During the early emergent phase of burns, the nurse will anticipate giving opioid analgesics by the IV route. What is the rationale for this route?

Loss frequent administration is needed.

Respiratory depression can be easily treated.

The medications will be rapidly effective.

Larger doses of medications can be given.

Answer and Explanation

The Correct Answer is C

A. Loss frequent administration is needed: Frequent administration is sometimes required in burn management to maintain consistent pain control, but this is not the primary reason for selecting the IV route. Oral or subcutaneous routes may require more frequent dosing, but the urgency and severity of burn pain necessitate a faster onset of action.

B. Respiratory depression can be easily treated: While respiratory depression is a potential adverse effect of opioids, the IV route does not inherently make treatment easier. Monitoring and intervention are needed regardless of the administration route, and this is not the rationale for choosing IV administration in acute burn pain.

C. The medications will be rapidly effective: IV administration allows opioids to enter the systemic circulation directly, bypassing absorption barriers, and produces rapid analgesic effects. In the early emergent phase of burns, pain is severe, and immediate relief is necessary to reduce sympathetic stress, facilitate procedures, and prevent complications such as tachycardia, hypertension, and increased metabolic demands.

D. Larger doses of medications can be given: The IV route allows for precise titration rather than simply administering larger doses. The goal is to achieve rapid analgesia with controlled dosing, minimizing the risk of adverse effects while addressing the acute, intense pain characteristic of the emergent burn phase.

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Correct Answer is B

Explanation

A. Hypertension and narrowing pulse pressure: Increased intracranial pressure leads to a widening pulse pressure rather than a narrowing one. As ICP rises, systolic pressure increases while diastolic pressure may remain stable or decrease, producing a widened pulse pressure. Narrow pulse pressure is not characteristic of late ICP elevation.

B. Elevated systolic blood pressure and bradycardia: These are classic components of Cushing’s triad, a late and ominous sign of significantly increased ICP. Rising ICP decreases cerebral perfusion, triggering sympathetic-mediated hypertension to maintain blood flow. The resulting baroreceptor response causes reflex bradycardia, indicating brainstem involvement and impending herniation.

C. Hypotension and tachycardia: Hypotension and tachycardia are more consistent with hypovolemia or shock rather than increased ICP. In elevated ICP, the body attempts to preserve cerebral perfusion by increasing systemic blood pressure, not lowering it.

D. Hypotension and bradycardia: This combination does not reflect the compensatory physiologic response to increased ICP. Late ICP elevation is associated with systemic hypertension, not hypotension, as the body attempts to overcome reduced cerebral perfusion pressure.

A. "CRRT causes less electrolyte changes." B. "CRRT is faster than hemodialysis." C. "CRRT is used for hemodynamically unstable patients." D. "CRRT is used to treat acute kidney injury."

Correct Answer is B

Explanation

A. "CRRT causes less electrolyte changes.": Continuous renal replacement therapy is slower and continuous, which results in gradual removal of fluids and solutes, minimizing rapid shifts in electrolytes and hemodynamic instability. This statement accurately reflects the advantage of CRRT over intermittent hemodialysis.

B. "CRRT is faster than hemodialysis.": CRRT is intentionally slow and continuous, typically running 24 hours a day, whereas conventional hemodialysis is intermittent and completed over 3–5 hours. The slower rate of CRRT reduces rapid fluid and solute shifts, which is particularly important for unstable patients.

C. "CRRT is used for hemodynamically unstable patients.": CRRT is preferred for patients who cannot tolerate rapid fluid removal or abrupt blood pressure changes associated with traditional hemodialysis. This statement is accurate and reflects appropriate patient selection.

D. "CRRT is used to treat acute kidney injury.": CRRT is commonly employed in the management of acute kidney injury, especially in critically ill patients in the ICU. This statement correctly identifies one of the primary indications for CRRT.

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During the early emergent phase of burns, the nurse will anticipate giving opioid analgesics by the IV route. What is the rationale for this route?

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Naxlex Comprehensive Predictor Exams

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Explanation

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