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Exam 24: Burns, adverse Effects, and Poisonings

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Question 21

True/False

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When the reason for the admission or encounter is to provide treatment for external multiple burns,sequence first the code that reflects the burn of the highest degree.

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Question 22

Multiple Choice

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Match the following Z codes. -Allergy other than to medicinal agents-milk products

A) Z69.020
B) Z88.8
C) Z91.030
D) Z88.7
E) Z91.010
F) Z91.89
G) Z91.011
H) Z91.410

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Question 23

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Battered spouse syndrome: Confirmed abuse by her husband: __________

The patient reported to the ER with nausea/vomiting and weakness.The patient is on OxyContin for chronic pain due to unresectable pancreatic cancer.The patient was in extreme pain and decided to double the OxyContin dosage.When this did not relieve the pain,the patient decided to drink a couple of shots of whiskey.The patient got very weak and called 911.The patient was volume depleted and was treated with IVs;his pain medications were adjusted.Final Diagnosis: Accidental overdose of OxyContin.Pain due to pancreatic cancer.

In a toxic poisoning,the toxic poisoning code (T36-T50) should be sequenced first,followed by the external cause code(s).

Match the following Z codes. -History of physical abuse,adult

Patient admitted for a suicide attempt with multiple medications,including Naproxen,Keppra,and acetaminophen mixed with beer.Patient was somnolent on arrival in the ER.

Patient was admitted with second-degree burns of the left hand and first-degree burns of the left forearm.The patient touched a hot steam pipe.

All of the following are to be considered when one is questioning whether a poisoning has occurred EXCEPT whether the ____.

Debridement is one of the most common procedures performed on burn victims.

The patient was admitted with hematemesis.The patient has been taking NSAIDs as directed by the physician for arthritis pain.EGD showed that the patient had an acute erosive gastritis,most likely due to NSAIDs,that is the likely cause of the bleeding.Final Diagnosis: Erosive gastritis with hemorrhage due to NSAIDs.Procedure: EGD with gastric biopsy.

Match the following Z codes. -History of poisoning

A patient was admitted because of an intentional overdose of Valium.The patient is in a coma.

Debridements must always be done in the OR.

Patient had an adverse reaction to Cipro: __________

Active treatment of non-healing second-degree burn to right forearm due to hot iron while ironing (accidental): __________

Match the following Z codes. -Personal history of allergy to medicinal agents-serum or vaccine

Match the following degrees of burns. -Erythema or redness of the skin

External cause code(s) are never used to identify the cause and intent of the injury or poisoning.

The patient was admitted with acute renal failure.The patient had been treated by Home Health with IV gentamicin for Pseudomonas pneumonia.The patient was experiencing some edema and decreased urine output.Blood was drawn,and the physician admitted the patient for IV fluids and investigation of the patient's renal status.Gentamicin was stopped,and another antibiotic was given.The patient's renal function returned to normal.Final Diagnosis: Acute renal failure due to gentamicin.Recent pneumonia.