Can you help with the following questions

Can you help with the following questions for this scenario? Please You are working in the emergency department (ED) of a community hospital when the ambulance arrives with A.N., a 28-year-old woman who was involved in a house fire. She was sleeping when the fire started and managed to make her way out of the house through thick smoke. The emergency medical system crew started 100% humidified oxygen at 10L/min per non-rebreather mask and started a 16-gauge IV with lactated Ringer’s solution. On arrival in the ED, her vital signs are BP – 98/58, P-125, R-32, SpO2 91%. She is alert and oriented x4 and appears anxious and in pain. Interpret the following lab results Laboratory Test Values Hgb 12 g/dL WBC 15,000 Hct 51% K 6.9 mEq/dL (6.9 mmol/L) Na 133 mEq/dL (133 mmol/L) Cl 95 mEq/dL (95 mmol/L) Glucose 159 mg/dL (8.8 mmol/L) BUN 28 mg/dL (10.0 mmol/L) Creatinine Kinase 300 units/L ANSWER: Hgb 12 g/dL – within normal (N: 12 – 15.5 g/dL in women) Hct 51% – increased and shows fluid loss WBC 15,000 – increased due to inflammatory response (N – 4,500-11,000) K 6.9 mEq/dL – increased (N- 3.5-5.5) because of injuries that cause potassium to leak. Na 133 mEq/dL – this is decreased due to sodium loss due to plasma leaking as well as sodium trapping in the fluids contributing to pt edema; she is hyponatremic. Cl 95 mEq/dL – not a significant decrease (N – 96-106 mEq) it’s decreased by 1 point so it’s not really significant. Glu 159 mg/dL – this is increased due to uptake alterations related to tissue injury as well as the pt.’s stress response BUN 28 mg/dL – this is elevated and related to fluid loss (Kidney function) Creatinine Kinase 300 units/L- increased means the kidneys are affected because of decreased fluid volume. Also related to kidney function (N – 30 – 145 u/L) 2. The physician increases A.N.’s IV rate and orders a new set of lab investigations. Compare the current results below with those from admission. Laboratory Test Values Hgb 14 g/dL WBC 13,000 Hct 59% K 5.7 mEq/dL (5.7 mmol/L) Na 128 mEq/dL (128 mmol/L) Cl 92 mEq/dL (92 mmol/L) Glucose 122 mg/dL (6.8 mmol/L) BUN 38 mg/dL (13.6 mmol/L) Creatinine Kinase 190 units/L ANSWER? 3. A.N. is in severe pain. What is the drug of choice for pain relief after burn injury, why, and how should it be given? ANSWER? 4. By the end of the shift, which assessment findings would best indicate that A.N. is responding to therapy? Justify. Respiratory rate 22; BP 120/74 BP 120/70; urine output 25 mL/hr. for past 4 hours BP 104/64; urine output 40 mL/hr. for past 4 hours Heart rate 110; urine output 20 mL/hr. for past 4 hours 5. A.N. has one area of circumferential burns on her right lower leg. What complication is she in danger of developing? How will you monitor it? 6. A.N. is ordered a special burn diet. She has always gained weight easily and is concerned about the size of the portions. What diet-related teaching will you provide? SCIENCE HEALTH SCIENCE NURSING NURSING 232

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