CBRN Fluid Resuscitation & Pain Control 5

Question 1

A 55 kg patient with 25% TBSA burns arrives 3 hours post-injury. How much fluid should be infused over the remaining 5 hours of the first 8-hour period?

Accepted Answer

1,375 mL

Answer

Total 24h = 4×55×25 = 5,500 mL; first 8h share = 2,750 mL; 3 hours already elapsed leaves 5 hours, so infuse 2,750 mL over those 5 hours at 550 mL/hr, totaling 1,375 mL in the next ~2.5h — the rate is 550 mL/hr over the remaining 5 hours delivering 2,750 mL, so the remaining volume is the full 2,750 mL.

Question 2

Which sign most strongly suggests compartment syndrome in a circumferentially burned extremity?

Accepted Answer

Pain with passive stretch of muscles in the affected compartment

Answer

Pain out of proportion with passive muscle stretch is the most sensitive early indicator of compartment syndrome requiring urgent escharotomy or fasciotomy.

Question 3

Alpha-2 agonists (e.g., dexmedetomidine) are used in burn ICU patients primarily to:

Accepted Answer

Provide sedation and opioid-sparing analgesia while maintaining arousability

Answer

Dexmedetomidine provides sedation and reduces opioid requirements while allowing the patient to remain arousable, which is beneficial for neurologic monitoring.

Question 4

Inhalation injury is present in a burn patient. How does this affect fluid resuscitation?

Accepted Answer

It increases fluid requirements beyond standard formula predictions

Answer

Inhalation injury increases systemic inflammation and pulmonary edema risk, typically increasing actual fluid requirements above formula-predicted volumes.

Question 5

The FLACC scale is used in burn patients who are:

Accepted Answer

Critically ill, preverbal, or cognitively impaired and cannot self-report pain

Answer

FLACC (Face, Legs, Activity, Cry, Consolability) assesses pain via behavioral observation and is validated for patients unable to self-report, including preverbal children and cognitively impaired adults.

(CBRN) Certified Burn Registered Nurse Practice Test

(CBRN) Certified Burn Registered Nurse Practice Test

CBRN Fluid Resuscitation & Pain Control 5