Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

Exam 1 NRS 202 > Management of Patients with Burn Injury > Flashcards

Management of Patients with Burn Injury Flashcards

1
Q

Risk Factors to patients with burn injuries

A

Pre-existing heart, lung, and kidney diseases
DM
Peripheral vascular diseases
Physical weaknesses like alcoholism, malnutrition
Concurrent fractures
Head injuries

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

Goals of Burn Care

A

Lifesaving measures
Prevention of disability and disfigurement
Rehabilitation

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

First degree burns AKA

A

superficial

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

Second degree burns AKA

A

partial thickness

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

Third degree burns AKA

A

full thickness

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

Classification of burn that involves outermost layer of skin and stays intact. It is painful.

A

First degree

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

Classification of burn that involves entire epidermis and varying portions of the dermis. Painful with blisters

A

2nd degree

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

Classification of burn that involves destruction of epidermis, dermis, and underlying tissue Painless.

A

3rd degree

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

Classification of burn that involves necrosis of tissue extending into deep tissue, muscle, or bone.

A

4th degree

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

Types of burns

A

Thermal
Chemical
Electrical

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

Thermal burns can be caused by

A

flame, flash, scald, or contact with hot objects

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

What is the most common type of burn?

A

Thermal

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

The severity of a thermal burn depends on what factors?

A

Temperature of the burning agent
Duration of contact time

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

Chemical burns can result in injuries to?

A

skin, eyes, respiratory system, liver and kidneys

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

What MUST be done with every patient who has an electrical burn?

A

Stabilize C spine

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

Patients with an electrical burn are at risk for?

A

Dysrhythmias or MI
Myoglobinuria

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

Why does myoglobinuria happen in patients with an electrical burn?

A

Injured muscle tissues release myoglobin which travels to the kidneys and blocks the renal tubules

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

Electrical burns are known to cause what phenomena?

A

Iceberg effect

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

Myoglobinuria can lead to?

A

Acute tubular necrosis
Acute kidney injury

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

Factors to consider in determining burn depth

A

How the injury occurred
Causative agent
Temperature of causative agent
Duration of contact w causative agent
Thickness of skin at site of injury

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

Clues of smoke inhalation injury to lower airway

A

Facial burns
Singed nasal hair
Hoarseness
Painful swallowing
Dark mucosal membranes
Carbonaceous sputum**
Enclosed space
Clothing burns around neck and chest

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

What is the cardinal sign of a lower airway injury?

A

Carbonaceous sputum

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

What is carbonaceous sputum?

A

Dark colored sputum

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

3 Zones of Burn Injury

A

Zone of coagulation
Zone of stasis
Zone of hyperemia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
Q

Which zone of burn injury has the most damage?

A

Coagulation

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
26
Q

Which zone of burn injury may be viable or turn necrotic within 24 hrs?

A

Stasis

27
Q

Which zone of burn injury has the least amount of damage?

A

Hyperemia

28
Q

Burns more than __% may produce a local and systemic response and are considered major burns

A

30%

29
Q

Major burn injuries cause fluid shifts and shocks that result in what?

A

Tissue hypoperfusion and organ hypofunction

30
Q

Effects of a Major Burn Injury

A

Fluid and electrolyte shifts
CV effects
Pulmonary injury
Renal and GI alterations
Immunologic alterations
Effect on thermoregulation

31
Q

What type of pulmonary injuries may occur with a major burn?

A

Upper
Lower
CO2 poisoning
Restrictive defects

32
Q

List the emergency response to an on-the-scene burn injury scenario

A
  1. Prevent injury to self - safety check
  2. Stop injury - extinguish flame, cool burn, irrigate chemical burn
  3. ABCs
  4. Start O2 and large bore IVs
  5. Remove restrictive objects and cover wound
  6. Do head-to-toe assessment and obtain med hx
33
Q

Phases of Burn Injury

A

Emergent or resuscitative phase
Acute or intermediate phase
Rehabilitation phase

34
Q

Describe the emergent phase of a burn injury

A

Generalized dehydration
Reduced blood volume
Decreased urine output
Hyperkalemia
Hyponatremia
Metabolic acidosis

35
Q

When does the emergent phase of a burn injury begin and end?

A

At the time of injury to completion of fluid resuscitation

36
Q

When does the acute or intermediate phase of a burn injury begin and end?

A

From beginning of diuresis to wound closure

37
Q

When does the rehabilitation phase of a burn injury begin and end?

A

From wound closure to return to optimal physical and psychosocial adjustment

38
Q

Why is a foley catheter inserted during the emergent phase of a burn injury?

A

To carefully monitor I & O

39
Q

Nursing management of the patient during the emergent/resuscitative phase of a burn injury

A

Fluid resuscitation begins
Foley cath is inserted
NG tube inserted if burns exceed 20%
ECG if electrical burn
IV pain medications as appropriate
Psychosocial needs and support
ABCs
VS and hemodynamic status
Monitor for fluid volume deficit
Assess extent of burnP

40
Q

Potential complications during emergent phase of burn injury

A

Acute Resp Failure
Shock
AKI
Compartment syndrome
Paralytic ileus
Curlings ulcer

41
Q

When a burn injury occurs, immediate _______ in CO precedes loss of plasma volume

A

Decrease

42
Q

Vasoconstrictive compensatory means that the workload of the heart and O2 demand ________ but there is a _______ in CO

A

Increases

Decreases

43
Q

Hypovolemia due to plasma loss results in?

A

Decreased perfusion and oxygen delivery

44
Q

Burn shock is a type of what kind of shock?

A

Hypovolemic shock

45
Q

Appropriate fluid resuscitation does what for our burn patients?

A

Maintains the blood pressure in the low to normal range and improves CO

46
Q

The greatest volume of fluid leak occurs when after a burn injury?

A

The first 24-36 hrs, peaking by 6-8 hrs

47
Q

If fluid resuscitation is too vigorous, the patient will show s/s of?

A

Heart failure or pulmonary edema

48
Q

Superficial burns cause edema how many hours after injury?

A

within 4 hrs

49
Q

Deeper burns can continue to form edema up to how many hours post injury?

A

18 hrs

50
Q

What electrolyte imbalance forms in burn patients due to massive cell destruction?

A

Potassium

51
Q

An incision through full-thickness eschar to relieve pressure

A

Escharotomy

52
Q

3 common GI alteration in burn patients

A

Paralytic ileus
Curlings ulcer
Translocation of bacteria

53
Q

Your burn patient has absence of intestinal peristalsis and decreased bowel sounds, what may they be developing?

A

Paralytic ileus

54
Q

Your burn patient has developed gastric bleeding and is regurgitating coffee ground material from the stomach, what do they have?

A

Curlings ulcer

55
Q

What is the ABA fluid resuscitation formula for adults with a chemical or thermal burn?

A

2 mL x kg (weight) x %TBSA

One half of the fluid is given in the first 8 hrs from time of injury
The rest is given in the next 16 hrs

56
Q

What is the ABA fluid resuscitation formula for adults with an electrical burn?

A

4 mL x kg (weight) x %TBSA

One half of the fluid is given in the first 8 hrs from time of injury
The rest is given in the next 16 hrs

57
Q

Adequacy of urine output for a thermal or chemical burn is

A

0.5-1 mL/kg/hr or 30-50 mL/hr

58
Q

Adequacy of urine output for an electrical burn is

A

75-100 mL/hr

59
Q

Nursing Interventions for Acute/Intermediate Burn Injury Phase

A

Continue to assess and maintain respiratory and circulatory support
Fluid and electrolyte balances
GI and renal function
Infection prevention
Burn wound care
Pain management
Early positioning and mobility

60
Q

Potential complications during the acute/intermediate phase of burn injury

A

Acute Resp Failure
ARDS
Heart failure
Pulmonary edema
Sepsis
Delirium
Visceral damage

61
Q

Describe the Acute/Intermediate Phase of a burn injury

A

Fluid reenters vascular spaces
Increased urinary output
Hyponatremia
Hypokalemia (potential)
Metabolic acidosis

62
Q

Goals of burn wound care

A

Infection prevention
Promote tissue growth or successful skin grafting

63
Q

Types of burn pain

A

Background/resting
Procedural
Breakthrough

64
Q

Nonpharmacologic pain control for burns

A

Relaxation breathing
Distraction - itching
Guided imagery
Music
Hypnosis
Therapeutic touch
Humor

Exam 1 NRS 202 (7 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions