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Pathophysiology Exam > Multiple Interacting Systems > Flashcards

Multiple Interacting Systems Flashcards

Burns, Burn Shock, Fluid replacement/maintenance calculation, hypermetabolic phase, compartment syndrome, renal failure, multiple organ dysfunction disorder

1
Q

What does homeostasis require from the human body?

A

A balance between health and disease

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2
Q

What is the most common burn a patient may experience?

A

Thermal burn

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2
Q

What is the medical definition of a burn?

A

A traumatic injury to the skin that occurs primarily due to thermal or other acute exposures such as extreme cold, electricity, radiation or chemicals

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3
Q

What is the most common burn a child may experience?

A

Scalds

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4
Q

What is the alternative name for a first-degree burn?

A

Superficial burn

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5
Q

What is the alternative name for a second-degree burn?

A

A partial thickness burn

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6
Q

What is the alternative name for a third-degree burn?

A

Full-thickness burn

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7
Q

What does it mean if the patient has a fourth-degree burn?

A

The burn has extended into the muscle, bone or joints

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8
Q

What is the purpose of measuring the total burn surface area?

A

It measures the total percentage of the body surface area that is effected by burns?

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9
Q

What are the six main functions of the skin?

A
  • Protects body from external environment
  • Regulated body temperature
  • Detects cutaneous sensations
  • Excretes/absorbs substances
  • Synthesizes vitamin D
  • Stores blood
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10
Q

What does multiple organ dysfunction syndrome refer to?

A

The progressive dysfunction of two or more organ systems resulting from an uncontrolled inflammatory response to a severe illness or injury

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11
Q

True or False:
The organ dysfunction can progress to organ failure and death

A

True

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12
Q

How is multiple organ dysfunction syndrome managed?

A

Ideally by eliminating or controlling the inital inflammation, prevention, and support

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13
Q

What does the primary multiple organ dysfunction syndrome refer to?

A

The immediate local or mild systemic response to the triggering event or illness

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14
Q

What is the main function of the outer cell of the epidermis?

A

Acts as a protection layer that forms a watertight seal

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15
Q

What is the main purpose of the deeper layers of the epidermis?

A

Contains pigment to protect against ultaviolet radiation

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16
Q

What type of burn only effects the epidermis layer?

A

A superficial burn

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17
Q

What type of burn effects the epidermis and portions of the dermis?

A

A superficial, partial-thickness burn

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18
Q

What type of burn effects the deep dermal layers, hair follicles and glandular tissue?

A

A deep, partial-thickness burn

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19
Q

What type of burn effects all the layers of the dermis and the underlying subcutaneous tissues?

A

Full-thickness burns

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20
Q

What does the dermis layer refer to?

A

Tought, elastic connective tissue which contains specialized structures including nerve endings, blood vessels, sweat glands, oil glands, and hair follicles

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21
Q

If a patient comes into the clinic with a superficial burn, what signs and symptoms would the nurse be able to notice?

A
  • Pain
  • Dry skin
  • Red skin
  • Blanch with pressure
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22
Q

Would there be blisters present on a patient with superficial burns?

A

No blisters would be present

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23
Q

In reference to a patient with a superficial, partial thickness burn, where would blisters form?

A

Blister forms between the epidermis and dermis

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24
Q

In reference to a patient with a superficial, partial thickness burn, what would the blister look like?

A
  • Red or Pink in colour
  • Weeping or moist
  • Shiny appearence
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25
Q

In reference to a patient with a deep, partial thickness burn, what would the blister look like?

A
  • Blisters and bullae in deeper tissue
  • Pale ivory to red in colour (Variable mottled colour)
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26
Q

True or False:
A patient with a deep, partial thickness burn will blanch

A

False

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27
Q

When is the palm method used to measure burns?

A

When a quick estimate of te burn surface area is required for small or patchy burns

28
Q

In reference to full thickness burns, how are scars and wounds contracture minimized?

A

By early removal of the dead tissue and skin grafting

29
Q

In reference to full thickness burns, why does the burn wound become dry and leathery?

A

The elastic dermis is completely lost

30
Q

Why might a patient with full thickness burns not feel pain in the injured area?

A

The tactile receptors, thermoreceptors, and nociceptors are permanently damaged

31
Q

Why might a patient with full thickness burns still complain about pain in the injured area?

A

The partial thickness burns intermix with the full thickness burn

32
Q

Why do full thickness burns require hospitalization?

A

It takes more than three weeks to heal and requires hospitalization to close the area with grafts

33
Q

What colour is a full thickness burn?

A

Colours can range from dry white, grey, brown, maroon or charred black

34
Q

What do full thickness burns usually result in?

A

Eschar

35
Q

In reference to the palm method, the palm of the patient’s hand (excluding the fingers) is approximately what percent of the total body surface?

A

0.5%

36
Q

In reference to the palm method, the palm of the patient’s hand (including the fingers) is approximately what percent of the total body surface?

A

1%

37
Q

In reference to the rule of 9s, the anterior and posterior head and neck make up what percent of the total body surface?

A

9%

38
Q

In reference to the rule of 9s, the anterior and posterior upper limbs make up what percent of the total body surface?

A

18%

39
Q

In reference to the rule of 9s, the anterior and posterior lower limbs make up what percent of the total body surface?

A

36%

40
Q

In reference to the rule of 9s, the anterior and posterior trunk make up what percent of the total body surface?

A

36%

41
Q

In reference to the rule of 9s, the perineum makes up what percent of the total body surface?

A

1%

42
Q

What are the signs and symptoms of smoke inhalation within a patient?

A
  • Cough, stridor, wheeze
  • Hoarseness
  • Facial or neck burns
  • Nares with inflammation or singed hair
  • Burnt matter in mouth or nose
  • Edema of oropharynx
  • Depressed mental status
  • Respiratory distress
43
Q

In patients with caron monoxide poisoning, how long should a patient be treated with 100% oxygen?

A

Serum levels of carboxyhemoglobin level fall below 10%

44
Q

In reference to a burn-related pulmonary injury, what predisposes the patient to pulmonary infections and sepsis?

A

Thermal and chemical damage to the major airways and lung parenchyma

45
Q

In reference to a burn-related pulmonary injury, why would a patient require endotracheal intubation?

A

Upper airway occlusion caused by inhaled superheat air blisters and edema

46
Q

List six potential burn complications?

A
  • Hypovalemia
  • Hypothermia
  • Infections/Tetanus
  • Formation of Eschar
  • Renal or hepatic failure
47
Q

What leads to compartment syndrome?

A

When the pressure inside the burned area increases due to edema/fluid overload

48
Q

What is escharotomy?

A

Incision through the eschar

49
Q

What is fasciotomy?

A

Incision through all the fascial layers

50
Q

In reference to compartment syndrome, why might an escharotomy or fasciotomy need to be performed on a patient?

A

To release pressure off the burn area

51
Q

What is hemodialysis?

A

A machine that filters wastes, salts and fluid from the blood due the inadequate kidney function

52
Q

How many times does a patient need to go for hemodialysis per week?

A

x 3/Week for 4

53
Q

What are some indications for pulmonary system failure?

A
  • Acute respiratory distress syndrome
  • Dyspnea
  • Patchy infiltrates
  • Refractory hypoxemia
  • Respiratory acidosis
  • Abnormal oxygen levels
  • Pulmonary hypertension
54
Q

What are some indications for gastrointestinal system failure?

A
  • Abdominal distention
  • Intolerance to enteral feedings
  • Paralytic ileus
  • Upper and lower GI bleeding
  • Diarrhea
  • Ischemic colitis
  • Mucosal ulceration
  • Decreased bowel sounds
  • Bacterial overgrowth in stool
55
Q

What are some indications for hepatic system failure?

A
  • Increased serum bilirubin level
  • Increased liver enzyme levels
  • Increased serum ammonia level
  • Decreased serum transferrin level
  • Jaundice
  • Hepatomegaly
56
Q

What are some indications for metabolic system failure?

A
  • Decreased lean body mass
  • Muscle wasting
  • Severe weight loss
  • Negative nitrogen balance
  • Hyperglycemia
  • Increased serum lactate levels
  • Decreased serum albumin
  • Decreased serum transferrin
  • Decreased prealbumin
  • Decreased retinol-binding protein
56
Q

What are some indications for renal system failure?

A
  • Increased serum creatinine level
  • Increased blood urea nitrogen
  • Oliguria, anuria, or polyuria consistent with prerenal azotemia
57
Q

What are some indications for hyperdynamic (high-output) cardiovascular failure?

A
  • Decreased pulmonary capillary wedge
  • Decreased systemi vascular resistance
  • Decreased right atrial pressure
  • Decreased left ventricular stroke work index
  • Increased oxygen consumption
  • Increased cardiac output
  • Increased cardiac index
  • Increased heart rate
58
Q

What are some indications for hypodynamic (low-output) cardiovascular failure?

A
  • Increased systemic vascular resistence
  • Increased right atrial pressure
  • Increased left ventricular stroke work index
  • Decreased oxygen delivery and consumption
  • Decreased cardiac output
  • Decreased cardiac index
59
Q

What is a common complication of hemodialysis?

A

Hypotension

60
Q

Why would a nurse monitor a patient’s blood pressure, heart rate, and fluid status during hemodialysis?

A

To assess for complications such as hypotension, air embolisms, vascular access problems, hemolysis of red blood cells or dialyzer reactions

61
Q

Why might small amount of heparin be added to the dialyzer for hemodialysis?

A

To prevent clotting

62
Q

What basic compenents are required for hemodialysis?

A
  • Pressure gradients
  • Dialysate
  • Artificial kidney
  • Vascular access
63
Q

How does hemodialysis operate?

A

A pressure gradient with dialysate fluid facilitates the removal of toxic waste products

64
Q

The fluid runs in a _____________ flow to the patient’s blood flow within the artificial kidney

A

counter current

65
Q

Why should disinfectants not be used on a burn wound?

A

It inhibits the healing process

66
Q
A

Pathophysiology Exam (4 decks)

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