. In assessing the emergency patient's health history, what information is obtained with the use of the mnemonic AMPLE?
a. Anatomy of injuries, mucous membranes, peripheral edema, leukocytosis, eczema location
b. Approximate weight, motor function, palpable swelling, labored breathing, edema severity
c. Allergies, medications, past health history, last meal, and events/environment leading to the illness or injury
d. Abdominal sounds, memory loss, people exposed to, last medication, earliest availability of past medical records
a. Volume and electrolyte depletion
d. Rectal temperature of 99.6°F to 104°F (37.5°C to 40°C)
e. Causes mild confusion, headache, and dilation of pupils
In heat exhaustion, volume and electrolyte depletion, elevated rectal temperature, profuse diaphoresis, mild confusion, headache, and pupil dilation occur. Heatstroke is characterized by an elevated core temperature (above 104°F [40°C] without sweating), the need for oxygen administration and treatment with cooling methods, and a high risk of mortality and morbidity.
During the early emergent phase of burn injury, the patient's laboratory results would most likely include
a. ↑ Hct, ↓ serum albumin, ↓ serum Na, ↑ serum K.
b. ↓ Hct, ↓ serum albumin, ↓ serum Na, ↓ serum K.
c. ↓ Hct, ↑ serum albumin, ↑ serum Na, ↑ serum K.
d.↑Hct,↑serum albumin,↓serum Na,↓serum K.
c. Talk about what is troubling her with the nurse and/or her family
There is tremendous psychologic impact with a burn injury. Open communication with caregivers, close friends, and the burn team about fears regarding loss of life as she once knew it, loss of function, temporary or permanent deformity and disfigurement, return to routine life, financial burdens, rehabilitation, and her future are all essential. Simply convincing her to have the wound cared for ignores her psychologic, emotional, and perhaps spiritual needs.
b. Elevated serum bilirubin, serum creatinine of 3.8 mg/dL, and platelet count of 15,000/µL
. The presence of MODS is confirmed when there is defined clinical evidence of failure of two or more organs. Elevated serum bilirubin indicates liver dysfunction, a serum creatinine of 3.8 mg/dL indicates kidney injury, and a platelet count of 15,000/µL indicates hematologic failure. Other criteria include urine output less than 0.5 mL/kg/hr, blood urea nitrogen (BUN) ≥100 mg/dL, white blood cell (WBC) count >10000/µL, upper or lower GI bleeding, Glasgow Coma Scale (GCS) score ≤6, and Hct ≤20%. A respiratory rate of 45, PaCO2 of 60 mm Hg, and chest x-ray with bilateral diffuse patchy infiltrates indicate respiratory failure but not other organ damage.
No pain, waxy white skin, and no blanching with pressure
With full-thickness burns, the nerves and vasculature in the dermis are destroyed so there is no pain, the tissue is dry and waxy-looking or may be charred, and there is no blanching with pressure. Severe pain, blisters, and blanching occur with partial-thickness (deep, second-degree) burns. Pain, minimal edema, blanching, and redness occur with partial-thickness (superficial, first-degree) burns.