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NP 4- TOP 8 > BURNS > Flashcards

BURNS Flashcards

1
Q

Most effective defense against infection

A

Intact Skin

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2
Q

Types of Burns:

A
  1. Thermal Burn
    2.Electrical Burn
  2. Chemical Burn
    4.Radiation Burn
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3
Q

Type of burn where there is exposure to hot surface

A

Thermal Burn

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4
Q

Management of thermal Burn

A

Small portion: Put on running water

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5
Q

Type of burn that is due to electrical source

A

Electrical Burn

“The more solid the structure the faster electricity to travel”

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6
Q

Area damage first with the electrical burn:

A

Bone, Ligament, Fascia

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7
Q

Life threatening complication with electrical burn:

A

ARRHYTHMIA

Check Vital Signs: HEART RATE

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8
Q

Priority for Electrical burn:

A

Safety of Victim + Rescuer

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9
Q

Initial action for electrical burn:

A

Stop the source

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10
Q

Lightning safest place:

A

“When the thunder roar get indoor”

-Safest: Close Area (Inside Building)
-Person struck by a lightning; find exit on the foot

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11
Q

Best position for electrical burn:

A

-Tripod Position
-Hands & Feet touches the Ground

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12
Q

There is presence of lightning and thunder, you saw patient struck by lightning and got unconscious (-) pulse.

A

Bring pt in safety/Closed area before CPR in lightning.

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13
Q

While saving patient, (Healthworker) you lose your life

A

Principle of Double Effect

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14
Q

Type of burn that is Due to strong acid

A

Chemical Burn

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15
Q

Evidence of Chemical Burn

A

(+) Liquefaction Necrosis
(+) Stain

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16
Q

PLAN OF CARE/MANAGEMENT: CHEMICAL BURN

A

Powder: Scrape or Remove with a Brush
Liquid: Flood with water

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17
Q

Type of burn that is exposed to UV ray
-Sunburn
-Sauna
-Radiation Therapy

A

Radiation Burn

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18
Q

Management for Radiation Therapy

A

Apply Cold Pack

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19
Q

Degree of Burn:

Affected is Epidermis
-Sunburn
-Exfoliation
-Dermatitis

A

Partial Thickness/ Superficial Partial (1st Degree)

P-R-S
Painful
Redness
Swelling

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20
Q

Degree of Burn:

-Affected is Epidermis + Dermis
-Most Painful
-(+) Blisters
1. Ulcerations
2.Scalds: Boiling Water

A

Deep Partial (2nd Degree)

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21
Q

Degree of Burn:

-Painless
-Nerve Damage
-Epidermis + Dermis + SQ Tissue+ White Eschar

A

Full Thickness/ 3rd Degree

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22
Q

Tissue damage by burn

A

Eschar

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23
Q

Totally Burned Patient how will you communicate?

A

Communicate thru Eyes

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24
Q

Degree of Burn:

-Epidermis + Dermis + SQ Tissue + Muscle, Bone, Organ
-Black Eschar
-Charred Eschar
-Contractures

A

4th degree burn

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25
Q

Stiffening of Muscle

A

Contractures

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26
Q

Contracture in the Neck:

A

Turn the Head 90 degrees (ROM)

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27
Q

Management for Contractures:

A

-Range of Motion Exercises
-Passive ROME (Assisted by Nurse)

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28
Q

Phase of Burn

A

Emergent Phase
Diuretic Phase
Recovery Phase

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29
Q

-Occurs 1st within 48 hours
-Stage of Shock
-Fluid Shift from IV (Plasma) to Interstitial

A

Emergent Phase

-Hypovolemia
-↓ BP (Shock)
-Oliguria (↓ Urine Output)
-Hemoconcentration
-↑ Viscosity: RISK FOR THROMBUS
-↑ Hematocrit
-Hyperkalemia (Metabolic Acidosis)
-Hyponatremia: Sodium rush into cells

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30
Q

-Occurs after 48 hours
-Fluid shift from Interstitial to intravascular
-Fluid Remobilization

A

Diuretic Phase

-Hypervolemia
-↑BP
-Polyuria (Diuretic Phase)
-Hypokalemia (Metabolic Alkalosis)
-Hyponatremia: Sodium Excreted thru Diuresis
-Hemodilution
-↓ Blood Viscosity
-↓Hematocrit

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31
Q

-Occurs 5-6 days after

A

Recovery Phase

Hypokalemia: K+ is needed in cellular repair
Hypocalemia: Ca+ used in scar formation
***Ca+ helps in the Cell repair

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32
Q

Plan of care: Recover Phase

A

Priority: Pain Management
DOC: Morphine Sulfate (Narcotic/Opiods)

Close the door
-Nerve is hypersensitive to wind

To relieve the Pain
-Bed Craddle

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33
Q

Tissue damage by burn

A

Eschar

34
Q

How to communicate burn pt. who is totally burned?

A

Communicate thru eyes

35
Q

What is the indicator that fluid therapy is effective in burn patient?

A

Hematocrit return to normal level

36
Q

Prevent infection during recovery phase

A

-Private room
-Reverse Isolation
-Handwashing
-Wear Gloves
-Administer Tetanus Toxoid (Must be given with Antihistamine)

37
Q

Wound care: Recover phase

A

I & D : Irrigation & Debridement

Technique: “Wet to Dry”
-Wet gause with NSS then remove, and wet the affected area, then apply dry dressing.

38
Q

What gloves to use during removing old dressing?

A

Clean Gloves

39
Q

What gloves to use during irrigation & applying new dressing?

A

Sterile Gloves

40
Q

Topical antibiotic (burn ointment)
BURN OINTMENT

A

Treat Pseudomonas infection

Silver Nitrate (0.5%)
Sulfamylon (10%)
Silver sulfadiazine (1%)

41
Q

Best way to apply topical antibiotics?

A

With Gloved Hands
-To control pressure during application

42
Q

Burn ointment: This turns skin into black

A

Silver Nitrate (0.5%)

43
Q

Burn ointment:
-DOC: as antibiotic
-Penetrates into skin
-Kills Pseudomonas
-Painful
-administer analgesic 1 hour before apllication

A

Sulfamylon (10%)

44
Q

Burn ointment:
-Causes leukopenia (Agranulocytosis)

A

Silver Sulfadiazine (1%)

45
Q

Purposes of Skin Grafting:

A

-Allows new skin to grow
-Prevent infection
-Relieve the pain
-Relieve constrictures
-Prevent water loss

46
Q

skin grafting where Donor is from human skin

A

Homograft

47
Q

Types of Homograft:

A

Autograft
Isograft
Allograft

48
Q

skin grafting:
Donor and recipient are the same

A

Autograft

***Still experiences graft rejection

49
Q

Skin grafting from genetically related
Ideal donor: Identical Twins
Relatives

A

Isograft

50
Q

Skin grafting from not genetically related

A

Allograft

51
Q

Skin grafting where donor is from an animal/ Pigskin

A

Heterograft/ Xenograft

52
Q

Harvest Site for donor in skin grafting:

A

T-A-B-S

Thigh
Abdomen
Back
Scalp

53
Q

It helps to relieve pain, prevent sticking of exudates in the topsheet.

A

Bed Craddle

54
Q

Good to know

A

Contagious Pt: Isolation room
Immunosuppressed Pt: Private Room

55
Q

Care for the Skin Grafting:

A

-Apply on non-bleeding area
-Secure with suture or staple
-Suture is removed alternately 3-4 days after
**-Never apply lotion or powder on graft: Never expose graft on direct sunlight.
**-In case of dislodge: Soak the graft on NSS and immediately bring to hospital to reattach.

56
Q

Procedure: Cutting through a dead skin; Grid pattern.

A

Escharotomy

57
Q

Purpose of Escharotomy?

A

Relieve Constrictures

58
Q

Purpose of Escharotomy in chest:

A

Promote Breathing

59
Q

Purpose of Escharotomy in extremities:

A

Promote blood flow/ Circulation

How to determine if its effective:
-Return of distal Pulse

60
Q

Diet for Burns AFTER THE BURN:

A

NPO

Due to “Curling’s Ulcer” (Stress-induced ulcer)
↓
↑Hcl due to adrenaline rush

61
Q

Diet for burn during RECOVERY:

A

↑Calories: Provide energy
↑Protein: Tissue repair
Vit. C: Resistance for infection
Zinc: Resistance for infection

62
Q

What Principle to use when there is Fire and you are INSIDE?

A

RACE Principle

Rescue
Alarm
Confine/Contain Fire
Extinguish

63
Q

What Principle to use when there is Fire and you are OUTSIDE?

A

ARCE principle

Alarm :”Hey the building is burning”
Rescue
Contain/Confine
Extinguish

64
Q

Characteristic/Definition & Management for Small Fire:

A

Characteristic of small fire:
1) Waste Basket
2) Fire is not taller than you

Priority: Extinguish

65
Q

RACE PRINCIPLE

A

RESCUE
-Remove the victim
-Drop & Roll
-Throw a Blanket

ALARM
-Activate the fire alarm
-Scream: “Help”

CONFINE/CONTAIN
-Close the door
-Crawl & Cover the nose with wet towel

EXTINGUISH
-Water
-Fire Extinguisher

66
Q

EXTINGUISH

A

-Water
-Fire Extinguisher

67
Q

CONFINE/CONTAIN

A

-Close the door
-Crawl & Cover the nose with wet towel

68
Q

ALARM

A

-Activate the fire alarm
-Scream: “Help”

69
Q

RESCUE

A

-Remove the victim
-Drop & Roll
-Throw a Blanket

70
Q

Management for patient in a wheelchair during fire?

A

Throw a blanket on the patient to trap Oxygen.

71
Q

FIRE EXTINGUISHER

A

PASS

Pull the pin
Aim low
Squeeze the Lever
Sweeping manner towards the fire

72
Q

When to use Fire extinguisher?

A

-On the onset of fire
-Fire is not taller than you

73
Q

-Indicates Smoke Inhalation
-Indication of Carbon Monoxide Poisioning

A

Cherry Red Mucous

74
Q

Class of Fire: utilize on Light Materials
Symbol: Green Triangle

A

Class A

*Abo

75
Q

Class of Fire: utilized on Gas Fire/ Grease/ Oil
Source
Symbol: Square Red

A

Class B

*Boom

76
Q

Class of Fire: utilized on Electrical Source
Symbol: Blue Circle

A

Class C

Curyente

77
Q

Class of Fire: utilized on Metal Source
Symbol: Yellow Star

A

Class D

Di magigiba: Metal

78
Q

Class of Fire

A

Class A: Light materials
Class B: Gas fire/ Grease/ Oil source
Class C: Electrical Source
Class D: Metal source

79
Q

After the Burn Process

A

Priority: Establish Airway

Indicates Bronchoconstriction:
-Hoarseness
-Wheezing
-Tightness of throat
-Stridor

What should be available?
-Intubation set
-O2 Tank

80
Q

EMERGENT PHASE

A

Priority: Fluid Replacement

A) PLRS (Crystalloid)
B) Normal Hematocrit: Indicates adequate fluid replacement in burns.

81
Q

STEPS IN FLUID REPLACEMENT

A
  1. Get the weight (Kg)
    -Lbs / 2.2 = kg
  2. Rule of Nine
  3. Parkland’s/ Baxter’s Rule
    4ml PLRS x % TBSA x Wt (Kg)
82
Q

Parkland’s/Baxter’s Formula

A

4ml x %TBSA x kg

NP 4- TOP 8 (3 decks)

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