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NCLEX > Burns > Flashcards

Burns Flashcards

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1
Q

where do most burns occur

A

at home

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2
Q

why does plasma seep out into the tissues following a burn

A

increased capillary permeability

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3
Q

when does most plasma seep out into the tissue following a burn

A

first 24 hours

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4
Q

does your pulse increase or decrease following a burn, why?

A

increase - fluid volume deficit

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5
Q

what happens to CO following a burn

A

decrases - less volume

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6
Q

what happens to urine output following a burn? why?

A

decrease - kidneys trying to retain fluid or aren’t being perfused adequately

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7
Q

what catecholamine is ecreted following a burn and why?

A

epi - causes vasoconstriction - shunts blood to vital organs

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8
Q

what else is secreted during a burn to improve fluid levels

A

aldosterone and ADH - increase blood volume

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9
Q

what is the most common airway injury in a burn patient

A

CO poisoning - CO binds stronger causes hypoxia

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10
Q

what is the treatment for airway injury in burn patients

A

give 100% O2 to knock CO out

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11
Q

why is it important to know if the burn occured in a closed space or not

A

more smoke inhalation

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12
Q

what do you immediately think of if you see a patient with burn injuries to head or neck

A

airway!

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13
Q

what is a prophylactic measure the HCP may do for a burn victim

A

intubation - incase airway closes

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14
Q

what is the common formula to approximate burn area

A

9% everwhere
18% front of torso and back
1% groin

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15
Q

what is one of the most important burn managmenet interventions

A

fluid replacement

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16
Q

why is it important to know what time the burn occured

A

fluid therapy is calculated for the first 24 hours folowing the time of injury

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17
Q

what is the formula called to calculate fluid replacement in burn victims

A

parkland formula

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18
Q

what is the parkland formula

A

(4mL) x (body weight in Kg) x (% of TBSA burned) = total fluid requirement

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19
Q

how is the first 24 hours of fluid replacement divided up (1st, 2nd and 3rd 8 hour periods)

A

1st 8 hours = 1/2 of total volume
2nd 8 hours = 1/4 of total volume
3rd 8 hours = 1/4 of total volume

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20
Q

a restless burn client suggests what 3 problems

A

hypoxia ** priority
pain
inadequate fluid replacement

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21
Q

what should be done to stop the burning process

A

soak area with cool water

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22
Q

why do you remove jewlery on a burn victim

A

because swelling will occur

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23
Q

what should be done with clothing on a burn victim

A

removed and replaced with clean dry cloth

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24
Q

what medication is given for burn victims

A

albumin

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25
Q

why is albumin given to burn victims

A

holds fluid in vascular space

increases CO, BP, organ persion

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26
Q

what are you worried about with giving albumin

A

fluid overload

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27
Q

what should you look at to ensure you are not overloading a patient when rapidly infusiong fluids

A

CVP - need central line to measure

28
Q

why are IV pain meds preferred over IM with burns

A

act quickly ad Im requires adequate perfusion which is not necessarily the case

29
Q

whats the differene in immunity between giving tetnus toxoid and immune globulin

A

tentus toxoid - active immunity takes time to make own antibodies
IG - passive; but immunity immediately

30
Q

what are the 4 components of circulatory check

A

pulse
skin color
tem of skin
cap refill

31
Q

what are the names of procedures to relive pressure

A

escharotomy - cut through eschar

fasciotomy - cut is much deeper cutrs through the fascia of the muscle

32
Q

how often does urine output need to be monitored in a burn victim

A

hourly

33
Q

what does it mean if the urine is brown or red in a burn victim

A

muscle and tissue damage - can clog kidneys

34
Q

what drug may be ordered to flush the kidneys

A

mannitol

35
Q

what happens to serum potassium following a burn and why?

A

potassium usually in a cell - when a cell is damaged potassium leaks out and increases serum level

36
Q

are you worried about hyper or hypokalemia in a burn victim

A

hyper

37
Q

what can happen to the GI system in a burn patient? what medication is given?

A

can get a stress ulcer (hurlings ulcer)
given antacids, H2 Antagonists or PPI
ex. magenesium carbonate or pantaprazole

38
Q

what interventions might a primary health care provider order for a burn patient that are non pharmacological

A

NPO and NG tube - prevent paralytic ileus

39
Q

what does suction and an NG tube prevent in a burn patient? why?

A

paralytic ileus - decraesed vascular volume

decreased GI motility, hyperkalemia

40
Q

if a client doesn’t have bowel sounds what will happen to abdominal girth

A

increase

41
Q

do burn patients need more or less calories

A

more; they are in a hypermetabolic state

42
Q

when should an NG tube be removed

A

when you hear bowel sounds

43
Q

when you start GI feedings, wht should you measure to ensure that the supplement ismoving throuhg he GI tract?

A

gastric residuals >50

44
Q

what is some lab work you could check to ensure proper nutrtion and a postive nitrogen balance?

A

pre albumin
total protein
or albumin

45
Q

clients with partial or full thickness burns may experience what?

A

contractures

46
Q

what are the 3 classifations of burns

A

superfical, partial and full thickness

47
Q

what is a superfical thickness burn classifed as

A

first degree burn - damage to only epidermis

48
Q

what is a partial thickness burn classifed as

A

second degree burn - damage to entire epidermis and varying deptshof the dermis

49
Q

what is a full thickness burn classifed as

A

damage to entire dermis and sometiems fat

50
Q

if a patient has burns to their hands what are some spefici measures that should be taken

A

wrap each finger separately and use splints to prevent contractures

51
Q

what should be done to prevent chin-to-chest contracture

A

hyper extend the neck

52
Q

what is the number 1 complication with a perineal burn

A

infection

53
Q

what is eschar? what needs to be done with it?

A

dead tissue - needs to be removed

54
Q

what happens if eschar is not removed

A

new tissue cannot regenerate and bacteria can grow (infection)

55
Q

what type of isolation will you use with the burn client? why?

A

protective; severly immunocompromised

56
Q

what might be used to help remove necrotic dead tissue

A

enzymatic debridement agents

57
Q

whe should enzymatic drugs not be used on a burn patient to remove necrotic tissueq

A
  • not on face
  • not if pregnant
  • not over large nerves
  • dont use if are is opened to body cavity
58
Q

what is another method other than enzymatic drugs to debride that requires pain medication priro

A

hydrotherapy

59
Q

what is our main concern with hydrotherapy

A

cross contamination

60
Q

what are common drugs used with burns

A

mafenide acetate - can cause acid base problems and stings
silver nitrate - keeps these dressings wet, can cause electrolyte problems
provideone - iodine - stings and stains

61
Q

why are broad spectrum antibitocs avoided

A

super infections or secondary infections

62
Q

what do we worry about when giving antibitoics with the suffix mycin

A

clients BUN or creatinine - if increasing assume nephrotoxicitiy
drugs can lead to ototoxicity or nephrotoxicity

63
Q

what should you first do in a chemical burn

A

remove client from chemical and begin flushing for 15-30mins with water

64
Q

how many wounds are expected with an electrical burn

A

2 - entrance (smaller) and exit (bigger)

65
Q

what is the first thing you do with an electrical burn

A

heart monitor for 24 hours

66
Q

what arrhythmia is an electrical burn patient at high risk for

A

Vfib

67
Q

what can build up in electrical burns and cause what

A

myoglobin and hemoglobin can build up and cause renal damage

NCLEX (10 decks)

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