burns Flashcards
What do burns prognosis depend on
depth and size region of body increased or young age preexisting degenerative disease type of burn early amt of fluid loss and response early wound care
What are the types of burns
Flames
scalding
chemical
electrical
Characteristics of a 1st degree burn
only outer layer of epidermis red, pink, dry painful heals in 3-10 days palliative tx (sunburn)
characteristics of a 2nd degree burn
epidermis and various degrees of dermis scalding injuries, deep sunburn moist, red, blistered painful-sensitive to touch or pinprick (pain sensors in tact) heals in 7-21 days requires medical care scar forms varying tx
What do blisters do
prevent loss of body water and protect underneath the skin
What is the criteria to be admitted to a burn unit
more than 20% of the body being burned
When do you often see 3rd degree burns
when clothes cath on fire or person is directly exposed to flame
Characteristics of a 3rd degree burn
epidermis, dermis and extends into subcutaneous tissue varies in color, hard, dry, leathery extensive edema no pain (nerve endings are damaged) surrounded by 1st/2nd degree burns decreased blood supply
When are grafts likely
in 3rd degree burns if greater than 1/5 inches
characteristics of a 4h degree burn
extends beyond skin and into fat, muscle, bone
black, charred, dry, crisp
painless
amputation typical
What are more severe burn injuries
those to the hands, feet, face, genital, inhalation, electrical
what is the rule of 9’s
describes the extent and percentage of the burn
what is the total % for the head
9
what is the total % for two arms
18%
what is the total % for the trunk
36
what % is the perinium
1
what % are the two legs
36
complications from burns
hemodynamic instability respiratory dysfunction hypermetabolic response organ system dysfunction sepsis
at is hemodynamic instability due to
fluid loss
what is burn shock
associated with hemodynamic instability
decreasedcardiac output, increased vascular resistance, impaired blood supply to organs
What are you at risk for with hemodynamic instability
vascular coagulation (blood clots)
Tx for hemodynamic instability
hydration
What causes respiratory dysfunction
smoke inhalation and burned lungs
Symptoms of respiratory dysfunction
hoarseness drooling inability to manage secretions rales stridor hacking cough labored or shallow breathing
What does respiratory dysfunction appear
24-48 hrs
tx for respiratory dysfunction
humidified oxygen
ventilation
Cause of hypermetablic response
bruns cause an increase in metabolic and nutritional requirements
tx for hypermetabolic response
nutritional support
what occurs in renal dysfunction
increased metabolic demands
What are neurologic changes due to
hypoxia
what musculoskeletal changes occur
scarring contractures
what kind of gastric problems occur
vomitting
fecal impaction
ulcers
possible feeding tube
What is sepsis
condition where body fighting a severe infection that has spread via the bloodstream in response to the body trying to fight the infection
what needs to be a priority in burn tx
pain management
What causes emotional trauma
disfigurement
pain
length of recovery
what happens to the body after burns
decreased body temp
inflammation
edema fluid and electrolyte imbalance
What causes hypovolemic shock
fluid and electrolyte imbalance
What does fluid and electrolyte imbalance result in
hypovolemic shock
decreased cardiac output
hypotension
decreased urine output
Tx for burns
life saving tx nutrition replace fluid debridement skin graft
OTs role in burns
positioning (focus on head, axilla, and hands) ADLs Edu Splinting ROM fitting of pressure garment
How to splint in burns
in positions of function rather than comfort
what are pressure garments used for
to protect fragile skin
decrease/manage scarring
Adherence for pressure garments
needs to be worn when scar is new
should be worn 23 hrs/day
wear for 12-18 mo
What is a problem with pressure garments
compliance due to itchy,blisters, swelling, rash, fit
Psychological factors after burns
Fear Pain Loss of roles financial concerns depression
What do burns cause
massive loss of body fluids
interferes w/ temp regulation
challenges immune system
causes excessive demands on the metabolic system and bodys normal reparative process
