Burns and Burn Injury Q 93 - Gyan Darpan : Learning Portal
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Wednesday 30 March 2022

Burns and Burn Injury Q 93

What clinical manifestation should alert the nurse to possible carbon monoxide poisoning in a client who experienced a burn injury during a house fire?
    A. Pulse oximetry reading of 80%
    B. Expiratory stridor and nasal flaring
    C. Cherry red color to the mucous membranes
    D. Presence of carbonaceous particles in the sputum

Correct Answer: C. Cherry red color to the mucous membranes

The saturation of hemoglobin molecules with carbon monoxide and the subsequent vasodilation induces a “cherry red” color of the mucous membranes in these clients. Cherry-red skin color associated with severe carbon monoxide poisoning is seen in only 2-3% of symptomatic cases. Skin may develop erythematous lesions and bulla, especially over bony prominences.

Option A: Carbon monoxide quickly binds with hemoglobin with an affinity greater than that of oxygen to form COHb. The resulting decrease in arterial oxygen content and shift of the oxyhemoglobin dissociation curve to the left explains the acute hypoxic symptoms (primarily neurologic and cardiac) seen in patients with acute poisoning.
Option B: Patients suffering from smoke inhalation may have symptoms of burning sensation in the nose or throat (which is often caused by an irritant chemical toxin), a cough with increased sputum production, stridor, and dyspnea with rhonchi or wheezing.
Option D: The other manifestations are associated with inhalation injury, but not specifically carbon monoxide poisoning. Physical examination should include looking for facial burns, such as loss of facial and intranasal hair as well as carbonaceous material or soot in the mouth or sputum.

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