Burn Management and Treatment

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Questions and Answers

A patient has burns covering the entire front of their right leg and the front of their trunk. Using the Rule of Nines, approximately what percentage of their Total Body Surface Area (TBSA) is burned?

  • 9%
  • 27% (correct)
  • 36%
  • 18%

Which of the following systemic effects is most likely to develop during the emergent phase of burn recovery due to increased capillary permeability?

  • Metabolic Alkalosis
  • Hypertension
  • Increased Hemoglobin
  • Hypovolemic shock (correct)

A patient with full-thickness burns over a large portion of their body is at a high risk for infection. What is the MAIN reason for this increased risk?

  • Loss of the protective skin barrier (correct)
  • Increased white blood cell count
  • Elevated body temperature
  • Compromised immune system

During the acute phase of burn recovery, which dietary intervention is MOST important to promote wound healing?

<p>High-protein, high-calorie diet (A)</p> Signup and view all the answers

A patient who experienced a severe burn injury is exhibiting signs of anxiety and emotional distress. Which nursing intervention is MOST appropriate to address their psychological needs during the rehabilitation phase?

<p>Providing emotional support and counseling (B)</p> Signup and view all the answers

Which of the following is the MOST appropriate initial nursing intervention for a patient with a chemical burn?

<p>Immediate irrigation with copious amounts of water (D)</p> Signup and view all the answers

A patient with electrical burns is being admitted. What is the priority nursing assessment?

<p>Monitoring for cardiac arrhythmias (A)</p> Signup and view all the answers

During the emergent phase of burn care, a patient's urine output is significantly less than the prescribed rate despite adequate fluid administration. Which of the following actions should the nurse take FIRST?

<p>Notify the healthcare provider (B)</p> Signup and view all the answers

What type of burn involves the epidermis, dermis, and subcutaneous tissue?

<p>Full-thickness (third-degree) burn (A)</p> Signup and view all the answers

Which of the following is the primary goal of using pressure garments in burn scar management?

<p>Minimizing hypertrophic scarring (A)</p> Signup and view all the answers

A child has burns on their entire back and the back of their right arm. Using the Lund-Browder chart, the estimated TBSA % burned would be:

<p>14% (D)</p> Signup and view all the answers

Why is it important to closely monitor electrolyte levels, particularly potassium, in burn patients during the emergent phase?

<p>To detect and manage hyperkalemia (B)</p> Signup and view all the answers

Which of these strategies is MOST effective in preventing scald burns in young children?

<p>Checking water heater temperature to ensure it is not too high (B)</p> Signup and view all the answers

What is the PRIMARY purpose of debridement in burn wound care?

<p>Removing necrotic tissue to promote healing (D)</p> Signup and view all the answers

Which of the following accurately describes a partial-thickness (second-degree) burn?

<p>Involves the epidermis and dermis (D)</p> Signup and view all the answers

During the acute phase, what is the PRIMARY rationale for initiating physical and occupational therapy?

<p>To prevent contractures and maintain range of motion (A)</p> Signup and view all the answers

A patient who has suffered smoke inhalation is at risk for impaired gas exchange. What clinical manifestation would BEST indicate this complication?

<p>Restlessness and altered mental status (A)</p> Signup and view all the answers

In burn care, what is the PRIMARY advantage of using an autograft versus an allograft or xenograft?

<p>Lower risk of rejection (C)</p> Signup and view all the answers

Which of the following interventions is MOST important for preventing hypothermia in a patient with extensive burns during the emergent phase?

<p>Covering the burn with a clean, dry dressing (B)</p> Signup and view all the answers

A patient with a circumferential burn on their arm is at risk for developing compartment syndrome. What assessment finding is MOST indicative of this complication?

<p>Severe pain with passive movement (B)</p> Signup and view all the answers

What is the MOST important consideration when providing nutritional support to a burn patient during the acute phase?

<p>Meeting increased metabolic demands (C)</p> Signup and view all the answers

Which of the following burn types requires immediate and copious irrigation with water as a primary intervention?

<p>Chemical burns (C)</p> Signup and view all the answers

Why are children at a higher risk for complications from burns compared to adults?

<p>Children have a less developed immune system (C)</p> Signup and view all the answers

During burn assessment, what is the purpose of using the palmar surface (patient's palm) to estimate the burn size?

<p>To estimate the percentage of total body surface area (TBSA) burned (D)</p> Signup and view all the answers

Which of the following is a common electrolyte imbalance observed in burn patients during the emergent phase?

<p>Hyponatremia (C)</p> Signup and view all the answers

A patient with a burn injury develops a raised and thickened scar that extends beyond the original wound boundaries. What type of scar is this?

<p>Keloid (B)</p> Signup and view all the answers

In the rehabilitation phase, which intervention is MOST effective in preventing contractures?

<p>Using splints and positioning (A)</p> Signup and view all the answers

Which of the following is the MOST important nursing intervention for a patient with smoke inhalation injury?

<p>Maintaining a patent airway (A)</p> Signup and view all the answers

What type of burn results from heat sources such as flames, scalds, or contact with hot objects?

<p>Thermal burn (A)</p> Signup and view all the answers

Which of the following interventions is MOST appropriate for managing pain in a burn patient?

<p>Administering intravenous analgesics (C)</p> Signup and view all the answers

What is a key element in educating the public on burn prevention strategies?

<p>Installing smoke detectors in homes (A)</p> Signup and view all the answers

In burn care, what is the purpose of using topical antimicrobial agents?

<p>To prevent infection (C)</p> Signup and view all the answers

What is the likely cause of hyperkalemia in the emergent phase of burn injury?

<p>Release of potassium from damaged cells (B)</p> Signup and view all the answers

A patient with extensive burns is at risk for developing Curling's ulcer. Which intervention is MOST important for preventing this complication?

<p>Administering antacids or proton pump inhibitors (B)</p> Signup and view all the answers

Which of the following best describes the primary focus of the rehabilitation phase?

<p>Restoring function and improving quality of life (D)</p> Signup and view all the answers

What is the priority nursing intervention for a patient with a suspected inhalation injury?

<p>Assessing for singed nasal hairs and soot in the sputum (B)</p> Signup and view all the answers

Which of the following is the most accurate method for estimating the extent of burns, especially in children?

<p>Lund-Browder Chart (A)</p> Signup and view all the answers

What systemic effect is associated with hyperkalemia?

<p>Cardiac arrhythmias (B)</p> Signup and view all the answers

Which nursing intervention is MOST important for preventing cross-contamination and infection in a burn unit?

<p>Using sterile gloves and gowns during wound care (D)</p> Signup and view all the answers

Covering burns with a clean, dry dressing serves which purpose?

<p>Preventing infection (C)</p> Signup and view all the answers

In addition to infection, what major complication can result from smoke inhalation?

<p>ARDS (A)</p> Signup and view all the answers

Flashcards

What are burns?

Injuries to tissues caused by heat, electricity, radiation, or chemicals.

Thermal burns

Result from heat sources like flames, scalds, and hot objects.

Chemical burns

Caused by contact with acids, alkalis, or organic compounds.

Smoke inhalation injuries

Result from breathing hot air or toxic chemicals.

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Electrical burns

Result from intense heat generated by electrical current.

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Radiation burns

Caused by prolonged exposure to radiation.

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Superficial (first-degree) burns

Affect only the epidermis (outer layer of skin).

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Partial-thickness (second-degree) burns

Involve the epidermis and part of the dermis (second layer of skin).

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Full-thickness (third-degree) burns

Destroy the epidermis, dermis, and subcutaneous tissue.

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Deep full-thickness (fourth-degree) burns

Involve muscle, bone, and tendons.

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Rule of nines

Divides the body into percentages, each representing 9% of the total body surface area.

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Lund-Browder chart

A more precise method for estimating burn size, especially in children.

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Palmar surface

Estimates burn size on the adults hand at 1% TBSA.

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Local effects of burns

Include coagulation, protein denaturation, and cellular edema.

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Systemic effects of burns

Include fluid shifts, electrolyte imbalances, and inflammation.

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Fluid shifts in burns

Leads to hypovolemic shock due to increased capillary permeability.

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Electrolyte imbalances in burns

Include hyperkalemia and hyponatremia.

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Inflammatory response in burns

Causes vasodilation and increased capillary permeability.

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Emergent (resuscitative) phase

Focuses on immediate stabilization.

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Primary concerns during the emergent phase

Airway management, fluid resuscitation, and prevention of hypovolemic shock.

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ABCs

Assess the patient's airway, breathing, and circulation.

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Fluid resuscitation

Initiate with crystalloid solutions like lactated Ringer's.

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Urine output monitoring

Assess the adequacy of fluid resuscitation.

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Preventing infection

Cover the burn with a clean, dry dressing.

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Acute (wound healing) phase

Begin after the patient is hemodynamically stable.

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Focus of acute phase

Wound care, infection prevention, pain management, and nutritional support.

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Signs of infection

Redness, swelling, and purulent drainage.

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Nutritional support for wound healing

High-protein, high-calorie diet

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Debridement

Removes necrotic tissue to promote healing.

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Grafting

Transplanting skin to cover large burns

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Autografts

Use the patient's own skin.

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Allografts

Use skin from a cadaver.

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Xenografts

Use skin from an animal, typically a pig.

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Rehabilitation phase

Focuses on restoring function and improving quality of life.

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Scar management

Pressure garments, massage, and silicone gel sheets.

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Major complication

Loss of skin barrier.

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Hypertrophic scars

Raised and thickened scars.

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Keloids

Scars that extend beyond the original wound boundaries.

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Emotional distress

Can lead to anxiety, depression, and post-traumatic stress disorder (PTSD).

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Electrical burns

Cardiac arrhythmias and internal injuries.

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Study Notes

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