burns Flashcards

1
Q

increased risk of death in which age groups?

A

really old, really young

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2
Q

most common airway injury (burn)

A

carbon monoxide poisoning

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3
Q

rule of nines (adult)

  • head/neck
  • arms
  • trunk (back and front)
  • genitals
  • legs
A
9% - head/neck
9% - arms
18% - trunk (back and front)
1% - genitals
18% - legs
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4
Q

if burn client is restless, consider which 3 problems?

A
  • inadequate fluid replacement
  • pain
  • hypoxia
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5
Q

examine what to determine if fluid volume is adequate?

A

urine output

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6
Q

why is there more death with upper body burns?

A

airway injury

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7
Q

burn client with shallow respirations - retaining what and experiencing what imbalance?

A

CO2, acid

respiratory acidosis

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8
Q

measure this hourly to ensure not overloading burn client with fluid

A

CVP - want to see slow rise of BP

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9
Q

why give albumin to burn patient?

A

draws volume into the vessels

increases: vascular volume, BP, CO, workload of heart

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10
Q

why are IV meds preferred to IM meds in burn clients?

A

decreased perfusion to absorb IM

acts quicker

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11
Q

tetanus toxoid: type of immunity and length of time to develop

A

active, 2-4 weeks

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12
Q

immune globulin: type of immunity and length of time to develop

A

passive, immediate

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13
Q

escharotomy

A

cut through eschar to relieve pressure and restore circulation

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14
Q

fasciotomy

A

cut deep into tissue - through eschar and fascia - relives pressure and restores circulation

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15
Q

burn client circulatory check (x4)

A

pulse
color (skin)
temp (skin)
cap refill

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16
Q

burn client with brown or red urine: action and what it means

A

call provider

muscle damage –> myoglobin –> could gunk up glomerulus –> kidney damage

17
Q

drug used to flush out kidneys in burn patient

A

mannitol - osmotic diuretic

18
Q

uop less than 30mL/hour in burn client, worry?

A

kidney failure

19
Q

48 hours post burn concern?

A

client will begin to diurese (if kidneys not damaged) because fluid is going back into vascular space; worry about fluid volume excess

20
Q

electrolyte imbalance frequently seen in burn patients

A

hyperkalemia because cells have lysed and expelled contents into serum

21
Q

prevent stress ulcer/Kerling’s ulcer in burn patients

A

carbonate/magnesium carbonate (Mylanta)
pantoprazole (Protonix)
famotidine (Pepcid)

22
Q

paralytic ileus in burn patients: why and treatment

A

decreased vascular volume and gi motility; hyperkalemia

treat with: NPO and NG tube hooked to suction

23
Q

labs to ensure proper nutrition and positive nitrogen balance in burn patients? x3

A

albumin (status weeks ago)
prealbumin (status today)
total protein

24
Q

superficial thickness burn

A

aka 1st degree

damage to epidermis only

25
partial thickness burn
aka 2nd degree | damage to entire epidermis and varying depth of dermis
26
full-thickness burn
aka 3rd degree | damage to entire dermis and sometimes fat
27
#1 complication with perineal burn
infection
28
eschar
dead tissue, needs to be removed for tissue to regenerate bacteria love it!
29
enzymatic drugs to treat eschar in burn patients
sutilanis (Travase) collagenase (Santyl) silver sulfadiazine "eats" dead tissue
30
hydrotherapy
aka whirlpool therapy eschar debridement - give pain meds first - worry about cross contamination
31
considerations for broad spectrum abx in burn patients?
avoid to prevent secondary infection, superinfection ok to use until wound cultures return
32
two ae of -mycins
nephrotoxicity (will see increase in BUN, creat) | ototoxicity
33
how often can you reharvest from a graft donor site (given patient is well nourished?)
every 12 - 14 days
34
how long do you flush a chemical burn?
15 to 20 minutes
35
priority for new electrical burn patient?
heart monitor for 24 hours
36
what arrhythmia is electrical burn patient at risk for?
v fib
37
what causes renal damage in electrical burn patient?
myoglobin, hemoglobin build up