NUR 445: Exam 4 (#1 STUDY GUIDE) UPDATED ACTUAL
Questions and CORRECT Answers
What are the four different types of burns? 1. Thermal
2. Chemical
3. Electrical
4. Radiation
Describe thermal burns. Result of flash, scald, or contact with hot objects and flames. Associated
accelerant use (gasses) can increase severity of burn and inhalation injury due to
added chemical insult.
What are the common causes of thermal burns? House fires, car fires, cooking accidents, injury from smoking.
Note: Contact burns are thermal in nature and associated with cooking and
heating accidents, scald injuries are most prevalent among the young and
associated with accidents or abuse
Describe electrical burns. Can result in a wide spectrum of injuries from mild to lethal, majority are work
related
Describe chemical burns. Three subclasses include acids, alkaline, and organic compounds, both injury and
household
Describe radiation burns. Least common type of burn injury, severity of complications depend on type,
dose, and length of exposure.
What are the some cause of radiation burns? Often associated with industry of ionizing radiation, nuclear accidents, and
therapeutic radiation treatment. Sunburn is also considered radiation by UV
radiation.
Burn Depth: Describe the superficial layer. Only affect epidermal layer of skin
Note: Sunburn is the most common type.
What are the characteristics of the superficial layer? Mild erythema and hypersensitivity, typically resolve in 24-72 hours. Heal quickly
and typically do not require medical intervention or admission to a burn center,
don't usually result in scarring.
Burn Depth: Describe the superficial partial thickness Involves epidermis and the superficial/minimal layers of dermis, exposed nerve
layer. endings in the dermal later often make these burns painful.
What are the characteristics of the partial thickness layer? Wet, weeping blisters and pink in color, capillary refill time on open areas of
blisters remain normal, patient is sensitive to touch and air currents when the
wound is exposed. Heals in 1-2 weeks with minimal to no scarring.
Burn Depth: Describe deep partial thickness layer. Involves epidermis and extends into deeper portions of bottom layers of dermis
, Describe the characteristics of deep partial thickness Appear waxy and do not have weeping blisters, light pink or cherry red, capillary
layer. refill is decreased or absent, patient reports varying areas of pain and decreased
sensation
Burn Depth: Describe the full-thickness layer. Muscle and bone involvement.
Describe the rule of palms. Size of hand, including fingers is 1% TBSA, useful for very small and/or very large
burns, scattered burns, and in mass casualty situations where time is of the
essence
Describe the rule of nines. Most commonly used in pre-hospital setting, body surface areas broken into
percentages and is modified for infants and children, concern is that all people
have the same distribution of body surface area percentages.
Describe the Lund and Browder classification. In hospital setting and majority of burn centers, most widely accepted and
accurate method. Measurements take into account surface area related to age
and are assigned to each body part
Describe the fluid replacement formula (Parkland) 2-4ml/hr x TBSA x weight in kgs = Total fluid resuscitation in the first 24 hours
Remember: 50% needs to be infused in first 8 hours. The remaining 50% over the
next 16 hours.
Concentric Zones: Describe coagulation. Area that had most contact with heat source and location of most severe damage
Concentric Zones: Describe stasis. Immediately surrounds zone of coagulation and characterized by damaged cells
and impaired circulation
Concentric Zones: Describe hyperemia. Outermost area with area of increased blood flow in an effort to bring nutrients
for tissue recovery.
Describe inhalation injury. Can exist without cutaneous burn present, increases mortality rate r/t
development of pneumonia or hypoxia and requires lengthy ventilatory support
s/s- edema around nose and mouth and soot in nares.
Questions and CORRECT Answers
What are the four different types of burns? 1. Thermal
2. Chemical
3. Electrical
4. Radiation
Describe thermal burns. Result of flash, scald, or contact with hot objects and flames. Associated
accelerant use (gasses) can increase severity of burn and inhalation injury due to
added chemical insult.
What are the common causes of thermal burns? House fires, car fires, cooking accidents, injury from smoking.
Note: Contact burns are thermal in nature and associated with cooking and
heating accidents, scald injuries are most prevalent among the young and
associated with accidents or abuse
Describe electrical burns. Can result in a wide spectrum of injuries from mild to lethal, majority are work
related
Describe chemical burns. Three subclasses include acids, alkaline, and organic compounds, both injury and
household
Describe radiation burns. Least common type of burn injury, severity of complications depend on type,
dose, and length of exposure.
What are the some cause of radiation burns? Often associated with industry of ionizing radiation, nuclear accidents, and
therapeutic radiation treatment. Sunburn is also considered radiation by UV
radiation.
Burn Depth: Describe the superficial layer. Only affect epidermal layer of skin
Note: Sunburn is the most common type.
What are the characteristics of the superficial layer? Mild erythema and hypersensitivity, typically resolve in 24-72 hours. Heal quickly
and typically do not require medical intervention or admission to a burn center,
don't usually result in scarring.
Burn Depth: Describe the superficial partial thickness Involves epidermis and the superficial/minimal layers of dermis, exposed nerve
layer. endings in the dermal later often make these burns painful.
What are the characteristics of the partial thickness layer? Wet, weeping blisters and pink in color, capillary refill time on open areas of
blisters remain normal, patient is sensitive to touch and air currents when the
wound is exposed. Heals in 1-2 weeks with minimal to no scarring.
Burn Depth: Describe deep partial thickness layer. Involves epidermis and extends into deeper portions of bottom layers of dermis
, Describe the characteristics of deep partial thickness Appear waxy and do not have weeping blisters, light pink or cherry red, capillary
layer. refill is decreased or absent, patient reports varying areas of pain and decreased
sensation
Burn Depth: Describe the full-thickness layer. Muscle and bone involvement.
Describe the rule of palms. Size of hand, including fingers is 1% TBSA, useful for very small and/or very large
burns, scattered burns, and in mass casualty situations where time is of the
essence
Describe the rule of nines. Most commonly used in pre-hospital setting, body surface areas broken into
percentages and is modified for infants and children, concern is that all people
have the same distribution of body surface area percentages.
Describe the Lund and Browder classification. In hospital setting and majority of burn centers, most widely accepted and
accurate method. Measurements take into account surface area related to age
and are assigned to each body part
Describe the fluid replacement formula (Parkland) 2-4ml/hr x TBSA x weight in kgs = Total fluid resuscitation in the first 24 hours
Remember: 50% needs to be infused in first 8 hours. The remaining 50% over the
next 16 hours.
Concentric Zones: Describe coagulation. Area that had most contact with heat source and location of most severe damage
Concentric Zones: Describe stasis. Immediately surrounds zone of coagulation and characterized by damaged cells
and impaired circulation
Concentric Zones: Describe hyperemia. Outermost area with area of increased blood flow in an effort to bring nutrients
for tissue recovery.
Describe inhalation injury. Can exist without cutaneous burn present, increases mortality rate r/t
development of pneumonia or hypoxia and requires lengthy ventilatory support
s/s- edema around nose and mouth and soot in nares.
