Burns Flashcards
what are the types of burn injuries (5)
- thermal
- chemical
- smoke inhalation
- electrical
- cold thermal
1st degree (superficial) burns are treated with what
topical antibiotics (Bacitracin/Neosporin) 1-3x per day and can bathe in phisohex or antibiotic (Furacin) bath
2nd (partical thickness) degree and 3rd (full thickness) degree burns are treated with what
Silvadene cream (silver dulfadiazine)
-applied using sterile technique after debriding or a dermabrasive bath (pre-medicate prior to bath or therapy)
nitrofurazone (Furasin) is a ______ antibacterial
broad spetrum antibacterial
- used when bacteria is resistant to other agents
name some side effects of Nitrofurazone (Furasin)
rash, contact dermatitis, pruritus, local edema
Mafenide acetate (sulfamylon) is used to reduce bacteria present in ________
avascular tissue (dead tissue)
- completely cover burn when using
Mafenide acetate (sulfamylon) is _______ for gram negative and gram positive organisms
bacteriostatic
Mafenide acetate (sulfamylon) can be absorbed thru _________ areas and may cause what
devascularized; metabolic acidosis
(hyperventilation = notify PCP and wash off)
side effects of Mafenide acetate (sulfamylon)
local pain, rash
(hyperventilation, elevated blood pressure)
Silver sulfadiazine (Silvadene, Thermazene) has broad spectrum coverage against what three things
gram negative bacteria, gram positive bacteria, and yeast
who should not use Silver sulfadiazine (Silvadene, Thermazene)
children under 2 or pregnant women
Silver sulfadiazine (Silvadene, Thermazene): slow released = _______
selectively toxic
Silver sulfadiazine (Silvadene, Thermazene) should NEVER be used on the face because it can cause what
hearing loss and blindness
Silver sulfadiazine (Silvadene, Thermazene) should NOT be used on ______ tissue
healthy
side effects of Silver sulfadiazine (Silvadene, Thermazene)
rash, itching, secondary burns
adverse effects of Silver sulfadiazine (Silvadene, Thermazene)
leukopenia, interstitial nephritis
what should be monitiored when using Silver sulfadiazine (Silvadene, Thermazene)
CBC, WBC
- if WBC’s are elevated notify PCP
rule of nines percentages
- 4.5% front of head
- 4.5% back of head
- 18% torso
- 18% back
- 4.5% left anterior arm
- 4.5% left posterior arm
- 4.5% right anterior amr
- 4.5% right posterior arm
- 9% left anterior leg
- 9% right anterior leg
- 9% left posterior leg
- 9% right posterior leg
- 1% perineal area
why should patient’s with a third degree burn be intubated right away
airways could be daaged and swell, causing the airway to be lost (if the airway is lost, a trach would need to be placed)
pain management is MINOR after the first 24-48 hours if area is kept ____
moist
what forms of pain management can be used for first degree burns
oral narcotics, non-steroidal anti-inflammatory pain control agents, topical anesthetics
what degree of burns is the most painful
2nd degree
what should be used for pain management of 2nd degree burns
narcotic or non-narcotic analgesics (nubain, morphine, sulfate, demerol) in combination with sedatives or anti-anxiety meds (ativan/valium) (for anticipatory pain)
what degree of burn is the least painful
3rd degree
rapid fluid replacement should be done using what solutions
isotonic/ volume restoring solutions (LR)
(999ml/hr)
fluid replacement formula
2-4 ml/kg (wt) x %burn = total volume replacement needed
what two things may need to be added for fluid replacement
volume expanders (hespan or albumin) and osmotic diuretics (restore and maintain urinary output and reduce organ swelling - mannitol)
nursing considerations for electrocution
- watch for 24-48 hours
- monitor vitals
- maintain airway
- pain control
- IV fluids
- topical treatments
- nutrition
- tele (transient A Fib)
_____ may be needed for chemical burns prior to treatment
decontamination
(use nitrile gloves, may need decontamination suit)
sun protection is needed post burn to prevent what
secondary burns and hyper-pigmentation of new skin
what diet should be encouraged post burn
high calorie high protein
