The nurse is preparing to assist the burn surgeon in performing an escharotomy for a patient who has full-thickness circumferential burns that resulted in compartment syndrome. The nurse understands that the expected outcome of this procedure is to:
Enhance the formation of granulation tissue.
Ensure brisk bleeding from the sites so fluid volume status can be maintained.
Ensure the return of distal pulses.
Decrease edema formation.
The Correct Answer is C
Choice A reason: Enhancing the formation of granulation tissue is not the immediate expected outcome of an escharotomy.
Choice B reason: Ensuring brisk bleeding is not the goal; minimal bleeding is expected, and it should be controlled to maintain fluid volume status.
Choice C reason: Ensuring the return of distal pulses is the expected outcome of an escharotomy, as it relieves pressure and restores circulation to the affected limbs.
Choice D reason: Decreasing edema formation is a benefit of the procedure but not the primary expected outcome.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is D
Explanation
Choice A reason: Painful and red-tinged urination could be related to kidney stones but is not directly relevant to the preparation for an intravenous pyelogram.
Choice B reason: The end of the menstrual period is not typically relevant to the preparation for an intravenous pyelogram.
Choice C reason: Drinking fluids is generally encouraged but does not need to be reported unless it is restricted before the procedure.
Choice D reason: The client's allergy to shellfish is important to report because the contrast dye used in an intravenous pyelogram may contain iodine, which can cause a reaction in people with shellfish allergies.
Correct Answer is A
Explanation
Choice A reason: Evaluating the effectiveness of opioid analgesics is crucial as pain management is a primary concern for patients experiencing a sickle cell crisis.
Choice B reason: Limiting the patient's intake of oral and IV fluids is not recommended as hydration is important for patients with sickle cell crisis to reduce blood viscosity and improve circulation.
Choice C reason: Teaching the patient about high-protein, high-calorie foods is beneficial for long-term management but is not the immediate nursing intervention during a crisis.
Choice D reason: Encouraging ambulation may be part of recovery but is not the primary intervention during an acute sickle cell crisis due to the risk of pain exacerbation.
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