Burns 1

juniperk's version from 2018-03-05 03:46


Question Answer
What is the #1 concern about electrical burns? It may abnormally stimulate nerves, leading, for example, to fibrillation of the heart. #1 concern is arrythmia.
What is the #1 concern about thermal burns?Hypovolemic shock
What is the #1 sign of inhalation burn?sudden hoarseness
What is the initial management of all burns?airway, breathing and circulation (fluid replacement- Lactated Ringers)
Which assessment findings would best indicate that fluid resuscitation has been successful?Adequate urine output (at least 30 mL/hr, or 0.5 mL/kg/hr)
The rule of nines is often used when?initial evaluation and should be recalculated within the first 72 hours.
What are the rules of nines? The head is 9%, anterior torso 18%, posterior torso 18%, each arm 9%, each leg 18%, and groin 1%.
What are characteristics of first degree burns?Superficial 2. dry 3. red 4. blanches 5. painful
What are the characteristics of Second Degree (Partial Thickness superficial)?Blister formation (Bullae) 2. Painful 3. hyperemic 4. Moist
What are the characteristics of Second Degree (Partial Thickness Deep)?Few healthy cells are left. No blister formation, wound appears red and dry, pain, possibility skin grafting
What are the characteristics of third degree (full thickness)?Deep red, white, or yellow. 2. surface is dry 3. edema 4. no pain 5. healing does not occur on it's own
What are the characteristics of fourth degree (deep full thickness)?Injury to muscle 2. Area is black in color, leathery 3. Edema 4. No pain 5. No blisters 6. grafts required
What is the #1 complication of deep burns?Hypovolemia then compartment syndrome, electrolyte imbalance, infection, and hypothermia
What are the electrolyte imbalances for deep burns?Sodium down Potassium up initially. Then potassium decreases when diuresis occurs.
What types of labs are important to obtain for burns?ABGs BUN/Creat CBC
What is the main goal besides breathing in the Emergent phase?Prevent hypovolemic shock
What is the duration of the emergent phase?From onset of injury to completion of fluid resuscitation
What are the initial nursing considerations during the emergent phase?1. Remove source of heat 2. Assess ABCDE 3. Assess for additional trauma 4. Maintain body heat 5. Place sterile dressing over burns 6. IV fluids
What types of dressings can you put on burns in the emergent phase?Clean/dry over wound. Not cold or wet- this would prevent thermoregulation
Emergent phase diagnostics- Hct, Hgb, K, BUN/Cr, ABG'sHcT decreased (if +, it's a false +), Hgb decreased (plasma loss), K increase (Na decreased), BUN/Cr increased, ABG's -depends on resp issue
First aid during the emergent phase?Douse flames with water or smother with a blanket. Cool a scald burn with water. Flush chemical burns with water. Removed from electrical source. Remove rings/ jewlery
Complications during emergent phase?Asphyxia, Shock, renal failure, protein loss, potassium excess (kidney failure)
Emergent phase- Medications and EducationAnalgesics- IV route only, Tetanus booster, antibiotics, explain injury (do NOT get a mirror), Tx and ongoing care.
Can you apply ice to burns >10%?No. hypothermia

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