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Med Surg 2 > Burns, thermal injuries and endocrine disorders > Flashcards

Burns, thermal injuries and endocrine disorders Flashcards

1
Q

What is a 1 deg burn

A

superficial

no blistering or sluoghing

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2
Q

What is a 2 deg burn

A

blistering

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3
Q

Should you pop a blister

A

no

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4
Q

What are some signs of an inhalation injury

A

blackness around their nares, mouth or clothes
trouble swallowing
hoarseness
high carboxyhemoglobin level

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5
Q

How long will you likely be in the hospital after an inhalation injury and why

A

24 hours to monitor you for the extent of the damage

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6
Q

What percentage of burns will the pat be transfered to seattle

A

30%
Burns that involve face, hands, feet, genitals, perineum, or major joints
3rd degree burns in any age group
Electrical burns, including any lightning injury
Chemical burns
Inhalation injury

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7
Q

What is a consideration for incountering someone being electrocuted

A

do not touch them

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8
Q

What do we check first if its a large burn, electrical or inhalation burns

A

ABC’s

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9
Q

What is the greatest threat of a large burn

A

hypovolemic shock

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10
Q

Who are at increased risk of hypovol shock from a large burn

A

cardio pats

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11
Q

What are cardio pats more likely to get after a burn

A

hypovol shock
dysrthmia
VTE’s

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12
Q

What type of diagnostic test might be used to assess a lower resp inhalation injury

A

bronchoscopy

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13
Q

What is Most common complication in the emergency phase after a burn

A

Acute Tubular Necrosis (ATN)

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14
Q

What types of IV access will a larger burn pat likely get

A

Central access
PICC
Swans Gans

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15
Q

What is the next priority after the fluids have been addressed after a burn

A

wound care

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16
Q

What is an allograft

A

skin from skin donor cadavers

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17
Q

What is a homograft

A

skin from same species usu from live person like your self (i.e. human to human)

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18
Q

What route of med admin should not be used on burn pats

A

IM

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19
Q

What are some lipid soluble hormones

A

Steroids and thyroid hormone

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20
Q

What are some water soluble hormones

A

Insulin, growth hormone, and prolactin

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21
Q

What is acromegaly

A

over production of growth hormone

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22
Q

What are the manis of acromegaly

A

elarged hand feet
large protruding jaw
big thick tongue

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23
Q

Who are more likely to get a pituitary adenomas

A

african americans

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24
Q

What will be people with removed pituary glands need

A

lifelong meds to replace their thyroid hormone, sex hormones, and glucocorticoids

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25
Q

NURSING CARE POST PITUITARY SURGERY

A 
no blowing nose
drip pad under the nose  
increase bed 30 deg 
assessment for hemtoma formation 
Monitor peripheral vision, visual acuity, extraocular movements, and papillary response
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26
Q

NURSING CARE OF SIADH

A

monitor I/O with SG’s, heart, and LOC

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27
Q

What is the pat has a severe case of low sodium with SIADH and the doc order 3% saline

A

tell them they pat will need to be transfered to the ICU cause 3% can only be given there

28
Q

NURSING CARE OF DI

A

Give DDAVP
monitor no HA
Monitor vitals and urine SG
for acute DI fluids replaced by IV hypotonic saline or D5

29
Q

causes of graves dis

A

insufficient iodine supply, infection, stress, cigarette smoking

30
Q

What are some drugs that are used to treat thyroid storm

A

include propylthioracil (PTU) and methimazole (Tapazole)

31
Q

How long will the drugs for thyroid storm usu take to work

A

1-2 wks

32
Q

POST-OP CARE THYROID SURGERY

A

monitor pat q2h for 24hr for
resp distress from hemorrhage
Trousseau’s sign and Chvostek’s sign from hypocalcemia
control pain
Have (trach tray) suction equipment readily available

33
Q

S/S of hypocalcemia

A

↑ neuromuscular excitability (Tingling, muscle spasm-particularly in hands, feet, and facial muscles, intestinal cramping, hyperact bowel sounds
seizing up
Prolonged QT interval, cardiac arrest
Chvostek & Trousseau sign

34
Q

Symptoms of hypothy

A

Fatigue, lethargic, experience personality and mental changes, impaired memory, weight gain
myxedema

35
Q

Cooling with ice or cold water within the first _______ minutes reduces depth of the injury

A

1 min

36
Q

What is a potential complication with myxedema

A

myxedema coma

37
Q

What are some manifestations of myxedema coma

A

hypothermia
hypoT
hypoventilation

38
Q

What is the care with myxedema coma pats

A

labs for TSH, FT3, FT4, cortisol, ACTH, and glucose
respiratory support due to resp failure as major cause of death
support BP
passively warm them up
IV glucose for hypoG

39
Q

What is cushings syndrome

A

chronic high levels of cortisol

40
Q

What are some mani’s of cushings syndrome

A 
round flushed face (moon face)
fat pad on back of neck 
abdominal striae
thin skin
weak muscles 
HTN
easy bruising
41
Q

What is addison’s disease

A

hyposecretion of adrenal cortex or of ACTH from pituitary

42
Q

What is decreased in addisons disease

A

glucocorticoids
mineralcorticoids
androgens

43
Q

What are some symptoms of addisons disease

A 
fatigue 
anorexia 
hypoT
hyperpigmentation
hypoG
salt craving 
decreased libido
44
Q

What is PHEOCHROMOCYTOMA

A

a tumor in the adrenal medulla that causes overproduction of catecholamines (epi and norepi)

45
Q

What are some manifestations of PHEOCHROMOCYTOMA

A

severe HTN
pounding HA
tachycardia with palps
profuse sweating

46
Q

What is the main treatment for PHEOCHROMOCYTOMA

A

surgical removal

47
Q

When someone comes in to DKA and they receive IV insulin when can they eat

A

not until theyre off the IV insulin to subQ

48
Q

How often will blood sugars need to checked when on IV insulin

A

every hour

49
Q

What is troussea’s sign

A

when you blow up a blood pressure cuff on the arm and they get tetany in their hand/arm

50
Q

What is chvosteks sign

A

cheek spasm when you brush against it

51
Q

How do you know if a transplant pat is rejecting the transplant

A

biopsy’s of that organ

52
Q

Why is a fever not a sign of a transplant rejection

A

because those pat will be on a antirejection med so their immune system will be suppressed so no fever response

53
Q

What are transplant pats at high risk for

A

infection

54
Q

Do not give TPA if

A

they just had surg
new onset of HA
any clotting/bleeding problems already
hemorrhagic stroke

55
Q

examples of anticoag’s

A

lovonox
plavix
coumadine

56
Q

What pats are at higher risk for hemorrhagic stroke

A

HTN
Anticoag’s
Fam Hx
head aneurysm

57
Q

What is coumadines antidote

A

Vit K

58
Q

How to trouble shoot a pulse ox sat

A

compare the pulse reading on the device and one that you get by counting to make sure they are the same
then check that the oxygen supp is connected and on

59
Q

What is the antidote for valium

A

romazican

60
Q

What is normal bicarb level

A

22-28

61
Q

What signs might you see in someone with a basilar skull fracture

A

battle sign
clear drainage from ears or nose
rhinorrhea
periorbital bruising

62
Q

When is coumadine usu given

A

at night

63
Q

What can you give to diabetes that are hypoglycemic that cant take anything in the mouth or nose

A

glucagon

dextrose 50

64
Q

What is DI

A

deficient amount of ADH or impaired renal responses

65
Q

What are some signs of DI

A

polydipsia
low SG
hypernatremia

66
Q

What timeframe can TPA be given in to be effective

A

first 3 hours

Med Surg 2 (13 decks)

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