Term
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Definition
| Involve injury to the epidermis and portions of the dermis. |
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Term
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Definition
| Partial thickness, superficial, painful and red. Heal on their own in 3 to 7 days by epidermal cell regeneration. ie: Sunburn |
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Term
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Definition
| Partial thickness, blister formation or wet. Very painful. Heal on their own as long as they are small and do not become infected. |
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Term
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Definition
| Involve injury to through the entire epidermis and dermis. Appear dry, mottled, can be black, brown, white or red. |
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Term
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Definition
| Full thickness, burned tissue is usually painless due to nerve ending damage, surrounding skin painful. Unless small will require skin grafts to heal adequately. |
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Term
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Definition
| Full thickness, also involves subcutaneous fat, muscle and often bone. Require extensive surgical debridement and skin grafting. Amputation is common. |
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Term
| Signs of F/E imbalance in burn patients |
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Definition
| Low BP, Tachy,decreased UOP <30ml/hr, dry mucous membranes and poor skin turgor. |
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Term
| Burned Adult Fluid replacement formula (from notes) |
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Definition
2-4ml/kg x % TBSA burned
Give LR 1/2 in 1st 8hrs then 1/2 over next 16 hrs. |
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Term
| Burned Child Fluid replacement formula |
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Definition
| 4ml/kg x % TBSA + maintenance fluids |
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Term
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Definition
| Pt at rest, non procedure related activity (turning or breathing), continuous, low in intensity. Typically lasts the duration of recovery. Managed with long-acting analgesic agents (PCA). |
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Term
| Breakthrough pain response |
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Definition
| Increase in pain, exceeds background pain. Usually caused by movement of injured area. Managed with short acting agents. |
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Term
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Definition
| Experience of highly intensive pain during wnd cleaning or dressing change, PT or OT. Managed with short acting opioids, sometimes inhaled agents (nitrous oxide). |
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Term
| Resuscitative phase of burn pt |
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Definition
| Time between initial injury and 36 to 48 hrs after injury. Airway and breathing problems are major concern. Development of hypovolemia d/t capillary leakage from the intravascular space to intersitial spaces. Phase ends when fluid resuscitation is complete. |
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Term
| Goal of fluid resuscitation |
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Definition
| To maintain vital organ perfusion while avoiding the complications related to either inadequate or excessive fluid administration. |
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Term
| Indicators for good fluid resuscitation |
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Definition
| UOP = 0.5ml/kg/hr, adjust IVF based on pt physiologic response (UOP, VS, lung sounds, labs- BUN,CBG,creatinine, electrolytes and HCT) |
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Term
| Are colloids given to burn pt during the first 24 hrs? |
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Definition
| No, colloids (albumin, FFP) are not given during the first 24hrs d/t capillary leakage. Protein rich fluids leaked into the interstitial spaces will increase edema. |
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Term
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Definition
| Many pt with burns over 20-25% TBSA have NG's placed d/t gastrointestinal dysfuction (ileus) which occurs almost universally in clients EARLY post burn injury. All oral fluid should be restricted. |
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Term
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Definition
| Remove smoldering clothing or hot wet clothing, cover pt with dry blanket to preserve body heat. |
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Term
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Definition
| Occurs when pt is hemodynamically stable, capillary integrity is restored and diuresis has begun. Usually 48-72 hrs after injury, cont. until wnd closure is achieved. |
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Term
| Why is a burn pt at risk for renal failure? |
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Definition
| Inadequate fluid resuscitation. Myoglobin and hemoglobin are released from the damaged muscles and RBC, these precipitate in the renal tubules blocking the tubules and leading to tubular necrosis. |
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Term
| Why is there a higher mortality rate for burn pt older than 65? |
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Definition
| A combination of age related impairments (decresed mobility, slower reaction time, impaired judgement) environmental hazards, living alone and pre injury morbidities. Also older pts have thinning skin and atrophy of skin. |
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Term
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Definition
| Wnd debridement involves the removal of eschar, exudate and crusts. It promotes wund healing and |
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Term
| Clinical manifestations of infection in burn wnds |
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Definition
| Brown, black or hemorrhagic coloring of wnd, drainage, odor, delayed healing or spongy eschar. |
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Term
| Clinical indicators of sepsis |
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Definition
| HA,chills,N/V, VS changes, hyperglycemia, glycosuria, paralytic ileus, confusion, restlessness and hallucinations. |
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Term
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Definition
| Treatment for rehabilitation must start on the day of injury, continue through the acute phase and beyond DC. |
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