Burns and Lymphedema exam 2

Question 1

when treating burns, what is our utmost concer?

Answer 1

infections

Question 2

what source of thermal burns tends to cause full thickness burns?

Answer 2

contact

Question 3

do direct or alternating current cause more damage?

Answer 3

alternating

Question 4

will the entry wound or the exit wound of electrical burns have more superficial tissue damage?

Answer 4

exit wound

Question 5

which layers of skin does first degree frostbite affect?

Answer 5

epidermis

Question 6

what is the treatment for first degree frostbite?

Answer 6

just re-warming

Question 7

what layer of skin do second degree frostbite burns affect?

Answer 7

epidermis and dermis

Question 8

what layer of skin does third degree frostbite affect?

Answer 8

epi, dermis, subq

Question 9

what layer of skin does fourth degree frostbite affect?

Answer 9

subq and deeper

Question 10

how long does it take for the acute effects of radiation burns to manifest?

Answer 10

they manifest within 4 weeks

Question 11

what source of burns makes up the majority of burns in young children?

Answer 11

Scalds (very hot liquid or steam)

Question 12

what source of burns makes up the majority of burns in the working age adults?

Answer 12

flame

Question 13

which zone in burn injuries has no tissue perfusion?

Answer 13

zone of coagulation/necrosis

Question 14

what is the prognosis for the zone of stasis?

Answer 14

chance of tissue recovery if there is optimal management

Question 15

which zone of burns has a likely chance of tissue recovery?

Answer 15

zone of hyperemia

Question 16

what percent of TBSA needs to be burnt in order for there to be a systemic response?

Answer 16

20-30%

Question 17

what are some systemic responses when the body has a complex burn?

Answer 17

hypotension, bronchoconstriction, 3x increase in BMR, reduced immune response

Question 18

what factors does the Lund and Browder chart compensate for that the rule of nines does not?

Answer 18

age and body shape

Question 19

what percent of TBSA does a pt’s one palm and fingers make up?

Answer 19

1%

Question 20

what percent of TBSA would be burned if the entire trunk was burnt (not including the groin or neck)?

Answer 20

36%

Question 21

what percent of TBSA does a child’s head comprise?

Answer 21

18%

Question 22

what percent of TBSA does the anterior portion of the left leg of a child comprise?

Answer 22

6.7%

Question 23

if a wound appears to be pale and pink, what burn type is it likely to be?

Answer 23

superficial dermal

Question 24

what is the prognosis for superficial epidermal burns? (healing timeline and scars)

Answer 24

7-14 days. No scars

Question 25

what is the prognosis for superficial dermal burns? (healing timeline and scars)

Answer 25

2-3 weeks. no scars

Question 26

what is the prognosis for deep dermal burns? (healing timeline and scars)

Answer 26

possibly surgery. possible scarring

Question 27

what is the prognosis for full thickness burns?

Answer 27

typically requires surgery

Question 28

what percent of TBSA classifies a burn as non-complex for adults and for children?

Answer 28

less than or equal to 15 and 10

Question 29

what areas are considered critical in regards to complexity of burns?

Answer 29

hands, feet, face, perineum, genitalia

Question 30

which type of burns requires management of blisters as part of the treatment?

Answer 30

superficial dermal

Question 31

what is the next step if during the wound treatment the wound appears to have a local infection?

Answer 31

tx with antimicrobial

Question 32

what is the next step if during the wound treatment the wound begins to progress to a full thickness burn?

Answer 32

refer to burn unit

Question 33

when is deroofing blisters advised?

Answer 33

when they are greater than 1 cm

Question 34

what type of dressing is typically effective in non-complex superficial dermal burns?

Answer 34

non-adhesive contact layer with a secondary absorbent layer

Question 35

what dressing selection is advised for superficial epidermal burns?

Answer 35

gels or moisture cream

Question 36

what are the three Rs associated with hypertrophic scarring?

Answer 36

raised, red, rigid

Question 37

what are risk factors for hypertrophic scarring (there is 6)?

Answer 37

inadequate first aid, poor wound management, infection, position while in hospital, comorbidities, deeper burn depth

Question 38

what types of burns are at a higher risk for hypertrophic scarring?

Answer 38

deep dermal burns

Question 39

what are some management techniques for hypertrophic scarring?

Answer 39

massage and moisture; pressure garments; contact media; laser scar therapy, splinting, mobility, functional training.

Question 40

how can PT help manage hypertrophic scarring?

Answer 40

improving mobility and function. splinting the area to stretch scar tissue and prevent contractures

Question 41

what special test is there for lymphedema?

Answer 41

stemmer's sign

Question 42

what other diseases does pitting edema occur with?

Answer 42

CHF, CVI, and DM

Question 43

what is stage 1 of lymphedema?

Answer 43

spontaneous and reversible. there is pitting edema and elevation affects swelling

Question 44

what is stage 2 of lymphedema?

Answer 44

spontaneous and irreversible. No pitting edema and elevation does not help swelling

Question 45

what is stage 3 of lymphedema?

Answer 45

lymphostatic elephantiasis.

Question 46

How can one tell the difference between lipedema and lymphedema?

Answer 46

lipedema will be BL, have a - stemmer's sign, no pitting edema and will mostly occur in younger females

Question 47

what is class 1 of compression garments and what stages of lymphedema would we use them for?

Answer 47

15-20 mmHg. nurses who stand a lot of mild lymphedema of UE

Question 48

what is class 2 of compression garments and what stages of lymphedema would we use them for?

Answer 48

20-30 mmHg. Moderate lymphedema of UE, mild in LE

Question 49

what is class 3 of compression garments and what stages of lymphedema would we use them for?

Answer 49

30-40 mmHg. Severe lymphedema in UE, moderate in LE.

Question 50

what is class 4 of compression garments and what stages of lymphedema would we use them for?

Answer 50

>40 mmHg. Severe lymphedema in LE

Question 51

what signifigance does CKD play in a patient with lymphedema

Answer 51

must be careful performing manual lymph drainage b/c kidneys might not handle the uptake in fluid.

Question 52

when exercising with a pt who has lymphedema, what precautions should we take/things we should avoid?

Answer 52

repetetive UE movements