Burns Flashcards
What is the most devastating type of injury?
Burns
What burned in a 1st degree (superficial) burn?
The epidermis only
What is burned in a 2nd degree (partial thickness) burn?
The epidermis and the dermis
What is burned in a full thickness (third degree) burn?
The epidermis, dermis, subcutaneous fat, and possibly the muscle.
Which type of burn (Which degree) takes the longest to heal?
Full thickness (3rd degree) because it is the most serious type.
Where is the zOnE oF cOaGuLaTiON???
The area of a burn that is irreversibly damaged (necrosis)
What is blood flow like in the zone of stasis?
It is impaired
Is tissue salvagable in the “zone of COAGULATION” or the “zone of STASIS”?
Zone of stasis. Goal here is to increase tissue perfusion.
What happens to tissue in the Zone of Hyperaemia?
It is minimmaly damagd and usually heals rapidly.
A steam burn is classified as a chemical burn or a thermal burn?
Thermal
Contact with a superheated gas classified as a chemical burn or a thermal burn?
Thermal
Does it matter how long the length of exposure to the burning object was?
Yes. Length of exposure time to hot object is crucial.
With an electrical burn, what two things increase the severity of the injury?
Amount of voltage, and degree of contact.
What happens to the heart with a severe electrical current burn?
V-fib and then you die
With a chemical burn,what two things increase the severity of the injury?
Strength of the chemical, and length of time the person is exposed.
If an entire body is exposed to a radioactive burn, what is the prognosis for Healing?
Poor
How is size of a burn measured? 2 ways. Which is more accurate?
Rule of nines measures percentage of burn.
Lund Browder chart is a more accurate way.
What is the purpose of measuring the surface area of a burn?
It gives healers an estimation of how much fluid needs to be replaced.
Burn shock from burn injuries occurs after _____% of the total body surface area has been burned.
35% Total body surface area.
Inadequate Cellular Perfusion is called what?
Burn Shock.
When hypovolemic shock from a burn has been corrected, but cells are still inadequately perfused, what is this called?
BURN SHOCK
What makes blisters and edema form after a burn (on a cellular level)?
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.
Why does the body have an intravascular fluid deficit after a burn?
Because of the fluid shift from the capillaries dilating and so on that causes blisters
Edema only results from CHEMICAL/THERMAL burn injury
Thermal
What organ system is particularly affected by the extreme fluid shifts following a burn?
Cardiovascular
What is Multiple Organ Dysfunction Syndrome (MODS) ?
A lethal complication after resuscitation from burn shock
What is the treatment for burns to prevent renal failure, cardiovascular collapse, and death?
fluid resuscitation
What is the nurse’s responsibility regarding the patients fluid status?
monitor and assess
What electrolyte solution is given to burn patients? What is the formula for calculating?
lactated ringer’s 2-4 ml/kg x the %TBSA
What is the timing for giving fluid resuscitation for burn injuries?
1/2 during the first 8 hours
1/4 during the next 8 hours
1/4 during the 8 hours after that
When someone has been burned, what is the priority?
AIRWAY! AIRWAY! AIRWAY!
A patient who has is throat and face burn, what do you need to think about?
Airway
When a patient has been poisoned with CO, what percentage of oxygen should you be given?
100%
What is a normal CO content on a healthy patient’s carboxyhemoglobin level?
10-20%
What happens to a person at 60% and greater carbon monoxide content?
Death
What happens at 20-30% Carbon Monoxide content?
Headaches/Nausea/Vomiting, Loss of Judgement
At what level of carbon monoxide will the patient show mental confusion?
30-40%
What do you need to assess changes in lung sounds for?
Carbonaceous sputum
Why must urine output be monitored in a burn patient?
To assess the amount of kidney failure risk the patient has
What does myoglobinurinia in the urine mean? What medication should be given? What time of burns is this usually seen in?
Poor kidney function–> acidosis. Sodium bicarbonate. Electrical burn
What 2 medications are often used for pain management with burn injuries?
Morphine, Fentanyl
What medication is given for nerve pain in burn patients?
Neurontin
What medication is used in small doses to monitor respiratory depression?
Diprivan (Propofol), an anaesthetic
How should burn medications NOT be given (via what route)?
iM OR Sq because not absorbed easily
Why do burn patients have a NG tube?
Because of possible gastric dilation, or paralytic ileus.
Why are burn patients placed on Ranitidine?
Burn patients are prone to stress ulcers
The intensity of the metabolic changes in burn patients….
….is directly related to the extent of the injury
What happens to metabolic demands in a burn patient with > 20% TBSA?
Metabolic demands increase!! Drastically.What
What happens to REE (resting energy expenditure) after a burn injury?
It can be 200% greater after an a burn injury
Why is a catabolic response seen in burn patients?
Levels of catecholamines, cortical, and glucagon are all very elevated
