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sav nur 334 exam 3 week 5 > Patient with Burns > Flashcards

Patient with Burns Flashcards

1
Q

What causes a thermal burn?

A

Flame, flash, scald, or contact with hot objects

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2
Q

What is the most common type of burn?

A

Thermal Burn

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3
Q

What causes a chemical burn?

A

Exposure to acid, alkaline, or chemicals

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4
Q

What do inhalation burns cause?

A

Oral/nasal, esophageal, and direct parenchymal lung injury.

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5
Q

Parenchymal definition

A

The functional part of the organ.

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6
Q

What causes electrical burns?

A

The conversion of electrical energy into heat.

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7
Q

What causes radiation burns?

A

The transfer of radiant energy to the body. (Ex: radiation therapy for cancer)

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8
Q

What is an extreme temperature burn?

A

Frostbite

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9
Q

Who is at risk for an extreme temperature burn? Why?

A

Children and older adults. B/c of their reduced ability to generate heat.

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10
Q

What determines burn severity?

(4 determinants)

A
  1. Depth of burn.
  2. Extent of burn calculated in % of total body surface area.
  3. Location of burn.
  4. Age of pt., medical Hx, or other complicating factors.
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11
Q

Where will a patient be transferred if their burns are severe?

A

Burn Centers

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12
Q

What are the three depths of burns?

A
  1. Superficial Partial Thickness (1st degree)
  2. Deep Partial Thickness (2nd degree)
  3. Full-Thickness (3rd and 4th degree)
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13
Q

What is the purpose of the Rule of Nines chart?

A

Used for the initial assessment of a burn.

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14
Q

What does the Rule of Nines chart tell you?

A

The percentage of the body covered by the burn.

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15
Q

What are the 3 phases of burn management?

A
  1. Emergent (Resuscitative) Phase
  2. Acute Phase
  3. Rehabilitative Phase
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16
Q

Which phase is characterized by the time needed to resolve the immediate, life-threatening problems resulting from a burn injury?

A

The Emergent (Resuscitative) Phase

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17
Q

How long is the Emergent (Resuscitative) Phase?

A

Up to 72 hours from the time the burn occurred.

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18
Q

What are the 2 main concerns during the Emergent (Resuscitative) Phase?

A
  1. Hypovolemic Shock

2. Edema Formation

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19
Q

When does the Emergent (Resuscitative) Phase end?

A

When fluid mobilization and diuresis begins

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20
Q

Pathophysiology of Emergent (Resuscitative) Phase

A

Massive fluid and electrolyte shifts related to the massive increase in capillary permeability.

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21
Q

What are the clinical manifestations of Emergent (Resuscitative) Phase burns?

A
  1. Shock due to hypovolemia.
  2. Pain.
  3. Formation of blisters.
22
Q

What types of burns are painless at first, due to damaged nerve endings?

A

Partial-thickness and full-thickness.

23
Q

What 3 systems are most susceptible to complications r/t burns?

A
  1. Cardiovascular System.
  2. Pulmonary System.
  3. Urinary System.
24
Q

What is a circumferential burn?

A

When the burn goes all the way around the extremity.

25
Q

What type of burn impairs circulation?

A

Circumferential burn w/ edema

26
Q

Purpose of an escharotomy

A

To allow perfusion past the circumferential burn and edema.

27
Q

Eschar definition

A

The black part of the scar.

28
Q

What is the primary role of nurse management during the Emergent (Resuscitative) Phase?

A

Airway management.

29
Q

Fluid therapy during the Emergent (Resuscitative) Phase of a burn is focused on?

A

Aggressive resuscitation. (2 large-bore IVs or CVAD and fluid resuscitation)

30
Q

What is used for fluid therapy?

A

Crystalloids (LR), colloids (Albumin), or a combination of the two.

31
Q

What is the goal of fluid therapy?

A

Increase cardiac output, to decrease shock.

32
Q

What is an escharotomy?

A

To open up the eschar.

33
Q

What is a fasciotomy?

A

To put a slice in the fascia.

34
Q

Purpose of escharotomy/fasciotomy?

A

To improve circulation distal to the burn.

35
Q

Disadvantages of wound care during the Emergent (Resuscitative) Phase.

A

Physically and mentally demanding for the patient.

36
Q

PPE for treating an open wound/burn.

A

Hats, masks, gloves, gowns.

37
Q

What must you wear to apply ointments/dressing to open wound/burn?

A

Sterile gloves.

38
Q

What temperature should a room be when treating a burn?

A

Warm. 85 degrees.

39
Q

Why must the room be warm when treating a burn?

A

Because patients do not have a skin barrier.

40
Q

What is the primary goal of wound care?

A

Permanent skin coverage.

41
Q

Drug therapy for burns?

A
  1. Opioid analgesics and sedatives. (ATC and IV). For excruciating pain.
  2. Tetanus immunization (if not had in last 10 years).
  3. Topical antimicrobials (Silver sulfadiazine).
  4. VTE prophylaxis. (Due to increased viscosity of blood).
42
Q

What is the leading cause of death associated with burns?

A

Sepsis

43
Q

Nutritional therapy for burns

A

Enteral feedings to treat extreme hypermetabolic state.

44
Q

What phase of a burn begins with mobilization of extracellular fluid and subsequent diuresis?

A

Acute phase.

45
Q

When does the acute phase end for a partial-thickness burn?

A

When the wound is healed.

46
Q

When does the acute phase end for a full-thickness burn?

A

When the wound is covered by skin grafts.

47
Q

How long is the acute phase?

A

Weeks to months.

48
Q

Why is it important to monitor lab values in the acute phase?

A

Because fluid and electrolytes are still in extreme flux.

49
Q

What teams will the patient work with during the acute phase?

A

Physical Therapy and Occupational Therapy.

50
Q

What is the 3rd phase of a burn?

A

Rehabilitation Phase.

51
Q

What are the goals during the rehab phase?

A
  1. Resuming functional role in society.

2. Rehabilitate from any reconstructive surgery that may be needed.

52
Q

How does a patient avoid contractures and hypertrophic scarring during the rehab phase?

A

Scheduled ROM and pressure garments.

sav nur 334 exam 3 week 5 (8 decks)

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