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Med Surg I > Wk 4 Burns > Flashcards

Wk 4 Burns Flashcards

1
Q

What are the 6 types of burns?

A

Thermal
Chemical
Inhalation
Electrical
Radiation
Extreme temperature

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2
Q

What is the most common type of burn?

A

Thermal

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3
Q

What is a chemical burn?

A

Exposed to acid, alkaline, or chemicals

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4
Q

What happens during an inhalation burn?

A

Causes oral/nasal, esophageal, and direct parenchymal lung injury

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5
Q

Who is at risk for extreme temperature burns?

A

Children and the elderly due to their reduced ability to generate heat

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6
Q

What 5 factors influence severity of a burn?

A

Depth
% of body covered
Location
Age of patient
Health of patient

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7
Q

If the burn is severe enough the patient will be transferred to..

A

a burn center

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8
Q

What is a second degree burn?

A

Includes epidermis and dermis

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9
Q

What is another name for a second degree burn?

A

Deep partial thickness

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10
Q

What is a third degree burn?

A

Full thickness, includes all layers

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11
Q

What is a 1st degree burn called?

A

Superficial partial thickness

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12
Q

A third and fourth degree burn, a patient may not…

A

feel because the nerves are destroyed

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13
Q

% of body burned

A

Rule of Nines

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14
Q

The head accounts for __% of rule of nines

A

4.5% (on one side)

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15
Q

The torso accounts for __% of rule of nines

A

18% (on one side)

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16
Q

The legs account for __% of rule of nines

A

9% each, on one side

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17
Q

The arms account for _% of rule of nines

A

4.5% each, on one side

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18
Q

The groin area accounts for __% of rule of nines

A

1%

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19
Q

What are the 3 phases of burn management

A

Emergent/Resuscitative Phase
Acute Phase
Rehabilitative Phase

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20
Q

How long does the emergent phase last for?

A

Up tp 72 hours from the time the burn occurred

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21
Q

What are the main concerns in the emergent phase of burns?

A

Hypovolemic shock
Edema formation

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22
Q

When does the emergent phase end?

A

Fluid mobilization and diuresis begins

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23
Q

What is the pathophysiology (general) of the emergent phase of a burn?

A

Massive fluid and electrolyte shift related to massive increase in capillary permeability

24
Q

What is the primary concern with the emergent phase?

A

Hypovolemic shock

25
Q

What is a circumferential burn?

A

A burn that goes all the way around the extremity

26
Q

What are thew 2 major concerns of the cardiovascular system during the emergent phase of a burn?

A

Shock and increased blood viscosity, + VTE
Circumferential burns and edema impair circulation

27
Q

What might a provider need to do to restore circulation during the emergent phase of a burn?

A

Escharotomy

28
Q

What is an escharotomy?

A

full-thickness incision through the eschar, exposing the subcutaneous fat

29
Q

This is an example of a…

A

Escharotomy

30
Q

What are we concerned about with the pulmonary system during the emergent phase of a burn?

A

upper and lower airway

31
Q

What is the concern with the urinary system during the emergent phase of a burn?

A

Acute renal failure

32
Q

Why do the kidneys shut down during the emergent phase of a burn?

A

Decreased blood flow (from hypovolemic shock)

Excessive myoglobin and hemoglobin released can block renal tubules

33
Q

What is the number 1 nursing management during the emergent phase of a burn?

A

Airway management

34
Q

What is the number 2 nursing management of the emergent phase of a burn?

A

Fluid therapy

35
Q

A patient in the emergent phase of a burn will have have type of IV/fluids

A

2 large bore IV’s or CVAD

Fluid resuscitation

36
Q

What are the IV fluids that are typically used during an emergeny phase of a burn? (2)

A

Crystalloids (Lactated Ringers)

Colloids (Albumin)

or both

37
Q

What is the reason behind infusing large amounts of fluid into a patient in the emergent phase of a burn?

A

Increase blood volume to increase cardiac output

38
Q

What is a fasciotomy?

A

a surgery to relieve swelling and pressure in a compartment of the body, cut into the fascia

39
Q

When burn wounds are exposed, you must

A

PPE (hat, mask, gown, gloves)

Sterile gloves to apply ointments/dressings

40
Q

How warm should a burn patient’s room be in the emergent phase of a burn?

A

85 degrees

41
Q

Drug therapy for burns includes…

A

Opiods

Sedatives

Tetanus immunization

Topical antimicrobials

VTE Prophylaxis

42
Q

What is a topical antimicrobial agent used in burns?

A

Silver sulfadiazine

43
Q

What is the name brand for silver sulfadiazine?

A

Silvadene

44
Q

When are systemic antibiotics used in burn patients?

A

Concerns regarding sepsis

45
Q

What is the leading cause of death in burns?

A

Sepsis

46
Q

What type of feeding would a burn patient be on?

A

Enteral to treat extreme hypermetabolic state

47
Q

When does the acute phase of a burn begin?

A

With mobilization of extracellular fluid and subsequent diuresis

48
Q

When does the actue phase end?

A

When partial-thickness wounds are healed and full-thickness are covered by skin grafts

49
Q

How long is the acute phase?

A

Takes weeks to months

50
Q

With partial thickness, there is eschar formation, it is then…

A

Removed for regeneration of epithelium

51
Q

With full thickness burns, the eschar takes longer…

A

to separate. Surgical debridement and skin grafting is common

52
Q

A burn patient may need what types of therapy?

A

PT

OT

Psychiatry

53
Q

What are the 2 goals of the rehabilitation phase?

A

Working toward resuming functional role in society

Rehabilitate from any reconstructive surgery that may be needed

54
Q

What do you want to avoid during the rehabilitation phase?

A

Contractures and hypertrophic scarring

55
Q

What helps keep scars flat?

A

Pressure garments

56
Q

What else might a patient need to do in the rehabilitation phase?

A

Schedule ROM

Med Surg I (41 decks)

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