Chapter #26 Burns

Question 1

Pathophysiology of burn injury?

Answer 1

Skin changes
anatomic changes
functional changes
temperature

Question 2

Depth of burn injury

Answer 2

Depends on the severity and differences in skin thickness

Question 3

Superficial burns

Answer 3

Lease damage, epidermis is only part of skin that is injured

Question 4

Desquamination

Answer 4

Peeling of dead skin occurs 2-3 days after brun. Superficial burns

Question 5

Resuscitation Phase

Answer 5

1st Phase of burn injury: Begins at onset of injury and lasts 24-48 hours.

Question 6

Priorities during Resuscitation Phase

Answer 6

Secure airway, organ perfusion, support circulation, keep patient comfortable with analgesics, prevent infection, maintain body temp, emotion support.

Question 7

When do you call Rapid Response for a patient in resuscitation phase?

Answer 7

When patient is hoarse, has brassy cough, drools, has difficulty swallowing, produces audible breath sound on exhalation. Give oxygen ASAP, then call Rapid response.

Question 8

Carbon Monoxide Poison levels

Answer 8

Normal (1-10%) - Threshold to visual stimuli.
Mild Poison (11-20%) - Headache, SOB, decrease in vision, decrease cerebral.
Moderate (21-40%) - Headache, tinnitus, nausea, drowsy, vertigo, confusion, altered mental state.
Severe (41-60%) - Coma, Convulsions.
Fata (61-80%) - Death.

Question 9

Priorities during Resuscitation Phase

Answer 9

Secure airway, organ perfusion, support circulation, keep patient comfortable with analgesics, prevent infection, maintain body temp, emotion support.

Question 10

Nursing Intervention when manifestations of pulmonary edema are present?

Answer 10

Elevate head of bed to 45 degrees, apply oxygen, notify burn team or Rapid Response.

Question 11

Culture Considerations for African-American Patients that are burn victims?

Answer 11

Sickle cell prep is performed if sickle status is unknown. Trauma of burn can trigger a sickle cell crisis in patients who have disease or carry that trait.

Question 12

Carbon Monoxide Poison levels

Answer 12

Normal (1-10%) - Threshold to visual stimuli.
Mild Poison (11-20%) - Headache, SOB, decrease in vision, decrease cerebral.
Moderate (21-40%) - Headache, tinnitus, nausea, drowsy, vertigo, confusion, altered mental state.
Severe (41-60%) - Coma, Convulsions.
Fata (61-80%) - Death.

Question 13

Interventions for signs of respiratory distress or change in respiratory patterns

Answer 13

Document and report to burn team and Respiratory therapist ASAP.

Question 14

When intubation has not been performed in a patient whose upper airways were exposed to heat or toxic gases, what do you do?

Answer 14

Continually assess upper airway for recognition of edema and obstruction.

Question 15

Nursing Intervention when manifestations of pulmonary edema are present?

Answer 15

Elevate head of bed to 45 degrees, apply oxygen, notify burn team or Rapid Response.

Question 16

Culture Considerations for African-American Patients that are burn victims?

Answer 16

Sickle cell prep is performed if sickle status is unknown. Trauma of burn can trigger a sickle cell crisis in patients who have disease or carry that trait.

Question 17

Acute Phase of burn injuries

Answer 17

Wound infection, 36-48 hrs after injury, grieving process

Question 18

Rehabilitative Phase of burns

Answer 18

Scarring and contracture formation, psychological problems, loss of function and deformities

Question 19

Resuscitation/Early Phase of burns

Answer 19

Continues for about 24-48 hrs after injury, maintain airway…. theres more to add here i think

Question 20

Injuries to respiratory system

Answer 20

Direct airway injury, Carbon monoxide poisoning, thermal injury, smoke poisoning, pulmonary fluid overload, external factors, facial edema

Question 21

Nonsurgical management: Acute Phase

Answer 21

Mechanical debridement- Hydrotherapy

Enzymatic debridement- Autolysis, Collagenase

Question 22

Fluid Shift

Answer 22

Third spacing or capillary leak syndrome, occurs in 12 hr, can continue 24-36 hr after.
Profound imbalance of fluids

Question 23

Kidney and Urinary Assessment for burn patients

Answer 23

Myoglobin released from damaged muscle circulates to kidney. Check kidney function, BUN, serum creatinine

Question 24

How to give opioids to burn victims in resuscitation phase?

Answer 24

Give via IV route to prevent delayed rapid absorption leading to lethal blood levels.

Question 25

Interventions for signs of respiratory distress or change in respiratory patterns

Answer 25

Document and report to burn team and Respiratory therapist ASAP.

Question 26

Rules of 9s

Answer 26

Body is split up into % to determine the burn amount?

Question 27

Nonsurgical management of burns

Answer 27

IV fluids
Monitor fluid therapy to avoid overload
Drug therapy (pain)

Question 28

escharotomy

Answer 28

Incisions through the eschar. Done to relieve pressure and allow normal blood flow and breathing.

Question 29

fasciotomy

Answer 29

Incisions through eschar and fascia. Done to relieve pressure and allow normal blood flow and breathing.

Question 30

What technique to use when caring for wounds and during invasive monitoring?

Answer 30

Use aseptic technique, this will prevent infection.

Question 31

Nonsurgical managment: Acute Phase

Answer 31

Mechanical debridement- Hydrotherapy

Enzymatic debridement- Autolysis, Collagenase

Question 32

Homograft

Answer 32

human skin (allograft AKA)

Question 33

heterograft

Answer 33

skin from other species (pigskin)

Question 34

Surgical Management

Answer 34

Surgical excision
Wound covering (skin graft)

Question 35

Rehabilitiative Phase of burn injury

Answer 35

..

Question 36

Compensatory responses

Answer 36

Inflammatory response