Help
Options
Didn't know it?
click below
click below
Knew it?
click below
click below
Don't Know
Remaining cards (0)
Know
retry
shuffle
restart
0:00
Embed Code - If you would like this activity on your web page, copy the script below and paste it into your web page.
Normal Size Small Size show me how
Normal Size Small Size show me how
Burns
Test 5
| Question | Answer |
|---|---|
| Escharotomy | surgical procedure incising through areas of burnt skin to release the eschar and its constrictive effects, allows for adequate circulation and ventilation. Done only on Full thickness burn, |
| Rule of 9 | Used to calculate total body surface area % of the body that is burned |
| What fluids do you use with burns? | Use lactated ringer (Isotonic) |
| How long should fluids be given to burns victims? | Half of the total volume must be given the first 8hrs, the rest should be given over next 16hrs |
| What should know about a burn pt on admission? | Weight (pre-burn) |
| What is the biggest threat in burns patients? | First 24hrs of leaking, Keeping BP up |
| Parkland formula | 4mL x TBSA (%) x Weight (K) /2=Amount given first 8hrs *If asked hourly rate divide by 8 |
| Function of skin: | Barrier to infection, protection, temperature control |
| If pt states will I ever look the same? | Your ans should be "NO, you won't look the same we hope we can help improve" "Identity" |
| Types of burns: | Cutaneous heat, electrical, chemicals, radiation, friction, contact, flame, scald |
| First degree *picture | epidermis is intact, redness, No scarring, painful |
| Third degree | extend into fat layer, beneath the dermis; stiff, waxy white, tan |
| Superficial partial thickness | Key "Superficial" not deep; entire dermis and portion of epidermis, some painful, blisters, chance for infection, hair intact, may not scar, |
| Deep partial thickness 2nd degree | Much deeper, much worse, some potential for pain, reticular dermis, usually scars, heals in about 3 weeks, some grafting |
| Full thickness 3rd degree | Into fat or deeper, all the way to the bone, Escharotomy may be necessary, grafts, painless, numb, red, white , brown, shock, leathery appearance |
| What burn is considered child abuse? | Scald burns (Somebody holds them down) |
| What should you think of with electrical burns? | Electric shock, think cardiac; may stop your heart, may cause elevated cardiac enzymes, EKG; must be placed on monitor |
| Inhalation injury | Exposure to heat & toxic products of combustion 50% of fire death, Inspect for Burned face, eyes, clothes; may need trach |
| Signs and symptoms of inhalation injury: | Carbonation sputum (Black sputum), Hoarseness, drooling, sut, burned eyelashes, bronchorrhea, stridor, conjunctivitis, anxiety, wheezing, shortness of breath |
| Where should you auscultate? | Trachea and R stem bronchos |
| When you inhale carbon monoxide poisoning what signs and symptoms are experience? | Not feeling good, Confusion and headache; most common toxin competes with O2 |
| If you come across a pt next to a boiling pot of water what should you do? | Remove clothes immediately because it is burning them; remove the clothes the burning stops |
| If its a flame burn you should NOT? | Remove patient from object might peel skin off |
| What should you never use on a burn? | Icepack |
| What area are special; gets you admitted into the burn center immediately? | Hands, perineum, feet, face, genitalia, major joints |
| Every burn unit has what type of pt? | Stephen Johnsen syndrome; they lose their skin, worse than burn pt |
| What vascular changes results from burns: | Circulatory disruption at burn site; Blood flow decreases Damage macrophages within tissues; Hyperkalemia (Cells burst) Blood vessels Leak (thrombosis) may occur causing necrosis |
| Fluid shift is initiated by? | Initial vasoconstriction, then vasodilates; Pressure lowers; Blood vessels dilates and leak fluid into interstitial space; Third spacing or capillary leak syndrome |
| What does fluid shift cause? | Decrease blood volume and BP; occurs within the first 12 hours up until 36hrs |
| What happens if fluid is not given to burn patients? | Kidneys weaken/ go into failure; will shut down |
| Fluid imbalances: | Hypovolemia, metabolic acidosis, hyperkalemia, hyponatremia, blood osmolarity, hemoconcentration due to dehydration Everything is elevated; no volume |
| Fluid remobilization is initiated by? | Diuretic stage, resuscitation phase, Hypokalemia |
| What does fluid remobilization cause? | Blood volume increases, body weight returns to normal; occurs after 23hrs capillary leak stop; might see hypokalemia AKA resuscitation stage |
| Curling ulcer: | Peptic ulcer (stomach) Occurs within 24hrs, due to reduce GI blood flow *Big burn |
| Are curling ulcers treatable? | Can try to treat; watch for H&H if it drops you know they have a GI bleed |
| Emergent phase: | Airway is first; temp, prevent infection, wound care, emotional support, pain meds, support circulation |
| what to do to meet metabolic demands for burned pt? | Burned pt need massive amount of nutrition, due to high calories being burned, may need NG tube |
| Will they meet metabolic needs? | No matter what they do we wont be meeting their metabolic needs |
| Clinical manifestations will be? | Cardiovascular (shock) |
| Range of motion: | Passive ROM, make sure they move 1-2hrs, avoid contractures |
| What should you never give burn patients? | Diuretics; we need to maintain BP, keep fluid replacement (lactated ringers) Monitor for infection |
| What is given for infection? | Silvadene |
| What shot is given to all burn pt? | Tetanus shot |
| Allograft | obtain by cadaver |
| Autograft | patients own skin |
| Homograft | the skin of another person |
| What is the ONLY permanent graft material? | Patients own skin |
| When giving pt fluids what increases? | Blood pressure; if it drops or stays the same be concerned |
| What are indicators of perfusion: | Blood pressure either stays same/ goes up; Urine 30ml/hr; LOC |
| Rehab | Best of your ability |
| Psychosocial aspect: | Pt are self conscious, never look the same; don't feel like themselves |
| You should always do what with burn pt? | WASH hands when entering room, treat 2 burns separate |
| How long should compression garmens be worn for? | 23hrs |
| When discharging a burn pt you should talk about? | Diet, Bathing, wound care, compression stockings, follow up, contact for complications . |
| When do you use a 22 gage? | For fragile veins, ex. 80yo, pt is not dehydrated, No blood products |
| The higher the gage # | the smaller the needle |
| Phlebitis | Pain, redness, tenderness, cord like feeling, purulent drainage Her words=Red, Hot, Hard to touch |
| Infiltration | Compare side to side, Cool temp, Wet (leaky), Her words=Swollen, cool to touch, redness, remove IV |
| Vancomycin: | Tissue necrosis, Causes Red man Syndrome |
| Lab values: WBC | 5,000-10,000 |
| Hypokalemia; potassium level 3.5-5.2 | Less than 3 |
| Hematocrit | 37-52 |
| Hemoglobin | 12-18; 8-11 risky; Below 7 dead |
| What are you concerned with burn victims? | Infection, temperature regulation (lose barrier), protecting them from yourself |
| Escharotomy signs/ symptoms | Tingling, numbness, can't breath, no tissue circulation, capillary refill; Look for S/S don't just palpate late sign |
| Patients Palm is what? | Approximate 1% total body surface area |
| High burn % | Greater the problem |
| Total fluid resuscitation is estimate by? | The rule of 9 |
| Pounds to KIlo | Pounds /2.2 =Kilo |
| Very beginning burn patients are? | Hyperkalemia; cells are bursting; Grater than 5 |
| When you resuscitate they are? | Hypokalemia; Less than 3 |
| Airway problem inhalation signs? | Face burn, red face |
| Carbon monoxide percentage? | Smoker 10%, air control, 60% fatal |
| Medications to treat pain/ control for burn pt? | Narcotics; IV only (Morphine) |
| 4th degree burn | All the way to bone, full thickness, no pain |
| Labs of dehydrated pt | Labs are falsely high |
| Hyponatremia | Below 135 |
| What does elevated hematocrit mean? | Hemoconsentration |
| In emergent phase; Hypovolemic shock S/S? | Increase HR, Decrease BP, decreased Cardiac output |
| What does shock cause? | Low blood pressure; organs go into failure Sign: Cold & Clammy skin priority |
| Hypovolemic shock? | Blood loss; causing low blood pressure, low blood volume from fluid shift S/S Hypotension, Tachycardia, Low central venous pressure, low urine output |
Created by:
golds_berry
Popular Science sets