Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

MedPsych Exam 3 > Burns > Flashcards

Burns Flashcards

1
Q

how does smoke inhalation injure?

A

Heat
Systemic Toxins
Smoke

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

what are primary burn diagnoses?

A 
Flame
Scald
Contact
Inhalation
Radiation 
Chemical 
Electrical 
Frostbite
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

what are the levels of frozen soft tissue effects?

A

–10 erythema, edema, numbness
–20 same plus blisters
–30 same bloody blisters
–40 full thickness injury to muscles, tendons, bone

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

how do you tx someone with frostbite that isnt totally frozen?

A

immersion in warm water. Do not allow refreezing

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

how do you tx totally frozen dead tissue?

A

CONSERVATIVE debridement

taking off dead skin

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

how do you recognize frostbite?

A

White or grayish- yellow skin area
Skin feels firm, waxy Numbness
Victim usually unaware

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

what is frost nip?

A

White insensate areas, usually on fingertips. Respond to warming, no permanent damage

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

what is chilblains?

A

Red swollen patches of skin exposed to cold with burning and/or itching sensation

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

what is trench foot?

A

Prolonged exposure to moisture and cold (non-freezing)

Foot: red, swollen, numb, bleeds easily, blisters

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

what are common causes of thermal injuries?

A 
Residential fires
MVA
Playing with matches
Improperly stored gasoline 
Space heater malfunction 
Arson
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

what are high risk groups for burns?

A

children: scalds
teens: flames, hot liquids
elderly

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

what are the 3 cell types in the epidermis?

A

Melanocytes = Base of epidermis, synthesize and secrete pigment

Langerhans cells = Migrate from bone marrow, initiate immune response, provide defense against antigens

Merkel cell = Slow adapting mechanoreceptors respond to touch

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

if layer of skin is destroys what happens to the cells in that layer?

A

they lose function

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

what are the 3 types of connective tissue in the dermis?

A

Collagen can regenerate the epidermis
Elastin and reticulin
Gel-like ground substance

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

what structures does the dermis contain?

A

Hair follicles, sebaceous glands, sweat glands, blood & lymphatic
vessels, and nerves

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

what types of cells are in the dermis?

A

Fibroblasts: secrete connective tissue matrix
Mast cells: release histamines
Macrophages: participate in immune response

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

what are the functions of the skin?

A 
Protects against infection
Prevents loss of body fluid
Controls body temp
excretory organ
sensory organ
Produces vitamin D
Determines identity, self-worth
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

what are the causes, involved skin, presentation & healing time of a 1st degree burn?

A

Causes = Sunburn, ultraviolet, short flash fire
Involved skin = Superficial epidermis
Clinical presentation = Red, edema, painful
Healing = 3-5 days, no pigment change

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

what are the causes, involved skin, presentation & healing time of a 2nd degree superficial burn?

A

Causes = Scalds, spills, flashes of flame
Involved skin = Epidermis, most of basal layer remains
Clinical presentation = pink or mottled red, blisters, weeping, painful
Healing = < 3 weeks, min scar or pigment change

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

what are the causes, involved skin, presentation & healing time of a 2nd degree deep burn?

A

Causes = Immersions, scalds, flame
Involved skin = Epidermis and dermis
Clinical presentation = Cherry red, pale, pain (+,-), skin pliable
Healing = > 3 weeks, severe scar may occur, may need grafting

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

what are the causes, involved skin, presentation & healing time of a 3rd degree burn?

A

Causes = Flame, chemical, electrical
Involved skin = Total skin destruction, may involve deeper structures (fat, muscles, bone)
Clinical presentation = Tan or pearly white, leathery, odor of burned skin, non- pliable parchment-like, anesthetic
Healing = Skin grafts required

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

what are the causes, involved skin, presentation & healing time of a 4th degree burn?

A

Causes = Prolonged exposure to source of heat or Electrical
Involved skin = Total destruction, burned to bone
Clinical presentation = May see burned bone or deeper structures (Mummified)
Healing = grafting or amputation

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

what are the factors that determine severity of burns?

A

age, medical history, extent & depth of injury, body area involved

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

what % burned is considered a minor burn for adults, children?

A 
Adult = 15% TBSA (1st and 2nd)
Child = 10% TBSA (1st and 2nd)
Both = 2% (3rd) as long as does not involve eyes, ears, face, genitalia
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
Q

what % burned is considered a moderate burn for adults, children?

A 
Adult = 15-20% TBSA (2nd)
Child = 10-21% TBSA (2nd)
Both = 2-10% (3rd) not involving eyes, ears, face, genitalia
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
26
Q

what % burned is considered a severe burn for adults, children?

A 
Adult = 25% TBSA (2nd)
Child = 20% TBSA
All 3rd degree greater than 10%
All burn of face, eyes, ears, feet, genitalia
All electrical
All inhalation
Complications
Pts in high risk groups
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
27
Q

what is the hypovolemic component of burn shock?

A

Massive fluid loss from circulating blood volume

Caused by increased capillary permeability for 24 hrs

28
Q

what are the organs affected by burn shock?

A

Cardiac contractility diminished

Shunts blood away from kidneys, liver, gut

29
Q

what is disrupted during burn shock?

A

Cellular metabolism

30
Q

which effects pose greater threat to mortality?

A

systemic rather than local

31
Q

what are symptoms of burn shock?

A

dull eyes, pupils dilated
shallow, rapid breathing
nausea, vomit, thirst
weak, rapid pulse

32
Q

how does invasion of bacteria occur?

A

Occurs when epidermis is broken

Dead tissue, warmth and moisture are ideal for bacterial growth

33
Q

what are the priorities of a burn care pt?

A

Airway
Breathing
Circulation
Disability (Mini-Neurologic Exam) Exposure/Temperature Control

34
Q

what occurs during emergent phase recovery?

A

At site: est. airway, provide fluids

ER: use burn sheet to est. fluid needs

35
Q

what are the steps for wound care?

A

Resuscitate pt for 48-72 hours
Excise burn beginning post burn day 2 or 3 limited debriding
Debride burn for no longer than 30-45 minutes
Cover wound with cadaver skin
Attempt to remove entire burn within 7-10 days
Remove heterograft and cover wound with autograft

36
Q

what are the topical antibiotics used and their implications?

A

Sulfamyalon: bacteriocidal, causes metabolic
acidosis, painful

Silver sulfadiazine: bacteriostatic, causes leukopenia, painless

General approach: Sulfamyalon during day, Silver sulfadiazine at night

37
Q

what are the acute care goals?

A 
Scar Management
Control edema
Prevent loss of mobility
Promote self-care
Orientation activities/simulation
Pt + family education
38
Q

what is neutral positioning of burn body?

A

head: neutral
shoulder: 60 degree abduction
elbow: 30 degree abduction
wrist: 30 degree extension
metacarp: 60 degree flex
digits: full extension
leg: 15 degree abduction
ankle: 90 degree flex

39
Q

what are factors affecting positioning?

A 
Associated injuries
Tracheotomy
Ventilator dependency
Intravenous/arterial lines
Pre-existing conditions
Skin grafts and other surgeries
40
Q

what is skin escahrotomy?

A

cutting of skin to allow expansion

41
Q

what is an Allograft (Homograft, Cadaver)?

A

taken from a donor who is a member of the same species but in NOT genetically identical to recipient

42
Q

what is an autograft?

A

taken from the recipients body

43
Q

what is a full thickness graft?

A

graft that contains all the layers of skin but not contain subcutaneous fat

44
Q

what is a Heterograft (Xenograft)?

A

graft taken from another species

45
Q

what is a mesh graft?

A

the donor skin is cut to form a mesh so that it can be expanded to cover a larger area

46
Q

what is a sheet graft?

A

the donor skin is applied without alteration to the site

47
Q

what is a Split-thickness skin graft?

A

graft that contains only superficial dermal layers

48
Q

what are possible complications after skin graft surgery?

A 
Bleeding
Graft failure
Infection at donor or recipient site
Poor healing
Increased/decreased sensation
No hair growth
Contracture of graft
49
Q

what are risk factors for complications?

A

Age (Newborn, 60 years & older)
Smoking
Diabetes
Poor overall health

50
Q

How do Skin graft procedures and other surgeries influence therapeutic goals?

A

Splints & positioning
Adaptive devices for ADL
Exercise (Continue with goals of earlier phase)

51
Q

what are exercise goals for burn pts?

A

Reduce edema
Maintain ROM
Prevent skin contracture

52
Q

what are exercise goals for burn pts that are sick?

A

Positioning, splinting, PROM, AAROM. AROM Stretch

53
Q

when should pt start ROM after grafting? Ambulation & ADLs?

A

7-10 days

Ambulation & ADLs immediately

54
Q

what are goals in rehab for burn pts?

A

Joint mobility & flexibility (via exercise)
ADLs: increase participation as patientis able Strength & endurance
Re-acquisition of social/vocational skills

55
Q

what should be a primary goal in wound healing?

A

scar control

56
Q

what are methods for scar management?

A

Positioning: Acute phase and continue

Stretch: PROM and passive stretch, Splinting, casting

Pressure:Early contact dressing, Splinting, Pressure garments

57
Q

what is heterotopic ossification?

A

Bone formation in tissues that normally do not ossify

58
Q

what is Calcific tendonitis?

A

due to scarring that shifts to other joints

Usually shoulder, pain with limited ROM

59
Q

how does Joint dislocation or ankylosis occur?

A

result of faulty positioning or scar contracture

60
Q

who is most likely to get Scoliosis or Kyphosis?

A

Usually in children with neck, trunk burns

61
Q

what influences adjustment after burn injuries?

A 
Pre-morbid personality 
Family stability
Extent of burn
Location of burn
Hospital and outpatient environment
Attitudes of burn team members & family  Community support systems
62
Q

what are the psychological effects during the acute phase?

A

Patient may be disoriented, fearful, in pain Survival issues dominate

63
Q

how do OT’s tx survival issues?

A

Repeat information, involve family/friends early in patient support
Provide consistent/accurate information

64
Q

what are the psychological effects during the sub-acute phase?

A

Pt is anxious about future-appearance, work, family, social, acceptance
May see depression, withdrawal, emotional lability

65
Q

what are the psychological effects during the rehab phase?

A

Long term adjustment issues continue especially if hands or face are involved

66
Q

what does the burn care outcome depends on?

A

combined efforts of the pt and a well-organized multidisciplinary burn team

67
Q

what are the burn care outcomes if left to spontaneous recovery?

A

severe scarring and contractures

MedPsych Exam 3 (7 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions