Burns, thermal injuries and endocrine disorders

Question 1

What is a 1 deg burn

Answer 1

superficial

no blistering or sluoghing

Question 2

What is a 2 deg burn

Answer 2

blistering

Question 3

Should you pop a blister

Answer 3

no

Question 4

What are some signs of an inhalation injury

Answer 4

blackness around their nares, mouth or clothes
trouble swallowing
hoarseness
high carboxyhemoglobin level

Question 5

How long will you likely be in the hospital after an inhalation injury and why

Answer 5

24 hours to monitor you for the extent of the damage

Question 6

What percentage of burns will the pat be transfered to seattle

Answer 6

30%
Burns that involve face, hands, feet, genitals, perineum, or major joints
3rd degree burns in any age group
Electrical burns, including any lightning injury
Chemical burns
Inhalation injury

Question 7

What is a consideration for incountering someone being electrocuted

Answer 7

do not touch them

Question 8

What do we check first if its a large burn, electrical or inhalation burns

Answer 8

ABC’s

Question 9

What is the greatest threat of a large burn

Answer 9

hypovolemic shock

Question 10

Who are at increased risk of hypovol shock from a large burn

Answer 10

cardio pats

Question 11

What are cardio pats more likely to get after a burn

Answer 11

hypovol shock
dysrthmia
VTE’s

Question 12

What type of diagnostic test might be used to assess a lower resp inhalation injury

Answer 12

bronchoscopy

Question 13

What is Most common complication in the emergency phase after a burn

Answer 13

Acute Tubular Necrosis (ATN)

Question 14

What types of IV access will a larger burn pat likely get

Answer 14

Central access
PICC
Swans Gans

Question 15

What is the next priority after the fluids have been addressed after a burn

Answer 15

wound care

Question 16

What is an allograft

Answer 16

skin from skin donor cadavers

Question 17

What is a homograft

Answer 17

skin from same species usu from live person like your self (i.e. human to human)

Question 18

What route of med admin should not be used on burn pats

Answer 18

IM

Question 19

What are some lipid soluble hormones

Answer 19

Steroids and thyroid hormone

Question 20

What are some water soluble hormones

Answer 20

Insulin, growth hormone, and prolactin

Question 21

What is acromegaly

Answer 21

over production of growth hormone

Question 22

What are the manis of acromegaly

Answer 22

elarged hand feet
large protruding jaw
big thick tongue

Question 23

Who are more likely to get a pituitary adenomas

Answer 23

african americans

Question 24

What will be people with removed pituary glands need

Answer 24

lifelong meds to replace their thyroid hormone, sex hormones, and glucocorticoids

Question 25

NURSING CARE POST PITUITARY SURGERY

Answer 25

``` no blowing nose drip pad under the nose increase bed 30 deg assessment for hemtoma formation Monitor peripheral vision, visual acuity, extraocular movements, and papillary response ```

Question 26

NURSING CARE OF SIADH

Answer 26

monitor I/O with SG's, heart, and LOC

Question 27

What is the pat has a severe case of low sodium with SIADH and the doc order 3% saline

Answer 27

tell them they pat will need to be transfered to the ICU cause 3% can only be given there

Question 28

NURSING CARE OF DI

Answer 28

Give DDAVP monitor no HA Monitor vitals and urine SG for acute DI fluids replaced by IV hypotonic saline or D5

Question 29

causes of graves dis

Answer 29

insufficient iodine supply, infection, stress, cigarette smoking

Question 30

What are some drugs that are used to treat thyroid storm

Answer 30

include propylthioracil (PTU) and methimazole (Tapazole)

Question 31

How long will the drugs for thyroid storm usu take to work

Answer 31

1-2 wks

Question 32

POST-OP CARE THYROID SURGERY

Answer 32

monitor pat q2h for 24hr for resp distress from hemorrhage Trousseau’s sign and Chvostek’s sign from hypocalcemia control pain Have (trach tray) suction equipment readily available

Question 33

S/S of hypocalcemia

Answer 33

↑ neuromuscular excitability (Tingling, muscle spasm-particularly in hands, feet, and facial muscles, intestinal cramping, hyperact bowel sounds seizing up Prolonged QT interval, cardiac arrest Chvostek & Trousseau sign

Question 34

Symptoms of hypothy

Answer 34

Fatigue, lethargic, experience personality and mental changes, impaired memory, weight gain myxedema

Question 35

Cooling with ice or cold water within the first _______ minutes reduces depth of the injury

Answer 35

1 min

Question 36

What is a potential complication with myxedema

Answer 36

myxedema coma

Question 37

What are some manifestations of myxedema coma

Answer 37

hypothermia hypoT hypoventilation

Question 38

What is the care with myxedema coma pats

Answer 38

labs for TSH, FT3, FT4, cortisol, ACTH, and glucose respiratory support due to resp failure as major cause of death support BP passively warm them up IV glucose for hypoG

Question 39

What is cushings syndrome

Answer 39

chronic high levels of cortisol

Question 40

What are some mani's of cushings syndrome

Answer 40

``` round flushed face (moon face) fat pad on back of neck abdominal striae thin skin weak muscles HTN easy bruising ```

Question 41

What is addison's disease

Answer 41

hyposecretion of adrenal cortex or of ACTH from pituitary

Question 42

What is decreased in addisons disease

Answer 42

glucocorticoids mineralcorticoids androgens

Question 43

What are some symptoms of addisons disease

Answer 43

``` fatigue anorexia hypoT hyperpigmentation hypoG salt craving decreased libido ```

Question 44

What is PHEOCHROMOCYTOMA

Answer 44

a tumor in the adrenal medulla that causes overproduction of catecholamines (epi and norepi)

Question 45

What are some manifestations of PHEOCHROMOCYTOMA

Answer 45

severe HTN pounding HA tachycardia with palps profuse sweating

Question 46

What is the main treatment for PHEOCHROMOCYTOMA

Answer 46

surgical removal

Question 47

When someone comes in to DKA and they receive IV insulin when can they eat

Answer 47

not until theyre off the IV insulin to subQ

Question 48

How often will blood sugars need to checked when on IV insulin

Answer 48

every hour

Question 49

What is troussea's sign

Answer 49

when you blow up a blood pressure cuff on the arm and they get tetany in their hand/arm

Question 50

What is chvosteks sign

Answer 50

cheek spasm when you brush against it

Question 51

How do you know if a transplant pat is rejecting the transplant

Answer 51

biopsy's of that organ

Question 52

Why is a fever not a sign of a transplant rejection

Answer 52

because those pat will be on a antirejection med so their immune system will be suppressed so no fever response

Question 53

What are transplant pats at high risk for

Answer 53

infection

Question 54

Do not give TPA if

Answer 54

they just had surg new onset of HA any clotting/bleeding problems already hemorrhagic stroke

Question 55

examples of anticoag's

Answer 55

lovonox plavix coumadine

Question 56

What pats are at higher risk for hemorrhagic stroke

Answer 56

HTN Anticoag's Fam Hx head aneurysm

Question 57

What is coumadines antidote

Answer 57

Vit K

Question 58

How to trouble shoot a pulse ox sat

Answer 58

compare the pulse reading on the device and one that you get by counting to make sure they are the same then check that the oxygen supp is connected and on

Question 59

What is the antidote for valium

Answer 59

romazican

Question 60

What is normal bicarb level

Answer 60

22-28

Question 61

What signs might you see in someone with a basilar skull fracture

Answer 61

battle sign clear drainage from ears or nose rhinorrhea periorbital bruising

Question 62

When is coumadine usu given

Answer 62

at night

Question 63

What can you give to diabetes that are hypoglycemic that cant take anything in the mouth or nose

Answer 63

glucagon | dextrose 50

Question 64

What is DI

Answer 64

deficient amount of ADH or impaired renal responses

Question 65

What are some signs of DI

Answer 65

polydipsia low SG hypernatremia

Question 66

What timeframe can TPA be given in to be effective

Answer 66

first 3 hours