Exam 55: Nursing Care of Patients With Burns

The nurse is providing care for a patient who is receiving fluid replacement after being burned on 37 percent of the body. Nursing assessment reveals a blood pressure of 80/60 mm Hg, pulse of 120 beats/min, and urine output of 10 mL over the past hour. After reporting these findings, which order does the nurse expect to be prescribed for this patient?

A patient receives extensive burns to the face, chest, and hands from a random act of violence. The patient states, "I was doing so well, but I will never fit in again with my family, friends, or coworkers." The nurse identifies which need for this patient?

A child is brought to the emergency department with burns from hot liquid pulled from the stove. Which information is most important for the nurse to acquire from the accompanying adult?

The nurse is assisting in the care of a patient with a circumferential burn to the leg. The health care provider determines that an escharotomy is necessary. Which action does the nurse recognize as the most important nursing intervention?

The nurse is providing care for a patient in the emergent stage of treatment for a partial-thickness burn. The patient has been stabilized, with blood pressure 140/88 mm Hg, pulse 78 beats/min, respirations 22 breaths/min, and temperature 97.4°F (36.3°C) orally. Which new assessment finding does the nurse immediately communicate to the health care provider (HCP)?

The nurse is assisting with the care of a patient with second-degree burns to 35 percent of the body. Five hours after the burn occurs, the HCP prescribes nasogastric (NG) enteral feedings. For which reason does the nurse understand the value of the NG feedings and the importance of the time frame?

The nurse is working on the rehabilitation unit in a burn facility. The nurse has been reinforcing the importance of returning the patient to an optimal level of physical functioning. Which statement by the patient indicates a lack of understanding?

The nurse is providing care for a patient with burns covering the entire surface of both arms and the anterior trunk. Approximately what percentage of the patient's body surface area has been affected?

The nurse is providing care for a patient who received synthetic dressings over partial-thickness burns. Which comment by the patient indicates to the nurse that additional information is needed about the procedure?

The nurse is assisting with the care of an older adult patient who is hospitalized for second-degree burns of the legs and feet acquired when a deep fryer tipped over. Which factor has the least impact on the condition and recovery of the patient?

The nurse is providing care for a patient admitted to the burn unit with burns to 45 percent of the body. After 3 days, the nurse notes that the patient's temperature is newly elevated at 100.2°F (37.9°C), and the patient exhibits new-onset agitation and confusion. Which action does the nurse take first?

The nurse on a burn rehabilitation unit presents information addressing the incidence of postburn itching. Which information from researching the topic will the nurse identify as incorrect?

The nurse is assisting with the care of a patient admitted to the emergency department with chemical burns across the chest and hands. Which actions are included in the plan of care? (Select all that apply.)

The nurse is preparing a patient with 46 percent total body surface area burned for graft placement. Which anatomical locations does the nurse expect to have a lower rate of graft success than other areas of the body? (Select all that apply.)

The nurse notes that a patient with full thickness burns has an increase in hematocrit level. What does the nurse realize is causing this change in laboratory value?