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NPTE > Burns > Flashcards

Burns Flashcards

1
Q

Electrical burn

A

entrance and exit wound
complications: cardia arrhythmias, respiratory arrest, renal failure, neurological damage and fxs
Example: lightning strike

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2
Q

Chemical burn

A

sulfuric acid
lye
hydrochloric acid
gas

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3
Q

Radiation burn

A

exposure to external beam radiation therapy
DNA is altered and ischemic injury may be irreversible
severe blistering and desquamation, non-healing wounds, tissue fibrosis, permanent discoloration and new malignancies

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4
Q

Zone of stasis

A

less severe injury
reversible damage
surrounds zone of coagulation

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5
Q

Zone of coagulation

A

most severe injury with irreversible cell damage

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6
Q

Zone of hyperemia

A

surrounding zone of stasis
presents with inflammation
will fully recover without any intervention or permanent damage

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7
Q

Superficial burn

A

outer epidermis
red with slight edema
Healing occurs without peeling or evidence of scarring in 2-5 days

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8
Q

Superficial partial-thickness burn

A

epidermis and upper portion of dermis
extremely painful and exhibits blisters
minimal to no scarring 5-21 days

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9
Q

Deep partial thickness burn

A

complete destruction of epidermis and majority of dermis
may appear discolored with broken blisters and edema
damage to nerve endings results in only moderate levels of pain
hypertrophic or keloid scarring may occur
without infection healing can occur in 21-35 days

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10
Q

Chemical burns can occur from

A

iontophoresis

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11
Q

When do chemical burns from ionto occur?

A

when skin pH increases or decreases beyond range of normal tolerance

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12
Q

Chemical burns in ionto occur more severely under which electrode?

A

negative

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13
Q

What factors contribute to chemical burns from ionto treatment?

A

delivered with excessive current
prolonged duration
electrode placement over defective skin areas with lower resistance

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14
Q

Poor ionto electrode placement can contribute to

A

thermal burn in cases of excessive impedance or poor electrode contact

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15
Q

Full-thickness burn

A

complete destruction of epidermis and dermis and partial damage to subcutaneous fat layer
eschar formation and minimal pain
requires grafts and are susceptible to infection

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16
Q

Subdermal burn

A

complete destruction of epidermis, dermis and subcutaneous tissue
may involve muscle and bone
often requires multiple surgical interventions

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17
Q

Rule of Nines:
Head and neck

A

9%

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18
Q

Rule of Nines:
Anterior trunk

A

18%

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19
Q

Rule of Nines:
Posterior trunk

A

18%

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20
Q

Rule of Nines:
Bilateral anterior arm, forearm and hand

A

9%

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21
Q

Rule of Nines:
Bilateral posterior arm, forearm and hand

A

9%

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22
Q

Rule of Nines:
Genitals

A

1%

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23
Q

Rule of Nines:
bilateral anterior leg and foot

A

18%

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24
Q

Rule of Nines:
Bilateral posterior leg and foot

A

18%

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25
Q

Child under one year head and neck rule of nines:
This extra 9% is taken from LE.

A

18%

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26
Q

Each year of life for a child, ___% is distributed back to lower extremities until age 9 when head is considered same proportion as adult.

27
Q

When is head considered same proportion for burn percentage as adult?

28
Q

If burn is anterior neck what is the anticipated deformity and possible splint?

A

flexion with possible lateral flexion
soft collar, molded collar, Philly collar

29
Q

If burn is anterior chest and axilla, what is the anticipated deformity and possible splint?

A

shoulder adduction, extension and IR
axillary or airplane splint
shoulder abduction brace

30
Q

If burn is on elbow what is the anticipated deformity and possible splint?

A

flexion and pronation
gutter splint, conforming splint, three-point splint, air splint

31
Q

If burn is at hand and wrist, what is the anticipated deformity and possible splint?

A

extension or hyperextension of MCP joints
flexion of IP joints
adduction and flexion of thumb
flexion of wrist
wrist splint
thumb spica splint
palmar or dorsal extension splint

32
Q

If burn is at hip, what is the anticipated deformity and possible splint?

A

flexion and adduction
anterior hip splica
abduction splint

33
Q

If burn is at knee what is the anticipated deformity and possible splint?

A

flexion
conforming splint
three-point splint
air splint

34
Q

If burn is at ankle, what is the anticipated deformity and possible splint?

A

PF
posterior foot drop splint
posterior ankle conforming splint
anterior ankle conforming splint

35
Q

Development of ___ scars is common with severe burn injuries.

A

hypertrophic

36
Q

Complications associated with hypertrophic scars

A

contracture
adhesions
hypersensitivity
functional limitation
poor cosmesis

37
Q

Scar assessment with
General characteristics to note:

A

tonometer
rating scales for scar characteristics
location, sensation, texture, pigmentation, vascularity, pliability and height

38
Q

Scar massage should be done how?

39
Q

When should scar massage from a burn occur?

A

not too soon or too aggressively

40
Q

Compression garments with burns

A

reduce hypertrophic scarring in burns that take more than 14 days to heal.
Sustained compression from 15-35 mmHg
worn 22-23 hours per day
Start use of compression between 2 weeks and 2 months after wound closure or grafting continuing up to 2 years.

41
Q

What can be used for desensitization?

A

TENS
compression

42
Q

Desensitization techniques should be performed for how many minutes how many times a day?

A

5-10 minutes
3-4 times daily

43
Q

Silver sulfadiazine advantages

A

can be used with or without dressings
painless
can be applied to wound directly
broad-spectrum
effective against yeast

44
Q

Silver sulfadiazine disadvantages

A

does not penetrate into eschar

45
Q

Silver nitrate advantages

A

broad-spectrum
non-allergenic
dressing application is painless

46
Q

Silver nitrate disadvantages

A

poor penetration
discolors, making assessment difficult
can cause sever electrolyte imbalances
removal of dressing is painful

47
Q

Povidone-iodine advantages

A

broad-spectrum
antifungal
easily removed with water

48
Q

Povidone-iodine disadvantages

A

not effective against pseudomonas
may impair thyroid function
painful application

49
Q

Mafenide acetate advantages

A

broad-spectrum
penetrates burn eschar
may be used with or without occlusive dressings

50
Q

Mafenide acetate disadvantages

A

may cause metabolic acidosis
may compromise resp function
may inhibit epithelialization
painful application

51
Q

Gentamicin advantages

A

broad-spectrum
may be covered or left open to air

52
Q

Gentamicin disadvantages

A

has causes resistant strains
ototoxic
nephrotoxic

53
Q

Nitrofurazone advantages

A

bacteriocidal
broad-spectrum

54
Q

Nitrofurazone disadvantages

A

may lead to overgrowth of fungus and pseudomonas
painful application

55
Q

Allograft (homograft)

A

temporary skin graft from another human (usually a cadaver)
covers a large burned area

56
Q

Autograft

A

permanent skin graft from donor site on patients own body

57
Q

Escharotomy

A

opens or removes eschar from a burn site to reduce tension on surrounding structure, relieve pressure from interstitial edema and subsequently enhance circulation

58
Q

Full-thickness graft

A

contains dermis and epidermis

59
Q

Heterograft (xenograft)

A

temporary skin graft taken from another species

60
Q

Mesh graft

A

altered to create mesh-like pattern in order to cover a large surface area

61
Q

Sheet graft

A

transferred directly from unburned donor site to prepared recipient site

62
Q

Split-thickness graft

A

contains only superficial layer of dermis in addition to epidermis

63
Q

Z-plasty

A

surgical procedure where cut z shape to eliminate scar contracture

NPTE (54 decks)

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