Page 2434 - Saunders Comprehensive Review For NCLEX-RN

The airway is a priority concern in an

inhalation injury.
b. Assessment (Box 69-9)

2. Carbon monoxide poisoning
a. Carbon monoxide is a colorless,
odorless, and tasteless gas that has an
affinity for hemoglobin 200 times
greater than that of oxygen.
b. Oxygen molecules are displaced and
carbon monoxide reversibly binds to
hemoglobin to form
carboxyhemoglobin.
c. Tissue hypoxia occurs.
d. Assessment (Table 69-6)

3. Direct thermal heat injury
a. Thermal heat injury can occur to the
lower airways by the inhalation of
steam or explosive gases or the
aspiration of scalding liquids.
b. Injury can occur to the upper airways,
which appear erythematous and
edematous, with mucosal blisters and
ulcerations.
c. Mucosal edema can lead to upper
airway obstruction, especially during
the first 24 to 48 hours.
d. All clients with head or neck burns
should be monitored closely for the
development of airway obstruction
and are considered immediately for
endotracheal intubation if obstruction
occurs.
e. Assessment: findings include erythema
and edema of the upper airways and
mucosal blisters and ulcerations
F. Pathophysiology of burns
1. Following a burn, vasoactive substances are released
from the injured tissue, and these substances cause an
increase in capillary permeability, allowing the
plasma to seep into the surrounding tissues.
2. The direct injury to the vessels increases capillary
permeability (capillary permeability decreases 18 to
26 hours after the burn but does not normalize until 2
to 3 weeks following injury).

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