Fluid Resuscitation & Pain Control Flashcards
7 cards from real CBRN practice questions. Tap to flip, then mark Knew It or Still Learning — missed cards come back until you master them.
Read the first 7 Fluid Resuscitation & Pain Control flashcards as text
The Modified Brooke formula differs from the Parkland formula in that it uses:
Answer: 2 mL/kg/%TBSA of LR for the first 24 hours, then colloid in the second 24 hours
The Modified Brooke formula uses 2 mL/kg/%TBSA of LR in the first 24 hours, then switches to colloid (0.3–0.5 mL/kg/%TBSA) in the second 24 hours.
A patient with electrical burns has cola-colored urine. Which intervention is the priority?
Answer: Increase IV fluid rate to maintain urine output of 1–1.5 mL/kg/hr and consider mannitol
Cola-colored urine indicates myoglobinuria; aggressive fluid resuscitation to flush the renal tubules (target UO 1–1.5 mL/kg/hr) prevents acute tubular necrosis, with mannitol as an adjunct.
When calculating TBSA for fluid resuscitation, partial-thickness and full-thickness burns are included but which areas are excluded?
Answer: Superficial (first-degree) burns
Superficial (first-degree) burns such as simple sunburn do not compromise the dermal barrier sufficiently to warrant inclusion in TBSA calculations for resuscitation.
Which pharmacological intervention is used to treat opioid-induced pruritus in burn patients?
Answer: Nalbuphine (a mixed opioid agonist-antagonist)
Nalbuphine acts as a mu-receptor antagonist and kappa-receptor agonist, reducing opioid-induced pruritus while preserving analgesia.
A burn patient is receiving patient-controlled analgesia (PCA). Which nursing assessment is most critical for safe PCA management?
Answer: Assessing respiratory rate and sedation level hourly
Respiratory depression and over-sedation are the most serious PCA-related adverse effects; hourly assessment of respiratory rate and sedation level is essential for patient safety.
Hypertonic saline resuscitation in burns is thought to offer which advantage over isotonic crystalloids?
Answer: It reduces total fluid volume needed by drawing interstitial fluid into the vasculature
Hypertonic saline's osmotic effect draws fluid from the interstitium into the intravascular space, potentially reducing the total resuscitation volume and edema.
Which statement about methadone use in burn pain management is correct?
Answer: Methadone is useful for chronic burn pain due to its long half-life and NMDA antagonism
Methadone's long half-life provides sustained analgesia and its NMDA receptor antagonism helps combat opioid tolerance, making it useful in chronic burn pain management.