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Questions and Answers
What is the primary cause of electrical burns?
What is the primary cause of electrical burns?
Which type of burn is caused by exposure to acid, alkali, or organic substances?
Which type of burn is caused by exposure to acid, alkali, or organic substances?
What is the purpose of IV fluid therapy in burn clients?
What is the purpose of IV fluid therapy in burn clients?
What is the primary characteristic of superficial burns?
What is the primary characteristic of superficial burns?
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What is NOT a common IV fluid used in burn clients?
What is NOT a common IV fluid used in burn clients?
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At what percentage of body surface involvement is hospitalization required for deep burns?
At what percentage of body surface involvement is hospitalization required for deep burns?
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What is the goal of fluid replacement formulas in burn clients?
What is the goal of fluid replacement formulas in burn clients?
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What is the primary factor that determines the extent of injury in electrical burns?
What is the primary factor that determines the extent of injury in electrical burns?
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Why should diuretics not be given to burn clients?
Why should diuretics not be given to burn clients?
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What is the recommended diet for burn clients initially?
What is the recommended diet for burn clients initially?
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Which type of burn is caused by radiant energy being transferred to the body?
Which type of burn is caused by radiant energy being transferred to the body?
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What is the primary characteristic of full-thickness burns?
What is the primary characteristic of full-thickness burns?
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What is the purpose of debridement in burn wound care?
What is the purpose of debridement in burn wound care?
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What is the primary method of classifying burn wounds?
What is the primary method of classifying burn wounds?
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When are skin grafts typically done?
When are skin grafts typically done?
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What is the purpose of dressing the burn wound?
What is the purpose of dressing the burn wound?
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What is a characteristic of full thickness burns?
What is a characteristic of full thickness burns?
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What is the purpose of the Lund and Browder Chart?
What is the purpose of the Lund and Browder Chart?
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What is the percentage of the body surface area attributed to the head and neck according to the Rule of Nines?
What is the percentage of the body surface area attributed to the head and neck according to the Rule of Nines?
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What is the result of blood vessel thrombosis in burn injuries?
What is the result of blood vessel thrombosis in burn injuries?
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What is the term for the leakage of fluid from blood vessels into the interstitial space after a burn injury?
What is the term for the leakage of fluid from blood vessels into the interstitial space after a burn injury?
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What is the timeframe for fluid shift to occur after a burn injury?
What is the timeframe for fluid shift to occur after a burn injury?
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What is a consequence of fluid shift in burn injuries?
What is a consequence of fluid shift in burn injuries?
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What is a result of cell damage and fluid shift in burn injuries?
What is a result of cell damage and fluid shift in burn injuries?
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Study Notes
Burn Injuries and Management
- Burns are wounds caused by exposure to excessive heat, chemicals, fire/steam, radiation, or electricity.
Types of Burns
- Thermal burns: caused by exposure to flame, hot object, or very cold object.
- Chemical burns: caused by exposure to acid, alkali, or organic substances.
- Electrical burns: result from the conversion of electrical energy into heat, extent of injury depends on the type of current, pathway of flow, local tissue resistance, and duration of contact.
- Radiation burns: result from radiant energy being transferred to the body, resulting in production of cellular toxins.
Burn Wound Assessment
- Classified according to depth of injury and extent of body surface area involved.
- Burn wounds differentiated depending on the level of dermis and subcutaneous tissue involved.
Superficial Burns (First-Degree)
- Epidermal tissue only affected.
- Erythema, blanching on pressure, mild swelling, no vesicles or blisters.
- Not serious unless large areas involved, e.g., sunburn.
Deep Burns (Second-Degree)
- Involves the epidermis and deep layer of the dermis.
- Fluid-filled vesicles, red, shiny, wet, and associated with severe pain.
- Hospitalization required if over 15-20% of body surface involved, e.g., tar burn, flame.
Full-Thickness Burns (Third/Fourth-Degree)
- Destruction of all skin layers.
- Requires immediate hospitalization.
- They are dry, waxy white, leathery or hard skin, and with no pain.
- Exposure to flames, electricity, or chemicals can cause 3rd-degree burns.
Calculation of Burned Body Surface Area
- Superficial burns are not involved in the calculation.
- Lund and Browder Chart is the most accurate because it adjusts for age.
- Rule of nines divides the body, its adequate for initial assessment for adult burns.
Vascular Changes Resulting from Burn Injuries
- Circulatory disruption occurs at the burn site immediately after a burn injury.
- Blood flow decreases or ceases due to occluded blood vessels.
- Damaged macrophages within the tissues release chemicals that cause constriction of vessels.
- Blood vessel thrombosis may occur, causing necrosis.
Fluid Shift
- Occurs after initial vasoconstriction, then dilation.
- Blood vessels dilate and leak fluid into the interstitial space, known as third spacing or capillary leak syndrome.
- Causes decreased blood volume and blood pressure.
- Occurs within the first 12 hours after the burn and can continue up to 36 hours.
Fluid and Electrolytes Imbalances
- Occur as a result of fluid shift and cell damage, leading to:
- Hypovolemia
- Metabolic acidosis
- Hyperkalemia
- Hyponatremia
- Hemoconcentration (elevated blood osmolarity, hematocrit/hemoglobin) due to dehydration.
IV Fluid Therapy
- Infusion of IV fluids is needed to maintain sufficient blood volume for normal CO.
- Clients with burns involving 15% to 20% of the TBSA require IV fluid.
- Purpose is to prevent shock by maintaining adequate circulating blood fluid volume.
Common Fluids
- Protenate or 5% albumin in isotonic saline.
- LR (Lactate Ringer) without dextrose.
- Crystalloid (hypertonic saline) adjust to maintain urine output at 30 mL/hr.
- Crystalloid only (lactated ringers).
Dressing the Burn Wound
- After burn wounds are cleaned and debrided, topical antibiotics are reapplied to prevent infection.
- Standard wound dressings are multiple layers of gauze applied over the topical agents on the burn wound.
Diet
- Initially NPO.
- Begin oral fluids after bowel sounds return.
- High protein, high calorie diet.
Debridement
- Done with forceps and curved scissor or through hydrotherapy (application of water for treatment).
- Only loose eschar removed.
Skin Grafts
- Done during the acute phase.
- Used for full-thickness and deep partial-thickness wounds.
Post-Care of Skin Grafts
- To be determined.
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Description
This quiz covers the different types of burns, including thermal, chemical, and electrical, and their causes. It also discusses the management of burn injuries.
