burns

Question 1

increased risk of death in which age groups?

Answer 1

really old, really young

Question 2

most common airway injury (burn)

Answer 2

carbon monoxide poisoning

Question 3

rule of nines (adult)

• head/neck
• arms
• trunk (back and front)
• genitals
• legs

Answer 3

9% - head/neck
9% - arms
18% - trunk (back and front)
1% - genitals
18% - legs

Question 4

if burn client is restless, consider which 3 problems?

Answer 4

• inadequate fluid replacement
• pain
• hypoxia

Question 5

examine what to determine if fluid volume is adequate?

Answer 5

urine output

Question 6

why is there more death with upper body burns?

Answer 6

airway injury

Question 7

burn client with shallow respirations - retaining what and experiencing what imbalance?

Answer 7

CO2, acid

respiratory acidosis

Question 8

measure this hourly to ensure not overloading burn client with fluid

Answer 8

CVP - want to see slow rise of BP

Question 9

why give albumin to burn patient?

Answer 9

draws volume into the vessels

increases: vascular volume, BP, CO, workload of heart

Question 10

why are IV meds preferred to IM meds in burn clients?

Answer 10

decreased perfusion to absorb IM

acts quicker

Question 11

tetanus toxoid: type of immunity and length of time to develop

Answer 11

active, 2-4 weeks

Question 12

immune globulin: type of immunity and length of time to develop

Answer 12

passive, immediate

Question 13

escharotomy

Answer 13

cut through eschar to relieve pressure and restore circulation

Question 14

fasciotomy

Answer 14

cut deep into tissue - through eschar and fascia - relives pressure and restores circulation

Question 15

burn client circulatory check (x4)

Answer 15

pulse
color (skin)
temp (skin)
cap refill

Question 16

burn client with brown or red urine: action and what it means

Answer 16

call provider

muscle damage –> myoglobin –> could gunk up glomerulus –> kidney damage

Question 17

drug used to flush out kidneys in burn patient

Answer 17

mannitol - osmotic diuretic

Question 18

uop less than 30mL/hour in burn client, worry?

Answer 18

kidney failure

Question 19

48 hours post burn concern?

Answer 19

client will begin to diurese (if kidneys not damaged) because fluid is going back into vascular space; worry about fluid volume excess

Question 20

electrolyte imbalance frequently seen in burn patients

Answer 20

hyperkalemia because cells have lysed and expelled contents into serum

Question 21

prevent stress ulcer/Kerling’s ulcer in burn patients

Answer 21

carbonate/magnesium carbonate (Mylanta)
pantoprazole (Protonix)
famotidine (Pepcid)

Question 22

paralytic ileus in burn patients: why and treatment

Answer 22

decreased vascular volume and gi motility; hyperkalemia

treat with: NPO and NG tube hooked to suction

Question 23

labs to ensure proper nutrition and positive nitrogen balance in burn patients? x3

Answer 23

albumin (status weeks ago)
prealbumin (status today)
total protein

Question 24

superficial thickness burn

Answer 24

aka 1st degree

damage to epidermis only

Question 25

partial thickness burn

Answer 25

aka 2nd degree

damage to entire epidermis and varying depth of dermis

Question 26

full-thickness burn

Answer 26

aka 3rd degree

damage to entire dermis and sometimes fat

Question 27

1 complication with perineal burn

Answer 27

infection

Question 28

eschar

Answer 28

dead tissue, needs to be removed for tissue to regenerate

bacteria love it!

Question 29

enzymatic drugs to treat eschar in burn patients

Answer 29

sutilanis (Travase)
collagenase (Santyl)
silver sulfadiazine
“eats” dead tissue

Question 30

hydrotherapy

Answer 30

aka whirlpool therapy
eschar debridement
- give pain meds first
- worry about cross contamination

Question 31

considerations for broad spectrum abx in burn patients?

Answer 31

avoid to prevent secondary infection, superinfection

ok to use until wound cultures return

Question 32

two ae of -mycins

Answer 32

nephrotoxicity (will see increase in BUN, creat)

ototoxicity

Question 33

how often can you reharvest from a graft donor site (given patient is well nourished?)

Answer 33

every 12 - 14 days

Question 34

how long do you flush a chemical burn?

Answer 34

15 to 20 minutes

Question 35

priority for new electrical burn patient?

Answer 35

heart monitor for 24 hours

Question 36

what arrhythmia is electrical burn patient at risk for?

Answer 36

v fib

Question 37

what causes renal damage in electrical burn patient?

Answer 37

myoglobin, hemoglobin build up