NR 328 Final Exam Peds study guide Final Exam ● Partial Thickness burns (maybe treatment?) ○ Types ■ Superficial ● Second degree ○ Damage to the entire epidermis ○ Dermal elements are intact ● Appearance ○ Painful, moist, red in color with blisters ○ Mild to moderate edema ○ No eschar ● sensation/ healing ○ Painful ○ Heals in less than 21 days ○ Variable amounts of scarring ○ Sensitive to temperature changes ○ Exposure to air and light touch ■ Deep ● Second degree ○ Damage to the entire epidermis and some parts of the dermis ○ Sweat glands and hair follicles remain intact ● Appearance ○ Mottled, red and white in color in blisters and moderate edema ○ Blanches with pressure ● Sensation/ healing ○ Painful ○ Sensitive to temperature changes in the light touch ○ Healing time can extend beyond 21 days ○ Scarring likely ○ Treatment ■ Mild ● Stop the burning process ● Cover the burn with a clean cloth to prevent contamination ● Cleanse with mild soap and tepid water ● Do not remove blisters ● Apply dress 1 / 2
○ Nonadherent: fine-mesh gauze
○ Hydrocolloid: occlusive dressing
● Provide warmth ● Check immunizations ● Avoid greasy lotions or butter on burns ● Educate the family to monitor for manifestations of infection ■ Major ● Maintain airway and ventilation ● Provide 100% O2 ● Monitor VS ● Maintain cardiac output ● Initiate IV access with large-bore catheter ● Fluid replacement ● Monitor for septic shock ● Manage pain ● Prevent infection ○ Change position ○ Limit visitors ● Provide nutrition ● Restore mobility ● Provide Psychological support ● Vision Screening for a 4-year-old ○ This is completed using the Snellen letter, tumbling E, or picture chart (HOTV test) useful for preschoolers ○ Place the child 10 feet from the chart with heels on the 10-foot mark.○ The child should be wearing glasses, if appropriate, and keep both eyes open during the screening.○ While covering one eye, the child reads each line on the chart, starting at the bottom of the chart, until he can pass a line.○ The child needs to identify four of the six characters in the line correctly to pass.○ The child is then asked to start at the top and move down until he can no longer pass a line.○ The procedure is repeated with the other eye.● Wilms Tumor ○ Do not palpate the abdomen ● If you suspect abuse of a child what do you do?○ Bruises ○ 1 st action that needs to be taken ● Cardinal cancer signs
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