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NCLEX > Burns > Flashcards

Burns Flashcards

(67 cards)

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1
Q

where do most burns occur

A

at home

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2
Q

why does plasma seep out into the tissues following a burn

A

increased capillary permeability

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3
Q

when does most plasma seep out into the tissue following a burn

A

first 24 hours

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4
Q

does your pulse increase or decrease following a burn, why?

A

increase - fluid volume deficit

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5
Q

what happens to CO following a burn

A

decrases - less volume

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6
Q

what happens to urine output following a burn? why?

A

decrease - kidneys trying to retain fluid or aren’t being perfused adequately

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7
Q

what catecholamine is ecreted following a burn and why?

A

epi - causes vasoconstriction - shunts blood to vital organs

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8
Q

what else is secreted during a burn to improve fluid levels

A

aldosterone and ADH - increase blood volume

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9
Q

what is the most common airway injury in a burn patient

A

CO poisoning - CO binds stronger causes hypoxia

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10
Q

what is the treatment for airway injury in burn patients

A

give 100% O2 to knock CO out

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11
Q

why is it important to know if the burn occured in a closed space or not

A

more smoke inhalation

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12
Q

what do you immediately think of if you see a patient with burn injuries to head or neck

A

airway!

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13
Q

what is a prophylactic measure the HCP may do for a burn victim

A

intubation - incase airway closes

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14
Q

what is the common formula to approximate burn area

A

9% everwhere
18% front of torso and back
1% groin

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15
Q

what is one of the most important burn managmenet interventions

A

fluid replacement

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16
Q

why is it important to know what time the burn occured

A

fluid therapy is calculated for the first 24 hours folowing the time of injury

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17
Q

what is the formula called to calculate fluid replacement in burn victims

A

parkland formula

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18
Q

what is the parkland formula

A

(4mL) x (body weight in Kg) x (% of TBSA burned) = total fluid requirement

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19
Q

how is the first 24 hours of fluid replacement divided up (1st, 2nd and 3rd 8 hour periods)

A

1st 8 hours = 1/2 of total volume
2nd 8 hours = 1/4 of total volume
3rd 8 hours = 1/4 of total volume

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20
Q

a restless burn client suggests what 3 problems

A

hypoxia ** priority
pain
inadequate fluid replacement

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21
Q

what should be done to stop the burning process

A

soak area with cool water

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22
Q

why do you remove jewlery on a burn victim

A

because swelling will occur

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23
Q

what should be done with clothing on a burn victim

A

removed and replaced with clean dry cloth

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24
Q

what medication is given for burn victims

A

albumin

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25
why is albumin given to burn victims
holds fluid in vascular space | increases CO, BP, organ persion
26
what are you worried about with giving albumin
fluid overload
27
what should you look at to ensure you are not overloading a patient when rapidly infusiong fluids
CVP - need central line to measure
28
why are IV pain meds preferred over IM with burns
act quickly ad Im requires adequate perfusion which is not necessarily the case
29
whats the differene in immunity between giving tetnus toxoid and immune globulin
tentus toxoid - active immunity takes time to make own antibodies IG - passive; but immunity immediately
30
what are the 4 components of circulatory check
pulse skin color tem of skin cap refill
31
what are the names of procedures to relive pressure
escharotomy - cut through eschar | fasciotomy - cut is much deeper cutrs through the fascia of the muscle
32
how often does urine output need to be monitored in a burn victim
hourly
33
what does it mean if the urine is brown or red in a burn victim
muscle and tissue damage - can clog kidneys
34
what drug may be ordered to flush the kidneys
mannitol
35
what happens to serum potassium following a burn and why?
potassium usually in a cell - when a cell is damaged potassium leaks out and increases serum level
36
are you worried about hyper or hypokalemia in a burn victim
hyper
37
what can happen to the GI system in a burn patient? what medication is given?
can get a stress ulcer (hurlings ulcer) given antacids, H2 Antagonists or PPI ex. magenesium carbonate or pantaprazole
38
what interventions might a primary health care provider order for a burn patient that are non pharmacological
NPO and NG tube - prevent paralytic ileus
39
what does suction and an NG tube prevent in a burn patient? why?
paralytic ileus - decraesed vascular volume | decreased GI motility, hyperkalemia
40
if a client doesn't have bowel sounds what will happen to abdominal girth
increase
41
do burn patients need more or less calories
more; they are in a hypermetabolic state
42
when should an NG tube be removed
when you hear bowel sounds
43
when you start GI feedings, wht should you measure to ensure that the supplement ismoving throuhg he GI tract?
gastric residuals >50
44
what is some lab work you could check to ensure proper nutrtion and a postive nitrogen balance?
pre albumin total protein or albumin
45
clients with partial or full thickness burns may experience what?
contractures
46
what are the 3 classifations of burns
superfical, partial and full thickness
47
what is a superfical thickness burn classifed as
first degree burn - damage to only epidermis
48
what is a partial thickness burn classifed as
second degree burn - damage to entire epidermis and varying deptshof the dermis
49
what is a full thickness burn classifed as
damage to entire dermis and sometiems fat
50
if a patient has burns to their hands what are some spefici measures that should be taken
wrap each finger separately and use splints to prevent contractures
51
what should be done to prevent chin-to-chest contracture
hyper extend the neck
52
what is the number 1 complication with a perineal burn
infection
53
what is eschar? what needs to be done with it?
dead tissue - needs to be removed
54
what happens if eschar is not removed
new tissue cannot regenerate and bacteria can grow (infection)
55
what type of isolation will you use with the burn client? why?
protective; severly immunocompromised
56
what might be used to help remove necrotic dead tissue
enzymatic debridement agents
57
whe should enzymatic drugs not be used on a burn patient to remove necrotic tissueq
- not on face - not if pregnant - not over large nerves - dont use if are is opened to body cavity
58
what is another method other than enzymatic drugs to debride that requires pain medication priro
hydrotherapy
59
what is our main concern with hydrotherapy
cross contamination
60
what are common drugs used with burns
mafenide acetate - can cause acid base problems and stings silver nitrate - keeps these dressings wet, can cause electrolyte problems provideone - iodine - stings and stains
61
why are broad spectrum antibitocs avoided
super infections or secondary infections
62
what do we worry about when giving antibitoics with the suffix mycin
clients BUN or creatinine - if increasing assume nephrotoxicitiy drugs can lead to ototoxicity or nephrotoxicity
63
what should you first do in a chemical burn
remove client from chemical and begin flushing for 15-30mins with water
64
how many wounds are expected with an electrical burn
2 - entrance (smaller) and exit (bigger)
65
what is the first thing you do with an electrical burn
heart monitor for 24 hours
66
what arrhythmia is an electrical burn patient at high risk for
Vfib
67
what can build up in electrical burns and cause what
myoglobin and hemoglobin can build up and cause renal damage

NCLEX (10 decks)

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