Burns 1

Question 1

burns cause what

Answer 1

physiologic, metabolic and psychological changes with loss of tissue integrity

Question 2

tissue destruction by burn injuries leads to ______

Answer 2

fluid and electrolyte imbalance

Question 3

what are the priorities of care when dealing with burns

Answer 3

prevention of infection and closure of burn wound

Question 4

what is a major cause for disability and death among burn pts

Answer 4

lack of or delay in wound healing which causes systemic problems

Question 5

these include sweat and oil glands and hair follicles

Answer 5

dermal appendages

Question 6

what is the severity of the burn determined by

Answer 6

by how much body surface area is involved and the depth of the burn

Question 7

what is the largest organ in the body

Answer 7

skin

Question 8

when burns occur, skin can regrow as long as what

Answer 8

as long as parts of the dermis are present

if the dermis is totally burned (including dermal appendages), skin cannot restore itself

Question 9

what does it mean for the subcutaneous level to be burned

Answer 9

means the layer below dermal is burned/damaged and bones, muscle, or tendons are likely exposed

Question 10

when tissue integrity is intact what is the function of the skin

Answer 10

to act as a protective barrier against injury and microbe invasion
**burns break this barrier and increase risk for infection

Question 11

all burn injuries are ____

Answer 11

painful to some degree
cause massive fluid loss
and decrease excretory (sweat) ability

Question 12

what does desquamation mean

Answer 12

peeling of dead skin

Question 13

describe a superficial burn

Answer 13

• least amount of burn damage
• only epidermis is injured
• red/pink, mild edema, pain
• heals within 3-6 days (desquamation)

Question 14

examples of superficial burns

Answer 14

sunburn or flash burn

Question 15

describe partial thickness burn

Answer 15

involves tissue integrity loss of entire epidermis and varying depth of dermis
can be superficial or deep

Question 16

describe superficial partial thickness burn

Answer 16

• injury to upper third of dermis
• pink, moist, blanch (lighten when pressure is applied)
• blister, pain, mild edema
• heals withing 2 wks (10-20 days)

Question 17

examples of superficial partial thickness burn

Answer 17

-scalds, flames, brief contact with hot surface

Question 18

describe deep partial thickness burn

Answer 18

• injury to deeper layers of dermis
• red to white, dry, blanches slowly or not at all
• pain, no blister, soft/dry eschar
• grafts used if healing is prolonged
• healing takes 2-6 wks
• blood flow is decreased

Question 19

examples of deep partial thickness burn

Answer 19

scalds, flames, prolonged contact with hot surface, tar, grease, chemicals

Question 20

describe full thickness burns

Answer 20

• destruction of entire epidermis and dermis (no skin cells to repopulate)
• requires grafting
• black, brown, yellow, white, red
• hard, dry leathery eschar
• severe edema
• sensation and pain are decreased d/t lack of nerves
• healing takes wks to months

Question 21

describe eschar

Answer 21

dead tissue that need to slough off or be removed before wound can heal

Question 22

specific descriptors for full thickness burns

Answer 22

• circumferential- blood flow and chest may be reduced for breathing
• escharotamies or fasciotomies to relieve pressure

Question 23

what is circumferential

Answer 23

completely surrounds an extremity or the chest

Question 24

what is escharotomies and fasciotomies

Answer 24

escharotomies: incisions through eschar
fasciotomies: incisions through eschar and fascia

Question 25

describe deep full thickness burns

Answer 25

• healing takes wks to months
• extends beyond skin and damage to the bone, muscle, or tendons
• back skin
• no sensation or pain
• need early excision or grafting
• amputations may be necessary

Question 26

cardiac changes with burns

Answer 26

• initially increased HR and C.O. d/t initial fluid shift and hypovolemia
• eventually C.O. improves with fluid remobilization

Question 27

pulmonary problems that can be a major cause of death

Answer 27

• resp problems d/t superheated air, steam, toxic fumes, and smoke
• *these are a major cause of death in pt with burns (esp tend to occur if burn happened outdoors)

Question 28

pulmonary changes with burns

Answer 28

• potential airway obstruction if heat in upper airway causes inflammatory response and edema
• chemical and toxic gases cause airway injury

Question 29

metabolic changes with burns

Answer 29

• hypermetabolism d/t increased secretion of catecholamines, ADH, aldosterone, and cortisol
• cause increased need for calories and O2 (may need 2x or 3x as many calories as normal)
• increased core body temp

Question 30

immune changes with burns

Answer 30

• destroy protective layer, puts at risk for infection
• inflammatory response often inhibits immune response
• antibiotics may be needed prophylatically