Nursing Care of burns

Question 1

at the scene

Answer 1

-remove: source of fire or burning & clothing/jewelry
-apply cool water soaks or run cool water over injury (not ice)
-chemical burns (flushed with the appropriate neutralizing agent
-cover burn with a clean cloth
-provide warmth
-perform ABCDE primary survey and provide treatment

Question 2

Emergent/Resuscitative Phase

Answer 2

-duration: from onset of injury to completion of fluid resuscitation
-Priorities: ABCDE, prevention of shock, prevention of respiratory distress, detection and treatment of injuries, wound assessment and initial care

Question 3

ABCDE of burns

Answer 3

airway
breathing
circulatory & cardiac status
disability (broken/wounds)
expose/examine

Question 4

fluid resuscitation

Answer 4

-initiated in burns are greater than 20% TBSA
-under and over resuscitation are associated with outcomes
–Under: shock, ischemic complications, MODS
–over: heart failure, pulonmary edema

Question 5

at gage needle do you want for fluids?

Answer 5

16 or 18

Question 6

Acute/intermediate phase

Answer 6

-begins 48-72 hours after the burn
-clinical findings:
–upper airway edema
–changes in xray, ABGs as effects of fluid resuscitation, chemical reaction of smoke in lung tissue, carboxyhemoglobin, bronchoscopy
–use caution with fluid/electrolytes
–hyperthermia
–early excision

Question 7

Wound debridement

Answer 7

-when: early and intermediate phases

-goals of debridement: removal of devitalized tissue or burn eschar & removal of tissue contamination by bacteria and foreign bodies

-types: natural (peeling), mechanical, chemical, surgical

Question 8

Pain management

Answer 8

-burns are one of the most painful types of trauma a person can experience (exposes nerve endings, debridement & surgeries moving, therapy)

Question 9

nutrition

Answer 9

require greater than 5000 calories

Question 10

complications during rehabilitation phase

Answer 10

-neuropathies
-wound breakdown
-scarring
-joint instability
-contractures
-complex pain