Term
| explain the epidermis after a burn injury |
|
Definition
| it can grow back fairly quick because the cells surrounding the sweat and oil glands and hair follicles extend into the dermis - |
|
|
Term
| where do the nutrients come from to heal the epidermis after a burn |
|
Definition
| from the bottom layers becuse there is no blood vessles |
|
|
Term
| what happens in the dermis after a burn injury is just minimal what if its sever? |
|
Definition
| skin can regrow as long as parts of the skin are still present, when the entire dermis is burned all the epitehlial cels and dermal appendages are destroyed and the skin cant restore itself |
|
|
Term
| all bruns are painful!! what is exposed with partial thickness burns |
|
Definition
| nerve endings that increase sensitivity and pain |
|
|
Term
| what is exposed with full thickness burns and what type of pain is felt |
|
Definition
| nerve endings are destroyed the pt have dull pressure but the wound edges still may have sensory intact and can cause pain |
|
|
Term
| what happens with vitamin d and partial thickness burns and what about full thickness burns |
|
Definition
| reduces the activation of D and in full thickness burns this is completely lost |
|
|
Term
| what temp can the skin tolerate temps up to without injury/ and what happen abve this temp |
|
Definition
| 158*/ above this temp cell destruciton is so fast that even breif exposure the skin below is damged |
|
|
Term
| what color would a cuperficial and partial thickness burn be |
|
Definition
|
|
Term
| what color is a deep partial thickness burn |
|
Definition
|
|
Term
| what color is a full thickness burn |
|
Definition
| black brown yellow red or white |
|
|
Term
explain the pain in a superficial burn
partial thickness
deep partial
full thickness |
|
Definition
| pain in all of the first 3 and then in full thickness it can be ther is deep full thickness the pain is absent |
|
|
Term
|
Definition
| deep partial thickness less then 15% |
|
|
Term
|
Definition
| deep partial thickness 15 to 25% |
|
|
Term
| what is the criteria in a pt with a minor or moderate burn in order to be in this cateogry with their health |
|
Definition
| must be younger then 60 no heart, lung or endocrine disorders |
|
|
Term
| what can not be burned in order to classify under minor or moderate burns |
|
Definition
| no burns of the eyes ears face hands feet or perineum |
|
|
Term
| what is body part included in a major burn |
|
Definition
eyes
ears
feet
hands
perineum |
|
|
Term
|
Definition
|
|
Term
| what are superficial partail thickness wounds caused by |
|
Definition
| injury to the upper third dermis leaving a good blood supply |
|
|
Term
| the superficial partial thickness wounds are red and moist do they blanch with pressure |
|
Definition
|
|
Term
| the small vessles in the superficial partial thickness burn are damage so what happens |
|
Definition
| theyleak plasma and lifes off the ehat destroyed epidermis causing blisters |
|
|
Term
| small blisters from a bunr may be left intact what do they do with larger blister |
|
Definition
| open and debride then to promote healing |
|
|
Term
| deep partial thickness wounds extend into the dermis and fewer healthier cells remain why dont blisters form here |
|
Definition
| because the dead tissue layer is thick and sticks to the underlying dermis so it cant really lift off the surface |
|
|
Term
| full thickness wounds is from destruciton of the entire epidermis and dermis what does this wound require and why |
|
Definition
| grafting because it can not regrow |
|
|
Term
| what is apparent on the full thickness burn and what is done with it |
|
Definition
| eschar and this must be removed before healing can occur |
|
|
Term
| why is eschar removal from a full thickness burn difficult |
|
Definition
| because it sticks to the lower tissues with collagen |
|
|
Term
| escharotomies/ fasciotomies |
|
Definition
| incisions thru the eschar/ incisions in the eschar and into the fasica |
|
|
Term
| deep full thickness burns extend beyound the skin into dep underlying fascia and tissues what else is damaged in these burns |
|
Definition
|
|
Term
| circulating disruption happens immediately after a burn what happens to the blood vessels |
|
Definition
| they are occluded and blood flow is reduced or stopped |
|
|
Term
| what happens after vascoconstriction initially after a burn |
|
Definition
| the fluid shifts into the interstitial space and its a continuous leak of plasma |
|
|
Term
| what does the amount of fluid shifted in a burn depend on |
|
Definition
| the amount of burn and extent |
|
|
Term
| where does capillary leak occur after a burn |
|
Definition
| both burned and unburned tissues |
|
|
Term
| why does edema develop from a burn |
|
Definition
| because the proteins are now in the interstitial spave and causes movement of fluids out from vascualr space |
|
|
Term
| what are four imbalances that occur from a burn |
|
Definition
hypovolemia
hyperkalemia
acidosis
hyponatremia |
|
|
Term
| why does hyperkalemia occur after a burn |
|
Definition
| cells injured release large amounts of potassium |
|
|
Term
| why is sodium retained after a burn |
|
Definition
| stress- aldosterone secreation increases leading to increased sodium reabsorption |
|
|
Term
| hemoconcentration develops from a burn why |
|
Definition
| from vascular dehydration |
|
|
Term
|
Definition
| happens 24 hours after burn when the capillaries stop leaking |
|
|
Term
| what happens during the diuretic stage of a burn |
|
Definition
| low sodium low potassium anemia |
|
|
Term
| whjen would a person need a transfusion after a burn |
|
Definition
| if the hematocrit is less then 25% with hypoxia |
|
|
Term
| what are the heart changes after a burn |
|
Definition
|
|
Term
| what happens with burn to irrantant that enter the lungs |
|
Definition
| a reflex occurs whent he vocal cords close off to educe the entry of smok |
|
|
Term
| what can leaking capillaries do to the pulmonary system |
|
Definition
|
|
Term
| what happens to the gi system with a burn |
|
Definition
| gastric motility is decreased and the secreations and gases collect in the intestines and stomach |
|
|
Term
|
Definition
| acute ulce that occurs with the stress of a sever injury |
|
|
Term
| what is used toprotect the gi after a burn injury |
|
Definition
| h2 histamine blockers nd proton pump inhibitors |
|
|
Term
| serious burn injuries can increase metabolism how does it do this |
|
Definition
increases catecholamines
antidiuretics
aldosterones
corisol |
|
|
Term
| the hypermetabolic state increases the body temp why does the core temp increase |
|
Definition
| because the person has lost the eat thru burned areas and teh hypothalamus this is trying to reset the bodys normal temp to a hgiher baseline |
|
|
Term
|
Definition
| caused from an open flame |
|
|
Term
|
Definition
|
|
Term
|
Definition
| from hot metal grease contact thes skin |
|
|
Term
|
Definition
| chemical on the skin or ingested |
|
|
Term
| alkalis where is this chemical found |
|
Definition
| oven cleaners fertilizers drain cleaners |
|
|
Term
| what do alkalis chemical do to the skin |
|
Definition
| causes the skin proteins to liquify |
|
|
Term
| alkalis liquifies proteins in the skin what does this allow for burns |
|
Definition
| deeper spread of the chemical and more sever burns |
|
|
Term
| grand masquerder of burns |
|
Definition
| electrical burns because they lok small but internal damages can be horrible |
|
|
Term
| bone will allow electrical flow along the surface why |
|
Definition
| because is has a high resistance because its density |
|
|
Term
| how do external electricty burns occur |
|
Definition
| when the electricla stimulus jusmps or arches between two body surfaces |
|
|
Term
|
Definition
| wehn people are exposed to large doses of radioactive material |
|
|
Term
| resucitation phase of a burn |
|
Definition
| first phase it begins onset and about 24 hours |
|
|
Term
| what are the priorities in the resusitation pahse |
|
Definition
secure the airway
circulation with fluids
anagesics
preent infeciton
maintain body temp
provide emotional support |
|
|
Term
| what should be administered with all burns |
|
Definition
|
|
Term
| with flame burns first smother the flames and then |
|
Definition
| remove all clothing and metal object |
|
|
Term
| what are two things done with chemical burns |
|
Definition
do not wet dry chemicals
brush off any chemicals present on skin or clothing |
|
|
Term
| what should you do with a pt with an electricle burn |
|
Definition
|
|
Term
| what does carbon monoxide do in the body |
|
Definition
| transported across lung membrae and is bond to hemaglobin in place of o2 causes the curve to switch to the left |
|
|
Term
| except for steam inhalation aspiration of scalding liguid are usually limited to |
|
Definition
|
|
Term
| heat damage of the pharynx is sever enough to cause |
|
Definition
| edema obstruction epiglottis |
|
|
Term
| circulatory overload may cause |
|
Definition
|
|
Term
| during a fluid shift with a burn what happens to the kidneys |
|
Definition
| urine is decreased and urine is concentrated as a high specific gravity |
|
|
Term
| when muscle damge has occured from a burn what happens |
|
Definition
| myoglobin is released and circulates to the kidney all of the molecules can create a sludge in the kidney and block flow |
|
|
Term
| what is fluid recusitationprovided at to maintain urine output |
|
Definition
|
|
Term
|
Definition
| this method for burns where the body is divided into areas that ar multiple of 9% |
|
|
Term
| use the rule of nine of the lower half of the body |
|
Definition
rt let anterior9% posterior 9%
lt leg anterior 9% posterior 9% |
|
|
Term
| use the rule of nines for the chest |
|
Definition
|
|
Term
| use the rule of nines for the arms |
|
Definition
| 4.5% anterior and 4.5% posterior |
|
|
Term
| use the rule of nines for the head |
|
Definition
| 4.5% anterior and posterior |
|
|
Term
| explain the persons wbc count immediately after a burn and then later in the stage |
|
Definition
| early the wbc rise then drop dramatically with a left shift |
|
|
Term
| what are heamglobin and hematocrite levels after a burn during resucitaiton phase |
|
Definition
|
|
Term
| gluclose levels normal/ what happens in the rescusitiation stage of a burn |
|
Definition
|
|
Term
sodium
potassium chloride normal levels |
|
Definition
na 136-145
k- 3.5-5.0
chloride-98-106 |
|
|
Term
total protein levls
albumin levles |
|
Definition
|
|
