Exam 4

Question 1

Which Pt Populations are most likely to suffer burns?

Answer 1

• 60yo
• Lower Socioeconomic status
• Teens/Drug Users

Question 2

Describe the Patho of a Burn??

Answer 2

➚ in Capillary Permeability
⇢Edema/➘Intravascular Vol (3rd spacing)
               -in as little as 20min
⇢➚Hct/blood becomes viscous
⇢➚Peripheral Resistance
⇢Burn Shock (Hypovolemic)

Question 3

4 Types of Burns?

Answer 3

• Electrical
• Chemical
• Thermal
• Radiation

Question 4

Treatment and severity of burns is dependent on??

Answer 4

• Depth of burn
• Extent (Total body surface area %) of burn
• Location of burn
• Pt Risk Factors

Question 5

4 goals/focus areas in Burn care?

Answer 5

• wound healing
• Prevent infection
• Pain Management
• Return to Pre-Injury function

Question 6

Name the Degree of the Burn…

Epidermis only, red, hot, dry, mild pain, poor turgor, and requires 7-10 days to heal.

Answer 6

First Degree Burn

Question 7

Name the degree of the Burn…

Deep partial thickness burn including epidermis and dermis, Red, Blisters, Edema, Extremely painful

Answer 7

Second Degree Burn

Question 8

Name the degree of the burn…

Full Thickness burn affecting all skin layers, Pale, White, Charred, Leathery (Eschgar), Painless, dry , hard skin.

Answer 8

Third Degree Burn

Question 9

Name the Degree of the burn…

Skin, Muscle, & Bone affected.

Answer 9

Fourth Degree Burn

Question 10

What to do to stop the burning process.

Answer 10

• Cool it with cool water to temp of unburned skin.

- Remove clothing/Jewlery/Smothering fabrics that hold the heat in.

Question 11

Rule of nines %’s:

Trunk?
Legs?
Arms/Hands?
Head?
Groin?

Answer 11

T- 18% per front/back (Total 36%)
L- 9%per front/back (18%ea total leg)
A/H- 9%ea (4.5% per hand/arm)
H- 9% (4.5% per front/back)
G- 1%

Question 12

3 types of inhalation injury related to burns.

Answer 12

• Carbon Monoxide Intoxication
• Above Glottis
• Below Glottis

Question 13

Characteristics of an above the glottis inhalation injury.

Answer 13

• Limited to upper airway
• swelling in first hr
• damage to pharynx/vocal chords

Question 14

Characteristics of a below the glottis inhalation injury.

Answer 14

• mostly associated with chemicals

- impaired cilliary activity, edema, mucus membrane ulceration, stridor, wheezing, crackles, ➚WoB

Question 15

S%S of Carbon monoxide Intoxication?

Answer 15

“flu-like” S&S, confusion, altered judgment, disorientation, lethargy, stupor, Bright Red Skin (Very Late Sign).

Treat with 100% O2

Question 16

Do you early intubate an inhalation burn??

Answer 16

yes, and 100% Humidified O2

-➚ing edema may prevent intubation later

Question 17

________: Scalpel/ incision through the full thickness eschar to be performed to restore circulation.

Answer 17

Escharotomy

Question 18

Diet Considerations for a burn Pt?

Answer 18

High calorie, High protein Diet.

Question 19

IV fluid formula for Burn Pt’s?

Answer 19

2-4mL/kg/TBSA (total body surface area)

-Chlidren 3-4mL/kg/TBSA

Question 20

top 3 topical antibiotics for burns?

Answer 20

-Silvadene (Gold-Standard)
      ~Cooling effect
      ~Don't use for facial burns
-Silver nitrate
-Sulfa/mefanide acetate (Sulfa Allergies)

Question 21

The spinal column is divided into what three sections with how many total??

Answer 21

-7 cervical
-12 thoracic
-5 lumbar
~7+5+12
-33 total including sacral area

Question 22

What are primary and secondary Spinal Chord injuries??

Answer 22

-P: initial injury d/t stretch/laceration
-S: ongoing damage that occurs post injury
~ischemia/hypoxia/edema

Question 23

Injury to C5 and up can mean what?

Answer 23

• sensation and movement from neck up
• MIGHT be able to breath w/o vent
• Resp compromise/No diaphragm stimulation

Question 24

Suspected Spinal injury CPR…

Answer 24

Do a jaw thrust NOT a head tilt back

Question 25

Patho of autonomic dysreflexia?

S&S?

Answer 25

-Medical Emergency!
-Pain stimulus that can’t reach brain
⇢Blood vessels constrict
⇢➚BP & ➘HR

S&S: ➚BP, face flushing, pounding headache, goosebumps, sweating above the injury, nausea, Anxiety, bradycardia.

Question 26

Nutritional considerations for Spinal Chord Injury Pt’s?

Answer 26

High Carb/High Protein