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NPTE > Burns - Patho, Complications, Healing, Classification > Flashcards

Burns - Patho, Complications, Healing, Classification Flashcards

(70 cards)

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1
Q

What are the 3 zones of a burn wound?

A

Zone of coagulation
Zone of stasis
Zone of hyperemia

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2
Q

In which zone are cells irreversibly injured?

A

Zone of coagulation

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3
Q

In which zone is there minimal cell injury, with good chance of recovery?

A

Zone of hyperemia

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4
Q

In which zone are cells injured?

A

Zone of stasis

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5
Q

How soon should cells in the zone of stasis be treated to prevent cell death?

A

Within 24 - 48 hours.

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6
Q

What is the rule of nines for estimating burn area?

A
  • Head and neck 9 %
  • Anterior trunk 18 %
  • Posterior trunk 18 %
  • Arms 9 % each
  • Legs 18 % each
  • Perineum 1 % each
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7
Q

What percent of burn area would a Pt with burns along both arms and posterior trunk cover?

A

36 %

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8
Q

What percent of burn area would a Pt with burns along one leg, posterior trunk, and head and neck cover?

A

45 %

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9
Q

What percent of burn area would a Pt with burns along one arm, head and neck, both legs, and perineum cover?

A

55 %

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10
Q

What can change the rule of nines?

A

Pt age.

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11
Q

What are the classifications of burns by body area?

A

Crticial: 10 % of body with 3rd degree, 30 % or more with 2nd degree
Moderate:

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12
Q

What classification by body area would a Pt with 3rd degree burns on head and neck, and 2nd degree burns on both arms be?

A

Moderate

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13
Q

What classification by body area would a Pt with no 3rd degree burns, but 2nd degree burns along anterior and posterior trunk be?

A

Critical

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14
Q

What tissue is damaged in an 1st degree burn?

A

Epidermis only

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15
Q

What tissue is damaged in a 1st degree burn?

A

Epidermis only

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16
Q

What is the appearance of a 1st degree burn?

A

Pink or red with no blistering, minimal edema.

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17
Q

How much pain associated with a 1st degree burn?

A

Tenderness with delayed pain

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18
Q

How long does it take for a 1st degree burn to heal?

A

3 - 7 days.

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19
Q

How much scarring occurs with a 1st degree burn?

A

None

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20
Q

What tissue is affected in a 2nd degree superficial partial-thickness burn?

A

Epidermis, and upper layers of dermis.

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21
Q

What is the appearance of a 2nd degree superficial partial-thickness burn?

A
  • Bright pink or red
  • Blanching with quick capillary refill
  • Blisters, moist surface, weeping
  • Moderate edema
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22
Q

How much pain is present in a 2nd degree superficial partial-thickness burn?

A

Painful, sensitive to touch and temperature changes.

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23
Q

How long does it take for a 2nd degree superficial partial-thickness burn to heal?

A

7 - 21 days.

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24
Q

How much scarring occurs with a 2nd degree superficial partial-thickness burn?

A

Minimal to no scarring or discoloration.

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25
What tissue is affected in a 2nd degree deep partial-thickness burn?
- Epidermis - Dermis - Nerve endings - Sweat glands - Hair follicles
26
What is the appearance of a 2nd degree deep partial-thickness burn?
- Mixed red or waxy white appearance - Blanching with slow capillary refill - Broken blisters, wet surface - Marked edema
27
How much pain is associated with a 2nd degree deep partial-thickness burn?
Sensitive to pressure, but insensitive to light touch or soft pin prick.
28
How long does it take for a 2nd degree deep partial-thickness burn?
- Healing is slow
29
How does a 2nd degree deep partial-thickness burn heal?
- Scar formation and re-epithiliazation
30
What will occur without preventative treatment of 2nd degree deep partial-thickness burn?
Excessive scarring.
31
What tissue is affected in a 3rd degree burn?
- Epidermis - Dermis - Subcutaneous tissue - Possibly muscle
32
What tissue is affected in a 3rd degree burn?
- Epidermis - Dermis - Subcutaneous tissue - Possibly muscle
33
What is the appearance of a 3rd degree burn?
- White (ischemic) - Charred - Tan - Black - No blanching, poor circulation distally
34
How much pain is associated with a 3rd degree burn?
Little pain because nerve endings are destroyed.
35
How does a 3rd degree burn heal?
- Removal of eschar and skin grafting necessary
36
What are 3 potential complications of a 3rd degree burn that can be reduced with preventative treatment?
- Infection - Hypertrophic scarring - Wound contracture
37
What tissue is affected in a 4th degree burn?
- Epidermis - Dermis - Subcutaneous tissue and muscle - Possibly vascular system
38
What is the appearance of a 4th degree burn?
- Charred
39
Why may further necrosis develop as a result of a 4th degree burn?
- Compromised vascular system
40
How do 4th degree burns develop?
- Electrical burns | - Prolonged exposure to flame
41
What are 3 additional possible complications with an electrical burn?
- Ventricular fibrillation - Acute kidney damage - Spinal cord damage
42
How does a 4th degree burn heal?
- Skin grafting - Scarring - Extensive surgery
43
What may be necessary following a 4th degree burn surgically?
Amputation
44
What are 6 complications following burns?
- Infection - Shock - Pulmonary complications - Metabolic complications - Cardiac and circulatory complications - Integumentary scars
45
What is the leading cause of death following burns?
- Infection/ gangrene
46
How do pulmonary complications develop following burns?
- Inhalation of hot smoke - Smoke poisoning - Pulmonary edema results with airway obstruction - Restrictive lung disease from burns to trunk - Pneumonia
47
What should be a sign of potential smoke inhalation?
- Singed nose hairs | - Burns of the face
48
What metabolic complications arise form burns?
- Increased metabolic/ catabolic activity - Leads to weight loss - Nitrogen balance becomes negative - Energy decreases
49
How are cardiac and circulatory systems affected following burns?
- Fluid and blood plasma loss leads to decreased cardiac output
50
How do epithelial cells heal?
- Cells that are still viable are retained | - Epithelial cells grow and proliferate over wound - epithelialization
51
What is essential in the treatment of epithelial burns?
- Protect epithelial cells | - Prevent wound drying and cracking 2o to loss of sebaceous glands with moisturing creams
52
What is essential in the treatment of epithelial burns?
- Protect epithelial cells | - Prevent wound drying and cracking 2o to loss of sebaceous glands with moisturing creams
53
How do dermal wounds heal?
- Scar formation - replacement of injured cells with connective tissue
54
What color are scars?
- Initially red or purple | - Later white
55
What are the 3 phases of burn healing?
- Inflammatory - Proliferative - Maturation
56
How long is each phase of burn healing?
- Inflammatory: 3 - 5 days | - Proliferative/ maturation: Up to 2 years
57
What are the 4 primary events of the proliferative phase?
- Angiogenesis - Granulation formation - Wound contraction - Epithelialization
58
What types of collagen are used in the proliferative phase of burn healing?
- Type III initially | - Type I/ scar tissue later
59
What cells synthesize collagen, glycoaminoglyicans, and elastin?
Fibroblasts
60
What cells cause wound contraction in dermal wounds?
Myofibroblasts.
61
When does a scar become immature?
6 - 12 weeks
62
What color is an immature scare?
Bright pink
63
What is the appearance of a mature scar?
Soft, white, flat
64
How long does it take for a scar to mature?
> 1 year
65
What is a hypertrophic scar?
Raise scar within boundaries of burn
66
What is the appearance of a hypertrophic scar?
- Red - Raised - Firm
67
What is a Keloid scar?
Raised scar that extends beyond boundaries of original burn
68
What is the appearance of a Keloid scar?
- Red - Raised - Firm
69
In whom are keloid scars more likely to develop?
- Young women | - Individuals with darker skin
70
What is the appearance of a hypothrophic scar?
- Flat | - Depressed below surrounding skin

NPTE (7 decks)

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