Shared Flashcard Set

Details

Principles 3, test 1 burn lecture, slides 19-26
"fire"
14
Nursing
Graduate
01/16/2010

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Cards

Term
After a burn injury, how long does the increase in microvascular permeability last for in injured tissue? In noninjured tissue?
Definition
3-5 days injured, 24 hours noninjured
Term
list the stages of shock following a major burn injury
Definition
cardiogenic shock occurs early, followed by hypovolemic shock, and if fluid volume is resucitated septic shock ensues
Term
what is the hallmark cardiovascular response to a burn injury? Why?
Definition
decreased cardiac output due to the initial increase in SVR and capillary permeability (pushes fluid volume out of vasculature and reduces CO, decreased contractility (due to circulating mediators), reduced response to catecholamines, and reduced coronary blood flow
Term
kids with burn injuries will have what cardiac response for weeks after their burn?
Definition
HTN, due to increased catecholamines and increased renin/angio response
Term
Which fluids are more successful at volume resuscitation in burn pts, crystalliods or collids?
Definition
no difference
Term
why might hypertonic solutions be avoided in the burn pt?
Definition
large amounts of hypertonic fluid deplete intracellular water, produce hypernatremia, and increase incidince of renal failure
Term
why might dextrose drive up a burn pts blood sugar higher than normal?
Definition
within the first 24 hours, the cells develop glucose intolerance
Term
do burn pts with inhalation injuries require more or less fluids?
Definition
more
Term
when replacing fluids in a burn pt, what 5 endpoints should drive our replacement regimen?
Definition
urine output, base deficits, HR, lactate levels, Hgb/Hct
Term
what is the parkland formula of fluid resuscitation in burn pts?
Definition
4cc LR x percent burned (expressed as a whole number, not a decimal)x kg
give half in the first 8 hours then 1/4 in the second eight and 1/4 in the third eight hours
Term
what is the leading cause of long term death following a burn?
Definition
infection
Term
what are the changes to the immune system following a burn injury?
Definition
loss of skin barrier, eschar is a good medium for bacteria (gram negative presence results in high mortality), pneumonia is common, leukocytes, humoral, and cellular responses are depressed
Term
Which type of burn injury causes massive muscle necrosis and results in myoglobinemia and potentially renal failure?
Definition
electrical
Term
does shock post burn increase or decrease GFR? what happens next?
Definition
increase, renin/angiotensin and ADH conserve sodium and water to compensate, and ARF may develop
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