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BSN Burns

by: Arlene Notetaker


Arlene Notetaker
Marywood University

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About this Document

These notes are an overview of Nursing of Burns. This study guide is from the spring semester in 2016.
Medical Surgical Nursing III
Professor Wescott
Study Guide
Nursing, burns
50 ?




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This 3 page Study Guide was uploaded by Arlene Notetaker on Wednesday September 7, 2016. The Study Guide belongs to NURS at Marywood University taught by Professor Wescott in Fall 2016. Since its upload, it has received 5 views. For similar materials see Medical Surgical Nursing III in NURSING at Marywood University.

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Date Created: 09/07/16
BURN Functions of skin  Protective (microbes and evaporation -4x as fast)  Excretory (contains sweat glands)  Sensory (all burns are painful)  Vitamin D activation  Maintains temperature Blister formation with superficial partial thickness burn  Superficial partial thickness wounds  Small blood vessels are injured - Leakage of large amounts of plasma - Lifts off destroyed epidermis causing blister formation - Small blisters left alone - Large blisters debrided Eschar- associated with, removal of  dead tissue  must slough off or be removed for healing to occur  may constrict underlying vasculature  may restrict chest movement in breathing  escarotomy or fasciotomy Burn effect on vascular system  circulatory disruption  damaged microphages release chemicals causing vasoconstriction  thrombosis  vasodilation occurs causing fluid shifts into interstitial space (3 spacing  decreases blood volume/BP  excessive weight gains 12-36 hours after burn Burns and electrolyte disturbances  hyperkalemia  hyponatremia Pulmonary burns- S&S, vocal cord reflex, agents  usually injury from superheated air, stream, toxic fumes, smoke  major cause of death in burn patients  most likely to occur in burn injuries occurring indoors  irritants may cause reflex closure of vocal cords which is protective  ciliated membranes may no longer trap bacteria/foreign materials  lining of trachea/bronchi may slough (48-72 hours’ post)  leaking capillaries cause alveolar edema  may go into ARDS Caloric needs and burns  caloric needs are higher- 2-3x normal energy needs, indirect calorimetry  2% loss of body weight mild deficit, 10% needs evaluated/adjustment Compensatory responses  Fluid shifts diverts blood from GI system (integrity/motility impaired)  SNS stress response- EPI and NOREPI released, increased O2 and glucose  Inflammatory response (triggers healing but also causes fluid shifts) best when local and short-term  First 3 days of injury Burn resuscitation- first 8 hours, starts time of injury, avoid boluses  Fluid resuscitation formulas (Parkland, modified parkland, modified brooke) st  All give ½ of 24-hour fluid protocol in 1 8 hours, rest in the next 16 hours  After first day plan based on specific patient fluid/electrolyte imbalances  Boluses are avoided Airway patency and signs for intubation  Patent airway (may need ETT, trachea)  O2 therapy, avoid fluid overload  Suctioning PRN, CPT, Aerosol treatments, positioning, deep breathing  Larynx- may seem ok until fluid resuscitation, may need to intubate prior to obstruction  Edema may very quickly cut off airway Dry weight  Pre-burn weight  Used to calculate fluid rates, caloric needs, and drug doses  Needs to take into consideration urine output No diuretics  Diuretics usually not used in burn patients Pain management- opioids route, chance of lethal dose  Think: amount of nerve endings damaged vs destroyed  Non-opioids  Opioids (IV route only in resuscitation phase)  Must be careful of fluid shifts (lethal dose accumulates in interstitial fluid nd takes effect as fluid shift resolves) Grafting- difference between auto/allo/xeno  Auto-  tissue which is removed from and then used on the same individual, perminant  Allo­ tissue that is removed from one individual and used on a different individual, temporary, will be rejected by recipient usually within 7-21 days  Xeno- skin graft from a donor of a different species from the recipient  Decrease pain, decrease LOS, hasten recovery Infection prevention in burn patient  Wound sepsis is the leading cause of death during acute phase  Tetanus shot/tetanus IG  Topical antibiotics (not applied to fresh grafts)  Systemic antibiotics for signs of infection (increased metabolic rate may require higher dosing)  Isolation, no plants, no raw foods, no sharing  Aseptic technique


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