4092 10 burns Flashcards by Richard smith

In addition to destruction of body tissue, a burn injury results in the loss of: _____ regulation

temperature

How well did you know this?

Not at all

Perfectly

Metabolism ____ to maintain body heat as a result of burn injury and tissue damage

increases

How well did you know this?

Not at all

Perfectly

Quick method to approximate the extent of burn by dividing the body into multiples of nine. The total of the sum is equal to the total body surface area (TBSA). This determines the measurement and the extent of the burn

Rule of Nines

How well did you know this?

Not at all

Perfectly

A more exact method estimating the extent of burn by the percentage of surface area of anatomic parts, particularly the head and legs of the client injured. Dividing body into smaller parts and providing a TBSA for each body part, an estimate of TBSA can be determined

Lund and Browder Method

How well did you know this?

Not at all

Perfectly

Quick method to approximate scattered burns using the palm of the client’s hand. The palm of the client’s hand (excluding the fingers) is equal to 0.5% TBSA. This method can be used for all age groups.

Palmer Method

How well did you know this?

Not at all

Perfectly

One factor in how severe a wound is, is the involvement of the ___ blank system

respiratory (did they breath in smoke)

How well did you know this?

Not at all

Perfectly

Three Phases of Burn Care: Emergent

First 24 to 48 hr after the burn occurs

How well did you know this?

Not at all

Perfectly

Three Phases of Burn Care: Acute phase begins when

fluid resuscitation is finished

How well did you know this?

Not at all

Perfectly

Three Phases of Burn Care: Acute phase ends when

the wound is covered by tissue

How well did you know this?

Not at all

Perfectly

Three Phases of Burn Care: Rehabilitative phase begins when

most of the burn area is healed

How well did you know this?

Not at all

Perfectly

Three Phases of Burn Care: Rehabilitative phase ends when

reconstructive and corrective procedures are complete (may last for years)

How well did you know this?

Not at all

Perfectly

Reduce setting on water heater to below

140° F (60° C).

How well did you know this?

Not at all

Perfectly

Risk for Death from Burns: Burn involves greater than ___ TBSA

40% TBSA

How well did you know this?

Not at all

Perfectly

Superficial burn

damage to epidermis

How well did you know this?

Not at all

Perfectly

Superficial partial thickness

damage to the entire epidermis and some parts of the dermis

How well did you know this?

Not at all

Perfectly

Deep partial thickness

damage to entire epidermis and deep into the dermis

How well did you know this?

Not at all

Perfectly

Full thickness

damage to the entire epidermis and dermis, and may extend into the subcutaneous tissue. Nerve damage also occurs

How well did you know this?

Not at all

Perfectly

Deep full thickness

damage to all layers of skin and extends to muscle, tendons and bones

How well did you know this?

Not at all

Perfectly

Example of Superficial burn

sun burn

How well did you know this?

Not at all

Perfectly

Example of Superficial partial thickness

Flame or burn scalds

How well did you know this?

Not at all

Perfectly

Burn Appearance: Pink to red, tender, no blisters, mild edema, and no eschar

Superficial

How well did you know this?

Not at all

Perfectly

Burn Appearance: Pink to red, blisters, mild to moderate edema, and no eschar

Superficial partial thickness

How well did you know this?

Not at all

Perfectly

Burn Appearance: Red to white, with moderate edema, free of blisters, and soft and dry eschar

Deep partial thickness

How well did you know this?

Not at all

Perfectly

Burn Appearance: Red to tan, black, brown, or white. Free from blisters, severe edema, and hard and inelastic eschar

Full thickness

How well did you know this?

Not at all

Perfectly

Burn Appearance: Black, no edema

Deep full thickness

Possible grafting involved

Deep partial thickness

Grafting required

Full thickness and Deep full thickness

Clinical manifestations may not be evident for ____ and are seen as wheezing, hoarseness, and increased respiratory secretions

24 to 48 hr

Carbon monoxide inhalation findings: e_____ upper airway ____ s____

errythemia (red skin) upper airway edema sloughing of respiratory tract

H_____ and s____ may result when injury to at least 20% to 30% TBSA occurs

Hypovolemia and shock

Initial fluid shift (first 24 hr after injury): H and H will be

increased (because they lost fluid)

Initial fluid shift (first 24 hr after injury): Sodium and Potassium

Hyponatremia Hyperkalemia

Minor Burns: Stop the burning process: Remove ____ or ____ that might conduct heat

clothing or jewelry

Minor Burns: Stop the burning process: Apply cool water soaks or run cool water over injury; do not use

ice

Minor Burns: Stop the burning process: chemical burns

Flush chemical burns with large volume of water

Minor Burns: Stop the burning process: to prevent contamination and hypothermia

Cover the burn with clean cloth

Minor Burns: Stop the burning process: Provide w____

warmth

Minor Burns: Cleanse with mild soap and tepid water, avoid excess

friction

Minor Burns: Apply dressing (n_____, h_____) if the burn area is irritated by clothing

nonadherent, hydrocolloid

Minor Burns: Check immunization status for t____ and determine need for immunization

tetanus

Moderate and Major Burns: first priority

Maintain airway

Moderate and Major Burns: A ______ tube may be indicated for clients at risk for aspiration.

nasogastric

Moderate and Major Burns: Assist client to _______ every hour

cough and deep breathe

Moderate and Major Burns: Keep head of bed

elevated at all times (airway priority)

Moderate and Major Burns: Initiate intravenous access using

large-bore needle

Moderate and Major Burns: Initiate intravenous access using a large-bore needle. If a large area of the body is burned,

a central venous catheter is inserted

Moderate and Major Burns: ____ ____ replacement is needed during the emergent phase to maintain tissue perfusion and prevent hypovolemic (burn) shock

Rapid fluid

Moderate and Major Burns: AFTER the first 24 hours, the IV fluids given would be

Colloid solutions, such as albumin (DURING the 1st 24 hours its NS or LR)

Follow _____ precautions when performing wound care.

standard

A client with large burns could need up to ____ calories per day

5,000

Avoid pain medication that's given

IM or SQ

When performing wound care follow ___ precautions

standard

When do you assist with ambulation?

as soon as they're stable

In addition to retaining water and protein, Biologic Skin Coverings also cover nerve endings which means the help with

pain

Allograft vs Autograft

Allo is from any human, Auto specifically means its from your own body

Mesh graft

A skin graft that can be stretched to cover a bigger area

Graft: the extremity should be kept

elevated

The skin will regrow as long as

there is some part of the dermis left

No matter what, even if nerve endings are destroyed all burns

all burns are painful

superficial thickness wounds are the least

damaging because it only involves the epidermis.

superficial thickness wound example

sun burn

in a partial thickness wound, it affects

the epidermis and part of the dermis (think partial = part)

You can have 2 kinds of partial thickness wounds

superficial and deep

superficial partial thickness ___ when pressured

blanch

superficial partial thickness: they develop blisters because

there's plasma leaking out

superficial partial thickness usually don't

scar

Deep partial compared to superficial partial

are LESS painful because nerves are gone

Deep partial: healing can be sped up with

grafting

Full thickness burn is when

the epi and entire dermis is gone

lethary eschar

Full thickness burn

Full thickness burn: the eschar must be

removed

Full thickness burn: the eschar can have a constricting affect so you may need

fasciotomy

Deep full thickness

not only is dermis gone, but it extends into other tissue