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NCLEX > Burns > Flashcards

Burns Flashcards

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1
Q

Where do most burns occur?

A

At home

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2
Q

Why does plasma seep out into the tissue and when does the majority of this occur?

A

Increased capillary permeability; first 24 hours

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3
Q

What is the major concern with burn patients?

A

Hypovolemic shock - fluid status

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4
Q

Why does the cardiac output decrease in burn patients?

A

Less volume to pump out

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5
Q

Why does the urine output decrease in burn patients?

A

Kidneys are either trying to hold onto fluid or they aren’t being perfused

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6
Q

Why is epinephrine secreted?

A

Causes vasoconstriction, shunts blood back to vital organs; want to give the patient their pressure back

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7
Q

Why are ADH and aldosterone secreted?

A

Retain sodium and water with aldosterone
Retain water with ADH
–> Blood volume will go up

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8
Q

What is the most common airway injury?

A

Carbon monoxide poisoning; client is hypoxic

Treat with 100% oxygen

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9
Q

Is it important to know if the burn occurred in an open or closed space?

A

Yes - more carbon monoxide in closed space

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10
Q

What might a physician prophylactically do for a patient with burns to the neck, face, or chest?

A

Intubate

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11
Q

Explain the rule of nines.

A 
Head and neck: 9%
Trunk: front 18%; back 18%
Genital area: 1%
Leg: 18% each
Arm: 9% each
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12
Q

Why is it important to know what time the burn occurred?

A

Fluid replacement for the first 24 hours is based on the time the injury occurred, not when treatment is started

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13
Q

Explain the parkland formula for fluid replacement.

A

(4ml of LR) X (weight in kg) X (%of TBSA burned) = total fluid replacement for first 24 hours

1st 8 hours = 1/2 total volume
2nd 8 hours = 1/4 total volume
3rd 8 hours = 1/4 total volume

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14
Q

What is used to determine if a client’s fluid volume is adequate?

A

Urine output

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15
Q

What 2 things can be done to stop the burning process?

A
  1. Blanket

2. Cool water

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16
Q

Should jewelry be removed from a burn patient?

A

Yes - swelling occurs, metal gets hot

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17
Q

Should clothing be removed from a burn patient?

A

Non-adherent clothing and cover with clean dry cloth

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18
Q

What are 4 signs of airway injury/burn?

A
  1. Singed hair or eyebrows
  2. Soot present around mouth and nose
  3. Blistering
  4. Coughing up mucous with black specks
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19
Q

A client’s respirations are shallow. They are retaining _____ and therefore they are in respiratory acidosis.

A

CO2

20
Q

Why is albumin given to the burn patient?

A

Holds onto fluid in the vascular space (can’t give for first 24 hours)
Increases vascular volume, kidney perform, BP, cardiac output).

21
Q

In a client who is receiving fluids rapidly, which is a measurement you could take hourly to ensure you’re not overloading the client?

A

CVP

22
Q

What are the 2 immunizations given to burn patients?

A
  1. Tetanus toxoid

2. Immune globulin

23
Q

Relieves the pressure and restores the circulation, cuts through the eschar.

A

Escharotomy

24
Q

Relieves the pressure and restores circulation but the cut is much deeper into the tissue, the cut goes through the eschar and the fascia.

A

Fasciotomy

25
Q

Does a burn patient have a foley?

A

Yes - check output hourly

26
Q

What would you do if the urine was brown or red?

A

Call doctor

27
Q

What drug might be ordered to flush out the kidneys?

A

Mannitol

never put in fridge, inspect in light for crystals

28
Q

What electrolyte imbalance is a burn patient at risk for?

A

Hyperkalemia (cells split up and releases potassium)

29
Q

Why would a physician want a burn patient to be NPO and have an NG tube hooked to suction?

A

Patient could develop a paralytic ileus due to decreased vascular volume and hyperkalemia. NG tube removed when BS X 4 quads

30
Q

Classification of burns:

Damage only to epidermis

A

Superficial thickness

31
Q

Classification of burns:

Damage to entire epidermis and varying depths of the dermis

A

Partial thickness

32
Q

Classification of burns:

Damage to entire dermis and sometimes fat

A

Full thickness

33
Q

What are 2 specific measures for a patient who has burns on their hands?

A
  1. Wrap each finger separate

2. Use splints to prevent contractures

34
Q

Should a client with burns on their head or neck use a pillow?

A

No - promotes chin to chest

35
Q

What 2 things like to grow in eschar?

A

Bacteria and fungus

Necrotic tissue must be removed

36
Q

What type of isolation is used with burn patients?

A

Reverse isolation

37
Q

What are the 2 enzymatic drugs used to eat dead tissue?

A
  1. Sutilanis (Traverse)

2. Collagenase (Santyl)

38
Q

Can be used to debride. Give pain medication to patients at least 30 minutes prior. Worry about cross contamination.

A

Hydrotherapy

39
Q

What are the 4 common drugs used with burns?

A
  1. Silver sulfadizine (silveadene)
  2. Mafedine acetate
  3. Silver nitrate
  4. Povidone-iodine (betadine)
40
Q

What 3 things must be monitored when giving -mycin drugs?

A
  1. BUN
  2. Creatinine
  3. Hearing loss
    (ototoxicity and nephrotoxicity - assume they are toxic if BUN and Cr are increasing)
41
Q

Removes the dead burned tissue and takes good skin from a healthy donor site (usually the buttock or thigh).

A

Grafting

42
Q

What should be done first when someone has suffered a chemical burn?

A

Remove patient from chemical
Remove contacts
Flush for 15-20 minutes for body; 30 minutes for eyes

43
Q

How many wounds occur from an electrical burn?

A

2 - enter and exit

44
Q

What is the first thing you do for an electrical injury?

A

Turn off electricity for 24 hours

45
Q

What arrhythmia is an electrical burn patient at risk for?

A

V. Fib

NCLEX (16 decks)

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