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Burn M
Burn flashcard
| Question | Answer |
|---|---|
| What is the primary problem with mortality in burn injuries? | Smoke inhalation |
| What are the three ages when burns are more likely to occur? | Children 1-5, males 18-35, adults 60+ |
| Your patient is burned on their abdomen, entire left arm, upper back and front right leg (it was a wacky fire). What is the burn size using the rule of nines? | 36% |
| Burns to the head, neck and chest will have ________ complications. | pulmonary |
| Burns of the face often occur with _________. | corneal abrasions |
| Burns of the hands/joints require intense _____. | intense PT and OT |
| Burns of the peri area are susceptible to __________. | infection |
| Circumferential burns of the extremities can have a ___________ which can lead to ___________. | tournequet-like effect; distal vascular compromise |
| Circumferential burns of the thorax may lead to ___________________. | inadequate chest wall expansion and pulmonary insufficiency |
| Treatment in a burn unit is indicated for burns that are greater than ______, or located on the __________________, involve ____________ or include _____________. | 10%; involvement of hands, face and feet; smoke inhalation; comorbidities that affect healing |
| How do you calculate mortality rate? | TBSA + age. |
| Decisions are made to not seek a cure for sums of _____ or greater, if ________ is present or if ___________ exist. | 120; smoke inhalation; comorbidities |
| When do you put in a ETT? | burns of face and neck; greater than 40% TBSA; smoke inhalation; actual respiratory distress without smoke inhalation |
| What are the diagnostic indicators for smoke inhalation? | blackened, burned nasal hair; soot in mouth or nostrils; stridor, wheezing, progressive hoarseness. |
| Regarding fluid...if pt is able to swallow what to do you do? | Give cool fluids and tell them not to talk |
| What is the calculation for determining fluid resuscitation? | kg x TBSA x 4ml/hr; give half over the first 8 hours from time of burn; give the rest over the next 16 hours (titrate to urine output after first hour) |
| Burns over ______% need Foley cath. | 20% |
| Why will you not give your pt IM pain meds? | because they may not be perfusing well and the med would just sit there and not get circulated. |
| When does diuresis begin? | After 24-36 hours |
| What is the approximate rate of fluids for burn maintenance? | 200 ml/hr |
| A pt with a burn greater than _____% needs a salem sump and feeding tube. | 20% |
| When is it OK to pop a blister? | Only when it's impeding movement |
| What are the goals during the acute phase? | wound closed or closing; pain controlled with oral meds except for wound care; passive participation in OT, PT; nutrition goals met orally; no mechanical respiratory support |
| What are the goals during the emergent phase? | Fluids at burn maintenance; urine output 0.5 ml/kg/hr; VS stable; hgb WNL; diuresis of resuscitation fluids; resp status stable; wound care pattern initiated |
| What are the goals for rehabilitation phase? | patient responsible for skin care, nutrition, active range of motion; patient formulates own plan for the near and distant future |
| Why might the burn get MORE painful (and is normal, not pathologic) | Nerve endings grow back so the nerve becomes more painful |
| How can you help prevent ICU psychosis? | Try to keep quiet so pt can sleep at night and have somewhat of a normal day/night rhythm. |
| How do you calculate calorie needs? | 25 kcal per kg +40 kcal per TBSA. |
| What percentage of calories should protein? | 20% |
| T or F, a temp of 38-degrees is expected. | T...the body has a hypermetabolic response to burn injury |
| T or F, your pt will have slight metabolic acidosis. | T...acidosis will be d/t dead tissue and lactic acid buildup |
| What is oxandrolone? | an anabolic steroid given for improved muscle protein metabolism through enhanced protein sufficiency. |
| How much time between skin harvesting? | about 2 weeks |
| What is the most important reason for using SSD on a fresh burn? | it kills bacteria |
| Why are all postoperative burn patients with leg grafts confined to bed with legs elevated? | Swelling and edema can "float" the graft off. |
Created by:
tp667
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