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Flashcards in Burns Deck (13)
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1

The risk for death increased with burns in what type of clients?

Why?

The very old young and very young

The very young because more surface area is covered when they area burn . The greater the body area affected . The greater the chance that person is going to die

The elderly because they have less subcutaneous fat we have. The less subcutaneous fat the deeper the burn can go deeper . The deeper the burn the greater the chance of death

2

After Burns pathophysiology

After a burn many different pathophysiology changes occur.
1. Why does plasma seep out into the tissue?
Increased ___________________________ permeability


2. When does the majority of this occur? _________________________

3. When does the pulse increase?
Anytime you’re in a ____________, the pulse will __________________

4. Why does the cardiac output decrease? Less ___________ to pump out.

5. Why does the urine output decrease?
Kidneys are either trying to _______on to fluid or they aren’t being ______________.

6. Why is epinephrine secreted?
Makes you _________________________, shunts blood to vital organs

7. Why are ADH and aldosterone secreted?
Retain _______________ & ______________ with aldosterone and Retain _______________ with ADH
Therefore, the blood volume will go _______________.

Why does plasma seep out into the tissue?

Increased capillary permeability( leaking )
Aka vessels are leaking because they been damaged so he vascular volume is going down . So this person can gone into shock


2. When does the majority of this occur? 1st 24hrs

3. When does the pulse increase?

Anytime you’re in a FVD the pulse will increase


4. Why does the cardiac output decrease? Less volume to pump out.


5. Why does the urine output decrease?

Kidneys are either trying to hold on to fluid or they aren’t being perfume.


6. Why is epinephrine secreted?

Makes you vasoconstriction, shunts blood to vital organs . It also helps BP go back up


7. Why are ADH and aldosterone secreted?


Retain sodium& water with aldosterone and

Retain water with ADH

Therefore, the blood volume will go up.

3

permeability=

permeability( leaking )

4

Where do most burns occur?

So think what ?

Home

Safety

5

Airway injury

Airway Injury:
• What is the most common airway injury? ____________ ____________ poisoning

• Normally, oxygen binds with ___________________. Carbon monoxide travels much faster than oxygen.... Therefore, it gets to the hemoglobin first and binds....Can oxygen bind now? Yes or No

Now the clients is ?

What is the most common airway injury? Carbon monoxide poisoning

• Normally, oxygen binds with hemoglobin . Carbon monoxide travels
much faster than oxygen…. Therefore, it gets to the hemoglobin first and
binds….Can oxygen bind now? Yes or (No)
• Now the client is hypoxic

7

Airway injury treatment

What’s the treatment for hypoxia?

Why do we give a 100% of treatment ?

Is it important to determine if the burn occur in the open space or a close space?

When you see a client with burns to the neck/face/chest you had better think what?

What might the physician do prophylactically and why ?

When does swelling get worse ?

Always go for what first?

Tx: oxygen hundred %

By putting more oxygen out there it’s a better chance they will reach the hemoglobin before the carbon monoxide
• From this information, do you think it would be important to determine if the burn
occurred in an open or closed space?yes, very important

In a close space they would’ve have inhale more carbon monoxide so that puts them at greater risk for airway injury

• When you see a client with burns to the neck/face/chest you had better think what?
Airway
*What might the physician do prophylactically? ET tube

Because the airway will close off or swell and if she wait to long the airway can swell so tightly we can get the tube down at all

After 24 hours after a burn has occur . It may be no option left accept to intubate the client

Least Invasive

7

Burn treatment

Classification of Burn Injury:

• A client is burned over 40% of their body. How do you think this is determined?

How many times is the rules of nines done

Classification of Burn Injury:

• A client is burned over 40% of their body. How do you think this is determined? Rule of nines

At the er and in 2-3 days. After two or three days there’s better evidence to where wounds begin and end. Better. Demarcation

Estimate of Total Body Surface Area

• A common formula is called the we look nines

8

What is the treatment for hypoxia?

Oxygen

9

Fluid Replacement:
• One of the most important aspects of burn management is _____________________
• Is it important to know what time the burn occurred?___________________
• Why? Fluid therapy (for the first 24 hours) is based on the time the injury ___________, not when the treatment was ______________________.
Common rule: Calculate what is needed for the first __________ hours and give half of the volume calculated during the first 8 hours. This is the __________________Formula.

Fluid replacement

Yes



Why? Fluid therapy (for the first 24 hours) is based on the time the injury _____occur______, not when the treatment was _____begin _________________.




Common rule: Calculate what is needed for the first ____24______ hours and give half of the volume calculated during the first 8 hours. This is the __________parkland ________Formula.

10

What is the parkland formula?


The Parkland formula equals what?



1st 8 hours =
2nd 8 hours =
3rd 8 hours =

4ml of LR) X (body weight in kg) X (% of TBSA burned)

= total fluid requirement for the first 24 hours after burn

11

• To calculate fluid replacement properly you also need to know the client’s ___________ (in kilograms) and TBSA affected. *1 kg = 2.2 pounds

Body weight

12


• If the client is restless it could suggest three problems:

Which problem takes priority?

inadequate fluid replacement, pain, or hypoxia. Or all 3

Hypoxia , Because this is the one that can kill the patient

13

Which of the following would you choose to determine if a client’s fluid volume is adequate? Their weight or their urine output?

What the minimal urine output ?

Urine output

It’s should be a minimal of 0.5 ml/kg/hr