Ch. 26 Burns

Question 1

Epidermis:

Answer 1

outermost skin layer. First line of defense between the body and the environment.

Question 2

Dermis (corium):

Answer 2

is the layer above the fat layer and contains no skin cells.

Question 3

Subcutaneous fat

Answer 3

(adipose tissue [fat]): innermost layer of the skin, lying over muscle and bone.

Question 4

roles the skin play

Answer 4

• protective barrier
• helps maintain fluid and electrolyte imbalance
• excretory organ
• pain, pressure, temperature, and touch sensation
• Vitamin D activation

Question 5

WHAT HAPPENS WHEN YOUR SKIN IS ‘BURNED’?

Answer 5

Within minutes, inflammatory mediators are released by damaged cells, which increase vascular permeability, causing fluid, electrolytes and proteins to leak into interstitial space

Causes burn edema

Fluid shift from intravascular to interstitial spaces can cause hypovolemic shock state- also a contributor- fluid loss by evaporation from burn wound- burn shock!

Question 6

Excessive weight gain from

Answer 6

fluid shift occurs in first 12 hours after burn and can continue for 24-36 hours

Question 7

FLuid and electrolyte imbalances that occur with burns

Answer 7

• hypovolemia
• Metabolic acidosis
• hyperkalemia
• hyponatremia
• hemoconcentration

Question 8

Metabolic acidosis

Answer 8

• lose bicarb in urine and have increased rate metabolism

Question 9

Hyperkalemia

Answer 9

• d/t direct cell injury that releases large amounts cellular potassium

Question 10

Hyponatremia-

Answer 10

sodium leaks into interstitial space but is trapped and causes deficit

Question 11

Hemoconcentration-

Answer 11

d/t vascular dehydration- increases blood viscosity, reducing blood flow and increasing tissue hypoxia

Question 12

cardiac changes with burns

Answer 12

Fluid shifts, plasma leaks cause hypovolemia- which causes increased HR and decreased CO

Question 13

Patho of burn injury…

Answer 13

Gastrointestinal changes: Decreased blood flow. This can lead to curling’s ulcer or a paralytic ileus because bowel is not perfused. Decreased peristalsis.

Immunologic changes: Burns destroy protective skin tissues and that puts patient at risk for infection. How can we prevent this?

Question 14

rule of 9 percentage

Answer 14

arms are 9% each 
legs are 18% each 
front torso and back is 18%
head total- 9%
hips- 1%

Question 15

superficial thickness

Answer 15

• Least damage
• Epidermis is only part of skin that is injured
• Desquamation (peeling of dead skin) occurs 2 to 3 days after burn