications for burn management Carbon monoxide poisoning Phases of burn care and related priority interventions Types of burns and management Lab values and their relationships to burns/burn phases Prioriti...

Exam 2 Test Key Points Parkland formula calculation Rule of nines -- BSA calculation Medications for burn management Carbon monoxide poisoning Phases of burn care and related priority interventions Types of burns and management Lab values and their relationships to burns/burn phases Prioritization of burn patients Risk for burns across the lifespan Prevention of burns/education Priority actions for pt with F & E imbalances Risk for AKI, CRF across the lifespan Patient teaching diuretics Nephrotoxic medications Expected findings with abnormal GFR Management /indications for dialysis Management of fluid volume deficit/overload Prioritization of patients Renal biopsy Third-spacing Dietary teaching 1\. **Parkland Formula Calculation** - The Parkland formula is used for calculating fluid resuscitation needs in burn patients. It is calculated as: Fluid Requirement (mL)=4×body weight (kg)×total BSA burned (%) Half of this amount is given over the first 8 hours from the time of burn injury, and the remaining half is given over the next 16 hours. **Rationale**: This formula helps prevent hypovolemic shock by restoring circulating volume, maintaining tissue perfusion, and preventing organ failure. 2\. **Rule of Nines -- BSA Calculation**    Answer: The rule of nines is a method used to estimate the total body surface area (TBSA) affected by burns. It divides the body into sections, each representing 9% or multiples of 9% of the total body area:    - Head and neck: 9%    - Each arm: 9%    - Each leg: 18%    - Anterior trunk: 18%    - Posterior trunk: 18%    - Genital area: 1%    Rationale: Accurately estimating TBSA is critical for guiding fluid resuscitation and treatment. 3\. **Medications for Burn Management**    Answer:    - Pain management: Opioids like morphine or fentanyl.    - Infection prevention: Topical antibiotics like silver sulfadiazine, systemic antibiotics as needed.    - Sedatives: For anxiety and agitation, benzodiazepines like lorazepam.    - Antipruritic medications: Antihistamines like diphenhydramine for itchiness.    Rationale: Pain control, prevention of infection, and comfort management are essential in the holistic care of burn patients. 4\. **Carbon Monoxide Poisoning** Answer: Carbon monoxide binds to hemoglobin more readily than oxygen, leading to hypoxia. Symptoms include headache, dizziness, nausea, confusion, and cherry-red skin coloration in severe cases. Treatment: involves high-flow 100% oxygen or hyperbaric oxygen therapy.    Rationale: Prompt treatment is essential to prevent tissue hypoxia and death. 5\. **Phases of Burn Care and Related Priority Interventions**    Answer: - [Emergent Phase:] First 24-48 hours. Priority: Airway, breathing, circulation, fluid resuscitation, and pain management. - [Acute Phase:] From diuresis to wound closure. Priority: Wound care, prevention of infection, pain control, and nutrition. - [Rehabilitation Phase:] After wound closure. Priority: Psychological support, physical therapy, and scar management.   Rationale: Different phases focus on stabilizing the patient, wound healing, and long-term recovery. 6\. **Types of Burns and Management**    Answer: - First-degree burns: Superficial, only epidermis affected. Management: Cool compresses, analgesics. - Second-degree burns: Partial thickness, epidermis, and part of the dermis. Management: Wound care, pain control, possible antibiotics. - Third-degree burns: Full thickness, affecting all skin layers. Management: Surgical interventions like grafting, intensive wound care.   Rationale: Management varies with the depth and severity of the burn. 7\. **Lab Values and Their Relationships to Burns/Burn Phases**    Answer: - [Electrolytes:] Hyponatremia or hyperkalemia common in the emergent phase due to fluid shifts. - [CBC:] Elevated WBCs in infection, decreased hematocrit due to hemolysis. - [BUN/Creatinine]: Monitored for renal function.    Rationale: Lab values guide fluid and electrolyte management and detect complications. 8\. **Prioritization of Burn Patients**    Answer: Airway management (especially with facial burns/inhalation injury) \> Fluid resuscitation \> Pain management \> Infection prevention.    Rationale: Airway and circulation are immediate life threats. 9\. **Risk for Burns Across the Lifespan**    Answer: - [Children]: Scald injuries from hot liquids. - [Elderly:] Decreased mobility and sensory perception.    Rationale: Age-specific factors increase burn risk, requiring targeted prevention. 10\. **Prevention of Burns/Education**    Answer: Use of smoke alarms, safe cooking practices, water heater temperature settings, and protective gear.    Rationale: Education reduces incidence and severity of burns. 11\. **Priority Actions for Patient with Fluid & Electrolyte Imbalances**    Answer: Monitor vital signs, fluid intake/output, and lab values. Administer appropriate IV fluids and electrolytes.    Rationale: Prevent complications like arrhythmias or shock. 12\. **Risk for AKI, CRF Across the Lifespan**    Answer: Dehydration in children, polypharmacy in elderly, existing comorbidities increase risk.   Rationale: Early recognition and management can prevent progression to chronic kidney failure. 13\. **Patient Teaching Diuretics** Answer: Take in the morning, monitor weight daily, report dizziness, muscle cramps. Maintain potassium intake if on non-potassium-sparing diuretics.   Rationale: Prevent adverse effects and ensure effective management. 14\. **Nephrotoxic Medications**   Answer: NSAIDs, aminoglycosides, contrast agents.    Rationale: Monitoring and minimizing use to protect kidney function. 15\. **Expected Findings with Abnormal GFR**   Answer: Elevated creatinine, uremic symptoms (fatigue, nausea), fluid overload. Rationale: Reduced GFR indicates impaired kidney function. 16\. **Management /Indications for Dialysis** Answer: Indicated for severe fluid overload, electrolyte imbalances (e.g., hyperkalemia), or uremic symptoms. Management includes monitoring fluid, electrolyte status, and access site care.   Rationale: Dialysis replaces kidney function in severe kidney failure. 17\. **Management of Fluid Volume Deficit/Overload**    Answer:    - Deficit: Administer IV fluids, monitor vital signs, urine output.    -Overload: Fluid restriction, diuretics, monitor respiratory status. Rationale: Proper balance is crucial for organ function. 18\. **Prioritization of Patients**   Answer: ABCs (Airway, Breathing, Circulation), severe pain, and high-risk patients (elderly, comorbidities). Rationale: Prioritize based on severity and potential for deterioration. 19\. **Renal Biopsy** Answer: Indicated for unexplained AKI, nephrotic syndrome. Post-procedure: Monitor for bleeding, bed rest. Rationale: Diagnosis of renal pathologies. 20\. **Third-spacing** Answer: Fluid shifts to interstitial spaces, seen in burns, sepsis. Management: Fluid resuscitation, monitor for signs of hypovolemia. Rationale: Can lead to decreased circulating volume and shock. 21\. **Dietary Teaching**    Answer: Low-sodium, low-potassium diet for renal patients. High-protein for wound healing in burns. Rationale: Diet tailored to condition aids in recovery and prevents complications. 1\. **Parkland Formula Calculation Practice Question** - **Question: A 70 kg adult patient presents with 40% total body surface area (TBSA) burns. Using the Parkland formula, calculate the total fluid requirement for the first 24 hours and the amount to be administered in the first 8 hours.** 2\. Rule of Nines -- BSA Calculation Practice Question - Question: A 30-year-old patient has burns covering the entire anterior torso and right leg. Using the Rule of Nines, estimate the percentage of body surface area burned. 3\. Medications for Burn Management Practice Question - Question: Which medication is most appropriate to administer to a burn patient with severe pain and why? 4\. Carbon Monoxide Poisoning Practice Question - Question: A patient is suspected of carbon monoxide poisoning after being found in a house fire. What is the priority treatment? 5\. Phases of Burn Care Practice Question - Question: During the [acute phase] of burn care, which intervention [is most critical]? 6\. Types of Burns and Management Practice Question - Question: What is the appropriate initial management for a patient with a superficial partial-thickness burn on the arm? 7\. **Lab Values and Burns Practice Question** - Question: A burn patient's potassium level is 6.2 mmol/L in the emergent phase. What is the most likely cause? C\) Hemoconcentration 8\. Prioritization of Burn Patients Practice Question - Question: Which burn patient should be seen first in the emergency department? 9\. **Risk for Burns Across the Lifespan Practice Question** - Question: Which burn prevention strategy is most appropriate for an elderly population? 10\. Prevention of Burns/Education Practice Question - Question: Which teaching point is crucial for preventing scald burns in toddlers? 11\. Priority Actions for Fluid & Electrolyte Imbalances Practice - Question: A burn patient has a sodium level of 128 mEq/L. What is the priority nursing action? 12\. Risk for AKI, CRF Across the Lifespan Practice Question - Question: Which factor places a pediatric patient at increased risk for acute kidney injury (AKI)? 13\. Patient Teaching: Diuretics Practice Question - Question: What is an important teaching point for a patient starting furosemide? 14\. Nephrotoxic Medications Practice Question - Question: Which medication should be used cautiously in a patient with a history of chronic kidney disease? 15\. Expected Findings with Abnormal GFR Practice Question - Question: A patient has a GFR of 25 mL/min. Which symptom is expected? 16\. Management/Indications for Dialysis Practice Question - Question: What is a primary indication for initiating dialysis in a patient with chronic kidney disease? 17\. Management of Fluid Volume Deficit/Overload Practice - Question: A patient with congestive heart failure presents with jugular vein distention and edema. What is the priority nursing intervention? 18\. Prioritization of Patients Practice Question - Question: Which patient should the nurse assess first? 19\. Renal Biopsy Practice Question - Question: What is the most important post-procedure nursing intervention for a patient who has undergone a renal biopsy? **20. Third-spacing Practice Question** - Question: A burn patient develops severe edema and decreased urine output. What does this indicate? 21\. **Dietary Teaching Practice Question** - Question: Which dietary instruction is appropriate for a patient with chronic kidney disease?