Burns Flashcards
Where do most burns occur?
At home
Patho Increased \_\_\_\_\_\_ permeability in first \_\_\_\_ hours Pulse increases because \_\_\_\_\_\_\_\_\_\_ Cardiac output decreases because \_\_\_\_\_\_\_\_ Urine output decreases because \_\_\_\_\_\_\_\_ Why is epi secreted \_\_\_\_\_\_\_\_ Why are aldosterone and ADH secreted \_\_\_\_\_\_\_
capillary
24
FVD
less volume
hold on to fluid or inadequate perfusion
vasoconstricts–shunt blood to vital organs
retain water and sodium/water to increase volume
Airway injury
most common _______
client becomes \_\_\_\_\_\_\_\_ treatment \_\_\_\_\_\_\_\_ SpO2 could be \_\_\_\_\_\_\_\_ see burns to face/chest/neck think \_\_\_\_\_\_\_\_ prophylactic \_\_\_\_\_\_\_\_\_ possible
carbon monoxide poisoning--hemoglobin binds with CO instead of O2 HYPOXIC 100% O2 normal AIRWAY intubation (LEAST INVASIVE FIRST)
Classification of burns
Rule of 9s
Fluid replacement
Consensus formula = __mL x ____ % x ____kg
Divide by two–first half given in first __ hours post burn
Second half given over ____ hours
Restless could indicate __________
______ measurement determines adequacy of fluid replacement?
4 mL x burn % x weight kg
first half given in first 8 hours post burn
16
HYPOXIA, pain, inadequate fluid replacement
Urine output
_____ NEVER KILLED ANYONE
PAIN
Emergency management
______ has not stopped when flames stop
__________ can be used to stop burning
____ helps by holding in _____ & keeps out _____
remove jewelry to d/t ________
remove _____________ & cover with clean cloth
signs of airway injury _______________
higher occurrence of death with ______ body burns
respirations shallow, retain _______ =
burning cool water blanket, heat, germs swelling/metal gets hot non-adherent clothing singed facial/nose hair, soot, black specks blisters in mucosa upper CO2 = respiratory acidosis
Med management: Albumin
holds on to _______ in the __________
Vascular volume will ________
Kidney perfusion will _______
Blood pressure will _______
Cardiac output will _______
This will correct a ______ because ________
Workload of the heart will _____ d/t _______
Could cause ______, will ______ CO, lungs will be _____, check ______ hourly
CVP could ______ too fast if ______ too fast
fluid, vascular space increase increase increase increase FVD, fluid will stay in the vascular space increase, increased volume FVE, decrease, wet, CVP
increase, fluids (ENSURE WE’RE NOT OVERLOADING THE CLIENT)
Pain management
IV or IM
need _______ for IM to work
IV–faster
perfusion
Immunization \_\_\_\_\_\_ toxoid: \_\_\_\_\_\_\_ immunity immune \_\_\_\_\_\_\_\_\_: \_\_\_\_\_\_\_ immunity \_\_\_\_ is immediate \_\_\_\_ takes 2-4 weeks
tetanus, active
globulin, passive
immune globulin
tetanus toxoid
Circulatory System Complications
circumferential burns = check __________
4 things included in circulatory check:
if vascular check is BAD, will have ______ or ______
BOTH relieve ________ & restore _________
CIRCULATION
1. pulse 2. cap refill 3. skin temp 4. skin color
escharotomy or fasciotomy
pressure, circulation
Renal System Complications check \_\_\_\_\_\_\_\_\_ hourly possible for \_\_\_\_\_ UOP d/t \_\_\_\_\_\_ Call provider if urine is \_\_\_\_\_ or \_\_\_\_\_\_ flush out kidneys with \_\_\_\_\_\_\_\_ worry about \_\_\_\_\_\_\_\_\_\_\_\_\_\_\_ \_\_\_\_\_\_\_ begins after 48 hours d/t \_\_\_\_\_\_\_\_\_ now worry about \_\_\_\_\_\_\_\_\_ UOP should \_\_\_\_\_\_\_\_\_
urine output NO, holding onto fluid/inadequate perfusion brown or red MANNITOL RENAL FAILURE diuresis, increased volume in vascular space FVE increase
Electrolyte Imbalance Complications
what happens to cells with a burn?
so ________ increases in vascular space
which electrolyte imbalance?
cells lyse/rupture
potassium
hyperkalemia
GI System Complications
antacids/H2 antagonists/PPI ordered for:
could develop ______________ so we make them ______ and have _______ to suction
reasons for paralytic ileus to develop:
abdominal girth will ________ with _______ BS
require ______ calories due to ________ state
NG can removed when you hear _______
measure ________ to ensure supplements moving through GI tract
best indicator of nutrition status is ___________
maximize nutrition with _______ & vitamin _____
stress/Curling's ulcer NPO, NG decreased GI motility, decreased vascular volume, hyperkalemia increase, NO MORE, hypermetabolic bowel sounds residual
prealbumin
protein & vit C
Integumentary System Complications can develop \_\_\_\_\_\_ wrap each \_\_\_\_\_\_\_ separately use \_\_\_\_\_ to prevent contractures \_\_\_\_\_\_\_\_ the neck -- no \_\_\_\_\_\_\_\_
contractures
finger
splints
hyperextend, pillows
