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Nursing 304 > Burns > Flashcards

Burns Flashcards

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1
Q

At what age is survival rate best for burns?

A

age 15-45

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2
Q

Which people are at greatest risk for burns?

A

Children
Elderly
Diabetics

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3
Q

What total body area is survival best if burns are less than?

A

Survial best if <20% of total body area

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4
Q

What are some types of burns?

A

Thermal
Chemical
Electrical
Radiation

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5
Q

What causes a thermal burn?

A

Exposure to flame or hot object

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6
Q

What causes a chemical burn?

A

Exposure to acid, alkali, or organic substances

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7
Q

What causes an electrical burn?

A

result from the conversion of electrical energy into heat. Extent of injury depends on the type of current, the pathway of flow, local tissue resistance, and duration of contact

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8
Q

What causes radiation burns?

A

result from radiant energy being transferred to the body resulting in production of cellular toxins

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9
Q

What factors influence the severity of the injury?

A 
Depth of wound
Size of wound
Age of patient
Past medical history
Location of burn injury
Associated trauma
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10
Q

What are the three factors that burns are classified according to?

A

1 to depth of injury

2 extent of the body surface area involved

3 severity

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11
Q

What are the five levels of burn depth?

A 
Superficial
Superficial-partial thickness
Deep partial thickness
Full thickness 
4th degree
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12
Q

What are the characteristics of superficial burns? (Used to be called first degree)

A 
Epidermal tissue only affected
Erythema, blanching on pressure, mild swelling
    no vesicles or blister initially
Not serious unless large areas involved
i.e. sunburn
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13
Q

What are characteristics of deep partial thickness burns? (used to be called second degree)

A

*Involves the epidermis and deep layer of the dermis
Fluid-filled vesicles –red, shiny, wet, severe pain
Hospitalization required if over 25% of body surface involved
i.e. tar burn, flame

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14
Q

What are the characteristics of full thickness burns? (Third/fourth degree)

A

Destruction of all skin layers
Requires immediate hospitalization
Dry, waxy white, leathery, or hard skin, no pain
Exposure to flames, electricity or chemicals can cause full thickness burns
Fourth degree burns involve bones (burnt bones)

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15
Q

How is the extent of the body surface burn injury calculated?

A

Expressed by percentage of total body surface area (TBSA) burned
This is calculated and documented on specific body charts,such as
“rule of nines”
Lund-Browder chart
“palmer surface”

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16
Q

How is the severity of a burn determined?

A

Severity of burn injury is determined by the depth and total body surface area burned (TBSA).

17
Q

What are three classifications of burn severity?

A

Minor
Moderate
Major

18
Q

What are characteristics/criteria for minor burns?

A 
< 15% if the total BSA
Full thickness burns < 2%
No involvement of eyes, face, hands, feet or perineum
No pre-existing medical conditions
Adult < 50 years old
No other injury associated with burn
19
Q

What are characteristics/criteria for moderate burns?

A 
< 25% of BSA
 full thickness burns < 10%
 no involvement of eyes, face, hands, feet or perineum
 no pre-existing medical conditions
 adult < 50 years old
 no other injury associated with burn
20
Q

What are characteristics/criteria for major burns?

A

> 25% of BSA
full thickness > 10 %
involvement of eyes, face, hands, feet or perineum
caused by electricity
50 years old
accompanied by other injuries or inhalation burns
has pre-existing medical conditions

21
Q

What are the three stages of burn care? (they overlap)

A

Emergent

Acute

rehabilitation

22
Q

What is the emergent stage of burn care?

A

From onset of injury to completion of fluid resuscitation
ABCs of trauma care
Critical management of the burn wound is essential at the time of the injury

23
Q

What are the immediate problems during the emergent phase of burn care?

A

Immediate problem is fluid loss, edema, reduced blood flow (fluid and electrolyte shifts)

24
Q

What are the goals of the emergent phase of burn care?

A 
Secure airway
Support circulation by fluid replacement
Keep client comfortable with analgesics
Prevent infection through wound care
Maintain body temperature
Provide emotional support
25
Q

What is the pathophysiology of burns? (What does it affect)?

A 
Local skin response
Systemic response
Cellular response
Cardiac function
Renal function
GI function
Stress response
Immune response
26
Q

What are the types of airway burn injuries?

A

Carbon monoxide poisoning
Inhalation injury above the glottis
Inhalation injury below the glottis

27
Q

What are the signs and symptoms of airway burn injury above the glottis?

A

Singed nasal hair
Facial burn
Carbonaceous sputum

28
Q

What are the important things to perform during the emergent/resuscitative phase of burn care? (Besides ABCs)

A

Knowledge of circumstances surrounding the burn injury
Obtain client’s pre-burn weight (dry weight) to calculate fluid rates
Calculates based on weights obtained after fluid replacement is started are not accurate because of water-induced weight gain
Know client’s health history because the physiological stress seen with a burn can make a latent disease process develop symptoms

29
Q

What is the fluid of choice for crystalloid replacement?

A

Warmed ringers lactate

30
Q

What is the consensus formula for fluid replacement?

A

2mL RL x %TBSA x pt. weight (kg)

31
Q

What is the parkland formula for fluid replacement?

A

4mLs RL X %TBSA X pt. weight (kg)

32
Q

What is done during the acute stage of burn wound care?

A

Efforts directed at managing the wound through pain relief
Adequate nutrition
Maintaining fluid, electrolyte and acid-base balance
Ongoing monitoring of complications
Providing emotional support
Planning for rehab and discharge

33
Q

How long is the acute stage? (From when to when?)

A

From start of diuresis to near completion of wound closure

34
Q

How long is the emergent/resuscitative stage? (From when to when)

A

From onset of injury to completion of fluid resuscitation

35
Q

What are the four goals of wound management?

A

Contain bacterial growth
Provide comfort
Facilitate the healing process
Promote restoration and function

36
Q

What occurs during the rehabilitation stage of burn wound care?

A

Often a long process not only encompassing physical injuries but also the psychosocial care of the individual and family
Reconstructive surgery may be necessary to address functional and cosmetic problems

Nursing 304 (12 decks)

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