Burns 5

Question 1

describe synthetic wound dressing

Answer 1

• ** best type
• solid silicone and plastic membrane
• applied directly to surface of wound
• *promoted faster healing, low infection rates, minimized pain, decreased cost

Question 2

describe biosynthetic wound dressing

Answer 2

• combo of biosynthetic and synthetic

- effective with superficial partial thickness

Question 3

describe surgical wound dressing

Answer 3

• grafting used when full thickness cannot close
• involves excision and wound covering (autograft covering)
• skin taken from another unburned part of the patients body

Question 4

s/s of infection

Answer 4

• foul smelling discharge
• fever
• blood culture
• wound culture/wound site colonization
• increased WBC

Question 5

what infection is a burn pt at risk for

Answer 5

auto contamination and cross contamination

Question 6

pts own normal flora overgrows and invades other body areas which causes infection

Answer 6

auto contamination

Question 7

organisms from other people/environment transfer to pt

Answer 7

cross contamination

Question 8

how to prevent infections in general

Answer 8

safe environment, monitoring early detection of infection

Question 9

drug therapy in acute phase

Answer 9

• tetanus toxoid administration

- tatanus immune globulin (hyper tet)

Question 10

burn wounds promote growth of ______

Answer 10

clostridium tetani (deadly infection)

Question 11

what is tetanus toxoid

Answer 11

its administration enhances immunity to C. tetani

Question 12

what is tetanus immune globulin

Answer 12

recommended when pts tetanus status is not known

Question 13

what topical antimicrobials are given in acute phase

Answer 13

• silver sulfadiazine (silvadene, thermazene)
• collagenase (Santyl with polysporin powder)
• mafenide acetate (sulfamylon)

Question 14

what is given if s/s of infection

Answer 14

systemic antibiotics (broad spectrum until culture comes back)

Question 15

what are prohibited in the rooms of burn pts

Answer 15

d/t pseudomonas, plants and flowers

raw foods may be prohibited (like fruit without peel)

Question 16

if infection is suspected…

Answer 16

• uses asepsis

- lab cultures and biopsies are recommended

Question 17

infected wound with colony counts at or near ____ colonies per gram of tissue may be life threatening

Answer 17

10 ^5

Question 18

how to minimize wt loss in acute phase

Answer 18

• calculate pt calorie needs and provide adequate daily calories
• coordinate with dietitian

Question 19

if large burn pt, what may be needed

Answer 19

5,000 kcal/day

Question 20

what types of feedings are used in the beginning stages of burns

Answer 20

enteral feedings

parenteral if GI not functional or nutritional needs not being met

Question 21

pt is expected to maintain/regain what is acute….

Answer 21

optimal mobility

Question 22

why is positioning critical

Answer 22

• neutral body position with minimal flexion

- prevent contractures ***

Question 23

how often should ROM exercises be performed

Answer 23

at least 3x a day

Question 24

when does ambulation occur

Answer 24

begins after fluid shift has resolved (aka in acute)

Question 25

when should compression dressings be applied

Answer 25

after grafts heal

Question 26

what is the final phase of burn recovery

Answer 26

rehabilitative

Question 27

describe rehabilitative

Answer 27

• psychosocial adjustment
• prevent scars/contractures
• resume activity
• may take yrs-lifetime
• successful discharge depends on extensive planning
• education ie/ how to do dressing changes