Module 6

Question 1

Burns

Answer 1

fluid loss through evaporation

Question 2

exposed nerve endings

Answer 2

partial-thickness burns

Question 3

nerve endings destroyed

Answer 3

full-thickness burns

Question 4

Minor Burns

Answer 4

Partial-Thickness:
<10% TBSA

Full-Thickness:
<2-10% TBSA

No hands, eyes, feet, perineum
No electrical, no inhalation, no additional complicated injury
Patients <60 years & no chronic cardiac, pulmonary, endocrine disorder

Question 5

Moderate Burns

Answer 5

Partial-Thickness:
15-25% TBSA

Full-Thickness:
2-10%

No eyes, hands, feet, perineum
No electrical, no inhalation
No additional complicated injury
Patients <60 years & no chronic cardiac, pulmonary, endocrine disorder

Question 6

Major Burns

Answer 6

Partial-Thickness
>25% TBSA

Full-Thickness
>10% TBSA

Any eyes, ears, face, hands, feet, perineum, electrical, inhalation
Patients >60 years
Complicated with other injuries, cardiac, pulmonary, other chronic metabolic disorders

Question 7

1st Degree

Answer 7

Superficial Thickness

Question 8

2nd Degree

Answer 8

Superficial Partial Thickness
Deep Partial Thickness

Question 9

3rd Degree

Answer 9

Full Thickness

Question 10

Phases of burns

Answer 10

Resuscitation/Emergent
Acute
Rehabilitative

Question 11

Vascular Changes with Burns

Answer 11

Fluid shifting
Fluid leaks into interstitial space (third-spacing)
Leaks plasma
Edema in unburned areas
Occurs in first 12 hours (can last into 24-36 hours)
Imbalances (hypovolemia, hyperkalemia, hyponatremia, metabolic acidosis
Increased HR; Decreased cardiac output
Decreased GI motility, blood flow (due to SNS stimulation)

Question 12

S/S of inhalation injury

Answer 12

burns to face, mouth, nose
singed eyelashes, nasal hair, eyelids, scalp hair
Coughing up black or blood-tinged sputum
Poor O2 sat, ventilation, use of accessory muscles
Wheezing Stridor, bronchospasms
Hoarseness or brassy cough
Drool or difficulty swallowing

Question 13

Burn Resuscitation
Cardiovascular Assessment

Answer 13

tachycardia & hypotension
EKG monitoring (especially electrical burns)
Hypovolemic shock

Question 14

Burn Resuscitation
Kidney/Urinary Assessment

Answer 14

hourly urine output
decreased blood flow due to hypovolemic shock

Question 15

Burn Resuscitation
GI
Assessment

Answer 15

decreased absorption
decreased peristalsis

Question 16

Parkland Formula

Answer 16

4ml/kg/TBSA%
first half in first 8 hours
second half in next 16 hours

Question 17

Surgical Burn Resuscitation Phase Interventions

Answer 17

Tracheostomy
Chest tubes
Escharotomy
Fasciotomy
Debridement

Question 18

Burns
Acute Phase

Answer 18

36-48 hours after surgery
maintenance of function
fluid shift resolves
pain control
wound care
continued assessment
psychosocial interventions

Question 19

Acute Phase Cardiac & Respiratory Assessment

Answer 19

maintain function & identify possible complications
PNA can develop
Infection/Sepsis also affect cardiac/resp systems

Question 20

Acute Phase
Nero/Endocrine Assessment

Answer 20

weight loss
increased metabolic demand
calorie counts
dietician consult
daily weights
high calorie, high protein diet

Question 21

Third Spacing

Answer 21

Hypovolemia
decreased Cardiac Output
[agitation, increased BUN/creatinine, decreased urinary output/creatinine clearance, tachycardia, GI (decreased perfusion, decreased motility, curling ulcers), decreased pH (anaerobic metabolism, increased lactic acid, increased potassium)]