NUR 4323 - MDC4 Final Study Guide. Questions and Answers.

NUR 4323 - MDC4 Final Study Guide. Questions and Answers. Parkland Formula a) 4ml x % BSA x weight (kg)= volume of fluid that needs to be infused b) ½ of the total volume of fluid in first 8 hours c) Last half in 16 hours MAP Calculation a) MAP= 1/3 * SBP + 2/3 * DBP Treatment for frostbite a) Rewarming the skin a. Rewarm the area using a warm-water bath for 15 to 30 minutes b. Skin may turn soft and look red or purple c. You may be encouraged to gently move the affected area as it rewarms. b) Oral pain medicine a. The rewarming process can be painful c) Protecting the injury a. Once the skin thaws, loosely wrap the area with sterile sheets, towels, or dressing to protect the skin. b. May have to protect fingers and toes as they thaw by gently separating them from each other c. You may need to elevate the affected area to reduce swelling d) Debridement (removal of damaged tissue) a. To heal properly, frostbitten skin needs to be free of damaged, dead or infected tissue. e) Whirlpool therapy or physical therapy a. Hydrotherapy can aid healing by keeping skin clean and naturally removing dead tissue b. Pt may be encouraged to move the affected area f) Antibiotics a. If the skin or blisters appear to be infected, the doctor may prescribe oral antibiotics g) TPA a. IV injection of a drug that helps restore blood flow (thrombolytic) such as TPA. b. TPA lowers the risk of amputation c. These drugs can cause serious bleeding and are typically used only in the most serious situations and within 24 hours of exposure. h) Wound care i) Surgery a. Severe frostbite patients may need surgery or amputation to remove dead or decaying tissue. j) Hyperbaric oxygen therapy a. Some patients show improved symptoms after this therapy, but more study is needed. Treatment and differences of heat stroke and heat exhaustion a) Heat exhaustion a. Symptoms i. General weakness, increased heavy sweating, a weak but faster HR, N/V, possible fainting, pale/cold/clammy skin b. Treatment i. Stop physical activity, transfer to cool space ii. Cooling measures (ice water bath, mist skin with water, ice packs, special cooling blanket) iii. Rehydration therapy b) Heat stroke a. Symptoms i. Elevated body temperature above 103 F (39.4 C), rapid and strong HR, loss or change of consciousness, hot, red, dry, or moist skin b. Treatment i. Oxygen therapy, IV lines, urinary catheter, continuous cooling (Ice bath, mist skin with water, ice packs, special cooling blanket), benzodiazepine if shivering occurs, monitor for multi system organ dysfunction syndrome and electrolyte imbalances. Priority assessment in triage a) ABC’s Temperature reduction