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Burns > Burns Flashcards > Flashcards

Burns Flashcards

1
Q

Major burns

A

25 percent or more of TBSA/adult

10 percent or more of TBSA/children

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2
Q

Response of the body

A

Systemic

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3
Q

Burn affects

A

All systems of the body

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4
Q

FIRST STEP

A

airway patency

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5
Q

SECOND STEP

A

oxygen

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6
Q

THIRD STEP

A

vitals

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7
Q

FOURTH STEP

A

IV line and fluid replacement

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8
Q

FIFTH STEP

A

elevate extremities

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9
Q

SIXTH STEP

A

keep warm and put on NPO

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10
Q

Superficial-thickness burn (first degree) 6

A
  • only epidermis
  • dry/pink to red
  • no blistering
  • blanching is present
  • pain eased by cooling
  • healing in 3-6 days
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11
Q

Superficial partial-thickness burns (second degree) 4

A
  • into dermis
  • moist red blanching blistering edematous
  • sensitive to cold air
  • 10-21 days
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12
Q

Deep partial-thickness burns (second degree)

A
  • deeper into dermis
  • No blistering
  • Red and dry with moderate edema
  • May need grafting
  • Scar formation and perhaps contractures
  • soft and dry eschar
  • 3 to 6 weeks
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13
Q

Full thickness (third-degree)

A
  • into the fatty layer of the skin
  • dry hard leathery eschar
  • severe edema
  • reduced or absent sensation
  • removal of eschar and grafting is necessary
  • weeks to months
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14
Q

deep-full thickness burns

A
  • muscle tendon and bone are damaged
  • black and no sensation whatsoever
  • severe edema
  • grafts are required
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15
Q

Major priorities

A

prevention of infection and wound closure

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16
Q

Thinner skin, sensory impairment, decreased mobility

A

increased depth of injury, and increased risk of burn injury

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17
Q

slower healing time

A

greater infection and loss of function risk

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18
Q

reduced inflammatory and immune responses

A

increased risk for infection/sepsis, no fever

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19
Q

pre-existing conditions

A

can interfere with wound healing

20
Q

circumferential burns of extremities

A

compartment syndrome

21
Q

circumferential thorax burns

A

inadequate chest wall expansion and pulmonary insufficiency

22
Q

Mortality rate

A

higher younger than four and birth to one, older than 65 years

23
Q

Assessment findings in inhalation injury

A
  • facial burns
  • singed hair, eyebrows, and eyelashes
  • black carbon particles in the nose, mouth, and sputum
  • edema of the nasal septum
  • drooling
  • difficulty swallowing
  • tachy
  • agitation and anxiety
  • wheezing, dyspnea
  • edema in the oropharynx and nasopharynx
24
Q

For inhalation injuries

A

IMMEDIATELY PLACE UPRIGHT

25
Q

Vasoactive substances

A

cause an increase in capillary permeability

26
Q

Extensive burns

A

generalized body edema, decrease in circulating blood volume

27
Q

Fluid losses result in…

A

a decrease in organ perfusion

28
Q

Heart rate, blood pressure, and cardiac output…

A

increases, decreases, and decreases.

29
Q

Hyponatremia and hyperkalemia…

A

occur.

30
Q

Hematocrit levels…

A

increase.

31
Q

The kidneys start with…

A

oliguria

32
Q

Gastrointestinal tract…

A

intestinal ileus and gastrointestinal dysfunction

33
Q

Pulmonary hypertension

A

decrease in lung compliance and oxygen

34
Q

Primary goals in resuscitation/emergent phase

A

maintain airway, administer IV fluids, preserve organs

Conserve body heat and get an IV going.

35
Q

Major burns

A

Administer 100 percent oxygen with a nonrebreather mask until the carboxyhemoglobin level is below 15%.

Maintain urine output.

NPO status (until bowel sounds are heard)

NG tube

Administer tetanus.

36
Q

Minor burns

A

Active range of motion exercises and wound care treatments

37
Q

Resuscitative Phase

A

Begins with fluid initiation.
Ends with capillary integrity mainly intact and large fluid shifts decreasing.

Prevent shock!!

Fluids are calculated from time of injury.

Elevate head of bed to 30 degrees.

Initiate ECG monitoring.

Monitor daily weights (expect a weight gain of 15 to 20 pounds in the first 72 hours).

Prevent stress ulcers.

Watch for occult blood.

Urine output needs to be between 30 to 50.

Elevate burns of the extremites above the heart.

No diuretics.

Keep room warm.

Keep sterile sheets off of client’s skin

Watch myoglobin and hemoglobin levels.

No pain meds via oral route.

Don’t do subq or IM injections.

Diet high in protein, carbs, fats, vitamins (more than 5000 calories).

Daily weights.

38
Q

Acute phase

A

Restorative therapy until wound closure.
The client is stable, capillary permeability is restored, diuresis.
48-72 hours.
Infection control, pain management, physical therapy, nutritional support.

39
Q

Escharotomy

A

no anesthesia

pack it with fine mesh guaze

40
Q

Fasciotomy

A

general anesthesia

41
Q

Hydrotherapy

A

30 minutes or less

Premedicate!!

Not used for unstable clients or those with new skin grafts.

Maintain body temp!!

42
Q

Autografting

A

Immobilization of graft site and elevation

Monitor for infection suspicions.

Protect from sunlight.

Donor site needs to be kept clean, dry, and free from infection.

Apply lotions.

43
Q

Rehabilitative phase

A

Increase strength and function…provide emotional support…minimize deformities…promote wound healing.

44
Q

Fentanyl

A

can prevent oversedation

45
Q

Longer procedures

A

use morphine

Burns (1 decks)

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