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Sensory/Integumentary > Exam 1 > Flashcards

Exam 1 Flashcards

1
Q

What are some ways to advocate health promotion

A

Avoiding environmental hazards
Adequate hygiene and good nutrition
Skin self-examination
Periodic professional exams for areas difficult to see

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2
Q

What is the NUMBER ONE environmental hazard when it comes to skin

A

The sun

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3
Q

What are the two types of ultraviolet rays

A

UVA

UVB

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4
Q

What does exposure to UVA cause

A

tanning

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5
Q

What does exposure to UVB cause

A

sunburn

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6
Q

What are some other factors to consider as environmental factors to sun exposure

A

High altitude
Being in snow
Tanning booths

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7
Q

What kind of ultraviolet is the worst type

A

UVB

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8
Q

True or false: Broad spectrum sunscreen covers both rays

A

True

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9
Q

When should you avoid the sun

A

Anywhere from 10 AM- 2 PM

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10
Q

How can you be safe when going outside

A

Wearing protective layers

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11
Q

How often should you be reapplying suncreen?

A

Every 2 hours and reapply after swimming

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12
Q

What are other environmental hazards when it comes to skin care

A 
Irritants and allergens 
Radiation 
Sleep 
Exercise
Hygiene 
Nutrition 
Medications
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13
Q

What are some major classes of medications that cause photosensitivity

A

Antibiotics
Antidepressants
Psych

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14
Q

Some risk factors for skin cancer

A 
Having fair skin
Blonde or red hair, blue eyes 
Outdoor sunbathing 
Living near the equator (more exposed to the sun) high altitudes
History of skin cancer
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15
Q

Actinic keratosis is a type of ____

A

Nonmelanoma skin cancer

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16
Q

In what population is actinic keratosis common

A

In older white adults

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17
Q

What is the number one way to get a clear diagnosis when it comes to skin diagnosis

A

BIOPSY

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18
Q

Actinic Keratosis is also known as

A

Solar keratosis

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19
Q

What is the first line of treatment for actinic keratosis

A

Nonsurgical procedures and biopsy

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20
Q

What is the most common precancerous skin lesion

A

Actinic keratosis

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21
Q

What kind of topical medication can be used to treat actinic keratosis and what does it do

A

Topical 5-FU

Will erode lesions over several weeks

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22
Q

What is some nursing education for the topical medication 5-FU

A

Teach patients that pain and burning is normal to feel when on this medication

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23
Q

Seborrheic keratoses is what kind of skin problem

A

Benign

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24
Q

When does seborrheic keratoses usually occur

A

After age 40

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25
Q

What are the clinical manifestations of seborrheic keratoses

A

Well defined shape
Appearance of being stuck on
Increase in pigmentation with time
Can look like melanoma

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26
Q

Because seborrheic keratoses can look like melanoma what is important to diagnose

A

BIOPSY

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27
Q

How is seborrheic keratoses removed

A

Cryosurgery

Curettage

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28
Q

What is the most common type of skin cancer

A

Basal cell carcinoma

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29
Q

What is the the least deadly skin cancer

A

Basal cell carcinoma

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30
Q

BCC (basal cell carcinoma) occurs most commonly in what population

A

Middle-aged to older adults

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31
Q

You have an open sure that doesn’t heal, a shiny bump or nodule, or small pink growth or scar like that were not there before

A

Basal cell carcinoma

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32
Q

What are the types of basal cell carcinoma

A 
Nodular BCC
Superficial BCC
Pigmented BCC
Morphoeic BCC 
Basosquamous BCC
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33
Q

What are some nonmelanoma skin cancers

A

Actinic keratosis
BCC
Squamous cell carcinoma

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34
Q

Squamous cell carcinoma (SCC) occurs where on the skin

A

The first layer

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35
Q

True or false SCC is aggressive and has potential to metastasize

A

True

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36
Q

What are the main risk for SCC

A

Sun exposure

Immunosuppression after organ transplantation

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37
Q

What contributes to the formation of SCC on the mouth and lips

A

Pipe, cigar, and cigarette smoking

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38
Q

SCC will appear in places where

A

You’ve had sun exposure

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39
Q

Moles that look suspicious but are not cancer

A

Atypical/dysplastic nevus

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40
Q

Can be precursor for melanoma

A

atypical nevus

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41
Q

What are some causes of malignant melanoma

A

Environmental factors

Genetics factors

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42
Q

What is the main cause of melanoma

A

UV radiation from the sun

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43
Q

What are some risk factors for malignant melanoma

A 
Red or blonde hair 
Light-colored eyes 
Fair skin that freckles 
Chronic sun exposure 
Family history
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44
Q

True or false: people who are more likely to get sunburned are more likely to get melanoma

A

True

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45
Q

What is the ABCD rule

A 
Asymmetry
Border irregularity
Color change 
Diameter > 6mm
Evolving in appearance
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46
Q

If the mole looks different than the other moles then you should be ____

A

Suspicious

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47
Q

Treatment for malignant melanoma is determined by what

A

Site of original tumor
Stage of the cancer
Patients age and general health

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48
Q

What is the initial treatment for malignant melanoma

A

Surgical excision

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49
Q

What additional (adjuvant) therapy is often required for malignant melanoma

A

Chemo but mostly used for advanced disease

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50
Q

What happens when melanoma gets into the lymph

A

It can metastasize everywhere in the body

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51
Q

remove layers of skin slowly and looking at them under microscope until we don’t see anymore cancerous tissue; done as outpatient procedure so don’t need to be NPO; they are very effective because they don’t have to go in multiple times; teach patient that ice is their best friend because they will have a lot of inflammation

A

Moh’s procedure

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52
Q

Moh’s procedure can be indicated for what

A

Malignant melanoma

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53
Q

You want to catch melanoma early because survival rate for later stages is so low. We try to catch it early by doing what

A

Educating patients on what to look for

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54
Q

Cross section of the skin is taken and the depth of the tumor is determined; thickness of the lesion determines the treatment

A

Breslow measurement

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55
Q

Medical term for hives

They are raised and generalized

A

Urticaria

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56
Q

Chronic hive infection
Chronically exposed to something
Stays around for a long period of time

A

Allergic contact dermatitis

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57
Q

Patch testing can help determine possible causative agents of

A

Contact dermatitis

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58
Q

What do you treat contact dermatitis with

A

Steroids and moisture we NEVER want to give antibiotics for this

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59
Q

Another name for atopic dermatitis

A

Eczema

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60
Q

What do you treat atopic dermatitis with

A

Steroids and moisture

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61
Q

Type 4 delayed hypersensitivity response
Sensitization occurs after one or more exposures
Red papules and plaques

A

Contact dermatitis

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62
Q

Type 1 hypersensitivity response
Genetically influenced, chronic, relapsing disease
Exaggerated by a skin response to environmental allergens

A

Atopic dermatitis

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63
Q

Topical immunomodulator used to treat atopic dermatitis

A

Elidel which helps with inflammation

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64
Q

What patient teaching should you given when giving Elidel

A

Burns on application

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65
Q

Corticosteroids can be given to patients with atopic dermatitis but can cause what

A

Skin thinning leaving patient at more risk for skin breakdown

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66
Q

When is Stevens Johnson Syndrome (SJS) usually seen

A

With IV medication

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67
Q

Acts and looks like a burn

A

Stevens Johnson Syndrome

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68
Q

Severe and life threatening conditions that will cause skin to fall off

A

Stevens Johnson Syndrome and toxic epidermal necrolysis (TEN)

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69
Q

Stevens Johnson syndrome is a systematic and _____ response

A

Heightened

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70
Q

It is important to maintain what in Stevens Johnson

A

A patent airway

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71
Q

Allergic skin reaction involving less than 10% of total body surface area

A

SJS

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72
Q

Allergic skin reaction involving more than 30% of total body surface area

A

TEN (toxic epidermal necrolysis)

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73
Q

Phototherapy

A

Treats many skin problems including psoriasis

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74
Q

What are some side effects of phototherapy

A

Nausea
Itching
Erythema

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75
Q

What are the best candidates for radiation therapy to treat BCC and SCC

A
  • patients with lesions in challenging locations such as the ear, nose, scalp, neck and shin
  • those how have trouble with wound healing
  • those with comorbidities who can’t have surgery
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76
Q

This form of treatment can help make measurable, repeatable, consistent zones of tissue damage with a decreased risk for scarring

A

Laser technology

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77
Q

Some medications used as drug therapy to treat dermatologic problems

A 
Steroids
Corticosteroids 
Antihistamines 
Topical Fluorouracil
Immunomodulators
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78
Q

What are diagnostic and surgical therapies for dermatologic problems

A 
Skin scraping
Curettage 
Punch biopsy
Cryosurgery 
Excision-Moh's procedure
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79
Q

The removal and scooping away of tissue using an instrument called a curette

A

Curettage

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80
Q

Punch biopsy

A

Procedure used to obtain tissue sample or to remove small lesions

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81
Q

A punch is rotated into the skin and a small cylinder of skin is removed

A

Punch biopsy

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82
Q

The use of subfreezing temp. to destroy epidermal lesions

A

Cryosurgery

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83
Q

___ is an option if the lesion involves the dermis

A

Excision

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84
Q

Microscopically controlled removal of a skin cancer by removing tissue sections in this horizontal layers

A

Moh’s procedure

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85
Q

Use this for superficial skin problems that involves inflammation, itching, and infection

A

Wet compresses

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86
Q

This is an appropriate intervention for treatment of large areas of the body

A

Baths

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87
Q

How do you apply topical medications

A

Topical medications are applied with gloves, in the direction of the hair, and in a thin even layer

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88
Q

Pruritus

A

Medical term for itching

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89
Q

How to control pruritus

A
  • Break the itch/scratch cycle
  • Cool environment causes vasoconstriction decreasing itching
  • Hydration, wet compresses, moisturizers
  • Topical meds
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90
Q

Why do we want a patient with pruritus to avoid anything that causes vasodilation like heat and rubbing

A

Vasodilation will cause increased blood flow resulting in inflammation and more itching

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91
Q

How can you prevent the spread of skin infections

A

Always wear gloves when working with open would

Proper handwashing

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92
Q

How to prevent secondary skin infections

A

Hand washing and proper dressing changes

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93
Q

How can you help patients dealing why chronic dermatologic problems and their psychological effects

A
  • Reinforce to the patient to follow the prescribed regimen
  • Refer patient to support groups
  • Camouflage like makeup but also consider product ingredients when recommending them
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94
Q

Occur when there is injury to the skin or other tissues of the body caused by heat, chemicals, electrical current, or radiation

A

Burns

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95
Q

Burns are a ____ issue because everything is affected by burns

A

Systemic

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96
Q

True or false” Most burn accidents are preventable

A

True

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97
Q

What are the types of burns

A 
Thermal
Chemical Inhalation 
Electrical 
Radiation 
Cold
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98
Q

Caused by flame, flash, scald, or contact with hot objects

A

Thermal burn

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99
Q

What is the most common type of burn injury

A

Thermal burn

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100
Q

The severity of injury from burn depends on what

A
  • Temperature of burning agent

- Duration of contact time

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101
Q

Result of contact with acids, alkalis, and organic compounds

A

Chemical burns

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102
Q

___ burns can be more difficult to manage because they cause protein hydrolysis and melting

A

Alkali

103
Q

Where can alkali be found

A

Found in cement
Oven and drain cleaners
Heavy metal cleaners

104
Q

True or false chemicals can be very hard to get off so they can cause a burn to be more severe because it is on pt. for longer

A

True

105
Q

Caused by breathing noxious chemicals or hot air which can damage the respiratory tract

A

Smoke inhalation injuries

106
Q

____ ____ ____ are major predictor of mortality in burn victims

A

Smoke inhalation injuries

107
Q

Rapid initial and ongoing assessment is critical in smoke inhalation injuries because

A

airway can be compromised and pulmonary edema can happen quickly

108
Q

What are the three types of smoke inhalation injuries

A
  • Upper airway injury
  • Lower airway injury
  • metabolic asphyxiation
109
Q

This happens when you breathe in carbon monoxide or hydrogen cyanide

A

Metabolic asphyxiation

110
Q

Impaired oxygen delivery to tissues occurs in what type of burn injury

A

Metabolic asphyxiation

111
Q

Impaired oxygen to tissue in metabolic asphyxiation results in what

A
  • Hypoxia
  • Elevated carboxyhemoglobin levels
  • Death when carboxyhemoglobin levels are >20%
112
Q

Metabolic asphyxiation can still occur in the absence of a ___

A

Burn injury

113
Q

What will be the first indicator that the patient is not getting enough oxygen

A

Decreased LOC

114
Q

How to determine if patient has metabolic asphyxiation

A

Test carboxyhemoglobin levels

115
Q

Results from injury to the mouth, oropharynx, and/or larynx

A

Upper airway injury

116
Q

This injury is caused by thermal burns of the inhalation of hot air, stream or smoke

A

Upper airway injury

117
Q

Mucosal burns of oropharynx and larynx are manifested by ___, ___, and ___.

A

Redness
Blistering
Edema

118
Q

What would be a good indication that the person has an airway injury

A

Soot around their mouth or nose

119
Q

In what type of airway injury will swelling be massive and have a rapid onset

A

Upper airway injury

120
Q

Important to remember from upper airway injury

A

Eschar and edema may compromise breathing
Edema from facial and neck burns can be lethal
Internal pressure from edema may narrow airway

121
Q

True or false patients with an upper airway injury may need to be trached very early on bc of the concerns for their airway

A

True

122
Q

Injury to the trachea, bronchioles and alveoli and usually caused by breathing in toxic chemicals or smoke

A

Lower airway injury

123
Q

In a lower airway injury tissue damage is related to ___ of exposure to toxic fumes or smoke

A

Duration

124
Q

In a lower airway injury pulmonary edema may not appear until when

A

12-48 hours after burn

125
Q

Once pulmonary edema appears in a lower airway injury it may manifest as what

A

Acute respiratory distress syndrome (ARDS)

126
Q

Why does pulmonary edema take longer to manifest in a lower airway injury

A

Because it is deeper in the body

127
Q

With a lower airway injury what are we more concerned with

A

Breathing rather than airway

128
Q

What do want to asses for in a lower airway injury

A 
Facial burns
Singed nasal hair
Hoarseness
Painful swallowing
Darkened oral and nasal membranes
Carbonaceous sputum: coughing up black and soot
History of being burned in enclosed space
Clothing burns around neck and chest
129
Q

These burns results from intense heat generated from an electric current

A

Electrical burns

130
Q

These kinds of burns may not be externally apparent

A

Electrical burns

131
Q

With a patient with electrical burns it is VITAL that _____ monitoring is done

A

Cardiac

132
Q

Electrical burns leave patients at risk for what

A

Dysrhythmias

133
Q

These kinds of burns can result in direct damage to nerves and vessels causing tissue anoxia and death

A

Electrical burns

134
Q

The severity of an injury from electrical burns depends on what

A
  • amount of voltage
  • tissue resistance
  • current pathways
  • surface area
  • length of time current flow was sustained
135
Q

Electrical burns will leave more damage when there is more tissue ____

A

Resistance

136
Q

Electricity that only went one way

A

Monophasic electricity

137
Q

Electricity that came in and bounced around

A

Biphasic electricity

138
Q

True or false:
Current that passes through vital organs produces more life-threatening sequelae than current that passes through other tissues

A

True

139
Q

Before when shocking patients and there would be oxygen present it could lead to patient

A

Catching on fire

140
Q

What kind of burn injury leaves patients at risk for dysrhythmias or cardiac arrest, severe metabolic acidosis, and myoglobinuria

A

Electrical injury

141
Q

What causes myoglobin to be released

A

When there is massive muscle damage it is released in circulation where it travels to kidneys and cause blockage

142
Q

What causes hemoglobin to be released in an electrical injury

A

Massive blood vessel damage causes RBC to be broken down, hgb then travels to kidney where it can cause blockage

143
Q

What causes an acute tubular necrosis and acute kidney injury in an electrical injury

A

Myoglobin and hemoglobin travel to the kidneys can block renal tubules

144
Q

Exposure to extremely low temps or prolonged exposure to low temps leads to what kind of burns

A

Cold burns

145
Q

Cold burns start with ___, ___, then ___

A

Swelling, blistering, dry necrosis

146
Q

Burns used to be defined by degrees which used to be what

A

First, second, and third degree

147
Q

ABA now classifies burns according to what

A

Depth of skin destruction

148
Q

How does the ABA now classify burns

A

Partial thickness burn

Full thickness burn

149
Q

Involves the epidermis
First degree burn
Sunburn

A

Superficial partial thickness burn

150
Q

Involves the dermis

Second degree burn

A

Deep partial thickness burn

151
Q

Involves all skin elements, nerve endings, fat, muscle, bone
Third and fourth degree burn

A

Full thickness burn

152
Q

With this degree of burn there is only damage to the epidermis with no blisters but there is pain, mild swelling, and erythema

A

Superficial partial thickness burns

153
Q

With this degree of burn there is damage to the epidermis with fluid filled blisters, severe pain, mild to moderate edema

A

Deep partial thickness burn

154
Q

What is important to educate the patient when it comes to blisters from burns

A

DO NOT POP THEM

155
Q

With this degree of burn there is damage to all skin layers and beyond; it’s dry, waxy, leathery, insensitive to pain

A

Full thickness burn

156
Q

Why is there no pain with fourth degree burn or full thickness burn

A

Because the nerve endings have been damaged

157
Q

What degree is the most painful kind of burn because the nerves are irritated

A

Deep partial thickness

158
Q

What are the two common tools for determining the total body surface area when it comes to burns

A

Lund-Browder chart

Rule of nines

159
Q

Out of the two common tools to determine total BSA which one is more accurate

A

Lund-Browder

160
Q

What is the rule of nines

A 
The front of the head: 4.5%
Back of the head: 4.5%
The upper chest: 9%
Upper back: 9%
The abdomen: 9%
Lower back: 9%
Genitals: 1%
Hand with finger 1% 
Front part of arm: 4.5%
Back part of each arm: 4.5%
Each anterior part of the leg  9% 
Each posterior part of the leg: 9%
161
Q

The severity of burn injury is determined by the __ of burn wound

A

Location

162
Q

Burns to what locations are more severe because they can interfere result in respiratory obstruction from edema and eschar

A

Face
Neck
Chest
Back

163
Q

Burns to what locations are of concerns because they make self-care difficult and may jeopardize future function

A

Hands, feet, joints and eyes

164
Q

Burns to what locations can leave pt. at risk for infection as the skin is very thin and underlying cartilage may be exposed

A

Ears, nose, buttocks, perineum

165
Q

Circumferential burns of extremities can cause ___ problems

A

Circulation

166
Q

Patients with burns can develop ____ syndrome

A

Compartment

167
Q

The greatest initial threat to a patient with a major burn is ____ _____

A

Hypovolemic shock

168
Q

What is third spacing

A

Fluid shifts from the vascular system or blood vessels and into the cells

169
Q

Third spacing causes blood volume to increase or decrease

A

Decrease

170
Q

Lower blood volume causes blood to become

A

Thicker

171
Q

This is the time needed to resolve the immediate, life-threatening problems resulting from a burn injury

A

Emergent (resuscitative) phase

172
Q

The emergent phase lasts up to ___ hours

A

72

173
Q

What are the main concerns in the emergent phase of a burn injury

A

Hypovolemic shock

Edema

174
Q

When does the emergent phase end

A

When fluid mobilization and diuresis begins

175
Q

Fluid and electrolyte shifts can begin as early as ___ minutes postburn

A

20

176
Q

In fluid and electrolyte shifts in burn patients does colloidal osmotic pressure increase or decrease

A

Decrease

177
Q

In third spacing how does fluid shift

A

Out of the vascular space into interstitial spaces

178
Q

What are examples of third spacing in burn injury

A

Exudate and blisters, and edema in unburned areas

179
Q

Why does colloidal pressure decrease in burn injury

A

Because of the progressive loss of protein from the vascular space

180
Q

What is normal urine output by the hour

A

30-50 mL/hr

181
Q

In a severely burned patients insensible losses increase or decrease

A

Increase

182
Q

Signs of hypovolemic shock

A

Decreased BP

Increased heart rate

183
Q

Is hematocrit increased or decreased in burn victims

A

Increased

184
Q

Thrombosis in the capillaries of burned tissue causes there to be less

A

RBCs

185
Q

A potassium shift develops because injured cells and hemolyzed RBSs release ___ into circulation

A

Potassium

186
Q

What electrolyte moves into the interstitial spaces and stays there until edema formation ends

A

Sodium

187
Q

How do you correct or prevent hypovolemic shock in burn injuries

A

Fluid resuscitation

Given them massive amount of fluids and increase the fluid in intravascular space

188
Q

How to determine how much fluid to give burn patients

A

Parkland (Baxter) Formula

189
Q

What is the Baxter formula

A

4 ml of LR per kg/%TSBA for 1st 24 hours
½ of total in 1st 8 hours
¼ of total in 2nd 8 hours
¼ of total in 3rd 8 hours

190
Q

Example of Baxter formula:

You have a 70 kg pt. with a 50% TBSA burn

A

4 ml x 70 kg x 50 (TSBA)= 14,000 ml in 24 hr
1/2 of total in first hour= 7000 ml
1/4 of total in second 8 hr= 3500 ml
1/4 of third 8 hr= 3500 ml

191
Q

Before doing fluid resuscitation we need to intubate or check their ___

A

Airway

192
Q

You’ll need 2 large bore IV placed for patients with burns that are what % of TBSA

A

15% or more

193
Q

For burns greater than 20% we’ll need to insert a

A

Central line

194
Q

This kind of line is placed if frequent ABGs or invasive BP is needed

A

Arterial line

195
Q

Two main parameters need to be monitored during fluid therapy

A

Urine output

Cardiac output

196
Q

Urine output goals for burn patients should be

A

1 mL/kg/hr

197
Q

What are cardiac output goals for burn patients

A

MAP >65
HR <120
SBP >90

198
Q

What are some immunologic changes when burn injury occurs

A

Skin barrier is destroyed
Bone marrow depression occurs
Circulating levels of immune globulins are decreased
Defects occur in function of WBCs

199
Q

Why are circulating levels of immune globulins decreased in burn injuries

A

Because of all that fluid that moved into the cells

200
Q

Defects occurring in the function of WBCs in burn injuries can cause what

A

Patient to be at greater risk for infection

201
Q

What re your first priorities during the emergent care of burn injuries

A

SAFETY AND DECONTAMINATION

  • live electrical wires
  • fire
  • chemical spills
  • smoke
202
Q

Airway management of the burn injury patient involves early

A

Endotracheal intubation

203
Q

Escharotomies of the chest may be needed for what for the burn patient

A

To relieve respiratory distress with circumferential full thickness burns of the neck and chest

204
Q

What is an escharotomy

A

Surgical incision done to remove pressure from eschar

205
Q

Fiberoptic bronchoscopy is done to assess the lower

A

Airway after injury if smoke inhalation is suspected and needed for intubation

206
Q

Treatment of inhalation injury may require giving __% humidified oxygen

A

100

207
Q

True or false: It is important to place the burn pt. in high fowlers, provide suctioning and chest physiotherapy.

A

True

208
Q

What kind of medications may be indicated for burn pts. to treat severe bronchospasm

A

Bronchodilators

209
Q

What are some clinical manifestations during he emergent phase of burn victims

A 
Shock
Pain 
Blisters 
Paralytic ileus 
Shivering 
Altered mental status
210
Q

Why does paralytic ileus happen with burn injuries

A

SNS response of all blood diverted away from GI system

211
Q

What is paralytic ileus

A

Condition where the motor activity of the bowel is impaired

212
Q

What causes shivering with a burn injury

A

Shivering is a response from the heat loss

213
Q

What causes the altered mental status in a burn patient

A

Hypoxia causes this

214
Q

What are complications from burn injuries

A
  • Circumferential burns can lead to escharotomy
  • Dehydration and shock
  • Acute tubular necrosis ATN may need dialysis
  • Infection
215
Q

When does the acute phase of a burn injury begin

A

Begins with mobilization of extracellular fluid and subsequent diuresis

216
Q

When does the acute phase of a burn injury end

A

When Partial thickness wounds are healed or

Full thickness burns are covered by skin grafts

217
Q

Bowel sounds return during what phase of the burn injury

A

During the acute phase

218
Q

During this phase the necrotic tissue begins to slough

Granulation tissue forms

A

Acute phase

219
Q

During acute phase partial thickness burns heal from wound edges and dermal bed known as ____ intention

A

Secondary

220
Q

During acute phase full thickness burns have to have ____ removed and ___ ____ applied

A

Eschar

Skin grafts

221
Q

What kind of nutritional therapy will burn pts. in acute phase need

A

High protein and calories

222
Q

Is it important to give pt. pain medication prior to or after debridement

A

Prior

223
Q

When is the best time for exercise for a burn pt. in the acute phase

A

During dressing changes when they’ve been medicated for pain

224
Q

What are the major therapeutic interventions in the acute phase of a burn injjury

A
  1. wound care
  2. excision and grafting
  3. pain management
  4. PT and OT
  5. nutritional therapy
225
Q

What are the goals of wound care

A
  • to prevent infection by cleansing and debriding the area of necrotic tissue
  • promote wound re-epithelialization and/or successful skin grafting
226
Q

What does surgical debridement mean

A

Removal of the necrotic tissue

227
Q

Burn patients will be on ____ isolations

A

Reversed isolations similar to neutropenic precautions

228
Q

When open burn wounds are exposed, staff should wear PPE such as

A

Disposable hats
masks
gowns
gloves

229
Q

___ gloves need to be used to apply antimicrobial ointment and sterile dressings

A

Sterile

230
Q

It is important to use custom fitted splints in areas that bend so that we maintain join ___

A

Function

231
Q

What is an allograft

A

Skin graft taken from burn patients own skin usually the thigh to place somewhere else

232
Q

What is a homograft

A

Skin graft taken from donor cadavers

233
Q

This type of graft is used with newer biosynthetic options

A

Homograft

234
Q

What are some analgesics and sedatives used in drug therapy for burn patients

A 
Morphine 
Hydromorphone (Dilaudid)
Haloperidol (Haldol) 
Lorazepam (Ativan)
Midazolam
235
Q

Why do we give burn pts. sedatives

A

It can help them not have flashbacks to what caused the burns and also because they can develop anxiety from dressing changes

236
Q

Why are burn pts. given tetanus shot

A

As prophylactic treatment for anaerobic burn would contamination

237
Q

Why are antibiotics not used for burns

A

Because the eschar has no blood supply so little antibiotic is delivered to the wound and could also lead to resistant bacteria

238
Q

Silver sulfadiazine and Mafenide acetate are both used for what

A

They are topical agents used as antimicrobial agents

239
Q

Antimicrobial agents do what

A

Penetrate the eschar and inhibit bacterial invasion

240
Q

___ therapy is started when the diagnosis of sepsis is made or when some other source of infection is identified

A

Antibiotic

241
Q

What is the leading cause of death in pt. with major burns and may lead to multiple organ dysfunction syndrome

A

Sepsis

242
Q

Why are burn pts. given low molecular heparin

A

Because they are at risk for VTE but only given if not contraindicated

243
Q

Burn pts. with high bleeding risk are given what for VTE prophylaxis

A

Compression devices or stockings until heparin until bleeding risk decreased and heparin can be started

244
Q

___ takes priority once fluid replacement needs have been addressed

A

Nutrition

245
Q

Early and aggressive ____ support within hours of burn injury
Decreases complications and mortality
Optimizes burn wound healing
Minimizes negative effects of hypermetabolism and catabolism

A

Nutritional

246
Q

Because the burn injury destroys the body’s first line of defense the wound is colonized by the ___ own flora

A

Patient’s

247
Q

Burn patients have WBCs with a functional deficit leaving patient

A

Immunosuppressed

248
Q

___ can cause partial thickness burns to convert to full-thickness wounds

A

Infection

249
Q 
These s/s mean what 
hypothermia or hyperthermia 
increased HR and RR
decreased BP 
decreased urine output
A

Indicate infection

250
Q

Causative organisms of sepsis are usually gram ___ bacteria

A

Negative

251
Q

What do you want to do if sepsis is suspected

A

Get cultures from all sources

Get lactate level

252
Q

This lab shows lactic acid levels and if normal shows that there is sufficient oxygen at the cellular level and that any s/s are not due to lactic acidosis

A

Lactate level

253
Q

___ level identifies sepsis

A

Lactate

254
Q

What are some neurological complications in the acute phase

A
  • Disorientation
  • Combative
  • Hallucinations
  • Frequent nightmare-like episodes

Sensory/Integumentary (1 decks)

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