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nursing theory iv a- cindy's class > Burns > Flashcards

Burns Flashcards

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1
Q

What are the 5 types of burns?

A
  1. Thermal
  2. Chemical
  3. Smoke Inhalation Injury
  4. Electrical
  5. Cold thermal
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2
Q

What are thermal burns?

A

Burns that are caused by flame, flash, scald, or contact with hot objects
MOST COMMON

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3
Q

What are chemical burns?

A

Result from tissue injury and destruction from necrotizing substances(acid)
- immediately take out contacts and take off clothes containing chemicals

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4
Q

What is smoke inhalation injury?

A

Airway injuries resulting from inhalation of hot air or noxious chemicals that needed to be treated as soon as possible

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5
Q

What are three types of smoke inhalation injury?

A
  1. Carbon monoxide poisoning
  2. inhalation injury above the glottis
  3. inhalation injury below the glottis
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5
Q

What is the signs and symptoms of carbon monoxide poisoning?

A

Cherry red skin, headache, dizziness, nausea, breathlessness, collapse, loss of consciousness

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6
Q

What is the signs and symptoms of inhalation injury below the glottis?

A

Manifests as acute respiratory syndrome
- injury depends on length of exposure to smoke or toxic fumes
- causes inflamed airways with pulmonary edema

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7
Q

What is the signs and symptoms of inhalation injury above the glottis?

A

True medical emergency caused by hot air, smoke, or steam
- facial burns, singed nasal hair , hoarseness, painful swallowing, darkened oral membranes

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8
Q

What are electrical burns?

A

result form coagulation necrosis caused by intense heat generated from an electrical current. Can potentially cause spine injuries, death, and/or direct damage to nerves and vessels

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9
Q

What are Cold thermal injuries?

A

frostbite

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10
Q

What is a superficial partial thickness burn?

A

1st degree burn that involves the epidermis, reddened skin, and pain at injured site
example: sunburn

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11
Q

What is a deep partial thickness burn?

A

2nd degree burn that involves the epidermis, dermis, intense pain, and white/reddish skin with blisters
example: burn from the stove

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12
Q

What is a full thickness burn?

A

3rd degree burn that involves epidermis, dermis, fat, muscle, and bone with little to no pain
example: fire

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13
Q

What are the two methods that estimate total body surface area burned?

A

Lund-Browder Chart and Rule of Nines

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14
Q

What are the four phases of a burn injury?

A
  1. prehospital care
  2. emergent (resuscitation)
  3. acute (wound healing)
  4. rehabilitative (restorative)
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15
Q

What is prehospital care?

A

Removes the person from the source of the burn and stop the process. First stage of a burn injury.
Electrical: you remove pt from contact of source Chemical: you brush solid particle off skin
Small thermal burn: Cover with cool, damp towel
large thermal burn: Watch ABC, do not put body in cool water, will CAUSE shock. remove clothing and wrap in dry sheet
Inhalation injury: observe for signs of respiratory distress and treat quickly

16
Q

What is the emergent phase? Primary concerns?

A

Second phase of a burn injury.
-Period of time required to resolve the immediate problems resulting from burn injury lasting up to 72 hrs
- includes respiratory, cardiovascular systems, wound care, drug therapy, nutritional therapy
PRIMARY CONCERNS: hypovolemic shock and edema

17
Q

What happens during hypovolemic shock?

A

massive shift of fluid out of the blood vessels as a result of increased capillary permeability causing a decrease in osmotic pressure. Blood goes to important organs(brain and heart)

18
Q

What is the normal insensible loss of body fluid per hour?

A

50 ml/ hr
sweating, breathing

19
Q

What is the severely burned patient loss of body fluid per hour?

A

200-400ml/hr

20
Q

What is the complications in the respiratory system in the emergent phase?

A

The main concern is airway management.

complications: upper respiratory tract injury, direct insult at the alveolar level, pneumonia, pulmonary edema

21
Q

What is the complications in the cardiovascular system in the emergent phase?

A

Blood goes to the two most important parts of the body: Brain and heart

complications: arrhythmias, edema, necrosis, ischemia

22
Q

What is the complications in the urinary system in the emergent phase?

A

Decrease blood flow to kidneys causes renal ischema

complications: acute tubular necrosis

23
Q

What consists of wound care in the emergent phase?

A

should be delayed until a patient airway, adequate circulation, and adequate fluid replacement have been established
cleansing: done in hydrotherapy tub, cart shower, shower, or bed
debridement: done in OR and loose necrotic skin is removed

24
Q

How long can can someone stay in an immersion tank? Why?

A

20-30 minutes. Any longer can lead to cross contamination of wounds

25
Q

What is the most important measure to be done as soon as the burn patient is able?

A

range of motion. Must move or it can lead to contractures

26
Q

What immunization is given routinely to all burn patients?

A

tetanus

27
Q

What consists of nutritional therapy in the emergent phase?

A
  • When bowel sounds return, the patient may eat.
  • 5000kcal/day
  • supplements, fluid replacement as needed
28
Q

What is the acute phase in a burn injury?

A
  • Begin with mobilization of extracellular fluid and subsequent diuresis
  • Concluded when the burn area is completely covered by skin grafts or when the wounds are healed
  • Necrotic tissue begins to slough, formation of granulation tissue
  • watch for infections
29
Q

How do you prevent curling ulcers?

A

Feed right when there is bowel sounds

30
Q

What are the three types of excision and grafting in the acute phase?

A
  1. eschar
    - removed from subcutaneous tissue or fascia
  2. cultured epithelial autographs (CEA)
    - grown skin from biopsies obtained from patients own skin
  3. Artificial Skin
    - For life threatening full thickness pr deep partial thickness wounds where conventional autografts is not available or advisable
31
Q

With smoke inhalation injuries, what would you look for when the pt comes to the hospital?

A

Swelling, singed nasal hairs, horse voice

32
Q

How do you prevent contractors in a burn patient?

A

Move as soon as possible and as much as possible. Keep up with ROM

33
Q

If a pt has swelling from burns, what do you do?

A

Elevate limbs

34
Q

What are the priorities when it comes to burns?

A

oxygen and airway

35
Q

How would a burn patient receive medication?

A

Iv route

nursing theory iv a- cindy's class (17 decks)

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