Reading...
Play button
Play button
Use LEFT and RIGHT arrow keys to navigate between flashcards;
Use UP and DOWN arrow keys to flip the card;
H to show hint;
A reads text to speech;
74 Cards in this Set
- Front
- Back
|
What is the main concern for burns especially the 1st 24 hours?
|
1st: fluid/electrolytes, 2nd infection prevention
|
|
|
Body surface area is a formula that involves what 3 factors?
|
Age, weight and height
|
|
|
Extent and depth, effect on physiologic functioning, and degree and mechanism of healing are determined by what 3 factors?
|
Time exposed, area exposed, temperature
|
|
|
Burns affecting the epidermis heal by ______, whereas burns involving deeper dermal and subcutaneous tissues heal by _____ ______ ________
|
regeneration vs scar tissue replacement
|
|
|
First-degree involve what layer(s)? 1) epidermis 2) epidermis and some dermis 3) epidermis and entire dermis 4) epidermis, dermis and subcutaneous
|
1-epi
|
|
|
Second-degree superficial partial thickness involve what layer(s)? 1) epidermis 2) epidermis and some dermis 3) epidermis and entire dermis 4) epidermis, dermis and subcutaneous
|
2 epi and some dermis
|
|
|
2nd degree deep partial thickness involve what layers? 1) epidermis 2) epidermis and some dermis 3) epidermis and entire dermis 4) epidermis, dermis and subcutaneous
|
3 epi and entire dermis
|
|
|
Third-degree involve what layer(s) 1) epidermis 2) epidermis and some dermis 3) epidermis and entire dermis 4) epidermis, dermis and subcutaneous
|
epi, dermis, and subcutaneous
|
|
|
Which burn causes the most pain?
|
2nd partial thickness (??superfical or deep?)
|
|
|
Which burn doesn’t hurt?
|
Full-thickness or 3rd
|
|
|
Burns that should go to burn unit:
|
Partial thickness greater than 10% of total body, Face, hands, feet, genitalia, perineum or major joints, 3rd degree, Burns in pts that require special interventions, Electrical, chemical or inhalation burns, Burn w/ any preexisting med disorder that could complicate management, Burns and concomitant trauma ie fractures, Children if no qualified personal
|
|
|
Magnitude of body response proportional to extent of injury, usually reaching plateau when approximately __% of body is burned
|
60%
|
|
|
Hemodynamic instability begins within what time frame?--with injury to capillaries in the burned area and persists for approximately how long after burn injury? A-w/in 24 hrs/days b- w/in minutes/24 hrs c-w/in 1hr/48hrs d-none of the above.
|
w/in min/24 hrs
|
|
|
loss of capillary seal is what?
|
Fluid loss from vascular, interstitial and cellular componenets.
|
|
|
Burn Shock – significant decrease in ______ output and systemic peripheral vascular ______, and impaired _______ of organs
|
cardiac output, vascular resistance, perfusion
|
|
|
Why are burn patients disposed to blood clotting?
|
↑ blood viscosity
|
|
|
Burns wider than ____ [in or cm??] usually require skin grafts as the regenerative layer (dermal) have been destroyed
|
1.5 in
|
|
|
Burn shock is ______ involving cardiovascular and cellular components. A-hypervolemic b-hypometabolic c-hypovolemic d-none of the above.
|
|
|
|
Burn complicatins: Respiratory system dysfunction-Damages mucous membranes leading to _______and ______. Signs and symptoms may be delayed for___ to ___ hours
|
bronchospasms and edema. 24-48hrs.
|
|
|
Burn complications: [Hypermetabolic or hypometabolic??] response in metabolic and nutritional requirements, [Increase or decrease???] in O2 consumption, glucose use, and protein and fat wasting, Peaks in _ to__days – enteral and parenteral hyperalimentation may be used to treat.
|
Hypermetobolic, increase, 7-10 days.
|
|
|
Complications of Burns: Dysfunction of other organ systems such as Renal insufficiency due to? A- hypervolemia b-hypovolemia c-hypernatremia d-hypokalemia
|
b-hypovolemia
|
|
|
Burn complications: renal system- May have initial _____ followed by diuresis (generally after the first 24 hours) A-anuria b-enuresis c-polyuria d-dysuria
|
a-anuria
|
|
|
Burn complications: GI tract Decreased _______ – often compounded by immobility and narcotics – observe carefully for what and what? A-peristalsis b-motility c-dysphagia d-anorexia
|
a-peristalsis, observe for vomiting and fecal impaction
|
|
|
Burn complications GI tract- May develop _______ syndrome (peptic ulcer of the duodenum) due to stress & ischemia – H2 antagonists or proton pump inhibitors
|
Curling’s syndrome
|
|
|
Sepsis may occur from burn or from what other 2illness?
|
pneumonia, or UTI
|
|
|
Tx of Burns Remove causative agent ––what type of water/ don’t use what?
|
flowing water or immersion, don’t use ice
|
|
|
Tx of Burns Emergent treatment to stabilize if severe – IV fluid resuscitation ( ___% TBSA in child – ____% TBSA in adult) Crystalloids or colloids used
|
10% child, 15% adult
|
|
|
Circumferential burns (arms, legs, torso) – if severe can act as _______ and cause major tissue damage to muscles, tendons, and vasculature – can form from _______or formation of leathery_______
|
tournaquite, edema, eschar
|
|
|
What is the leading cause of morbidity for burns?
|
Systemic infection
|
|
|
Evaporative Water Loss (EWL) Changes dramatically with burns as skin loss increases and loss from lungs due to what? A-hyperventilation and hypometabolism b-hyperventilation and hypermetabolism
|
b-hyperventilation and hypermetabolism
|
|
|
Formula for Basal, evaporative and total maintence fluids.
|
|
|
|
Burns-grafts: person’s own body 1) Synthetic grafts 2) 3) Heterograft 4) Autograft 5) Homograft
|
autograft
|
|
|
Burns-grafts: skin obtained from another person, alive or dead 1) Synthetic grafts 2) 3) Heterograft 4) Autograft 5) Homograft
|
homograft
|
|
|
Burns-grafts: skin obtained from another species, such as the pig 1) Synthetic grafts 2) 3) Heterograft 4) Autograft 5) Homograft
|
heterograft
|
|
|
Burns-grafts: two layers, silicone and fibers, skin attaches to fibers enabling dermal growth 1) Synthetic grafts 2) 3) Heterograft 4) Autograft 5) Homograft
|
synthetic
|
|
|
Skin Cancer [Increase or decrease????] in incidence during the last several decades. Why?
|
Increase, lifestyle, environ
|
|
|
Skin cancer -Increases on average are __% per year
|
|
|
|
Most prevalent form of cancer
|
skin
|
|
|
Nearly all persons over age___ will have @ least 1 skin cancer
|
65
|
|
|
Cumulative sun exposure increases risk of ? Where as intermittent severe sun exposure with blistering increases risk of?
|
Basal, squamous. Intermittent. Or lots at young age: melanoma
|
|
|
Most important risk factor for melanoma is what???
|
Amount of exp as young child
|
|
|
Which melanoma account for 70% has Raised edges; grow horizontally and vertically and will Ulcerate and bleed 1) Superficial Spreading 2) Nodular 3) lentigo maligna 4) acral lentiginous
|
1-superficial spreading
|
|
|
Which melonoma is Dome-shaped, blue-black and account for 15%–30%? 1) Superficial Spreading 2)Nodular 3) lentigo maligna 4) acral lentiginous
|
2-nodular
|
|
|
Which melonoma account for 4%–10% and are Slow growing, flat? 1) Superficial Spreading 2) Nodular 3) lentigo maligna 4) acral lentiginous
|
3-lentigo maligna
|
|
|
Which melonoma account for 2%–4% and On palms, soles, nail beds, mucous membranes 1) Superficial Spreading 2) Nodular 3) lentigo maligna 4) acral lentiginous
|
4-acral lentiginous
|
|
|
Squamous cell carcinoma-Where is the tumor? A-outer epidermis b- deeper
|
a- outer epi
|
|
|
Is squamous cell carcinoma metastasis more or less common than w/ basal?
|
More common
|
|
|
What is the treatment for squamous?
|
Surgical/chemo/rad.
|
|
|
When Does the person need to monitored for rest of life with squamous, or basal?
|
Squamous
|
|
|
Which type of skin cancer? Melanoma, basal or squamous? Most common skin cancer accounting for 75% of all nonmelanoma skin cancers
|
basal
|
|
|
Which type of skin cancer? Melanoma, basal or squamous Incidence twice as high among men as women and greatest in 55 to 75 year old age group
|
basal
|
|
|
Which type of skin cancer? Melanoma, basal or squamous Usually nonmetastasizing tumor that can extend wide and deep if not treated
|
basal
|
|
|
Which burn- Involve only epidermis only. A-1st b-2nd –partial c-2nd full d-3rd
|
a-1st
|
|
|
Red or pink, dry and painful . A-1st b-2nd –partial c-2nd full d-3rd
|
a-1st
|
|
|
skin can maintain its softness & elasticity. A-1st b-2nd –partial c-2nd full d-3rd
|
c-2nd full
|
|
|
if Blisters only after 24 hrs. . A-1st b-2nd –partial c-2nd full d-3rd
|
a-1st
|
|
|
Important to maintain intact blisters (act as bandage) and may promote wound healing, . A-1st b-2nd –partial c-2nd full d-3rd
|
b-2nd partial
|
|
|
Require supportive medical care to prevent further tissue damage, provide hydration, and ensure granular bed can support re-epithelialization . A-1st b-2nd –partial c-2nd full d-3rd
|
c-2nd full
|
|
|
Heal in approximately 1 to 2 weeks . A-1st b-2nd –partial c-2nd full d-3rd
|
b-2nd partial
|
|
|
Hair follicles and sweat glands remain intact. A-1st b-2nd –partial c-2nd full d-3rd
|
c-2nd full
|
|
|
Also painful as pain sensors intact but diminished. A-1st b-2nd –partial c-2nd full d-3rd
|
c-2nd full
|
|
|
Vary in color from waxy white or yellow to tan, brown, deep red, or black – hard, dry, and leathery . A-1st b-2nd –partial c-2nd full d-3rd
|
d-3rd
|
|
|
Extensive loss of skin tissue predisposes to attack by _______, causes massive loss of __________body fluids, interferes with _______-________ regulation, and imposes excessive demands on the ________ and reparative processes of the body
|
microorganisms, body- temperature, metabolic
|
|
|
Appeal mottled pink, red, or waxy white areas with blisters & edema,
|
2nd full
|
|
|
Heal in approximately 1 month
|
2nd full
|
|
|
No pain because nerve sensors have been destroyed
|
3rd
|
|
|
may be loss of some sensation with formation of scar tissue
|
2nd full
|
|
|
Extend into subcutaneous tissue and may involve muscle and bone, Underlying vascular involved,
|
3rd
|
|
|
Edema is extensive in burn area and surrounding tissue,
|
3rd
|
|
|
Most painful, moist, red, and blistered – sensitive to temperature changes, air exposure and touch
|
2nd partial
|
|
|
heals in 3-10 days
|
1st
|
|
|
abcde rule for skin cancer
|
a-asymmetrical
b-borders-irregular c-color -what colors? d-diameter >.6 cm e-evolving |
|
|
rule of nines
|
head front 4.5, head back: 4.5
trunk front: 18, trunk back 18 1 arm front: 4.5 1 arm back: 4.5 genitals 1 1 leg front: 9 1 leg back: 9 |
|
|
rule of nines
head front, head back trunck front, trunk back 1 arm front, 1 arm back genitals 1 leg front, 1 leg back |
head front 4.5, head back: 4.5
trunk front: 18, trunk back 18 1 arm front: 4.5 1 arm back: 4.5 genitals 1 1 leg front: 9 1 leg back: 9 |
