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ER/Burns, MODS/Shock, Liver Flashcards | StudBud
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ER/Burns, MODS/Shock, Liver
ER/Burns, MODS/Shock, Liver
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1
Hypovolemic shock is a result of:
Pump Failure
Widespread Vasodilation
Low volume
Masasive Vasoconstriction
2
Delirium tremens is the most severe form of alcohol withdrawal syndrome.
True
False
3
Cardiogenic shock is
a psychiatric problem.
a volume problem.
a pump problem.
a container problem.
4
Typical signs and symptoms of Cushing Syndrome include
buffalo hump
hypotension
hypoglycemia
weight loss
5
Treatment of moderate respiratory distress as a result of ascites is?
pericardial effusion
Paracentesis
thoracentesis
Lobectomy
6
The major function of the parathyroid hormone is the regulation of serum calcium.
True
False
7
The compensatory stage of shock is when?
The patient dies
The patient develops organ failure
The body has trouble keeping up and fails to compensate
The body activates neural, hormonal, and biochemical compensatory mechanism
8
Classify this burn
Deep partial thickness burn
Superficial burn
Deep full-thickness burn
Superficial partial thickness burn
9
Symptoms of Grave's Disease include
Puffiness of face
Weight Loss, tachycardia, anxiety
Weight gain, slow heart beat
Lethargy
10
Calculate the TBSA burn percentage
40-45%
30-35%
10-15%
20-25%
11
What is the TBSA of an adult leg?
9%
14%
18%
7%
12
Calculate 24 hour fluid resuscitation: chemical burn, weight 60 lb, TBSA 37%
4,400 mL
8,880 mL
1,998 mL
3,996 mL
13
Failure of the cardiac pump occurs in the _____ stage of shock.
compensative
progressive
irreversible
refractory
14
What is the priority for anaphylactic reaction?
IV access
airway
put patient on monitor
finding the cause
15
The formula to calculate the total amount of fluid in the 1st 24h needed to resuscitate is?
0.2 L/kg/%TBSA Burned
0.2 ml/kg/%TBSA Burned
2 L/kg/%TBSA Burned
2 ml/kg/%TBSA Burned
16
Which of the following is the preferred IV fluid for burn resuscitation?
D5W
Normal saline (NS)
Lactated Ringer’s (LR)
Total parenteral nutrition (TPN)
17
Calculate 24 fluid resuscitation: electrical burn, weight 110 lb, TBSA 54%
8,100 mL
10,800 mL
5,400 mL
23, 760 mL
18
A burn that results in total destruction of the epidermis/dermis/underlying tissue & lacks sensation is considered
first
third
fourth
second
19
A hypoparathyroid pt asks why he can't eat cheese, "it has calcium, right"?
Cheese has a high phosphorus content
Cheese has a high magnesium content
Cheese has a high iron content
Cheese has a high potassium content
20
A patient is in the progressive stage of shock. Nurse management of client should focus on what intervention?
Reviewing cause of shock and prioritizing patient's psychosocial needs
Promoting patient's coping skills
Providing tx but shifting focus to giving family time as survival unlikely
Assessing shock & significant changes in assessment data to guide tx plan
21
If a patient has a positive Asterixis sign, you know
The patient is very friendly
Ammonia levels are high
Esophageal varicies are ruptured
Icterus is not present
22
What is the goal of therapy when administering any vasoactive drug during the tx of shock
Maintain a MAP of 60 mm Hg
constriction of vessels to maintain BP
Dilating vessels to improve tissue perfusion
increasing urine output to 50ml/hr
23
What is the TBSA of this burn patient?
9%
18%
5%
54%
24
A client has burns on the anterior trunk and left arm. Calculate TBSA burned?
45%
27%
18%
36%
25
What is the most reliable criterion of adequate fluid resuscitation after a major burn injury?
Pulse rate
Urine output
Blood pressure
Respiratory rate
26
Which of the following is a symptom of the progressive stage of shock that is associated with the cardiovascular system
Seizures
Increased pulmonary artery pressure
Dysthymias
High blood pressure
27
we measure abdominal girth to see changes in ascites
True
False
28
Where do you measure abdominal girth?
At the umbilicus
The upper right quadrant
Ilium
Below the last rib
29
Which is not classified as a major burn?
>20% TBSA 2nd degree burn in child/older adult (>40yr)
high voltage, chemical burn, smoke inhalation
>25% TBSA 2nd degree burn in adult
>15% TBSA 3rd degree burn
30
Asterixis, twitching of the extremities, and displaying inappropriate behavior is associated with?
decreased Serum ammonia
Hepatic encephalopathy
Gallstones
ascites
31
Hyperparathyroid is where the DX is ?
Calcium is low and PTH is low
Calcium is high and the PTH is high
calcium is low and PTH is high
calcium is high and the PTH is low
32
Elevated body temperature (hyperthermia), common with sepsis, is considered to be at a dangerous level when it reaches?
104 degrees
106 degrees
103 degrees
108 degrees
33
The most common and serious side effects of fluid replacement are cardiovascular overload and urinary retention
False
True
34
Organ failure with MODS usually starts in the
Lungs
Heart
Brain
Kidneys
35
During the emergent phase of burn injury, which finding indicates the client requires additional fluid resuscitation?
Hourly urine output 60 mL/hr
Little fluctuation in daily weight
Serum creatinine 2.5
Serum albumin 3.8
36
A common sign of Graves' disease includes ________, or protrusion of the eyes.
goiter
exophthalmos
ophthalmnia
exproptosis
37
The person who has ingested a corrosive poison is given ____ to drink 10 minutes before vomiting induced
apple juice
cola
water
milk
38
Addison's disease
Makes you pee!
Too much ADH
adrenal gland hyperfunction
Adrenal gland hypofunction
39
The nurse has a hypoparathyroid pt. The nurse taps the client’s facial nerve and mouth twitches and the jaw tightens. ?
Positive Trousseau’s sign
Positive Babinski’s sign
Positive Chvostek’s sign
Positive paresthesias
40
Symptoms of Addison's disease:
weight loss, fatigue, exercise intolerance, muscle weakness
bone deformation, hunchback
strength in legs and feet but not in arms and hands
weight gain, bones fracture easily
41
Thyroidectomy is the treatment of choice for thyroid cancer.
False
True
42
An escharotomy is needed in a circumferential burn when
Cannot distinguish the sensation of sharp versus dull.
The burn is full thickness rather than partial thickness
The client is unable to fully pronate and supinate.
Cap refill is slow in the digits & distal pulse is absent.
43
Ascites is defined as:
a proximal loop of the large intestine
an accumulation of serous fluid in the peritoneal cavity
a bowel obstruction
an abnormal enlargement of the spleen
44
What is the most common cause of MODS (Multiple Organ Dysfunction Syndrome)?
Burns
Sepsis
Renal failure
Anaphylaxis
45
Using the rules of nines, calculate the TBSA. The patient has burns on the Rt arm and leg.
27
9
18
18.5
46
________ disease occurs when the adrenal cortex function is inadequate to meet the patient’s need for cortical hormones
Addison
Cushing
Grave's
Hashimoto
47
___________ disease, an autoimmune disorder, is the most common cause of hyperthyroidism
Grave's
Hashimoto
Cushing
Addison
48
Which is
true
of esophageal varices?
Seen less frequently in individuals with liver failure
Typically occurs in the upper 1/3 of the esophagus
Benign condition without severe injury potential
Can rupture, causing massive bleeding and death
49
Symptoms of hypothyroid include:
intolerance to cold, bradycardia, constipation
overgrowth of jaw bone, hands and feet
intolerance to heat, waxy skin, diarrhea
nausea, vomiting, and diarrhea
50
What is a paracentesis?
Aspiration of ascitic fluid from peritoneal cavity
Aspiration of fluid from Douglas’ pouch
Aspiration of fluid from Morrison’s pouch
Aspiration of fluid from the lungs
51
The most life-threatening symptom of esophageal varices would be
copious hematemesis.
dark, tarry stools.
melena.
abdominal pain.
52
How much to infuse in 1st 8 hours for an adult burn victim weighing 81 kg with a chemical burn of TBSA of 36%
4,856 mL
5,832 mL
3,980 mL
2,916 mL
53
This is a method to calculated fluid resuscitation for burn victims
Parkland method
Chekov method
Hille method
Overland method
