Burns

Question 1

How are burns classified

Answer 1

Depth
Extent
Location
Patient Risk factors (diabetic, elder patient, pediatrics)

Question 2

What is the epidermis

Answer 2

nonvascular protective outer layer

Question 3

What is the dermis

Answer 3

lies beneath the epidermis

contains CT, and blood vessels, hair follicles, nerve endings, sweat glands, and sebaceous glands

Question 4

What is subcutaneous tissue

Answer 4

lies under the dermis
connects major vascular networks
fat
nerves and lymphatics

Question 5

What are 1st degree burns

Answer 5

superficial partial thickness
sunburns
may have water blisters

Question 6

What are 2nd degree burns

Answer 6

deep partial thickness

Question 7

what are 3rd degree burns

Answer 7

full thickness

Question 8

Characteristics of 1st degree burn

Answer 8

erythema (bright red), blanching, pain, water blisters only

may peal after 24 hours

Question 9

What causes 1st degree burn

Answer 9

sunburn/flash burns

Question 10

How do you treat 1st degree burn

Answer 10

Acetaminophen
Aloe vera gel
cool compress

Question 11

Characteristics of second degree burns

Answer 11

epidermis and dermis involved

fluid-filled vesicles or blisters

Question 12

What causes 2nd degree burns

Answer 12

flames
scalds
chemicals
tar
contact burn

Question 13

Initial Cleaning of 2nd degree burns

Answer 13

remove clothing 
remove loose skin
remove blisters 
clean and disinfect
(may need surgical debridement/ skin grafting)

Question 14

Modern treatment for 2nd degree burns and traditional

Answer 14

hydrocolloids
hydrofiber
sillcone
alginate
polyurethane 
Traditional::
silvadene
paraffin gauze

Question 15

Characteristics of 3rd degree burn

Answer 15

destruction of entire epidermis and dermis

dry and often painless

Question 16

Define escharotomy

Answer 16

to release circumferential burn eschar and improve circulation to distal extremity

Question 17

What is shock

Answer 17

a clinical syndrome involving impaired tissue perfusion and oxygenation

Question 18

Burn Shock

Answer 18

state of hypovolemia that is life threatening and can begin 20 minutes ater injury
Evidenced by a severe drop in blood pressure and increased HR
- allow for an increased permeability

Question 19

Electrolyte shift following burns

Answer 19

increased intracellular sodium leading hyponatremia
decreased intracellular K
Na/K pumps damaged
Magnesium and calcium may be lost through leakage from damaged tissue

Question 20

define burn

Answer 20

an injury to the tissue of the body caused by heat, chemicals, electric current, radiation

Question 21

define thermal burns

Answer 21

caused by flame, flash, scald, or contact hot object

Question 22

The severity of thermal burns are dependent on?

Answer 22

the burning agent, and the duration of contact time

Question 23

define chemical burns

Answer 23

results of contact with acids, alkalis, and organic compound

Question 24

what are the three types of smoke and inhalation injuries?

Answer 24

metabolic asphyxiation
upper airway injury
lower airway injury

Question 25

Metabolic asphyxiation causes what?

Answer 25

oxygen delivery impairment or oxygen consumption by tissue impairment

Question 26

What are the consequences of metabolic asphyxiation

Answer 26

hypoxia and death when carbooxyhemoglobin has occurred

Question 27

upper airway injuries result from what?

Answer 27

inhalation injury to mouth, oropharynx, and or larynx

Question 28

Manifestation of upper airway injuries

Answer 28

redness, blistering, and edema (which can become lethal)

Question 29

lower airway injury results from what?

Answer 29

breathing in toxic chemicals or smoke

Question 30

where do lower airway injuries occur

Answer 30

trachea, bronchioles and alveoli

Question 31

Clinical manifestations of lower airway injury

Answer 31

``` presence of facial burns or singed nasal or facial hair dyspnea carbonaceous sputum wheezing hoarseness altered mental status ```

Question 32

When does pulmonary edema appear in lower airway injury

Answer 32

may not appear until 12-24 hours after the burn

Question 33

Define electrical burns

Answer 33

result from intense heat generated from an electric current

Question 34

consequences of electrical burns

Answer 34

damage to nerves and vessels, causing tissue anoxia and death

Question 35

The severity of electrical burns is dependent on what

Answer 35

amount of voltage, tissue resistance, current pathways, and amount of voltage

Question 36

Risks for patient who has suffered an electrical burn

Answer 36

dysrhythmias, cardiac arrest, severe metabolic acidosis, and myoglobinuria

Question 37

Phases of burn management

Answer 37

emergent, acute and rehavilitative

Question 38

what is the greatest initial threat to a patient with major burns?

Answer 38

hypovolemic shock

Question 39

what is second spacing

Answer 39

when fluid moves into the interstitium following a burn

Question 40

what is third spacing

Answer 40

when fluid moves into areas that normally have minimal to no fluid

Question 41

how are RBC lost as a consequence of a burn

Answer 41

by hemolysis from free radicals direct loss from the burn thrombosis in capillaries

Question 42

what are the immunologic changes that occur as a result of a burn

Answer 42

skin barrier destroyed bone marrow depression occurs immunoglobins decreased

Question 43

what three organ systems are susceptible to complications during the emergent phase?

Answer 43

cardiovascular system respiratory system urinary system

Question 44

what is an escharotomy

Answer 44

incision through the full thickness of the burn