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NP 4- TOP 8 > BURNS > Flashcards

BURNS Flashcards

1
Q

Most effective defense against infection

A

Intact Skin

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2
Q

Types of Burns:

A
  1. Thermal Burn
    2.Electrical Burn
  2. Chemical Burn
    4.Radiation Burn
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3
Q

Type of burn where there is exposure to hot surface

A

Thermal Burn

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4
Q

Management of thermal Burn

A

Small portion: Put on running water

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5
Q

Type of burn that is due to electrical source

A

Electrical Burn

“The more solid the structure the faster electricity to travel”

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6
Q

Area damage first with the electrical burn:

A

Bone, Ligament, Fascia

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7
Q

Life threatening complication with electrical burn:

A

ARRHYTHMIA

Check Vital Signs: HEART RATE

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8
Q

Priority for Electrical burn:

A

Safety of Victim + Rescuer

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9
Q

Initial action for electrical burn:

A

Stop the source

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10
Q

Lightning safest place:

A

“When the thunder roar get indoor”

-Safest: Close Area (Inside Building)
-Person struck by a lightning; find exit on the foot

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11
Q

Best position for electrical burn:

A

-Tripod Position
-Hands & Feet touches the Ground

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12
Q

There is presence of lightning and thunder, you saw patient struck by lightning and got unconscious (-) pulse.

A

Bring pt in safety/Closed area before CPR in lightning.

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13
Q

While saving patient, (Healthworker) you lose your life

A

Principle of Double Effect

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14
Q

Type of burn that is Due to strong acid

A

Chemical Burn

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15
Q

Evidence of Chemical Burn

A

(+) Liquefaction Necrosis
(+) Stain

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16
Q

PLAN OF CARE/MANAGEMENT: CHEMICAL BURN

A

Powder: Scrape or Remove with a Brush
Liquid: Flood with water

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17
Q

Type of burn that is exposed to UV ray
-Sunburn
-Sauna
-Radiation Therapy

A

Radiation Burn

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18
Q

Management for Radiation Therapy

A

Apply Cold Pack

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19
Q

Degree of Burn:

Affected is Epidermis
-Sunburn
-Exfoliation
-Dermatitis

A

Partial Thickness/ Superficial Partial (1st Degree)

P-R-S
Painful
Redness
Swelling

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20
Q

Degree of Burn:

-Affected is Epidermis + Dermis
-Most Painful
-(+) Blisters
1. Ulcerations
2.Scalds: Boiling Water

A

Deep Partial (2nd Degree)

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21
Q

Degree of Burn:

-Painless
-Nerve Damage
-Epidermis + Dermis + SQ Tissue+ White Eschar

A

Full Thickness/ 3rd Degree

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22
Q

Tissue damage by burn

A

Eschar

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23
Q

Totally Burned Patient how will you communicate?

A

Communicate thru Eyes

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24
Q

Degree of Burn:

-Epidermis + Dermis + SQ Tissue + Muscle, Bone, Organ
-Black Eschar
-Charred Eschar
-Contractures

A

4th degree burn

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25
Stiffening of Muscle
Contractures
26
Contracture in the Neck:
Turn the Head 90 degrees (ROM)
27
Management for Contractures:
-Range of Motion Exercises -Passive ROME (Assisted by Nurse)
28
Phase of Burn
Emergent Phase Diuretic Phase Recovery Phase
29
-Occurs 1st within 48 hours -Stage of Shock -Fluid Shift from IV (Plasma) to Interstitial
Emergent Phase -Hypovolemia -↓ BP (Shock) -Oliguria (↓ Urine Output) -Hemoconcentration -↑ Viscosity: RISK FOR THROMBUS -↑ Hematocrit -Hyperkalemia (Metabolic Acidosis) -Hyponatremia: Sodium rush into cells
30
-Occurs after 48 hours -Fluid shift from Interstitial to intravascular -Fluid Remobilization
Diuretic Phase -Hypervolemia -↑BP -Polyuria (Diuretic Phase) -Hypokalemia (Metabolic Alkalosis) -Hyponatremia: Sodium Excreted thru Diuresis -Hemodilution -↓ Blood Viscosity -↓Hematocrit
31
-Occurs 5-6 days after
Recovery Phase Hypokalemia: K+ is needed in cellular repair Hypocalemia: Ca+ used in scar formation ***Ca+ helps in the Cell repair
32
Plan of care: Recover Phase
Priority: Pain Management DOC: Morphine Sulfate (Narcotic/Opiods) Close the door -Nerve is hypersensitive to wind To relieve the Pain -Bed Craddle
33
Tissue damage by burn
Eschar
34
How to communicate burn pt. who is totally burned?
Communicate thru eyes
35
What is the indicator that fluid therapy is effective in burn patient?
Hematocrit return to normal level
36
Prevent infection during recovery phase
-Private room -Reverse Isolation -Handwashing -Wear Gloves -Administer Tetanus Toxoid (Must be given with Antihistamine)
37
Wound care: Recover phase
I & D : Irrigation & Debridement Technique: "Wet to Dry" -Wet gause with NSS then remove, and wet the affected area, then apply dry dressing.
38
What gloves to use during removing old dressing?
Clean Gloves
39
What gloves to use during irrigation & applying new dressing?
Sterile Gloves
40
Topical antibiotic (burn ointment) BURN OINTMENT
Treat Pseudomonas infection Silver Nitrate (0.5%) Sulfamylon (10%) Silver sulfadiazine (1%)
41
Best way to apply topical antibiotics?
With Gloved Hands -To control pressure during application
42
Burn ointment: This turns skin into black
Silver Nitrate (0.5%)
43
Burn ointment: -DOC: as antibiotic -Penetrates into skin -Kills Pseudomonas -Painful -administer analgesic 1 hour before apllication
Sulfamylon (10%)
44
Burn ointment: -Causes leukopenia (Agranulocytosis)
Silver Sulfadiazine (1%)
45
Purposes of Skin Grafting:
-Allows new skin to grow -Prevent infection -Relieve the pain -Relieve constrictures -Prevent water loss
46
skin grafting where Donor is from human skin
Homograft
47
Types of Homograft:
Autograft Isograft Allograft
48
skin grafting: Donor and recipient are the same
Autograft ***Still experiences graft rejection
49
Skin grafting from genetically related Ideal donor: Identical Twins Relatives
Isograft
50
Skin grafting from not genetically related
Allograft
51
Skin grafting where donor is from an animal/ Pigskin
Heterograft/ Xenograft
52
Harvest Site for donor in skin grafting:
T-A-B-S Thigh Abdomen Back Scalp
53
It helps to relieve pain, prevent sticking of exudates in the topsheet.
Bed Craddle
54
Good to know
Contagious Pt: Isolation room Immunosuppressed Pt: Private Room
55
Care for the Skin Grafting:
-Apply on non-bleeding area -Secure with suture or staple -Suture is removed alternately 3-4 days after ***-Never apply lotion or powder on graft: Never expose graft on direct sunlight. ***-In case of dislodge: Soak the graft on NSS and immediately bring to hospital to reattach.
56
Procedure: Cutting through a dead skin; Grid pattern.
Escharotomy
57
Purpose of Escharotomy?
Relieve Constrictures
58
Purpose of Escharotomy in chest:
Promote Breathing
59
Purpose of Escharotomy in extremities:
Promote blood flow/ Circulation How to determine if its effective: -Return of distal Pulse
60
Diet for Burns AFTER THE BURN:
NPO Due to "Curling's Ulcer" (Stress-induced ulcer) ↓ ↑Hcl due to adrenaline rush
61
Diet for burn during RECOVERY:
↑Calories: Provide energy ↑Protein: Tissue repair Vit. C: Resistance for infection Zinc: Resistance for infection
62
What Principle to use when there is Fire and you are INSIDE?
RACE Principle Rescue Alarm Confine/Contain Fire Extinguish
63
What Principle to use when there is Fire and you are OUTSIDE?
ARCE principle Alarm :"Hey the building is burning" Rescue Contain/Confine Extinguish
64
Characteristic/Definition & Management for Small Fire:
Characteristic of small fire: 1) Waste Basket 2) Fire is not taller than you Priority: Extinguish
65
RACE PRINCIPLE
RESCUE -Remove the victim -Drop & Roll -Throw a Blanket ALARM -Activate the fire alarm -Scream: "Help" CONFINE/CONTAIN -Close the door -Crawl & Cover the nose with wet towel EXTINGUISH -Water -Fire Extinguisher
66
EXTINGUISH
-Water -Fire Extinguisher
67
CONFINE/CONTAIN
-Close the door -Crawl & Cover the nose with wet towel
68
ALARM
-Activate the fire alarm -Scream: "Help"
69
RESCUE
-Remove the victim -Drop & Roll -Throw a Blanket
70
Management for patient in a wheelchair during fire?
Throw a blanket on the patient to trap Oxygen.
71
FIRE EXTINGUISHER
PASS Pull the pin Aim low Squeeze the Lever Sweeping manner towards the fire
72
When to use Fire extinguisher?
-On the onset of fire -Fire is not taller than you
73
-Indicates Smoke Inhalation -Indication of Carbon Monoxide Poisioning
Cherry Red Mucous
74
Class of Fire: utilize on Light Materials Symbol: Green Triangle
Class A *Abo
75
Class of Fire: utilized on Gas Fire/ Grease/ Oil Source Symbol: Square Red
Class B *Boom
76
Class of Fire: utilized on Electrical Source Symbol: Blue Circle
Class C Curyente
77
Class of Fire: utilized on Metal Source Symbol: Yellow Star
Class D Di magigiba: Metal
78
Class of Fire
Class A: Light materials Class B: Gas fire/ Grease/ Oil source Class C: Electrical Source Class D: Metal source
79
After the Burn Process
Priority: Establish Airway Indicates Bronchoconstriction: -Hoarseness -Wheezing -Tightness of throat -Stridor What should be available? -Intubation set -O2 Tank
80
EMERGENT PHASE
Priority: Fluid Replacement A) PLRS (Crystalloid) B) Normal Hematocrit: Indicates adequate fluid replacement in burns.
81
STEPS IN FLUID REPLACEMENT
1. Get the weight (Kg) -Lbs / 2.2 = kg 2. Rule of Nine 3. Parkland's/ Baxter's Rule 4ml PLRS x % TBSA x Wt (Kg)
82
Parkland's/Baxter's Formula
4ml x %TBSA x kg

NP 4- TOP 8 (3 decks)

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