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NUR372 > Burns > Flashcards

Burns Flashcards

1
Q

Three key things related to Burns

A

1) Airway
2) Fluid Shifts
3) Infection

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2
Q

Skin

A

largest organ in the body

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3
Q

Etiology of Burns

A

Energy Transfer

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4
Q

thermal burns

A

dry heat
moist heat
contact with hot or rough surfaces

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5
Q

dry heat

A

house fire or explosion

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6
Q

moist heat

A

contact with hot liquids or steam

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7
Q

contact with hot or rough surfaces

A

hot metal, tar or grease. Often causes a full-thickness burn.

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8
Q

chemical burns

A

home or industrial, acids, organic compounds, home cleaners

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9
Q

electricity

A

surface injury might look minimal, but internal injuries might be severe.

Look for entrance and exit wound

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10
Q

Ionizing radiation

A

from radioactive material. Can be from therapeutic radiation, usually minor skin irritation.

use gloves to remove

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11
Q

Smoke and Inhalation

A

can occur at the same time as a thermal or chemical burn.

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12
Q

When are systemic responses to burns elicited?

A

after 30% of TBSA is burned

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13
Q

Jackson’s Zone

A

Coagulation
Stasis Zone
Hyperemia

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14
Q

Coagulation

A

worse part of the burn, most direct contact, irreversible tissue loss

coagulation of proteins

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15
Q

Stasis Zone

A

occurs around the coagulation zone, hopefully salvageable

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16
Q

hyperemia

A

most outer edge of the burn with edema, heals pretty quickly

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17
Q

Cardiovascular

A

increase capillary permeability,

increase heart rate, decrease cardiac output

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18
Q

Integ

A

Think of zones and what happens at the local response

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19
Q

Vasular

A

leakage from the intravascular department to the interstitial department

hypovolemic, hypotensive

20
Q

Fluid and Electrolytes

A

hyponatremia, sodium and water follow each other, hyperkalemic

decreased protein

21
Q

Pulmonary

A

inflammation mechanisms can cause edema, most overlooked reason when people die, cyanosis,

22
Q

Gastrointestinal

A

massive stress can leave to ulcer, curling ulcer

23
Q

Metabolic

A

will increase 2-3 times, increase intake of calories, increase protein, hard time regulating temp

24
Q

Immunologic

A

decrease in overall immune function, higher risk for infection, lost primary barrier against infection

25
Q

Superficial-thickness

A

Epidermis is the only part of skin injured

26
Q

Superficial Partial-Thickness

A

Caused by injury to the upper third of the dermis, leaving a good blood supply
blanches
Heal in 10-21 days

27
Q

Deep Partial-Thickness

A

Extend deeper into the skin dermis and fewer healthy cells remain.
no pain
potential graft

28
Q

Full-Thickness

A

Destruction of the entire epidermis and dermis, leaving no cells to repopulate

29
Q

Rule of nines

A

Quickly estimate the total body surface area that is burned

Multiples of nine

30
Q

Rule of Palms

A

their palm is 1%

31
Q

Deep full thickness burns

A

may have to amputate

muscle, bones, and tendons

32
Q

General care for all types of burns

A

Assess for airway patency
Administer oxygen as needed
Start IV and fluids
Perform head to toe assessment

33
Q

Chemical burn care

A

DO NOT WET THEM!

Brush off dry chemicals on skin and clothing

Remove patients clothing

34
Q

Electrical Burns care

A

Separate the patient from the electrical current

Smother any flames that are present

Initiate CPR

Obtain EKG
entrance and exit wounds

35
Q

Radiation Burns care

A

Remove patient from source

Remove clothing with tongs or lead protective gloves

If patient has radioactive particles on skin, send to radiation decontamination center

Help patient bathe or shower

36
Q

Flame burns

A

smother flames

remove smoldering clothing and all metal objects

37
Q

Resuscitation

A

onset to 24/48 hrs

airway 
edema
pain
fluid shifts, hypovolemia(ARDS-->ABG)
decreased cardiac output
38
Q

Acute

A

36-48 hrs after until wound is closed

39
Q

Rehabilitation

A

wound closure to highest level of functioning

40
Q

Resuscitation phase problems

A

airway, fluid imbalance, edema, decreased cardiac output, body temp, pain, hypotensive, decreased cardiac output, decrease urine output

41
Q

ABCDE

A

Airway (inhalation injury)
Breathing (inhalation injury, pulmonary fluid overload)
Circulation (FLUID SHIFTS, hypotension, fluid overload, urine)
Disability (LOC, pupils, neuro)
Exposure/environment (energy source, jewelry or clothes, chemical exposure, warmth)

42
Q

Parkland Formula

A

4ml/kg/TBSA

43
Q

signs of airway closure

A

hoarseness, hard cough, difficulty swallowing

44
Q

Acute phase

A 
Worried about airway and replacing fluids 
Daily weights
More focused on infection 
Risk for pneumonia increases
Kidneys kick back in
Increase in urine
Lose some of the initial edema

increase calorie and protein
graft

45
Q

Rehabilitative Phase

A

Begins with wound closure and ends when the patient returns to the highest possible level of functioning

Psychosocial care, ways to dress their wound, make up to cover it, talk to people similar,

46
Q

large bore IV

A

18g or larger

47
Q

Health Promotion and Maintenance

A 
check bathe water
use pit holders
wear sunscreen
do not smoke around oxygen
have an exit plan 
never reenter buildings

NUR372 (13 decks)

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