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COMPLEX > burns + transplant > Flashcards

burns + transplant Flashcards

1
Q

what are the types of burns?

A
  • thermal
  • chemical
  • smoke inhalation injury
  • electrical
  • cold thermal
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2
Q

what are the common causes of thermal burns?

A
  • flame
  • flash
  • scald
  • contact with hot objects
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3
Q

thermal burns are the most common type of burn injury

A

true

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4
Q

what are the factors that affect the severity of burn injury?

A
  • temperature of burning agent
  • duration of contact
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5
Q

partial thickness burn

A
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6
Q

full thickness burn

A
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7
Q

what are the common causes of chemical burns?

A

contact with
* acids
* alkalis
* organic compounds

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8
Q

why are alkali burns more difficult to manage?

A

leads to protein hydrolysis & melting

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9
Q

where are alkalis most commonly found?

A
  • cement
  • oven cleaners
  • drain cleaners
  • heavy metal cleaners
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10
Q

which organic compounds can be found in alkalis?

A
  • phenols
  • petroleum products
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11
Q

a patient arrives in the ED following an accidental fall in wet cement at a construction site, what type of burn injury does the nurse expect to be sustained?

A

chemical burn

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12
Q

what are the causes of smoke inhalation injury?

A

inhaling
* hot air
* noxious chemicals

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13
Q

what types of complications following a smoke inhalation injury can rapidly develop?

A
  • airway compromise
  • pulmonary edema
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14
Q

what are the types of smoke inhalation injuries?

(3)

A
  • upper airway
  • lower airway
  • metabolic asphyxiation
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15
Q

how does metabolic asphyxiation occur?

A

CO & hydrogen cyanide are inhaled

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16
Q

metabolic asphyxiation can lead to what complications?

A
  • hypoxia
  • elevated carboxyhemoglobin levels
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17
Q

carboxyhemoglobin levels of greater than 20% leads to imminent death

A

true

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18
Q

definition

upper airway injury

A

injury to mouth, oropharynx, & larynx

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19
Q

a physical assessment of a patient in the ED reveals their oral mucosa is red, blistered, & edematous, what type of injury did they sustain?

A

upper airway injury from smoke inhalation

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20
Q

why is the nurse’s priority in caring for a patient with an upper airway injury from smoke inhalation to ensure patent airway?

A

eschar & edema from the injury will quickly obstruct the airway and compromise breathing

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21
Q

definition

lower aiway injury

A

injury to
* trachea
* bronchioles
* alveoli

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22
Q

how long does it typically take for pulmonary edema to manifest following a lower airway injury?

A

12-48 hours

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23
Q

pulmonary edema from lower airway injury first manifests as

A

ARDS

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24
Q

definition

electrical burns

A

injury from intense heat generated from an electric current

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25
Q

electrical burns will result in damage to nerves & vessels

A

true

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26
Q

what are the categories that are included in the depth of burn?

A
  • partial thickness (superficial & deep)
  • full-thickness
27
Q

what are factors that determine the severity of injury?

A
  • depth
  • extent (TBSA)
  • location
  • age(young & elderly pt’s most likely critical)
  • pre-burn medical Hx
28
Q

characteristics

superficial partial-thickness burn

A
  • epidermis
  • first-degree
29
Q

characteristics

deep partial-thickness

A
  • dermis
  • second degree
30
Q

characteristics

full-thickness burn

A
  • involves skin elements, nerve endings, fat, muscle, bone
  • third/ fourth degree
31
Q

how is TBSA determined?

A

rule of nines

32
Q

Rule of Nines

A
  • 18% (torso)
  • 9% (lower extermities)
  • 4.5% (upper extremities, head)
  • 1% (genitals)
33
Q

burns to the ears, nose, & genitals pose a higher risk for infection

A

true

34
Q

what are the phases of burn management?

A
  • emergent
  • acute
  • rehabilitative
35
Q

definition

emergent phase of burn management

A

time required to resolve immediate problems resulting from injury

36
Q

how long does the emergent phase of burn management take?

A

72 hours

37
Q

what are the main concerns during the emergent phase (1) of burn management?

A
  • hypovolemic shock
  • edema
  • paralytic ileus
38
Q

what are the resuscitative measures taken during the emergent phase of burn management?

A
  • fluid mobilization (counter hypovolemic shock)
  • diuresis
39
Q

what are the common clinical manifestations of burns?

A
  • hypovolemic shock
  • paralytic ileus (no bowel sounds)
  • pain
  • blisters
  • AMS
  • shivering
40
Q

what is the nursing management for partial-thickness burn during the acute phase?

A
  • escharotomy
  • facilitate skin re-epithelization
41
Q

what is the medical management for full-thickness burn during the acute phase (2)?

A
  • skin grafting
  • surgical debridement
42
Q

what are the nursing actions for airway management regarding burns?

A
  • high fowlers
  • CPT
  • bronchodilation
  • escharotomies of the chest
  • humidified 100% O2
  • fiberoptic bronchoscopy
  • intubation
43
Q

what are the nursing actions for fluid therapy?

A
  • use Parkland Burn formula
  • initiate central lines or 2 large bore IV lines
44
Q

when is it appropriate to initiate 2 large bore IV lines?

A

fo TBSA of greater than 15%

45
Q

when is a central line appropriate?

A

for burns greater than 20% of TBSA

46
Q

what are the purposes of starting arterial lines in burn patients?

A
  • invasive BP monitoring
  • drawing frequent ABGs
47
Q

what is the purpose of the Parkland Burn formula?

A

to calculate the amount of IV fluids needed for the first 24 hours after a burn injury of greater than 20% ONLY

48
Q

Parkland Burn formula

A

(4mL) x (weight) x (% TBSA) = volume of fluids w/in 24 hours

49
Q

what are the guidelines for appropriately following the Parkland burn formula in administering the correct amount of fluids?

A
  • first 8 hrs: 1/2
  • second 8 hrs: 1/4
  • third 8 hrs: 1/4

FIRST 8 IS CRUCIAL!!

50
Q

patients who suffered from burns are allowed to take showers once daily

A

true

51
Q

how often do dressing changes occur for patients who suffered from burns?

A

twice a day in the morning and night

52
Q

for how long are antimicrobial dressings left in place?

A

3-14 days

53
Q

nurses need to don PPE when caring for patients with open burn wounds

A

true

54
Q

nurses must use strerile gloves when applying antimicrobial ointment & sterile dressings on a burn patient

A

true

55
Q

why can hyperkalemia occur in a burn patient?

A

large amounts of potassium are released into the bloodstream by damaged cells from burns

56
Q

what happens during the acute phase of burn management?

A

mobilization of extracellular fluid & subsequent diuresis

57
Q

when does the rehabilitative phase in burn management begin?

A
  • partial thickness wounds have healed
  • full thickness burns are covered by skin grafts
58
Q

what are the signs of organ rejection?

A
  • flu-like symptoms
  • fatigue
  • fever
  • organ specific symptoms
58
Q

what indicates successful fluid resus during the emergent phase of burn management?

A

diuresis

59
Q

what are the types of organ rejection?

A
  • hyperacute rejection
  • acute rejection
  • chronic rejection
60
Q

characteristics

hyperacute rejection

A
  • within 24 hours of transplant
  • must remove organ
61
Q

characteristics

acute rejection

A
  • within 6 months of transplant
  • must increase immunosuppressants
62
Q

why is there a need to increase immunosuppressants in organ rejection?

A

prevent further rejection & save the organ

63
Q

characteristics

chronic rejection

A

within months or years; typically irreversible

COMPLEX (11 decks)

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