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Burns

QuestionAnswer
Thermal burns are from... flames, scalds, heat
Nonthermal burns are from... electricity, chemical, radiation
What is plasma its liquid compartment of blood
What kind of water is in the body IntracellularExtracellular (intravascular) Extracellular (interstitial)
Stage I is what stage Is hypovolemic stage - first 48 hours
Stage II is what stage Is diuretic stage 48-72 hours
What not to give and not give first 24 hours after burn? Give IV fluids. Do NOT give K+
What happend durring Stage I? Capilaries dilate -> increased capillar permeabiity -> Plasma to interstitial fluid shifting -> Edema-Blistering Hyperkalemia - Cardiac arrest BP low->hypovolemia-Ac.Ren.Fail
What happend durring Stage II? Interstitial to plasma fulid shifting -> Increased blood volume -> Increased urine output - hypokalemia -> circul.overload - CHF
12-48 hours post burn greatest fluid loss proteins, plasma & electrolytes shift from the VASCULAR TO THE INTERSTITIAL SPACE. hyperkalemia falsely elevated hematocrithypotensionoliguria - low urine outputrapid, shallow respirations, restlessnesshypovolemic shock
48-72 hours post burn fluids shift back from the INTERSTITIAL TO THE VASCULAR COMPARTMENT increased blood volume- increased cardiac output increased urine outputhypokalemiafluid overloading
Normal K+ level 3.5 - 5
What is hematocrit hematocrit says how your blood is concentrated (syrupe)
What determines rule of nines? BSA burned - total volume of body surface
Factors affecting severity of burn injury % of BSA burn,edage, location, cause, other diseases, depth injuries sustained
History of what nurse has to determine in past 5 years? Tetanus booster
S&S of smoke inhalation hoarse voicesinged nasal hairsbrassy caugherythema of the pharyngxsooty, black sputum
Rule of Nines arm 9% eachhead 9%chest 18%back 18%leg 18% eachgroin 1%
First degree burn Superficial - causes redness, minimal affectiong only the epidermis, painful, dry, without blisters
Second degree burn Partial Thicknes - involves the epidermis and the dermis, appears red, blistered, maybe swollen and very painful (contact with hot liquids or solids, direct flame, chemicals)
Third degree burn Full thickness - burns-destroy the epidermis, dermis, underlying bones, muscles, and tendons.The site appears white or charred. No sensation in the area since the nerve endings are destroyed. (flame, chemicals, electrical).
Child burn percentage Head to neck 18%Leg (groin to toe) 14%Anterior trunk 18%Posterior trunk 18%
How many % of burn require hospitalization and rehabilitation and are classified as a major injuries? 10% child15-20% adult
Burn dx tests electrolites, CBC, serum chemistries, ABG, carboxyhemoglobin
Burn Emergent Phase stop, drop, roll techniqueremove clothing and shoesdo not apply iceopen airway and control bleedingremove jewelrycover area with clean sheet
S&S of carbon monoxide poisoning headache, nausea, vomiting, unsteady gait,
Treatment of carbon monoxide poisoning give 100% oxygen
Burn med. mng IV therapy (Ringers lactate)Insert foley cat. (to monitor output)Insert NGT (decompress to remove gas - paralytic ileus - means yor intestitnes dont work and u retain gas)Morphine sulfateTetanus prophylaxis
Burn acute phase 10 days to monthsprevent infectionprevent other complications - HF, contractures, RF, paralytic ileus, Curling ulcer
What is Hypoximia, Hypoxia, Ischemia lack of oxygen
Burn nursing interventions complete ABCVSMIOBUN & creatit.High cal. protein & vit. diet/TPNprotective (reverse) isolationSTRICT surg. aseptic tech.hydrotherapyTemporary skin substitutes (TransCyte - prevents frequent, painful drsg changes)
Burn nursing interventions continued Debride wound - prevent infectionAply topical ATB/drugsChange drsg. 2xDRemove Eschar (excherotomy) to increase prepheral circulationOpen/closed wound care methodproper posioning and ROMSpecial beds (bed cradle,Cirocolectic bed, Clinitron)
Burn nursing interventions continued 2. Skin grafts to full thinkness burnsimobilie graft sitegive antacid or proton pump inhibor drugs (ulcer)
Burn medicatios (ATB) mefenide (Sulfamylon) - is painful to applysilver sulfadiazine (Silvadene)silver nitrate - stains skin
Types of skin grafting autograft - from same personhomograft/allograft - from another person/cadaverheterograft/xenograft - from another species (pig or cow)
Burn regabilitation phase Begins at admissionPhysical therapySkin careExcercisesAmbulation
Burn prognosis outcome depends on the siz, depth of burn, age of victim, body part ivoved and presence of other disease
Burns related nrsg diagnoses Disturbed body image related to scarringDeficient self care related to pain or fatioquePost trauma syndrome related to the cause of the burnIneffective coping related to long term rehabilitationGrieving related to loss of wellness
Created by: Lidunka25