Burns 5 Flashcards
describe synthetic wound dressing
- ** best type
- solid silicone and plastic membrane
- applied directly to surface of wound
- *promoted faster healing, low infection rates, minimized pain, decreased cost
describe biosynthetic wound dressing
- combo of biosynthetic and synthetic
- effective with superficial partial thickness
describe surgical wound dressing
- grafting used when full thickness cannot close
- involves excision and wound covering (autograft covering)
- skin taken from another unburned part of the patients body
s/s of infection
- foul smelling discharge
- fever
- blood culture
- wound culture/wound site colonization
- increased WBC
what infection is a burn pt at risk for
auto contamination and cross contamination
pts own normal flora overgrows and invades other body areas which causes infection
auto contamination
organisms from other people/environment transfer to pt
cross contamination
how to prevent infections in general
safe environment, monitoring early detection of infection
drug therapy in acute phase
- tetanus toxoid administration
- tatanus immune globulin (hyper tet)
burn wounds promote growth of ______
clostridium tetani (deadly infection)
what is tetanus toxoid
its administration enhances immunity to C. tetani
what is tetanus immune globulin
recommended when pts tetanus status is not known
what topical antimicrobials are given in acute phase
- silver sulfadiazine (silvadene, thermazene)
- collagenase (Santyl with polysporin powder)
- mafenide acetate (sulfamylon)
what is given if s/s of infection
systemic antibiotics (broad spectrum until culture comes back)
what are prohibited in the rooms of burn pts
d/t pseudomonas, plants and flowers
raw foods may be prohibited (like fruit without peel)
if infection is suspected…
- uses asepsis
- lab cultures and biopsies are recommended
infected wound with colony counts at or near ____ colonies per gram of tissue may be life threatening
10 ^5
how to minimize wt loss in acute phase
- calculate pt calorie needs and provide adequate daily calories
- coordinate with dietitian
if large burn pt, what may be needed
5,000 kcal/day
what types of feedings are used in the beginning stages of burns
enteral feedings
parenteral if GI not functional or nutritional needs not being met
pt is expected to maintain/regain what is acute….
optimal mobility
why is positioning critical
- neutral body position with minimal flexion
- prevent contractures ***
how often should ROM exercises be performed
at least 3x a day
when does ambulation occur
begins after fluid shift has resolved (aka in acute)
