A 32-year-old male patient sustains 78% TBSA burn and is currently admitted to the burn unit. Which sequential order would the nurse arrange the events involved in burn shock following a patient's exposure to burns?
Decreased blood volume
Increased Increased vascular permeability
peripheral resistance
Development of edema
The Correct Answer is A,B,D,C
A. Decreased blood volume: Burn injuries can lead to fluid loss, primarily through damaged skin. This fluid loss causes a decrease in blood volume, leading to hypovolemia. Hypovolemia contributes to decreased cardiac output and tissue perfusion.
B. Increased vascular permeability: Burn injuries cause an inflammatory response, leading to increased vascular permeability. This increased permeability allows fluid, electrolytes, and proteins to leak from the intravascular space into the interstitial space.
C. Development of edema: The increased vascular permeability and fluid leakage lead to the development of edema. Edema occurs as fluid accumulates in the interstitial spaces, further contributing to tissue swelling and compromised perfusion.
D. Increased peripheral resistance: In response to decreased blood volume and tissue hypoperfusion, the body activates compensatory mechanisms to maintain blood pressure and tissue perfusion. One of these mechanisms is increased peripheral resistance, which occurs as blood vessels constrict to maintain blood pressure. Increased peripheral resistance helps redirect blood flow to vital organs but also contributes to increased workload on the heart.
Therefore, the correct sequential order of events involved in burn shock following a patient's exposure to burns is:
A. Decreased blood volume B. Increased vascular permeability D. Development of edema C. Increased peripheral resistance
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is A
Explanation
The QTc (corrected QT) interval is a measure of the time it takes for the ventricles to depolarize and repolarize during a cardiac cycle. It is corrected for heart rate (HR) to account for variations in the cardiac cycle length.
The normal range for the QTc interval varies depending on the calculation method used but generally falls within 0.36 to 0.44 seconds. In the given options, the range of 0.33 to 0.47 seconds for the QTc interval is wider than the normal range, suggesting a prolonged QTc interval, which can be indicative of a potential risk for arrhythmias, including ventricular tachycardia and torsades de pointes.
B. QT interval that varies with HR in (option B) is normal because The QT interval alone can vary with heart rate, and this is considered a normal physiological adaptation.
C. QRS interval <0.12 seconds in (option C) is normal because The QRS interval represents the time it takes for ventricular depolarization and is normally less than 0.12 seconds.
D. PR interval 0.12 to 0.24 seconds in (option D) is normal because The PR interval represents the time it takes for atrial depolarization and conduction through the AV node. The normal range is typically 0.12 to 0.20 seconds.
Correct Answer is C
Explanation
In the initial 24 hours after burn injury, fluid resuscitation is a critical priority in the management of burn patients. Burn injuries can lead to significant fluid loss, both locally at the burn site and systemically due to increased capillary permeability. Fluid resuscitation aims to restore and maintain adequate intravascular volume, ensuring sufficient tissue perfusion and organ function.
The Parkland Formula is commonly used to guide fluid resuscitation in burn patients. It involves calculating the total volume of fluid needed in the first 24 hours, with a portion given in the initial hours after injury and the remainder given over the remaining hours.
A. Sterile dressing changes (option A) are incorrect because they are important in wound care management for burn patients to prevent infection. However, fluid resuscitation takes precedence within the first 24 hours.
B. Emotional support (option B) is incorrect because it is an essential aspect of burn care, as burn injuries can have a significant psychological impact. While emotional support is crucial for the patient's overall well-being, it may not be the highest priority within the first 24 hours compared to addressing the physiological needs of fluid resuscitation.
D. Range-of-motion exercises (option D) are incorrect because they are important for preventing contractures and maintaining joint mobility in burn patients. However, they are typically initiated after the initial fluid resuscitation phase and wound stabilization.
Therefore, the priority the nurse anticipates within the first 24 hours for a 31-year-old male patient with burn injuries is fluid resuscitation.
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