Burns

Question 1

What is the most devastating type of injury?

Answer 1

Burns

Question 2

What burned in a 1st degree (superficial) burn?

Answer 2

The epidermis only

Question 3

What is burned in a 2nd degree (partial thickness) burn?

Answer 3

The epidermis and the dermis

Question 4

What is burned in a full thickness (third degree) burn?

Answer 4

The epidermis, dermis, subcutaneous fat, and possibly the muscle.

Question 5

Which type of burn (Which degree) takes the longest to heal?

Answer 5

Full thickness (3rd degree) because it is the most serious type.

Question 6

Where is the zOnE oF cOaGuLaTiON???

Answer 6

The area of a burn that is irreversibly damaged (necrosis)

Question 7

What is blood flow like in the zone of stasis?

Answer 7

It is impaired

Question 8

Is tissue salvagable in the “zone of COAGULATION” or the “zone of STASIS”?

Answer 8

Zone of stasis. Goal here is to increase tissue perfusion.

Question 9

What happens to tissue in the Zone of Hyperaemia?

Answer 9

It is minimmaly damagd and usually heals rapidly.

Question 10

A steam burn is classified as a chemical burn or a thermal burn?

Answer 10

Thermal

Question 11

Contact with a superheated gas classified as a chemical burn or a thermal burn?

Answer 11

Thermal

Question 12

Does it matter how long the length of exposure to the burning object was?

Answer 12

Yes. Length of exposure time to hot object is crucial.

Question 13

With an electrical burn, what two things increase the severity of the injury?

Answer 13

Amount of voltage, and degree of contact.

Question 14

What happens to the heart with a severe electrical current burn?

Answer 14

V-fib and then you die

Question 15

With a chemical burn,what two things increase the severity of the injury?

Answer 15

Strength of the chemical, and length of time the person is exposed.

Question 16

If an entire body is exposed to a radioactive burn, what is the prognosis for Healing?

Answer 16

Poor

Question 17

How is size of a burn measured? 2 ways. Which is more accurate?

Answer 17

Rule of nines measures percentage of burn.

Lund Browder chart is a more accurate way.

Question 18

What is the purpose of measuring the surface area of a burn?

Answer 18

It gives healers an estimation of how much fluid needs to be replaced.

Question 19

Burn shock from burn injuries occurs after _____% of the total body surface area has been burned.

Answer 19

35% Total body surface area.

Question 20

Inadequate Cellular Perfusion is called what?

Answer 20

Burn Shock.

Question 21

When hypovolemic shock from a burn has been corrected, but cells are still inadequately perfused, what is this called?

Answer 21

BURN SHOCK

Question 22

What makes blisters and edema form after a burn (on a cellular level)?

Answer 22

The burning agent causes the capillaries and small vessels to dilate. This increases capillary permeability. The plasma seeps out into surrounding tissues. Causes blisters and massive edema.

Question 23

Why does the body have an intravascular fluid deficit after a burn?

Answer 23

Because of the fluid shift from the capillaries dilating and so on that causes blisters

Question 24

Edema only results from CHEMICAL/THERMAL burn injury

Answer 24

Thermal

Question 25

What organ system is particularly affected by the extreme fluid shifts following a burn?

Answer 25

Cardiovascular

Question 26

What is Multiple Organ Dysfunction Syndrome (MODS) ?

Answer 26

A lethal complication after resuscitation from burn shock

Question 27

What is the treatment for burns to prevent renal failure, cardiovascular collapse, and death?

Answer 27

fluid resuscitation

Question 28

What is the nurse's responsibility regarding the patients fluid status?

Answer 28

monitor and assess

Question 29

What electrolyte solution is given to burn patients? What is the formula for calculating?

Answer 29

lactated ringer's 2-4 ml/kg x the %TBSA

Question 30

What is the timing for giving fluid resuscitation for burn injuries?

Answer 30

1/2 during the first 8 hours 1/4 during the next 8 hours 1/4 during the 8 hours after that

Question 31

When someone has been burned, what is the priority?

Answer 31

AIRWAY! AIRWAY! AIRWAY!

Question 32

A patient who has is throat and face burn, what do you need to think about?

Answer 32

Airway

Question 33

When a patient has been poisoned with CO, what percentage of oxygen should you be given?

Answer 33

100%

Question 34

What is a normal CO content on a healthy patient's carboxyhemoglobin level?

Answer 34

10-20%

Question 35

What happens to a person at 60% and greater carbon monoxide content?

Answer 35

Death

Question 36

What happens at 20-30% Carbon Monoxide content?

Answer 36

Headaches/Nausea/Vomiting, Loss of Judgement

Question 37

At what level of carbon monoxide will the patient show mental confusion?

Answer 37

30-40%

Question 38

What do you need to assess changes in lung sounds for?

Answer 38

Carbonaceous sputum

Question 39

Why must urine output be monitored in a burn patient?

Answer 39

To assess the amount of kidney failure risk the patient has

Question 40

What does myoglobinurinia in the urine mean? What medication should be given? What time of burns is this usually seen in?

Answer 40

Poor kidney function--> acidosis. Sodium bicarbonate. Electrical burn

Question 41

What 2 medications are often used for pain management with burn injuries?

Answer 41

Morphine, Fentanyl

Question 42

What medication is given for nerve pain in burn patients?

Answer 42

Neurontin

Question 43

What medication is used in small doses to monitor respiratory depression?

Answer 43

Diprivan (Propofol), an anaesthetic

Question 44

How should burn medications NOT be given (via what route)?

Answer 44

iM OR Sq because not absorbed easily

Question 45

Why do burn patients have a NG tube?

Answer 45

Because of possible gastric dilation, or paralytic ileus.

Question 46

Why are burn patients placed on Ranitidine?

Answer 46

Burn patients are prone to stress ulcers

Question 47

The intensity of the metabolic changes in burn patients....

Answer 47

....is directly related to the extent of the injury

Question 48

What happens to metabolic demands in a burn patient with > 20% TBSA?

Answer 48

Metabolic demands increase!! Drastically.What

Question 49

What happens to REE (resting energy expenditure) after a burn injury?

Answer 49

It can be 200% greater after an a burn injury

Question 50

Why is a catabolic response seen in burn patients?

Answer 50

Levels of catecholamines, cortical, and glucagon are all very elevated