Burns (Exam #3)

Question 1

Which degree of burn involves epidermis only?

Answer 1

1st degree

Question 2

Which degree of burn involves epidermis + partial dermis?

Answer 2

2nd degree

Question 3

Which degree of burn involves epidermis + full dermis?

Answer 3

3rd degree

Question 4

Which degree of burn involves epidermis + dermis + muscle/tendon/bone/blood vessels/nerves?

Answer 4

4th degree

Question 5

Which degree of burn involves NO blisters, blanch with pressure?

Answer 5

1st degree

Question 6

Which degree of burn involves blanch, moist, pink/blister?

Answer 6

Superficial 2nd degree

Question 7

Which degree of burn involves moist, mottled color, NO blanch?

Answer 7

Deep 2nd degree

Question 8

Which degree of burn involves dry, NO blanch, hard/leathery?

Answer 8

3rd degree

Question 9

Which degree of burn involves black/charred, painless?

Answer 9

4th degree

Question 10

What is the recommended tx for a 1st degree burn (3)?

Answer 10

• Cool with room temp. water
• Gentle cleanse
• Aloe vera

Question 11

What is the recommended tx for a superficial 2nd degree burn (2)?

Answer 11

Petroleum-based moisturizer vs. Bacitracin

Question 12

What is the recommended tx for a deep 2nd degree burn (2)?

Answer 12

ED

• Same as superficial unless eschar
• If eschar, use Silver Sulfadiazine

Question 13

What is the recommended tx for a 3rd and 4th degree burn?

Answer 13

ED for surgery (debridement, grafting)

Question 14

What is the recommended tx for a chemical burn?

Answer 14

Copious water irrigation

Question 15

What is the recommended tx for an electrical burn? What two sxs may be seen?

Answer 15

Fluid resuscitation

• May see cardiac abnormalities
• May see muscle damage/rhabdo

Question 16

What two sxs may be seen with a lightning burn?

Answer 16

• Fatal arrhythmias

- Respiratory failure

Question 17

What is the recommended tx for a circumferential burn (2)? What condition are you at increased risk for?

Answer 17

Escharotomy vs. fasciotomy

- Increased risk for compartment syndrome (6 P’s)

Question 18

What should be checked for suspected CO poisoning?

Answer 18

COHb

Question 19

What should be checked for suspected cyanide poisoning?

Answer 19

Hydroxycobalamin (use Cyanokit)

Question 20

What three sxs may be seen with smoke inhalation injury to the UPPER airway?

Answer 20

• Hoarse
• Stridor
• Substernal retractions

Question 21

What four sxs may be seen with smoke inhalation injury to the LOWER airway?

Answer 21

• Tachypnea
• Dec. breath sounds
• Wheezing/rhonchi/rales
• Accessory muscle use

Question 22

What is Parkland Resuscitation, and when should it be implemented?

Answer 22

If 20+% of TBSA…

- 4 mL of LR x kg x TBSA over 24 hours (1/2 of volume in first 8 hours, second 1/2 of volume in last 16 hours)

Question 23

Why is nutrition care so important for burn tx?

Answer 23

Increased RMR = increased caloric demand

Question 24

What two specific nutrition groups are you at increased need for with burn tx?

Answer 24

• Protein (2-3x normal)

- Vitamins (A, C, D, E, selenium, zinc)

Question 25

What two sxs may be seen with Abdominal Compartment Syndrome?

Answer 25

• Decreased UOP

- Increased bladder pressure

Question 26

What is the recommended tx for Abdominal Compartment Syndrome?

Answer 26

Decompressive laparotomy (if not reversible)

Question 27

What two sxs are often seen with Tetanus?

Answer 27

• Sore throat with dysphasia

- Descending muscle rigidity

Question 28

How might descending muscle rigidity with Tetanus present locally vs. generalized?

Answer 28

• Local = only affected limb

- Generalizer = trismus

Question 29

What six conditions make a patient MORE prone to Tetanus?

Answer 29

• 6+ hours since event
• 1+ cm deep
• Contaminated
• Exposed to saliva/feces
• Avulsion/puncture/crush wound
• BURNS