Pediatric burns: Initial response, lasting effects

doi: 10.1097/01.NURSE.0000387242.53272.7c
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INSTRUCTIONS Pediatric burns: Initial response, lasting effects


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GENERAL PURPOSE To provide nurses with an overview of burn injuries in pediatric patients. LEARNING OBJECTIVES After reading this article and completing the test, you should be able to: 1. Discuss the pathophysiology of burns. 2. Describe the assessment of a pediatric patient with a burn injury. 3. Identify nursing interventions for the pediatric patient with burn injuries.

1. The secondary survey of the patient with a burn injury includes assessment of

a. airway.

b. blood pressure.

c. respirations.

d. pulses.

2. Eighty percent of all thermal injuries in children come from

a. flames.

b. chemicals.

c. electricity.

d. hot liquids.

3. The zone of ischemia is the local zone of injury in each burn wound that

a. is located at the center of the burn injury.

b. consists of necrotic tissue.

c. contains tissue that's oxygen/nutrient deprived.

d. is an area of vasodilation and increased perfusion.

4. Pediatric burn patients should be intubated

a. within 48 hours postburn injury in all cases.

b. as soon as possible if airway compromise is likely.

c. only if a nasopharyngeal airway attempt fails.

d. only if airway edema is noted.

5. ABLS guidelines recommend providing 100% oxygen

a. to all burn victims.

b. only to dyspneic patients.

c. only if carbon monoxide poisoning is suspected.

d. only to patients over age 12 years.

6. During the exposure/environment assessment, keep burn wounds covered primarily to

a. reduce pain.

b. prevent infection.

c. prevent fluid loss.

d. prevent heat loss.

7. Burned children with no prior tetanus immunization should receive which vaccine?

a. Td.

b. DTaP.

c. TIG.

d. DT.

8. Compartment syndrome may result from

a. circumferential eschar.

b. hypercapnia.

c. inadequate fluid resuscitation.

d. hypoxemia.

9. Full-thickness burns may not be painful because of

a. blisters.

b. intact underlying adipose tissue.

c. burn eschar.

d. nerve receptor destruction.

10. Burns previously known as second-degree are now called

a. superficial.

b. epidermal.

c. partial-thickness.

d. full-thickness.

11. A deep partial-thickness burn may progress to full-thickness due to

a. circumferential burn eschar.

b. inadequate fluid resuscitation.

c. impaired venous outflow.

d. fluid volume overload.

12. When calculating percentage of TBSA injured,

a. exclude superficial burns.

b. include epidermal burns.

c. include all burned areas.

d. exclude superficial partial-thickness burns.

13. Calculating an accurate TBSA is important for determining

a. the patient's prognosis.

b. the need for an escharotomy.

c. fluid resuscitation requirements.

d. analgesia requirements.

14. Which statement about determining the extent of burns is accurate?

a. The Parkland burn formula considers the patient's age.

b. The rule of nines is accurate for all ages.

c. The patient's palm defines about 1% of the TBSA.

d. TBSA determination isn't important in children.

15. LR solution is preferred for fluid resuscitation after burns because it helps alleviate

a. metabolic alkalosis.

b. metabolic acidosis.

c. hypoglycemia.

d. hypernatremia.

16. Which statement about maintenance fluid resuscitation in children age 6 months to 5 years is accurate?

a. Administer half the calculated volume within the first 4 hours postburn injury.

b. Adjust the rate to maintain a urine output of 2 mL/kg/hour.

c. Calculate the amount of LR needed based on TBSA and age.

d. Include fluid containing dextrose.

17. The patient least likely to need referral to a burn center is one with

a. partial-thickness burns involving 8% of TBSA.

b. inhalation injury.

c. electrical burns.

d. chemical burns.

18. Which pain intensity rating scale is most appropriate for children under age 3?

a. numeric pain scale

b. Wong-Baker FACES scale

c. FLACC pain scale

d. checklist of non-verbal indicators

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