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Hesi PN > Burns > Flashcards

Burns Flashcards

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NCLEX-PN® flashcards
1
Q

Why does plasma seep out into the tissue

A

increased capillary permeability

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2
Q

when does the majority of plasma seep out into tissue

A

first 24 hours

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3
Q

why does the pulse increase

A

anytime someone is in a FVD the pulse will increase because the heart works harder

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4
Q

why does the cardiac output decrease

A

less volume to pump out

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5
Q

why does the urine output decrease

A

kidneys are either trying to hold on to fluid or they aren’t being professed adequately

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6
Q

how long does it take to hurt kidneys with poor perfusion

A

20 minutes

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7
Q

why is epinephrine secreted

A

epinephrine and norepinephrine secretin make you peripherally vasoconstrict, bloodies shunted to the vital organs

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8
Q

why are ADH and aldosterone secreted

A

retain sodium and water with aldosterone and retain water withADH causing blood volume to go up

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9
Q

does the burning process stop when flames are gone

A

no

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10
Q

what is the number one cause of death in burns

A

inhalation injury

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11
Q

what causes inhalation injury

A

inhaling carbon monoxide or hydrogen cyanide

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12
Q

what does oxygen bind with

A

hemoglobin

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13
Q

what happens to hemoglobin when carbon monoxide is present

A

Carbon monoxide attaches to hemoglobin before oxygen can causing hypoxia

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14
Q

why does it matter if a burn occurred inside or outside

A

if the burn is in a closed space they will inhale more carbon monoxide or hydrogen cyanide so the risk for complications is increased

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15
Q

when you see a Client with neck, face, chest burns what do you focus on

A

airway

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16
Q

what may be done to prophylactically treat airway

A

intubate because the airway will swell

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17
Q

indicators of inhalation injury

A

singed nose hair
singed facial hair
soot on face
coughing up secretions with dark/black specks
difficult swallowing
wheezing
blisters found on the oral/pharngeal mucosa
hoarseness
susternal intercostal retractions and stridor

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18
Q

does more death happen with upper or lower body burns

A

upper

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19
Q

why do you avoid broad spectrum antibiotics

A

their usage could lead to super infections and/or sepsis

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20
Q

what is the exception to broad spectrum antibiotic use

A

use them until wound cultures return

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21
Q

when do you obtain wound cultures

A

before you start ABX

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22
Q

what should you monitor when giving mycin drugs

A

increased bun or creatinine or hearing loss

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23
Q

what can mycin drugs cause

A

ototoxicity and or nephrotoxicity

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24
Q

what do you assume if bun and creatinine increase

A

they have nephrotoxicity

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25
Q

what happens if they have reduced blood flow to burned area

A

delivery of ABX is reduced

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26
Q

what do silver impregnated dressings do

A

provide broad antimicrobial effects to the burn

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27
Q

how long can silver impregnated dressing stay on

A

3-14 days depending on situation

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28
Q

what can mafenide acetate cause

A

acid base problems and stings

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29
Q

what can silver nitrate cause

A

electrolyte problems, keep dressing wet

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30
Q

why should antibiotic drugs be alternated

A

bacteria will build a tolerance

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31
Q

how do you apply topical agents to a burn

A

apply a thin layer using sterile gloves

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32
Q

what are enzymatic debridement agents used for

A

to remove necrotic dead tissue

33
Q

examples of enzymatic debridement agents

A

sutilains
collagenase (saintly)

34
Q

when should you avoid enzymatic debridement agents

A

dont use on face (scaring)
dont use if pregnant
dont use over large nerves
dont use use if area is opened to a body cavity (internal organ damage)

35
Q

why is hydrotherapy used for

A

debridement

36
Q

what do you need to remember before hydrotherapy

A

pain management

37
Q

what could happen to this client if immersion hydrotherapy is used

A

cross contamination

38
Q

how often can you reharvest an autograft from the same site

A

12-14 days if well nourished

39
Q

what does it mean if the skin graft is blue or cool

A

poor profusion

40
Q

what happens if air, blood or exudate is accumulating under the graft

A

the new graft will not adhere leading to total or partial loss of the graft

41
Q

why do burn patients need more calories

A

they are in a hyper metabolic state

42
Q

what are needed in the diet to promote healing

A

protein and vitamin c

43
Q

what labs do you need to ensure proper nutrition and a positive nitrogen balance

A

pre albumin, nitrogen

44
Q

what are the circulatory checks

A

pulse
color
temp
cap refill

45
Q

what does elevation of the extremity do

A

may improve circulation by reducing edema

46
Q

what procedures help relieve pressure

A

escharotomy
fasciotomy
(relieves pressure and restores circulation

47
Q

what is the difference between a fasciotomy and escharotomy

A

the faciotomy cut is deeper into the tissue, it cuts through the fascia of the muscle

48
Q

how often does urine need to be monitored

A

every hour

49
Q

is it possible that no urine will return when you insert the catheter

A

yes

50
Q

why would there be no urine in the catheter

A

the kidneys are trying to retain fluid or they are not being professed adequately

51
Q

what would cause brown or red urine

A

RBC and hemoglobin excretion

52
Q

what drub might be ordered to flush the kidneys

A

mannitol

53
Q

if there is no urine output or if it is less than 30ml/hr what do yo worry about

A

kidney failure

54
Q

why would a client diurese after 48 hour

A

fluid returns to vascular space

55
Q

what do you worry about when pt begins to diurese

A

FVE

56
Q

where is most potassium

A

inside the cell

57
Q

what happens to cells with a burn

A

they rupture

58
Q

what electrolyte embalance does cell lysing cause

A

hyperkalemia

59
Q

why are magnesium carbonate, pantoprazole or famotidine prescribed

A

to prevent stress ulcer (curlings ulcer)

60
Q

types of antacids

A

aluminum hydroxide gel (amphojel)
magnesium hydroxide (MOM)

61
Q

H2 antagonists

A

famotidine
nizatidine

62
Q

proton pump inhibitors

A

pantoprazole, esomeprazole

63
Q

why would they be NPO and have an NG hooked to suction

A

They could develop a paralytic ileus

64
Q

why would they develop a paralytic ileus

A

decreased vascular volume
decrease GI motility
hyperkalemia

65
Q

if a client doesn’t have bowel sounds what will happen to the abdominal girth

A

increase

66
Q

when is NG tube removed

A

when bowl sounds return

67
Q

when you start GI feedings what should you measure to ensure the supplement is moving through GI tract

A

gastric residual

68
Q

what should be done to prevent contractures

A

wrap each finger separately
use splints
hyperextend the neck

69
Q

what is the number once complication of perineal burn

A

infection

70
Q

can new tissue regenerate if old is not removed

A

no

71
Q

what likes to grow in eschar

A

bactera

72
Q

how many wounds in an electrical burn

A

2
an entrance and exit

73
Q

which wound in electrical burn is bigger

A

exit

74
Q

what is the first thing you do for an electrical burn

A

heart monitoring for 24 hours

75
Q

what arrhythmia is this client at high risk for

A

V-fib

76
Q

what can build up in electrical burns

A

myoglobin and hemoglobin and can cause kidney damage

77
Q

why does an electrical burn patient need a spine board and c collar

A

they usually occur in high places, muscle contractions can cause fracture and force can throw victim forcefully

78
Q

what happens to circulatory system with electrical burns

A

destroyed

79
Q

complications of electrical burns

A

cataracts, gait problems, neurological deficit

Hesi PN (24 decks)

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