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NBCOT > Burns > Flashcards

Burns Flashcards

1
Q

Superficial (1st degree) burn

A

Superficial epidermis
Pain is minimal to moderate; NO blistering, NO erythema

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2
Q

Superficial burn healing time

A

3-7 days
sunburn or coffee/hot soup spill
dry, redness

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3
Q

Superficial burn tx

A

elevation
keep it clean
aloe or moisturizer to reduce dry and itchy skin

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4
Q

Superficial partial thickness (2nd degree) burn

A

epidermis and upper dermis layers
pain is significant
wet blistering and erythema

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5
Q

Healing time for superficial partial thickness burn

A

1-3 weeks
curling iron/severe sunburn

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6
Q

Superficial partial thickness burn tx

A

wound care
AROM to preserve jt fx and improve circulation
protective garments
sunscreen
acknowledge pts pain
coordinate tx with pain meds

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7
Q

Deep partial thickness (deep 2nd degree) burns

A

deep reticular dermis
Epidermis, deep dermis, hair follicles, sweat glands, and most painful
pain severe, even to light touch
erythema with or without blisters (red and white)
hypertrophic scar risk is high

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8
Q

Hypertrophic scar

A

a thick raised scar
compression therapy until scar matures
scar gel pads

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9
Q

Healing time for deep partial thickness burn

A

3-5 weeks
most painful
can turn into a full thickness bc of infection
typically caused by FIRE

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10
Q

TX for deep partial thickness burn

A

frequent AROM
elevate
splints
vascular support garments
silicone inserts to manage hypertrophic scars
lubrication to healed skin
prolonged stretch to contracted jts
ADLs
psych referral if needed
team collaboration/intraprofessional collaboration

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11
Q

Full thickness (3rd degree) burn

A

Subcutaneous tissue
epidermis, dermis, hair follicles, sweat glands, & NERVE endings
pain free, no sensation to light touch
pale and non blanching
peripheral pain

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12
Q

Healing time for full thickness burn

A

variable, could take multiple months
hypertrophic scars
chemical burns/extreme heat
graft needed

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13
Q

Tx for full thickness burn

A

skin graft
positioning/immobilization
exercise despite pain
vibration for itching
educate on skin precautions
support/pressure garments
use inserts and overlays to manage concave areas
peer support group
return to recreation, work, school, fam, and community responsibilities

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14
Q

Subdermal Burn (4th degree)

A

full thickness burn with damage to tissue (fat, muscles, tendon, or bone)
charring present, with exposed fat, muscles, tendon or bone may be present

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15
Q

Healing time for subdermal burn

A

variable healing time
amputation or reconstruction surgery might be needed
electrical burn/house fire
no pain but peripheral nerve damage

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16
Q

Tx for subdermal burn

A

deep tendon massage
AE
prosthetic fitting and training
counseling or water therapy for PTSD
memory retraining
peer support group
work retraining if unable to return safely to previous job

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17
Q

Dorsal burns to the hand commonly results in deformities

A

thumb webspace contractures
loss of motion at MP, IP and composite finger flex
claw hand
boutonniere deformity if extensor tendons were damaged

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18
Q

Palmer/volar burn lead to

A

limited thumb, finger, and composited extension due to the hand being in a fit position

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19
Q

When applying dressings, what should you do to prevent restricted movement?

A

wrap the digits individual from the hand

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20
Q

Why should you encourage mobilization of non-burned areas?

A

to avoid weakness from disuse

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21
Q

AE/AD that help with grasp

A

built up handles
universal cuffs

22
Q

Burn stages

A

Emergent
acute
Skin grafting
rehab

23
Q

Burn stage: emergent

A

first 72 hours after a burn
splinting in anti deformity positions
infection control/temp control
fluid resuscitation
resp mangement
edema forms = escharotomy
edema can cause compartment syndrome

24
Q

compartment syndrome

A

painful build up of pressure around muscles

25
Q

Burn stage: acute

A

lasts until wound closure
splinting
positioning
edema management
education
early ADLs
skin grafts

26
Q

Burn stage: skin grafting

A

must have regained full ROM immobilization 5-7 days
splinting
split thickness = increased survival of graft
full thickness = graft survival is less
meshed = stretched/meshed
sheet = laid down exactly over

27
Q

Autograft

A

own skin

28
Q

Allograft

A

donor skin

29
Q

xenograft

A

pig skin

30
Q

Burn stage: rehab

A

would closure to scar maturation
lubricate, massage, stretch
contracture = serial casting/dynamic splints
positioning starts on day 1
splinting
skin care education/caregiver
ADL
IADL
reducing edema
start with AROM to protect grafts
Daily ROM with heterotrophic ossification confirmed
LE = compression support w/ standing

31
Q

Heterotrophic ossification

A

formation of bone where bone shouldn’t be
loss of ROM is rapid, pain is localized and severe
hard end Geel during PROM
AROM within pain free range to preserve jt
typically requires surgery to fix

32
Q

Burn positioning for neck

A

neutral/slight extension
no pillows
collar/towel roll behind neck or scapula

33
Q

burn positioning for axilla

A

shoulder ABD 90 degrees external rotation
airplane splint

34
Q

burn positioning for elbow

A

extension
anterior elbow extension orthosis

35
Q

burn positioning for ankle

A

neutral 0-5 degrees dorsiflexion
burn multipodus boot

36
Q

burn position for knee

A

extension
knee immobilizer

37
Q

burn position for wrist

A

neutral/up to 45 degrees extension
wrist cock up/volar splint

38
Q

burn position for hand

A

rising hand or extending hand (palmer/volar) = finger extension or baseball glove splint (palmer/volar)

intrinsic plus/safe position/ anti deformity (dorsal) = intrinsic plus/safe position/anti deformity splint (dorsal)

39
Q

Eval

A

rule of the 9s = 100%
profile
ROM = composite flex & assess each finger individually
strength
sensation
edema (no volumeter with open wound)
scar tightness vs joint stiffness
educate on early movement

40
Q

temporary compression garments

A

worn all the time, except bathing, skin care, and dressing

41
Q

custom made compression garments

A

provide gradient pressure
worn at all times

42
Q

contracture

A

tight scar band, hypertrophic scar or prolonged immobilization
addressed with early anti contracture positioning, continuous exercise, serial casting

43
Q

heat intolerance

A

loss of the ability to sweat due to loss of sweat glands
special accommodations and modifications = air conditioning in work or school

44
Q

Pruritic

A

persistent itching may lead to reopening the wound
use compression garment, maintenance of skin lubrication, use of cold packs and antihistamine meds to help with itching

45
Q

Edema

A

address 1st

46
Q

after wound closes

A

address scar contractures

47
Q

wound management

A

water, soap and a dressing
antibiotic/antimicrobial dressing
enzymatic debridment
hydro therapy/whirlpool
grafts
surgical txs

48
Q

Volar burn

A

splint in extension

49
Q

thumb is adducted

A

splint in abduction

50
Q

PAM

A

Paraffin = heat and skin lubrication are good for motion
Fluidotherapy = desensitization of hypersensitive scars

NBCOT (26 decks)

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