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Nursing In a Flash 
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Question Answer
How are chemical burns initially treated?
Show Answer
Remove chemical from skin (may scrub with soft brush to remove alkaline agent); Remove clothing; and Water lavage.
What changes to K+ occur as a result of burns?
Show Answer
Injured cells and hemolyzed RBCs release K+ into extracellular spaces leading to hyperkalemia. Then, K+ shifts and decreases K+ leading to hypokalemia.
Tissue destruction related to a chemical burn can occur up to _______ hours after the initial injury.
Show Answer
72 hours
How can the liver or kidneys be damaged from an external chemical burn?
Show Answer
The substance can be absorbed into the circulation and cause damage as it's detoxified or excreted.
What are the 2 commonly used guides to determine the extent of burns?
Show Answer
Lund-Browder Chart (most accurate) and Rule of 9's (good for initial adult assessment).
_______ is an electrolyte imbalance that can occur following successful fluid replacement due to improper tube feedings of burn patients.
Show Answer
Acute phase (hypernatremia)
A good time for exercise of a burn patient is during _______.
Show Answer
wound cleaning
Depth? Involves Dermis. Moist, pink, painful, blisters, blanches. 10-21 days healing time.
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Deep partial-thickness
What should staff wear when caring for patients with open burn wounds?
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Disposable hats, masks, gown, and gloves.
Chemical burns result from tissue injury caused by...
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acids, alkalis, and organic compounds.
Depth? Requires skin grafting...
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Full thickness
What wound care method is used for facial burn?
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Open method (topical ointment only).
How is corneal burns treated?
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Antibiotic ointment (*note patient may be frightened by periorbital edema).
How should hands and arms be positioned for burn patients?
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Extended and elevated on pillows or slings to prevent contractures.
How are small thermal burns initially treated?
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Cover with clean, cool tap water (dampened towel).
What are the 3 major types of inhalation injuries?
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CO poisoning, injury above glottis, and injury below glottis.
What are clues a patient has an inhalation injury above the glottis?
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Facial burns, soot around the mouth/nose, singed nose hair, hoarseness, painful swallowing, dark nasal/oral membranes, and stridor.
Inhalation injury _______ the glottis causes tracheal or bronchial constriction and alveolar damage.
Show Answer
below
What are the clinical manifestations seen during the emergent phase of burns?
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Shock (pain and hypovolemia), blisters, shivering, and altered mental status.
What drugs are commonly used in the treatment of burn patients?
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Morphine (increased doses, 10 mg not uncommon), deluded, haloperidol, Ativan, versed, tetanus shot, sulfamylon, and silvadene.
How is an inhalation injury below the glottis treated?
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Bronchoscopy within 6-12 hours. If interstitial edema, endotracheal intubation.
The emergent phase of burns begins with _______ and ends with _______. It lasts _______ hours.
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fluid loss and edema; fluid mobilization and diuresis; lasts 24-48 hours
What are the major complications during the acute phase of burns?
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Infection, decreased ROM, contractures, paralytic ileus/Curling's ulcer, and hyperglycemia.
Burn location: Face, neck, chest - _______, Hands, feet, joints, eyes - _______, and Ears, nose - _______.
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face, neck, chest - respiratory obstruction; hands, feet, joints, eyes - self-care; ears, nose - infection.
What patient risk factors can contribute to delayed recovery from burns?
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Alcoholism, drug abuse, malnutrition, concurrent fractures, head injuries, and trauma.
What changes to Na+ occur as a result of burns?
Show Answer
Shifts into interstitial spaces and remains there until edema formation ceases.
What are the characteristics of hypovolemic shock associated with burns?
Show Answer
Decreased albumin, edema, increased HR, decreased BP, increased hematocrit, increased Na+, increased, then decreased K+, WBC changes.
What can cause increased K+ in a burn patient during the acute phase?
Show Answer
Renal failure, adrenocortical insufficiency, and massive deep muscle injury.
What Electrolyte Imbalance? Dysrhythmias, ventricular failure, weakness, and ECG changes.
Show Answer
Hyperkalemia
Patients with electrical burns are at most risk for:
Show Answer
dysrhythmias, metabolic acidosis, and myoglobinuria (leads to renal failure).


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