N4581 - Exam 3 (Complex Needs-Reid)
True or False: IV cannot be placed through burned skin - answer False
True or False: BP cuff can be placed over burned skin - answer True
An increased capillary permeability after a burn is caused by __________.
Occurs how long after injury?
Lasts how long? - answer inflammatory response
occurs w/in 10min of injury
leakage continues for 24-36 hours
Fluid resuscitation is needed when? - answer>20% BSA
Burn severity is influenced by (3) – answer temp of burning agent
duration of contact
type of tissue injured
What can minimized the depth of a burn? - answercooling w/in 1 minute of burn (cool
water, NOT ICE ∵ vasoconstriction)
Large burns should be cooled for how long?
What should be used? - answerno longer than 10 minutes or risk hypothermia
use water, never ice (will cause vasoconstriction and ↓circulation ∴ ↑ischemia)
What type of burn is not used in calculating total BSA? - answersuperficial!
Define the following burn types;
superficial (3)
partial-thickness superficial (2)
partial-thickness deep (4)
full-thickness (2) - answers: pink, blanches w/ pressure, no blisters
pts: blisters, wet/shiny
ptd: may blister, white/red/pink, mottled, initially moist then dry
ft: leathery, needs skin graft
What severity burn is classified as mottled?
How would you expect the burn to progress? - answerpartial-thickness: deep
initially moist then dry
Patient is experiencing a brief loss of consciousness followed by periods of alertness.
What type of hematoma do you suspect? - answerepidural: arterial blood, lemon shape,
FAST
, Dr. Reid's meaning regarding calculating total BSA of burn;
face
head
arm
anterior arm - answerface: 4.5%
head: 9% (means front and back)
arm: 9% (means front and back)
anterior arm: 4.5%
Describe the stick man for calculating total BSA for burns - answerfront:
face = 4.5
chest (top & bottom) = 18
legs (each) = 9
arms (each) = 4.5
groin = 1
back:
head = 4.5
back (top & bottom) = 18
legs (each) = 9
arms (each) = 4.5
Define the ABA fluid resuscitation formula - answergive LR @ 2mL/kg/total BSA for first
24 hours
give half in 1st 8hours (from burn time)
give remainder in 16h
*don't use for electrical burns: 4 mL/kg/hr*
Patient presents to ER at 14:00 with burns to 32% of his body after a grilling accident
occurring at 12:00. Patient weighs 85kg
a) how much fluid should patient receive in the next day?
b) patient should receive _____mL by what time?
c) what rate will you set infusion?
d) at 20:00 rate will decrease to ________ - answera) 2mL x 85kg x 32 = 5440 mL in 24
hours
b) must get 2720 mL by 20:00 (8 hours from BURN not from admission)
c) 453 mL/hr for first 6 hours
d) at 20:00 rate will ↓ to 170 mL/hr
What are the phases of the burn cycle? (3)
Define when each begins and ends - answeremergent: begins @ onset of injury, ends
@ completion of fluid resuscitation
intermediate (aka acute): begins @ diuresis, ends @ wound closure
rehab: begins @ wound closure, ends @ return to optimal physical adjustment
True or False: IV cannot be placed through burned skin - answer False
True or False: BP cuff can be placed over burned skin - answer True
An increased capillary permeability after a burn is caused by __________.
Occurs how long after injury?
Lasts how long? - answer inflammatory response
occurs w/in 10min of injury
leakage continues for 24-36 hours
Fluid resuscitation is needed when? - answer>20% BSA
Burn severity is influenced by (3) – answer temp of burning agent
duration of contact
type of tissue injured
What can minimized the depth of a burn? - answercooling w/in 1 minute of burn (cool
water, NOT ICE ∵ vasoconstriction)
Large burns should be cooled for how long?
What should be used? - answerno longer than 10 minutes or risk hypothermia
use water, never ice (will cause vasoconstriction and ↓circulation ∴ ↑ischemia)
What type of burn is not used in calculating total BSA? - answersuperficial!
Define the following burn types;
superficial (3)
partial-thickness superficial (2)
partial-thickness deep (4)
full-thickness (2) - answers: pink, blanches w/ pressure, no blisters
pts: blisters, wet/shiny
ptd: may blister, white/red/pink, mottled, initially moist then dry
ft: leathery, needs skin graft
What severity burn is classified as mottled?
How would you expect the burn to progress? - answerpartial-thickness: deep
initially moist then dry
Patient is experiencing a brief loss of consciousness followed by periods of alertness.
What type of hematoma do you suspect? - answerepidural: arterial blood, lemon shape,
FAST
, Dr. Reid's meaning regarding calculating total BSA of burn;
face
head
arm
anterior arm - answerface: 4.5%
head: 9% (means front and back)
arm: 9% (means front and back)
anterior arm: 4.5%
Describe the stick man for calculating total BSA for burns - answerfront:
face = 4.5
chest (top & bottom) = 18
legs (each) = 9
arms (each) = 4.5
groin = 1
back:
head = 4.5
back (top & bottom) = 18
legs (each) = 9
arms (each) = 4.5
Define the ABA fluid resuscitation formula - answergive LR @ 2mL/kg/total BSA for first
24 hours
give half in 1st 8hours (from burn time)
give remainder in 16h
*don't use for electrical burns: 4 mL/kg/hr*
Patient presents to ER at 14:00 with burns to 32% of his body after a grilling accident
occurring at 12:00. Patient weighs 85kg
a) how much fluid should patient receive in the next day?
b) patient should receive _____mL by what time?
c) what rate will you set infusion?
d) at 20:00 rate will decrease to ________ - answera) 2mL x 85kg x 32 = 5440 mL in 24
hours
b) must get 2720 mL by 20:00 (8 hours from BURN not from admission)
c) 453 mL/hr for first 6 hours
d) at 20:00 rate will ↓ to 170 mL/hr
What are the phases of the burn cycle? (3)
Define when each begins and ends - answeremergent: begins @ onset of injury, ends
@ completion of fluid resuscitation
intermediate (aka acute): begins @ diuresis, ends @ wound closure
rehab: begins @ wound closure, ends @ return to optimal physical adjustment
