HESI MED SURGE MIDTERM III: LATEST EXAM WITH
VERIFIED SOLUTIONS
Burns - ANSWERTissue injury or necrosis caused by transfer of energy from a heat
source to the body
Categories of Burns - ANSWERThermal
radiation
electrical
chemical
Tissue destruction results from - ANSWERCoagulation
protein denaturation ionization of cellular contents
Critical systems affected include - ANSWERRespiratory integumentary cardiovascular
renal
G.I.
neurologic
Severity is determined by - ANSWERBurn depth
1st° burn - ANSWERSuperficial partial thickness, injury to the epidermis, leaves skin
pink or red but no blisters, dry, painful, slight edema, no scarring or skin graft
required
2nd° burn - ANSWERDeep partial thickness destruction of epidermis and upper
layers of dermis, injury to deeper portions of the dermis, painful, appears red or
white, weeps fluid, blisters present, hair follicles intact, very edematous, blanching
followed by capillary refill, heals without surgical intervention
3rd° burn - ANSWERFull thickness and deep full thickness involves total destruction
of dermis and epidermis, skin cannot regenerate, require skin grafting, underlying
tissue may be involved, wound appears dry and leathery as eschar develops, painless
Severity is determined by: - ANSWERRule of nines, Lund and browder method
Rules of Nines: head/neck - ANSWER9%
Rule of Nines: upper extremities - ANSWER9% each
4.5% anterior&posterior
Rule of Nines: lower extremities - ANSWER18% each
9% anterior/posterior
Rule of Nines:
Front trunk - ANSWER18%
,Rule of Nines: back trunk - ANSWER18%
Rule of Nines: perineal area - ANSWER1% for adults
Three stages of burn care - ANSWERResuscitative/emergent
acute
rehabilitation
Resuscitative/emergent stage: 48-72 hrs - ANSWERBegins at time of injury and
concludes with the restoration of capillary permeability. Characterized by fluid shift
from intravascular to interstitial and shock.dnsjd Candid Expect to administer large
volumes of fluid. Fluid replacement formulas calculated from time of injury.
Acute phase: 48-72 hrs after injury - ANSWEROccurs from beginning of diuresis to
near completion of wound closure. Characterized by fluid shift from interstitial to
intravascular. Focus on infection control wound care & closure, pain management,
nutritional support, physical therapy
Rehabilitation phase - ANSWEROccurs from Major wound closure to return to
optimal level of physical and psychosocial adjustment. Characterized by grafting and
rehabilitation specific to the client.
Absence of bowel sounds indicate - ANSWERParalytic ileus
Urine output in first 72 hours after injury - ANSWERRadically decreased with
increased specific gravity
Urine output 72 hours to two weeks after injury - ANSWERRadically increased
Signs of inhalation burn - ANSWERRed or burned face, cinched facial and nasal hairs,
conjunctivitis, sooty nasal mucosal or bloody sputum, hoarseness, rails or wheezing
denoting smoke inhalation
Nursing plans for emergent phase - ANSWERadmission care, monitor hydration
status, monitor respiratory functioning, asses for paralytic ileus, wound care, pain
management, asses for circulatory compromise, proper nutrition.
Nursing plans for acute phase - ANSWERProvide infection control, no live plants or
flowers in room, perform ROM, prevent contractures, provide fluid therapy, provide
adequate nutrition ( up to 5000 calories per day)
Pain management - ANSWERProvide pain medication before dressing change
Dietary interventions with burn clients - ANSWERHigh calorie, high protein, high
carb, no free water, tube feeding at night, weigh daily
, Hyperthyroidism - ANSWERExcessive activity of thyroid gland.
graves disease or goiter.
Treatment for hyperthyroidism - ANSWERThyroid ablation by medication, radiation,
thyroidectomy, adenectomy of portion of anterior pituitary where TSH producing
tumor is located = hormone replacement
Signs and symptoms for hyperthyroidism - ANSWERWeight-loss
increased appetite diarrhea
heat intolerance tachycardia diaphoresis nervousness
Exophthalmos
T3 elevated above 220
T4 elevated above 12
Thyroid storm - ANSWERLife threatening symptoms include fever, tachycardia,
agitation, anxiety and hypertension. Maintain an airway.
Drugs for thyroid storm - ANSWERPTU (propylthiouracil)
Tapazole (methimazole)
Diet for hyperthyroidism - ANSWERHigh calorie
High protein
low caffeine
Low Fiber
Treatment of hyperthyroidism - ANSWERThyroid ablation, radiation, thyroidectomy,
adenectomy
Normal calcium level - ANSWER9.0-10.5
Tests for hypocalcemia - ANSWERTrousseau sign
Chvostek sign
Hypothyroidism - ANSWERHashimoto, myxedema. Hypofunction of the thyroid gland
resulting in insufficiency of thyroid hormone
Signs & symptoms of hypothyroidism - ANSWERThin, dry hair
Thick, brittle nails
constipation
bradycardia
Goiter
PeriOrbital edema
cold intolerance
weight gain
Diagnosis of hypothyroidism - ANSWERLow T3 below 70
Low T4 below 5
VERIFIED SOLUTIONS
Burns - ANSWERTissue injury or necrosis caused by transfer of energy from a heat
source to the body
Categories of Burns - ANSWERThermal
radiation
electrical
chemical
Tissue destruction results from - ANSWERCoagulation
protein denaturation ionization of cellular contents
Critical systems affected include - ANSWERRespiratory integumentary cardiovascular
renal
G.I.
neurologic
Severity is determined by - ANSWERBurn depth
1st° burn - ANSWERSuperficial partial thickness, injury to the epidermis, leaves skin
pink or red but no blisters, dry, painful, slight edema, no scarring or skin graft
required
2nd° burn - ANSWERDeep partial thickness destruction of epidermis and upper
layers of dermis, injury to deeper portions of the dermis, painful, appears red or
white, weeps fluid, blisters present, hair follicles intact, very edematous, blanching
followed by capillary refill, heals without surgical intervention
3rd° burn - ANSWERFull thickness and deep full thickness involves total destruction
of dermis and epidermis, skin cannot regenerate, require skin grafting, underlying
tissue may be involved, wound appears dry and leathery as eschar develops, painless
Severity is determined by: - ANSWERRule of nines, Lund and browder method
Rules of Nines: head/neck - ANSWER9%
Rule of Nines: upper extremities - ANSWER9% each
4.5% anterior&posterior
Rule of Nines: lower extremities - ANSWER18% each
9% anterior/posterior
Rule of Nines:
Front trunk - ANSWER18%
,Rule of Nines: back trunk - ANSWER18%
Rule of Nines: perineal area - ANSWER1% for adults
Three stages of burn care - ANSWERResuscitative/emergent
acute
rehabilitation
Resuscitative/emergent stage: 48-72 hrs - ANSWERBegins at time of injury and
concludes with the restoration of capillary permeability. Characterized by fluid shift
from intravascular to interstitial and shock.dnsjd Candid Expect to administer large
volumes of fluid. Fluid replacement formulas calculated from time of injury.
Acute phase: 48-72 hrs after injury - ANSWEROccurs from beginning of diuresis to
near completion of wound closure. Characterized by fluid shift from interstitial to
intravascular. Focus on infection control wound care & closure, pain management,
nutritional support, physical therapy
Rehabilitation phase - ANSWEROccurs from Major wound closure to return to
optimal level of physical and psychosocial adjustment. Characterized by grafting and
rehabilitation specific to the client.
Absence of bowel sounds indicate - ANSWERParalytic ileus
Urine output in first 72 hours after injury - ANSWERRadically decreased with
increased specific gravity
Urine output 72 hours to two weeks after injury - ANSWERRadically increased
Signs of inhalation burn - ANSWERRed or burned face, cinched facial and nasal hairs,
conjunctivitis, sooty nasal mucosal or bloody sputum, hoarseness, rails or wheezing
denoting smoke inhalation
Nursing plans for emergent phase - ANSWERadmission care, monitor hydration
status, monitor respiratory functioning, asses for paralytic ileus, wound care, pain
management, asses for circulatory compromise, proper nutrition.
Nursing plans for acute phase - ANSWERProvide infection control, no live plants or
flowers in room, perform ROM, prevent contractures, provide fluid therapy, provide
adequate nutrition ( up to 5000 calories per day)
Pain management - ANSWERProvide pain medication before dressing change
Dietary interventions with burn clients - ANSWERHigh calorie, high protein, high
carb, no free water, tube feeding at night, weigh daily
, Hyperthyroidism - ANSWERExcessive activity of thyroid gland.
graves disease or goiter.
Treatment for hyperthyroidism - ANSWERThyroid ablation by medication, radiation,
thyroidectomy, adenectomy of portion of anterior pituitary where TSH producing
tumor is located = hormone replacement
Signs and symptoms for hyperthyroidism - ANSWERWeight-loss
increased appetite diarrhea
heat intolerance tachycardia diaphoresis nervousness
Exophthalmos
T3 elevated above 220
T4 elevated above 12
Thyroid storm - ANSWERLife threatening symptoms include fever, tachycardia,
agitation, anxiety and hypertension. Maintain an airway.
Drugs for thyroid storm - ANSWERPTU (propylthiouracil)
Tapazole (methimazole)
Diet for hyperthyroidism - ANSWERHigh calorie
High protein
low caffeine
Low Fiber
Treatment of hyperthyroidism - ANSWERThyroid ablation, radiation, thyroidectomy,
adenectomy
Normal calcium level - ANSWER9.0-10.5
Tests for hypocalcemia - ANSWERTrousseau sign
Chvostek sign
Hypothyroidism - ANSWERHashimoto, myxedema. Hypofunction of the thyroid gland
resulting in insufficiency of thyroid hormone
Signs & symptoms of hypothyroidism - ANSWERThin, dry hair
Thick, brittle nails
constipation
bradycardia
Goiter
PeriOrbital edema
cold intolerance
weight gain
Diagnosis of hypothyroidism - ANSWERLow T3 below 70
Low T4 below 5
