Pharm 2 Burns

Pharm 2 Burns What is a first degree burn? - epidermis, red/painful, sunburn How do you treat a first degree burn? - hydration and moisturize What is a second degree burn? - epidermis and dermis, blistering, very painful, severe sunburn/scald What are key components of second degree burns? - need to assess for blanching, can develop into a 3rd degree if not managed well What is a third degree burn? - epidermis, dermis, subcutaneous tissue, nerve damage, permanent scarring, eschar won't stretch, severe burn What are key components of third degree burns? - eschar indicates no perfusion, do not heal on own What is a fourth degree burn? - epidermis, dermis, subcutaneous tissue, bone & muscle, most severe burn What are the key nursing priorities for burn patients? - ABCs, fluid balance, infection control, nutrition, temperature, pain control, lab monitoring What labs need to be monitored in burn patients? - ABGs for metabolic acidosis, electrolytes (potassium and sodium), glucose for hyperglycemia What is the preferred fluid resuscitation for burn patients? - lactated ringers What are burn patients at risk for when trying to balance fluids? - hypovolemic shock: maintain BP and perfusion What is fluid balance based on? - urine output 50 ml/hr How do you control infection for burn patients? - debridement (surgical, hydrotherapy, dressings): removing necrotic tissue How do you manage nutrition in burn patients? - enteral feeds, check blood sugars: patients are in hyper metabolic state What does temperature control look like for burn patients? - keep them warm What are the pain control options for burn patients? - opioids, hypnotics, pre-medicate before procedures and hydrotherapy! How do you control tissue damage? - escharotomy, skin grafts What is an escharotomy? - opens up swelling tissue to prevent compartment syndrome What is an auto graft? - the donor is the patient What is an allo graft? - cover with mesh temporarily What is a xeno graft? - donor is an animal What is a synthetic graft? - graft grown from stem cells What is the zone of coagulation? - no perfusion, must be removed What is the zone of stasis? - possible healing with early and aggressive intervention; perfusion compromised but not totally gone What is the zone of hyperaemia? - maintaining decent perfusion and will heal What are the 4 main aims of burn treatment? - protection from the environment, temperature control, fluid control, energy control