week8

Question 1

What are epidermal burns?

Answer 1

Burns of the epidermal layer of the skin, these are pink, red and painful and take up to 7 days to heal

Question 2

What are superficial partial thickness burns?

Answer 2

Burns of the epidermis and the superficial dermis, these blister are red or mottled and heal within 14 days

Question 3

What are mid dermal partial thickness burns?

Answer 3

Burns of the epidermis and dermis, creating a large zone of non-viable tissue, these are less painful and are pale to dark pink

Question 4

What are deep partial thickness burns?

Answer 4

Burns that go deep into the dermis, they are pink to pale ivory in colour and the skin does not blanch

Question 5

What are full thickness burns?

Answer 5

Burns where the epidermis and dermis are destroyed and burns may penetrate the underlying structures, they are white, waxy and charred looking

Question 6

What is the treatment of circumferential burns?

Answer 6

Escarotomy

Question 7

What is the rule of nines?

Answer 7

It is a way of calculating the total body surface area of burns

Question 8

What are each of the following worth on the rule of nines?

Answer 8

Head – 9%				
Each arm – 9%
Leg (whole) – 18%			
Trunk (front) – 18%
Trunk (back) – 18%			
Perineum – 1%
Hands (incl. fingers) – 1%

Question 9

What are the local effects of major burns?

Answer 9

Zone coagulation
Zone of stasis
Zone of hyperaemia

Question 10

What are the systemic effects of major burns?

Answer 10

Cardiovascular
Respiratory
Metabolic
Immunological

Question 11

What are the 2 phases of the care of a patient with a burn injury?

Answer 11

Immediate care

Care provided throughout the first 24hrs

Question 12

What is the care of a patient with a burns injury?

Answer 12

Emergency care – remove patient from danger and stop the burning process, place under running water for 20mins, provide adequate analgesia

Airway – Supplemental oxygen for all patients, monitor for signs of obstruction

Breathing – monitor for signs and symptoms of dyspnoea, tachypnoea and pulmonary oedema

Circulation – Fluid Resuscitation

Minimisation of hypothermia and hyperkalaemia

Burns Dressings

Question 13

What is the criteria for fluid resuscitation?

Answer 13

Adults (>15%TBSA burn)

Children (>10%TBSA burn)

Question 14

What is the formula for fluid resuscitation?

Answer 14

4mls/kg x %TBSA x pre-burn body weight (kg) = Vol in mls

On top of the formula the patient also requires the “normal” daily intake over 24 hours

Question 15

An 80 kg patient has 25% TBSA burns. The patient is NBM so also include the 2L maintenance fluid requirements. Formula: 4ml/kg/TBSA% + 2000mls.
What are the fluid requirements for the first 24 hours?
a) 4000ml
b) 7380ml
c) 10,000ml
d) 14,760ml

Answer 15

c) 10,000ml

Question 16

The incidence of burns injuries in Aust/NZ 1999-2004 is?

a) 460 admissions
b) 4,600 admissions
c) 46,000 admissions

Answer 16

c) 46,000 admissions

Question 17

True or false, the classification of burns injuries is superficial, partial thickness and full thickness

Answer 17

true

Question 18

The aim of Pre-hospital care is:

Answer 18

Education
Keep matches/lighters away from children
Replace batteries in smoke detectors
Set hot water to temperature no higher than 50*
Use caution when cooking

Question 19

What is the A-E for a burns patient?

Answer 19

Airway/breathing – consider need for early intubation
Circulation – fluid replacement
Disability – monitor GCS and possible reasons for lowered GCS
Exposure – loss of fluid

Question 20

What are the further nursing considerations for a burns patient?

Answer 20

Analgesia
Neurovascular
Dressings

Question 21

What is another name for Enoxaparin?

Answer 21

Heparin

Question 22

What is Enoxaparin?

Answer 22

It is an anticoagulant used to prevent VTE

Question 23

What are the contraindications for Enoxaparin?

Answer 23

Haemorrhage risk

Haemorrhagic stroke

Question 24

What are the possible reactions to Enoxaparin?

Answer 24

Haemorrhage			
Anaemia
GI upset			
Headache
Skin necrosis			
Pain
Haematoma at site		
Allergic Reaction

Question 25

What is the dosage of Enoxaparin?

Answer 25

High risk patients – 40mg OD
Moderate risk patients – 20mg OD
Duration dependent on prophylaxis or treatment of condition

Question 26

Name three local effects of a burn

Answer 26

Zone coagualtion
Zone of stasis
Zone of hyperaemia

Question 27

Name four systemic effects of a burn

Answer 27

Cardiovascular
Respiratory
Metabolic
Immunological

Question 28

Burns prevention

Answer 28

Preventing scalds
Contact burns
Flame burns
Explosions
Friction