Chapter 34: Thermal Injuries Buttaro: Primary Care: A Collaborative Practice, 6th Edition

Multiple Choice

1. A provider attending a soccer match on a hot day is assisting a player who feels hot and appears dehydrated, but who is alert and oriented. What does the provider suspect?

a. Heat cramps b. Heat exhaustion c. Heat stroke d. Heat syncope

ANS: B a. Administer antipyretic medications to reduce the temperature. b. Administer intravenous fluids in the clinic and monitoring response. c. Rehydrate the patient with oral fluids containing electrolytes. d. Transport the patient to the emergency department (ED).

Heat exhaustion is present when patients have excessive sweating accompanied by sodium and water loss. Heat cramps involve muscle pains or spasms. Heat stroke causes a core body temperature of >106°F. Heat syncope causes fainting or dizziness.

2. A patient is brought to a clinic after fainting while working outdoors on a hot day. The patient has slurred speech and headache and has a temperature of 104°F. What will the provider do?

ANS: D

This patient has CNS signs and an elevated temperature with a history consistent with heat stroke. This patient should be immediately transported to an emergency department. Antipyretic medications are not useful for treating thermal injury. The patient will be given IV fluids and electrolytes in the ED. Oral rehydration is not indicated.

Multiple Response

NURSINGTB.COM a. Administer antibiotics. b. Apply warmed blankets. c. Elevate the child’s extremities. d. Massage the hands and feet. e. Remove all wet clothing.

1. A child is brought to the emergency department after getting lost while camping on a cold, rainy day. The child is lethargic on admission. The cardiorespiratory monitor shows a normal heart rate and rhythm, a respiratory rate of 8 to 10 breaths per minute, and a normal blood pressure. The assessment reveals erythema and edema of the child’s hands and feet. What treatments are indicated? (Select all that apply.)

ANS: B, C, E

The child has signs of frostbite without other systemic signs. Warming with warm blankets is indicated. The affected areas should be elevated, but not massaged or rubbed. The providers should remove the child’s clothing which may be restrictive or wet and examine the child’s entire skin surface for other signs of frostbite. Antibiotics are not given unless signs of infection are present.