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mski > SPECONLEC_S1_L2 - 73-109 > Flashcards

SPECONLEC_S1_L2 - 73-109 Flashcards

1
Q

Long Term Goal of medical mx for burns is:

A

To restore skin integrity, function and appearance

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2
Q

immediate goal is restore skin integrity t or f

A

f, this is the long term goal

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3
Q

Immediate Goal (Post Resucitation) of medical mx for burns:

a. Prevent infection
b. Decrease pain
c. Prepare wounds for grafting
d. Prevent contracture and scarring
e. Maintain strength and function
f. all

A

f. all

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4
Q

acute or initial medical mx of burns

A

transport
fluid replacement
determining the extent and depth of injury
wound cleansing
Topical Antibacterial Agents
Proper positioning for optimal joint placement
wound coverage
grafting

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5
Q

t or f goal of wound debridement is To remove dead tissue, prevent
infection, and promote
revascularization/reepithelialization

A

f, this is the goal of wound cleansing

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6
Q

what acute medical mx would help reduce the number of bacteria

A

Topical Antibacterial Agents

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7
Q

Topical antibacterial agent; effective against gram-negative or
gram-positive organisms; diffuses easily to eschar

A

Mafenide acetate (sulfamylon)

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8
Q

Most commonly used
anti-bacterial agent; effective against
Pseudomonas infections

A

Silver Sulfadiazine

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9
Q

Topical solution with antimicrobial function against gram-positive
and gram negative organisms.

A

Mafenide acetate solution (sulfamylon 5% solution) silver nitrate

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10
Q

t or f using mafenide acetate is effective against
Pseudomonas infections

A

f, using silver sulfadiazine

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11
Q

Maintains moist environment

A

Mafenide acetate solution (sulfamylon 5% solution) silver nitrate

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12
Q

Antiseptic germicide and astringent;
will penetrate only 1-2mm of eschar; useful for surface bacteria;
stains black

A

Mafenide acetate solution (sulfamylon 5% solution) silver nitrate

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13
Q

mafenide acetate soultion (sulfamylon 5% solution) silver nitrate will
penetrate only how many mm of what

A

1-2 mm of eschar

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14
Q

Bland ointment; effective against gram-positive organisms

A

Bicitracin/ Polysporin

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15
Q

Enzymatic debriding agent selectively
debrides necrotic tissue; no antibacterial action

A

Collagenase, accuzyme

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16
Q

_ applied with sterile glove_ directly to wound or impregnated into _ IN
silver sulfadiazine

A

white cream, 2-4 mm, fine mesh gauze

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17
Q

White cream applied __ to wound with thin _ layer how many times daily;
may be left undressed or covered with _ in mafenize acetate

A

directly, 1-2 mm, 2 times, thin layer of gauze

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18
Q

White cream applied with sterile glove 2-4mm directly to wound or
impregnated into fine mesh gauze in what topical medication

A

Silver Sulfadiazine

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19
Q

50-gram packet of white powder that is mixed with either 1000mL
sterile water or 0.9% sodium chloride soaked gauze in what topical
medication

A

Mafenide acetate solution (sulfamylon 5% solution) silver nitrate

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20
Q

Dressings or soaks used every __ hours; also available as _ to _ small
open areas in what topica ointment

A

2 hrs, small sticks, to cauterize, Mafenide acetate solution (sulfamylon 5% solution) silver nitrate

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21
Q

how many grams of packet of _that is mixed with either _
or _ soaked gauze in Mafenide acetate solution
(sulfamylon 5% solution) silver nitrate

A

50 gram, white powder, 1000 mL sterile water or 0.9% sodium chloride

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22
Q

t or f bicitracin is a thin layer of ointment
applied directly to wound and left closed

A

f, left open

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23
Q

Ointment applies to eschar and covered with
moist occlusive dressing with or without an antimicrobial agent.

A

Collagenase, accuzyme

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24
Q

thin layer of ointment applied directly to wound and left open

A

Bicitracin/ Polysporin

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25
Q

collagenzase is applied to __ and covered with __ with or wihtout
an antimicrobial agent

A

eschar, moist occlusive dressing

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26
Q

WOUND CLEANSING (2):

A

Debridement
Review methods in wound management

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27
Q

Removal of eschar is callled

A

Debridement

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28
Q

Removal of necrotic tissue is also called debirdement t or f

A

t

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29
Q

debridement would help in preventing bacterial proliferation t or f

A

t

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30
Q

dressing is done to prevent wound _

A

contamination

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31
Q

debreidement keeps microorganism at bay t or f

A

f, dressing

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32
Q

wound cleansing Prevent further injuries t or f

A

f, dressing

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33
Q

Apply pressure to control the hemorrhage in wound dressing t or f

A

t

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34
Q

t or f wound dressing Absorb wound drainage
and Assist in wound healing

A

t

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35
Q

two techniques of wound coverage (dressing)

A

open technique
closed technique

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36
Q

Applying a topical cream or ointment with or
without dressings (usually without)

A

OPEN TECHNIQUE

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37
Q

Applying dressings over a topical agent: what technique

A

Closed Technique

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38
Q

Allows for ongoing inspection of the
wound and examination of the healing process

A

OPEN TECHNIQUE

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39
Q

purpose of closed technique:

A

Hold topical antimicrobial agents on the
wound
Reduce fluid loss
Protect the wound

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40
Q

The topical medication must be reapplied throughout the week for open
technique

A

f, throughout the day

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41
Q

for closed technique, how many times should you change in a day

A

Change once to twice a day

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42
Q

Layers of closed technique:

A

1st - Non-adherent
2nd - Cotton padding
3rd - Gauze or elastic bandage
4th - Roller gauze
5th - Elastic wrap

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43
Q

Patient’s own skin, taken from an unburned
area

A

autograft

44
Q

autograft is temporary coverage t or f

A

f, permanent

45
Q

Taken from cadaver of own species: what kind of grafting

A

Homograft/Allograft

46
Q

what kind of grafting is taken from non human like pigs

A

Heterografts/Xenografts

47
Q

ARE A LIFE-SAVING
TECHNOLOGY FOR
LARGE, FULL-
THICKNESS, TOTAL
BODY SURFACE AREA
(TBSA) BURNS

A

CULTURED EPITHELIAL
AUTOGRAFTS (CEAS)

48
Q

CULTURED EPITHELIAL
AUTOGRAFTS (CEAS) is used for __

A

LARGE, FULL-
THICKNESS, TOTAL
BODY SURFACE AREA
(TBSA) BURNS.

49
Q

CEAs are composed of

A

AUTOLOGOUS
KERATINOCYTES

50
Q

CEAs ARE CULTURED UNDER
CONDITIONS THAT
GENERATE __SUITABLE FOR
GRAFTING.

A

EPITHELIAL
SHEETS

51
Q

what to put in subjective:

A

Patient’s background
Chief complaints
HPI
PMHx
Lifestyle
Social and Physical Environment
Patient’s goal

52
Q

Preesisting limitations or previous injuries: what subj part

A

PMHx

53
Q

part of subj where the pt will told you the first aid
administered

A

HPI

54
Q

MOI is what part of subj

A

HPI

55
Q

Objective

A

VS
OI
ROM
MMT/FMT
Sensory testing
wound assessment
cardiopulmonary assessment
antrhopometric measurement
PA, FA, GA

56
Q

what to put in OI

A

Attachments
Splints
Site of wounds etc

57
Q

what to put in wound assessment

A

% TBSA Classification
Burn type and depth
Wound dressings
Presence of grafting, graft sites

58
Q

omts for Burn Outcome Measures

A

Burn Specific Health Scale -Brief (BSHS-B)
Burns Scar Index (Vancouver Scar Scale)

59
Q

PTDx: what to put

A

Classification of burn injury
% TBSA
Severity of burn

60
Q

determinants of prognosticating factors (5)

A

Severity of burns
Current health status
Age
Physical Condition
Mental condition

61
Q

RISK FACTORS TO RETURN TO
WORK AFTER MAJOR BURN INJURY (6)

A

● Preburn psychiatric history
● Extremity burns
● Electric etiology
● Longer stay at hospital
● Inpatient rehabilitation
● Burn injury occurred at work

62
Q

BARRIERS TO RETURN TO
WORK AFTER MAJOR BURN INJURY (5)

A

● Wound issues
● Neurologic problems
● Physical abilities, impaired mobility
● Working conditions (temperature, humidity, and safety)
● Psychosocial factors

63
Q

Psychosocial factors in barriers include: (6)

A

○ Drug and alcohol dependence
○ Insomnia
○ Depression
○ Post Traumatic stress (nightmares, flashbacks)
○ Anxiety
○ Appearance issues and concerns over body image

64
Q

Suggested goals and outcomes for the physical
therapy plan of care for the patient with burns include: (12)

A

○ Wound and soft tissue healing is enhanced.
○ Risk of infection and complication is reduced
○ Risk of secondary impairments is reduced.
○ Maximal range of motion is achieved
○ Pre-injury level of cardiovascular endurance is
restored
○ Good to normal strength is achieved
○ Independent ambulation is achieved
○ Independent function in ADL and IADL is increased
○ Scar formation is minimized
○ Patient, family, and caregiver’s understanding of
expectations and goals and outcomes is increased
○ Aerobic capacity is increased
○ Self-management of symptoms is improved

65
Q

PT INTERVENTION (2)

A

positioning
splinting

66
Q

what PT intervention prevent contracture formation

A

positioning and splinting

67
Q

Splinting uses

A

Facilitate proper positioning
Prevention of joint contracture
Protecting skin grafts or fragile wounds
Assisting desired motions

68
Q

to maintain hand at a functional position, what do u use

A

Hand splints

69
Q

to avoid neck flexion (position of comfort);
to maintain at neutral or slight extension

A

neck brace

70
Q

neck brace avoid _

A

neck flexion

71
Q

to help reduce scarring/ maintain or decrease appearance of scars

A

Compression garments

72
Q

to maintain patency of mouth, what do pts wear

A

face splints

73
Q

to maintain foot at neutral position, what do pts wear

A

dorsiflexion brace

74
Q

t or f Compression garments help maintain or decrease appearance of
scars which is why they are worn throughout the body or burned area

A

t

75
Q

positioning strategy: ANTERIOR NECK common deformity

A

Flexion

76
Q

positioning strategy: shoulder - axilla common deformity

A

Adduction and internal rotation

77
Q

positioning strategy: elbow common deformity

A

Flexion and pronation

78
Q

positioning strategy: hand common deformity

A

Claw hand (also called intrinsic minus position)

79
Q

positioning strategy: hip and groin common deformity

A

Flexion and adduction

80
Q

positioning strategy: knee common deformity

A

Flexion

81
Q

positioning strategy: ankle common deformity

A

Plantarflexion

82
Q

positioning strategy: anterior neck motions to be stresssed

A

Hyperextension

83
Q

positioning strategy: shoulder axilla motions to be stressed

A

Abduction, flexion, and external rotation

84
Q

positioning strategy: elbow motions to be stressed

A

Extension and supination

85
Q

positioning strategy: hand motions to be stressed

A

Wrist extension; MCP flexion, proximal IP and distal IP extension; thumb abduction

86
Q

positioning strategy: hip and groin motion to be stressed

A

All motions, especially hip extension and abduction

87
Q

positioning strategy: knee motion to be stressed

A

Extension

88
Q

positioning strategy: ankle motion to be stressed

A

All motions (especially dorsiflexion)

89
Q

positioning strategy: anterior neck suggested approaches

A

Use double mattress; position neck in extension; with healing use rigid cervical orthosis

90
Q

positioning strategy: shoulder axilla suggested approaches

A

Position with shoulder flexed and abducted (airplane splint)

91
Q

positioning strategy: elbow suggested aproaches

A

Splint in extension

92
Q

positioning strategy: hand suggested approaches

A

Wrap fingers separately.
Elevate to decrease edema.
Position in intrinsic plus position, wrist in extension, MBP in flexion, proximal IP and distal IP in extension, thumb in abduction with large web space

93
Q

positioning strategy: hip and groin suggested approaches

A

Hip neutral (zero degrees of flexion/extension), with slight abduction

94
Q

positioning strategy: knee suggested apporaches

A

Posterior knee splint

95
Q

positioning strategy: ankle suggested approaches

A

Plastic ankle-foot orthosis with cutout at Achilles tendon and ankle positioned in neutral

96
Q

The common deformity of the hand after burn injuries is in the claw
hand position or intrinsic plus. t or f

A

f

97
Q

Significant factors involving mortality involvement
of the head, upper extremity, and the perineum. t or f

A

f

98
Q

The free nerve endings that are found only in the
dermis, convey the sensation of pain and itch to the brain. t or f

A

f

99
Q

Inhalation injuries are the most devastating type of burns. t or f

A

f

100
Q

In electrical burns, PNS and CNS problems may occur
immediately after injury. t or f

A

f

101
Q

In chemical burns, acidic products usually cause more
damage compared to alkali products.

A

f

102
Q

Complete healing of superficial thickness
burns occurs in 7 to 10 days. t or f

A

t

103
Q

The most common cause of burns in children 1 to 5 years
of age is scalding from hot liquids t or f

A

t

104
Q

The tissue with the least resistance to electricity is the
blood as it is made up of water. t or f

A

f

105
Q

Inhalation injuries are called carbon monoxide poisoning,
heat injuries, or smoke inhalation injuries. t or f

A

t

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