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NCLEX > Burns > Flashcards

Burns Flashcards

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1
Q

Where do most burns occur?

A

home

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2
Q

Why does plasma seep out into the tissue?

A

increased capillary permeability

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3
Q

When does majority of the plasma seep out into the tissue?

A

first 24 hours

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4
Q

What do you worry about with plasma seeping into the tissues?

A

shock

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5
Q

Why does the pulse increase with burns?

A

Burns can cause FVD, which causes the pulse to increase

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6
Q

Why does the cardiac output decrease with burns?

A

There is less volume to pump out

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7
Q

Why does the urine output decrease with burns?

A

kidneys are trying to hold on to the fluid that is left or the kidneys are not being perfused well

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8
Q

Why is epinephrine secreted with burns?

A

This causes vasoconstriction and shunts blood to the vital organs.

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9
Q

anytime the systolic BP drops below what number means the organs are not being adequately perfused?

A

90

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10
Q

Why are ADH and aldosterone secreted with burns?

A

ADH retains water and aldosterone retains sodium and water. This is to try and increase the blood volume.

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11
Q

What percentage is the head and neck in the rule of 9’s?

A

9%

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12
Q

what percentage is the trunk in the rule of 9’s?

A

Front: 18%
Back: 18%

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13
Q

What percentage is the genital area in the rule of 9’s?

A

1%

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14
Q

What percentage are the arms in the rule of 9’s?

A

9% each

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15
Q

What percentage are the legs in the rule of 9’s?

A

18% each

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16
Q

What is another name for partial thickness burns?

A

first and second degree burns

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17
Q

What is another name for full thickness burns?

A

third and fourth degree burns

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18
Q

What are ways to stop the burning process?

A 
wrap the client in a blanket
cool water (no longer than 10 minutes)
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19
Q

Why should you remove a clients jewelry?

A

swelling will occur

metal gets hot

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20
Q

what is the number one cause of death with burns?

A

inhalation injury

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21
Q

What are burn injuries caused by?

A

inhaling carbon monoxide or hydrogen cyanide

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22
Q

What is treatment for carbon monoxide poisoning and hydrogen cyanide?

A

100% oxygen

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23
Q

Why is it important to determine if the burn occurred in an open or closed space?

A

a closed space could lead to more carbon monoxide and/or hydrogen cyanide being inhaled and could cause more complications

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24
Q

What should you focus on when a client has burns to the neck/face/chest?

A

airway

25
Q

What might a primary care provider do prophylactically for a client with facial area burns?

A

endotracheal tube

26
Q

indications of inhalation injury

A 
singed nose hair/facial hair
soot on face
coughing up secretions with dark specks
difficult swallowing
wheezing
blisters on the oral/pharyngeal mucosa
hoarseness
substernal/intercostal retractions 
stridor
27
Q

what is one of the most important aspects of burn management?

A

fluid replacement

28
Q

how many large bore IV’s will the client need for fluid replacement?

A

2

29
Q

What will be used for fluid replacement?

A

crystalloids (LR) and colloids (albumin)

30
Q

Why is it important to know what time the burn occured?

A

fluid replacement therapy is based on the time that the injury occurred.

31
Q

how much of the total fluid needed for the first 24 hours do you give within the first 8 hours?

A

1/2 of total volume

32
Q

what do you need to know to properly calculate fluid replacement?

A

clients weight in kilograms

33
Q

What is the formula for fluid replacement for the first 24 hours?

A

(2-4 mL of LR) X (body weight in kg) X (% of total body surface area burned)

34
Q

what is the goal urinary output for an electrical burn client?

A

75-100 mL/ hr

35
Q

what is the required urinary output for a child?

A

1 mL/kg/hr

36
Q

why is albumin a medication for burns?

A

Holds fluid in the vascular space

37
Q

Why is albumin administered after the first 24 hours?

A

capillary permeability is normal again

38
Q

What is a potential complication of albumin?

A

FVE

39
Q

what could be measured hourly to monitor for FVE with albumin?

A

CVP

40
Q

what is the drug of choice for pain management with burns?

A

opioids

41
Q

what are common topical drugs used with burns?

A 
mafenide acetate (Sulfamylon)
silver nitrate
antimicrobial ointments
42
Q

why should antibiotic drugs be alternated?

A

bacteria will build resistance or tolerance

43
Q

why are broad spectrum antibiotics avoided with burns?

A

could lead to super infections or secondary infections or even sepsis

44
Q

what should be collected before antibiotics are started?

A

cultures

45
Q

how do you apply topical agents to a burn?

A

apply a thin layer with sterile gloves

46
Q

What are two types of debridement?

A

enzyme debridement

hydrotherapy

47
Q

What is important to remember before sending a client to hydrotherapy?

A

pain management

48
Q

what is an autograft?

A

using the client own skin for a skin graft

49
Q

after how long can a surgeon re-harvest from the same donor site if the client is well nourished?

A

12-14 days

50
Q

what would it mean if the graft becomes blue or cool?

A

poor circulation

51
Q

will the client need more or less calories?

A

more

52
Q

what two things are needed in the diet to promote healing?

A

protein

vitamin C

53
Q

what lab work checks to ensure proper nutrition and positive nitrogen balance?

A

Pre-albumin

54
Q

what are complications of burns?

A 
circulation
renal failure
electrolyte imbalance
stress ulcers
paralytic ileus
contractures
infections
55
Q

how many wounds are there with electrical burns?

A

2 (entrance and exit)

56
Q

what is the first thing you do for an electrical injury?

A

heart monitoring for 24 hours

57
Q

what kind of arrhythmia is an electrical burn client at risk for?

A

v fib

58
Q

why are amputations common with electrical burn clients?

A

circulatory system is destroyed

NCLEX (4 decks)

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