exam part 2 Flashcards

Question

Metabolic effects of burn

Answer 1

Secretion of stress hormones - tachycardia Neural response via sympathetic nervous system and hypothalamus - hyperthermia Suppression of anabolic hormones and development of massive catabolic response - protein wasting Depression of immune response - susceptibility to infection

Answer 2

Stop drop cover roll Cool the burn Asap Avoid hypothermia Cdontinue 20 mins If chemical irrigate copiously with water

Answer 3

epidermos dermis - capillaries and nerves fat

Answer 4

epidermal red superficial pale pink mid dermal dark pink deep dermal blotchy red full thickness white

Answer 5

Skin intact red brisk capillary refill erythema not included Heal spontaneously

Answer 6

Blisters present Pink brisk cap refill Should heal within 7-14 days With minimal dressing requirements

Answer 7

Heterogeneous Dark pink sluggish cap refill Should heal within 14-21 days Deeper areas over a joint may need surgical intervention and referral

Answer 8

Heterogeneous variable depth Blotchy red white sluggish to absent cap refill Surgical intervention

Answer 9

Outer skin and some underlying tissue dead White brown red black No cap refill Surgical intervention and long term scar

Answer 10

relating to burns 9% of body parts to compromise the entire body palm and fingers of the patient useful for small and scattered burns

Answer 11

Increased cap permeability persist for 24 hours How to give Large canulas fluid resus give hartmans solution half in first 8 hours of injury and second halfd in next 16 hours Extra fluid is required in Inhalation injury Electrical injury Delayed resus Dehydration Intoxcitarted patients and fire fighters

Answer 12

Urine output reflects perfusion Desired hourly output Assess output over several hours for adequacy

Answer 13

Can be caused by heat chemical compounds in the atmosphere Upper airway supra glottic Lower airway subglottic Systemic intoxication (CO, HCN, poisoning) Obtain history Give o2 Examine signs of airway burn Consider intubation early Monitor o2 saturation

Answer 14

Brunt skin -rigid Around limbs - venous occlusion Venous occlusion -arterial occlusion around chest - restricted expansion Childs front - restrict diaphragm Elevation reduces swelling

Answer 15

Analgesia Plastic wrap Contact burn Clean dry sheet Keep warm prevent hypothermia Consult and transfer to burn unit Documentation

Answer 16

Obstructed airway Severe respiratory distress Severe haemodynamic compromise No pulse Skin pale moist mottled Uncontrolled hemorrhage HR less than 60 Ecg Gsc lower than 8

Answer 17

Patent airway Moderate respiratory distress Moderate haemodynamic compromise Thready pulse Cap refill 2-3 seconds Gsc 9-12 Severe pain

Answer 18

Mild respiratory distress Mild haemodynamic compromise Altered vital signs Skin warm pale Gsc 13 Moderate pain Moderate neurovascular compromise

Answer 19

Airway patent No respiratory distress no haemodynamic compromise Normal gsc Mild pain Mild neurovascular compromise

Answer 20

Primary survey approach Consideration to appearance, behavior and conversation Based on clinical criteria acute behavior disturbances and risk of harm to self or others

Answer 21

Perform quick accurate assessments Prioritize Function under stress Communication Think ahead Control patient flow Diffuse conflict Initiate first aid

Answer 22

Possess good public relation skills Possess good crisis intervention skills Deal with barriers to communication Process referrals Know the operational policy of the ED Have a working knowledge of the pre hospital system

Answer 23

An intoxicated patient Verbally abusive person Confused elderly person Prisoner in police custody Intellectually disabled person Non english speaking person Sexually abused

Answer 24

Endocrinology refers to hormones Collection of glands Responsible for sending chemical signals Hormones fall into 2 major classifications Amino acids derived Lipid derived eg steroids Then you have catecholamines

Answer 25

Responsibilities include Aiding with metabolism growth sleep reproduction mood Responds to external stimulus flight or fight Interal Ay be product of an organ Thyroid is one of the most primary glands Most common endocrine disturbance is diabetes

Answer 26

DKA HYPOGLYCEMIA Thyroid storm Acute adrenal crisis

Answer 27

Autoimmune Lack of insulin Destruction of insulin producing beta cells in pancrea Cannot be prevented Developed resistance Insulin resistance Unable to transfer glucose

Answer 28

Lifethreanting metabolic state characterised by high bgls ketosis and acidosis If untreated with result in severe dehydration, cerebral oedema, coma and eventually death Insulin deficency - hypergylcermia prolonged hyperglycemia activates a acascade of events Cellular starvation causing release of counter -regulatory hormones These hormones produce more glucose in an attempt to supply energy to cells Bgls exceed kidneys ability to reabsorb glucose- resulting to glucose in urine and polyuria High glucose spills into urine porcess of osmotic diuresis Polyuria, polydispia, hyperkaemia Counter regulatory hormone activate lipolysiss Fats and proteins transferred to glucose called beta oxidation Weight loss Ketone production (mainly acetone) Fuel for brain during glucose stravation Large amounts of ketones result in metabolic acidosis Weight loss polyphagia keto-breath Initially - body buffers acidosis with bicarbonate buffering system but this system is quickly overwhelmed and nother mechanisms Eg hyperventilation to lower the blood co2 leveles compensatory respiratory alkolisis Kussmaul breathing

Answer 29

Severe dehydration Weight loss Hyperventilation Acetone breath Flushed cheek Abdo pain Disorientation Shock poly dipsia and polyuria Cerebral oedema Severe dehydration Prolonged hyperkaelmia Thrombosis Hyperglycemia hypermosolar state High bgl

Answer 30

Abcdgef Minimum 2 large bore IVC Symptomatic mangemange Treat the cause CXR FBC UA NSU Weight ECG ongoing cardiac monitoring Nursing responsibilities Assess and manage threats to life Symptomatic treatment Idc Strict fbc Insulin Check ketones Check k Fluid replacement

Answer 31

Bgl less than 4 mild to severe Symptoms Hunger Shakiness Anxiety Relestness Decreased loc Diaphoretic dizziness Changes in sensrioum most common

Answer 32

have 15 grams of fast acting carbohydrate 6-7 jelly beans fruit jucie recheck bgl 15 mins

Answer 33

Responsible for growth and metabolism Secretes 3 mian hormones T3 t3 and calcitonin T3 and t4 increase metabolic rate for growth when we are cold Relies on pituitary gland to tell it to make it more or less Could be overactive or underactive

Answer 34

Life threatening Excess amounts of thyroid Mutil organ dysfunction Common in young teenage and women Presentation Thermoregulatory dysfunction Altered loc seizure coma psychosis Cardiovascular af tachycardia hypertension Tachypnea Diarrha abdo pain nausea vomiting

Answer 35

Severe infection Undertreated hyperthyroidism Dka Surgery Trauma to thyroid Pulmonary embolism Surgical manipulation of thyroid gland Radiotherapy Treatment Early intervention A-g immediate management prn Symptoms management and supportive care

Answer 36

Secrete hormones to regular metabolism bp and stress response Cortisol aldersterone adrenaline and noradrenaline

exam part 2 Flashcards

(60 cards)