2.6b Environmental Safety, Burns

Question 1

Describe appearance, healing, pain, and common causes associated with each
type burn
superficial, partial thickness burns

Answer 1

Superficial, partial thickness burns

Skin layer: Epidermis into top layer of dermis

Appearance: Bright pink/red, moist/shiny, blister, blanches with pressure

Pain: Present, often severe at blister site

Skin function: Absent

Treatment: Cleansing, topical agent, analgesic

Expected outcome: Healing in about 21 days, minimal scarring, may have pigment changes

Question 2

Describe appearance, healing, pain, and common causes associated with each
type burn
deep, partial thickness burns

Answer 2

Deep, partial thickness burns

Skin layer: Entire epidermis and deeper into dermis, hair/sweat glands intact

Appearance: Pale, mottled, waxy, white, moist or dry depending blistering, decreased cap refill to area of burn

Pain: Less severe pain due to nerve damage

Skin function: Absent

Treatment: Cleansing, topical agent, analgesic, possible debridement, skin graft

Expected outcome: Healing is >21 days, hypertrophic scarring, possible contractures causing decreased function

Question 3

Describe appearance, healing, pain, and common causes associated with each
type burn
full
thickness burns

Answer 3

Full thickness burns

Skin layer: Epidermis, dermis and underlaying tissues

Appearance: Waxy, white, dry, leather appearance, possible charring

Pain: Minimal to absent

Skin function: Absent

Treatment: Cleansing, topical agent, analgesic, debridement of eschar, skin graft

Expected outcome: Healing can only take place with skin grafting, scarring of graft area

Extension to deep tissue means that the burn further invades bone, fascia and muscle and this is often life threatening

Question 4

Differentiate between minor and major burn injury and associated history/assessment related to major
burns

Answer 4

Minor burns:

Major burns:

Question 5

Describe the “rule of nines”. (Also review how it varies for children.)

Answer 5

Rule of nines:
Rapid way of estimation used in the prehospital and the ED setting.
Body is divided into 5 sections: head/neck, trunk, arms, legs and perineum
Areas are designated by “nine” percent in the way of a total or sum
Only include partial and full thickness burns
Infants and children have a greater percent designated to their head, and less to their legs due to their disproportionate size

Question 6

Describe the 3 stages of burn care including the length of each stage and the priority of care during
each phase

Answer 6

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Question 7

Identify the nursing assessments and interventions for RESPIRATORY DYSFUNCTION

Answer 7

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Question 8

Identify the nursing assessments and interventions for

FLUID AND ELECTROLYE IMBALANCE/ALTERED CARDIC OUTPUT

Answer 8

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Question 9

Identify the nursing assessments and interventions for

ALTERED NUTRITION AND METABOLIC PATTERNS

Answer 9

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Question 10

Identify the nursing assessments and interventions for

PAIN

Answer 10

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Question 11

Identify the nursing assessments and interventions for

IMPAIRED MOBILITY

Answer 11

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Question 12

Identify the nursing assessments and interventions for

ALTERATION IN SELF CONCEPT

Answer 12

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Question 13

Discuss the pathophysiology, signs and symptoms, treatment, and nursing interventions related to a
fat embolism

Answer 13

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Question 14

Define triage. Explain classes/priorities used in ER and disasters

Answer 14

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Question 15

Differentiate between an emergency and a disaster.

Answer 15

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Question 16

Identify the agents (pathogen and chemical) that are most likely to be used in a terrorist attack and
their effects on body systems

Answer 16

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Question 17

Discuss the components of the primary and secondary survey method used in assessment and
treatment of trauma patients in the emergency room

Answer 17

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Question 18

Healing phases for burn wounds

Answer 18

Burn wound healing:
Inflammation:
Onset of injury- 2 days
Coagulation at the burn site
Local vasodilation
Increase in capillary permeability

Proliferation:
Days 2-14
Presence of fibroblasts in the wound
Granulation tissue begins to form

Remodeling:
Weeks to years
Scar tissue formation
Burn wound closure