Burns Notes NSG 335
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This 3 page Class Notes was uploaded by Brieanna Phipps on Sunday January 31, 2016. The Class Notes belongs to NSG 335 at University of North Carolina - Wilmington taught by Dr. Sauer in Spring 2016. Since its upload, it has received 29 views. For similar materials see Pathology and Pharmacology in Nursing and Health Sciences at University of North Carolina - Wilmington.
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Date Created: 01/31/16
Degree of Burns -1 degree (superficial) -only the epidermis is burned -sunburn without blisters -can cause chills, HA, edema, N/V -takes 3-5 days to heal -2nddegree (superficial and deep partial thickness) -Superficial: blisters present, but sensors remain in tact, especially tactile and pain sensors -scars are unusual -takes 3-4 weeks to heal -Deep Partial Thickness: entire dermis is burned, but sweat glands are in tact -appears white and leathery, but painless because the nerve endings are damaged -dead tissue needs to be removed, may require graft. -scarring and lack of function can occur -takes weeks to heal Superficial Deep Partial Thickness (after necrotic tissue is removed) -3 degree (full thickness) -dermis and underlying SQ tissue are destroyed -has to heal by secondary intension -skin grafting is required -4 degree burns -dermis, SQ, tendons, muscles and bones are destroyed -appears black -grafts are needed -will not heal Burn Unit Referral -partial thickness burns that exceed about 10% of the body -third degree burns -electrical and chemical burns -injury caused by smoke inhalation -all children -and complex situations (i.e. burns on hands, or is someone tried to set the individual on fire) Note: when someone is burned, their capillaries become more permeable, causing hypovolemia and hyperviscosity. This leads to lack of blood supply to the tissues and edema. What to look for during an assessment: -ABCDE’s -Airway: stridor -Breathing: what is the depth and rate, do they have difficulty breathing, is it labored -Circulation: pulses, temperature, color of skin, capillary refill -Disability: are they alert and oriented? What is their level of consciousness? -Exposure/Environment: remove clothes, jewelry, glasses, and contacts. -History Three stages of patient management: 1. Emergency 2. Acute (wound healing) 3. Rehabilitative Fluid resuscitation is required for anyone with more than 15% of their body area burned, usually lactated ringer. Foley is inserted, and morphine is used for pain.
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