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Burn M

Burn flashcard

QuestionAnswer
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