Test Three

Question 1

What classifies a superficial burn (first degree)?

Answer 1

epidermal tissue only affected, erythema, blanchable, mild swelling, no vesicles or blister initially (sunburn), pink to red, mild edema, pain, no eschar

Question 2

What classifies as a deep/partial burn (second degree)?

Answer 2

involves epidermis and deep dermis layers

• blisters
• hospitalization if over 25% of body
• pink to red, mild to moderate edema, painful, no eschar

Question 3

What classifies a full thickness burn (3rd and 4th degree)?

Answer 3

• destruction of all skin layers
• Dry, waxy white, leathery, or hard skin, no pain
• requires immediate hospitalization
• black, brown, yellow, edema, eschar

Question 4

Why should you check creatinine in burn pts?

Answer 4

Because they are dehydrated, WBCs and inflammation are hard on the kidneys
-decreased renal blood flow (shock), UO decreased first 48 hours, check BUN, creatinine, and Na

Question 5

What happens to the pts metabolism from a burn injury?

Answer 5

hypermetabolism (high catabolism), increased oxygen use and high calorie needs
-increased secretion of catecholamines, ADH, aldosterone, and cortisol due to stress response

Question 6

What happens to glucose levels in burn injuries?

Answer 6

increase as a result of the stress response and altered uptake across injured tissues

Question 7

Why is ROM important with burn pts?

Answer 7

to avoid contractures

Question 8

What makes septic shock different from other types of shock?

Answer 8

lactic acid (b/c metabolism is high so cells metabolize anerobically bc O2 is used up)
-also temperature

Question 9

Why do vessels get leaky in shock?

Answer 9

-widespread vasodilation
leaky vessels leak electrolytes into interstitial fluids and you can’t check those values (electrolyte abnormalities and edema)

Question 10

What are the problems/complications with thoracic level spinal cord injuries? (6)

Answer 10

loss of movement of the chest, trunk, bowel, bladder and legs (depending on the level of injury), leg paralysis, autonomic dysreflexia due to distended bladder or fecal impaction

Question 11

What is autonomic dysreflexia?

Answer 11

occurs with lesions or injuries above T6, caused by visceral distention from a distended bladder or impacted rectum

Question 12

What are the symptoms of autonomic dysreflexia?

Answer 12

sudden HA, severe hypertension and bradycardia, flushing above the level of injury, pale extremities below level of injury, nausea, nasal stuffiness, dilated pupils, blurred vision, sweating, goose bumps, restlessness

Question 13

What are the 4 stages in MS?

Answer 13

Relapsing-remitting
Primary progressive
Secondary progressive
Progressive-relapsing

Question 14

Which MS stage is this?

occurs in most cases of MS, symptoms develop and resolve in a few weeks to months and the pt returns to baseline

Answer 14

Relapsing-remitting

Question 15

Which MS stage is this?
involves a steady and gradual neurologic deterioration without remission of symptoms. Progressive disability with no acute attacks

Answer 15

Primary progressive

Question 16

Which MS stage is this?

begins with relapsing-remitting course that later becomes steadily progressive.

Answer 16

Secondary progressive

Question 17

Which MS stage is this?
frequent relapses with partial recovery but not a return to baseline (rare). Progressive, cumulative symptoms and deterioration occur over several years

Answer 17

Progressive-relapsing

Question 18

Early onset MS signs

Answer 18

muscle weakness, spasticity, fatigue stiffness (legs), flexor spasms, hyper DTR, positive babinski, unsteady gait, intension tremor, clumsy, poor coordination, tinnitis, vertigo, hearing loss, slurred speech, blurred vision, diplopsia, nystagmus, ataxia, dysphagia, decreased perception to sensory

Question 19

Treatment for Gullian-Barre

Answer 19

treatment of symptoms (pain management), monitor respiratory status, respiratory treatments, monitor cardiac status

• Plasmapheresis: to remove offending antibodies
• IV immunoglobulin infusions: to suppress immune response
• Supportive care: ventilator support

Question 20

How do you diagnose Guillian-Barre?

Answer 20

there is no single test but physical exam (cranial nerves mainly VII and reflexes), lumbar puncture, blood test, tensilon test, electromyopgraphy study, MRI/CT, and ABGs

Question 21

What causes “oozing”?

Answer 21

Severe hypovolemic shock occurs as a result of an inability of the blood to clot because the platelets and clotting factors were consumed earlier. Capillary leak continues and increases the risk for hemmorhage

Question 22

Myasthenia Gravis – what part of the body is affected?

Answer 22

-Enlarged thymus gland

Respiratory muscles. When pt. can’t take a deep breath/positioning, suction

Question 23

What would you look for when a patient comes in and a stroke is suspected?

Answer 23

hemiplegia, unilateral neglect, impaired speech, change in LOC, abnormal cranial nerves V, VII, IX, X, and XII, nuchal rigidity, ataxia, paralysis

Question 24

What is plavix?

Adverse effects?

Answer 24

an antiplatelet drug (decreases risk for stroke/MI)

-GI bleed, rash, neutropenia, petechiae,