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NUR 340 > Exam 1: week 2 > Flashcards

Exam 1: week 2 Flashcards

1
Q

What are the different types of burns

A
  • heat
  • electrical
  • chemical
  • cold
  • radiation
  • friction
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2
Q

What are some causes of heat burns

A

Most common
- hot liquid
- steam
- fire

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3
Q

What are some complications of electrical burns

A

being electrocuted puts the heart at risk for arrhythmias
Skin and structures affected release myoglobin and hemoglobin that clog kidney tubules

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4
Q

What are some causes of chemical burns

A
  • alkalotic (harder to manage/more severe)
  • acidotic
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5
Q

What are some causes of cold burns

A

frost bite

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6
Q

What are some causes of radiation burns

A
  • sun burn
  • cancer treatment
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7
Q

What are some causes of electrical burns

A

road rash

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8
Q

What are the three methods of determining total body surface when assessing burns

A

Lund and Browder method
Palm method
Rule of nines

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9
Q

How does the rule of nines break up body sections

A
  • each arm is 9%
  • head is 9%
  • each leg is 18%
  • anterior thorax is 18%
  • posterior thorax is 18%
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10
Q

What are the three zones of burn injury

A
  1. zone of hyperemia (top layer of skin)
  2. zone of stasis (blood supply)
  3. zone of coagulation (cell death occurs here)
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11
Q

What are the different classifications of burns

A
  • first degree (superficial)
  • second degree (partial thickness)
  • third degree (full thickness)
  • fourth degree (deep full thickness)
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12
Q

What are the characteristics of first degree burns

A

E.g. sunburn
- pink or red
- painful
- warm to touch
- no blisters or scars
- good cap refill

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13
Q

What are the characteristics of second degree burns

A

Requires medical treatment
- affects epidermis and dermis
- painful
- shiny
- moist
- blisters present
- scars left behind
- blanchable

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14
Q

What are the characteristics of third degree burns

A
  • destroyed epidermis and dermis
  • destroyed hair follicles
  • destroyed sweat glands
  • destroyed nerves
  • decreased or no pain
  • no healing of skin
  • black, yellow, or red coloring
  • matte/dry
  • eschar tissue
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15
Q

What are the characteristics of fourth degree burns

A
  • all layers of skin destroyed
  • extends to muscle, ligaments, and bone
  • black/charred
  • all sensation gone
  • needs skin graft
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16
Q

What happens to body fluids with burns

A

fluids shift to extravascular space

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17
Q

What electrolyte problems can be caused by burns

A
  • Hyperkalemia due to cell destruction
  • potassium imbalances may cause cardiac issues
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18
Q

What are some pulmonary issues that can be associated with burns

A
  • inhalation injury
  • carbon monoxide poisoning
  • airway restriction
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19
Q

What is important to know about burns on the ears and nose

A

They don’t heal

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20
Q

Swelling from burns can cause what syndrome

A

compartment syndrome

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21
Q

What are the phases of burn injuries

A

Emergent/resuscitative phase
Acute/intermediate phase
Rehabilitation phase

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22
Q

What are the characteristics of the emergent/resuscitative phase of burn injuries

A

Starts at the onset of the burn and goes until restoration of capillary permeability (24-48 hours)
- Stop the injury: extinguish flames, cool burn, irrigate chemical burns
- ABCs
- start O2 and large bore IV
- remove restrictive devices and clothing (prevent compartment syndrome and airway obstruction)
- monitor for shock, respiratory distress, and compartment syndrome

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23
Q

What are the characteristics of the acute/intermediate phase of burn injuries

A

Starts when capillary permeability is stabilized until wound closure (starts at 48-72 hours until wound closes)
- transport patient to ER
- insert foley catheter
- if burns exceed 20-25%, insert NG tube to suction
- NPO
- monitor for infection, pain, and fluid/nutrition imbalance
- sterile technique for wound care

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24
Q

What are the characteristics of the rehabilitation phase of burn injuries

A

Starts immediately in the emergent phase and last long after the burns are healed
- psychosocial support
- self-image
- reconstructive surgery to restore function and appearance
- vocational counseling and support groups

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25
Q

What are some complications of major burn injuries

A
  • respiratory failure
  • acute renal failure
  • heart failure
  • pulmonary edema
  • compartment syndrome
  • sepsis
  • delirium
26
Q

What are some signs of inhalation injury

A
  • burned in an enclosed structure
  • burns on face
  • hair singeing
  • soot on nose or mouth
  • bright red lips (due to CO2)
  • issues talking (hoarse voice)
  • confusion/anxiety
27
Q

What are the different types of wound debridement

A
  • natural
  • mechanical
  • chemical
  • surgical
28
Q

What should the nurse know about burn pain

A

One of the most painful
pain meds via IV route only during the emergent and acute phases
- morphine
- fentanyl

29
Q

Which nerve is important for swallowing and preventing aspiration

A

superior laryngeal nerve

30
Q

What are the risk factors of oral cancer

A
  • tobacco use (including smokeless tobacco)
  • alcohol
  • men
  • older than 40
  • African American
31
Q

What are the risk factors for esophageal cancer

A
  • GERD
  • alcohol
  • tobacco use
32
Q

How is esophageal cancer diagnosed

A
  • mostly asymptomatic
  • seek treatment because of a feeling that something is stuck in their throat
  • usually caught late so not very good outcomes
33
Q

What is a radical neck dissection

A

Surgical procedure done in patients with esophageal cancer to stop the spread to other parts of the body
Removes:
- all cervical lymph nodes from mandible to clavicle
- sternocleidomastoid muscle
- internal jugular vein
- spinal accessory muscle on one side of the neck
not very good outcomes - high mortality rate

34
Q

What is Zenker’s diverticulum

A

A sack of esophagus tissue that has protruded behind the cricopharengeus muscle
Increased pressure in the esophagus leads to aspiration and airway issues

35
Q

How is someone diagnosed with GERD

A

having reflux at least twice a week

36
Q

What are the risk factors for GERD

A
  • getting older
  • irritable bowel syndrome
  • obstructive airway disorders (COPD, asthma, CF)
  • Barrett esophagus
  • peptic ulcer disease
  • angina
  • drinking coffee
  • alcohol
  • tobacco
  • h. Pylori infection
37
Q

What are some teaching points for patients with GERD

A
  • 4-6 small meals a day
  • avoid coffee, tea, and chocolate
  • avoid snacking
  • avoid fluids during meals
  • lose weight
38
Q

Why is it recommended to avoid fluids during meals for patients with GERD

A

Drinking fluids promotes peristalsis which means the food they are eating isn’t being digested enough

39
Q

Abnormalities in the assessment of the Right upper quadrant can be signs of which disorders

A
  • hepatitis
  • acute hepatic congestion
  • biliary (gall) stones
  • colic (pain with gall stones blocking a duct)
  • acute cholecystitis
  • perforated peptic ulcer
40
Q

Abnormalities in the assessment of the Right lower quadrant can be signs of which disorders

A
  • appendicitis
  • perforated duodenal ulcer
  • cecal volvulus
  • strangulated hernia
41
Q

Abnormalities in the assessment of the left upper quadrant can be signs of which disorders

A
  • splenic trauma
  • pancreatitis
  • pyloric obstruction
42
Q

Abnormalities in the assessment of the left lower quadrant can be signs of which disorders

A
  • ulcerative colitis
  • colonic diverticulitis
43
Q

What are the signs and symptoms of peritonitis

A
  • rigid, severe abdomen pain
  • tenderness
  • nausea
  • vomiting
  • chills
  • fever
44
Q

What is erosive gastritis

A

When the mucosa of the stomach is damaged and the acidity of the stomach acids eat away at the stomach lining
- leads to peritonitis and sepsis

45
Q

What are the symptoms of erosive gastritis

A
  • abdominal pain
  • headache
  • N/V
  • blood in vomit or stool
46
Q

How do we treat acute gastritis

A
  • stop eating food and drinking alcohol until symptoms go away
  • neutralizing agents to prevent acidic or alkaline damage
  • no lavage or emetics to prevent perforation
47
Q

How do we treat chronic gastritis

A
  • modify diet
  • promote rest
  • reduce stress
  • avoid alcohol
  • avoid NSAIDS
  • medication
48
Q

What are some nursing management techniques for patients in the hospital with gastritis

A
  • reduce anxiety
  • promote optimal nutrition
  • promote optimal fluid balance
  • discourage caffeine
  • discourage alcohol
  • discourage smoking
  • pain relief measures
49
Q

What are the symptoms of a peptic ulcer due to a gastric h. pylori infection

A
  • epigastric pain
  • food makes pain worse
  • dull/achy pain
  • weight loss
  • severe ulcer can cause GI bleeding
  • coffee ground or bright red emesis
50
Q

What are the symptoms of a peptic ulcer due to a duodenal h. pylori infection

A
  • epigastric pain
  • food makes pain better
  • gnawing pain that wakes you up
  • normal weight
  • severe ulcer can cause GI bleeding
  • black tarry stools
51
Q

What are some potential complications of peptic ulcers

A
  • GI bleeding
  • perforated stomach lining
  • bowel blockage
  • increased risk of GI cancer
52
Q

What is dumping syndrome

A

When food enters the intestine too fast
- Early symptoms: swollen abdomen, nausea, diarrhea
- late symptoms: dizziness, sweating, weakness

53
Q

What should the nurse teach a patient in order to avoid dumping syndrome after treatment for peptic ulcer

A
  • eat small, frequent meals
  • lie down 30 minutes after eating
  • dont drink fluids with meals (wait 30 min)
  • avoid sugary foods and liquids
  • eat high protein and high fiber
54
Q

What what kind of diet should a patient have if they have ulcers

A
  • avoid spicy food
  • avoid acidic foods
  • eat low fiber foods that are bland and easy to digest
55
Q

What are some medications used to treat peptic ulcers

A
  • antacids
  • mucosal healing medications (carafate)
  • H2 receptor blockers
  • Bismuth
  • PPi’s
  • Antibiotics
56
Q

What are some causes of acute gastrointestinal hemorrhage

A
  • peptic ulcer disease (mainly caused by NSAIDS and H. pylori)
  • stress related erosive syndrome
  • esophageal varices
57
Q

What is hematochezia

A

The passage of bright red bloody stools
- commonly associated with lower GI bleeding
- most common causes are hemorrhoid’s, diverticulosis, and colon cancer
- if this is from an upper GI source, it is life threatening

58
Q

What is melena

A

Black tarry stool resulting from blood that’s been altered by the gut flora

59
Q

What does the post-op diet look like for someone who underwent gastric bypass surgery

A
  • six small meals a day
  • 600-800 calories/day at first then progress to 800-1000 calories/day once they can tolerate soft foods
  • high protein in diet
60
Q

What is a major complication post gastric bypass

A

dumping syndrome

61
Q

What are some weightloss medications

A
  • orlistat
  • phentermine
  • phentermine/topiramate
62
Q

What are the signs and symptoms of gastric cancer

A
  • pain thats relieved by antacids
  • dyspepsia
  • low appetite
  • weight loss
  • abdominal pain
  • bloating after meals
  • N/V

NUR 340 (10 decks)

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