The nurse is caring for a patient with major bums Total Body Surface Area (TBSA) of 63%. The nurse understands that this patient is at the highest risk for the combination of which types of shock? (Select All that Apply.)

distributive shock

cardiogenic shock

obstructive shock

hypovolemic shock

neurogenic shock

Answer and Explanation

Correct Answer : A,B

A. Distributive shock

Severe burns lead to systemic inflammatory response syndrome (SIRS), causing massive vasodilation, similar to septic shock (a type of distributive shock).

D. Hypovolemic shock

Fluid loss from burns leads to hypovolemic shock, which is the most common type of shock seen in burn patients.

B. Cardiogenic shock

Cardiogenic shock is caused by heart failure and is not a primary concern in burn injuries.

C. Obstructive shock

Obstructive shock (e.g., tension pneumothorax, cardiac tamponade) does not occur in burn patients unless another condition is present.

E. Neurogenic shock

Neurogenic shock occurs from spinal cord injuries, not burns.

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Correct Answer is A

Explanation

A. Atropine 1 mg IV push

A C3 spinal cord injury disrupts sympathetic control, causing bradycardia. Atropine is the first-line treatment for symptomatic bradycardia.

B. Epinephrine 1 mg IV

Epinephrine is used for cardiac arrest, not initial management of bradycardia.

C. Adenosine 6 mg IV push

Adenosine is used for supraventricular tachycardia, not bradycardia.

D. Milrinone 50 mcg/kg IV push

Milrinone is an inotrope used in heart failure, not bradycardia.

A. Notify the physician and anticipate the need for endotracheal intubation B. Place the client in semi-fowler's position and administer albuterol breathing treatment C. Encourage the client to cough, take deep breaths, and then auscultate again D. Recommend a medical prescription for guaifenesin and encourage use of incentive spirometry

Correct Answer is A

Explanation

A. Notify the physician and anticipate the need for endotracheal intubation
The client is showing progressive airway obstruction due to inhalation injury. The absence of wheezes indicates impending respiratory failure, requiring immediate airway management.

B. Place the client in semi-Fowler's position and administer an albuterol breathing treatment
Albuterol may help bronchospasm, but this client's issue is upper airway swelling, not bronchospasm. Intubation is the priority.

C. Encourage the client to cough, take deep breaths, and then auscultate again
The loss of wheezes suggests airway swelling has worsened, not that secretions are the issue. Immediate intervention is needed.

D. Recommend a medical prescription for guaifenesin and encourage use of incentive spirometry
Guaifenesin and incentive spirometry help with secretion clearance, but they are not the priority in this emergent airway situation.

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The nurse is caring for a patient with major bums Total Body Surface Area (TBSA) of 63%. The nurse understands that this patient is at the highest risk for the combination of which types of shock? (Select All that Apply.)

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

The nurse is caring for a client with a spinal cord injury at C3. The nurse notices on the cardiac monitor a heart rate of 30 beats per minute & upon assessment of the patient, a change in mental status. What medication does the nurse anticipate will be ordered by the physician STAT?

Correct Answer is A

Explanation

Correct Answer is A

Explanation

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