Nur144 Exam 2:burns

Front 1

Burns
I. Skin’s Function--all care for burns in reflective of skin’s purpose (largest body organ)
B. Temperature Regulation (impairment leads to inability to maintain ------------)

Back 1

Burns
I. Skin’s Function--all care for burns in reflective of skin’s purpose (largest body organ)
B. Temperature Regulation (impairment leads to inability to maintain body temp)

Front 2

Burns
I. Skin’s Function--all care for burns in reflective of skin’s purpose (largest body organ)
C. Keep body fluids in (impairment leads to inability to maintain ---------)

Back 2

Burns
I. Skin’s Function--all care for burns in reflective of skin’s purpose (largest body organ)
C. Keep body fluids in (impairment leads to inability to maintain fluid balance)

Front 3

Burns
II. Types--most injuries take place at ---------- (need prevention); highest fatalities in ----------- and elderly

Back 3

Burns
II. Types--most injuries take place at home (need prevention); highest fatalities in children and elderly

Front 4

Burns
II. Types--
A. Thermal--flame, -------------, ------------, steam, and contact with ----------- objects (most common)
1. Major causes of fire in home--smoking, cooking, space heaters, and chemicals

Back 4

Burns
II. Types--
A. Thermal--flame, flash/explosion, scald, steam, and contact with hot objects (most common)
1. Major causes of fire in home--smoking, cooking, space heaters, and chemicals

Front 5

Burns
II. Types--
A. Thermal--flame, flash/explosion, scald, steam, and contact with hot objects (most common)
1. Major causes of fire in home--smoking, -------------, ---------------, and chemicals

Back 5

Burns
II. Types--
A. Thermal--flame, flash/explosion, scald, steam, and contact with hot objects (most common)
1. Major causes of fire in home--smoking, cooking, space heaters, and chemicals

Front 6

Burns
II. Types--
B. Chemical--result of ------------ injury and destruction from ------------- substances (most commonly acids)

Back 6

Burns
II. Types--
B. Chemical--result of tissue injury and destruction from necrotizing substances (most commonly acids)

Front 7

Burns
II. Types--
B. Chemical--result of tissue injury and destruction from necrotizing substances (most commonly acids)
1. Causative agents: things with -----------, paint removers, drain cleaners (acids and ------------)

Back 7

Burns
II. Types--
B. Chemical--result of tissue injury and destruction from necrotizing substances (most commonly acids)
1. Causative agents: things with lye, paint removers, drain cleaners (acids and alkaloids)

Front 8

Burns
II. Types--
B. Chemical--result of tissue injury and destruction from necrotizing substances (most commonly acids)
2. Can cause respiratory problems and ----------- manifestations (usually smaller extent)

Back 8

Burns
II. Types--
B. Chemical--result of tissue injury and destruction from necrotizing substances (most commonly acids)
2. Can cause respiratory problems and systemic manifestations (usually smaller extent)

Front 9

Burns
II. Types--
B. Chemical--result of tissue injury and destruction from necrotizing substances (most commonly acids)
3. Looks ----------- pink and slightly wet (can continuously burn for -----------hrs after chemicals removed)

Back 9

Burns
II. Types--
B. Chemical--result of tissue injury and destruction from necrotizing substances (most commonly acids)
3. Looks cherry pink and slightly wet (can continuously burn for 72hrs after chemicals removed)

Front 10

Burns
II. Types--
B. Chemical--result of tissue injury and destruction from necrotizing substances (most commonly acids)
4. Tissue damage based on concentration, --------------, time on skin, and extent of ------------

Back 10

Burns
II. Types--
B. Chemical--result of tissue injury and destruction from necrotizing substances (most commonly acids)
4. Tissue damage based on concentration, quantity, time on skin, and extent of penetration

Front 11

Burns
II. Types--
B. Chemical--result of tissue injury and destruction from necrotizing substances (most commonly acids)
5. Treatment
a. Remove ------------ of burn (brush off powder or remove clothing/jewelry, etc.)
b. Wash for ---------min with--------- water or until not complaining of pain
c. Wrap area in sterile dressing

Back 11

Burns
II. Types--
B. Chemical--result of tissue injury and destruction from necrotizing substances (most commonly acids)
5. Treatment
a. Remove cause of burn (brush off powder or remove clothing/jewelry, etc.)
b. Wash for min 20min with cold water or until not complaining of pain
c. Wrap area in sterile dressing

Front 12

Burns
II. Types--
B. Chemical--result of tissue injury and destruction from necrotizing substances (most commonly acids)
5. Treatment
c. Wrap area in ---------- dressing

Back 12

Burns
II. Types--
B. Chemical--result of tissue injury and destruction from necrotizing substances (most commonly acids)
5. Treatment
c. Wrap area in sterile dressing

Front 13

Burns
II. Types--
C. Smoke and Inhalation
1. Types
a. Inhalation injury ↑ ---------- (inhale hot air/steam/smoke ------------- obstruction)

Back 13

Burns
II. Types--
C. Smoke and Inhalation
1. Types
a. Inhalation injury ↑ glottis (inhale hot air/steam/smokeedemaairway obstruction)

Front 14

Burns
II. Types--
C. Smoke and Inhalation
1. Types
b. Inhalation injury ↓---------- (inhale hot air , ------------ swelling can’t exchange gases)

Back 14

Burns
II. Types--
C. Smoke and Inhalation
1. Types
b. Inhalation injury ↓ glottis (inhale hot airalveolar swellingcan’t exchange gases)

Front 15

Burns
II. Types--
C. Smoke and Inhalation
1. Types
b. Inhalation injury ↓ glottis (inhale hot airalveolar swellingcan’t exchange gases)
i. Chemically produced (depends on -------------- exposed)

Back 15

Burns
II. Types--
C. Smoke and Inhalation
1. Types
b. Inhalation injury ↓ glottis (inhale hot airalveolar swellingcan’t exchange gases)
i. Chemically produced (depends on amount of time exposed)

Front 16

Burns
II. Types--
C. Smoke and Inhalation
1. Types
b. Inhalation injury ↓ glottis (inhale hot airalveolar swellingcan’t exchange gases)
ii. Symptoms usually present ____-______hrs after and can cause ARDS

Back 16

Burns
II. Types--
C. Smoke and Inhalation
1. Types
b. Inhalation injury ↓ glottis (inhale hot airalveolar swellingcan’t exchange gases)
ii. Symptoms usually present 12-24hrs after and can cause ARDS

Front 17

Burns
II. Types--
C. Smoke and Inhalation
1. Types
b. Inhalation injury ↓ glottis (inhale hot airalveolar swellingcan’t exchange gases)
iii. Check for coughing up soot, diff -----------, forced voice, singed ------------, facial burns, and fume---------- (if fire was in enclosed space)

Back 17

Burns
II. Types--
C. Smoke and Inhalation
1. Types
b. Inhalation injury ↓ glottis (inhale hot airalveolar swellingcan’t exchange gases)
iii. Check for coughing up soot, diff swallowing, forced voice, singed nose hairs, facial burns, and fume inhalation (if fire was in enclosed space)

Front 18

Burns
II. Types--
C. Smoke and Inhalation
1. Types
c. CO Poisoning--CO displaces -------- on Hg w/ ---------x affinity hypoxia death

Back 18

Burns
II. Types--
C. Smoke and Inhalation
1. Types
c. CO Poisoning--CO displaces O2 on Hg w/ 250x affinity hypoxia death

Front 19

Burns
II. Types--
C. Smoke and Inhalation
1. Types
c. CO Poisoning--CO displaces O2 on ------- w/ 250x affinity ----------- death

Back 19

Burns
II. Types--
C. Smoke and Inhalation
1. Types
c. CO Poisoning--CO displaces O2 on Hg w/ 250x affinity hypoxia death

Front 20

Burns
II. Types--
C. Smoke and Inhalation
1. Types
c. CO Poisoning--CO displaces O2 on Hg w/ 250x affinity hypoxia death
i. Manifestations: HA, N/V, -----------, confusion, ----------- damage, ---------

Back 20

Burns
II. Types--
C. Smoke and Inhalation
1. Types
c. CO Poisoning--CO displaces O2 on Hg w/ 250x affinity hypoxia death
i. Manifestations: HA, N/V, fatigue, confusion, brain damage, death

Front 21

Burns
II. Types--
C. Smoke and Inhalation
1. Types
c. CO Poisoning--CO displaces O2 on Hg w/ 250x affinity hypoxia death
ii. Fatigue lay down to sleep, -------- in sleep

Back 21

FIX
Burns
II. Types--
C. Smoke and Inhalation
1. Types
c. CO Poisoning--CO displaces O2 on Hg w/ 250x affinity hypoxia death
i. Manifestations: HA, N/V, fatigue, confusion, brain damage, death

Front 22

Burns
II. Types--
C. Smoke and Inhalation
1. Types
c. CO Poisoning--CO displaces O2 on Hg w/ 250x affinity hypoxia death
iii. Caused by inappropriate burnings of wood, ----------, grilling -----------, etc.

Back 22

Burns
II. Types--
C. Smoke and Inhalation
1. Types
c. CO Poisoning--CO displaces O2 on Hg w/ 250x affinity hypoxia death
iii. Caused by inappropriate burnings of wood, kerosene, grilling inside, etc.

Front 23

Burns
II. Types--
C. Smoke and Inhalation
1. Types
c. CO Poisoning--CO displaces O2 on Hg w/ 250x affinity hypoxia death
iv. Treatment--100% ---------- w/ NR mask in high --------- (may need to intubate)

Back 23

Burns
II. Types--
C. Smoke and Inhalation
1. Types
c. CO Poisoning--CO displaces O2 on Hg w/ 250x affinity hypoxia death
iv. Treatment--100% O2 w/ NR mask in high fowlers (may need to intubate)

Front 24

Burns
II. Types--
C. Smoke and Inhalation
1. Types
c. CO Poisoning--CO displaces O2 on Hg w/ 250x affinity hypoxia death
iv. Treatment--100% O2 w/ ---------- mask in high fowlers (may need to -----------)

Back 24

Burns
II. Types--
C. Smoke and Inhalation
1. Types
c. CO Poisoning--CO displaces O2 on Hg w/ 250x affinity hypoxia death
iv. Treatment--100% O2 w/ NR mask in high fowlers (may need to intubate)

Front 25

Burns
II. Types--
C. Smoke and Inhalation
2. Treatment
a. Administration of ----------- air

Back 25

Burns
II. Types--
C. Smoke and Inhalation
2. Treatment
a. Administration of humidified air

Front 26

Burns
II. Types--
C. Smoke and Inhalation
2. Treatment
b. Position in high -----------

Back 26

Burns
II. Types--
C. Smoke and Inhalation
2. Treatment
b. Position in high fowler’s

Front 27

Burns
II. Types--
C. Smoke and Inhalation
2. Treatment
c. Cough and -------- breath q----------hr

Back 27

Burns
II. Types--
C. Smoke and Inhalation
2. Treatment
c. Cough and deep breath q1hr

Front 28

Burns
II. Types--
C. Smoke and Inhalation
2. Treatment
d. Use of --------------

Back 28

Burns
II. Types--
C. Smoke and Inhalation
2. Treatment
d. Use of bronchodilators

Front 29

Burns
II. Types--
C. Smoke and Inhalation
2. Treatment
e. Suction --------

Back 29

Burns
II. Types--
C. Smoke and Inhalation
2. Treatment
e. Suction prn

Front 30

Burns
II. Types--
C. Smoke and Inhalation
2. Treatment
f. Continuous ------------- of resp. status/prep for ----------- (swelling is greatest danger)

Back 30

Burns
II. Types--
C. Smoke and Inhalation
2. Treatment
f. Continuous monitoring of resp. status/prep for intubation (swelling is greatest danger)

Front 31

Burns
II. Types--
C. Smoke and Inhalation
2. Treatment
g. Indications for immediate intubation
i. Full thickness burns to ----------
ii. Circumferential---------- burns
iii. Acute ---------- distress

Back 31

Burns
II. Types--
C. Smoke and Inhalation
2. Treatment
g. Indications for immediate intubation
i. Full thickness burns to face
ii. Circumferential neck burns
iii. Acute respiratory distress

Front 32

Burns
II. Types--
C. Smoke and Inhalation
2. Treatment
g. Indications for immediate intubation
iv. Respiratory ------------- or altered mental status
v. --------------- edema and inflammation noted on bronchoscopy

Back 32

Burns
II. Types--
C. Smoke and Inhalation
2. Treatment
g. Indications for immediate intubation
iv. Respiratory depression or altered mental status
v. Supraglottic edema and inflammation noted on bronchoscopy

Front 33

Burns
II. Types--
D. Electrical--coagulation ---------- caused by intense heat from electrical current (less common, ____-9%)

Back 33

Burns
II. Types--
D. Electrical--coagulation necrosis caused by intense heat from electrical current (less common, 3-9%)

Front 34

Burns
II. Types--
D. Electrical--coagulation necrosis caused by intense heat from electrical current (less common, 3-9%)
1. Severity--burn will not look that bad (most destruction is within ---------)

Back 34

Burns
II. Types--
D. Electrical--coagulation necrosis caused by intense heat from electrical current (less common, 3-9%)
1. Severity--burn will not look that bad (most destruction is within body)

Front 35

Burns
II. Types--
D. Electrical--coagulation necrosis caused by intense heat from electrical current (less common, 3-9%)
1. Severity--burn will not look that bad (most destruction is within body)
a. Amount of voltage
i. <------------V (low)--energy can’t enter body unless opening exists (not hospitalized)

Back 35

FIX
Burns
II. Types--
D. Electrical--coagulation necrosis caused by intense heat from electrical current (less common, 3-9%)
1. Severity--burn will not look that bad (most destruction is within body)
a. Amount of voltage
i. <1000V (low)--energy can’t enter body unless opening exists (not hospitalized)

Front 36

Burns
II. Types--
D. Electrical--coagulation necrosis caused by intense heat from electrical current (less common, 3-9%)
1. Severity--burn will not look that bad (most destruction is within body)
a. Amount of voltage
i. <1000V (low)--energy can’t enter body unless ------------ exists (not hospitalized)

Back 36

Burns
II. Types--
D. Electrical--coagulation necrosis caused by intense heat from electrical current (less common, 3-9%)
1. Severity--burn will not look that bad (most destruction is within body)
a. Amount of voltage
i. <1000V (low)--energy can’t enter body unless opening exists (not hospitalized)

Front 37

Burns
II. Types--
D. Electrical--coagulation necrosis caused by intense heat from electrical current (less common, 3-9%)
1. Severity--burn will not look that bad (most destruction is within body)
a. Amount of voltage
ii. >------------V (high)--entry exit wound (damp/sweaty areas-hands, feet, axillaries)

Back 37

Burns
II. Types--
D. Electrical--coagulation necrosis caused by intense heat from electrical current (less common, 3-9%)
1. Severity--burn will not look that bad (most destruction is within body)
a. Amount of voltage
ii. >1000V (high)--entry exit wound (-------------- areas-hands, feet, axillaries)

Front 38

Burns
II. Types--
D. Electrical--coagulation necrosis caused by intense heat from electrical current (less common, 3-9%)
1. Severity--burn will not look that bad (most destruction is within body
b. Tissue resistance--fat and ----------- more resistant (most damage done to ----------- vessels)

Back 38

Burns
II. Types--
D. Electrical--coagulation necrosis caused by intense heat from electrical current (less common, 3-9%)
1. Severity--burn will not look that bad (most destruction is within body
b. Tissue resistance--fat and bone more resistant (most damage done to nerves vessels)

Front 39

Burns
II. Types--
D. Electrical--coagulation necrosis caused by intense heat from electrical current (less common, 3-9%)
1. Severity--burn will not look that bad (most destruction is within body
c. Current pathways--goes through---------- resistant path (were ----------- organs in the way?)

Back 39

Burns
II. Types--
D. Electrical--coagulation necrosis caused by intense heat from electrical current (less common, 3-9%)
1. Severity--burn will not look that bad (most destruction is within body
c. Current pathways--goes through least resistant path (were vital organs in the way?)

Front 40

Burns
II. Types--
D. Electrical--coagulation necrosis caused by intense heat from electrical current (less common, 3-9%)
1. Severity--burn will not look that bad (most destruction is within body
c. Current pathways--goes through least resistant path (were vital organs in the way?)
i. Hand to hand goes through ------------ (burns across hands --------x great for arrhythmias)

Back 40

Burns
II. Types--
D. Electrical--coagulation necrosis caused by intense heat from electrical current (less common, 3-9%)
1. Severity--burn will not look that bad (most destruction is within body
c. Current pathways--goes through least resistant path (were vital organs in the way?)
i. Hand to hand goes through heart (burns across hands 3x great for arrhythmias)

Front 41

Burns
II. Types--
D. Electrical--coagulation necrosis caused by intense heat from electrical current (less common, 3-9%)
1. Severity--burn will not look that bad (most destruction is within body
d. ------------- area in contact with current--look at skin carefully

Back 41

Burns
II. Types--
D. Electrical--coagulation necrosis caused by intense heat from electrical current (less common, 3-9%)
1. Severity--burn will not look that bad (most destruction is within body
d. Surface area in contact with current--look at skin carefully

Front 42

Burns
II. Types--
D. Electrical--coagulation necrosis caused by intense heat from electrical current (less common, 3-9%)
1. Severity--burn will not look that bad (most destruction is within body
e. -------------- current flow was sustained

Back 42

Burns
II. Types--
D. Electrical--coagulation necrosis caused by intense heat from electrical current (less common, 3-9%)
1. Severity--burn will not look that bad (most destruction is within body
e. Length of time current flow was sustained

Front 43

Burns
II. Types--
D. Electrical--coagulation necrosis caused by intense heat from electrical current (less common, 3-9%)
2. Complications--can occur during and after burn
a. Risk for cardiac arrest/arrhythmias (massive --------------cardiac standstill/----------)

Back 43

Burns
II. Types--
D. Electrical--coagulation necrosis caused by intense heat from electrical current (less common, 3-9%)
2. Complications--can occur during and after burn
a. Risk for cardiac arrest/arrhythmias (massive depolarization-cardiac standstill/asystole)

Front 44

Burns
II. Types--
D. Electrical--coagulation necrosis caused by intense heat from electrical current (less common, 3-9%)
2. Complications--can occur during and after burn
b. Acid-base imbalance--metabolic ----------- as cells rupture

Back 44

Burns
II. Types--
D. Electrical--coagulation necrosis caused by intense heat from electrical current (less common, 3-9%)
2. Complications--can occur during and after burn
b. Acid-base imbalance--metabolic acidosis as cells rupture

Front 45

Burns
II. Types--
D. Electrical--coagulation necrosis caused by intense heat from electrical current (less common, 3-9%)
2. Complications--can occur during and after burn
c. Kidney failure--massive -------------

Back 45

Burns
II. Types--
D. Electrical--coagulation necrosis caused by intense heat from electrical current (less common, 3-9%)
2. Complications--can occur during and after burn
c. Kidney failure--massive myoglobinuria

Front 46

Burns
II. Types--
D. Electrical--coagulation necrosis caused by intense heat from electrical current (less common, 3-9%)
2. Complications--can occur during and after burn
i. Big proteins from ------------- tissues block renal ----------, renal failure

Back 46

Burns
II. Types--
D. Electrical--coagulation necrosis caused by intense heat from electrical current (less common, 3-9%)
2. Complications--can occur during and after burn
i. Big proteins from damaged tissues block renal tubules renal failure

Front 47

Burns
II. Types--
D. Electrical--coagulation necrosis caused by intense heat from electrical current (less common, 3-9%)
2. Complications--can occur during and after burn
d. Injury to CNS--coma, ----------, epilepsy, -----------------, spinal injury (falls)

Back 47

Burns
II. Types--
D. Electrical--coagulation necrosis caused by intense heat from electrical current (less common, 3-9%)
2. Complications--can occur during and after burn
d. Injury to CNS--coma, aphasia, epilepsy, peripheral neuropathy, spinal injury (falls)

Front 48

Burns
II. Types--
D. Electrical--coagulation necrosis caused by intense heat from electrical current (less common, 3-9%)
2. Complications--can occur during and after burn
d. Injury to CNS--________, aphasia, _________, peripheral neuropathy, _______ injury (falls)

Back 48

Burns
II. Types--
D. Electrical--coagulation necrosis caused by intense heat from electrical current (less common, 3-9%)
2. Complications--can occur during and after burn
d. Injury to CNS--coma, aphasia, epilepsy, peripheral neuropathy, spinal injury (falls)

Front 49

Burns
II. Types--
D. Electrical--coagulation necrosis caused by intense heat from electrical current (less common, 3-9%)
2. Complications--can occur during and after burn
e. ------------- injury--muscle spasms due to current causing bones to break, trauma

Back 49

Burns
II. Types--
D. Electrical--coagulation necrosis caused by intense heat from electrical current (less common, 3-9%)
2. Complications--can occur during and after burn
e. Musculoskeletal injury--muscle spasms due to current causing bones to break, trauma

Front 50

Burns
II. Types--
D. Electrical--coagulation necrosis caused by intense heat from electrical current (less common, 3-9%)
2. Complications--can occur during and after burn
f. ----------- shock

Back 50

Burns
II. Types--
D. Electrical--coagulation necrosis caused by intense heat from electrical current (less common, 3-9%)
2. Complications--can occur during and after burn
f. Hypovolemic shock

Front 51

Burns
II. Types--
D. Electrical--coagulation necrosis caused by intense heat from electrical current (less common, 3-9%)
3. Treatment--LR with urine output at _____-______mL/hr (all electrical burns go to burn ________)

Back 51

Burns
II. Types--
D. Electrical--coagulation necrosis caused by intense heat from electrical current (less common, 3-9%)
3. Treatment--LR with urine output at 75-100mL/hr (all electrical burns go to burn center)

Front 52

Burns
II. Types--
E. Cold Thermal--frostbite
1. Pathophysiology--ice crystals in --------- and cells ↓-------- flow and destry cell membrane

Back 52

Burns
II. Types--
E. Cold Thermal--frostbite
1. Pathophysiology--ice crystals in tissue and cells ↓blood flow and destry cell membrane

Front 53

Burns
II. Types--
E. Cold Thermal--frostbite
2. Depth--result of ----------- temperature, length of-----------, and type/condition of clothing

Back 53

Burns
II. Types--
E. Cold Thermal--frostbite
2. Depth--result of ambient temperature, length of exposure, and type/condition of clothing

Front 54

Burns
II. Types--
E. Cold Thermal--frostbite
2. Depth--result of ambient temperature, length of exposure, and type/condition of clothing
a. Superficial--skin, ---------- tissue (ears, cheeks, ---------, toes)

Back 54

Burns
II. Types--
E. Cold Thermal--frostbite
2. Depth--result of ambient temperature, length of exposure, and type/condition of clothing
a. Superficial--skin, SQ tissue (ears, cheeks, fingers, toes)

Front 55

Burns
II. Types--
E. Cold Thermal--frostbite
2. Depth--result of ambient temperature, length of exposure, and type/condition of clothing
a. Superficial--skin, SQ tissue (ears, cheeks, fingers, toes)
i. Treatment--immerse in bath water at ______-______° blisters will form after

Back 55

Burns
II. Types--
E. Cold Thermal--frostbite
2. Depth--result of ambient temperature, length of exposure, and type/condition of clothing
a. Superficial--skin, SQ tissue (ears, cheeks, fingers, toes)
i. Treatment--immerse in bath water at 102-108° blisters will form after

Front 56

Burns
II. Types--
E. Cold Thermal--frostbite
2. Depth--result of ambient temperature, length of exposure, and type/condition of clothing
ii. Re-warming is very painful (pain can continue for-------- to --------- after injury)

Back 56

Burns
II. Types--
E. Cold Thermal--frostbite
2. Depth--result of ambient temperature, length of exposure, and type/condition of clothing
ii. Re-warming is very painful (pain can continue for weeks to years after injury)

Front 57

Burns
II. Types--
E. Cold Thermal--frostbite
2. Depth--result of ambient temperature, length of exposure, and type/condition of clothing
b. Deep--muscles, ---------, tendons (skin mottled ---------)

Back 57

Burns
II. Types--
E. Cold Thermal--frostbite
2. Depth--result of ambient temperature, length of exposure, and type/condition of clothing
b. Deep--muscles, bones, tendons (skin mottled gangrene)

Front 58

Burns
II. Types--
E. Cold Thermal--frostbite
2. Depth--result of ambient temperature, length of exposure, and type/condition of clothing
b. Deep--muscles, bones, tendons (skin mottled gangrene)
i. Treatment--usually requires -------------

Back 58

Burns
II. Types--
E. Cold Thermal--frostbite
2. Depth--result of ambient temperature, length of exposure, and type/condition of clothing
b. Deep--muscles, bones, tendons (skin mottled gangrene)
i. Treatment--usually requires amputation

Front 59

Burns
III. Severity
A. Depth--know ----------- of skin

Back 59

Burns
III. Severity
A. Depth--know layers of skin

Front 60

Burns
III. Severity
A. Depth--know layers of skin
1. Superficial --------- Thickness (1st degree)

Back 60

Burns
III. Severity
A. Depth--know layers of skin
1. Superficial Partial Thickness (1st degree)

Front 61

Burns
III. Severity
A. Depth--know layers of skin
1. Superficial Partial Thickness (1st degree)
a. Involves mainly ------------- and uppermost part of dermis

Back 61

Burns
III. Severity
A. Depth--know layers of skin
1. Superficial Partial Thickness (1st degree)
a. Involves mainly epidermis and uppermost part of dermis

Front 62

Burns
III. Severity
A. Depth--know layers of skin
1. Superficial Partial Thickness (1st degree)
b. Manifestations--redness, --------, blanches under pressure, mild swelling w/ ------------

Back 62

Burns
III. Severity
A. Depth--know layers of skin
1. Superficial Partial Thickness (1st degree)
b. Manifestations--redness, --------, blanches under pressure, mild swelling w/ ------------

Front 63

Burns
III. Severity
A. Depth--know layers of skin
1. Superficial Partial Thickness (1st degree)
c. Heals in about-------- days (may peel after ---------hrs)

Back 63

Burns
III. Severity
A. Depth--know layers of skin
1. Superficial Partial Thickness (1st degree)
c. Heals in about 7 days (may peel after 24hrs)

Front 64

Burns
III. Severity
A. Depth--know layers of skin
2. --------- Partial Thickness (2nd degree)

Back 64

Burns
III. Severity
A. Depth--know layers of skin
2. Deep Partial Thickness (2nd degree)

Front 65

Burns
III. Severity
A. Depth--know layers of skin
2. Deep Partial Thickness (2nd degree)
a. Damage through epidermis into ------------

Back 65

Burns
III. Severity
A. Depth--know layers of skin
2. Deep Partial Thickness (2nd degree)
a. Damage through epidermis into dermis

Front 66

Burns
III. Severity
A. Depth--know layers of skin
2. Deep Partial Thickness (2nd degree)
b. Manifestations--salmon pink/cherry red w/ red, shiny/wet --------------, blanches under pressure,------------, mild-moderate ---------

Back 66

Burns
III. Severity
A. Depth--know layers of skin
2. Deep Partial Thickness (2nd degree)
b. Manifestations--salmon pink/cherry red w/ red, shiny/wet fluid-filled vesicles, blanches under pressure, severe pain, mild-moderate edema

Front 67

Burns
III. Severity
A. Depth--know layers of skin
2. Deep Partial Thickness (2nd degree)
b. Manifestations--salmon pink/------------, shiny/wet fluid-filled vesicles, ---------- under pressure, severe pain, mild-moderate edema

Back 67

Burns
III. Severity
A. Depth--know layers of skin
2. Deep Partial Thickness (2nd degree)
b. Manifestations--salmon pink/cherry red w/ red, shiny/wet fluid-filled vesicles, blanches under pressure, severe pain, mild-moderate edema

Front 68

Burns
III. Severity
A. Depth--know layers of skin
2. Deep Partial Thickness (2nd degree)
c. Heals in ____-______days

Back 68

Burns
III. Severity
A. Depth--know layers of skin
2. Deep Partial Thickness (2nd degree)
c. Heals in 7-21days

Front 69

Burns
III. Severity
A. Depth--know layers of skin
3. --------- Thickness (3rd degree)

Back 69

Burns
III. Severity
A. Depth--know layers of skin
3. Full Thickness (3rd degree)

Front 70

Burns
III. Severity
A. Depth--know layers of skin
3. Full Thickness (3rd degree)
a. Destruction of epidermis -------------- (can be into fat, muscle, and bone)

Back 70

Burns
III. Severity
A. Depth--know layers of skin
3. Full Thickness (3rd degree)
a. Destruction of epidermis through dermis (can be into fat, muscle, and bone)

Front 71

Burns
III. Severity
A. Depth--know layers of skin
3. Full Thickness (3rd degree)
c. Manifestations--dry, ----------, ------------, charred black, insensitive to -----------

Back 71

Burns
III. Severity
A. Depth--know layers of skin
3. Full Thickness (3rd degree)
c. Manifestations--dry, leathery, waxy white, charred black, insensitive to pain/pressure

Front 72

Burns
III. Severity
A. Depth--know layers of skin
3. Full Thickness (3rd degree)
d. Will require skin ---------

Back 72

Burns
III. Severity
A. Depth--know layers of skin
3. Full Thickness (3rd degree)
d. Will require skin grafting

Front 73

Burns
III. Severity
B. Extent--need to know in order to calculate needed fluid replacement
1. Rule of ---------(faster)

Back 73

Burns
III. Severity
B. Extent--need to know in order to calculate needed fluid replacement
1. Rule of 9s (faster)

Front 74

Burns
III. Severity
B. Extent--need to know in order to calculate needed fluid replacement
1. Rule of 9s (faster)
a. Head/neck--_____%
b. Arms--_____%
c. Anterior trunk--_____%

Back 74

Burns
III. Severity
B. Extent--need to know in order to calculate needed fluid replacement
1. Rule of 9s (faster)
a. Head/neck--9%
b. Arms--9%
c. Anterior trunk--18%

Front 75

Burns
III. Severity
B. Extent--need to know in order to calculate needed fluid replacement
1. Rule of 9s (faster)
d. Posterior trunk--______%
e. Legs--____%
f. Perineum--_____%

Back 75

Burns
III. Severity
B. Extent--need to know in order to calculate needed fluid replacement
1. Rule of 9s (faster)
d. Posterior trunk--18%
e. Legs--18%
f. Perineum--1%

Front 76

Burns
III. Severity
B. Extent--need to know in order to calculate needed fluid replacement
2. --------------- Chart (more detailed and more accurate)
**Cut off age--need to be >6yrs

Back 76

Burns
III. Severity
B. Extent--need to know in order to calculate needed fluid replacement
2. Lund-Browder Chart (more detailed and more accurate)
**Cut off age--need to be >6yrs

Front 77

Burns
III. Severity
B. Extent--need to know in order to calculate needed fluid replacement
2. Lund-Browder Chart (more detailed and more accurate)
**Cut off age--need to be >______yrs

Back 77

Burns
III. Severity
B. Extent--need to know in order to calculate needed fluid replacement
2. Lund-Browder Chart (more detailed and more accurate)
**Cut off age--need to be >6yrs

Front 78

Burns
III. Severity
C. Location
1. Face,------------, and circumferential chest--severe b/ increase possibility of --------- compromise

Back 78

Burns
III. Severity
C. Location
1. Face, neck, and circumferential chest--severe b/ increase possibility of resp. compromise

Front 79

Burns
III. Severity
C. Location
2. Hands, feet, ---------, eyes, and -------: difficult to treat (high movement ↑ ----------)

Back 79

Burns
III. Severity
C. Location
2. Hands, feet, joints, eyes, and perineum--difficult to treat (high movement ↑ complications)

Front 80

Burns
III. Severity
C. Location
3. Ears, nose--susceptible to infection b/c -------------- to cartilage

Back 80

Burns
III. Severity
C. Location
3. Ears, nose--susceptible to infection b/c poor blood supply to cartilage

Front 81

Burns
III. Severity
C. Location
4. Circumferential extremities--risk of ------------- syndrome (↓blood supply to distal region)

Back 81

Burns
III. Severity
C. Location
4. Circumferential extremities--risk of compartment syndrome (↓blood supply to distal region)

Front 82

Burns
III. Severity
D. Patient Risk Factors
1. Age--<_______yrs (not full development of immune system) and >_______yrs

Back 82

Burns
III. Severity
D. Patient Risk Factors
1. Age--<2yrs (not full development of immune system) and >60yrs

Front 83

Burns
III. Severity
D. Patient Risk Factors
2. Pre-existing cardiovascular, -----------, or --------- disease--can be worsened

Back 83

Burns
III. Severity
D. Patient Risk Factors
2. Pre-existing cardiovascular, respiratory, or renal disease--can be worsened

Front 84

Burns
III. Severity
D. Patient Risk Factors
3. ------------ or PVD--↓healing and ↑infection

Back 84

Burns
III. Severity
D. Patient Risk Factors
3. Diabetes or PVD--↓healing and ↑infection

Front 85

Burns
III. Severity
D. Patient Risk Factors
4. Debilitating states--chronic ---------, history of ---------, malnutrition

Back 85

Burns
III. Severity
D. Patient Risk Factors
4. Debilitating states--chronic disease, history of ETOH, malnutrition

Front 86

Burns
III. Severity
D. Patient Risk Factors
5. Concurrent injuries--often ------------- injuries (need to know circumstances of injury)

Back 86

Burns
III. Severity
D. Patient Risk Factors
5. Concurrent injuries--often traumatic injuries (need to know circumstances of injury)

Front 87

Burns
IV. Burn Center Referral Criteria (check book)
A. Partial thickness burns >_________% of total body surface area (TBSA)
B. All ------------- burns
C. Electrical and ---------- burns

Back 87

Burns
IV. Burn Center Referral Criteria (check book)
A. Partial thickness burns >10% of total body surface area (TBSA)
B. All full thickness burns
C. Electrical and chemical burns

Front 88

Burns
IV. Burn Center Referral Criteria (check book)
D. --------------- injury
E. All burns involving injury to --------, eyes, face, ---------, feet, -----------, and joints

Back 88

Burns
IV. Burn Center Referral Criteria (check book)
D. Inhalation injury
E. All burns involving injury to ears, eyes, face, hands, feet, perineum, and joints

Front 89

Burns
V. Treatment
A. ------------- process--mostly prehospital

Back 89

Burns
V. Treatment
A. Stop burning process--mostly prehospital

Front 90

Burns
V. Treatment
A. Stop burning process--mostly prehospital
1. Removal of ---------- and jewelry (especially w/ --------- burns)

Back 90

Burns
V. Treatment
A. Stop burning process--mostly prehospital
1. Removal of clothing and jewelry (especially w/ chemical burns)
2. Cut around areas where clothing is stuck to skin

Front 91

Burns
V. Treatment
A. Stop burning process--mostly prehospital
2. Cut around areas where clothing is -------- to skin

Back 91

Burns
V. Treatment
A. Stop burning process--mostly prehospital
2. Cut around areas where clothing is stuck to skin

Front 92

Burns
V. Treatment
A. Stop burning process--mostly prehospital
3. Brush -------------- off skin followed by lavage w/ water for at least -------min (for chemical)

Back 92

Burns
V. Treatment
A. Stop burning process--mostly prehospital
3. Brush solid particles off skin followed by lavage w/ water for at least 20min (for chemical)

Front 93

Burns
V. Treatment
A. Stop burning process--mostly prehospital
4. Cover and ---------- dressing or clean sheet to prevent -------- loss (for thermal)

Back 93

Burns
V. Treatment
A. Stop burning process--mostly prehospital
4. Cover and dry dressing or clean sheet to prevent heat loss (for thermal)

Front 94

Burns
V. Treatment
B. Assess ABCs--burns to airway can cause swelling that blocks flow of air into lungs
1. A--keep ---------- patent

Back 94

Burns
V. Treatment
B. Assess ABCs--burns to airway can cause swelling that blocks flow of air into lungs
1. A--keep airway patent

Front 95

Burns
V. Treatment
B. Assess ABCs--burns to airway can cause swelling that blocks flow of air into lungs
2. B--assess ------- and -------

Back 95

Burns
V. Treatment
B. Assess ABCs--burns to airway can cause swelling that blocks flow of air into lungs
2. B--assess RR and O2Sat

Front 96

Burns
V. Treatment
B. Assess ABCs--burns to airway can cause swelling that blocks flow of air into lungs
3. C--assess --------- and look for ------------ burns

Back 96

Burns
V. Treatment
B. Assess ABCs--burns to airway can cause swelling that blocks flow of air into lungs
3. C--assess pulses and look for circumferential burns

Front 97

Burns
V. Treatment
C. Assess for __________--circumstances of injury

Back 97

Burns
V. Treatment
C. Assess for other injuries--circumstances of injury

Front 98

Burns
V. Treatment
C. Assess for other injuries--circumstances of injury
1. -------------- burns--concurrent w/ spinal injuries due to falls

Back 98

Burns
V. Treatment
C. Assess for other injuries--circumstances of injury
1. High voltage burns--concurrent w/ spinal injuries due to falls

Front 99

Burns
VI. Phases
A. --------------- Phase--period of time required to resolve immediate problems (usually 24-48hrs)

Back 99

Burns
VI. Phases
A. Emergent Phase--period of time required to resolve immediate problems (usually 24-48hrs)

Front 100

Burns
VI. Phases
A. Emergent Phase--period of time required to resolve immediate problems (usually 24-48hrs)
1. ------------------- formation and continues until mobilization and diuresis begins

Back 100

Burns
VI. Phases
A. Emergent Phase--period of time required to resolve immediate problems (usually 24-48hrs)
1. Initial fluid loss and edema formation and continues until mobilization and diuresis begins

Front 101

Burns
VI. Phases
A. Emergent Phase--period of time required to resolve immediate problems (usually 24-48hrs)
2. Changes--systemic response (w/ burns >____%)

Back 101

Burns
VI. Phases
A. Emergent Phase--period of time required to resolve immediate problems (usually 24-48hrs)
2. Changes--systemic response (w/ burns >30%)

Front 102

Burns
VI. Phases
A. Emergent Phase--period of time required to resolve immediate problems (usually 24-48hrs)
2. Changes--systemic response (w/ burns >30%)
a. ---------- and ------------ shifts (hypovolemia greatest risk)--leads to formation of edema (as early as 20min and can last 7-10days)

Back 102

Burns
VI. Phases
A. Emergent Phase--period of time required to resolve immediate problems (usually 24-48hrs)
2. Changes--systemic response (w/ burns >30%)
a. Fluid and electrolyte shifts (hypovolemia greatest risk)--leads to formation of edema (as early as 20min and can last 7-10days)

Front 103

Burns
VI. Phases
A. Emergent Phase--period of time required to resolve immediate problems (usually 24-48hrs)
2. Changes--systemic response (w/ burns >30%)
a. Fluid and electrolyte shifts (------------- greatest risk)--leads to formation of edema (as early as -------min and can last 7-10days)

Back 103

Burns
VI. Phases
A. Emergent Phase--period of time required to resolve immediate problems (usually 24-48hrs)
2. Changes--systemic response (w/ burns >30%)
a. Fluid and electrolyte shifts (hypovolemia greatest risk)--leads to formation of edema (as early as 20min and can last 7-10days)

Front 104

Burns
VI. Phases
A. Emergent Phase--period of time required to resolve immediate problems (usually 24-48hrs)
2. Changes--systemic response (w/ burns >30%)
a. Fluid and electrolyte shifts (hypovolemia greatest risk)--leads to formation of edema (as early as 20min and can last 7-10days)
i. Larger burns ↑---------- shift (↑----------- volume loss insensible skin loss)

Back 104

Burns
VI. Phases
A. Emergent Phase--period of time required to resolve immediate problems (usually 24-48hrs)
2. Changes--systemic response (w/ burns >30%)
a. Fluid and electrolyte shifts (hypovolemia greatest risk)--leads to formation of edema (as early as 20min and can last 7-10days)
i. Larger burns ↑fluid shift (↑intravascular volume loss insensible skin loss)

Front 105

Burns
VI. Phases
A. Emergent Phase--period of time required to resolve immediate problems (usually 24-48hrs)
2. Changes--systemic response (w/ burns >30%)
a. Fluid and electrolyte shifts (hypovolemia greatest risk)--leads to formation of edema (as early as 20min and can last 7-10days)
ii. ____________--Na moves into the interstitial spaces

Back 105

Burns
VI. Phases
A. Emergent Phase--period of time required to resolve immediate problems (usually 24-48hrs)
2. Changes--systemic response (w/ burns >30%)
a. Fluid and electrolyte shifts (hypovolemia greatest risk)--leads to formation of edema (as early as 20min and can last 7-10days)
ii. Hyponatremia--Na moves into the interstitial spaces

Front 106

Burns
VI. Phases
A. Emergent Phase--period of time required to resolve immediate problems (usually 24-48hrs)
2. Changes--systemic response (w/ burns >30%)
a. Fluid and electrolyte shifts (hypovolemia greatest risk)--leads to formation of edema (as early as 20min and can last 7-10days)
iii. ----------------: released from injured cells and hemolysed RBCs vasculature

Back 106

Burns
VI. Phases
A. Emergent Phase--period of time required to resolve immediate problems (usually 24-48hrs)
2. Changes--systemic response (w/ burns >30%)
a. Fluid and electrolyte shifts (hypovolemia greatest risk)--leads to formation of edema (as early as 20min and can last 7-10days)
iii. Hyperkalemia-released from injured cells and hemolysed RBCs vasculature

Front 107

Burns
VI. Phases
A. Emergent Phase--period of time required to resolve immediate problems (usually 24-48hrs)
2. Changes--systemic response (w/ burns >30%)
a. Fluid and electrolyte shifts (hypovolemia greatest risk)--leads to formation of edema (as early as 20min and can last 7-10days)
iv. ---------------- (↑Hct)--blood is more viscous

Back 107

Burns
VI. Phases
A. Emergent Phase--period of time required to resolve immediate problems (usually 24-48hrs)
2. Changes--systemic response (w/ burns >30%)
a. Fluid and electrolyte shifts (hypovolemia greatest risk)--leads to formation of edema (as early as 20min and can last 7-10days)
iv. Hemoconcentration (↑Hct)--blood is more viscous

Front 108

Burns
VI. Phases
A. Emergent Phase--period of time required to resolve immediate problems (usually 24-48hrs)
2. Changes--systemic response (w/ burns >30%)
a. Fluid and electrolyte shifts (hypovolemia greatest risk)--leads to formation of edema (as early as 20min and can last 7-10days)
v. -------------- (↓albumin)--↑permeability fluid from intravascular to interstitial space ↓colloidal vascular pressure 2nd and 3rd spacing

Back 108

Burns
VI. Phases
A. Emergent Phase--period of time required to resolve immediate problems (usually 24-48hrs)
2. Changes--systemic response (w/ burns >30%)
a. Fluid and electrolyte shifts (hypovolemia greatest risk)--leads to formation of edema (as early as 20min and can last 7-10days)
v. Hypotproteinemia (↓albumin)--↑permeability fluid from intravascular to interstitial space ↓colloidal vascular pressure 2nd and 3rd spacing

Front 109

Burns
VI. Phases
A. Emergent Phase--period of time required to resolve immediate problems (usually 24-48hrs)
2. Changes--systemic response (w/ burns >30%)
a. Fluid and electrolyte shifts (hypovolemia greatest risk)--leads to formation of edema (as early as 20min and can last 7-10days)
v. Hypotproteinemia (↓-------------)--↑permeability fluid from ------------- to interstitial space ↓---------- vascular pressure 2nd and 3rd spacing

Back 109

Burns
VI. Phases
A. Emergent Phase--period of time required to resolve immediate problems (usually 24-48hrs)
2. Changes--systemic response (w/ burns >30%)
a. Fluid and electrolyte shifts (hypovolemia greatest risk)--leads to formation of edema (as early as 20min and can last 7-10days)
v. Hypotproteinemia (↓albumin)--↑permeability fluid from intravascular to interstitial space ↓colloidal vascular pressure 2nd and 3rd spacing

Front 110

Burns
VI. Phases
A. Emergent Phase--period of time required to resolve immediate problems (usually 24-48hrs)
2. Changes--systemic response (w/ burns >30%)
a. Fluid and electrolyte shifts (hypovolemia greatest risk)--leads to formation of edema (as early as 20min and can last 7-10days)
vi. At end of stage--restored ------------ (still creates problems)

Back 110

Burns
VI. Phases
A. Emergent Phase--period of time required to resolve immediate problems (usually 24-48hrs)
2. Changes--systemic response (w/ burns >30%)
a. Fluid and electrolyte shifts (hypovolemia greatest risk)--leads to formation of edema (as early as 20min and can last 7-10days)
vi. At end of stage--restored capillary permeability (still creates problems)

Front 111

Burns
VI. Phases
A. Emergent Phase--period of time required to resolve immediate problems (usually 24-48hrs)
2. Changes--systemic response (w/ burns >30%)
• Proteins can’t return to -------------

Back 111

Burns
VI. Phases
A. Emergent Phase--period of time required to resolve immediate problems (usually 24-48hrs)
2. Changes--systemic response (w/ burns >30%)
• Proteins can’t return to vascular space

Front 112

Burns
VI. Phases
A. Emergent Phase--period of time required to resolve immediate problems (usually 24-48hrs)
2. Changes--systemic response (w/ burns >30%)
• ----------- can move back into vascular space

Back 112

Burns
VI. Phases
A. Emergent Phase--period of time required to resolve immediate problems (usually 24-48hrs)
2. Changes--systemic response (w/ burns >30%)
• Fluids can move back into vascular space

Front 113

Burns
VI. Phases
A. Emergent Phase--period of time required to resolve immediate problems (usually 24-48hrs)
2. Changes--systemic response (w/ burns >30%)
• Assess for ↓------- (as --------- moves back into cell and pt. diureses hypokalemia)

Back 113

Burns
VI. Phases
A. Emergent Phase--period of time required to resolve immediate problems (usually 24-48hrs)
2. Changes--systemic response (w/ burns >30%)
• Assess for ↓K (as K moves back into cell and pt. diureses hypokalemia)

Front 114

Burns
VI. Phases
A. Emergent Phase--period of time required to resolve immediate problems (usually 24-48hrs)
2. Changes--systemic response (w/ burns >30%)
• Assess for ↓K (as K moves back into cell and pt. diureses hypokalemia)
b. Immunologic--widespread impairment causing susceptibility to ---------

Back 114

Burns
VI. Phases
A. Emergent Phase--period of time required to resolve immediate problems (usually 24-48hrs)
2. Changes--systemic response (w/ burns >30%)
• Assess for ↓K (as K moves back into cell and pt. diureses hypokalemia)
b. Immunologic--widespread impairment causing susceptibility to infection

Front 115

Burns
VI. Phases
A. Emergent Phase--period of time required to resolve immediate problems (usually 24-48hrs)
2. Changes--systemic response (w/ burns >30%)
b. Immunologic--widespread impairment causing susceptibility to infection
i. ↑Release------------ ---------------- markers ↑permeability (severe w/ >---------%)

Back 115

Burns
VI. Phases
A. Emergent Phase--period of time required to resolve immediate problems (usually 24-48hrs)
2. Changes--systemic response (w/ burns >30%)
b. Immunologic--widespread impairment causing susceptibility to infection
i. ↑Release cytokines inflammatory markers ↑permeability (severe w/ >30%)

Front 116

Burns
VI. Phases
A. Emergent Phase--period of time required to resolve immediate problems (usually 24-48hrs)
2. Changes--systemic response (w/ burns >30%)
b. Immunologic--widespread impairment causing susceptibility to infection
ii. ------------ suppression and ↓circulating WBCs

Back 116

Burns
VI. Phases
A. Emergent Phase--period of time required to resolve immediate problems (usually 24-48hrs)
2. Changes--systemic response (w/ burns >30%)
b. Immunologic--widespread impairment causing susceptibility to infection
ii. Bone marrow suppression and ↓circulating WBCs

Front 117

Burns
VI. Phases
A. Emergent Phase--period of time required to resolve immediate problems (usually 24-48hrs)
2. Changes--systemic response (w/ burns >30%)
c. Cardiovascular--volume depletion ↑-------------- ↑SVR ↓---------

Back 117

Burns
VI. Phases
A. Emergent Phase--period of time required to resolve immediate problems (usually 24-48hrs)
2. Changes--systemic response (w/ burns >30%)
c. Cardiovascular--volume depletion ↑cardiac workload ↑SVR ↓CO

Front 118

Burns
VI. Phases
A. Emergent Phase--period of time required to resolve immediate problems (usually 24-48hrs)
2. Changes--systemic response (w/ burns >30%)
c. Cardiovascular--volume depletion ↑cardiac workload ↑SVR ↓CO
i. Release of tumor necrosis factor --------------- depression (↓contractility)

Back 118

Burns
VI. Phases
A. Emergent Phase--period of time required to resolve immediate problems (usually 24-48hrs)
2. Changes--systemic response (w/ burns >30%)
c. Cardiovascular--volume depletion ↑cardiac workload ↑SVR ↓CO
i. Release of tumor necrosis factor myocardial depression (↓contractility)

Front 119

Burns
VI. Phases
A. Emergent Phase--period of time required to resolve immediate problems (usually 24-48hrs)
2. Changes--systemic response (w/ burns >30%)
c. Cardiovascular--volume depletion ↑cardiac workload ↑SVR ↓CO
ii. ↓BP ↓-----------

Back 119

Burns
VI. Phases
A. Emergent Phase--period of time required to resolve immediate problems (usually 24-48hrs)
2. Changes--systemic response (w/ burns >30%)
c. Cardiovascular--volume depletion ↑cardiac workload ↑SVR ↓CO
ii. ↓BP ↓organ perfusion

Front 120

Burns
VI. Phases
A. Emergent Phase--period of time required to resolve immediate problems (usually 24-48hrs)
2. Changes--systemic response (w/ burns >30%)
d. Respiratory--_____________; ARDS (__________ is a risk factor)

Back 120

Burns
VI. Phases
A. Emergent Phase--period of time required to resolve immediate problems (usually 24-48hrs)
2. Changes--systemic response (w/ burns >30%)
d. Respiratory--brochoconstriction; ARDS (trauma is a risk factor)

Front 121

Burns
VI. Phases
A. Emergent Phase--period of time required to resolve immediate problems (usually 24-48hrs)
2. Changes--systemic response (w/ burns >30%)
e. Metabolic--basic metabolic rate ↑-------x need ↑------------ (aggressive w/ caloric intake)

Back 121

Burns
VI. Phases
A. Emergent Phase--period of time required to resolve immediate problems (usually 24-48hrs)
2. Changes--systemic response (w/ burns >30%)
e. Metabolic--basic metabolic rate ↑3x need ↑nutrition (aggressive w/ caloric intake)

Front 122

Burns
VI. Phases
A. Emergent Phase--period of time required to resolve immediate problems (usually 24-48hrs)
3. Clinical Manifestations
a. -------------- shock--↓BP, ↑HR

Back 122

Burns
VI. Phases
A. Emergent Phase--period of time required to resolve immediate problems (usually 24-48hrs)
3. Clinical Manifestations
a. Hypovolemic shock--↓BP, ↑HR

Front 123

Burns
VI. Phases
A. Emergent Phase--period of time required to resolve immediate problems (usually 24-48hrs)
3. Clinical Manifestations
b. ____________--fluid overload need fluids b/c all fluid is not where it needs to be

Back 123

Burns
VI. Phases
A. Emergent Phase--period of time required to resolve immediate problems (usually 24-48hrs)
3. Clinical Manifestations
b. Edematous--fluid overload need fluids b/c all fluid is not where it needs to be

Front 124

Burns
VI. Phases
A. Emergent Phase--period of time required to resolve immediate problems (usually 24-48hrs)
3. Clinical Manifestations
c. Pain--__________ and ___________ burns

Back 124

Burns
VI. Phases
A. Emergent Phase--period of time required to resolve immediate problems (usually 24-48hrs)
3. Clinical Manifestations
c. Pain--superficial and partial thickness burns

Front 125

Burns
VI. Phases
A. Emergent Phase--period of time required to resolve immediate problems (usually 24-48hrs)
3. Clinical Manifestations
d. Shivering--heat loss (can lead to -----------) ↑---------- requirements

Back 125

Burns
VI. Phases
A. Emergent Phase--period of time required to resolve immediate problems (usually 24-48hrs)
3. Clinical Manifestations
d. Shivering--heat loss (can lead to hypothermia) ↑energy requirements

Front 126

Burns
VI. Phases
A. Emergent Phase--period of time required to resolve immediate problems (usually 24-48hrs)
3. Clinical Manifestations
e. ______________-- massive trauma response and occurs from K shifts (must assess gut)

Back 126

Burns
VI. Phases
A. Emergent Phase--period of time required to resolve immediate problems (usually 24-48hrs)
3. Clinical Manifestations
e. Adynamic ilius-- massive trauma response and occurs from K shifts (must assess gut)

Front 127

Burns
VI. Phases
A. Emergent Phase--period of time required to resolve immediate problems (usually 24-48hrs)
4. Complications
a. Cardiovascular
i._____________--electrolyte shifts (especially electrical burns through heart)

Back 127

Burns
VI. Phases
A. Emergent Phase--period of time required to resolve immediate problems (usually 24-48hrs)
4. Complications
a. Cardiovascular
i. Dysrhythmias--electrolyte shifts (especially electrical burns through heart)

Front 128

Burns
VI. Phases
A. Emergent Phase--period of time required to resolve immediate problems (usually 24-48hrs)
4. Complications
a. Cardiovascular
ii. ______________ shock--can become irreversible shock end organ failure

Back 128

Burns
VI. Phases
A. Emergent Phase--period of time required to resolve immediate problems (usually 24-48hrs)
4. Complications
a. Cardiovascular
ii. Hypovolemic shock--can become irreversible shock end organ failure

Front 129

Burns
VI. Phases
A. Emergent Phase--period of time required to resolve immediate problems (usually 24-48hrs)
4. Complications
a. Cardiovascular
iii. Impaired --------------- circulation--especially w/ circumferential burns (compartment syndrome need escoratomy-burns or fashiotomy-nonburns)

Back 129

Burns
VI. Phases
A. Emergent Phase--period of time required to resolve immediate problems (usually 24-48hrs)
4. Complications
a. Cardiovascular
iii. Impaired peripheral circulation--especially w/ circumferential burns (compartment syndrome need escoratomy-burns or fashiotomy-nonburns)

Front 130

Burns
VI. Phases
A. Emergent Phase--period of time required to resolve immediate problems (usually 24-48hrs)
4. Complications
a. Cardiovascular
iii. Impaired peripheral circulation--especially w/ circumferential burns (compartment syndrome need --------------- or --------------)

Back 130

Burns
VI. Phases
A. Emergent Phase--period of time required to resolve immediate problems (usually 24-48hrs)
4. Complications
a. Cardiovascular
iii. Impaired peripheral circulation--especially w/ circumferential burns (compartment syndrome need escoratomy-burns or fashiotomy-nonburns)

Front 131

Burns
VI. Phases
A. Emergent Phase--period of time required to resolve immediate problems (usually 24-48hrs)
4. Complications
b. Respiratory (can occur ---------- days after initial injury)--inflammatory ------------ release

Back 131

Burns
VI. Phases
A. Emergent Phase--period of time required to resolve immediate problems (usually 24-48hrs)
4. Complications
b. Respiratory (can occur 2 days after initial injury)--inflammatory marker release

Front 132

Burns
VI. Phases
A. Emergent Phase--period of time required to resolve immediate problems (usually 24-48hrs)
4. Complications
b. Respiratory (can occur 2 days after initial injury)--inflammatory marker release
i. Upper respiratory tract injury--___________ airway

Back 132

Burns
VI. Phases
A. Emergent Phase--period of time required to resolve immediate problems (usually 24-48hrs)
4. Complications
b. Respiratory (can occur 2 days after initial injury)--inflammatory marker release
i. Upper respiratory tract injury--swelling/blocking airway

Front 133

Burns
VI. Phases
A. Emergent Phase--period of time required to resolve immediate problems (usually 24-48hrs)
4. Complications
• Pneumonia risk
ii. Inhalation injury--___________ and ↓______ diffusion

Back 133

Burns
VI. Phases
A. Emergent Phase--period of time required to resolve immediate problems (usually 24-48hrs)
4. Complications
• Pneumonia risk
ii. Inhalation injury--interstitial edema and ↓gas diffusion

Front 134

Burns
VI. Phases
A. Emergent Phase--period of time required to resolve immediate problems (usually 24-48hrs)
4. Complications
• Inflammatory marker release ↑--------------- permeability, ↑------------, ↑PVR, and ↑-------------- constriction

Back 134

Burns
VI. Phases
A. Emergent Phase--period of time required to resolve immediate problems (usually 24-48hrs)
4. Complications
• Inflammatory marker release ↑capillary permeability, ↑SVR, ↑PVR, and ↑peripheral constriction

Front 135

Burns
VI. Phases
A. Emergent Phase--period of time required to resolve immediate problems (usually 24-48hrs)
4. Complications
c. Urinary--Acute -------------- Necrosis (most common complication in this phase)

Back 135

Burns
VI. Phases
A. Emergent Phase--period of time required to resolve immediate problems (usually 24-48hrs)
4. Complications
c. Urinary--Acute Tubular Necrosis (most common complication in this phase)

Front 136

Burns
VI. Phases
A. Emergent Phase--period of time required to resolve immediate problems (usually 24-48hrs)
4. Complications
c. Urinary--Acute Tubular Necrosis (most common complication in this phase)
i. Can result from --------------- shock

Back 136

Burns
VI. Phases
A. Emergent Phase--period of time required to resolve immediate problems (usually 24-48hrs)
4. Complications
c. Urinary--Acute Tubular Necrosis (most common complication in this phase)
i. Can result from hypovolemic shock

Front 137

Burns
VI. Phases
A. Emergent Phase--period of time required to resolve immediate problems (usually 24-48hrs)
4. Complications
c. Urinary--Acute Tubular Necrosis (most common complication in this phase)
ii. Electrical burns ↑------------- and ------------- release block renal tubules

Back 137

Burns
VI. Phases
A. Emergent Phase--period of time required to resolve immediate problems (usually 24-48hrs)
4. Complications
c. Urinary--Acute Tubular Necrosis (most common complication in this phase)
ii. Electrical burns ↑Myoglobin and hemoglobin release block renal tubules

Front 138

Burns
VI. Phases
A. Emergent Phase--period of time required to resolve immediate problems (usually 24-48hrs)
4. Complications
c. Urinary--Acute Tubular Necrosis (most common complication in this phase)
iii. Treatment--__________ and diuretics, flush ___________ out

Back 138

Burns
VI. Phases
A. Emergent Phase--period of time required to resolve immediate problems (usually 24-48hrs)
4. Complications
c. Urinary--Acute Tubular Necrosis (most common complication in this phase)
iii. Treatment--fluids and diuretics flush myoglobin out

Front 139

Burns
VI. Phases
A. Emergent Phase--period of time required to resolve immediate problems (usually 24-48hrs)
5. Nursing Management
a. Airway Management
i. Assessment of ---------- and ------------

Back 139

Burns
VI. Phases
A. Emergent Phase--period of time required to resolve immediate problems (usually 24-48hrs)
5. Nursing Management
a. Airway Management
i. Assessment of ventilation and oxygenation

Front 140

Burns
VI. Phases
A. Emergent Phase--period of time required to resolve immediate problems (usually 24-48hrs)
5. Nursing Management
a. Airway Management
ii. Early ------------ and ventilatory management within 1-______hrs (ABGs)

Back 140

Burns
VI. Phases
A. Emergent Phase--period of time required to resolve immediate problems (usually 24-48hrs)
5. Nursing Management
a. Airway Management
ii. Early intubation and ventilatory management within 1-2hrs (ABGs)

Front 141

Burns
VI. Phases
A. Emergent Phase--period of time required to resolve immediate problems (usually 24-48hrs)
5. Nursing Management
a. Airway Management
iii. B__________

Back 141

Burns
VI. Phases
A. Emergent Phase--period of time required to resolve immediate problems (usually 24-48hrs)
5. Nursing Management
a. Airway Management
iii. Bronchoscopy

Front 142

Burns
VI. Phases
A. Emergent Phase--period of time required to resolve immediate problems (usually 24-48hrs)
5. Nursing Management
a. Airway Management
iv. Inhalation injury: humidified ----------% O2, ↑-----------, CDB, chest PT, -------------

Back 142

Burns
VI. Phases
A. Emergent Phase--period of time required to resolve immediate problems (usually 24-48hrs)
5. Nursing Management
a. Airway Management
iv. Inhalation injury: humidified 100% O2, ↑Fowlers, CDB, chest PT, suction

Front 143

Burns
VI. Phases
A. Emergent Phase--period of time required to resolve immediate problems (usually 24-48hrs)
5. Nursing Management
a. Airway Management
v. CO poisoning: ------------% O2

Back 143

FIX
Burns
VI. Phases
A. Emergent Phase--period of time required to resolve immediate problems (usually 24-48hrs)
5. Nursing Management
a. Airway Management
v. CO poisoning: ------------% O2 100% O2

Front 144

Burns
VI. Phases
A. Emergent Phase--period of time required to resolve immediate problems (usually 24-48hrs)
5. Nursing Management
b. Fluid therapy
i. Establish IV access--2 ------------- IVs and maybe central line

Back 144

Burns
VI. Phases
A. Emergent Phase--period of time required to resolve immediate problems (usually 24-48hrs)
5. Nursing Management
b. Fluid therapy
i. Establish IV access--2 large bore IVs and maybe central line

Front 145

Burns
VI. Phases
A. Emergent Phase--period of time required to resolve immediate problems (usually 24-48hrs)
5. Nursing Management
b. Fluid therapy
ii. Consider therapy for burns >------------% TBSA

Back 145

Burns
VI. Phases
A. Emergent Phase--period of time required to resolve immediate problems (usually 24-48hrs)
5. Nursing Management
b. Fluid therapy
ii. Consider therapy for burns >15% TBSA

Front 146

Burns
VI. Phases
A. Emergent Phase--period of time required to resolve immediate problems (usually 24-48hrs)
5. Nursing Management
b. Fluid therapy
iii. 1st -----------hrs colloids generally not given (leak out w/ ↑------------- cost more)

Back 146

Burns
VI. Phases
A. Emergent Phase--period of time required to resolve immediate problems (usually 24-48hrs)
5. Nursing Management
b. Fluid therapy
iii. 1st 12hrs colloids generally not given (leak out w/ ↑permeability cost more)

Front 147

Burns
VI. Phases
A. Emergent Phase--period of time required to resolve immediate problems (usually 24-48hrs)
5. Nursing Management
• Usually give ---------- instead

Back 147

Burns
VI. Phases
A. Emergent Phase--period of time required to resolve immediate problems (usually 24-48hrs)
5. Nursing Management
• Usually give LR instead

Front 148

Burns
VI. Phases
A. Emergent Phase--period of time required to resolve immediate problems (usually 24-48hrs)
5. Nursing Management
• b. Fluid therapy
iv. --------------- Formula: 4mL/kg/%TBSA = total fluid replacement in 24hrs

Back 148

Burns
VI. Phases
A. Emergent Phase--period of time required to resolve immediate problems (usually 24-48hrs)
5. Nursing Management
• b. Fluid therapy
iv. Parkland Burn Formula: 4mL/kg/%TBSA = total fluid replacement in 24hrs

Front 149

Burns
VI. Phases
A. Emergent Phase--period of time required to resolve immediate problems (usually 24-48hrs)
5. Nursing Management
• b. Fluid therapy
iv. Parkland Burn Formula: ---------mL/kg/%TBSA = total ---------- replacement in 24hrs

Back 149

Burns
VI. Phases
A. Emergent Phase--period of time required to resolve immediate problems (usually 24-48hrs)
5. Nursing Management
• b. Fluid therapy
iv. Parkland Burn Formula: 4mL/kg/%TBSA = total fluid replacement in 24hrs

Front 150

Burns
VI. Phases
A. Emergent Phase--period of time required to resolve immediate problems (usually 24-48hrs)
5. Nursing Management
• b. Fluid therapy
• ½ given in first -----------hrs from time of burn

Back 150

Burns
VI. Phases
A. Emergent Phase--period of time required to resolve immediate problems (usually 24-48hrs)
5. Nursing Management
• b. Fluid therapy
• ½ given in first 8hrs from time of burn

Front 151

Burns
VI. Phases
A. Emergent Phase--period of time required to resolve immediate problems (usually 24-48hrs)
5. Nursing Management
• b. Fluid therapy
• ½ given over next -----------hrs

Back 151

Burns
VI. Phases
A. Emergent Phase--period of time required to resolve immediate problems (usually 24-48hrs)
5. Nursing Management
• b. Fluid therapy
• ½ given over next 16hrs

Front 152

Burns
VI. Phases
A. Emergent Phase--period of time required to resolve immediate problems (usually 24-48hrs)
5. Nursing Management
• b. Fluid therapy
v. Monitory response to ------------ therapy

Back 152

Burns
VI. Phases
A. Emergent Phase--period of time required to resolve immediate problems (usually 24-48hrs)
5. Nursing Management
• b. Fluid therapy
v. Monitory response to fluid therapy

Front 153

Burns
VI. Phases
A. Emergent Phase--period of time required to resolve immediate problems (usually 24-48hrs)
5. Nursing Management
• b. Fluid therapy
• Urine output should be ______-50mL/hr (if electrical _____-100mL/hr)

Back 153

Burns
VI. Phases
A. Emergent Phase--period of time required to resolve immediate problems (usually 24-48hrs)
5. Nursing Management
• b. Fluid therapy
• Urine output should be 30-50mL/hr (if electrical 75-100mL/hr)

Front 154

Burns
VI. Phases
A. Emergent Phase--period of time required to resolve immediate problems (usually 24-48hrs)
5. Nursing Management
• b. Fluid therapy
• BP >____
• HR <_____

Back 154

Burns
VI. Phases
A. Emergent Phase--period of time required to resolve immediate problems (usually 24-48hrs)
5. Nursing Management
• b. Fluid therapy
• BP >90
• HR <120

Front 155

Burns
VI. Phases
A. Emergent Phase--period of time required to resolve immediate problems (usually 24-48hrs)
5. Nursing Management
c. Wound Care--done after --------- and IV ------- replacement (low priority) PAINFUL

Back 155

Burns
VI. Phases
A. Emergent Phase--period of time required to resolve immediate problems (usually 24-48hrs)
5. Nursing Management
c. Wound Care--done after ABCs and IV fluid replacement (low priority) PAINFUL

Front 156

Burns
VI. Phases
A. Emergent Phase--period of time required to resolve immediate problems (usually 24-48hrs)
5. Nursing Management
c. Wound Care--done after ABCs and IV fluid replacement (low priority) PAINFUL
i. Cleaning and debridement--remove -------- ------------skin (should not see blood)

Back 156

Burns
VI. Phases
A. Emergent Phase--period of time required to resolve immediate problems (usually 24-48hrs)
5. Nursing Management
c. Wound Care--done after ABCs and IV fluid replacement (low priority) PAINFUL
i. Cleaning and debridement--remove escar necrotic skin (should not see blood)

Front 157

Burns
VI. Phases
A. Emergent Phase--period of time required to resolve immediate problems (usually 24-48hrs)
5. Nursing Management
c. Wound Care--done after ABCs and IV fluid replacement (low priority) PAINFUL
ii. Hydrotherapy--immersed in ------------/NA water bath or showered no longer than ______-30min/day to flush off loose necrotic skin

Back 157

Burns
VI. Phases
A. Emergent Phase--period of time required to resolve immediate problems (usually 24-48hrs)
5. Nursing Management
c. Wound Care--done after ABCs and IV fluid replacement (low priority) PAINFUL
ii. Hydrotherapy--immersed in isotonic/NA water bath or showered no longer than 20-30min/day to flush off loose necrotic skin

Front 158

Burns
VI. Phases
A. Emergent Phase--period of time required to resolve immediate problems (usually 24-48hrs)
5. Nursing Management
c. Wound Care--done after ABCs and IV fluid replacement (low priority) PAINFUL
• Can cause --------------- (not sterile water)

Back 158

Burns
VI. Phases
A. Emergent Phase--period of time required to resolve immediate problems (usually 24-48hrs)
5. Nursing Management
c. Wound Care--done after ABCs and IV fluid replacement (low priority) PAINFUL
• Can cause cross contamination (not sterile water)

Front 159

Burns
VI. Phases
A. Emergent Phase--period of time required to resolve immediate problems (usually 24-48hrs)
5. Nursing Management
c. Wound Care--done after ABCs and IV fluid replacement (low priority) PAINFUL
• May cause too much ------------ shift (pulls Na out)
• For chemical burns flush w/ water no hotter than -----------°

Back 159

FIX
• May cause too much electrolyte shift (pulls Na out)
• For chemical burns flush w/ water no hotter than 104°

Front 160

Burns
VI. Phases
A. Emergent Phase--period of time required to resolve immediate problems (usually 24-48hrs)
5. Nursing Management
c. Wound Care--done after ABCs and IV fluid replacement (low priority) PAINFUL
iii. Open Method--exposing and ------------ wound w/ thin layer of topical -----------

Back 160

Burns
VI. Phases
A. Emergent Phase--period of time required to resolve immediate problems (usually 24-48hrs)
5. Nursing Management
c. Wound Care--done after ABCs and IV fluid replacement (low priority) PAINFUL
iii. Open Method--exposing and covering wound w/ thin layer of topical antibiotic

Front 161

Burns
VI. Phases
A. Emergent Phase--period of time required to resolve immediate problems (usually 24-48hrs)
5. Nursing Management
c. Wound Care--done after ABCs and IV fluid replacement (low priority) PAINFUL
iv. Closed Method--multiple dressing changes q-----------hrs (acticote can stay ---------- days)

Back 161

Burns
VI. Phases
A. Emergent Phase--period of time required to resolve immediate problems (usually 24-48hrs)
5. Nursing Management
c. Wound Care--done after ABCs and IV fluid replacement (low priority) PAINFUL
iv. Closed Method--multiple dressing changes q8hrs (acticote can stay 3 days)

Front 162

Burns
VI. Phases
A. Emergent Phase--period of time required to resolve immediate problems (usually 24-48hrs)
5. Nursing Management
c. Wound Care--done after ABCs and IV fluid replacement (low priority) PAINFUL
v. Prevention of ____________--primary goal (some__________ from pts own flora)

Back 162

Burns
VI. Phases
A. Emergent Phase--period of time required to resolve immediate problems (usually 24-48hrs)
5. Nursing Management
c. Wound Care--done after ABCs and IV fluid replacement (low priority) PAINFUL
v. Prevention of infection--primary goal (some infections from pts own flora)

Front 163

Burns
VI. Phases
A. Emergent Phase--period of time required to resolve immediate problems (usually 24-48hrs)
5. Nursing Management
c. Wound Care--done after ABCs and IV fluid replacement (low priority) PAINFUL
• Always gowned,-------------, and masked (strict visitor handwashing/gowning)
• Remove dirty bandages ------------ sterile gloves, but put on ---------- sterile gloves

Back 163

Burns
VI. Phases
A. Emergent Phase--period of time required to resolve immediate problems (usually 24-48hrs)
5. Nursing Management
c. Wound Care--done after ABCs and IV fluid replacement (low priority) PAINFUL
• Always gowned, gloved, and masked (strict visitor handwashing/gowning)
• Remove dirty bandages w/out sterile gloves, but put on w/ sterile gloves

Front 164

Burns
VI. Phases
A. Emergent Phase--period of time required to resolve immediate problems (usually 24-48hrs)
5. Nursing Management
c. Wound Care--done after ABCs and IV fluid replacement (low priority) PAINFUL
• Clean ------------ infected wounds first (clean to dirty)
• Antibiotics (------------, NaNO3, ---------------)--topical penetrates; can develop resistance (requires changing antibiotics)

Back 164

Burns
VI. Phases
A. Emergent Phase--period of time required to resolve immediate problems (usually 24-48hrs)
5. Nursing Management
c. Wound Care--done after ABCs and IV fluid replacement (low priority) PAINFUL
• Clean less infected wounds first (clean to dirty)
• Antibiotics (Silvidine, NaNO3, Sulfamyoline)--topical penetrates; can develop resistance (requires changing antibiotics)

Front 165

Burns
VI. Phases
A. Emergent Phase--period of time required to resolve immediate problems (usually 24-48hrs)
5. Nursing Management
c. Wound Care--done after ABCs and IV fluid replacement (low priority) PAINFUL
vi. Adequate pain control--IV -------------- before dressing changes (oral meds difficult w/ slow gut)

Back 165

Burns
VI. Phases
A. Emergent Phase--period of time required to resolve immediate problems (usually 24-48hrs)
5. Nursing Management
c. Wound Care--done after ABCs and IV fluid replacement (low priority) PAINFUL
vi. Adequate pain control--IV morphine before dressing changes (oral meds difficult w/ slow gut)

Front 166

Burns
VI. Phases
A. Emergent Phase--period of time required to resolve immediate problems (usually 24-48hrs)
5. Nursing Management
c. Wound Care--done after ABCs and IV fluid replacement (low priority) PAINFUL
vii. Avoid hypothermia--room >-------------° and wound changes under ------------

Back 166

Burns
VI. Phases
A. Emergent Phase--period of time required to resolve immediate problems (usually 24-48hrs)
5. Nursing Management
c. Wound Care--done after ABCs and IV fluid replacement (low priority) PAINFUL
vii. Avoid hypothermia--room >85° and wound changes under heat lamp

Front 167

Burns
VI. Phases
B. Acute Phase--occurs until wound is ------------ or completely covered by ------------- (weeks to months)

Back 167

Burns
VI. Phases
B. Acute Phase--occurs until wound is healed or completely covered by skin grafts (weeks to months)

Front 168

Burns
VI. Phases
B. Acute Phase--occurs until wound is healed or completely covered by skin grafts (weeks to months)
1. Pathophysiology--extracellular ------------ mobilization into ---------------- space pt diureses begins

Back 168

Burns
VI. Phases
B. Acute Phase--occurs until wound is healed or completely covered by skin grafts (weeks to months)
1. Pathophysiology--extracellular fluid mobilization into intravascular space pt diureses begins

Front 169

Burns
VI. Phases
B. Acute Phase--occurs until wound is healed or completely covered by skin grafts (weeks to months)
1. Pathophysiology--extracellular fluid mobilization into intravascular space pt diureses begins
a. ---------------- (necrotic tissue) separates and begins to slough off formation of -------------- tissue (for partial thickness buns)

Back 169

Burns
VI. Phases
B. Acute Phase--occurs until wound is healed or completely covered by skin grafts (weeks to months)
1. Pathophysiology--extracellular fluid mobilization into intravascular space pt diureses begins
a. Escar (necrotic tissue) separates and begins to slough off formation of granulation tissue (for partial thickness buns)

Front 170

Burns
VI. Phases
B. Acute Phase--occurs until wound is healed or completely covered by skin grafts (weeks to months)
1. Pathophysiology--extracellular fluid mobilization into intravascular space pt diureses begins
b. Full thickness burns must be covered by ----------
c. Return of ----------- sounds

Back 170

Burns
VI. Phases
B. Acute Phase--occurs until wound is healed or completely covered by skin grafts (weeks to months)
1. Pathophysiology--extracellular fluid mobilization into intravascular space pt diureses begins
b. Full thickness burns must be covered by skin grafts
c. Return of bowel sounds

Front 171

Burns
VI. Phases
B. Acute Phase--occurs until wound is healed or completely covered by skin grafts (weeks to months)
2. Complications
a. Alterations in Electrolytes--potential for all sorts of shifting (know -------- and -------- values)

Back 171

Burns
VI. Phases
B. Acute Phase--occurs until wound is healed or completely covered by skin grafts (weeks to months)
2. Complications
a. Alterations in Electrolytes--potential for all sorts of shifting (know K and Na values)

Front 172

Burns
VI. Phases
B. Acute Phase--occurs until wound is healed or completely covered by skin grafts (weeks to months)
2. Complications
a. Alterations in Electrolytes--potential for all sorts of shifting (know K and Na values)
i. Hyponatremia--excess-------------, ---------- suctioning, diarrhea, excess ----------- replacement, excess dieresis

Back 172

Burns
VI. Phases
B. Acute Phase--occurs until wound is healed or completely covered by skin grafts (weeks to months)
2. Complications
a. Alterations in Electrolytes--potential for all sorts of shifting (know K and Na values)
i. Hyponatremia--excess hydrotherapy, NG suctioning, diarrhea, excess fluid replacement, excess dieresis

Front 173

Burns
VI. Phases
B. Acute Phase--occurs until wound is healed or completely covered by skin grafts (weeks to months)
2. Complications
a. Alterations in Electrolytes--potential for all sorts of shifting (know K and Na values)
• Muscle cramps, fatigue, weakness, HA, ------------ (think O2, --------, or ↑---------)

Back 173

Burns
VI. Phases
B. Acute Phase--occurs until wound is healed or completely covered by skin grafts (weeks to months)
2. Complications
a. Alterations in Electrolytes--potential for all sorts of shifting (know K and Na values)
• Muscle cramps, fatigue, weakness, HA, confusion (think O2, Na, or ↑HR)

Front 174

Burns
VI. Phases
B. Acute Phase--occurs until wound is healed or completely covered by skin grafts (weeks to months)
2. Complications
a. Alterations in Electrolytes--potential for all sorts of shifting (know K and Na values)
ii. Hypernatremia--too much--------------- solution or not enough ----------- (dehydrated)

Back 174

Burns
VI. Phases
B. Acute Phase--occurs until wound is healed or completely covered by skin grafts (weeks to months)
2. Complications
a. Alterations in Electrolytes--potential for all sorts of shifting (know K and Na values)
ii. Hypernatremia--too much hypertonic solution or not enough fluid (dehydrated)

Front 175

Burns
VI. Phases
B. Acute Phase--occurs until wound is healed or completely covered by skin grafts (weeks to months)
2. Complications
a. Alterations in Electrolytes--potential for all sorts of shifting (know K and Na values)
• Thirsty, dried --------------, -------------, seizures

Back 175

Burns
VI. Phases
B. Acute Phase--occurs until wound is healed or completely covered by skin grafts (weeks to months)
2. Complications
a. Alterations in Electrolytes--potential for all sorts of shifting (know K and Na values)
• Thirsty, dried furrowed tongue, confusion, seizures

Front 176

Burns
VI. Phases
B. Acute Phase--occurs until wound is healed or completely covered by skin grafts (weeks to months)
2. Complications
a. Alterations in Electrolytes--potential for all sorts of shifting (know K and Na values)
iii. Hyperkalemia--Tissue -------------- (electrical burns ATN -------------- can’t filter out K)
• Dysrhythmias, muscle weakness

Back 176

Burns
VI. Phases
B. Acute Phase--occurs until wound is healed or completely covered by skin grafts (weeks to months)
2. Complications
a. Alterations in Electrolytes--potential for all sorts of shifting (know K and Na values)
iii. Hyperkalemia--Tissue destruction (electrical burns ATN kidney damage can’t filter out K)
• Dysrhythmias, muscle weakness

Front 177

Burns
VI. Phases
B. Acute Phase--occurs until wound is healed or completely covered by skin grafts (weeks to months)
2. Complications
a. Alterations in Electrolytes--potential for all sorts of shifting (know K and Na values)
iii. Hyperkalemia--Tissue destruction (electrical burns ATN kidney damage can’t filter out ----------)
• ------------, muscle weakness

Back 177

Burns
VI. Phases
B. Acute Phase--occurs until wound is healed or completely covered by skin grafts (weeks to months)
2. Complications
a. Alterations in Electrolytes--potential for all sorts of shifting (know K and Na values)
iii. Hyperkalemia--Tissue destruction (electrical burns ATN kidney damage can’t filter out K)
• Dysrhythmias, muscle weakness

Front 178

Burns
VI. Phases
B. Acute Phase--occurs until wound is healed or completely covered by skin grafts (weeks to months)
2. Complications
a. Alterations in Electrolytes--potential for all sorts of shifting (know K and Na values)
iv. Hypokalemia--excess hydrotherapy, -------------, ------------ suction, wound -----------
• Dysrhythmias

Back 178

Burns
VI. Phases
B. Acute Phase--occurs until wound is healed or completely covered by skin grafts (weeks to months)
2. Complications
a. Alterations in Electrolytes--potential for all sorts of shifting (know K and Na values)
iv. Hypokalemia--excess hydrotherapy, vomiting, GI suction, wound drainage
• Dysrhythmias

Front 179

Burns
VI. Phases
B. Acute Phase--occurs until wound is healed or completely covered by skin grafts (weeks to months)
2. Complications
b. Infections--often gram (-) -------------- (leading death cause in hospitalized burn pts)

Back 179

Burns
VI. Phases
B. Acute Phase--occurs until wound is healed or completely covered by skin grafts (weeks to months)
2. Complications
b. Infections--often gram (-) pseudomonas (leading death cause in hospitalized burn pts)

Front 180

Burns
VI. Phases
B. Acute Phase--occurs until wound is healed or completely covered by skin grafts (weeks to months)
2. Complications
b. Infections--often gram (-) pseudomonas (leading death cause in hospitalized burn pts)
i. Risk factors: >---------% full thickness burns, children, ------------, preexisting disease

Back 180

Burns
VI. Phases
B. Acute Phase--occurs until wound is healed or completely covered by skin grafts (weeks to months)
2. Complications
b. Infections--often gram (-) pseudomonas (leading death cause in hospitalized burn pts)
i. Risk factors: >30% full thickness burns, children, elderly, preexisting disease

Front 181

Burns
VI. Phases
B. Acute Phase--occurs until wound is healed or completely covered by skin grafts (weeks to months)
2. Complications
b. Infections--often gram (-) pseudomonas (leading death cause in hospitalized burn pts)
ii. ↑---------, ↑HR, ↑---------, ↓BP, ↓--------- output, mild confusion, ---------, ↓appetite, WBCs 10-20,000 (pt becomes immunosuppressed) can spread to blood (sepsis)

Back 181

Burns
VI. Phases
B. Acute Phase--occurs until wound is healed or completely covered by skin grafts (weeks to months)
2. Complications
b. Infections--often gram (-) pseudomonas (leading death cause in hospitalized burn pts)
ii. ↑temp, ↑HR, ↑RR, ↓BP, ↓urine output, mild confusion, chills, ↓appetite, WBCs 10-20,000 (pt becomes immunosuppressed) can spread to blood (sepsis)

Front 182

Burns
VI. Phases
B. Acute Phase--occurs until wound is healed or completely covered by skin grafts (weeks to months)
2. Complications
b. Infections--often gram (-) pseudomonas (leading death cause in hospitalized burn pts)
ii. ↑temp, ↑----------, ↑RR, ↓BP, ↓urine output, ----------- confusion, chills, ↓-------------, WBCs 10-20,000 (pt becomes immunosuppressed) can spread to blood (-----------)

Back 182

Burns
VI. Phases
B. Acute Phase--occurs until wound is healed or completely covered by skin grafts (weeks to months)
2. Complications
b. Infections--often gram (-) pseudomonas (leading death cause in hospitalized burn pts)
ii. ↑temp, ↑HR, ↑RR, ↓BP, ↓urine output, mild confusion, chills, ↓appetite, WBCs 10-20,000 (pt becomes immunosuppressed) can spread to blood (sepsis)

Front 183

Burns
VI. Phases
B. Acute Phase--occurs until wound is healed or completely covered by skin grafts (weeks to months)
2. Complications
b. Infections--often gram (-) pseudomonas (leading death cause in hospitalized burn pts)
ii. ↑temp, ↑HR, ↑RR, ↓BP, ↓urine output, mild confusion, chills, ↓appetite, WBCs 10-_________ (pt becomes immunosuppressed) can spread to blood (sepsis)

Back 183

Burns
VI. Phases
B. Acute Phase--occurs until wound is healed or completely covered by skin grafts (weeks to months)
2. Complications
b. Infections--often gram (-) pseudomonas (leading death cause in hospitalized burn pts)
ii. ↑temp, ↑HR, ↑RR, ↓BP, ↓urine output, mild confusion, chills, ↓appetite, WBCs 10-20,000 (pt becomes immunosuppressed) can spread to blood (sepsis)

Front 184

Burns
VI. Phases
B. Acute Phase--occurs until wound is healed or completely covered by skin grafts (weeks to months)
2. Complications
b. Infections--often gram (-) pseudomonas (leading death cause in hospitalized burn pts)
iii. Burn can worsen--2nd degree can convert to ----------- degree

Back 184

Burns
VI. Phases
B. Acute Phase--occurs until wound is healed or completely covered by skin grafts (weeks to months)
2. Complications
b. Infections--often gram (-) pseudomonas (leading death cause in hospitalized burn pts)
iii. Burn can worsen--2nd degree can convert to 3rd degree

Front 185

Burns
VI. Phases
B. Acute Phase--occurs until wound is healed or completely covered by skin grafts (weeks to months)
2. Complications
b. Infections--often gram (-) pseudomonas (leading death cause in hospitalized burn pts)
iv. Treatment--remove -------------- tissue early and wound ------------ as soon as possible

Back 185

Burns
VI. Phases
B. Acute Phase--occurs until wound is healed or completely covered by skin grafts (weeks to months)
2. Complications
b. Infections--often gram (-) pseudomonas (leading death cause in hospitalized burn pts)
iv. Treatment--remove necrotic tissue early and wound closure as soon as possible

Front 186

Burns
VI. Phases
B. Acute Phase--occurs until wound is healed or completely covered by skin grafts (weeks to months)
2. Complications
b. Infections--often gram (-) pseudomonas (leading death cause in hospitalized burn pts)
iv. Treatment--remove necrotic tissue early and wound closure as soon as possible
• IV antibiotics not given unless pt is truly ------------- (can create resistance)
• ------------ everything if sepsis is suspected

Back 186

Burns
VI. Phases
B. Acute Phase--occurs until wound is healed or completely covered by skin grafts (weeks to months)
2. Complications
b. Infections--often gram (-) pseudomonas (leading death cause in hospitalized burn pts)
iv. Treatment--remove necrotic tissue early and wound closure as soon as possible
• IV antibiotics not given unless pt is truly septic (can create resistance)
• Culture everything if sepsis is suspected

Front 187

Burns
VI. Phases
B. Acute Phase--occurs until wound is healed or completely covered by skin grafts (weeks to months)
2. Complications
c. Neurologic--extreme disorientation
i. ---------------- if no underlying cause of confusion (---------------’s Syndrome)

Back 187

Burns
VI. Phases
B. Acute Phase--occurs until wound is healed or completely covered by skin grafts (weeks to months)
2. Complications
c. Neurologic--extreme disorientation
i. ICU psychosis if no underlying cause of confusion (Sundowner’s Syndrome)

Front 188

Burns
VI. Phases
B. Acute Phase--occurs until wound is healed or completely covered by skin grafts (weeks to months)
2. Complications
d. Musculoskeletal--prevention of --------------- (frequent ----------, make pt/family aware)

Back 188

Burns
VI. Phases
B. Acute Phase--occurs until wound is healed or completely covered by skin grafts (weeks to months)
2. Complications
d. Musculoskeletal--prevention of contractions (frequent ROB, make pt/family aware)

Front 189

Burns
VI. Phases
B. Acute Phase--occurs until wound is healed or completely covered by skin grafts (weeks to months)
2. Complications
e. G__________
i. IV antibiotics and -------------- can cause diarrhea

Back 189

Burns
VI. Phases
B. Acute Phase--occurs until wound is healed or completely covered by skin grafts (weeks to months)
2. Complications
e. Gastrointestinal
i. IV antibiotics and tube feedings can cause diarrhea

Front 190

Burns
VI. Phases
B. Acute Phase--occurs until wound is healed or completely covered by skin grafts (weeks to months)
2. Complications
e. Gastrointestinal
ii. Too much ----------- + ------------ ↓motility constipation

Back 190

Burns
VI. Phases
B. Acute Phase--occurs until wound is healed or completely covered by skin grafts (weeks to months)
2. Complications
e. Gastrointestinal
ii. Too much narcotics + bed rest ↓motility constipation

Front 191

Burns
VI. Phases
B. Acute Phase--occurs until wound is healed or completely covered by skin grafts (weeks to months)
2. Complications
e. Gastrointestinal
iii. High risk for _________--↓blood flow to ________ track (_________’s ulcer-burn specific)

Back 191

Burns
VI. Phases
B. Acute Phase--occurs until wound is healed or completely covered by skin grafts (weeks to months)
2. Complications
e. Gastrointestinal
iii. High risk for ulcers--↓blood flow to GI track (Curling’s ulcer-burn specific)

Front 192

Burns
VI. Phases
B. Acute Phase--occurs until wound is healed or completely covered by skin grafts (weeks to months)
2. Complications
e. Gastrointestinal
• Tx w/ ___________, -__________-blocker (Zantac, etc.)

Back 192

Burns
VI. Phases
B. Acute Phase--occurs until wound is healed or completely covered by skin grafts (weeks to months)
2. Complications
e. Gastrointestinal
• Tx w/ antacid, H2-blocker (Zantac, etc.)

Front 193

Burns
VI. Phases
B. Acute Phase--occurs until wound is healed or completely covered by skin grafts (weeks to months)
2. Complications
f. ___________--risk for ↑blood sugar (check frequently-often need ________ coverage)

Back 193

Burns
VI. Phases
B. Acute Phase--occurs until wound is healed or completely covered by skin grafts (weeks to months)
2. Complications
f. Endocrine--risk for ↑blood sugar (check frequently-often need insulin coverage)

Front 194

Burns
VI. Phases
B. Acute Phase--occurs until wound is healed or completely covered by skin grafts (weeks to months)
3. Skin Grafting
a. Biological Dressings--temp wound closure prevents ------------- -------------- protects ------------- tissue until autogafting is possible (will be rejected due to diff DNA)

Back 194

Burns
VI. Phases
B. Acute Phase--occurs until wound is healed or completely covered by skin grafts (weeks to months)
3. Skin Grafting
a. Biological Dressings--temp wound closure prevents infection fluid loss protects granulation tissue until autogafting is possible (will be rejected due to diff DNA)

Front 195

Burns
VI. Phases
B. Acute Phase--occurs until wound is healed or completely covered by skin grafts (weeks to months)
3. Skin Grafting
a. Biological Dressings--temp wound closure prevents infection fluid loss protects granulation tissue until autogafting is possible (will be rejected due to diff DNA)
• Used until ----------------- established (48hrs) and up to several weeks

Back 195

Burns
VI. Phases
B. Acute Phase--occurs until wound is healed or completely covered by skin grafts (weeks to months)
3. Skin Grafting
a. Biological Dressings--temp wound closure prevents infection fluid loss protects granulation tissue until autogafting is possible (will be rejected due to diff DNA)
• Used until revascularization established (48hrs) and up to several weeks

Front 196

Burns
VI. Phases
B. Acute Phase--occurs until wound is healed or completely covered by skin grafts (weeks to months)
3. Skin Grafting
a. Biological Dressings--temp wound closure prevents infection fluid loss protects granulation tissue until autogafting is possible (will be rejected due to diff DNA)
i. Homografts (--------------)--skin from --------- (skin bank-fresh or frozen)

Back 196

Burns
VI. Phases
B. Acute Phase--occurs until wound is healed or completely covered by skin grafts (weeks to months)
3. Skin Grafting
a. Biological Dressings--temp wound closure prevents infection fluid loss protects granulation tissue until autogafting is possible (will be rejected due to diff DNA)
i. Homografts (Allografts)--skin from humans (skin bank-fresh or frozen)

Front 197

Burns
VI. Phases
B. Acute Phase--occurs until wound is healed or completely covered by skin grafts (weeks to months)
3. Skin Grafting
a. Biological Dressings--temp wound closure prevents infection fluid loss protects granulation tissue until autogafting is possible (will be rejected due to diff DNA)
ii. Heterografts (-----------)--from ------------- (mostly pigs)

Back 197

Burns
VI. Phases
B. Acute Phase--occurs until wound is healed or completely covered by skin grafts (weeks to months)
3. Skin Grafting
a. Biological Dressings--temp wound closure prevents infection fluid loss protects granulation tissue until autogafting is possible (will be rejected due to diff DNA)
ii. Heterografts (xenografts)--from animals (mostly pigs)

Front 198

Burns
VI. Phases
B. Acute Phase--occurs until wound is healed or completely covered by skin grafts (weeks to months)
3. Skin Grafting
b. Synthetic Dressings (------------)--dermalayer becomes permanent part of ------------ (absorbed) and top later removed in ~______weeks when autograft is placed (less costly)

Back 198

Burns
VI. Phases
B. Acute Phase--occurs until wound is healed or completely covered by skin grafts (weeks to months)
3. Skin Grafting
b. Synthetic Dressings (Integra)--dermalayer becomes permanent part of wound (absorbed) and top later removed in ~2weeks when autograft is placed (less costly)

Front 199

Burns
VI. Phases
B. Acute Phase--occurs until wound is healed or completely covered by skin grafts (weeks to months)
3. Skin Grafting
c. Autograft--unburned skin removed w/ ------------ (donor site take _______-15days to heal)

Back 199

Burns
VI. Phases
B. Acute Phase--occurs until wound is healed or completely covered by skin grafts (weeks to months)
3. Skin Grafting
c. Autograft--unburned skin removed w/ dermatome (donor site take 10-15days to heal)

Front 200

Burns
VI. Phases
B. Acute Phase--occurs until wound is healed or completely covered by skin grafts (weeks to months)
3. Skin Grafting
c. Autograft--unburned skin removed w/ dermatome (donor site take 10-15days to heal)
i. Donor sites
ii. Cultured ---------------- autografts--pt w/out enough own skin (>----------% body need)

Back 200

Burns
VI. Phases
B. Acute Phase--occurs until wound is healed or completely covered by skin grafts (weeks to months)
3. Skin Grafting
c. Autograft--unburned skin removed w/ dermatome (donor site take 10-15days to heal)
i. Donor sites
ii. Cultured epithelial autografts--pt w/out enough own skin (>50% body need)

Front 201

Burns
VI. Phases
B. Acute Phase--occurs until wound is healed or completely covered by skin grafts (weeks to months)
3. Skin Grafting
c. Autograft--unburned skin removed w/ dermatome (donor site take 10-15days to heal)
• Remove skin sample and culture in medium w/ ------------- growth factor
• Takes _________-4 weeks for skin to grow (use __________ graft during this time)

Back 201

Burns
VI. Phases
B. Acute Phase--occurs until wound is healed or completely covered by skin grafts (weeks to months)
3. Skin Grafting
c. Autograft--unburned skin removed w/ dermatome (donor site take 10-15days to heal)
• Remove skin sample and culture in medium w/ epidermal growth factor
• Takes 3-4 weeks for skin to grow (use temporary graft during this time)

Front 202

Burns
VI. Phases
B. Acute Phase--occurs until wound is healed or completely covered by skin grafts (weeks to months)
4. Nursing Management
a. Wound Management/Care
i. Cleanse and ----------- to prevent bacterial growth
ii. Minimize further destruction of ----------- skin
iii. Promote wound ----------------/successful skin grafting

Back 202

Burns
VI. Phases
B. Acute Phase--occurs until wound is healed or completely covered by skin grafts (weeks to months)
4. Nursing Management
a. Wound Management/Care
i. Cleanse and debride to prevent bacterial growth
ii. Minimize further destruction of viable skin
iii. Promote wound reepithelialization/successful skin grafting

Front 203

Burns
VI. Phases
B. Acute Phase--occurs until wound is healed or completely covered by skin grafts (weeks to months)
4. Nursing Management
b. Pain management--PCA (document effectiveness and assess for changes)
i. ----------------- methods esp. useful in burn (distractions, visualization, etc.)

Back 203

Burns
VI. Phases
B. Acute Phase--occurs until wound is healed or completely covered by skin grafts (weeks to months)
4. Nursing Management
b. Pain management--PCA (document effectiveness and assess for changes)
i. Nonpharmacologic methods esp. useful in burn (distractions, visualization, etc.)

Front 204

Burns
VI. Phases
B. Acute Phase--occurs until wound is healed or completely covered by skin grafts (weeks to months)
4. Nursing Management
c. PT and OT--prevents ------------- (get pt family involved)

Back 204

Burns
VI. Phases
B. Acute Phase--occurs until wound is healed or completely covered by skin grafts (weeks to months)
4. Nursing Management
c. PT and OT--prevents contractures (get pt family involved)

Front 205

Burns
VI. Phases
B. Acute Phase--occurs until wound is healed or completely covered by skin grafts (weeks to months)
4. Nursing Management
d. Nutritional therapy--hypermetabolic ---------------- state worsens w/ anxiety/pain
i. Need nutrition consultation (need food w/in -----------hrs)

Back 205

Burns
VI. Phases
B. Acute Phase--occurs until wound is healed or completely covered by skin grafts (weeks to months)
4. Nursing Management
d. Nutritional therapy--hypermetabolic hypercatabolic state worsens w/ anxiety/pain
i. Need nutrition consultation (need food w/in 72hrs)

Front 206

Burns
VI. Phases
C. Rehabilitation Phase--wounds are healed/grafts are in place
1. Scar control--prevent hypertrophic scaring due to ↑------------ deposit
a. Apply pressure garments (-----------hr/day for 1-2yrs until complete healing) to scar and ---------------- to prevent collagen deposit and keep scar fat

Back 206

Burns
VI. Phases
C. Rehabilitation Phase--wounds are healed/grafts are in place
1. Scar control--prevent hypertrophic scaring due to ↑collagen deposit
a. Apply pressure garments (23hr/day for 1-2yrs until complete healing) to scar and massage to prevent collagen deposit and keep scar fat

Front 207

Burns
VI. Phases
C. Rehabilitation Phase--wounds are healed/grafts are in place
1. Scar control--prevent hypertrophic scaring due to ↑collagen deposit
b. Keep out of sun for ----------yr (to prevent ---------------)

Back 207

Burns
VI. Phases
C. Rehabilitation Phase--wounds are healed/grafts are in place
1. Scar control--prevent hypertrophic scaring due to ↑collagen deposit
b. Keep out of sun for 1yr (to prevent hyperpigmentation)

Front 208

Burns
VI. Phases
C. Rehabilitation Phase--wounds are healed/grafts are in place
2. Prevent ___________--need PT, splinting, exercise/positioning
a. Occur due to tendons shortening and CT replaced by scar tissue limits mobility

Back 208

Burns
VI. Phases
C. Rehabilitation Phase--wounds are healed/grafts are in place
2. Prevent contractures--need PT, splinting, exercise/positioning
a. Occur due to tendons shortening and CT replaced by scar tissue limits mobility

Front 209

Burns
VI. Phases
C. Rehabilitation Phase--wounds are healed/grafts are in place
2. Prevent contractures--need PT, splinting, exercise/positioning
a. Occur due to tendons--------------- and CT replaced by ------------ limits mobility

Back 209

Burns
VI. Phases
C. Rehabilitation Phase--wounds are healed/grafts are in place
2. Prevent contractures--need PT, splinting, exercise/positioning
a. Occur due to tendons shortening and CT replaced by scar tissue limits mobility

Front 210

Burns
VII. Psychosocial Care--very important
A. Physical and ------------- scars (array of emotions)
B. Team effort--support from nurses, -------------, PT, OT, ------------ workers

Back 210

Burns
VII. Psychosocial Care--very important
A. Physical and emotional scars (array of emotions)
B. Team effort--support from nurses, physicians, PT, OT, social workers

Front 211

Burns
VII. Psychosocial Care--very important
C. Family and patient ------------ groups
D. Psychiatric treatment--__________

Back 211

Burns
VII. Psychosocial Care--very important
C. Family and patient support groups
D. Psychiatric treatment--depression

Front 212

Burns
VII. Psychosocial Care--very important
E. Nursing diagnosis--disturbed body image related to --------------- secondary to burn
1. Goal--pt sets realistic goals regarding ------------ lifestyle
2. Goal--acceptance of ----------- body image

Back 212

Burns
VII. Psychosocial Care--very important
E. Nursing diagnosis--disturbed body image related to disfigurement secondary to burn
1. Goal--pt sets realistic goals regarding future lifestyle
2. Goal--acceptance of altered body image