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NSG 252 > Burns > Flashcards

Burns Flashcards

1
Q

thermal burns

A

exposure to heat sources such as hot metals, scalding liquids, steam, or flames

most common type of burn injury

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2
Q

chemical burns

A

contact with acids, alkalines, or organic compounds can cause chemical burns through absorption, inhalation, or ingestion

examples: lye, sulfuric acid

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3
Q

electrical burns

A

intense heat generated from an electric current

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4
Q

cold thermal injury

A

frostbite

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5
Q

complications of electrical burns

A

current passing through vital organs such as brain, heart, kidneys have additional manifestations

electric current can cause muscle contractions strong enough to fracture long bones and vertebrae, can propel body and cause spinal/limb fractures

respiratory arrest
metabolic acidosis
myoglobinuria
cardiac arrest
v-fib

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6
Q

partial-thickness burn

A

involve the epidermis and sometimes part of the dermis

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7
Q

full-thickness burn

A

epidermis and dermis are destroyed

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8
Q

1st degree burn (superficial partial thickness) manifestations

A

erythema, blanching on pressure, pain, mild swelling

no vesicles or blisters (may blister/peel after 24 hrs)

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9
Q

2nd degree burn (deep partial thickness) manifestations

A

fluid-filled vesicles that are red, shiny, wet if ruptured

severe pain caused by nerve injury

mild to moderate edema

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10
Q

3rd and 4th degree burn manifestations (full thickness)

A

dry, waxy white, brown or charred, leathery, or hard skin

visible thrombosed vessels

insensitivity to pain

possible muscle, tendon, bone involvement

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11
Q

eschar

A

full-thickness nonviable burn tissue

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12
Q

face, neck, circumferential torso burns may interfere with ____________

A

gas exchange

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13
Q

full thickness extremity burns can impair ________

A

perfusion distal to injury

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14
Q

prehospital care for small thermal burns

A

cover with clean, cool, dampened towel

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15
Q

prehospital care for large thermal burns

A

if unresponsive, CAB

if responsive, ABC

flush wounds with cool water, wrap pt in dry, clean sheet or blanket

cool burns for no more than 10 min, do not immerse or cover with ice

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16
Q

emergent phase: time frame and priorities

A

up to 72 hours after initial injury

fluid/electrolyte shifts: hypovolemic shock
gas exchange

17
Q

fluid and electrolyte shifts are caused by

A

increased capillary permeability

colloidal osmotic pressure decreases - fluid shifts out of vascular space into interstitial spaces (third spacing)

increased insensible losses

injured cells release K+ into circulation

Na+ moves to interstitial spaces

18
Q

manifestations of emergent phase

A

hypovolemic shock
edema
weeping skin
pain
blisters
paralytic ileus
hypo/hyperthermia
AMS

19
Q

complications of emergent phase

A

dysrhythmias
impaired circulation
VTE
airway burns/injury - respiratory distress, altered ABGs
HF
pulmonary edema
pneumonia
WBC decrease
AKI

20
Q

nursing management of emergent phase

A

2 large bore IVs
central line for burns >20% TBSA
arterial line
Parkland (Baxter) formula for fluid replacement
intubation
O2
high fowler’s
suctioning
chest PT
bronchodilators
monitor I&O
wound care
no pillows, use rolled towel

21
Q

Parker (Baxter) Formula

A

2ml LR / weight in kg / TBSA
Given fluid vol to administer in 24 hours:
administer 50% in first 8 hours
25% in second 8 hours
25% in last 8 hours

22
Q

medications for emergent phase

A

Lactated Ringers
Heparin (VTE prophylaxis)
Tetanus shot
bronchodilators
morphine
hydromorphone
haldol
lorazepam
silver sufadiazine
IV abx

23
Q

allograft

A

from skin donor

24
Q

autograft

A

patient’s skin is used
commonly from thigh, abdomen

25
Q

causative organism of sepsis is usually _________

A

gram negative bacteria

26
Q

Type of diet for burn patients

A

high protein, high carbohydrate diet

27
Q

The acute phase begins with ________

A

the mobilization of interstitial fluid and diuresis, and continues until wounds are nearly healed

28
Q

changes in the acute phase

A

oxygenation problems may resolve
VS are more stable
wound healing begins - WBCs surround wound and phagocytosis occurs
necrotic tissue begins to slough

29
Q

fluid and electrolyte balance in the acute phase

A

hyponatremia - excess GI suction, diarrhea

hypernatremia - large amounts of hypertonic solution, inappropriate fluid admin

hyperkalemia - from renal failure, massive cell injury

hypokalemia - vomiting, diarrhea, prolonged GI suctioning, IV therapy without K supplementation

30
Q

complications during acute phase

A

infection

mucous membrane fungal infection

pneumonia

diarrhea, constipation, ulcers

hyperglycemia

31
Q

the most common complications during the rehab phase are __________

A

skin and joint contractures

hypertrophic scarring

NSG 252 (3 decks)

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