A nurse is caring for a client in the emergent/resuscitative phase of burn injury. During this phase, the nurse should monitor for evidence of what alteration in laboratory values?

Decreased prothrombin time

Increased hematocrit

Increased sodium

Potassium deficit

Answer and Explanation

The Correct Answer is B

A. Decreased prothrombin time is not typically associated with the emergent phase of a burn injury. Prothrombin time changes are more related to liver function or coagulation disorders.
B. Increased hematocrit is common in the emergent/resuscitative phase of burn injury due to fluid shifts and loss of plasma volume, leading to hemoconcentration.
C. Increased sodium is not typically seen in the emergent phase; instead, hyponatremia may occur due to fluid shifts and loss of sodium in the burn exudate.
D. Potassium deficit is more likely to occur later in the burn management phases. In the emergent phase, hyperkalemia is more common due to cell destruction and release of intracellular potassium.

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Correct Answer is D

Explanation

A. Placing the client on a ventilator to remove CO2 is not directly related to preventing the development of MODS. While ventilation might be necessary for respiratory support, it does not address the systemic infection and inflammation that contribute to MODS.
B. Advising the client to use their call light to reduce the risk of falls is important for general safety but does not address the critical factors involved in preventing MODS in the context of SIRS.
C. Providing a high protein diet can support overall nutrition and healing but is not the primary intervention for preventing MODS. Managing the infection and maintaining hemodynamic stability are more critical.
D. Administering antibiotics to treat the bacterial infection and maintaining a mean arterial pressure (MAP) of at least 65 mm Hg are essential interventions. Effective antibiotic therapy addresses the infection, and maintaining MAP ensures adequate organ perfusion, both of which help prevent the progression to MODS.

A. "I should drink 1 to 1.5 L of fluid each day." B. "I can use aspirin for management of gout pain." C. "I will focus on losing weight to achieve a normal body mass index (BMI)." D. "I will take allopurinol for an acute gout attack in the future."

Correct Answer is C

Explanation

A. A higher fluid intake, ideally 2 to 3 liters per day, is typically recommended to help flush uric acid from the body and prevent gout attacks, not just 1 to 1.5 L.
B. Aspirin is not recommended for gout pain management; nonsteroidal anti-inflammatory drugs (NSAIDs) or corticosteroids are more appropriate.
C. Focusing on losing weight to achieve a normal BMI is important for managing gout, as obesity is a risk factor for gout and can exacerbate symptoms. Weight loss can help reduce uric acid levels and improve overall management of the condition.
D. Allopurinol is used for long-term management to reduce uric acid levels and prevent attacks, but it is not used during acute attacks. Colchicine or NSAIDs are more appropriate for acute gout attacks.

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A nurse is caring for a client in the emergent/resuscitative phase of burn injury. During this phase, the nurse should monitor for evidence of what alteration in laboratory values?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

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Explanation

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Correct Answer is C

Explanation

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