Most of the deaths from burn trauma in the emergent phase that require a referral to a burn center result from:

cardiac arrest related to septic shock

Infection

adrenal failure

hypovolemic shock and renal failure.

Answer and Explanation

The Correct Answer is D

A. Cardiac arrest related to septic shock:

Septic shock can occur in burn patients due to the breakdown of the skin barrier, which allows pathogens to enter the bloodstream and cause systemic infection. However, while septic shock is a serious complication of burn injuries, it is not the primary cause of death in the emergent phase. Septic shock can lead to multiple organ failure and contribute to mortality, but it is often a later complication rather than an immediate cause in the emergent phase.

B. Infection:

Infections are a significant concern in burn patients, especially as the burn wound provides an ideal environment for bacterial growth. However, infections typically contribute more significantly to mortality in the later phases of burn care rather than in the emergent phase. In the emergent phase, hypovolemic shock and other immediate complications have a greater impact on mortality.

C. Adrenal failure:

Adrenal failure, specifically acute adrenal insufficiency or Addisonian crisis, can occur in burn patients due to the stress response and corticosteroid depletion. While adrenal insufficiency is a concern in severe burn cases, it is not the primary cause of death in the emergent phase requiring referral to a burn center.

D. Hypovolemic shock and renal failure:

Hypovolemic shock is a critical concern in the emergent phase of burn trauma because burns can lead to significant fluid loss and electrolyte imbalances. Hypovolemic shock results from insufficient circulating blood volume, leading to inadequate perfusion of organs and tissues, which can be life-threatening. Additionally, renal failure can develop due to hypovolemia, decreased cardiac output, and the release of inflammatory mediators, leading to acute kidney injury (AKI). Hypovolemic shock and subsequent renal failure are major contributors to mortality in the emergent phase of burn trauma, necessitating prompt referral to a burn center for specialized care.

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Correct Answer is A

Explanation

A. Intact skin with nonblanchable redness, painful, warm, soft localized area over a bony prominence

Stage 1 pressure injuries are characterized by intact skin with nonblanchable redness over a localized area, typically over a bony prominence like the sacrum, heel, or elbow. The skin may feel painful, warm, and soft to the touch. Nonblanchable redness means that when pressure is applied to the area, the redness does not fade or blanch (turn white). This stage indicates that tissue damage has occurred, but the skin is still intact.

B. Shallow, open, shiny, dry injury, pink-red wound bed without sloughing or bruising: This description is more indicative of a Stage 2 pressure injury, which involves partial-thickness skin loss with an intact or ruptured blister. The wound bed is usually pink or red, and there is no sloughing or bruising.

C. Full-thickness tissue loss, slough and black eschar in wound bed with undermining and tunneling: This description corresponds to a Stage 3 or Stage 4 pressure injury. Stage 3 involves full-thickness tissue loss with visible subcutaneous fat but no bone, tendon, or muscle exposed. Stage 4 involves extensive tissue loss with exposure of bone, tendon, or muscle. Both stages may include slough (yellow or white tissue) and black eschar (hard, necrotic tissue), along with undermining (tissue destruction under intact skin edges) and tunneling (narrow passageways extending from the wound).

D. Full-thickness tissue loss, subcutaneous fat visible, possible undermining and tunneling: This description also corresponds to a Stage 3 pressure injury, as it involves full-thickness tissue loss with visible subcutaneous fat. The mention of possible undermining and tunneling further suggests a Stage 3 pressure injury.

A. Morbidly obese patient B. A woman who smokes and takes oral contraceptives or smoke C. Wheelchair-bound patient D. Patient with a humerus fracture E. Patient who underwent a prolonged surgical procedure

Correct Answer is ["A","B","E"]

Explanation

A. Morbidly obese patient: Obesity is a known risk factor for VTE due to several reasons. Morbidly obese individuals often have impaired mobility, which can lead to venous stasis (sluggish blood flow in the veins). Additionally, obesity is associated with inflammation and changes in blood clotting factors, increasing the risk of developing blood clots in the veins.

B. A woman who smokes and takes oral contraceptives or smokes: Both smoking and oral contraceptive use are independent risk factors for VTE. Smoking can cause damage to blood vessels and alter blood clotting mechanisms, while oral contraceptives can increase the risk of blood clots due to hormonal changes.

C. Wheelchair-bound patient: While being wheelchair-bound alone may not always indicate a high risk for VTE, immobility is a significant risk factor for developing blood clots. Prolonged periods of immobility can lead to blood stasis in the veins, making wheelchair-bound patients susceptible to VTE, especially if other risk factors are present.

D. Patient with a humerus fracture: A humerus fracture on its own may not necessarily increase the risk of VTE significantly. However, if the fracture requires immobilization or surgery, especially if it affects the lower extremities or leads to prolonged immobility, the risk of VTE can increase due to decreased blood flow and stasis.

E. Patient who underwent a prolonged surgical procedure: Prolonged surgical procedures often involve anesthesia, immobility during surgery, and postoperative immobilization, all of which can contribute to venous stasis and increase the risk of developing VTE. Additionally, the surgical trauma itself can trigger inflammatory responses and alterations in blood clotting factors, further elevating the risk of blood clots.

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Most of the deaths from burn trauma in the emergent phase that require a referral to a burn center result from:

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

What would be considered early signs/symptoms of pressure injury (Stage 1)?

Correct Answer is A

Explanation

A nurse recently hired to the preoperative area learns that certain patients are at higher risk for venous thromboembolism (VTE). Which patients are considered to be at high risk? (Select all that apply.)

Correct Answer is ["A","B","E"]

Explanation

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