Exam 4: NSG233/ NSG 233 (New 2023/ 2024 Update) Med Surg 3 Exam| Questions and Verified Answers| 100% Correct| Graded A- Herzing
Exam 4: NSG233/ NSG 233 (New 2023/ 2024
Update) Med Surg 3 Exam| Questions and
Verified Answers| 100% Correct| Graded AHerzing
QUESTION
How often must the patient’ s response to fluid therapy be evaluated
Answer:
q1hr
QUESTION
what topical agents are used in burn pt
Answer:
silvadine
antibiotic ointment
QUESTION
explain how the dressing should be applied to burn pt
Answer:
wrap each phalange single and then all together
dont wrap tight
QUESTION
what burns need graphs
Answer:
deep partial
full thickness
(decreases risk of infection, prevent further loss of protein fluid electrolytes)
QUESTION
whats an Autograft
Answer:
ideal graph
from pts own skin
QUESTION
Homograft
Answer:
donated skin from deceased or living
QUESTION
Xenograft
Answer:
skin from animals – usually a pig
QUESTION
how long should the dressings be on the new graph until change?
Answer:
3-5 days
QUESTION
burn pt edu for prevention of infection
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whose most likely at risk for burns men 2x
what percentage of burns occur at home 73
who is at isk for morbidity due to burns geriatrics pediatrics
burn education monitor kids in bath outlet coversfireplace enclosures table clothes can cause easy spills
first degree burn superficial sunburn
second degree burn entire epidermis some dermis painful blisters
third degree burn total destruction of epidermis, dermis, and underlying tissue lack of sensation
fourth degree burn Deep burn necrosis extends into deep tissue, muscle, or bon
Injuries that affect >20% ofTBSA are considered severe
describe the placement and percentage of the rule of nines Head 9%anterior trunk 18%posterior trunk 18%genitalia 1%arms 9%legs 18%
effects of major burns face neck upper extremity burns : inhalation of smoke / heat electrolyte shifts
what test assess carbon monoxide poisoning carboxyhemoglobin
whats CM of carbon monoxide poisoning “feverheadache dizzy NV bright pink lips “”sut”” black sputum”
Emergent or resuscitativephase onset of injury – fluid resuscitation
how to ensure a patent airway in burn victim give humidified 100% O2
Acute or intermediate phase beginning or diuresis – wound closure 48-72Management of shock: maintain BP, urine output 30-50mL, maintain serum sodium
Rehabilitation phase wound closure – return to optimal phsyical / psychosocial
what type of burn can cause hematuria electrical
what must be continuously assessed in but pt continuously assess airway breathing
what electrolytes are shifted in burn pt hyerkalemia -initial hyponatremia -later metabolic acidosisElevated hematocrit -initial Decrease platelets and increased clotting time -initial
What fluid resuscitation should be used for thermal or chemical burns 2mL LR /kg/% TBSA(only 2nd 3rd 4th degree burns)
What fluid resuscitation should be used for electrical burns 4mL LR / kg/ %TBSA (only 2nd 3rd 4th degree burns)
how are the infusions regulated on burn pts 1/2 of the vol within 8 hours of injury (injury time NOT who they got to hospital)rest within 16hours of injury
How often must the patient’ s response to fluid therapy be evaluated q1hr
what topical agents are used in burn pt silvadine antibiotic ointment
explain how the dressing should be applied to burn pt wrap each phalange single and then all together dont wrap tight
what burns need graphs deep partial full thickness (decreases risk of infection, prevent further loss of protein fluid electrolytes)
whats an Autograft ideal graph from pts own skin
Homograft donated skin from deceased or living
Xenograft skin from animals – usually a pig
how long should the dressings be on the new graph until change? 3-5 days
burn pt edu for prevention of infection limited visitors – may need full PPE no fresh fruit and flowers sterile procedurestubes /lines are only ok for 24hours – then need change
whats the number 1 route for pain relief in burn pt IV
Morphine & Fentanyl are commonly used in burn pt, what needs to be monitored respiratory and constipation
A client with a superficial partial-thickness solar burn (sunburn)of the chest, back, face, and arms is seen in urgent care. Thenurse’s primary concern should be pain management
when should nutrition be administered to burn pt ASAPhigh protein high cal pt not eating well : ask what you like to eat
nursing implementations for Psychosocial Support talk to how they feel promote body image talk to patient during dressing changes
follow up care for burn pts early ambulation (prevent pneumonia and DVT)have family pt demonstrate wound care compression garments/wraps promotes circulation pain meds q 30 mins intact blisters
average time between HIV + test and AIDS is 8-10 years
period from infection of HIV and development of HIV antibodies for 3 months
what cells does HIV target CD4
Reverse Transcriptase changes RNA to DNA
who is at risk for HIV breastfed infants or birth of HIV+ mom Bisexual men IV drug users
what edu should be given for prevention of HIV condoms needle exchange behavioral interventions avoid sharing needles antiviral medications within 72hours of exposure (2-3 rx for 28 days)
if an RN has a needle stick, what should they do first inform their manager
Antiretroviral medications aspostexposure prophylaxis forhealth care workers arestarted within how manyhours of exposure? 72
stage 0 HIV early HIV
stage 1 of HIV Primary/acutePeriod from infection with HIV to the development of HIV-specific antibodiesCD4+ T-cell counts normally 500 to1500 cells/mm3 of blood
how many stages of HIV are there 5
Stage 2 HIV t lymphocytes between 200-499
Stage 3 HIV CD4 count below 200 cells considered to have AIDS
stage unknown HIV no info on CD4 count
how do we treat immune Reconstitution InflammatorySyndrome (IRIS) in HIV pt’s steroids
Kaposi’s Sarcoma cancer caused by herpes virus TX: antibiotic or anti-tumor therapy (usually daunorubicin)
what to monitor w pt on daunorubicin monitor liver labs so if liver enzymes are high: we cut dose in half
CM of HIV asymptomatic in stage 1 or skin rash SOB dyspnea chest pain cough TB pneumonia NV anorexia dirrheaoral candidiasis
what do we put TB pt on w/ HIV rifampin could be in combo w/ other drugs
what do we put pneumonia pt on w/ HIV bactin
when does capos sarcoma usually occur in stage 3
Tx of HIV AIDS Antiretroviral therapycombo of 2+ rx
who would be on mono therapy for HIV pt pregnant woman (zidovudine: hepatic toxic)
what test can indicate the extent or stage of HIV CD4 increase in CD4= getting better on RX
what do HIV pt need to avoid no raw food fully cooked steakbird cages and cat litter sick people avoid bowl irritants – spicy food, alc, fried food, nuts
nutritional diet for HIV pt ensure / boost no raw food well done stk avoid bowl irritants – spicy food, alc, fried food, nuts
Which of the following is a clinical syndrome that is characterized by a progressive decline in cognitive, behavioral, and motor functions as a direct result ofHIV infection? HIV encephalopathy