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Med Surg > Burns/Sepsis/IVF 10 Q > Flashcards

Burns/Sepsis/IVF 10 Q Flashcards

1
Q

A patient with carbon monoxide poisoning is described as being ____ ____ in appearance

A

“cherry red”

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2
Q

Carbon monoxide poisoning is treated with _______.

A

100% humidified O2

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3
Q

Upper airway injury occurs ____ the glottis

A

above

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4
Q

Upper airway injury presents with…

A

redness, blistering, swelling, dysphagia, stridor, retractions

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5
Q

Why is an upper airway injury considered a medical emergency?

A

Mechanical obstruction can occur rapidly!

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6
Q

Lower airway injury occurs below the glottis and presents with…

A

facial burns, singed nasal hairs/eyebrows, dark sputum, wheezing, stridor, hoarseness, painful swallowing, presence of soot, altered mental status

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7
Q

The treatment for smoke inhalation injury is ____ _____ before the airway becomes occluded.

A

early intubation

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8
Q

What chemical burns are more difficult to manage? why?

A

alkali burns because they adhere to the tissue; (damage continues after the alkali is neutralized)

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9
Q

How do you manage a chemical burn?

A

brush solid particles off the skin, remove clothing containing the chemical, flush area with copious amounts of water.

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10
Q

How do you manage an electrical burn?

A

remove pt from contact with source, remove clothing/jewelry

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11
Q

How do you manage small thermal burns?

A

cover with clean, cool, tap water-dampened towel

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12
Q

How do you manage large thermal burns?

A

provide supplemental O2, remove burned clothing, wrap in clean and dry sheet/blanket, elevate extremities above the level of the heart (if burned), do NOT immerse in cool water or pack with ice.

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13
Q

What is the greatest threat of burns?

A

hypovolemic shock - result of increased capillary permeability (edema, hypotension, tachycardia)

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14
Q

What is the treatment for hypovolemic shock?

A

crystalloid solutions (LR)

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15
Q

What degree of burn is localized to the epidermis, is sensitive/painful, and has red/dry skin that blanches with pressure?

A

first degree

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16
Q

what degree of burn extends into the epidermis and possible dermis, is red, wet/shiny with the presence of fluid-filled blisters, and is sensitive to cold air?

A

second degree

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17
Q

What degree of burn extends through the epidermis, dermis, and into the subcutaneous tissue, is white/charred, and nerve endings are destroyed in deep part of wound?

A

third degree

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18
Q

What degree of burn extended through the subcutaneous tissue and includes muscle, fascia, or bone, and is pain free in deep part of wound?

A

fourth degree

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19
Q

Severity of burn is determined by the…

A

depth of burn, extent of burn, and location of burn

20
Q

A burn of the face, neck, or chest can result in…

A

respiratory obstruction

21
Q

A burn of the hands, feet, joints, or eyes can result in…

A

self-care difficulty

22
Q

A burn of the ears, nose, buttocks, or perineum can result in…

A

infection

23
Q

The emergent phase of care lasts up to 72 hours from the time of burn, begins with _____ and ______ and continues until fluid mobilization and diuresis begin

A

fluid loss; edema formation

24
Q

What is the Parkland formula for fluid replacement?

A

4 mL LR x weight (kg) x affected TBSA

25
Q

The parkland formula gives us the total fluid requirements needed for the first _____ hrs

A

24 hrs

26
Q

Adequacy of fluid replacement is assessed with a UOP of…

A

> 0.5 to 1 mL/kg/hr

27
Q

What drug therapy is included for burns?

A

analgesics/sedatives, H2 receptor antagonists, tetanus immunizations, and antimicrobial agents (topical)

28
Q

Diet for a burn pt is one of high ____ and high ____

A

protein; calorie

29
Q

What is the name of the procedure when an incision is made into the eschar to relieve pressure and improve circulation

A

escharotomy

30
Q

Custom-fitted pressure garments are worn for ________ for 12 - 18 months

A

24 hrs/day

31
Q

____ the the inflammatory process that occurs with or without an infection

A

SIRS

32
Q

What is the criteria for SIRS?

A

Has 2 or more of the following:

  1. temp > 100.4 or < 96.8
  2. HR > 100 bpm
  3. RR > 20 or PaCO2 < 32
  4. WBC > 12,000 or < 4,000 or > 10% immature band forms
33
Q

True or False: It is considered sepsis when there is SIRS with an infection.

A

TRUE

34
Q

What occurs in sepsis?

A
  1. VASODILATION
  2. increased capillary permeability (third-spacing, appear hypovolemic and hypotensive)
  3. Increased coagulation (results in microthrombi and occlusion of microvasculature, decreased perfusion to tissues)
35
Q

True or false: Severe sepsis occurs when there is sepsis PLUS organ dysfunction, hypoperfusion, or hypertension

A

FALSE: HYPOtension not HYPERtension

36
Q

What occurs with severe sepsis?

A
  1. VASOCONSTRICTION (temp rises, changing from warm and flushed to cool and pale)
  2. Lactic Acidosis ( > 4)
37
Q

What is the result of uncontrolled sepsis?

A

Septic shock

38
Q

What is seen with septic shock?

A
  1. refractory hypotension despite adequate fluid resuscitation
  2. systolic BP < 90 mmHg
  3. MAP < 60 mmHg
  4. OR a drop in pt’s baseline of > 40 mmHg
  5. Pt is only able to maintain BP and CO with vasopressors
39
Q

MODS occurs when there is failure of ____ or more organ systems

A

2

40
Q

A group of evidence0based interventions related to a specific disease process that, when initiated together, results in better outcomes than if implemented individually.

A

sepsis bundle

41
Q

Vasopressors are used to try to ____ the BP

A

increase

42
Q

What are the vasopressor agents used?

A 
dobutamine
dopamine
epinephrine
phenylephrine
norepinephrine
43
Q

_______ are recommended for pts in septic shock requiring vasopressors

A

Corticosteroids

44
Q

The patient on antibiotics and a vasopressor is in severe _____ ______

A

septic shock

45
Q

Lactate levels are used to monitor for…

A

occult tissue hypoxia

46
Q

Maintain glucose levels between

A

80 and 120

Med Surg (19 decks)

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