NSG 233 Med Surg III
EXAM 4 STUDY GUIDE
Topic Location Student Notes
1. Characteristics of NSG233.10.01.01 First degree burns: Erythema, blanching on pressure, mild swelling no vesicles
Burns or blister initially. (Small zone of injury)
Second degree burn: (Necrosis involving most skin layers)
Third/Fourth Degree: Destruction of all layer, require hospitalization, [dry,
waxy, leathery hard skin] no pain (No remaining viable dermis)
2. Emergent/ NSG233.10.02.01 Secure airway, fluid replacement, analgesics, wound care, body temp,
Resuscitative phase emotional support
care 1. Transfer to ED 2. Fluid Replacement 3. Foley Inserted 4. 20-25% burns
NT tube and suction 5. Pt with electrical burns need ECG
2. ABCD
3. Fluid and Electrolyte NSG233.10.01.02
alterations The patient’s response to fluid therapy (heart rate, blood pressure, and urine
output) should be evaluated at least hourly
4. Nursing management NSG233.10.02.01
of electrical burns
5. Pharmacologic NSG233.10.03.03 a. Treatment of choice is IV opioids (hydromorphone-Dilaudid), morphine,
Management of burns fentanyl
b. If patient tolerating PO foods: twice daily long acting opioid: MS Contin
(morphine)
c. PCA used in some burn units
d. Anxiolytics: Lorazepam (Ativan), midazolam (Versed), benzodiazepines
e. Adjunct analgesics: gabapentin (Neurontin), pregabalin (Lyrica)
f. NSAIDS
g. Anesthetic agents( use of anesthetics in a nonoperative setÝng requires
administration and monitoring by qualified personnel
h. Use of nonpharmacologic therapies:
1. Relaxation techniques
2. Distraction
3. Guided imagery
, 4. Hypnosis
5. Therapeutic touch
6. Humor
7. Music therapy
8. Virtual reality techniques
Breakthrough pain: acute intense, and episodic
1. short-acting agents used to control breakthrough pain
6. Inhalation burns NSG233.10.01.02
7. Emergent/resuscitative NSG233.10.02.01 •Predominant therapeutic interventions in the acute phase are
phase care a. Wound care
b. Excision and grafting
c. Pain management
d. Physical and occupational therapy
e. Nutritional therapy
8. Graft care NSG233.10.02.03
9. Coping strategies NSG233.10.03.01
10. Preventing infection NSG233.10.03.01 Environmental cleaning with periodic cultures of patient care equipment
(special attention to hydrotherapy equipment)
Burn wounds should be cultured prior to beginning of antibiotic/antifungal
therapy
Screening for MRSA on admission or VRE
•Prevent infection by cleansing and debriding area of necrotic tissue that
would promote bacterial growth
11. Rule of Nines NSG233.10.01.01
12. Fluid Resuscitation NSG233.10.02.01
13. Incidence of burns NSG233.10.01.01
14. Wound care NSG233.10.02.03
15. Prevention of burns NSG233.10.01.01 Create evacuation plan and practice it, keep lighters away from children, never
leave children around fire, keep a working extinguisher in the home PASS
16. Nutrition NSG233.10.03.01 Oxandrolone (Oxandrin): anabolic steroid
a. Given to burn patients to improve protein synthesis and metabolism
EXAM 4 STUDY GUIDE
Topic Location Student Notes
1. Characteristics of NSG233.10.01.01 First degree burns: Erythema, blanching on pressure, mild swelling no vesicles
Burns or blister initially. (Small zone of injury)
Second degree burn: (Necrosis involving most skin layers)
Third/Fourth Degree: Destruction of all layer, require hospitalization, [dry,
waxy, leathery hard skin] no pain (No remaining viable dermis)
2. Emergent/ NSG233.10.02.01 Secure airway, fluid replacement, analgesics, wound care, body temp,
Resuscitative phase emotional support
care 1. Transfer to ED 2. Fluid Replacement 3. Foley Inserted 4. 20-25% burns
NT tube and suction 5. Pt with electrical burns need ECG
2. ABCD
3. Fluid and Electrolyte NSG233.10.01.02
alterations The patient’s response to fluid therapy (heart rate, blood pressure, and urine
output) should be evaluated at least hourly
4. Nursing management NSG233.10.02.01
of electrical burns
5. Pharmacologic NSG233.10.03.03 a. Treatment of choice is IV opioids (hydromorphone-Dilaudid), morphine,
Management of burns fentanyl
b. If patient tolerating PO foods: twice daily long acting opioid: MS Contin
(morphine)
c. PCA used in some burn units
d. Anxiolytics: Lorazepam (Ativan), midazolam (Versed), benzodiazepines
e. Adjunct analgesics: gabapentin (Neurontin), pregabalin (Lyrica)
f. NSAIDS
g. Anesthetic agents( use of anesthetics in a nonoperative setÝng requires
administration and monitoring by qualified personnel
h. Use of nonpharmacologic therapies:
1. Relaxation techniques
2. Distraction
3. Guided imagery
, 4. Hypnosis
5. Therapeutic touch
6. Humor
7. Music therapy
8. Virtual reality techniques
Breakthrough pain: acute intense, and episodic
1. short-acting agents used to control breakthrough pain
6. Inhalation burns NSG233.10.01.02
7. Emergent/resuscitative NSG233.10.02.01 •Predominant therapeutic interventions in the acute phase are
phase care a. Wound care
b. Excision and grafting
c. Pain management
d. Physical and occupational therapy
e. Nutritional therapy
8. Graft care NSG233.10.02.03
9. Coping strategies NSG233.10.03.01
10. Preventing infection NSG233.10.03.01 Environmental cleaning with periodic cultures of patient care equipment
(special attention to hydrotherapy equipment)
Burn wounds should be cultured prior to beginning of antibiotic/antifungal
therapy
Screening for MRSA on admission or VRE
•Prevent infection by cleansing and debriding area of necrotic tissue that
would promote bacterial growth
11. Rule of Nines NSG233.10.01.01
12. Fluid Resuscitation NSG233.10.02.01
13. Incidence of burns NSG233.10.01.01
14. Wound care NSG233.10.02.03
15. Prevention of burns NSG233.10.01.01 Create evacuation plan and practice it, keep lighters away from children, never
leave children around fire, keep a working extinguisher in the home PASS
16. Nutrition NSG233.10.03.01 Oxandrolone (Oxandrin): anabolic steroid
a. Given to burn patients to improve protein synthesis and metabolism
