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NUR 211 Final Exam 3
- Diagnostics for epiglottitis
Answer Lateral neck x-ray (thumb print), blood cultures (WBC;20-30,000)
- Sprain
Answer Injury to ligaments surrounding a joint usually called by wrenching or twisting motion
- S/S of epiglottitis
- Ds
Answer
drooling, dysphagia, dysphonia, difficulty inspirority breathing, fever, restlessness, stridor, tripod position, (slowed breating=too tired to breathe)
- First-degree (mild) Sprain
Answer involves tears in only a few fibers, resulting in mild tenderness and minimal swelling
- priority intervention for epiglottitis
Answer Intubation
- Second-degree (moderate) Sprain
Answer partial disruption of the involved tissue with more swelling and tenderness
- Cause of epiglottitis
Answer HIB virus; teach about vaccinations 1 / 4
- Third-Degree (severe) Sprain
Answer complete tearing of the ligament in association with moderate to severe swelling
- Emotional needs of a burn patient
Answer assess circumstances of the burn. burn survivors often experience guilt, concern, frustrations.new fares will arise during recovery, self esteem may be adversely affected. Address spiritual and cultural needs. Issues of sexuality must be met with honesty. Family and patient support groups to manage the enormous range of emotional responses that the burn patient may exhibit, assess the circumstances of the burn, family relationships, and previous coping experiences with stressful stimuli. At any time the patient may experience a variety of emotions such as fear, anxiety, anger, guilt, and depression. encouraged patient to discuss fears regarding loss of life as he or she once knew it, loss of function, temporary or permanent deformity and disfigurement.Discuss returning to work and home life, and financial burdens resulting from the long and costly Hospital stay and rehab.
- Strain
Answer excessive stretching of a muscle, it's fascial sheath, or a tendon
- Dietary sources of nutrients for burn pts
Answer Increase protein intake (meats & beans) and calorie intake (5,000/day)
- Clinical Manifestations of Sprains/ Strains
Answer pain, edema, decrease in func- tion, contusion
- Avulsion Fx
Answer Ligament pulls loose a fragment of bone
- Evidence that fluid resuscitation is effective
Answer Increased urine output and normalization of lab values 2 / 4
- Hallmark sign of shock
Answer Low BP
- Health Promotion (Strains/Sprains)
Answer Strengthening exercises, balancing exer- cises and endurance exercises
- Lactate levels indicative of sepsis
Answer >2
- Acute Care (Sprains/Strains)
Answer -Stop activity
-Apply ice packs -Compress involved area -Elevate -Analgesia PRN
- Stages of Shock
Answer -Compensated
-Decompensated -Irreversible
- Time Restraints for Cryotherapy and Heat therapy
Answer Apply no more than 20-30 min and avoid direct contact with skin
- Compensatory stage of shock 3 / 4
Answer Confusion Decreased urinary output BP systolic < 100
- Elastic Compression Bandage is wrapped how?
Answer Begin at the farthest point from the trunk of the body and progress proximally
- decompensated shock (progressive)
Answer when the body can no longer compen- sate for low blood volume or lack of perfusion. Late signs such as decreasing blood pressure become evident
- Time Restraints for Elastic Compression Bandage
Answer Leave in place for 30 minutes and remove for 15 minutes
- irreversible shock (prefractory)
Answer When the body has lost the battle to maintain perfusion to vital organs. Even if adequate vital signs return, the patient may die days later due to organ failure.
- Contraindication for elastic compression bandage?
Answer Dislocation
- What is oxygen delivery of choice for shock
Answer High flow O2 (100%) via non-re- breather mask or bag-valve mask; anticipate need for intubation and mechanical ventilation
- When do we begin using Heat therapy instead of cryotherapy?
- / 4
Answer 24-48 hours post injury
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