The nurse is preparing to assist the burn surgeon in performing an escharotomy for a patient who has full-thickness circumferential burns that resulted in compartment syndrome. The nurse understands that the expected outcome of this procedure is to:
Enhance the formation of granulation tissue.
Ensure brisk bleeding from the sites so fluid volume status can be maintained.
Ensure the return of distal pulses.
Decrease edema formation.
The Correct Answer is C
Choice A reason: Enhancing the formation of granulation tissue is not the immediate expected outcome of an escharotomy.
Choice B reason: Ensuring brisk bleeding is not the goal; minimal bleeding is expected, and it should be controlled to maintain fluid volume status.
Choice C reason: Ensuring the return of distal pulses is the expected outcome of an escharotomy, as it relieves pressure and restores circulation to the affected limbs.
Choice D reason: Decreasing edema formation is a benefit of the procedure but not the primary expected outcome.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is C
Explanation
Choice A reason: Systolic Blood Pressure is not a direct measure of preload; it indicates the pressure in the arteries during the contraction of the heart muscles.
Choice B reason: Mean Arterial Blood Pressure is an average blood pressure in an individual during a single cardiac cycle, but it does not specifically measure preload.
Choice C reason: Central Venous Pressure (CVP) is a direct measure of the blood volume returning to the heart and the ability of the heart to pump the blood into the arterial system, making it a key indicator of preload.
Choice D reason: Systemic Vascular Resistance refers to the resistance to blood flow offered by all of the systemic vasculature, excluding the pulmonary vasculature, and is not a measure of preload.
Correct Answer is D
Explanation
Choice A reason: Urine output is important but not the priority after administration of fibrinolytic medication.
Choice B reason: Vital signs are routinely monitored but the priority is assessing for any signs of complications from the medication, such as bleeding or stroke.
Choice C reason: The name of the patient's dog is irrelevant to the patient's medical care and assessment.
Choice D reason: Neurological status is the priority to monitor for signs of intracranial hemorrhage, a potential complication of fibrinolytic therapy.
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