Burns Flashcards
where do most burns occur?
at home
why does plasma seep out into the tissue with burns?
increased capillary permeability
why does the pulse increase with burns?
anytime you’re in a deficit, your pulse will go up
why does CO decrease with burns?
less volume to pump out
why does UO decrease with burns?
kidneys are either trying to hold onto fluid or they aren’t being perfused adequately
why is epi secreted with burns?
makes you vasoconstrict so it can shunt blood to the vital organs
why are ADH and aldosterone secreted?
retain Na+ and water with aldosterone
retain water with ADH
makes BV go up!
what’s the most common airway injury
carbon monoxide poisoning
treatment for carbon monoxide poisoning
O2
one of the most important aspects of burn management is _____ _____
fluid replacement
fluid replacement for burns is based on when?
the time of the injury not when they got to the hospital
the formula for the amount of fluids needed in the first 24 hours for burn victims
consensus formula
to calculate fluid replacement properly, you also need to know the client’s ____ and _____ affected
weight in kilograms
TBSA affected
if the client is restless it suggests 3 problems:
pain
inadequate fluid replacement
hypoxia
is weight or urine output a better determinant if the client’s fluid volume is adequate?
UO
consensus formula =
(4ml of LR) X (body weight in kg) X (% of TBSA burned)
blankets help with burns by keeping in the ____ and keeps out the _____
heat; germs
sx of airway injury
singed nose hair singed facial hair soot coughing up stuff with dark specks blisters on the oral/pharyngeal mucosa
albumin holds onto ____ in the ___ space
fluid
vascular
albumin increases what 4 things
vascular volume
kidney perfusion
blood pressure
CO
when you start giving a client albumin, you know that the vascular volume will _____
increase
if a client is receiving fluids rapidly, what is a measurement you could take hourly to ensure you’re not overloading the client?
CVP
immunizations for burns
tetanus toxoid
immune globulin
what does circumferential burn mean?
goes all the way around
if a client’s vascular check in their arm is bad, what are the names of the procedures to relieve the pressure?
escharotomy
fasciotomy
relieves the pressure and restores the circulation, cuts through the eschar
escharotomy
relieves the pressure and restores the circulation, but the cut is much deeper into the issue; it cuts through the fascia of the muscle
fasciotomy
how often do we measure UO with burn clients?
q hour
what do you do if the urine is red or brown?
call dr
what drug might be ordered to flush out the kidneys
mannitol
where do we find most of our potassium?
inside the cell
with a burn what happens to cells?
ruptured
will the burn pt have hypo or hyperkalemia?
hyperkalemia
why would the healthcare provider want the client to be NPO and have an NGT hooked to suction with burns?
they could develop a paralytic ileus
if a client doesn’t have bowel sounds, what will happen to abdominal girth?
increase
what is some lab work you could check o ensure proper nutrition and a positive nitrogen balance?
prealbumin
total protein
albumin
most sensitive indicator of nutrition
prealbumin
superficial thickness burn is only damage to the _____
epidermis
partial-thickness burns have damage where?
to entire epidermis and varying depths of the dermis
full-thickness burns have damage where?
damage to entire dermis and some fat
what to do if there are fingers burned?
wrap each finger individually
use splints
with a perineal burn, the #1 complication is ______
infection
what likes to grow in eschar?
bacteria
what type of isolation for the burn client?
reverse
enzymatic debridement agents (2)
sutilains or collagenase
4 reasons to not use debridement agents?
don’t use on face
don’t use if pregnant
don’t use over large nerves
don’t use if area is opened to a body cavity
4 parts of the circulatory check
cap refill
pulse
skin temp
skin color
when giving mycin drugs worry aobut
BUN/CR
with mycin drugs worry about which 2 toxicities
ototoxicity
nephrotoxicity
when grafting the donor site is an open wound until when?
the bleeding stops
after the bleeding stops the donor site can be ?
left open to air
if the client is well nourished, the surgeon can reharvest from the same donor site every ___-___ days
12-14
with a chemical burn first remove the client from the chemical and begin _____
flushing
how long do you flush with chemical burns?
15-30 minutes
what is the first thing you do for an electrical burn?
heart monitor for 24 hours
what arrhythmia are electrical burn clients at risk for?
V. Fib
with electrical burns, myoglobin and hemoglobin can build up and cause ____ damage
kidney
why are amputations common with electrical burns?
circulatory system is destroyed
other complications with electrical wounds
cataracts
gait problems
neuro deficits
