NU455- Exam 3 Guide With
Complete Solution
Care at the scene for a burn patient
-extinguish: "stop and pat"/ "stop, drop, and roll"
-cool the burn: NO ICE
-remove restrictions and JEWELRY (holds heat)
-cover the wound: clean dry sheet
-continuously irrigate chemical burns
*careful about preventing hypothermia
care in the ED for a burn patient
-start an IV
-establish airway=> check mouth and nares for singe/soot
-initiate infusion of lactated ringers
-cover with clean sheet
-coordinate car w. burn center
-estimate TBSA affected, document IV placement, volume of LR received,
comorbidities, mechanism of burn, Is&Os, foley cath?
phases of care
,emergent: onset to completion of fluid resuscitation, prevent shock, resp
distress, wound assessment, v/s
acure/immediate: beginning of diuresis, completion of wound closure,
prevention of infection, nutrition
rehabilitation: treatment of scars, counseling, increase (as layers begin to
heal pain increases), rehab
Burn types and degrees symptoms and treatments associated with each.
-1st degree (superficial):
-2nd degree (partial thickness)
-3rd degree (full thickness)
-4th degree (full thickness)
TYPES: electrical vs Thermal vs chemical
symptoms and treatments associated with each burn
(1st degree)
-1st degree (superficial): sunburn, superficial scald, low intensity flash
-epidermis maybe portion of dermis
-tingling, peeling, itching, pain, blanchable, reddened (blancahble erythema),
minimal edema
-recovery is quick
2nd degree s/s
treatment
, scalds, flash flame, contact
-epidermis and portion of dermis
-pain (more than 3rd degree), sensitivity to air, blister, mottled base,
weeping surface, edema
-recovery is 2-3 weeks scarring and depigmentation possible, grafting may
be needed
3rd degree full thickeness s/s
treatment
prolong exposure to hot liquid, electrical current, chemical contact
-epidermis, dermis, subcutaneous tissue, may involve fascia
-dry pale, white, eschar may slough, edema, scarring, loss of function
-complications: shock, possible hemolysis, myoglobinuria (causing urine to
be red) secondary to skeletal muscle damage
-grafting needed
-pain increases as it heals but no pain at the beginning (premedicate for
wound changes) bc nerves are destroyed
4th degree s/s
treatment
-prolonged exposure/ high voltage electrical injury
-deep tissue, muscle, bone
-shock, myoglobinuria, hemolysis
Complete Solution
Care at the scene for a burn patient
-extinguish: "stop and pat"/ "stop, drop, and roll"
-cool the burn: NO ICE
-remove restrictions and JEWELRY (holds heat)
-cover the wound: clean dry sheet
-continuously irrigate chemical burns
*careful about preventing hypothermia
care in the ED for a burn patient
-start an IV
-establish airway=> check mouth and nares for singe/soot
-initiate infusion of lactated ringers
-cover with clean sheet
-coordinate car w. burn center
-estimate TBSA affected, document IV placement, volume of LR received,
comorbidities, mechanism of burn, Is&Os, foley cath?
phases of care
,emergent: onset to completion of fluid resuscitation, prevent shock, resp
distress, wound assessment, v/s
acure/immediate: beginning of diuresis, completion of wound closure,
prevention of infection, nutrition
rehabilitation: treatment of scars, counseling, increase (as layers begin to
heal pain increases), rehab
Burn types and degrees symptoms and treatments associated with each.
-1st degree (superficial):
-2nd degree (partial thickness)
-3rd degree (full thickness)
-4th degree (full thickness)
TYPES: electrical vs Thermal vs chemical
symptoms and treatments associated with each burn
(1st degree)
-1st degree (superficial): sunburn, superficial scald, low intensity flash
-epidermis maybe portion of dermis
-tingling, peeling, itching, pain, blanchable, reddened (blancahble erythema),
minimal edema
-recovery is quick
2nd degree s/s
treatment
, scalds, flash flame, contact
-epidermis and portion of dermis
-pain (more than 3rd degree), sensitivity to air, blister, mottled base,
weeping surface, edema
-recovery is 2-3 weeks scarring and depigmentation possible, grafting may
be needed
3rd degree full thickeness s/s
treatment
prolong exposure to hot liquid, electrical current, chemical contact
-epidermis, dermis, subcutaneous tissue, may involve fascia
-dry pale, white, eschar may slough, edema, scarring, loss of function
-complications: shock, possible hemolysis, myoglobinuria (causing urine to
be red) secondary to skeletal muscle damage
-grafting needed
-pain increases as it heals but no pain at the beginning (premedicate for
wound changes) bc nerves are destroyed
4th degree s/s
treatment
-prolonged exposure/ high voltage electrical injury
-deep tissue, muscle, bone
-shock, myoglobinuria, hemolysis
