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N3122 Child Health > Toddler: Burns > Flashcards

Toddler: Burns Flashcards

1
Q

What is a thermal burn?

A

most common, through exposure to flames, or scalds, contact with hot object

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2
Q

What is a chemical burn?

A

touch or ingest caustic agents

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3
Q

What is an electrical burn?

A

exposure to direct or alternative current that passess through muscles, organs, nerves, vessels

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4
Q

What is a radiation burn?

A

exposure to radioactive substances or sunlight

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5
Q

first degree burn = ______ thickness burn

A

superficial

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6
Q

2nd degree burn = ______ thickness burn

A

partial

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7
Q

3rd and 4th degree burn = ______ thickness burn

A

full

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8
Q

Define 1st degree burn

A

Damages occur only on outer layer of skin, burn is painful and red

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9
Q

Define 2nd degree burn

A

Partial thickness

involves epidermis and upper layers of dermis

may have soaring of sweat glands and sebaceous glands

heals in 10-14 days

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10
Q

Define 3rd degree burn

A

Full thickness

involves all of epidermis and dermis

may also involve underlying tissue

nerve endings usually destroyed

requires skin grafting

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11
Q

Characteristics of 1st degree burn

A

Pain at site

redness on burned area

blanches on pressure

no bullae (blisters)

peeling after a few days due to premature cell death

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12
Q

Characteristics of 2nd degree burn

A

Blisters or bullae

erythema

blanches on pressure

pain and sensitivity to cold air

minimal scar formation

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13
Q

characteristics of 3rd degree burn

A

Skin may appear brown, black, deep cherry red, with to gray, waxy or translucent

usually no pain (due to damaged nerve endings),

injured area may appear sunken

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14
Q

What does management for 1st degree burn include?

A

Pain management moist soaks or cool cloths

antibiotics

dressing changes

increase fluid intake

HPHC (high protein and high calorie) diet

follow up visits

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15
Q

What does management for 2nd degree burn include?

A

IV fluids

pain management

HPHC diet

wound dressings

antibiotics

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16
Q

What does management for 3rd degree burn include?

A

IV fluid resuscitation

antibiotics

skin grafts and proper dressing changes

high protein high calorie (HPHC) die

vitamins and mineral supplements

debridement

pain management

17
Q

What are the 8 body responses to moderate-severe burns?

A
  • Increased capillary permeability (fluid moves from capillaries into cells/tissues)
  • Decreased cardiac output due to fluid shift & increased vascular resistance (to improve blood flow/BP)
  • Airway inflammation
  • Bone marrow Suppression (late response)
  • Hypermetabolic state (response to trauma of burn)
  • Decreased digestive absorption (due to trauma)
  • Inflammatory response
  • Immune suppression (due to bone marrow suppression or over-proliferation of WBC)
18
Q

Why may airway inflammation occur with burns?

A

not initial response, usually from smoke inhalation

19
Q

What is a late body response to burns?

A

bone marrow suppression

20
Q

What are the clinical manifestations and therapy for increased cap. permeability?

A
  • Edema in burned and unburned skin, hypovolemia, oliguria
  • T: Increased IV therapy for 24-48 hours (fluid resuscitate)
21
Q

What are the clinical manifestations and therapy for dec. cardiac output & inc. vascular resistance?

A

Hypovolemia, poor cap refill, tachycardic, cool extremities

T: Aggressive fluid resuscitation to maintain urinary output

22
Q

What are the clinical manifestations and therapy for airway inflammation?

A

Hoarseness, stridor, hypoxemia (from airway edema or narrowing), soot in mouth

T: Supplemental O2, Intubation and ventilation

23
Q

What are the clinical manifestations and therapy for bone marrow suppression?

A

anemia

T: transfusion of packed red blood cells

24
Q

What are the clinical manifestations and therapy for hypermetabolic state?

A

Loss of weight and lean body mass, hyperglycemia

T: High protein diet, enteral tube, insulin

25
Q

What are the clinical manifestations and therapy for decreased digestive absorption?

A

Food aversion, nausea, vomiting, paralytic ileus

T: IV fluids and electrolytes, nasogastric tube

26
Q

What are the clinical manifestations and therapy for inflammatory response?

A

Fever, tachycardia, open wounds

T: Debridement, excision of full thickness burns, wound dressings, protective isolation (to prevent infection)

27
Q

What are the clinical manifestations and therapy for immune suppression?

A

infection

T: antibiotics

28
Q

What is the biggest risk with thermal burns? and why?

A

risk of hypovolemic shock

A potentially critical condition that results from an extracellular fluid loss, plasma loss due to burn

29
Q

What are the early signs of hypovolemic shock?

A
  • Signs of dehydration
  • Confusion
  • Cool, pale skin
  • tachycardia
30
Q

What is included in the assessment of burn severity?

A
  • Depth of the burn
  • % of body surface area (BSA): Use rule of nines (one for child and one for adult)
  • Involvement of specific body parts: face, hands, genitals, circumferential?
31
Q

What is the treatment of major burns in order? (7)

A
  1. stabilize ABC
  2. manage fluid shifts and minimize fluid loss
  3. control pain
  4. prevent infection and further tissue loss
  5. promote nutrition
  6. aid ROM and mobility
  7. supportive effective coping
32
Q

When would you switch to oral/enteral feeds?

A

when theres good bowel sounds

33
Q

Why do you need a high protein and calorie diet?

A
  • prevent weight loss
  • protein good for cell development/growth
34
Q

What is the parkland formula?

A

4ml x kg x % body surface area burned + maintenance fluids = 24 hour total fluid replacement

note: do parkland formula and calculate rate for certain amount of hours first

then add maintenance fluid rate

35
Q

How do you use parkland formula by hours?

A
  • ½ first 8 hours
  • ¼ next 8 hours
  • ¼ next 8 hours
36
Q

What is the fluid choice for resuscitation and why?

A

Lactated ringers: matches biochemical composition of human plasma with balanced electrolyte formulation

N3122 Child Health (14 decks)

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