A nurse is attending to an adult client in the intensive care unit.

For each patient finding below, indicate whether the finding is consistent with fluid overload or dehydration in burn patients. Each finding may support more than one condition.

Increased Heart Rate

Decreased Urine Output

Elevated Blood Urea Nitrogen (BUN)

Decreased Hematocrit

Answer and Explanation

The Correct Answer is {"A":{"answers":"A,B"},"B":{"answers":"A,B"},"C":{"answers":"B"},"D":{"answers":"A"}}

Increased Heart Rate: A rise in heart rate can be seen in both fluid overload and dehydration. In dehydration, tachycardia is a compensatory mechanism: the body increases heart rate to maintain cardiac output despite reduced circulating volume. In fluid overload, the heart may also beat faster because of increased workload and stress on the cardiovascular system, especially if fluid shifts impair effective circulation. In burn patients, tachycardia is often more strongly associated with hypovolemia from fluid loss, but it can signal either condition depending on the broader context.

Decreased Urine Output: Low urine output is a hallmark of dehydration, as the kidneys conserve water in response to reduced circulating volume. In burn patients, this is particularly concerning because it reflects inadequate perfusion and possible progression toward shock. However, decreased urine output can also occur in fluid overload if renal perfusion is compromised by third spacing of fluids or if acute kidney injury develops. Thus, while it most commonly points to dehydration, it is not exclusive to it.

Elevated Blood Urea Nitrogen (BUN): An elevated BUN is strongly consistent with dehydration. When fluid volume is low, renal blood flow decreases, leading to impaired clearance of nitrogenous waste products. This results in a rise in BUN levels. In fluid overload, BUN is not typically elevated unless there is underlying renal dysfunction. Therefore, in this patient, the elevated BUN is a clear indicator of hypovolemia and dehydration.

Decreased Hematocrit: A low hematocrit suggests hemodilution, which occurs when excess fluid dilutes the concentration of red blood cells. This finding is consistent with fluid overload rather than dehydration. In dehydration, hematocrit usually rises due to hemoconcentration. In burn patients, decreased hematocrit may reflect aggressive fluid resuscitation or ongoing capillary leak with fluid shifts back into circulation, leading to dilution of blood components.

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Correct Answer is ["1.5"]

Explanation

Step 1 is 1 gram × 1000 mg ÷ 1 gram = 1000 mg.

Step 2 is (750 mg ÷ 1000 mg) × 2 mL = 1.5 mL. The nurse should administer 1.5 mL.

A. Osteoarthritis is characterized by rapid bone growth around the joints, which enhances joint movement and reduces discomfort. B. Osteoarthritis is the result of repeated joint infections that lead to the accumulation of scar tissue in the joints, causing stiffness and discomfort. C. Osteoarthritis is caused by the gradual loss of joint cartilage due to wear and tear, resulting in bone-on-bone contact and joint pain. D. Osteoarthritis is primarily an autoimmune disorder where the body's immune system attacks the synovial joints, leading to inflammation and pain.

Correct Answer is C

Explanation

Choice A rationale

This statement is physiologically incorrect because osteoarthritis does not involve rapid bone growth that enhances movement. Instead, the body may attempt to repair damaged cartilage by creating osteophytes or bone spurs. These bony projections actually restrict the range of motion in the joint and increase friction. Rather than reducing discomfort, these changes contribute significantly to the chronic pain and mechanical stiffness associated with progressive joint degeneration in patients.

Choice B rationale

The pathophysiology of osteoarthritis is not defined by repeated joint infections or scar tissue accumulation. While septic arthritis involves infection, osteoarthritis is primarily a non-inflammatory, degenerative condition. The stiffness felt by patients results from the mechanical breakdown of the joint structures rather than the presence of fibrotic scar tissue from previous infections. Attributing the disease to infection ignores the primary role of mechanical stress and chondrocyte dysfunction in the breakdown of articular cartilage.

Choice C rationale

This is the accurate description of the disease process as it involves the progressive degradation of hyaline cartilage. As the protective cartilage thins, the subchondral bone is exposed, leading to increased pressure and friction during movement. This bone-on-one contact triggers nociceptors and leads to the characteristic pain and crepitus. Understanding this wear and tear mechanism helps patients realize why weight management and joint protection are vital for managing their specific symptoms.

Choice D rationale

Osteoarthritis is not an autoimmune disorder; that description applies to rheumatoid arthritis. In rheumatoid arthritis, the immune system targets the synovium, causing systemic inflammation. In contrast, osteoarthritis is localized and characterized by the mechanical failure of the joint. While minor secondary inflammation may occur due to cartilage debris, the underlying cause is not a systemic immune attack. Proper identification is crucial because treatments for autoimmune conditions, like DMARDs, are not effective for osteoarthritis.

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A nurse is attending to an adult client in the intensive care unit. For each patient finding below, indicate whether the finding is consistent with fluid overload or dehydration in burn patients. Each finding may support more than one condition.

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Naxlex Comprehensive Predictor Exams

A nurse is preparing to administer cefazolin 750 mg intramuscularly every 8 hours. The medication label reads cefazolin 1 gram per 2 mL. How many milliliters should the nurse administer per dose?

Correct Answer is ["1.5"]

Explanation

A nurse is reinforcing teaching to a client who was recently diagnosed with osteoarthritis about the disease process. Which of the following statements about the pathophysiology of osteoarthritis should the nurse include in the teaching?

Correct Answer is C

Explanation

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When planning care for a patient with severe burn injuries, what intervention should the nurse prioritize to promote healing?

A nurse is attending to an adult client in the intensive care unit.

For each patient finding below, indicate whether the finding is consistent with fluid overload or dehydration in burn patients. Each finding may support more than one condition.