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KN JD NPTE: INTEG > Burns: Healing, Management, PT Goals > Flashcards

Burns: Healing, Management, PT Goals Flashcards

1
Q

Epidermal healing:

Retention of ____ cells allows for epithelialization to occur

A

Viable

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2
Q

Epidermal healing:

Epithelial cells grow and proliferate, migrate to cover the ____

A

Wound

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3
Q

Epidermal healing:

Protection of _____ cells is critical

A

Epithelial

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4
Q

Epidermal healing: Loss of _____ glands can result in drying and cracking of wound; protection with moisturizing creams is important

A

Sebaceous

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5
Q

Dermal healing: Results in ____ formation (injured tissue is replaced by ___ ____)
Scars are initially ___ or ____, later become white

A

Scar
CT
Red, purple

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6
Q

Phases of healing: Inflamm phase: characterized by what 5 things? Lasts how many days?

A

Red, edema, warm, pain, dec ROM

3-10 days

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7
Q

Phases of healing: Proliferative, granulation, fibroblastic phase: lasts how many days?

A

Next 10-14 after inflamm

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8
Q

Phases of healing: Proliferative, granulation, fibroblastic phase:
What are the 4 primary events?

A

Angiogenesis
Granulation formation
Wound contraction
Epithelialization

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9
Q

Phases of healing: Proliferative, granulation, fibroblastic phase:
Fibroblasts synthesize collagen, GAGs and elastin. Type ___ collagen is initially deposited and later replace with type __ collagen and scar tissues

A

III

I

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10
Q

Phases of healing: Proliferative, granulation, fibroblastic phase:
________ are responsible for wound contraction in dermal tissues

A

Myofibroblasts

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11
Q

Phases of healing: Maturation phase:

Tissue remodeling lasts up to ____ years

A

2

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12
Q

Phases of healing: Maturation phase:
Normal mature scar is soft, _____, and ____
Takes over a _____ to occur

A

White, flat

Year

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13
Q

Phases of healing: Maturation phase:

At _____ weeks, scar is immature (bright pink)

A

6-12

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14
Q

Phases of healing: Maturation phase:

Hypertrophic scar may result: raised scar that stays within the boundaries of the burn wound and is ___, _____, ___

A

Red
Raised
Firm

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15
Q

Phases of healing: Maturation phase:
Keloid scar may result: raised scar that extends _____ boundaries of the original burn wound and is ___, ____, ____. More common in young ____ and those with ____ skin

A

Beyond
Red, raised, firm
Women, dark

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16
Q

Phases of healing: Maturation phase:

Hypotrophic scar: ____ and _______ below the surrounding skin

A

Flat and depressed

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17
Q

Burn Management:
Emergency care: Immersion in ____ water. If less than half the body is burn and injury is immediate, _____ ______ may also be used

A

Cold

Cold compress

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18
Q

Burn Management:
Emergency care:
Cover burn with _____ bandage or ____ ____
NO _____ or _____

A

Sterile
Clean cloth
Ointments or creams

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19
Q

Burn Management: Medical Management:
Asepsis and wound care
1. Remove ______ clothing
2. Wound _______
3. Topical medications (_______ agents): reapplied __ to ___ times daily
Ointments: Bacitracin, Polymyxin B, and Neomycin
Silver sulfadiazine: common topical agent. Avoid at _____ pregnancy, on infants less than ____ months and those with sulfa drug allergies
Sulfamylon: penetrates through _____. Avoid with sulfa drug allergies

A 
Charred
Cleansing
Antibacterial, 1-3 times
Term pregnancy, less than 2 months
Eschar
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20
Q

Burn Management: Medical Management:
Asepsis and wound care: Dressings
Prevent ______ contamination, prevents ____ loss, and protects the wound
May additionally limit _____
Dressings include silver-impregnated, hydrogen’s, petroleum impregnated, and gauze dressings

A

Bacterial, fluid

ROM

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21
Q

Burn Management: Medical Management:

Establish and maintain _____, adequate ____, and resp function

A

A/W

Oxygenation

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22
Q

Burn Management: Medical Management:
Monitor: ____, serum _____ _____, ____ output, ___
___ function: provide nutritional support

A

ABGs, electrolyte levels, urinary, VS

GI

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23
Q 
Burn Management: Medical Management:
Pain relief (\_\_\_\_\_)
A

Morphine

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24
Q

Burn Management: Medical Management:
Prevention and control of infection:
______ and ______
____ pxns

A

Tetanus prophylaxis and antibiotics

STANDARD

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25
Q

Burn Management: Medical Management:
Fluid replacement therapy:
Prevention and control of _______
_____ fluid and _____ replacement

A

Shock
Post shock
Fluid

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26
Q

Burn Management: Medical Management:
Surgery:
Primary excision: escharotomies, fasciotomies may be required to prevent _____ effects. As the patient is stabilized, surgical removal of _____ begins

A

Tourniquet

Eschar

27
Q

Burn Management: Medical Management:
Surgery:
______: closure of the wound
Allograft (homograft): temporary for large burns, used until ______ available

A

Grafts

Autograft

28
Q

Burn Management: Medical Management:
Grafts:
Xenograft (heterograft): Use of skin from _____ _____
A ______ graft

A 
Other species (pigskin)
Temporary
29
Q

Burn Management: Medical Management:
Grafts:
Biosynthetic grafts: combo of ____ and _____

A

Collagen and synthetics

30
Q

Burn Management: Medical Management:
Grafts:
Cultured skin: _____ grown from patient’s own skin

A

Lab

31
Q

Burn Management: Medical Management:
Grafts:
Autograft: use of ____ own skin

A

Pt’s

32
Q

Burn Management: Medical Management:
Grafts:
Split-thickness: contains ____ and ____ layers of ____ from donor site

A

UPPER
EPI
DERM

33
Q

Burn Management: Medical Management:
Grafts:
Full thickness graft: Contains ____ and _____ from donor site

A

EPI and DERM

34
Q

Burn Management: Medical Management:

Escharotomy and fasciotomy with circumferential burns of the extremities and compression due to increased tissue ______

A

Edema

35
Q

Burn Management: Medical Management:

Surgical resection of scar contracture (examples?)

A

Z-plasty: surgical incision in the form of the letter Z used to lengthen a burn scar

36
Q

Burn Management: Burn Wound Healing:

Factors that affect healing including: what 4 things?

A

Nutrition
Infection
Associated illness (DM, CA, vascular insufficiency)
Cytotoxic treatments — aka people with life threatening lupus!

37
Q

Burn Management: Burn Wound Healing:

Significant burn injury more likely in very _____ or the _____ who have thin skin

A

Young

Elderly

38
Q

PT Goals, Outcomes, Interventions:
Burn Wound Cleaning/Debridement:
Use _____ control techniques at all times

A

Infection

39
Q

PT Goals, Outcomes, Interventions:
Burn Wound Cleaning/Debridement:
Maintain _____ of burn wound by warming cleansing solutions, maintaining ambient temp and avoiding lengthy exposure of wet wound surfaces

A

Temp

40
Q

PT Goals, Outcomes, Interventions:
Burn Wound Cleaning/Debridement:
Cleansing with ____ soap and ____ water
Some wounds or dressings benefit from ______, wet removal of dressings
Excess immersion is _________
Risks include auto contamination and electrolyte imbalance

A

Disinfectant
Warm
Soaking
CONTRAINDICATED

41
Q

PT Goals, Outcomes, Interventions:
Burn Wound Cleaning/Debridement:
_____ _________: removal of loose, charred, dead skin

A

Wound debridement

42
Q

PT Goals, Outcomes, Interventions:
Debridement:
Autolytic dressings: use of _____ dressings such as _____ or ______ to help remove eschar

A

Moist

Hydrogel or hydrocolloids

43
Q

PT Goals, Outcomes, Interventions:
Debridement:
Surgical or sharp: excision of eschar using _____ surgical instruments

A

STERILE

44
Q

PT Goals, Outcomes, Interventions:
Debridement:
Enzymatic: example?

A

Fibrinolysins

45
Q

PT Goals, Outcomes, Interventions:
Debridement:
Mechanical: ___ to ___ dressings, pulsed lavage, gentle _____

A

Wet to dry

Washing

46
Q

PT Goals, Outcomes, Interventions:
Rehab:
Overall goals: limit loss of ____, reduce ____, prevent predictable ______ through positioning and splinting, and prevent or reduce complications of ________

A

ROM
Edema
Contractures
Immobilization

47
Q

PT Goals, Outcomes, Interventions:
Rehab:
Typically includes ______ daily therapy sessions times with planned ____ meds

A

Twice

Pain

48
Q

PT Goals, Outcomes, Interventions:
Rehab:
Exercises to promote ____ ____ and chest _____

A

Deep breathing and chest expansion

49
Q

PT Goals, Outcomes, Interventions:
Rehab:
Anti contracture positioning and splinting:
Starts from day ___ and continues for many months

A

1

50
Q

PT Goals, Outcomes, Interventions:
Rehab: Anti contracture positioning and splinting:
Anterior Neck: Common deformity? Stress what? Position with?

A

FLEXION
Stress HYPEREXTENSION
Position with firm (plastic) cervical orthosis

51
Q

PT Goals, Outcomes, Interventions:
Rehab: Anti contracture positioning and splinting:
Shoulder: Common deformity? Stress what? Position with?

A

ADDUCTION and IR
Stress ABD and ER and FLEX
Position with an axillary splint (airplane splint)

52
Q

PT Goals, Outcomes, Interventions:
Rehab: Anti contracture positioning and splinting:
Elbow: Common deformity? Stress what? Position with?

A

FLEXION and PRONATION
Stress EXT and SUPINATION
Position in EXT with posterior arm splint

53
Q

PT Goals, Outcomes, Interventions:
Rehab: Anti contracture positioning and splinting:
Hand: Common deformity? Stress what? Position with?

A

Common deformity is claw hand (intrinsic minus position)
Stress wrist ext (15), MP flex (70), PIP and DIP extension, thumb abduction (intrinsic plus position)
Position in intrinsic plus position with resting hand splint

54
Q

PT Goals, Outcomes, Interventions:
Rehab: Anti contracture positioning and splinting:
Hip: Common deformity? Stress what? Position with?

A

FLEXION and ADDUCTION
Stress EXT and ABD
Position in extension, abd, neutral rotation

55
Q

PT Goals, Outcomes, Interventions:
Rehab: Anti contracture positioning and splinting:
Knee: Common deformity? Stress what? Position with?

A

FLEXION
Stress EXT
Posterior knee splint

56
Q

PT Goals, Outcomes, Interventions:
Rehab: Anti contracture positioning and splinting:
Ankle: Common deformity? Stress what? Position with?

A

PF
Stress DF
Position with foot ankle in neutral with splint or plastic AFO

57
Q

PT Goals, Outcomes, Interventions:
Rehab:
Edema control: ______ of extremities, active ROM

A

Elevation

58
Q

PT Goals, Outcomes, Interventions:
Rehab:
Stretching and early mobs, taking all joints through full ____

A

PROM

59
Q

PT Goals, Outcomes, Interventions:
Rehab:
Red Flag: Schedule therapy to coincide with optimal pain med (______ minutes before session) and dressing changes/wound cleansing

Postgrafting: Discontinue exercise for ____ days to allow grafts to heal

A

30-45 min

3-5 days

60
Q

PT Goals, Outcomes, Interventions:
Rehab (post-acute):
Continued _____, increasing _____
Progressive ______ to correct loss of muscle mass and strength
Minimize _____: Elastic supports to control ______

A

PROM, AROM
Strengthening
Edema, edema

61
Q

PT Goals, Outcomes, Interventions:
Rehab (post-acute):
Scar management:
Massage and application of _______
Regular massage and touching of scars to ______ hypersensitive scars
Pressure garments to help prevent ______ scarring or _____ formation

A

Moisturizer
Desensitization
Hypertrophic, keloid

62
Q

PT Goals, Outcomes, Interventions:
Rehab (post-acute):
Progressive ambulation to improve ___ endurance and activity tolerance

A

CV

63
Q 
PT Goals, Outcomes, Interventions:
Rehab (post-acute):
Preparation for home, work, play, school.
Management of \_\_\_\_\_ pain
Provide education and emotional support
A

Chronic

KN JD NPTE: INTEG (15 decks)

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