Burn flashcard
Quiz yourself by thinking what should be in
each of the black spaces below before clicking
on it to display the answer.
Help!
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| What is the primary problem with mortality in burn injuries? | Smoke inhalation
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| What are the three ages when burns are more likely to occur? | Children 1-5, males 18-35, adults 60+
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| 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%
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| Burns to the head, neck and chest will have ________ complications. | pulmonary
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| Burns of the face often occur with _________. | corneal abrasions
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| Burns of the hands/joints require intense _____. | intense PT and OT
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| Burns of the peri area are susceptible to __________. | infection
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| Circumferential burns of the extremities can have a ___________ which can lead to ___________. | tournequet-like effect; distal vascular compromise
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| Circumferential burns of the thorax may lead to ___________________. | inadequate chest wall expansion and pulmonary insufficiency
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| 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
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| How do you calculate mortality rate? | TBSA + age.
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| Decisions are made to not seek a cure for sums of _____ or greater, if ________ is present or if ___________ exist. | 120; smoke inhalation; comorbidities
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| When do you put in a ETT? | burns of face and neck; greater than 40% TBSA; smoke inhalation; actual respiratory distress without smoke inhalation
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| What are the diagnostic indicators for smoke inhalation? | blackened, burned nasal hair; soot in mouth or nostrils; stridor, wheezing, progressive hoarseness.
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| Regarding fluid...if pt is able to swallow what to do you do? | Give cool fluids and tell them not to talk
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| 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)
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| Burns over ______% need Foley cath. | 20%
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| 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.
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| When does diuresis begin? | After 24-36 hours
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| What is the approximate rate of fluids for burn maintenance? | 200 ml/hr
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| A pt with a burn greater than _____% needs a salem sump and feeding tube. | 20%
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| When is it OK to pop a blister? | Only when it's impeding movement
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| 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
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| 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
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| 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
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| Why might the burn get MORE painful (and is normal, not pathologic) | Nerve endings grow back so the nerve becomes more painful
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| 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.
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| How do you calculate calorie needs? | 25 kcal per kg +40 kcal per TBSA.
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| What percentage of calories should protein? | 20%
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| T or F, a temp of 38-degrees is expected. | T...the body has a hypermetabolic response to burn injury
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| T or F, your pt will have slight metabolic acidosis. | T...acidosis will be d/t dead tissue and lactic acid buildup
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| What is oxandrolone? | an anabolic steroid given for improved muscle protein metabolism through enhanced protein sufficiency.
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| How much time between skin harvesting? | about 2 weeks
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| What is the most important reason for using SSD on a fresh burn? | it kills bacteria
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| Why are all postoperative burn patients with leg grafts confined to bed with legs elevated? | Swelling and edema can "float" the graft off.
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