MED SURG II: BURNS

Question 1

Examples of Thermal Burns

Answer 1

Flash, Flame, Scaled, Contact with hot objects

Question 2

What is the most common type of burn?

Answer 2

Thermal

Question 3

Bed position for burns of the face and head

Answer 3

Elevated HOB 30 degrees

Question 4

Primary concern with burns of face and head

Answer 4

fluid shift
AIRWAY
Early intubation

Question 5

What does fluid shifts cause

Answer 5

EDEMA

Question 6

What causes Chemical Burns

Answer 6

Tissue contact with strong acids, alkalis, or organic compounds

Question 7

Primary concern with smoke and inhalation burns

Answer 7

AIRWAY

Quick assessments are vital

Question 8

S/S of Inhalation burns of the upper airway

Answer 8

Blisters, Edema
Hoarseness
Difficulty Swallowing
Copious Secretions
Stridor
Substernal and Intercostal retractions
Total Airway Obstruction

Question 9

S/S of Inhalation burns below the airway

Answer 9

Chemical usually
wheezing
hoarsenss
altered mental status
dyspnea
Carbonaceous sputum

Question 10

What type of inhalation burn is likely if a patient was trapped in a fire or enclosed space?

Answer 10

Lower Airway

Question 11

Cherry Red Skin
Burn tinged Nasal Hairs
Dark Sputum
Trouble Breathing
Hoarseness
Facial Burns

Answer 11

S/S of Carbon Monoxide Poisoning

Question 12

Carbon monoxide displaced O2 on hemoglobin causing _____ which leads to death if carboxyhemoglobin levels >20%

Answer 12

Hypoxemia

Question 13

Tx for Carbon Monoxide Poisoning

Answer 13

Hyperbaric Oxygenation

Question 14

Type of Burn: caused by heat generated by electrical energy as it passes through the body

results in internal tissue damage

Answer 14

Electrical

Question 15

Entry point and Exit point

Answer 15

Entry point gives an idea of how the patient got burned

Question 16

What is a major concern if there is no exit point?

Answer 16

concerned about internal damage (particularly heart damage and risk for dysrhythmias)

Question 17

Iceberg Effect

Answer 17

Damage is worse on the inside than on the outside

Question 18

Complications of Electrical Burns

Answer 18

Dysrhythmias
Cardiac Arrest
Fractures
Fall Injuries
Acute Tubular Necrosis

Question 19

What depth:
(superficial)
Healed ~ 1 week

Answer 19

Partial Thickness

1st degree

Question 20

What depth:
blisters
mild and moderate swelling
3 weeks to heal (usually on it’s own)

Answer 20

Partial thickness

2nd degree

Question 21

What depth:

Charred and whitish skin (involving no bone)

Answer 21

Full thickness

3rd degree

Question 22

What depth:
Charred and whitish sin
Involves bone

Answer 22

Full thickness

4th degree

Question 23

Methods to measure TBSA

Answer 23

Lund-Browder (more specific)

Role of 9s (quick assessment)

Question 24

Facial/Respiratory Burn

Answer 24

Airway intubation should occur prior to swelling

Question 25

What places on the face are hardest to heal

Answer 25

Places filled with cartilage (ears, nose, etc.)

Question 26

Risks with Circumferential burns

Answer 26

Compartment Syndrome

Check pulses and cap refill

Question 27

How long should large burns be cooled for?

Answer 27

No longer than 10min (risk for hypothermia)

Question 28

Should ice be used when treating burns?

Answer 28

NO

Question 29

What major intervention needs to be done early for a patient experiencing a burn?

Answer 29

begin fluid replacement early

Question 30

What phase: direct burn injury to vessels increases capillary permeability
onset – time of injury – up to 72 hours
biggest concept: massive fluid shifts

Answer 30

Emergent (resuscitative) phase

Question 31

when does the emergent resuscitative phase end?

Answer 31

when fluid mobilization and diuresis starts

Question 32

How is H and H effected by burns

Answer 32

initial increases as a result of plasma

hemodiluted after fluid resuscitation