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Burns and Burn TreatmentMedical-Surgical Nursing-7th edition

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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?
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Shifts into interstitial spaces and remains there until edema formation ceases.
What are the characteristics of hypovolemic shock associated with burns?
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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?
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Renal failure, adrenocortical insufficiency, and massive deep muscle injury.
What Electrolyte Imbalance? Dysrhythmias, ventricular failure, weakness, and ECG changes.
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Hyperkalemia
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Patients with electrical burns are at most risk for:
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dysrhythmias, metabolic acidosis, and myoglobinuria (leads to renal failure).
_______ and _______ are the 1st WBCs to respond to burn injuries.
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Neutrophils and monocytes
What are signs and symptoms of carbon monoxide poisoning?
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Cherry red skin, hypoxia, carboxyhemoglobinemia, restlessness/confusion (15-40% Co), decreased LOC (40-60%), and death. *SaO2 unreliable.
When should a burn patient be treated at a burn center?
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Partial thickness burn over 10% of body; Burn on face, hands, feet, genitals or major joints; Chemical burn; and Full thickness burns.
What can cause decreased K+ in a burn patient during the acute phase?
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Hydrotherapy, v/d, GI suction, and IV therapy without supplementation. Leads to PVCs/V-tach.
How are large thermal burns initially treated?
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Airway, breathing, circulation. Don't immerse in cold water or pack with ice. Wrap in clear, dry sheet. Remove burned clothing.
What is the greatest risk for patients with burns?
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Hypovolemic shock. c/b: massive shift of fluids from blood vessels due to increased capillary permeability (moves into interstitial spaces)
Fluid resuscitation is initiated for burns that are _______ or more of TBSA.
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15%
What is the Parkland/Baxter formula for fluid replacement for burn patients the 1st 24 hours?
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4 mL lactated ringers/kg x TBSA (1/2 given 1st 8 hours)
_______ is used for grafts for life threatening full-thickness or deep partial thickness wounds.
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Artificial skin
_______ are grafts grown from the patient's own skin and is used for large BSA burns or for those with limited skin for harvesting.
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Cultured Epithelial Autografts (CEA)
  
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