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OCTH 1031 > FINAL EXAM - Integumentary System, Burns, Wounds > Flashcards

FINAL EXAM - Integumentary System, Burns, Wounds Flashcards

1
Q

Epidermis - Characteristics (10)

A
  1. Prevents dehydration2. Protects from microbes3. Keeps nutrients in the skin4. Responds to stimuli5. Keratin6. Reproductive layer of the skin7. Surrounds hair follicles8. Surrounds sweat and sebaceous glands9. thin10 avascular
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2
Q

The dermis contains (9)

A
  1. hair follicles2. nerve endings3. lymph vessels4. blood vessels5. collagen6. elastin7. sweat8. sebaceous glands 9. fibroblasts
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3
Q

fibroblasts in the dermis produce

A

collagen

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4
Q

Fn’s of the dermis (3)

A
  1. provides nutrition2. provides protection3. source of blood flow
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5
Q

Phases of wound healing (5)

A
  1. hemostasis2. inflammation3. epithelialization4. proliferation5. maturation
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6
Q

Hemostasis

A

platelets aggregate, clot formation

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7
Q

inflammation - what occurs and what are the clinical signs

A

phagocytosis, clinical signs are heat, pain, redness

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8
Q

epithelialization

A

migration of basal cells; need most environment

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9
Q

proliferation

A

granulation, contraction

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10
Q

maturation

A

remodeling, scar formation

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11
Q

Primary (First Intention)

A

wound borders approximate

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12
Q

Secondary

A

wound borders are not approximated

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13
Q

Delayed Primary (Third Intention)

A

Sutured after infection is controlled

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14
Q

Subcutaneous tissue - characteristics (3)

A
  1. mostly fat and fascia2. blood vessels that support the dermis and epidermis3. provides cushioning and insulation
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15
Q

What must remain intact in order to get wound to granulate?

A

periosteum

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16
Q

Tendons are _____ _____ when healthy, but have poor ______

A

shiny whitevascularity

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17
Q

Acute wound

A

heals in the expected sequence and time frame

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18
Q

Chronic wound

A

fails to heal as expected, does not proceed through normal phases of healing

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19
Q

Chronic wound characteristics (4)

A
  1. repeated trauma2. abnormal blood flow3. large bacterial load4. local tissue ischemia
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20
Q

Etiology of chronic wounds (3)

A
  1. PVD2. DM3. physical immobility
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21
Q

Intrinsic factors of delayed wound healing (5)

A
  1. age - geriatric2. chronic diseases3. edema4. poor perfusion - lack of blood flow5. immunosuppression
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22
Q

Extrinsic factors of delayed wound healing (6)

A
  1. poor nutrition and hydration2. medications3. necrosis4. bioburden5. infection6. incontinence
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23
Q

Iatrogenic factors of delayed wound healing (4)

A
  1. inappropriate wound management2. Desiccation (wound pops open)3. Inadequate offloading4. improper handling of dressings
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24
Q

Factors to consider with wound assessment (7)

A
  1. wound classification2. new onset vs recurrence3. wound history - time present, prior treatment interventions4. anatomical location5. Wound appearance6. Appearance of periwound7. sensation
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25
Q

Wound appearance includes (6)

A
  1. size2. shape3. tunneling or undermining4. wound bed5. exudate or drainage
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26
Q

Undermining

A

underneath the opening; NOT down into the wound

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27
Q

Factors looked at when assessing a wound bed (2)

A
  1. color2. tissue - granulation or necrotic
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28
Q

Nectrotic wound tissue is either

A

Eschar or slough

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29
Q

Factors looked at when assessing exudate or drainage (5)

A
  1. Amount2. odor3. serous = clear4. sanguineous = bloody5. purulent = thick yellow with green (bacteria)
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30
Q

Appearance of periwound factors that are assessed (3)

A
  1. Temperature - Warm=infection; Cold = lack of blood flow2. edema3. rolled edges
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31
Q

Sensation factors that are assessed (3)

A
  1. Pain2. temperature3. proprioception
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32
Q

Pressure ulcers

A

localized injury to the skin and/or underlying tissue usually over a bony prominence, as a result of pressure, or pressure in combination with shear and/or friction

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33
Q

What amount of time can a pressure ulcer occur?

A

Can occur in 2 hours

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34
Q

Common locations for Pressure ulcers (8)

A
  1. occiput2. scapula3. sacrum4. coccyx5. ischial tuberosity6. greater trochanter7. malleolus8. heel
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35
Q

Risk factors for pressure ulcers (8)

A
  1. cognitive decline2. impaired sensation3. advancing age4. contractures5. immobility/inactivity6. inadequate nutrition7. incontinence8. co-morbidities
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36
Q

Pressure Ulcer SDTI description

A

looks like a bruise, purple or maroon localized area of discolored intact skin or blood filled blister due to damage of underlying soft tissue from pressure and/or shear. May be painful, firm, mushy, warmer or cooler compared to adjacent tissue. Never Used to Describe a Bruise

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37
Q

Once a SDTI opens what stage is it usually?

A

III

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38
Q

Stage I pressure ulcer description

A

intact skin with nonblanchable redness of a localized area usually over a bony prominence. May be painful, firm, soft, warmer or cooler compared to adjacent skin

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39
Q

Stage II pressure ulcer description

A

Partial thickness, loss of dermis presenting as a shallow open ulcer with a pink wound bed WITHOUT slough. May present as an intact or open serum filled blister. Should not be used to describe skin tears, tape burns, dermatitis, maceration

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40
Q

Stage III pressure ulcer description

A

Full thickness tissue loss into the subcutaneous layer, fat may be visible but NOT bone, tendon or muscle. Slough may be present but does not cover the depth of the tissue loss. May include undermining and tunneling. Depth varies based on anatomical position

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41
Q

Stage IV pressure ulcer description

A

full thickness loss WITH exposed bone, tendon, or muscle; slough or eschar, and undermining or tunneling may be present. Osteomyelitis (bone infection) is possible based on the exposed structures

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42
Q

Unstageable pressure ulcer description

A

Full thickness tissue loss in which the base of the ulcer is cover by slough and/or eschar in the wound bed. True depth cannot be determined until the eschar is removed. NEVER remove a “hard cap”, unless it’s loose and there’s debris around it.

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43
Q

Stage a pressure ulcer by (4)

A
  1. ID the deepest part of the wound2. If eschar or slough cover the wound it’s unstageable and assumed it’s either Stage III or IV3. Using staging tools - Pressure ulcer scale for healing (PUSH); Pressure Sore status tool
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44
Q

Arterial Wounds signs and symptoms (6)

A
  1. diminished pulse - lack of blood flow to the extremity2. pale, cool, thin or shiny skin3. hair loss4. claudication5. Pain Increase with elevation and exercise (pain when walking)6. dependent position decreases symptoms ( leg hanging off side of bed)
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45
Q

Arterial wound risk factors (6)

A
  1. smoking2. htn3. hyperlipidemia4. obesity5. inactivity6. DM
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46
Q

Arterial wound etiology (2)

A
  1. acute - blunt trauma2. chronic - arteriosclerosis
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47
Q

Arterial wound - common locations ( 3)

A
  1. Anterior tibial region of lower leg2. Dorsum and lateral side of foot3. tips of toes (no blood flow = necrotic tissue)
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48
Q

Arterial wound appearance ( 6)

A
  1. punched - out or circular in appearance with measureable depth2. distinct borders with pale dry wound base3. scant to minimal drainage4. significant pain5. periwound reddened6. if edema - localized
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49
Q

Venous wounds - Signs and Symptoms (4)

A
  1. skin is dusky, ruddy color2. edema with pitting and possible weeping3. hemosiderin staining and lipodermaterosclerosis4. spider veins
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50
Q

Lipodermaterosclerosis appears

A

bumpy

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51
Q

hemosiderin staining

A

proteins leaks causing a brown stain like coloring in the skin

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52
Q

Venous wound risk factors (5)

A
  1. Immobility2. pregnancy3. prolonged standing4. smoking5. excessive sodium intake
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53
Q

Etiology of venous wounds

A

Vascular dysfunction resulting in venous hypertension

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54
Q

Common locations for venous wounds (2)

A
  1. pre-tibial area between knee and ankle2. medial malleolus
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55
Q

Appearance of venous wounds (6)

A
  1. moderate to heavy exudate2. yellow fibrinous superficial wound base3. wound edges irregular and large4. periwound fibrotic and indurated5. hypergranulation6. warm temperature - lots of fluid
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56
Q

neuropathic (diabetic) ulcers - signs and symptoms (3)

A
  1. prolonged inflammation2. impaired vascularization3. impaired immune system
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57
Q

neuropathic ulcer risk factors (7)

A
  1. chronic hyperglycemia2. high cholesterol3. elevated blood sugar levels4. smoking5. obesity6. sedentary lifestyle7. family history
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58
Q

Etiology of neuropathic ulcers

A

lack of protective sensation leads to injury that may go unnoticed; don’t realize they step on something

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59
Q

Neuropathic ulcer common location (3)

A
  1. plantar aspect of metatarsal heads2. toes- tips and between toes3. lateral aspect of foot
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60
Q

Neuropathic ulcers are commonly located on the feet because

A

the patient continually ambulates on bony prominence

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61
Q

Neuropathic ulcer appearance (6)

A
  1. bloody exudate2. dry and necrotic3. edema localized4. smaller, but significant depth5. painless due to lack of sensation6. callus formation around periwound
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62
Q

What is a burn and how is it classified?

A

thermal injury that destroys layers of the skin; classified by size, depth and mechanism

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63
Q

Classification of burn by size (2)

A
  1. TBSA - total burn surface area2. rule of 9s (even if only a small area on the chest it’s still 9%)
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64
Q

What are the classifications of burns by depth? (5)

A
  1. superficial or first degree2. superficial partial thickness or superficial second degree3. Deep partial thickness or deep second degree4. Full thickness or third degree5. subdermal or fourth degree
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65
Q

Characteristics of Superficial or First degree (3)

A
  1. Classic sunburn2. red, dry, painful3. Heals within 3-4 days without scarring
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66
Q

Characteristics of Superficial partial thickness or superficial second degree

A
  1. pink to red2. Painful3. blisters - still in tact4. moist5. edema6. heals within 7-10 days minimal scarring
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67
Q

Characteristics of Deep partial thickness or deep second degree (6)

A
  1. pale due to disrupted blood flow to the area2. painful3. edema4. decreased sensation5. heals in 3-4 wks - may require grafting6. Heterotrophic scarring
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68
Q

Characteristics of full thickness or third degree

A
  1. Dermis has been removed2. black to mottled red/brown to pale, waxy white 3. leather like - tight4. insensate5. epidermis & dermis destroyed6. heals in 4-6wks with scarring 7. need to keep the area stretched to avoid contractures
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69
Q

Characteristics of subdermal or fourth degree

A
  1. dry, charry appearance2. muscle or bone exposed3. requires grafting or muscle flap4. hypertrophic scarring - not flat, bumpy/rigid
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70
Q

Classification of burns by mechanism (5)

A
  1. thermal (hot liquids/scalding)2. radiation3. chemical (acid, alkali, gas or tar)4. Electrical - pure, arc and flame 5. Other - frostbite
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71
Q

electrical arc burn does not require _____ _____

A

direct contact

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72
Q

Who is at risk of burns? (7)

A
  1. children; ages 1-14yrs old, 2. children that are abused3. men due to work field4. pmh of mental health, dm, neuropathy, and substance abuse5. O2 Dependent (smokers)
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73
Q

Emergent phase 1. time frame 2. focus (6) (MM of burns)

A

0-72 hrs after injury1. sustain life2. preventing infection3. prepare for surgical closure4. promote healing5. managing pain6. scar formation

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74
Q

Acute phase 1. time frame 2. focus (6) (MM of burns)

A

72 hours after injury or until wound is closed1. infection control2. grafts3. dressings4. support along with pain management5. splinting6. Social and psychological support

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75
Q

Rehabilitation phase - focus (MM of Burns)

A
  1. nutrition2. hydration3. stability4. return to function5. psychological component
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76
Q

Complications of burns (8)

A
  1. contractures/deformities2. hypertrophic scarring3. heterotopic ossification4. pain5. heat intolerance6. sun exposure7. pruritus8. psychosocial adjustment
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77
Q

pruritus

A

itching

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78
Q

cutaneous

A

pertaining to the skin

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79
Q

lesion

A

wound, injury, or pathological change in body tissue

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80
Q

systemic

A

pertaining to a system or the whole body rather than a localized area

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81
Q

therapeutic

A

pertaining to treating, remediating, or curing a disorder or disease

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82
Q

What accessory organs of the skin are located in the dermis? (3)

A
  1. nails2. sweat glands3. sebaceous glands
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83
Q

CF for fat (3)

A

adip/olip/osteat/o

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84
Q

adipocele

A

hernia containing fat or fatty tissue

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85
Q

lipocyte

A

fat cell

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86
Q

steatoma

A

fatty tumor

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87
Q

CF that mean skin (3)

A

cutane/odermat/oderm/o

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88
Q

hypodermic

A

pertaining to below the skin (dermis)

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89
Q

cyan/o

A

blue

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90
Q

cyanosis

A

physical sign causing bluish discoloration of the skin and mucous membranes

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91
Q

CF that mean red (3)

A

erythem/oerythemat/oerythr/o

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92
Q

erythema

A

redness of the skin caused by congestion of the capillaries in the lower layers of the skin. It occurs with any skin injury, infection, or

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93
Q

erythematous

A

pertaining to erythema (redness of the skin)

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94
Q

erythrocyte

A

red blood cell

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95
Q

CF meaning sweat (2)

A

hidr/o**don’t mistake for h2o=hydr/osudor/o

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96
Q

hidrosis

A

formation and excretion of sweat

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97
Q

sudoresis

A

profuse sweating

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98
Q

ichthy/o

A

dry, scaly

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99
Q

ichthyosis

A

congenital (meaning present at birth) dermatological (skin) disease that is represented by thick, scaly skin.

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100
Q

kerat/o

A

horny tissue; hard; cornea

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101
Q

keratosis

A

Any lesion on the epidermis marked by the presence of circumscribed overgrowths of the horny layer.

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102
Q

melan/o

A

black

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103
Q

melanoma

A

malignant tumor that originates in melanocytes and is considered the most dangerous type of skin cancer, which, if not treated early, becomes difficult to cure anc can be fatal

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104
Q

myc/o

A

fungus

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105
Q

dermatomycosis

A

a superficial fungal infection of the skin or of its appendages

106
Q

onych/o

107
Q

onychomalacia

A

softening of the nails

108
Q

CFs meaning hair (2)

A
  1. pil/o2. trich/o
109
Q

pilonidal

A

pertaining to a nest of hair

110
Q

trichopathy

A

disease of the hair

111
Q

scler/o

A

hardening; sclera (white of the eye)

112
Q

scleroderma what is it?what does it cause?what does it affect?

A

autoimmune disorder where there is an overproduction of abnormal collagen accumulation throughout the body, causing hardening (sclerosis), scarring (fibrosis), and other damage. The damage may affect the appearance of the skin, or it may involve only the internal organs.

113
Q

seb/o

A

sebum, sebaceous

114
Q

seborrhea

A

excessive discharge from the sebaceous glands, forming greasy scales or cheesy plugs on the body; it is generally attended with itching or burning.

115
Q

squam/o

116
Q

squamous

A

scaly or platelike

117
Q

therm/o

118
Q

xer/o

119
Q

xeroderma

120
Q

pyoderma

A

Any acute, inflammatory, purulent bacterial dermatitis.

121
Q

diaphoresis

A

carrying, transmitting through or across

122
Q

dermatoplasty

A

surgical repair of the skin

123
Q

cryotherapy

A

cold “freezing” treatment

124
Q

anhidrosis

A

abnormal condition of the absence of sweating

125
Q

hyperhidrosis

A

abnormal excessive sweating

126
Q

abrasion

A

scraping or rubbing away of a surface, such as skin, by friction

127
Q

abscess

A

localized collection of pus at the site of an infection (characteristically a staphylococcal infection)

128
Q

furuncle

A

abscess that originates in a hair follicle; also called BOIL

129
Q

carbuncle

A

cluster of furuncles in the subcutaneous tissue

130
Q

acne

A

inflammatory disease of sebaceous follicles of the skin, marked by comedos, papules, and pustules

131
Q

comedos

A

discolored, dried sebum plugging an excretory duct of the skin; aka blackheads

132
Q

pustules

A

small skin lesion filled with purulent material

133
Q

alopecia

A

absence or loss of hair, especially of the head; also known as baldness

134
Q

carcinoma

A

uncontrolled growth of abnormal cells in the body; also called malignant cells

135
Q

cyst

A

closed sac or pouch in or under the skin with a definite wall that contains fluid, semifluid, or solid material

136
Q

pilonidal

A

growth of hair in a dermoid cyst or in a sinus opening on the skin

137
Q

eczema

A

redness of skin caused by swelling of the capillaries

138
Q

gangrene

A

death of tissue, usually resulting from loss of blood supply

139
Q

hemorrhage

A

external or internal loss of a large amount of blood in a short period

140
Q

contusion

A

hemorrhage of any size under the skin in which the skin is not broken; aka bruise

141
Q

ecchymosis

A

skin discoloration consisting of a large, irregularly formed hemorrhagic area with colors changing from blue-black to greenish brown or yellow, aka bruise

142
Q

petechia

A

minute, pinpoint hemorrhagic spot of the skin that is a smaller version of an ecchymosis

143
Q

hematoma

A

elevated, localized collection of blood trapped under the skin that usually results from trauma

144
Q

hirsutism

A

excessive growth of hair in unusual places, especially in women: may be due to hypersecretion of testosterone

145
Q

ichthyosis

A

genetic skin disorder in which the skin is dr and scaly, resembling fish skin

146
Q

impetigo

A

bacterial skin infection characterized by isolated pustules that become crusted a rupture

147
Q

keloid

A

overgrowth of scar tissue at the site of a skin injury (especially a wound, surgical incision, or sever burn) caused by excessive collagen formation during the healing process

148
Q

psoriasis

A

chronic skin disease characterized by itchy red patches covered with silvery scales

149
Q

scabies

A

contagious skin disease transmitted by the itch mite

150
Q

skin lesions

A

areas of pathologically altered tissue caused by disease, injury, or a cound resulting from external factors or internal disease

151
Q

tinea

A

fungal infection whose name commonly indicates the body part affected, such as tinea pedis (athlete’s foot); AKA ringworm

152
Q

ulcer

A

lesion of the skin or mucous membranes marked by inflammation, necrosis, and sloughing of damaged tissue

153
Q

pressure ulcer

A

skin ulceration caused by prolonged pressure, usually in a patient who is bedridden; also known as decubitus ulcer or bedsore

154
Q

urticaria

A

Allergic reaction of the skin characterized by eruption of pale red elevated patches that are intensely itchy; also called wheals (hives)

155
Q

verruca

A

rounded epidermal growth caused by a virus; asl called wart

156
Q

vesicle

A

small blister-like elevation on the skin containing a clear fluid; large vesicles are called bullae (singular bulla)

157
Q

vitiligo

A

localized loss of skin pigmentation characterized by milk- white patches; also called leukoderma

158
Q

wheal

A

smooth, slightly elevated skin that is white in the center with a pale red periphery; also call hives if itchy

159
Q

biopsy (bx)

A

removal of a small piece of living tissue from an organ or other part of the body for microscopic examination to confirm or establish a diagnosis, estimate prognosis, or follow the course of a disease

160
Q

skin test

A

any test in which a suspected allergen or sensitizer is applied to or injected into the skin to determine the patient’s sensitivity to it

161
Q

cryosurgery

A

use of subfreezing temperature, commonly with liquid nitrogen, to destroy abnormal tissue cells, such as unwanted, cancerous, or infected tissue

162
Q

debridement

A

removal of foreign material, damaged tissue, or cellular debris from a wound or burn to prevent infection and promote healing

163
Q

fulguration

A

tissue destruction by means of high-frequency electrical current; also called electrodesiccation

164
Q

incision and drainage (I&D)

A

incision of a lesion, such as an abscess, followed by the drainage of its contents

165
Q

Mohs surgery

A

surgical procedure used primarily to treat skin neoplasms in which tumor tissue fixed in place is removed layer by layer for microscopic examination until the entire tumor is removed

166
Q

skin graft

A

surgical procedure to transplant healthy tissue by applying it to an injured site

167
Q

allograft

A

transplantation of healthy tissue from one person to another person; also called homograft

168
Q

autograft

A

transplantation of healthy tissue from one site to another site in the same individual

169
Q

synthetic

A

transplantation of artificial skin produced from collagen fibers arranged in a lattice pattern

170
Q

xenograft

A

transplantation (dermis only) from a foreign donor (usually a pig) and transferred to a human; also called heterograft

171
Q

skin resufacing

A

procedure that repairs damaged skin, acne scars, fine or deep wrinkles, or tattoos or improves skin tone irregularities through the use of topical chemicals, abrasion or laster

172
Q

chemical peel

A

use of chemicals to remove outer layers of skin to treat acne scarring and general keratoses as well as from cosmetic purposes to remove fine wrinkles on the face; also called chemabraion

173
Q

cutaneous laser

A

any of several laser treatments employed for cosmetic and plastic surgery

174
Q

dermabrasion

A

removal of acne scars, nevi, tattoos, or fine wrinkles on the skin through the use of sandpaper, wire brushes, or other abrasive material on the epidermal layer

175
Q

antibiotics

A

kill bacteria that cause skin infections

176
Q

antifungals

A

kill fungi that infect the skin

177
Q

antipruritics

A

reduce sever itching

178
Q

corticosteroids

A

anti-inflammatory agents that treat skin inflammation

179
Q

Functions of the skin (six)

A

Protection against infection Prevention of loss of body fluidControl of body temperatureFunctioning as an excretory organHelping to determine personal identity

180
Q

What are the two primary factors that influence the amount of tissue destruction that occurs following a burn injury?

A

1.temperature2. Duration of exposure

181
Q

Ischemia

A

Restriction and blood supply to tissues

182
Q

There are three zones to a burn injury what are they?

A

Zone of coagulationZone of stasisZone of hyperemia

183
Q

What is the zone of coagulation?

A

Area of ear reversible tissue destruction

184
Q

What is the zone of stasis?

A

The area surrounding the zone of coagulation where damage results in decreased perfusion

185
Q

What is the zone of hyperemia?

A

The outer zone area. damaged and considered at risk but with proper care should recover and heal

186
Q

The aim of care after burn injury is to

A

Reduce or prevent dermal ischemia therefore avoiding further tissue death

187
Q

Eschar

A

The residual necrotic layers of skin destroyed by direct heat damage or the injury occurring secondary to heat damage

188
Q

The depth of a burn influences (four)

A

survival rates healing time treatment Scar formation

189
Q

Superficial burns are caused by (two)

A

A variety of causes1. Sunburn2. Flash from an explosion

190
Q

Superficial burn healing time

A

Within 3 to 6 days and does not produce any residual scars

191
Q

Because some of the dermis remains in a partial thickness burn the wound will eventually

A

Regenerate skin cells

192
Q

Full thickness burn injuries will not

A

Heal spontaneously

193
Q

Full thickness injuries may be in a variety of colors such as (4)

A

Black, cherry red, tan or pearly white

194
Q

Healing time for full thickness burns depend on

A

Availability of Donor sites

195
Q

Full thickness burns are at severe risk for

A

Contracture formations

196
Q

TBSA stands for

A

Total body surface area

197
Q

The rule of nines

A

Convenient and rapid method that may be effectively used at the scene of an accident to estimate extent of burns. It divides the body service into areas representing 9% are multiples of 9%. It has limited accuracy with children

198
Q

The Lund and Browder scale

A

Used when calculating the extent of burns on children. This scale modifies the percentage of the area according to age that’s reflecting the fact that the head and neck of the child make up greater percentages of the body surface area than that of an adult.

199
Q

One third of burn injuries are

A

On children

200
Q

Causes of burns include (6)

A

1.fire/flame injury2. Scalding3. Contact Burns4. Electrical5. Chemical6. Others

201
Q

Most burns occur where (four)

A
  1. In the home2. Occupationally3. Street/highway4. Other mechanisms
202
Q

Advance treatments of burn injuries include (three)

A

1.early excision and skin grafting2. Antibiotic treatment3. Use of cultured epithelium

203
Q

Factors that increase the risk of death with burns (three)

A
  1. Increasing burn size2. Age of patient3. Presence of an inhalation injury
204
Q

What are the two body systems affected by burns?

A

Cardiac and pulmonary

205
Q

Immediately following a burn injury during the emergency phase of treatment what two complications are the most common cause of death

A

Pulmonary and/or cardiac complications

206
Q

Most common pulmonary complications after burn (3)

A

1.carbon monoxide poisoning2. Upper airway obstruction3. Restrictive defects

207
Q

Carbon monoxide poisoning

A

Carbon monoxide binds hemoglobin more than oxygen thus displacing oxygen and leading to asphyxia

208
Q

Upper airway obstruction’s are caused by

A

Irritants released from gases cause respiratory mucosa edema

209
Q

Restrictive defects can lead to respiratory distress when the presence of

A

A tight, circumferential, restrictive eschar on the chest, neck or abdomen causes difficulty with inspiration and expiration

210
Q

Signs and symptoms that may indicate the potential for respiratory complications include (eight)

A
  1. Facial burns2. Singed nasal hair and or black oral mucosa3. Horse voice4. Cough5. Drooling6. Stridor 7. Tachypnea 8. Hypoxia
211
Q

Treatment for pulmonary complications

A

Administering of humidified 100% oxygen to maintain adequate oxygenation

212
Q

Escharotomies

A

Incision through the eschar down to viable tissue to release the restriction and allow for expansion of the chest wall during inspiration and expiration

213
Q

Burn shock

A

Cardiac complications due to the fluid or plasma portion of the circulating blood volume permeating into the interstitial Space producing burn wound edema. Lasts for the first 24 hours

214
Q

Hypovolemia due to the burn shock is untreated

A

Organ failure (most commonly renal), and tissue hypoxia occur

215
Q

Fluid resuscitation

A

Administration of intravenous fluid

216
Q

Large burn injuries triggers

A

A prolonged stress response in the body and initiates a hyper metabolic state

217
Q

Hyper metabolic state will require

A

Nutritional support to meet the resulting increase and basal energy expenditure

218
Q

Eschar is the common denominator for

A

Burn sepsis

219
Q

In the acute phase of treatment the most common cause of death is

220
Q

Debridement

A

Cleansing and removal of non-adherent and nonviable tissue; this is a painful procedure and it is important to make sure the patient has been premedicated with analgesics and sedative medications prior to starting dressing changes

221
Q

Daily cleansing and debridement of a burn wound is necessary to (3)

A

Decrease the potential for Burn wound sepsisFacilitate healingPrepare the wound for grafting if needed

222
Q

Commonly used analgesics include (three)

A

Morphine, fentanyl, or codeine

223
Q

A common drug given to sedate the patient is

224
Q

Anxiolytics are used to control

225
Q

Anxiety influences what?

A

Pain perception

226
Q

Hydrotherapy

A

Tub bath used for burn blown cleansing as the Jets help loosen nonviable tissue and facilitate range of motion exercises

227
Q

Dressing bandages act as

A

A barrier to the environment decreased temperature lost through the wound and promote comfort

228
Q

Topical antimicrobial agents such as silvadine are

A

Delay and minimize burn wound colonization

229
Q

Full thickness injuries are at risk for

A

Bacterial entrance and fluid/heat loss through the wound continues until the wound is closed either temporarily or permanently through the application of synthetic dressings or biologic coverage

230
Q

Grafting areas usually are

A

On the chest to allow for insertion of a central lineHands because of their functional importanceFace and ears

231
Q

If the patient does not have available donor sites then

A

The wound will be excised down to viable tissue and temporarily closed through the application of synthetic dressings or allograft

232
Q

Allograft

A

Referred to as homograft or cadaver skin; donor skin taken from another person rejection will usually occur within 10 to 14 days after application

233
Q

Synthetic and biological dressings are only temporary because

A

It allows for the time needed to achieve a permanent method for closing the wound

234
Q

The only way to achieve Permanent wound closure in large full thickness burn injuries is

A

through surgical intervention and the application of either an autographed or cultured epithelium

235
Q

Donor site takes about how many days to heal?

236
Q

Cultured epithelium

A

Used when a patient has limited donor sites available; a biopsy of unburned skin is taken and sent to a laboratory that can grow cultured epithelium; it takes 3 to 4 weeks to be available for grafting;they are sensitive to infection

237
Q

To prevent loss of graft

A

The grafted area is immobilized in a functional position and remains in the position until the first dressing change

238
Q

If graphs are placed on the chest or back the bandages are suture to the body to decrease

A

The risk of shearing when repositioning the patient

239
Q

Range of motion to the graft area is avoided until

A

The graft is stable which is usually about 4 to 5 days after surgery

240
Q

During the emergency phase rehabilitation focuses on(2)

A

1.range of motion exercises to help reduce edema and maintain joint mobility2. Splints are constructed to prevent the formation of contractor deformities and should be worn when the patient is asleep or resting

241
Q

In the acute phase of treatment rehabilitation focuses on

A
  1. Re-conditioning exercises2. Range of motion exercises3. Splinting
242
Q

Once the patient’s condition is stable then occupational therapy will focus on(2)

A

Ambulation and activities of daily living

243
Q

The focus of rehab for patients with graphs that have healed include (5)

A
  1. Reconditioning2. ROM3. Scar revision 4. Contractor release5. Reconstruction
244
Q

Destruction of sebaceous glands and partial and full thickness injuries cause

A

Dry skin and itching

245
Q

How to care for burn scars(4)

A

1.Use unscented soap2.Apply moisturizing lotion several times a day to reduce itching3.Take antihistamine to control itching and promote comfort4.Apply sunscreen to the burn scar

246
Q

Hypertrophic scar

A

Scars in Wichita’s shoes are enlarged above the surrounding skin and typically present as red, raised, and rigid

247
Q

As hypertrophic scars mature and they will(3)

A

Fade in color, flat in, and become more pliable

248
Q

Collagen

A

Basic structural fibrous protein found in all tissue

249
Q

Methods that may help control hypertrophic scar formation include(5)

A

Compression garmentsscar massagetopical siliconesteroid injectionsurgery

250
Q

Burn scars can take up to how many years to mature

251
Q

Wound healing involves three processes

A

One. EpithelializationTwo. Connective tissue depositionThree. Contraction

252
Q

Burn scar contracture(3)

A

Shortening and tightening of the burn scar most problematic over large joints severely limit ROM interfere with the ability to perform ADLs

253
Q

Prevent burn scar contracture’s through

A

ExercisePositioningSplinting

254
Q

Positioning of comfort often results in

A

Contracture formation

255
Q

ROM exercises help reduce the risk of

A

Contracture formation

256
Q

Individualized exercise plan should be developed that meet

A

The needs of the patient

257
Q

It is important to involve both the patient and his or her family members and the development and execution of their exercise plan because it will

A

Increase the likelihood that it will be followed

258
Q

The use of splints at night will aid in maintaining

A

The stretch achieved during the day through ROM Exercises

259
Q

Burn injuries that have the greatest potential to impact occupational performance include(5)

A
  1. Deep partial thickness or full thickness burns2. Burns involving major joints3. Larger burn injuries4. Hypertrophic scar formation5 contracture deformities
260
Q

Burn support groups can be helpful in assisting patients and families in dealing with

A

Lifelong disfigurement and dysfunction that may result from a major burn injury

261
Q

Families benefit from meeting with another burn survivor because

A

It will help them prepare for the challenges ahead and assist them to deal with their emotions

262
Q

Summer camp for burn children can also help to

A

Improve self-esteem and allow them to realize that they can overcome the difficulties they face

OCTH 1031 (22 decks)

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