Care of Patients with Burns

Questions and Answers

What is a key component that should be managed during the resuscitative phase after burn injuries?

Prevent skin loss

Increase metabolic rate

Fluid overload

Secure the airway (correct)

Which physiological change is commonly associated with burns and plays a role in the hypovolemic state?

Vasoconstriction

Increased peripheral resistance

Increased capillary permeability (correct)

Decreased metabolic rate

What is a potential complication during the diuretic phase following a burn injury?

Hyperglycemia

Decreased renal blood flow

Metabolic alkalosis

Fluid overload (correct)

Which of the following indicators is NOT used to assess the adequacy of fluid resuscitation?

Body temperature Signup and view all the answers

Which sign is commonly observed in a patient experiencing hypovolemic shock due to burn injuries?

Tachycardia Signup and view all the answers

What is the primary function of the skin?

Protection Signup and view all the answers

Which classification of burns involves the entire epidermis and dermis?

Third-degree burns Signup and view all the answers

What is NOT a component of the immune response?

Increased capillary permeability Signup and view all the answers

What is a characteristic feature of a fourth-degree burn?

Medical emergency Signup and view all the answers

Which factor is NOT considered when determining the severity of a burn?

Time of day when the injury occurred Signup and view all the answers

Which type of burn involves exposure to chemicals?

Chemical burn Signup and view all the answers

What does the term '3rd spacing' refer to in the context of burns?

Fluid loss into the interstitial space Signup and view all the answers

Which of the following responses is NOT one of the 6 P's of compartment syndrome?

Pneumonia Signup and view all the answers

Study Notes

Skin Function

Largest organ of the body
Serves protective, excretory, sensory, and thermoregulatory roles

Pathophysiology of Burns

Histamines are released initially after burn injury
Increased capillary permeability leads to fluid loss and sodium depletion
Vasodilation occurs in blood vessels

Immune Response

Protects body against disease
Identifies foreign materials
Maintains hemostasis with a systemic response

Burn Classifications

First-degree burns: Affect only the outer layer (epidermis)
Second-degree burns: Superficial partial thickness and deep partial thickness with blisters and deeper tissue damage

Determining Severity of Burns

Severity assessed by size (surface area), depth, age, health prior to injury, location, and associated injury severity

Rules of Nine

Method to assess burn size in adults using body regions as a percentage

Types of Burns

Electrical, thermal, chemical, and radioactive

First Degree Burn

Affects only the epidermis

Second Degree Burn

Superficial partial thickness: Blisters form, damage extends through the dermis

Third Degree Burn

Full-thickness burn, involves entire epidermis, dermis, and underlying tissue; sensation may be reduced

Fourth Degree Burn

Medical emergency involving skin, tendons, nerves, and possibly muscle; potential for permanent damage or amputation

Escharotomy and Fasciotomy

Procedures to relieve pressure in compartment syndrome, indicated by the 6 P's: Pain, Parathesia, Pallor, Paralysis, Pulselessness, Poikilothermia

Metabolic Response to Burns

Release of catecholamines, cortisone, ADH, aldosterone, and glucagon
Hypermetabolic state requires increased nutrition and oxygen
High evaporative water loss from burn wounds (up to 300 cc/m²/hr)

Resuscitative/Emergent Phase

Priority actions include securing the airway, fluid replacement, pain control, and prevention of sepsis

Hypovolemic State (48 Hours Post-Injury)

Rapid fluid shifts and increased capillary permeability
Fluid loss deep into wounds contributing to metabolic acidosis (loss of bicarbonate)

Diuretic Phase (48-720 Hours Post-Injury)

Potential for fluid overload due to increased intravascular volume
Continued metabolic acidosis and heightened renal blood flow leading to diuresis

Adequacy of Fluid Resuscitation

Assess through mental status, blood pressure, heart rate, capillary refill, arterial blood gases (ABGs), and urinary output

Cardiovascular Assessment

Signs of hypovolemic shock include tachycardia, decreased blood pressure, weak peripheral pulses, and ECG changes

Description

This quiz focuses on the care and management of patients with burn injuries. It explores skin function, the pathophysiology of burns, and the body's immune response to such injuries. Perfect for nursing students and healthcare professionals seeking to enhance their understanding of burn care.