A child is brought to the emergency department from a house fire. ...

[Mimi]

A child is brought to the emergency department from a house fire. She has singed eyebrows and sounds hoarse. After applying oxygen, which action by the nurse takes priority?
 
  A.
  Assemble intubation equipment.
  B.
  Gently cleanse any burn wounds.
  C.
  Place child on a cardiac monitor.
  D.
  Prepare to give pain medication.

Question 2

A child has been in the burn unit for 13 days. Which nursing assessment indicates that a priority goal has been met?
 
  A.
  Decreased albumen over 5 days
  B.
  Intake equals output for 24 hours
  C.
  Participates in dressing changes
  D.
  Weight gain of 0.5 kg in 1 week

[mrphibs]

Answer to Question 1

ANS: A
All actions are appropriate for this child; however, airway patency is always the priority. This child has manifestations that cause the nurse to consider an inhalation injury. Swelling can occur rapidly, cutting off the airway. The nurse applies oxygen and ensures intubation supplies are nearby. If needed, the nurse delegates this activity. The child should be placed on a cardiac monitor, but because this is not related to airway, this is not the priority. Pain medication will be an important intervention, as is burn care, but, again, they are not the priority over airway.

Answer to Question 2

ANS: D
Nutrition is an important problem for the child with burns, as the child is hypermetabolic and needs a high-calorie, high-protein diet. Children are generally weighed twice a week in the burn center. A weight gain shows that nutritional needs are being met. Albumen should increase with improved nutrition, but remember that this laboratory value lags behind other indicators of nutrition. Participating in dressing changes shows evidence of meeting a psychosocial goal, but that would not take priority over a physical problem. Intake should be more than output because of the insensible losses.