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ATI Pediatrics-MJ > Ch. 32: Burns > Flashcards

Ch. 32: Burns Flashcards

1
Q

What kind of burn can result in severe damage, including loss of organ function, tissue destruction with the subsequent need for amputation of a limb, and cardiac and/or respiratory arrest

A

Electrical burns

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2
Q

What are risk factors for burns?

A

Lack of supervision
Abuse, neglect
Developmental growth of the child

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3
Q

During assessment, if a child has a burn, what are some subjective data we need to document?

A
  • Type of burn (dry heat, moist heat, chemical, electrical, ionizing radiation)
  • Duration of contact
  • Area of the body to which burn occured
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4
Q

What do the objective findings tell us?

A

The physical assessment findings: depth, appearance, sensation/healing

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5
Q

What is the depth of a superficial (first-degree) burn?

A

Damage to epidermis

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6
Q

How does a superficial (first-degree) burn appear?

A 
Pink to red in color
No blisters
Mild edema
No eschar
Blanches with pressure
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7
Q

What is the sensation/healing for a superficial (first-degree) burn?

A

Painful

Heals within 5-10 days
No scaring

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8
Q

What is the depth for a superficial partial thickness (second-degree) burn?

A

Damage to entire epidermis

Dermal elements intact

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9
Q

What is the appearance of a superficial partial thickness (second degree) burn?

A 
Pink to red in color
BLISTERS*
Mild-Moderate edema
No eschar
Blanches with pressure

*superficial thickness and superficial partial thickness burns appearance= similar, the BLISTERs indicates the difference!

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10
Q

What is the sensation/healing for a second degree burn (superficial partial thickness)?

A

Pain is present

Heals within 14-21 days
Variable amounts of scaring
Sensitive to temperature changes and light touch

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11
Q

What degree burn is deep partial thickness?

A

Second degree

BOTH superficial partial thickness and deep partial thickness are classified for second degree burns!

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12
Q

What is the depth of a deep partial thickness (2nd degree) burn?

A

Damage to entire epidermis and some parts of the dermis

Sweat glands and hair follicles remain intact

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13
Q

How does a deep partial thickness (2nd degree) burn look?

A

Red-white in color
Blisters
Moderate edema
Blanches with pressure

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14
Q

What is the big difference in appearance between superficial partial thickness and deep partial thickness?

A

The color–superficial partial thickness is pink to red in color with blisters and deep partial thickness is red-white in color with blisters

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15
Q

What is the sensation/heeling for a deep partial thickness burn?

A

Pain present
Sensitive to temp changes and light touch

Healing time may extend beyond 21 days
Scaring is likely

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16
Q

What is the depth of a full thickness (3rd degree) burn?

A
  • Damage to the entire epidermis and dermis and possible damage to SQ tissue
  • Nerve endings, hair follicles, and sweat glands are destroyed
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17
Q

What is the appearance of a full thickness (3rd degree) burn?

A

Red to tan, black, brown, or white in color
Dry, leathery appearance
No blanching

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18
Q

What is the sensation/healing of a full thickness (3rd degree) burn?

A

As the burn heals, painful sensations return and severity of pain INCREASES

Heals within weeks to months
Scaring is present
Grafting is required!

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19
Q

What is the depth of a deep full thickness (4th degree) burn?

A

Damage to ALL layers of the skin that extends to muscle, tendons, and bones

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20
Q

What is the color of a deep full thickness burn (4th degree)?

A

Color variable
Dull and dry
Charring
Possible visible ligaments, bone, or tendons

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21
Q

What is the sensation/healing of a deep full thickness burn (4th degree)?

A

No pain is present

Heals within weeks to months
Scarring is present
Grafting is required
Amputation

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22
Q

What burn has a dry, leathery appearance?

A

Full thickness (3rd degree)

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23
Q

What burn is pink to red but has no blisters?

A

Superficial (1st degree)

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24
Q

What burn is pink to red and has blisters?

A

Superficial partial thickness (2nd)

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25
Q

What burn is red to white in color with blisters?

A

Deep partial thickness (2rd)

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26
Q

What burn has no pain?

A

Deep full thickness (4th)

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27
Q

What burns require grafting?

A

Full thickness (3rd) and deep full thickness (4th)

28
Q

What burn has nerve endings, hair follicles, and sweat glands destroyed?

A

Full thickness (3rd)

29
Q

Does scarring occur with a superficial burn?

A

No

30
Q

What burn hurts as it heals?

A

Full thickness (3rd)

31
Q

What are total body surface area charts?

A

Age-related charts that determine the extend of injury to body surface–expressed as %

32
Q

In infants skin is thin, therefore a burn to an infant, the injury is likely to be _____

A

Deeper

33
Q

How are burns classified?

A

Minor, moderate, major

34
Q

Where are minor burns treat?

A

Clinic setting

35
Q

Where are moderate burns treated?

A

In hospital with expertise in burn care

36
Q

Where are major burns treated?

A

Burn center

37
Q

Minor burns: We need to stop the burning process. How is this done?

A
  • Remove clothing/jewelry that can conduct heat
  • Apply cool water soaks or run cool water over the injury
  • Flush chemical burns with large amounts of water
38
Q

Minor burns: For cooling to stop the burning, is it okay to use ice?

A

No

39
Q

Minor burns: Why do we cover the burn with a clean cloth?

A

To prevent contamination

40
Q

Minor burn: How do we cleanse the burn?

A

Mild soap and tepid water (avoid excess friction)

41
Q

Minor burn: Should we remove the blisters?

A

Controversial on this

42
Q

Minor burn: What type of ointment? What type of dressing may we apply?

A

Antimicrobial; nonadherent, hydrocolloid

43
Q

Minor burn: What should we provide?

A

Provide warmth

Provide analgesia

44
Q

Minor burn: We check immunization status. At what point would we want to administer the tetanus vaccine?

A

If it has been more than 5 years since the last immunization

45
Q

Minor burn: How do we educate family?

A
  • Tell them not to use greasy lotions or butter on burns

- Tell them about signs of infections so they can monitor it

46
Q

Moderate and major burns: What do we maintain first? What do we provide? What do we monitor?

A

Airway and ventilation

Provide 100% supplemental oxygen as prescribed

Monitor VS

47
Q

Moderate and major burns: What are 3 ways to maintain CO?

A
  1. Initiate IV access with large-bore catheter
  2. Fluid replacement is important during first 24 horus
  3. Monitor for manifestations of septic shock
48
Q

What fluid replacement is used during the early stage of burn recovery?

A

Isotonic crystalloid solutions (0.9% sodium or lactated ringers)

49
Q

What fluid replacement is used after the first 24 hours of burn recovery?

A

Colloid solutions (albumin or synthetic plasma expanders)

50
Q

What should urine output if the child weighs less than 30 kg (66lb)?

A

1-2 ml/kg/hr

51
Q

What should urine output be if the child weighs more than 30 kg (66lb)?

A

30 mL/hr

52
Q

Moderate-major burns: What are manifestations of septic shock we need to monitor for?

A
  • Alterations in sensorium (confusion)
  • Increased cap refill
  • Spiking fever
  • Decreased bowel sounds and urine output
53
Q

Manage pain: Ok to give IM or SQ injections for burns?

A

No, avoid this

54
Q

Manage pain: What IV opioids should be use?

A
  • Morphine sulfate
  • Hydromorphone
  • Fentayl

*monitor for resp. depression tho!

55
Q

Manage pain: When should we administer the pain meds?

A

Prior to dressing changes or procedures

56
Q

Prevent infections: What should be restricted in the clients room and why?

A

Plants and flowers–risk of contact with pseudomonas

57
Q

Prevent infections: Why should positions be changed frequently?

A

-Prevent contractures and prolonged pressure

58
Q

Prevent infections: Any rule on visitors?

A

Limit them

59
Q

Nutritional support: Why do we increase caloric intake?

A

To meet the increased metabolic demands and prevent HYPOglycemia

60
Q

Nutritional support: What is needed to prevent tissue breakdown and promote healing?

A

Protein

61
Q

Nutritional support: What should we give to facilitate cell growth? What about for wound healing?

A

Vit. A and C for cell growth

Zinc for wound healing

62
Q

What topical agent is applied to second and third degree burns?

A
  1. Silver sulfadiazine
    - apply to cleansed, derided area
    - wear sterile gloves
    - apply thickness of 1/16th inch

or

  1. Mafenide acetate
    - apply to cleansed, derided area
    - wear sterile gloves for application
    - apply thickness of 16 mm
63
Q

What topical agent is used for prevention of secondary infection? When and how do we apply?

A

Bacitrcin

Apply thin film 2-4 times per day

64
Q

How would we administer morphine sulfate?

A

Continuously IV with boluses prior to procedures

65
Q

What IV meds to we give prior to the start of a procedure for sedation and analgesia?

A

Midazolam
Fentanyl
Propofol
Nitrous oxide

ATI Pediatrics-MJ (41 decks)

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