Burns

Question 1

Why does plasma seep out into the tissue

Answer 1

increased capillary permeability

Question 2

when does the majority of plasma seep out into tissue

Answer 2

first 24 hours

Question 3

why does the pulse increase

Answer 3

anytime someone is in a FVD the pulse will increase because the heart works harder

Question 4

why does the cardiac output decrease

Answer 4

less volume to pump out

Question 5

why does the urine output decrease

Answer 5

kidneys are either trying to hold on to fluid or they aren’t being professed adequately

Question 6

how long does it take to hurt kidneys with poor perfusion

Answer 6

20 minutes

Question 7

why is epinephrine secreted

Answer 7

epinephrine and norepinephrine secretin make you peripherally vasoconstrict, bloodies shunted to the vital organs

Question 8

why are ADH and aldosterone secreted

Answer 8

retain sodium and water with aldosterone and retain water withADH causing blood volume to go up

Question 9

does the burning process stop when flames are gone

Answer 9

no

Question 10

what is the number one cause of death in burns

Answer 10

inhalation injury

Question 11

what causes inhalation injury

Answer 11

inhaling carbon monoxide or hydrogen cyanide

Question 12

what does oxygen bind with

Answer 12

hemoglobin

Question 13

what happens to hemoglobin when carbon monoxide is present

Answer 13

Carbon monoxide attaches to hemoglobin before oxygen can causing hypoxia

Question 14

why does it matter if a burn occurred inside or outside

Answer 14

if the burn is in a closed space they will inhale more carbon monoxide or hydrogen cyanide so the risk for complications is increased

Question 15

when you see a Client with neck, face, chest burns what do you focus on

Answer 15

airway

Question 16

what may be done to prophylactically treat airway

Answer 16

intubate because the airway will swell

Question 17

indicators of inhalation injury

Answer 17

singed nose hair
singed facial hair
soot on face
coughing up secretions with dark/black specks
difficult swallowing
wheezing
blisters found on the oral/pharngeal mucosa
hoarseness
susternal intercostal retractions and stridor

Question 18

does more death happen with upper or lower body burns

Answer 18

upper

Question 19

why do you avoid broad spectrum antibiotics

Answer 19

their usage could lead to super infections and/or sepsis

Question 20

what is the exception to broad spectrum antibiotic use

Answer 20

use them until wound cultures return

Question 21

when do you obtain wound cultures

Answer 21

before you start ABX

Question 22

what should you monitor when giving mycin drugs

Answer 22

increased bun or creatinine or hearing loss

Question 23

what can mycin drugs cause

Answer 23

ototoxicity and or nephrotoxicity

Question 24

what do you assume if bun and creatinine increase

Answer 24

they have nephrotoxicity

Question 25

what happens if they have reduced blood flow to burned area

Answer 25

delivery of ABX is reduced

Question 26

what do silver impregnated dressings do

Answer 26

provide broad antimicrobial effects to the burn

Question 27

how long can silver impregnated dressing stay on

Answer 27

3-14 days depending on situation

Question 28

what can mafenide acetate cause

Answer 28

acid base problems and stings

Question 29

what can silver nitrate cause

Answer 29

electrolyte problems, keep dressing wet

Question 30

why should antibiotic drugs be alternated

Answer 30

bacteria will build a tolerance

Question 31

how do you apply topical agents to a burn

Answer 31

apply a thin layer using sterile gloves

Question 32

what are enzymatic debridement agents used for

Answer 32

to remove necrotic dead tissue

Question 33

examples of enzymatic debridement agents

Answer 33

sutilains collagenase (saintly)

Question 34

when should you avoid enzymatic debridement agents

Answer 34

dont use on face (scaring) dont use if pregnant dont use over large nerves dont use use if area is opened to a body cavity (internal organ damage)

Question 35

why is hydrotherapy used for

Answer 35

debridement

Question 36

what do you need to remember before hydrotherapy

Answer 36

pain management

Question 37

what could happen to this client if immersion hydrotherapy is used

Answer 37

cross contamination

Question 38

how often can you reharvest an autograft from the same site

Answer 38

12-14 days if well nourished

Question 39

what does it mean if the skin graft is blue or cool

Answer 39

poor profusion

Question 40

what happens if air, blood or exudate is accumulating under the graft

Answer 40

the new graft will not adhere leading to total or partial loss of the graft

Question 41

why do burn patients need more calories

Answer 41

they are in a hyper metabolic state

Question 42

what are needed in the diet to promote healing

Answer 42

protein and vitamin c

Question 43

what labs do you need to ensure proper nutrition and a positive nitrogen balance

Answer 43

pre albumin, nitrogen

Question 44

what are the circulatory checks

Answer 44

pulse color temp cap refill

Question 45

what does elevation of the extremity do

Answer 45

may improve circulation by reducing edema

Question 46

what procedures help relieve pressure

Answer 46

escharotomy fasciotomy (relieves pressure and restores circulation

Question 47

what is the difference between a fasciotomy and escharotomy

Answer 47

the faciotomy cut is deeper into the tissue, it cuts through the fascia of the muscle

Question 48

how often does urine need to be monitored

Answer 48

every hour

Question 49

is it possible that no urine will return when you insert the catheter

Answer 49

yes

Question 50

why would there be no urine in the catheter

Answer 50

the kidneys are trying to retain fluid or they are not being professed adequately

Question 51

what would cause brown or red urine

Answer 51

RBC and hemoglobin excretion

Question 52

what drub might be ordered to flush the kidneys

Answer 52

mannitol

Question 53

if there is no urine output or if it is less than 30ml/hr what do yo worry about

Answer 53

kidney failure

Question 54

why would a client diurese after 48 hour

Answer 54

fluid returns to vascular space

Question 55

what do you worry about when pt begins to diurese

Answer 55

FVE

Question 56

where is most potassium

Answer 56

inside the cell

Question 57

what happens to cells with a burn

Answer 57

they rupture

Question 58

what electrolyte embalance does cell lysing cause

Answer 58

hyperkalemia

Question 59

why are magnesium carbonate, pantoprazole or famotidine prescribed

Answer 59

to prevent stress ulcer (curlings ulcer)

Question 60

types of antacids

Answer 60

aluminum hydroxide gel (amphojel) magnesium hydroxide (MOM)

Question 61

H2 antagonists

Answer 61

famotidine nizatidine

Question 62

proton pump inhibitors

Answer 62

pantoprazole, esomeprazole

Question 63

why would they be NPO and have an NG hooked to suction

Answer 63

They could develop a paralytic ileus

Question 64

why would they develop a paralytic ileus

Answer 64

decreased vascular volume decrease GI motility hyperkalemia

Question 65

if a client doesn't have bowel sounds what will happen to the abdominal girth

Answer 65

increase

Question 66

when is NG tube removed

Answer 66

when bowl sounds return

Question 67

when you start GI feedings what should you measure to ensure the supplement is moving through GI tract

Answer 67

gastric residual

Question 68

what should be done to prevent contractures

Answer 68

wrap each finger separately use splints hyperextend the neck

Question 69

what is the number once complication of perineal burn

Answer 69

infection

Question 70

can new tissue regenerate if old is not removed

Answer 70

no

Question 71

what likes to grow in eschar

Answer 71

bactera

Question 72

how many wounds in an electrical burn

Answer 72

2 an entrance and exit

Question 73

which wound in electrical burn is bigger

Answer 73

exit

Question 74

what is the first thing you do for an electrical burn

Answer 74

heart monitoring for 24 hours

Question 75

what arrhythmia is this client at high risk for

Answer 75

V-fib

Question 76

what can build up in electrical burns

Answer 76

myoglobin and hemoglobin and can cause kidney damage

Question 77

why does an electrical burn patient need a spine board and c collar

Answer 77

they usually occur in high places, muscle contractions can cause fracture and force can throw victim forcefully

Question 78

what happens to circulatory system with electrical burns

Answer 78

destroyed

Question 79

complications of electrical burns

Answer 79

cataracts, gait problems, neurological deficit