during the acute phase of burn the priority nursing intervention in caring for this client is
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Nursing Elites

ATI RN

ATI RN Nutrition Online Practice 2019

1. During the acute phase of a burn, the priority nursing intervention in caring for this client is:

Correct answer: D

Rationale: During the acute phase of a burn, fluid resuscitation is the priority nursing intervention. This phase is characterized by fluid loss and the risk of hypovolemic shock. Administering fluids is crucial to maintain perfusion and prevent complications such as organ failure. While prevention of infection, pain management, and prevention of bleeding are important aspects of burn care, fluid resuscitation takes precedence in the acute phase to stabilize the client's condition and prevent further damage.

2. Systemic disease often manifests in the oral cavity first. Disease within the oral cavity can cause systemic complications.

Correct answer: A

Rationale: Both statements are true. Systemic diseases can often present with oral manifestations before other systemic signs appear. Additionally, oral diseases can have systemic implications by affecting a person's overall health, such as through inflammation or compromised nutrient intake. Choice B is incorrect because both statements are true, as supported by medical literature. Choice C is incorrect because the second statement is also true. Choice D is incorrect because the first statement is true.

3. During the first 24 hours after the thermal injury, you should assess Sergio for:

Correct answer: D

Rationale: During the initial phase after a thermal injury, the major concern is the release of potassium due to cell damage, leading to hyperkalemia. Hypernatremia is not typically a primary concern in the immediate post-injury phase. Hyponatremia is less likely to occur initially after a burn injury. Therefore, the correct assessment for Sergio during the first 24 hours after the thermal injury would be hyperkalemia and hypernatremia.

4. Which vitamin deficiency is most likely to be associated with increased risk of macular degeneration?

Correct answer: D

Rationale: Vitamin E is an antioxidant that helps protect eye health and prevent macular degeneration.

5. Where does carbohydrate digestion begin?

Correct answer: A

Rationale: Carbohydrate digestion begins in the mouth. The enzyme amylase, found in saliva, starts the process by breaking down starches into sugars. The esophagus is a passageway for food to reach the stomach and does not participate in digestion. The stomach mainly digests proteins and is not the primary site for carbohydrate breakdown. While the small intestine does play a crucial role in digesting carbohydrates, it is not where the process initiates. Therefore, the correct answer is the mouth.

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