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Med Surg II > Burns > Flashcards

Burns Flashcards

1
Q

Thermal burns are caused by

A

Flame, flash, scald, or contact burns

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2
Q

In the case of thermal burn, what should a client do

A
  1. Stop, drop, and roll to shut off o2 supply to oxygen, flush with cold water
  2. Cover with clean cover
    * do not remove clothes (cut if possible) you may tear off skin
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3
Q

Chemical burns are the result of

A

Contact with acids, alkalis and organic compounds

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4
Q

Why do alkalis burn more difficult than acid burns

A

Alkalis burns adhere to tissue causing protein hydrolysis and liquefaction

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5
Q

What should a client do if they are experiencing a chemical burn

A

Remove self from agent
Flush with water
Remove clothes if possible

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6
Q

How are electrical burns caused

A

Result from intense heat generated from electrical current. They damage vessels, nerves, and can cause anoxic and death

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7
Q

Describe 1st degree burns

A

Superficial partial thickness only epidermis, pink-red, slight edema and mild pain

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8
Q

Describe 2nd degree burn

A

Deep partial thickness includes epidermis and dermis, painful, red blisters

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9
Q

Describe 3rd

A

Full thickness, includes epidermis, dermis, subcutaneous, nerve endings
Little to no pain

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10
Q

Describe 4th degree burns

A

All parts from 3rd plus down to bone and organs. Dry, waxy, leathery, hard skin, no pain

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11
Q

What is the rule of nines

A

Is a tool used to assess the total body surface area % in pt with burns.

  1. Head & neck= 9%
  2. Upper extremity= 9%
  3. Lower Extremity= 18%
  4. Anterior trunk= 18%
  5. Posterior Trunk= 18%
  6. Genitalia= 1%
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12
Q

What are the vascular changes that occur in burn pt

A
  1. Decrease in blood flow (occluded blood vessels)
  2. Damage to macrophages in tissue (these cause constriction of vessel)
  3. Circulatory disruption at burn site
  4. Blood vessel thrombosis (can cause necrosis)
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13
Q

What contributes to the massive fluid shift in burn pt

A

Fluids shift out of blood vessels as a result of increased capillary permeability the fluid shifts in the interstitial spaces

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14
Q

Are superficial burns included in the TBSA calculation

A

No

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15
Q

The fluid shift has what effect on blood volume and pressure

A

It causes them to decrease

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16
Q

What are the complications that occur due to the fluid shift

A

Hypovolemia, metabolic acidosis, hyperkalemia, hyponatremia, hemoconcentration

17
Q

Describe the steps in fluid demobilization

A
  1. Occurs 24hrs after capillary leakage stops
  2. Diuretic stage; edema fluid shifts to vascular space
  3. Blood volume increases, increase renal blood flow and diuresis
  4. Body weight returns to normal
  5. Develop hypokalemia
18
Q

What is Curling Ulcer

A

Acute ulcerative gastroduodenal disease that occurs 24hrs after burn.

19
Q

What causes Curling ulcer

A

Reduced GI blood flow and mucosal damage

20
Q

How is Curling ulcer managed

A

H2 blockers, mucoprotectants and early enteral nutrition. Watch for sudden drop in hemoglobin

21
Q

What are the three phases of burn injuries

A

Emergent, Acute, Rehabilitative

22
Q

Describe the emergent phase of burn injuries

A

resuscitative phase; time required to resolve the immediate ice threatening problems

23
Q

How long does the emergent phase of burns last

A

From the onset of burn to the beginning of fluid demobilization and diuresis. Usually 24-48hrs

24
Q

What are the primary goals of the emergent phase

A
  1. Secure airway
  2. Fluid replacement (support circulation)
  3. Analgesics (comfort)
  4. Prevent infection (wound care)
  5. Maintain body temperature
  6. Provides emotional support
25
Q

What is the fluid replacement used during the emergent phase

A

Lactated ringers w/o destrose

26
Q

T/F CO position is the most immediate cause of death from the fire

A

True

27
Q

What are the signs and symptoms of Carbon Monoxide poisoning

A 
Edema in airway
Hoarseness
Dysphagia
Strider
Copies secretions black tinged
Substernal retractions
28
Q

What intervention need to be performed if CO poisoning is suspected

A 
High fowler position
Assess degree of poisoning
Humidifier O2 100% via face mask
Turn, cough, deep breath
Incubation & ventilation
Bronchodilators for bronchospasm
29
Q

What are the clinical manifestations of the emergent phase in a pt who has an inhalation injury

A

1.May have severe respiratory problems. Upper airway edema. auscultate for wheezes if they disappear this indicates impending airway obstruction and demands immediate incubation

30
Q

What is the purpose of IV fluid therapy during the emergent phase

A

To prevent shock by maintaining adequate circulating blood flow volume, severe burns require large fluid loads in a short time to maintain blood flow to vital organs.

31
Q

What are the interventions for a pt who has impaired gas exchange

A 
Early incubation
Ventilation 
Humidifier O2
ABG's
Bronchodilators

Med Surg II (4 decks)

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